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1.
Inflamm Res ; 71(10-11): 1327-1345, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35962798

ABSTRACT

BACKGROUND AND OBJECTIVE: Acute lung injury (ALI)/ acute respiratory distress syndrome (ARDS) was increasingly recognized as one of the most severe acute hyperimmune response of coronavirus disease 2019 (COVID-19). Clofazimine (CFZ) has attracted attention due to its anti-inflammatory property in immune diseases as well as infectious diseases. However, the role and potential molecular mechanism of CFZ in anti-inflammatory responses remain unclear. METHODS: We analyze the protein expression profiles of CFZ and LPS from Raw264.7 macrophages using quantitative proteomics. Next, the protective effect of CFZ on LPS-induced inflammatory model is assessed, and its underlying mechanism is validated by molecular biology analysis. RESULTS: LC-MS/MS-based shotgun proteomics analysis identified 4746 (LPS) and 4766 (CFZ) proteins with quantitative information. The key proteins and their critical signal transduction pathways including TLR4/NF-κB/HIF-1α signaling was highlighted, which was involved in multiple inflammatory processes. A further analysis of molecular biology revealed that CFZ could significantly inhibit the proliferation of Raw264.7 macrophages, decrease the levels of TNF-α and IL-1ß, alleviate lung histological changes and pulmonary edema, improve the survival rate, and down-regulate TLR4/NF-κB/HIF-1α signaling in LPS model. CONCLUSION: This study can provide significant insight into the proteomics-guided pharmacological mechanism study of CFZ and suggest potential therapeutic strategies for infectious disease.


Subject(s)
Acute Lung Injury , COVID-19 Drug Treatment , Respiratory Distress Syndrome , Animals , Mice , Acute Lung Injury/chemically induced , Acute Lung Injury/drug therapy , Acute Lung Injury/metabolism , Anti-Inflammatory Agents/pharmacology , Anti-Inflammatory Agents/therapeutic use , Chromatography, Liquid , Clofazimine , Lipopolysaccharides/pharmacology , Lung/pathology , NF-kappa B/metabolism , Proteomics , Tandem Mass Spectrometry , Toll-Like Receptor 4/metabolism
2.
Cell Mol Neurobiol ; 42(8): 2893-2907, 2022 Nov.
Article in English | MEDLINE | ID: mdl-34698960

ABSTRACT

Aging is a risk factor for multiple retinal degeneration diseases. Entraining brain gamma oscillations with gamma-flicker light (γFL) has been confirmed to coordinate pathological changes in several Alzheimer's disease mouse models and aged mice. However, the direct effect of γFL on retinal aging remains unknown. We assessed retinal senescence-associated beta-galactosidase (ß-gal) and autofluorescence in 20-month-old mice and found reduced ß-gal-positive cells in the inner retina and diminished lipofuscin accumulation around retinal vessels after 6 days of γFL. In immunofluorescence, γFL was further demonstrated to ameliorate aging-related retinal changes, including a decline in microtubule-associated protein 1 light chain 3 beta expression, an increase in complement C3 activity, and an imbalance between the anti-oxidant factor catalase and pro-oxidant factor carboxymethyl lysine. Moreover, we found that γFL can increase the expression of activating transcription factor 4 (ATF4) in the inner retina, while revealing a decrease of ATF4 expression in the inner retina and positive expression in the outer segment of photoreceptor and RPE layer for aged mice. Western blotting was then used to confirm the immunofluorescence results. After mRNA sequencing (NCBI Sequence Read Archive database: PRJNA748184), we found several main mechanistic clues, including mitochondrial function and chaperone-mediated protein folding. Furthermore, we extended γFL to aged Apoe-/- mice and showed that 1-m γFL treatment even improved the structures of retinal-pigment-epithelium basal infolding and Bruch's membrane. Overall, γFL can orchestrate various pathological characteristics of retinal aging in mice and might be a noninvasive, convenient, and tissue-specific therapeutic strategy for retinal aging.


