Long-term compliance of patients with osteoporosis treatment and its effect to fracture occurrence.

OBJECTIVES: The objective of this study was to evaluate the effect of long-term treatment of patients with osteoporosis being actively managed by medical staff and following the therapeutic methods and principles of treatment of osteoporosis. METHODS: The medical records of patients which were examined in an osteological outpatient office first time in the year 2009 were reviewed. The results of densitometry examinations were compared with the results from the year 2019. Patients regularly absolved densitometry, properly and regularly took prescribed medicaments for either anti-osteoporotic treatment or for supplementation of vitamin D and calcium. The cohort consisted of 100 patients. Next, we split the group into 3 categories - less than 65 years of age, 65-75 years of age and lastly over 75 years of age. By default, we assessed and compared the T-scores (deviation from the average value of bone density of 30 years old healthy person) in the area of the proximal femur and in the area of the lumbar spine. The bone mineral density (BMD) values in g/cm2 and their relation to corresponding T-score from set area were also reviewed. RESULTS: Based on the results of densitometry, osteoporosis was diagnosed in 41 patients, manifest osteoporosis in 14 and osteopenia in 36, nine patients had their bone density value within the normal range. The average T-score values of "total hip" were -1.42, "neck" -2.08, BMD values of "total hip" were 0.802 g/cm2, "L1-L4" -2.05, "L total" -1.45, and BMD of "L total" was 0.886 g/cm2. In the time of the last examination, the T-score (disregarding the type of treatment) raised from the initial value by 40.16% in the area of lumbar spine, by 56.69% in the area of "total hip", and by 40.16% in the area of "neck". While sorting the cohort based on age, we detected a similar effect of active management of treatment in each of the 3 categories. CONCLUSION: Cooperation of the patients during the treatment of a chronic disease requiring long-term usage of medicaments is often problematic and it is necessary to devote adequate attention to it. The solution to improve the treatment can be active management of the patient by the medical facility or by the medical staff.

RNA-seq of human T cells after hematopoietic stem cell transplantation identifies Linc00402 as a regulator of T cell alloimmunity.

Mechanisms governing allogeneic T cell responses after solid organ and allogeneic hematopoietic stem cell transplantation (HSCT) are incompletely understood. To identify lncRNAs that regulate human donor T cells after clinical HSCT, we performed RNA sequencing on T cells from healthy individuals and donor T cells from three different groups of HSCT recipients that differed in their degree of major histocompatibility complex (MHC) mismatch. We found that lncRNA differential expression was greatest in T cells after MHC-mismatched HSCT relative to T cells after either MHC-matched or autologous HSCT. Differential expression was validated in an independent patient cohort and in mixed lymphocyte reactions using ex vivo healthy human T cells. We identified Linc00402, an uncharacterized lncRNA, among the lncRNAs differentially expressed between the mismatched unrelated and matched unrelated donor T cells. We found that Linc00402 was conserved and exhibited an 88-fold increase in human T cells relative to all other samples in the FANTOM5 database. Linc00402 was also increased in donor T cells from patients who underwent allogeneic cardiac transplantation and in murine T cells. Linc00402 was reduced in patients who subsequently developed acute graft-versus-host disease. Linc00402 enhanced the activity of ERK1 and ERK2, increased FOS nuclear accumulation, and augmented expression of interleukin-2 and Egr-1 after T cell receptor engagement. Functionally, Linc00402 augmented the T cell proliferative response to an allogeneic stimulus but not to a nominal ovalbumin peptide antigen or polyclonal anti-CD3/CD28 stimulus. Thus, our studies identified Linc00402 as a regulator of allogeneic T cell function.