Therapeutic plasma exchange for refractory Kawasaki disease in children weighing less than 10 kg.

INTRODUCTION: Therapeutic plasma exchange (TPE) is used for treating refractory Kawasaki disease (KD); however, there are few reports on its use in small children. METHODS: Nine children with refractory KD who underwent TPE between January 2010 and December 2022 were retrospectively investigated. Data on patient demographics, inflammatory markers, coronary artery lesions (CALs), TPE settings and complications, and outcomes were examined. RESULTS: A total of 37 TPE sessions were performed on nine patients, with 3-6 sessions per patient. The median body weight was 8.9 kg. C-reactive protein, white blood cell (WBC), and interleukin-6 levels significantly decreased (p < 0.05). Of the 33 coronary arteries with CALs before TPE, 44% and 3% had CALs at 1 month and 1 year after TPE, respectively. Minor complications, such as mild hypocalcemia and naturally recovering coagulopathy, occurred without serious complications. CONCLUSIONS: TPE for refractory KD may be safe and effective in preventing CALs.

Autologous cord blood cell therapy for neonatal hypoxic-ischaemic encephalopathy: a pilot study for feasibility and safety.

Neonatal hypoxic-ischaemic encephalopathy (HIE) is a serious condition; many survivors develop neurological impairments, including cerebral palsy and intellectual disability. Preclinical studies show that the systemic administration of umbilical cord blood cells (UCBCs) is beneficial for neonatal HIE. We conducted a single-arm clinical study to examine the feasibility and safety of intravenous infusion of autologous UCBCs for newborns with HIE. When a neonate was born with severe asphyxia, the UCB was collected, volume-reduced, and divided into three doses. The processed UCB was infused at 12-24, 36-48, and 60-72 hours after the birth. The designed enrolment was six newborns. All six newborns received UCBC therapy strictly adhering to the study protocol together with therapeutic hypothermia. The physiological parameters and peripheral blood parameters did not change much between pre- and postinfusion. There were no serious adverse events that might be related to cell therapy. At 30 days of age, the six infants survived without circulatory or respiratory support. At 18 months of age, neurofunctional development was normal without any impairment in four infants and delayed with cerebral palsy in two infants. This pilot study shows that autologous UCBC therapy is feasible and safe.

The membrane phospholipid cardiolipin plays a pivotal role in bile acid adaptation by Lactobacillus gasseri JCM1131T.

Bile acids exhibit strong antimicrobial activity as natural detergents, and are involved in lipid digestion and absorption. We investigated the mechanism of bile acid adaptation in Lactobacillus gasseri JCM1131T. Exposure to sublethal concentrations of cholic acid (CA), a major bile acid in humans, resulted in development of resistance to otherwise-lethal concentrations of CA by this intestinal lactic acid bacterium. As this adaptation was accompanied by decreased cell-membrane damage, we analyzed the membrane lipid composition of L. gasseri. Although there was no difference in the proportions of glycolipids (~70%) and phospholipids (~20%), adaptation resulted in an increased abundance of long-sugar-chain glycolipids and a 100% increase in cardiolipin (CL) content (to ~50% of phospholipids) at the expense of phosphatidylglycerol (PG). In model vesicles, the resistance of PG vesicles to solubilization by CA increased with increasing CL/PG ratio. Deletion of the two putative CL synthase genes, the products of which are responsible for CL synthesis from PG, decreased the CL content of the mutants, but did not affect their ability to adapt to CA. Exposure to CA restored the CL content of the two single-deletion mutants, likely due to the activities of the remaining CL synthase. In contrast, the CL content of the double-deletion mutant was not restored, and the lipid composition was modified such that PG predominated (~45% of total lipids) at the expense of glycolipids. Therefore, CL plays important roles in bile acid resistance and maintenance of the membrane lipid composition in L. gasseri.

Biodegradable polyesters as crystallization-accelerating agents of poly(l-lactide).

A series of biodegradable polyesters, poly[(R)-3-hydroxybutyrate] (PHB), poly(-caprolactone) (PCL), and polyglycolide (PGA), were found to be effective crystallization-accelerating agents for poly(l-lactide) (PLLA). Differential scanning calorimetry and polarized optical microscopy strongly suggested that the accelerated crystallization of PLLA in the presence of the three biodegradable polyesters is attributable to a nucleation-assisting effect of PCL and PGA and a spherulite growth-accelerating effect of PHB, although the incorporated PHB lowered the spherulite number of PLLA per unit area. The spherulite growth-accelerating effect of PHB probably resulted from the relatively high miscibility of PLLA with PHB and the low glass transition temperature of PHB compared to that of PLLA. The crystallization kinetics of PLLA varied only in the case of PLLA/PHB blends during cooling from the melt, as evidenced by the nucleation constant and radius growth rate values of the spherulites. The nucleation and growth types of PLLA crystallites are thought to be altered only in the case of PLLA/PGA blends during heating, as evidenced by Avrami exponent n values.