Subject(s)
Complement C3 , Lipofuscin , Activating Transcription Factor 4/metabolism , Animals , Antioxidants/metabolism , Apolipoproteins E/metabolism , Catalase/metabolism , Complement C3/metabolism , Lipofuscin/metabolism , Lysine/metabolism , Mice , Microtubule-Associated Proteins/metabolism , RNA, Messenger/metabolism , Reactive Oxygen Species/metabolism , Retina/metabolism , beta-Galactosidase/metabolism
3.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(3): 963-968, 2021 Jun.
Article in Chinese | MEDLINE | ID: mdl-34105501

ABSTRACT

OBJECTIVE: To investigate the changes in function of CD8+ T cell subsets, and explore its significance in pathogenesis of secondary hemophagocytic lymphohistiocytosis (sHLH). METHODS: Flow cytometry was used to detect the expressions of PD-1, TIM-3, and LAG-3, which were the markers of exhausted CD8+ T cell, as well as the secretion levels of interferon γ (IFN-γ) and expression of ΔCD107a after the stimulation; the numbers of effector-memory CD8+ T cells, regulatory T cells and double negative T cells were also detected. RESULTS: The expressions of inhibitory receptors (PD-1, TIM3 and LAG-3) on CD8+ T cells of sHLH patients were 40.73±22.64, 15.97±14.45 and 0.73 (0-37.41), respectively, which were significantly higher than those of the control group (P<0.001). In contrast, the expression of ΔCD107a (4.49±2.71 vs 6.07±2.14, P=0.035) and secretion level of IFN-γ (37.30±24.46 vs 55.17±22.23, P=0.034) were significantly lower. The number of effector-memory CD8+ T cells in sHLH patients was also lower as compared with that in control group (14.35±10.37 vs 22.92±11.12, P=0.016). But there was no significant difference in the number of regulatory T cell and double negative T cell. In addition, the expressions of PD-1, TIM3 and LAG-3 in active stage of sHLH were 38.09±21.87, 14.35±13.70 and 0.82 (0-13.22), respectively, which were significant higher than those in remission stage [24.27±17.23 (P=0.03), 8.64±5.60 (P=0.014) and 0.13 (0-3.69)]. CONCLUSION: The exhausted CD8+ T lymphocytes may play a critical role in the development of sHLH.


Subject(s)
Lymphohistiocytosis, Hemophagocytic , CD8-Positive T-Lymphocytes , Hepatitis A Virus Cellular Receptor 2 , Humans , Interferon-gamma , Lymphocyte Count
4.
Chin Med J (Engl) ; 134(13): 1584-1592, 2021 Jun 16.
Article in English | MEDLINE | ID: mdl-34133361

ABSTRACT

BACKGROUND: There were few studies on real-world data about autologous hematopoietic stem cell transplantation (auto-HSCT) or allogeneic HSCT (allo-HSCT) in peripheral T-cell lymphoma (PTCL). This study aimed to investigate the clinical outcomes of patients who received auto-HSCT or allo-HSCT in China. METHODS: From July 2007 to June 2017, a total of 128 patients who received auto-HSCT (n  = 72) or allo-HSCT (n  = 56) at eight medical centers across China were included in this study. We retrospectively collected their demographic and clinical data and compared the clinical outcomes between groups. RESULTS: Patients receiving allo-HSCT were more likely to be diagnosed with stage III or IV disease (95% vs. 82%, P = 0.027), bone marrow involvement (42% vs. 15%, P = 0.001), chemotherapy-resistant disease (41% vs. 8%, P = 0.001), and progression disease (32% vs. 4%, P < 0.001) at transplantation than those receiving auto-HSCT. With a median follow-up of 30 (2-143) months, 3-year overall survival (OS) and progression-free survival (PFS) in the auto-HSCT group were 70%(48/63) and 59%(42/63), respectively. Three-year OS and PFS for allo-HSCT recipients were 46%(27/54) and 44%(29/54), respectively. There was no difference in relapse rate (34%[17/63] in auto-HSCT vs. 29%[15/54] in allo-HSCT, P = 0.840). Three-year non-relapse mortality rate in auto-HSCT recipients was 6%(4/63) compared with 27%(14/54) for allo-HSCT recipients (P = 0.004). Subanalyses showed that patients with lower prognostic index scores for PTCL (PIT) who received auto-HSCT in an upfront setting had a better outcome than patients with higher PIT scores (3-year OS: 85% vs. 40%, P = 0.003). Patients with complete remission (CR) undergoing auto-HSCT had better survival (3-year OS: 88% vs. 48% in allo-HSCT, P = 0.008). For patients beyond CR, the outcome of patients who received allo-HSCT was similar to that in the atuo-HSCT group (3-year OS: 51% vs. 46%, P = 0.300). CONCLUSIONS: Our study provided real-world data about auto-HSCT and allo-HSCT in China. Auto-HSCT seemed to be associated with better survival for patients in good condition (lower PIT score and/or better disease control). For patients possessing unfavorable characteristics, the survival of patients receiving allo-HSCT group was similar to that in the auto-HSCT group.


