Hyperfunction of CD4 CD25 regulatory T cells in de novo acute myeloid leukemia.

BACKGROUND: Acute myeloid leukemia (AML) is a common hematopoietic malignancy that has a high relapse rate, and the number of regulatory T cells (Tregs) in AML patients is significantly increased. The aim of this study was to clarify the role of Tregs in the immune escape of acute myeloid leukemia. METHODS: The frequencies of Tregs and the expression of PD-1, CXCR4 and CXCR7 were examined by flow cytometry. The expression of CTLA-4 and GITR was tested by MFI. Chemotaxis assays were performed to evaluate Treg migration. The concentrations of SDF-1α, IFN-γ and TNF-α were examined by ELISA. Coculture and crisscross coculture experiments were performed to examine Treg proliferation and apoptosis and the effect of regulatory B cells (Breg) conversion. RESULTS: The frequencies of Tregs in peripheral blood and bone marrow in AML patients were increased compared with those in healthy participants. AML Tregs had robust migration towards bone marrow due to increased expression of CXCR4. AML Treg-mediated immunosuppression of T cells was achieved through proliferation inhibition, apoptosis promotion and suppression of IFN-γ production in CD4+CD25- T cells. AML Bregs induced the conversion of CD4+CD25-T cells to Tregs. CONCLUSION: In AML patients, the Breg conversion effect and robust CXCR4-induced migration led to Treg enrichment in bone marrow. AML Tregs downregulated the function of CD4+CD25- T cells, contributing to immune escape.

Recombinant Human Thrombopoietin Promotes Platelet Engraftment in Severe Aplastic Anemia Patients Following Treatment With Haploid Hematopoietic Stem Cell Transplantation using Modified Post-Transplantation Cyclophosphamide.

BACKGROUND: Recombinant human TPO (rhTPO) promotes platelet engraftment in patients after allogeneic HSCT (allo-HSCT). However, the effects of rhTPO on platelet recovery after Haplo-HSCT in patients with severe aplastic anemia (SAA) have not been intensively studied. OBJECTIVE: We aimed to evaluate the efficacy of rhTPO on platelet engraftment in patients with SAA who were treated with Haplo-HSCT using post-transplantation cyclophosphamide (PTCy). STUDY DESIGN: SAA patients who received Haplo-HSCT plus PTCy regimen were divided into the rhTPO group (with subcutaneous injection of rhTPO, n = 28) and Control group (no rhTPO administration, n = 27). The engraftment of platelet/neutrophil, platelet infusion amount, and transplant-related complications between the 2 groups were compared. RESULTS: All 55 patients showed successful hematopoietic reconstitution. The median time of platelet engraftment was 11 (9 to 29) days in the rhTPO group and 14 (9 to 28) days in the Control group (P = .003). The rhTPO group had a significantly reduced amount of infused platelets compared to the Control group (2 (1 to 11.5) versus 3 (1 to 14) therapeutic doses; P = .004). There was no significant difference between the 2 groups regarding median time of neutrophil engraftment, incidence of acute graft-versus-host disease (aGVHD) and chronic GVHD (cGVHD), incidence of cytomegalovirus or Epstein-Barr virus reactivation, 3-yr overall survival rate, and failure-free-survival rate. No obvious adverse reactions were observed in the rhTPO group. CONCLUSION: rhTPO promoted platelet engraftment, reduced the amount of transfused platelets, and demonstrated good safety profiles without evidence of adverse reactions in patients with SAA who received Haplo-HSCT using PTCy regimen.

Pulmonary tuberculosis infection and CMV reactivation following daratumumab treatment in a patient with relapsed plasmablastic lymphoma.

Plasmablastic lymphoma (PBL) is an aggressive lymphoma with limited treatment strategies. Tuberculosis (TB) infection poses a high risk for patients with hematologic malignancies, especially those treated with immune agents but were never reported post-daratumumab treatment. Herein, we reported a TB infection in a 57-year-old male diagnosed with HIV-negative PBL receiving daratumumab-based treatment, who showed atypical lung infection and yielded Mycobacterium tuberculosis and cytomegalovirus (CMV) in the bronchoalveolar lavage fluid. Anti-TB therapy was administered, and the following daratumumab treatment was complete with good tolerance. In this case, we demonstrated that TB infection might occur after daratumumab therapy, and adequate attention should be paid to atypical symptoms.

