Antihyperlipidemic activity of adenosine triphosphate in rabbits fed a high-fat diet and hyperlipidemic patients.

Context Recently, adenosine triphosphate (ATP) was occasionally found to decrease the triglyceride (TG) levels in several hyperlipidemic patients in our clinical practice. Objective The study investigates the anti-hyperlipidemic effects of ATP in a high-fat fed rabbit model and hyperlipidemic patients. Materials and methods Twenty-four rabbits were randomly divided into three groups of eight animals each as follows: normal diet, high-fat diet and high-fat diet + ATP group. ATP supplementation (40 mg/day) was started at the 20th day and lasted for 10 days. Serum concentrations of total cholesterol (TC), TG, LDL-C, HDL-C were measured on the 20th day and 30th day. Heart, liver and aorta were subjected histopathological examination. Twenty outpatients diagnosed primary hyperlipidemia took ATP at a dose of 60 mg twice a day for 1 week. Results Feeding rabbits with a high-fat diet resulted in a significant elevation of lipid parameters including TC, TG, LDL-C, VLDL-C compared to the normal diet group (p < 0.01). ATP treatment significantly decreased serum TG level (p < 0.01), whilst other parameters remained statistically unaltered. Meanwhile, ATP significantly reduced the thickness of fat layer in cardiac epicardium (p < 0.05) and pathological gradation of ballooning degeneration in hepatocytes (p < 0.05). After taking ATP for 1 week, hyperlipidemia patients exhibited a significant decrease of TG (p < 0.01), but other lipid parameters had no significant change. Discussion and conclusion The study indicates that ATP selectively decreases serum TG levels in high-fat diet rabbits and hyperlipidemic patients. Therefore, ATP supplementation may provide an effective approach to control TG level.

Case report: Treatment of Wilson's disease by human amniotic fluid administration.

Background: Wilson's disease (WD) is not an uncommon genetic disease in clinical practice. However, the current WD therapies have limitations. The effectiveness of stem cell therapy in treating WD has yet to be verified, although a few animal studies have shown that stem cell transplantation could partially correct the abnormal metabolic phenotype of WD. In this case report, we present the therapeutic effect of human amniotic fluid containing stem cells in one WD patient. Case presentation: A 22-year-old Chinese woman was diagnosed with WD 1 year ago in 2019. The available drugs were not effective in managing the progressive neuropsychiatric symptoms. We treated the patient with pre-cultured human amniotic fluid containing stem cells. Amniotic fluid was collected from pregnant women who underwent induced labor at a gestational age of 19-26 weeks, and then, the fluid was cultured for 2 h to allow stem cell expansion. Cultured amniotic fluid that contained amniotic fluid derived stem cells (AFSC) in the range of approximately 2.8-5.5 × 104/ml was administrated by IV infusion at a rate of 50-70 drops per minute after filtration with a 300-mu nylon mesh. Before the infusion of amniotic fluid, low-molecular-weight heparin and dexamethasone were successively administrated. The patient received a total of 12 applications of amniotic fluid from different pregnant women, and the treatment interval depended on the availability of amniotic fluid. The neuropsychiatric symptoms gradually improved after the stem cell treatment. Dystonia, which included tremor, chorea, dysphagia, dysarthria, and drooling, almost disappeared after 1.5 years of follow-up. The Unified Wilson's Disease Rating Scale score of the patient decreased from 72 to 10. Brain magnetic resonance imaging (MRI) showed a reduction in the lesion area and alleviation of damage in the central nervous system, along with a partial recovery of the lesion to the normal condition. The serum ceruloplasmin level was elevated from undetectable to 30.8 mg/L, and the 24-h urinary copper excretion decreased from 171 to 37 µg. In addition, amniotic fluid transplantation also alleviates hematopoietic disorders. There were no adverse reactions during or after amniotic fluid administration. Conclusion: Amniotic fluid administration, through which stem cells were infused, significantly improves the clinical outcomes in the WD patient, and the finding may provide a novel approach for managing WD effectively.

High-dose insulin and dexamethasone combined with radiotherapy in endometrial stromal sarcoma recurring with multiple metastases: A case report.