Subject(s)
Hematopoietic Stem Cell Transplantation , Lymphoma, T-Cell, Peripheral , China , Humans , Lymphoma, T-Cell, Peripheral/therapy , Neoplasm Recurrence, Local , Retrospective Studies , Transplantation, Autologous , Transplantation, Homologous , Treatment Outcome
5.
Int Immunopharmacol ; 96: 107606, 2021 Jul.
Article in English | MEDLINE | ID: mdl-33826999

ABSTRACT

Patients with Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) have a poor prognosis. This study investigated the efficacy of rituximab-containing immuno-chemotherapy regimens for EBV-HLH. In this study, 15 patients were treated with rituximab-containing regimens. The treatment efficacy and adverse events were evaluated. In 10 patients, EBV DNA became negative after the first course of treatment. The lymphocyte types infected by EBV in the 10 patients were only infected with B cells and mainly infected with B cells. In the other 5 patients, the EBV DNA of peripheral blood mononuclear cells (PBMC) before and after treatment with the regimens had no statistical difference (P = 0.111). In addition, in these 5 patients, EBV mainly infected T and NK cells. Among the 5 patients without a significant decline in EBV DNA of PBMC, 2 patients received allogeneic hematopoietic stem cell transplantation and turned negative for EBV DNA. This study suggests that rituximab-containing regimens are effective therapy for EBV-HLH with only and mainly B lymphocytes infected by EBV, especially for eliminating EBV.


Subject(s)
B-Lymphocytes/drug effects , Epstein-Barr Virus Infections/drug therapy , Epstein-Barr Virus Infections/immunology , Immunologic Factors/pharmacology , Lymphohistiocytosis, Hemophagocytic/drug therapy , Lymphohistiocytosis, Hemophagocytic/immunology , Rituximab/pharmacology , Adolescent , Adult , Aged , B-Lymphocytes/virology , Child , Child, Preschool , Drug Therapy, Combination , Epstein-Barr Virus Infections/blood , Epstein-Barr Virus Infections/complications , Female , Herpesvirus 4, Human/drug effects , Herpesvirus 4, Human/genetics , Herpesvirus 4, Human/immunology , Humans , Immunologic Factors/adverse effects , Immunologic Factors/therapeutic use , Infant , Leukocytes, Mononuclear/drug effects , Leukocytes, Mononuclear/virology , Lymphohistiocytosis, Hemophagocytic/blood , Lymphohistiocytosis, Hemophagocytic/complications , Male , Middle Aged , Rituximab/adverse effects , Rituximab/therapeutic use , Survival Rate , Treatment Outcome , Young Adult
7.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(4): 1376-1380, 2020 Aug.
Article in Chinese | MEDLINE | ID: mdl-32798429