Chronic active Epstein-Barr virus infection progresses to aggressive NK cell leukemia with a poor prognosis.

Epstein-Barr virus (EBV) associated T/NK-cell lymphoproliferative diseases (EBV-T/NK-LPDs) are a cluster of diseases that include chronic active EBV infection (CAEBV) and aggressive NK cell leukemia (ANKL). The pathogenesis of EBV-T/NK-LPDs is largely unclear and the treatment is difficult and in most cases a hematopoietic stem cell transplantation is needed. Hemophagocytic lymphohistiocytosis (HLH) is known to affect the prognosis of patients with EBV-T/NK-LPDs. This study reports a case of a 20-year-old male patient with repeated infectious mononucleosis (IM)-like symptoms such as high fever, splenomegaly, lymphadenopathy for more than two years. The patient had a high EBV-DNA load (NK cells were the main target cells). He was first diagnosed as CAEBV. However, the disease gradually progressed and the patient developed with high ferritin, phagocytosis and monoclonal NK cells in bone marrow, pancytopenia, increased cytokines, and elevated expression of Ki-67. Also, his NK cells had abnormal immunophenotypes and impaired function. The patient had a typical clinical course of progression from CAEBV to ANKL, accompanied by HLH complications and a poor prognosis. Herein, the detailed diagnostic and differential diagnostic process of EBV infection was shown in this report.

Risk communication on behavioral responses during COVID-19 among general population in China: A rapid national study.

OBJECTIVES: To describe the risk perception and behavioral responses among Chinese adults and to assess the associations of risk communication, risk perception, and behavioral adherence during the COVID-19 epidemic. METHODS: A national cross-sectional survey was conducted in 31 provinces in China with a total number of 5039 effective questionnaires collected. The questionnaire included sociodemographic characteristics, COVID-19 risk communication factors, mask and soap supply, and engagement in preventive behaviors during the epidemic. Multivariable Logistic regression was used. RESULTS: An overwhelmingly high prevalence of Chinese people was exposed to COVID-19 related risk communication messages (86.5%) and an overwhelming majority of respondents reported engagement in preventive behaviors (88.3%). Exposed to risk communication messages were positively associated with engaging in preventive behaviors, whereas, believing in misinformation were negatively associated with wearing masks when in public (p < 0.01). Respondents encountered an inadequate supplies of personal protection materials were negatively associated with their outdoor hygiene behaviors. People who were male, in an older age group, minorities, with lower education, with lower income, and lived in rural area showed lower exposures to risk communication messages. CONCLUSIONS: Future risk communication practices are recommended to better monitor population risk perceptions and pay attention to socio-demographically disadvantaged people.

Degenerated Virulence and Irregular Development of Fusarium oxysporum f. sp. niveum Induced by Successive Subculture.

Successive cultivation of fungi on artificial media has been reported to cause the sectorization, which leads to degeneration of developmental phenotype, and virulence. Fusarium oxysporum f. sp. niveum (Fon), the causal agent of watermelon Fusarium wilt, forms degenerated sectors after successive cultivation. In the present research, we demonstrated that subculture with aged mycelia increased the incidence of degenerations. To further investigate the differences between the Fon wild type (sporodochial type, ST) and variants (MT: mycelial type and PT: pionnotal type), developmental phenotypes and pathogenicity to watermelon were examined. Results in variants (PT2, PT3, PT11, and MT6) were different from ST with mycelia growth, conidia production and chlamydospore formation. Virulence of degenerated variants on susceptible watermelon Grand Baby (GB) cultivar was determined after inoculation with Fon variants and Fon ST. In root dipping methods, Fon variants showed no significant differences in disease progress compared with ST. Fon variants showed a significant decrease in disease progression compared with ST through infested soil inoculation. The contrasting results of two inoculation methods suggest that the degenerative changes due to repeated successive cultivation may lead to the loss of pathogen virulence-related factors of the early stage of Fon infection process. Therefore, cell wall-degrading enzymes (CWDEs; cellulase, pectinase, and xylanase) activities of different variants were analyzed. All Fon degenerated variants demonstrated significant decreases of CWDEs activities compared with ST. Additionally, transcript levels of 9 virulence-related genes (fmk1, fgb1, pacC, xlnR, pl1, rho1, gas1, wc1, and fow1) were assessed in normal state. The degenerated variants demonstrated a significantly low level of tested virulence-related gene transcripts except for fmk1, xlnR, and fow1. In summary, the degeneration of Fon is triggered with successive subculture through aged mycelia. The degeneration showed significant impacts on virulence to watermelon, which was correlated with the reduction of CWDEs activities and declining expression of a set of virulence-related genes.

