ABSTRACT
Duchenne muscular dystrophy (DMD) is X-linked recessive myopathy caused by mutations in the dystrophin gene. Although conventional treatments have improved their prognosis, inevitable progressive cardiomyopathy is still the leading cause of death in patients with DMD. To explore novel therapeutic options, a suitable animal model with heart involvement has been warranted.We have generated a rat model with an out-of-frame mutation in the dystrophin gene using CRISPR/Cas9 genome editing (DMD rats). The aim of this study was to evaluate their cardiac functions and pathologies to provide baseline data for future experiments developing treatment options for DMD.In comparison with age-matched wild rats, 6-month-old DMD rats showed no significant differences by echocardiographic evaluations. However, 10-month-old DMD rats showed significant deterioration in left ventricular (LV) fractional shortening (P = 0.024), and in tissue Doppler peak systolic velocity (Sa) at the LV lateral wall (P = 0.041) as well as at the right ventricular (RV) free-wall (P = 0.004). These functional findings were consistent with the fibrotic distributions by histological analysis.Although the cardiac phenotype was milder than anticipated, DMD rats showed similar distributions and progression of heart involvement to those of patients with DMD. This animal may be a useful model with which to develop effective drugs and to understand the underlying mechanisms of progressive heart failure in patients with DMD.
Subject(s)
Cardiomyopathies/physiopathology , Disease Models, Animal , Dystrophin/genetics , Heart/physiopathology , Muscular Dystrophy, Duchenne/physiopathology , Myocardium/pathology , Rats , Age Factors , Animals , Blood Flow Velocity , CRISPR-Cas Systems , Cardiomyopathies/diagnostic imaging , Cardiomyopathies/genetics , Cardiomyopathies/pathology , Echocardiography , Frameshift Mutation , Gene Editing , Heart/diagnostic imaging , Heart Ventricles/diagnostic imaging , Heart Ventricles/pathology , Heart Ventricles/physiopathology , Male , Muscular Dystrophy, Duchenne/diagnostic imaging , Muscular Dystrophy, Duchenne/genetics , Muscular Dystrophy, Duchenne/pathologyABSTRACT
We have little information on chronic graft-versus-host disease (GVHD) after cord blood transplantation (CBT). We investigated its clinical features in 1072 Japanese patients with hematologic malignancies who received a transplant through the Japan Cord Blood Bank Network. The primary end point was to investigate the incidence of any chronic GVHD. Median age of the patients was 33 years (range, 0-79 years). The cumulative incidence of chronic GVHD 2 years after transplantation was 28%. Chronic GVHD was fatal in 29 patients. Multivariate analysis demonstrated that development of chronic GVHD was favorably associated with both overall survival and event-free survival. Multivariate analysis identified risk factors of chronic GVHD: higher patient body weight, higher number of mismatched antigens for GVHD direction, myeloablative preparative regimen, use of mycophenolate mofetil in GVHD prophylaxis, and development of grades II to IV acute GVHD. Although chronic GVHD is a significant problem after CBT, it is associated with improved survival, perhaps due to graft-versus-malignancy effects.
Subject(s)
Cord Blood Stem Cell Transplantation/adverse effects , Graft vs Host Disease/epidemiology , Adolescent , Adult , Aged , Child , Child, Preschool , Chronic Disease , Data Collection , Graft vs Host Disease/etiology , Humans , Incidence , Infant , Japan/epidemiology , Middle Aged , Retrospective Studies , Risk Factors , Survival AnalysisABSTRACT
BACKGROUND: A novel filter system was developed for umbilical cord blood (UCB) volume reduction. The aim of this study was to compare the functions of cryopreserved UCB cells processed by the filter and by the hydroxyethyl starch (HES) sedimentation method from the aspect of the graft quality. STUDY DESIGN AND METHODS: UCB specimens were divided into two portions, processed in parallel by the filter or HES, and then cryopreserved in the clinical setting. The thawed UCB specimens containing 1 x 10(5) CD34+ cells were injected into nonobese diabetic/Shi-SCID mice, and the engraftment capacity in primary and secondary transplants was assessed. The functions of natural killer (NK) cells and monocyte-derived dendritic cells (DCs) were also assayed in vitro. RESULTS: The percentage of recovery of CD34+ cells by both methods was equivalent. In the marrow of the primary transplant recipients, the percentage of hCD45+ cells in the filter group and HES group was 58.2 +/- 31.6 and 46.5 +/- 28.4 percent, respectively (p = 0.016). The engraftment capacity and multilineage differentiation in the secondary transplantations were equal in both groups. The cytotoxic activity of the NK cells and phagocytosis activity of the DCs from both the groups were similar. CONCLUSION: The filter yielded a desirable percentage of recovery of hematopoietic cells with engraftment ability in the clinical setting. Thus, it is considered that the filter system may be useful for UCB banking for cord blood transplantation.