ABSTRACT

OBJECTIVE: To establish a secondary hemophagocytic lymphohistiocytosis(HLH) mouse model, and to investigate the effect of ruxolitinib on the disease manifestation of model mice. METHODS: Wild type C57BL/6 mice were randomly divided into 4 groups: two groups of mice were intraperitoneally injected with CpG oligodeoxynucleotide 1826 (CpG-ODN1826) every other day to induce HLH, and other two groups were control groups. One group of the CpG-ODN1826 groups and one of the control groups were given ruxolitinib, and other two groups were given the same amount of PBS. Blood samples, serum ferritin and hepatic/spleen weights of experimental mice were detected and serum cytokine levels were measured by ELISA. RESULTS: Compared with the control groups, the levels of white blood cells, hemoglobin and platelets in the CpG-ODN1826 groups were significantly lower (P<0.05); and liver/body weight, spleen/body weight, serum ferritin, sCD25, IL-10, IL-1ß, IFN-Ƴ, IL-12p70, GM-CSF, TNF-α and IL-18 levels significantly increased (P<0.05). There was no significant difference in the levels of IL-2, IL-4, IL-5, IL-6, IL-22, IL-13, IL-27 and IL-23 between the two groups (P>0.05). The spleen in CpG group had disordered internal structure, expanding red pulp and hyperplastic nucleated cells. The liver had severe perivascular inflammations. The spleen/weight of the ruxolitinib-treated mice in the CpG-ODN1826 group was significantly smaller than that of the unapplied ruxolitinib (P<0.05). CONCLUSION: The CpG-ODN1826 can induce secondary HLH symptoms in wild type C57BL/6 mice. Ruxolitinib can alleviate the symptoms of splenomegaly in HLH model mice.


Subject(s)
Lymphohistiocytosis, Hemophagocytic , Pyrazoles , Animals , Disease Models, Animal , Mice , Mice, Inbred C57BL , Nitriles , Pyrimidines
8.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(2): 652-656, 2020 Apr.
Article in Chinese | MEDLINE | ID: mdl-32319411

ABSTRACT

OBJECTIVE: To detect the erythrocyte life by breath carbon monoxide assay and to analyze the effect of erythrocyte life on the anemia in patients with hemophagocytic syndrome. METHODS: The breath carbon monoxide test and erythrocyte life assay were performed for 20 cases of hemophagocytic syndrome, at the same time the detection of 20 healthy persons was used as control. The difference of anemia-related indexes was compared between hemophagocytic syndrome patients and healthy persons. RESULTS: The average erythrocyte life of patients with hemophagocytic syndrome was 45.3 days, which was 65% shorter than that of healthy persons. Hemoglobin levels positively correlated with erythrocyte life, while sCD25, breath carbon monoxide concentration and hemophagocytosis negatively correlated with erythrocyte life. Bilirubin level and reticulocyte count showed no correlation with erythrocyte life. Serum level of IL-1ß, IL-2, sCD25, IL-6, IL-10, IL-17A, GM-CSF, TNF-α and IFN-γ in patients with newly diagnosed hemophagocytic syndrome were significantly higher than those of healthy persons (P<0.05). CONCLUSION: Breath carbon monoxide assay is a rapid and efficient method to assess erythrocyte life. Increased erythrocyte destruction may be an important pathogenic factor for anemia in hemophagocytic syndrome.


Subject(s)
Anemia , Lymphohistiocytosis, Hemophagocytic , Anemia/etiology , Erythrocytes , Humans , Lymphohistiocytosis, Hemophagocytic/complications , Reticulocyte Count , Tumor Necrosis Factor-alpha
9.
Acta Haematol ; 141(1): 55-60, 2019.
Article in English | MEDLINE | ID: mdl-30537757

ABSTRACT

Haemophagocytic lymphohistiocytosis (HLH) is a rare and severe clinical syndrome that can be classified as either primary or secondary. Secondary HLH can be triggered by a variety of diseases. Pregnancy-related HLH has already been observed clinically. However, most of these cases occur during pregnancy. Considering that the periods before and after delivery have different clinical features, we presented the first case series of HLH that presented during the postpartum stage of pregnancy. From these cases, we concluded that postpartum HLH is a common form of pregnancy-related HLH. Patients with postpartum HLH may suffer more complicated pathogenesis. Cytopenia was not as common as in other types of HLH, but liver dysfunction was present in almost all cases. The standard therapy of HLH-94/04 was very effective, and the outcomes of postpartum HLH were better.