RATIONALE: Endometrial stromal sarcoma (ESS) is a rare malignant tumor. There is insufficient data supporting the efficiency of current treatments in multiple metastatic settings, and novel therapeutic options for ESS are considered an area of high unmet clinical need. PATIENT CONCERNS: We report the case of a 28-year-old woman who was diagnosed with ESS after undergoing total hysterectomy and left adnexectomy at another hospital. Two years later, the disease recurred, with multiple abdominal cavities and lung metastases. The patient was treated with a variety of chemotherapeutic drugs, including tyrosine kinase inhibitors, at the same hospital; however, none of them inhibited disease progression. DIAGNOSES: Computed tomography (CT) revealed multiple masses in the abdominal and pelvic cavities and multiple pulmonary nodules. Ultrasound-guided biopsy was performed and the tumor tissue was histologically confirmed after treatment. INTERVENTIONS: Insulin 300-400 IU was administrated by intravenous infusion in 10% glucose (500 mL) with disodium adenosine triphosphate 60 mg, coenzyme A 100 units, 10% potassium chloride 5 mL and 25% magnesium sulfate 5 mL. Dexamethasone (20-25 mg/d) was diluted with 10 mL of 2% lidocaine and then intraperitoneally injected after ascites draw. After 9 months, the patient was referred to another center for radiotherapy. OUTCOMES: CT images tomography showed recurrent pelvic masses, and multiple abdominal cavity and lung metastases gradually shrunk with treatment. Histological biopsy revealed growth arrest of tumor cells. The patient experienced for 3-years survival. LESSONS: High-dose insulin and dexamethasone combined with radiotherapy provides a novel and promising option for patients with multiple ESS metastases.

Effects of vitamin D with or without calcium on pathological ossification: A retrospective clinical study.

Vitamin D protects against the development and severity of several rheumatic diseases. However, the effect of vitamin D on the pathological ossification associated with rheumatic diseases remains unknown. The present retrospective study analyzed the clinical outcomes of vitamin D without calcium compared with vitamin D with calcium on pathological ossification in joints and ligaments. Data were collected from patients who were diagnosed with osteoarthritis, rheumatoid arthritis or spondylarthritis, and the presence of pathological ossification in joints or ligaments was confirmed by X-ray, computed tomography or magnetic resonance imaging examination. A total of 2,965 patients aged 18-75 years old were included, among who, 1,725 were included in the vitamin D alone group and 1,240 in the vitamin D with calcium group. Vitamin D was administered intramuscularly (300,000 IU) once every 7-10 days, 4-6 times in total. Patients who ingested an oral calcium supplement (1,000 mg/day; ≥5 days/week) were considered the vitamin D with calcium group. The clinical outcome was evaluated based on the imaging changes of pathological ossification, which were classified as alleviation, aggravation and unchanged. The bone mineral density (BMD) was determined, and the calcium concentration in the serum and urine was measured. The results revealed that vitamin D alone alleviated pathological ossification, while vitamin D combined with calcium aggravated pathological ossification in the majority of patients (P<0.0001) independent of disease type and patient age. BMD measurements demonstrated a decreasing trend in the vitamin D alone group, whereas they exhibited an increasing trend in the vitamin D combined with calcium group. The urine calcium concentration increased after vitamin D treatment alone. Therefore, it was concluded that vitamin D exerted both pro-resorptive and anti-resorptive actions on pathological ossification. The bidirectional action of vitamin D on bone metabolism may depend on exogenous calcium supplementation.

Amniotic Fluid Transplantation Alleviates Hematopoietic Deficits in Experimental Rat Aplastic Anemia.

BACKGROUND Hematopoietic stem cell (HSC) transplantation is the most effective therapy for hematopoietic impairment. However, maintenance and self-renewal of HSCs in culture is still a central focus of HSC research. It is known that amniotic fluid contains a heterologous population of stem cells (AFSCs) and nutrients as well as various types of growth factors. We hypothesize that AFSCs may be expanded in vitro in pure amniotic fluid. MATERIAL AND METHODS Amniotic fluid with transparent appearance was harvested at embryo age of 13.5-15.5 days in rats and was placed in a cell culture CO2 incubator. The cell number in the amniotic fluid was counted before and after culture of amniotic fluid. Then, the effect of amniotic fluid transplantation on 5-fluorouracil combined with busulfan induced-rat aplastic anemia was investigated. RESULTS We found that after a short time (about 30 min) culture, the number of AFSCs expanded more than 100-fold. Flow cytometry showed that there was a population of cells expressing hematopoietic markers CD45 and CD34 in addition to a higher proportional of mesenchymal stem cells (MSCs) markers CD29 and CD90. Transplantation of the expanded AFSCs possessed significant therapeutic effect in toxic chemicals induced-aplastic anemia rats, manifested by decreasing animal mortality and alleviating the reduction of the 3 lineages of hematopoietic cells in blood. CONCLUSIONS Our observation for the first time demonstrates that amniotic fluid is an excellent medium for stem cells to maintain "stemness" proliferation and provides novel evidence to support the potential use of in vitro-expanded AFSCs for the treatment of hematopoietic disorders.