[Differential expression of six obesity-related genes with different disease phases of T2DM in cynomolgus monkey].

Type 2 diabetes mellitus (T2DM) is a metabolic disease with a strong genetic component that is very prevalent in the world. The aim of this study is to investigate the association of a set of six obesity-related genes with the different disease phases of T2DM in a model using middle or aged cynomogus monkeys. A total of 25 male monkeys were used and fed with high-fat diet (15% lard). The disease development and progression of T2DM were monitored through the levels of plasma glucose and lipid. The mRNA expression of 6 genes was evaluated using real-time PCR on monocyte isolated from monkey peripheral blood. The 2-hour plasma glucose levels followed oral glucose tolerance test (OGTT) were (11.06+/-6.05) mmol/L and (13.12+/-2.89) mmol/L respectively (P<0.01), and the fasting plasma glucose level was (7.58+/-1.56) mmol/L (vs controls, P<0.01), indicating that we developed successful the models of pre-diabetic and diabetic disease in the cynomolgus monkey. Of the six tested genes, CDKN2B, IGF2BP2, and FTO genes were significantly up-regulated with disease progression in T2DM. We found that the expression of IGF2BP2 and FTO increased 65.92 and 4.30 folds in the developed T2DM. We conclude that the genes of CDKN2B, IGF2BP2, and FTO can be used as early diagnostic and prognostic biomarkers in type 2 diabetes.

[Screening of spontaneous diabetes mellitus in middle-and old-aged cynomolgus monkey].

To screen spontaneous diabetic mellitus and explore methods for its rapid identification, the basal and inferred levels of blood glucose of 440 overweight, middle- and old-aged cynomolgus monkeys were analyzed. Diagnostic diabetes was further validated by the oral glucose tolerance test (OGTT) and urine glucose. The average level of blood glucose of these cynomolgus monkeys was (3.88±0.98) mmol/L, which was lower than the level for suspected diabetes (5.0 mmol/L). Of them, 56 (12.72%) monkeys were identified with levels of blood glucose greater than 5.0 mmol/L and diagnosed as the diabetic subjects. This population showed impaired glucose tolerance using the OGTT and 39 of the 56 (69.23%) had glucose positive urine. The methods for screening diabetic mellitus used in this study were simple, quick, and limited the harm to animals. However, the incidence of diabetes was higher in these tested monkeys than in the regular human population in China (9.7%), suggesting that these methods are useful for screening diabetic disease in a large population but not suitable for all cynomolgus monkeys.

Development of the molecular methods for rapid detection and differentiation of Fusarium oxysporum and F. oxysporum f. sp. niveum in Taiwan.

Fusarium wilt, caused by Fusarium oxysporum (Fo), is one of the most important fungal diseases worldwide. Like other plant pathogens, Fo displays specialized forms in association with its hosts. For example, F. oxysporum f. sp. niveum (Fon) is the damaging pathogen causing Fusarium wilt disease on watermelon, whereas F. oxysporum f. sp. cubense is the pathogen that infects banana. A rapid and reliable pathogen identification or disease diagnosis is essential for the integrated disease management practices in many crops. In this study, two new primer sets, Fon-1/Fon-2 and FnSc-1/FnSc-2, were developed to differentiate Fon and Fo, respectively. The PCR method using the novel primer sets has high sensitivity to detect Fon when the DNA concentration was as low as 0.01 pg or when the conidia number was as few as 5. In comparison with the published primer set, the Fon-1/Fon-2 primer set, derived from the sequence of OP-M12 random primer-amplified fragment, produced a 174 bp DNA fragment, and was more specific to Fon in Taiwan. In addition, with optimized PCR parameters, the molecular method using the Fon-1/Fon-2 primer set could directly detect Fon even when watermelon samples were collected in its early stage of disease development.