Subject(s)
Lymphohistiocytosis, Hemophagocytic/diagnosis , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bacteremia/complications , Bacteremia/diagnosis , Female , Humans , Lymphohistiocytosis, Hemophagocytic/complications , Lymphohistiocytosis, Hemophagocytic/drug therapy , Postpartum Period , Pregnancy , Treatment Outcome , Young Adult
10.
Chin Med J (Engl) ; 131(7): 776-783, 2018 Apr 05.
Article in English | MEDLINE | ID: mdl-29578120

ABSTRACT

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening clinical syndrome. Central nervous system (CNS) involvement is a severe complication, which can lead to rapid disease development and higher morality. However, this has not been given enough attention in adult HLH. Therefore, we carried out this study to analyze the clinical features, laboratory findings, treatment outcomes, and other characteristics of adult HLH with CNS involvement. METHODS: A retrospective analysis of 96 adult patients with HLH combined with CNS involvement between June 2003 and December 2016 was conducted. Clinical features, cerebrospinal fluid (CSF) features, image changes, and therapeutic outcomes were analyzed. RESULTS: Among the 96 patients, 86 had various CNS symptoms and 33 (38.4%) had already presented symptoms before the HLH diagnosis was confirmed. A total of 59 patients received CSF examinations and showed abnormalities in 23 patients (39.0%). Seventy patients received imaging examinations and the results showed fifty patients with imaging changes (71.4%). Fifty-seven patients received multiple rounds of repeated intrathecal injection therapy and 35 patients improved (61.4%). As for the multiple analyses of effective factors on survival time, the results showed that the effects of combined Epstein-Barr virus (EBV) infection (P = 0.026, Exp(B) = 2.309, 95% confidence interval [CI] [1.108, 4.823) and intrathecal injection therapy (P = 0.013, Exp(B) = 0.422, 95% CI [0.214, 0.831]) on the survival time of the CNS-HLH patients were significant. CONCLUSIONS: Complication with EBV infection is a risk factor, and intrathecal injection is a protective factor. CNS involvement in HLH is not rare, which can result in a poor prognosis. Multiple rounds of repeated intrathecal injection therapy can improve the prognosis of CNS-HLH patients.


Subject(s)
Central Nervous System/pathology , Epstein-Barr Virus Infections/pathology , Lymphohistiocytosis, Hemophagocytic/pathology , Adolescent , Adult , Aged , Central Nervous System/virology , Epstein-Barr Virus Infections/virology , Female , Humans , Lymphohistiocytosis, Hemophagocytic/virology , Male , Middle Aged , Retrospective Studies , Risk Factors , Treatment Outcome , Young Adult
11.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 24(4): 1061-5, 2016 Aug.
Article in Chinese | MEDLINE | ID: mdl-27531775

ABSTRACT

OBJECTIVE: To investigate the clinical characteristics, therapeutic outcomes and prognostic factors of primary central nervous system lymphoma (PCNSL). METHODS: Clinical records of 31 cases of PCNSL were collected, the clinical charactenstics were analyzed retrospectively. Survival curves were estimated using Kaplan-Meier survival methodology and statistical significance of continuous variables was assessed via the Cox proportional hazard model. RESULTS: The median age was 52 years, with a ratio of male to female 1:1. Headache/dizzy/limb numbness were the most common presentation and the lesions of PCNSL were primarily located at the frontal, parietal, temporal lobes and corpus callosum. All the cases were pathologically diffuse large B cell lymphoma (DLBCL), 6 cases were the type of germinal center (GC) and 25 cases of non-GC type, after craniotomy operation and biopsy. Among 31 cases, 17 patients accepted the combined treatment, 3 patients underwent simple chemotherapy, 8 patients received simple radiotherapy, the other patients accepted support therapy. The median follow-up for surviving patients was 24 months. The 1-, 3-, and 5-year survival rates were 80.6%, 55.1%, and 36.4%, respectively. The median overall survival time in the combined treatment group was significantly longer than that in simply radiotherapy. There was no significant difference in OS between the groups with and without rituximab. ECOG PS≥2 and elevated serum LDH predicted inferior survival. CONCLUSION: The clinical manifectation of PCNSL is various and complicated, and for the time being there is no optimal treatment scheme. The overall survival time of the combined treatment is longer than that in simply radiotherapy. ECOG PS≥2 and elevated serum LDH often are poor prognostic factors.