Potential function of amniotic fluid in fetal development---novel insights by comparing the composition of human amniotic fluid with umbilical cord and maternal serum at mid and late gestation.

BACKGROUND: Amniotic fluid (AF) is a dynamic and complex mixture. Up to now, little is known about the physiological functions of AF in the process of fetal development. We suppose that AF carries components such as proteins or peptides, which contribute to the regulation of fetal development. METHODS: Compositions including biochemical components and tumor markers were determined in human AF, umbilical cord serum (UCS) and maternal serum (MS) from the same subject in the range of 15-42 weeks of gestation. RESULTS: (1) The levels of primary electrolytes such as sodium, chloride, anion gap and osmotic pressure in AF was almost the same as in UCS and MS. (2) The levels of organic substances, including total protein, glucose, triglycerides, cholesterol and various enzymes, were markedly lower in AF than in UCS and MS, especially for total protein, which was 8- and 12.5-fold lower in AF than in UCS and MS, respectively. (3) The levels of tumor markers, including carcinoembryonic antigen, ferritin, cancer antigen 125 and 199, and alpha-fetoprotein in AF displayed different dynamic changes compared to UCS and MS as gestation advanced. CONCLUSION: This study demonstrated that AF is not a result of simple filtration from the blood but an independent fluid. We speculate that proteins or peptides in the amniotic fluid modulate the process of fetus development since they possess potent bioactivity on cellular growth and proliferation. AF provides a pathway to transport these "regulators" to the fetus and thus plays a pivotal role in fetal development.

Amniotic fluid may act as a transporting pathway for signaling molecules and stem cells during the embryonic development of amniotes.

Amniotic fluid (AF) is formed at the very early stages of pregnancy, and is present throughout embryonic development of amniotes. It is well-known that AF provides a protective sac around the fetus that allows fetal movement and growth, and prevents mechanical and thermal shock. However, a growing body of evidence has shown that AF contains a number of proteins and peptides, including growth factors and cytokines, which potently affect cellular growth and proliferation. In addition, pluripotent stem cells have recently been identified in AF. Herein, this article reviews the biological properties of AF during embryonic development and speculates that AF may act as a transporting pathway for signaling molecules and stem cells during amniote embryonic development. Defining this novel function of AF is potentially significant for further understanding embryonic development and regenerative medicine, preventing genetic diseases, and developing therapeutic options for human malignancies.

The complete preventive effect of homologous tumor vaccines--based on a 5-year experimental study in mice.

By using a frozen-thaw method, we developed homologous and heterologous cell-based tumor vaccines, which were derived from mouse H22 hepatoma, S180 sarcoma and human A549 lung carcinoma, SK-OV-3 ovarian, and SMMC-7721 hepatoma cell lines. The prophylactic and therapeutic effects of those vaccines were evaluated in mice challenged with live H22 or S180 cells. The result demonstrated that homologous vaccines and heterologous vaccines had no therapeutic effect on tumor growth. However, homologous vaccines showed a complete prevention against live H22 and S180 cell challenge and they could stimulate cross-immune response of anti-tumor in mice. Furthermore, these tumor-free mice immunized with homologous vaccines showed full protection against the repeat challenge every 3 months for 5 years. The study also revealed that tumor-free female, not male, mice transferred anti-tumor ability to some of their offsprings. Heterologous vaccines exhibited no protective effect on tumor development. Immunological analysis discovered that activities of CTLs and NK were enhanced and the levels of IL-2, IL-12 and IFN-γ were significantly increased. Our results demonstrated that homologous tumor vaccines could elicit complete cross-protection against the lethal challenge of tumor cells through enhancing cell-mediated immune response, which lasted for 5 years in mice. These observations may provide a new vaccine strategy for tumor prevention.