Subject(s)
Central Nervous System Neoplasms , Lymphoma , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Rituximab , Survival Rate
12.
Hepatobiliary Pancreat Dis Int ; 15(2): 173-9, 2016 Apr.
Article in English | MEDLINE | ID: mdl-27020634

ABSTRACT

BACKGROUND: Differentiation of liver progenitor cells (LPCs) to functional hepatocytes holds great potential to develop new strategies for hepatocyte transplantation and the screening of drug-induced cytotoxicity. However, reports on the efficient and convenient hepatic differentiation of LPCs to hepatocytes are few. The present study aims to investigate the possibility of generating functional hepatocytes from LPCs in an indirect co-culture system. METHODS: Mouse LPCs were co-cultured in Transwell plates with an immortalized human hepatic stellate cell line (HSC-Li) we previously established. The morphology, expression of hepatic markers, and functions of mouse LPC-derived cells were monitored and compared with those of conventionally cultured LPCs. RESULTS: Co-culturing with HSC-Li cells induced differentiation of mouse LPCs into functional hepatocyte-like cells. The differentiated cells were morphologically transformed into hepatocyte-like cells 3 days after co-culture initiation. In addition, the differentiated cells expressed liver-specific genes and possessed hepatic functions, including glycogen storage, low-density lipoprotein uptake, albumin secretion, urea synthesis, and cytochrome P450 1A2 enzymatic activity. CONCLUSIONS: Our method, which employs indirect co-culture with HSC-Li cells, can efficiently induce the differentiation of LPCs into functional hepatocytes. This finding suggests that this co-culture system can be a useful method for the efficient generation of functional hepatocytes from LPCs.


Subject(s)
Cell Differentiation , Hepatic Stellate Cells/metabolism , Hepatocytes/metabolism , Liver/metabolism , Paracrine Communication , Stem Cells/metabolism , Albumins/metabolism , Animals , Biomarkers/metabolism , Cell Line , Cell Shape , Coculture Techniques , Culture Media, Conditioned/metabolism , Cytochrome P-450 CYP1A2/metabolism , Gene Expression Regulation , Glycogen/metabolism , Humans , Lipoproteins, LDL/metabolism , Liver/cytology , Male , Mice, Inbred C57BL , Phenotype , Time Factors , Urea/metabolism
13.
Indian J Hematol Blood Transfus ; 31(4): 426-33, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26306066

ABSTRACT

To analyze the efficacy and safety of allogeneic hematopoietic stem cell transplantation (Allo-HSCT) in patients with relapsed or refractory lymphoma, the therapeutic efficacy, safety, and survival of 23 patients were evaluated. There were 18 (78.3 %) patients with relapsed lymphoma and 5 (21.7 %) patients with refractory lymphoma. Patients were grafted from human leukocyte antigen (HLA)-matched (10) or mismatched (7) related donors, or matched unrelated donors (6). The responses after Allo-HSCT included 13 (56.5 %) cases of complete remission, 5 (21.7 %) cases of partial remission, and 5 (21.7 %) cases of progressive disease. Overall, 16 of 23 patients were alive at a median follow up of 1,035 days (range 60-2,613), five patients died because of non-relapsed mortality, and two patients died of progressive disease. Progression-free survival rates were 64.6 and 48.4 % at 12 and 24 months, respectively, and overall survival rates were 68.6 and 59.5 % at 12 and 24 months, respectively. Allo-HSCT may be a salvage treatment for relapsed or refractory lymphoma. Myeloablative conditioning regimens may be effective and safe.

14.
Zhonghua Xue Ye Xue Za Zhi ; 36(6): 507-10, 2015 Jun.
Article in Chinese | MEDLINE | ID: mdl-26134018

ABSTRACT

OBJECTIVE: To investigate the outcomes, survival status, and the prognostic factors of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) patients. METHODS: A retrospective study was carried out to analyze the clinical data of 61 EBV-HLH cases, from January 2008 to July 2014. Prognostic factors were analyzed through COX model (single factor and multiple factors). RESULTS: A total of 246 patients with HLH were diagnosed, among which 102 cases were with EBV infection (including 61 EBV-HLH, 36 lymphoma associated HLH, 5 primary HLH. Among the 61 cases, 40 were male and 21 were female, with a ration of 1.9:1. The median age was 28 years (range, 12-78). 1, 3, 6 and 12-month overall survival rates of 61 EBV-HLH were 65.6%, 47.5%, 32.4%, and 25.0%, respectively. The median follow-up time was 3 (0.5-28) months. 12 patients didn't use etoposide within 4 weeks after diagnosis, while HLH-94 protocol was used in 33 patients and HLH-2004 protocol was used in 16 patients. Response rates of theses three groups were 33.3%, 51.5%, and 43.8%, respectively (P=0.401). There was statistically difference between the group without etoposide and the HLH-94/ HLH-2004 group in the overall survival rate (P=0.033). Serum albumin level (P=0.033) and whether EBV could became negative (P=0.010) were independent predictors for EBV-HLH. CONCLUSION: EBV-HLH patients have severe clinical feature and poor prognosis. Early application of immune chemotherapy based on etoposide can improve survival. Serum albumin level and whether EBV can become negative are independent prognostic factors for survival.


Subject(s)
Epstein-Barr Virus Infections , Herpesvirus 4, Human , Lymphohistiocytosis, Hemophagocytic , Adolescent , Adult , Aged , Child , Etoposide , Female , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Survival Rate , Treatment Outcome , Young Adult
15.
Int J Infect Dis ; 23: 28-30, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24657272

ABSTRACT

Leprosy is an infectious chronic granulomatous disease caused by Mycobacterium leprae. The disease mainly affects the skin, peripheral nerves, mucosa, and viscera. The World Health Organization has reported that most countries with high endemicity have reached the goal of eliminating leprosy (defined as reaching a prevalence of <1 leprosy case per 10 000 population) at the national level, after years of proactive control campaigns. The incidence of leprosy has been decreasing across the globe year by year. However, misdiagnosis happens occasionally due to the complexity of clinical manifestations and lack of physician awareness of this disease. We report a case of lepromatous leprosy complicated by hemophagocytosis misdiagnosed as hemophagocytic lymphohistiocytosis.


Subject(s)
Diagnostic Errors , Hematologic Diseases/diagnosis , Leprosy, Lepromatous/diagnosis , Lymphohistiocytosis, Hemophagocytic/diagnosis , Adult , Dexamethasone/therapeutic use , Hematologic Diseases/complications , Hematologic Diseases/drug therapy , Humans , Leprosy, Lepromatous/complications , Leprosy, Lepromatous/drug therapy , Levofloxacin/therapeutic use , Male , Treatment Outcome
17.
Acta Haematol ; 129(2): 114-20, 2013.
Article in English | MEDLINE | ID: mdl-23207655

ABSTRACT

Langerhans cell sarcoma (LCS) is extremely rare, with only 36 cases reported in English literature. In this report we represent the case of a 77-year-old woman with a 1-month history of left neck swelling and pain. A diagnosis of LCS was rendered from pathological findings of the cervical lymph node biopsy. The patient's condition deteriorated rapidly and she died 2 days after diagnosis. A literature review in the context of the present case was performed to better enhance understanding of the early diagnosis and treatment of this unusual lesion.


Subject(s)
Langerhans Cell Sarcoma/pathology , Lymph Nodes/pathology , Aged , Biopsy , Fatal Outcome , Female , Humans , Immunohistochemistry , Neck
18.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 20(4): 1042-6, 2012 Aug.
Article in Chinese | MEDLINE | ID: mdl-22931681

ABSTRACT

Langerhans cell tumor is a kind of tumor that originates from Langerhans cells (LC) and maintain their specific phenotype profile and ultrastructural features. Based on cell morphology, immunohistochemical and ultrastructural characteristics, Langerhans cell tumor has two main subcategories: Langerhans cell histiocytosis (LCH) and Langerhans cell sarcoma (LCS). LCH is a benign clonal proliferative disease of the LC, whereas LCS is an extremely rare neoplastic proliferation of Langerhans cells with overtly malignant cytologic features and spreads aggressively, which is considered to be a high level malignant type of LCH. Both LCH and LCS can involved various tissues and organs and have complex and diverse clinical manifestation, which cause different severity. The diagnosis depends on histopathological morphology and immunohistochemistry; the electron microscopy was used to assists diagnosis when necessary. The treatment includes surgery, chemotherapy, radiotherapy, immunotherapy and hematopoietic stem cell transplantation, etc, but lack of generally accepted optimal treatment options currently, individualized treatment is needed. The prognosis of LCH is primarily related to the number of damaged organ, while LCS has a poor overall prognosis as its invasion and rapid progress. This article reviews the pathogenesis, clinical manifestations, diagnosis, treatment and prognosis of both LCH and LCS.


Subject(s)
Histiocytosis, Langerhans-Cell , Humans
19.
Zhonghua Xue Ye Xue Za Zhi ; 33(4): 291-3, 2012 Apr.
Article in Chinese | MEDLINE | ID: mdl-22781720

ABSTRACT

OBJECTIVE: To introduce the clinical manifestations and laboratory tests of adult onset of primary hemophagocytic syndrome (HPS), and to investigate the essentials of diagnosis and the genotype characteristics in adult onset patient. METHODS: The definite diagnosis of HPS was made according to HLH-2004. Exons of PRF1, STX11, UNC13D, SH2D1A and RAB27A genes coding region were amplified using polymerase chain reaction. RESULTS: A 48-year-old man was admitted to our hospital because of recurrent fever, pancytopenia and lymph node enlargement. His laboratory test revealed bone marrow hemophagocytosis, elevated ferritin level (2000 µg/L), reduced level of NK cell activity (20.13%) and elevated soluble CD25 level (12277 U/ml). Based on the HLH-2004 diagnostic criteria, the patient was diagnosed as HPS. The patient had viral infection, and no other primary disease was identified that would cause HPS. The patient responded poorly to anti-viral therapy. DNA sequencing was used to confirm that perforin gene mutations might be one of the causes of the patient suffered from primary HPS. CONCLUSIONS: Although primary HPS usually affects infants and young children, it also occurred in teens and adults. It is essential to perform genetic screenings to patient whose illnesses recur with unknown causes. In addition, detection of molecular genetic alterations can be used to distinguish primary HPS from acquired HPS.


Subject(s)
Lymphohistiocytosis, Hemophagocytic , Humans , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/genetics , Male , Middle Aged , Perforin/genetics
20.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 19(6): 1505-8, 2011 Dec.
Article in Chinese | MEDLINE | ID: mdl-22169313

ABSTRACT

In order to explore the serum levels and clinical significance of tumor necrosis factor alpha (TNF-α) and interferon gamma (IFN-γ) in patients with hemophagocytic syndrome (HPS). The clinical data of HPS patients in Capital Medical University Beijing Friendship Hospital from October 2008 to October 2010 were collected. The serum concentration of TNF-α and IFN-γ in HPS patients and 20 healthy controls was measured with enzyme-linked immunosorbent assay (ELISA). The correlations between the levels of TNF-α and primary disease were analyzed, the levels of hemoglobin, ferritin, triglyceride, NK cell activity and sCD25 were detected on the same day, the correlations between the concentrations of TNF-α and IFN-γ and these laboratory indicators were analyzed. The results indicated that the serum levels of TNF-α and IFN-γ in 30 cases of HPS was higher than that in control group (p < 0.05, p < 0.01); the difference of TNF-α concentration was statistically significant in rheumatism-related and tumor-related HPS groups(p = 0.04), the level of TNF-α in HPS patients showed negative correlation with hemoglobin. It is concluded that the high levels of TNF-α and IFN-γ in HPS patients may play certain roles in the pathogenesis and progress of HPS. These data indicated that the high level of TNF-α may be the main factor for anemia in patients with HPS.


Subject(s)
Interferon-gamma/blood , Lymphohistiocytosis, Hemophagocytic/blood , Tumor Necrosis Factor-alpha/blood , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Enzyme-Linked Immunosorbent Assay , Female , Humans , Male , Middle Aged , Young Adult
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