Myelosuppression complicated with infection after chemotherapy in children with acute myeloid leukemia / 国际儿科学杂志

The overall survival rate of children with acute myeloid leukemia(AML) is significantly lower than that of acute lymphoblastic leukemia.The main causes of death include primary disease-related death and treatment-related death.Most of the treatment-related deaths are caused by infection, bleeding and organ failure.Infection is the most common complication of pediatric AML during the myelosuppression period after chemotherapy, and it is also the main cause of early death in AML.Based on the analysis of pathogens, laboratory tests and risk factors, this paper reviews the clinical characteristics and research progress of infection in myelosuppression following chemotherapy for AML, so as to provide a basis for early identification, clinical management and condition judgment, and further improve the survival rate of children with AML.

Analysis of risk factors in acute lymphoblastic leukemia complicated with acute pancreatitis in children / 中华实用儿科临床杂志

Objective:To analyze the early risk warning factors of clinical characteristics in children with acute lymphoblastic leukemia (ALL) complicated with acute pancreatitis (AP).Methods:Retrospective study.A total of 39 children with ALL complicated with AP admitted to the Hematology Center of Beijing Children′s Hospital, Capi-tal Medical University from May 2018 to December 2020 were selected as the case group, and 78 ALL patients were randomly selected as the control group according to the exact matching of 1∶2 of the same age and sex.The measurment data and counting data were analyzed by Rank sum test ( Mann Whitney U test) and χ2 test between the 2 groups, respectively, and further multivariate Logistic regression analysis was performed to find out the risk factors of ALL complicated with pancreatitis.At the same time, the relationship between each index and severity was explored. Results:The incidence of ALL complicated with AP was 8.55% (39/456 cases). The high incidence age was 3-10 years old.Sixty-four point nine percent (24/37 cases) of the pancreatitis occurred in the early stage of chemotherapy, and 66.7% (26/39 cases) was associated with asparaginase.There were significant differences in ALL risk stratification ( χ2=21.404, P<0.001), C-reactive protein (CRP)( U=232.000, P<0.001), procalcitonin (PCT)( t=3.950, P<0.001), hematocrit( t=3.981, P<0.001), serum calcium( t=-9.609, P<0.001), indirect bilirubin( U=1 142.000, P<0.05), triglyceride( t=3.600, P=0.001) and albumin( t=-6.296, P<0.001) between the 2 groups.The sensitivity of abdominal CT, abdominal ultrasound and pancreatic magnetic resonance imaging in the case group were 70.8%, 81.6% and 100.0%, respectively.Multivariate Logistic regression analysis showed that differences between albumin( OR=11.444, 95% CI: 3.240-40.423), triglyceride( OR=18.047, 95% CI: 5.020-65.074) and risk stra-tification( OR=8.894, 95% CI: 1.889-41.885) were statistically significant, and there were obvious differences in PCT( U=3.000, 2.000, all P<0.05) and serum calcium( U=4.500, 8.500, all P<0.05) between patients with severe pancreatitis and patients with mild or moderate severe pancreatitis. Conclusions:ALL complicated with AP often occurs in the early stage of chemotherapy, mainly caused by asparaginase.In imaging examination, the sensitivity of pancreatic magnetic resonance imaging is the highest, followed by abdominal ultrasound.Risk stratification, decreased albumin and elevated triglyceride are risk factors of ALL complicated with AP, which are helpful for early identification of high-risk patients with ALL complicated with AP.PCT and serum calcium may play an important role in severe pancreatitis.

Analysis of murine B-cell epitopes on bluetongue virus 12 nonstructural protein 1.

The bluetongue virus (BTV) NS1 protein is one of the major proteins synthesized during BTV infection and is responsible for the generation of virus-specific tubules. Although some functional and structural studies on the BTV NS1 protein have been reported, there have been no reports describing the linear B-cell epitopes recognized by humoral immune responses published to date. In this study, 25 BTV12 NS1-reactive monoclonal antibodies (MAbs) and polyclonal antisera (polyclonal antibodies, PAbs) were generated and analyzed. We identified 14 linear NS1 epitopes recognized by the PAbs and MAbs using NS1-derived peptides in an enzyme-linked immunosorbent assay. Moreover, we predicted 23 linear B-cell epitopes using the ABCpred online server which employs an artificial neural network. Analysis of the predicted and identified epitopes of NS1 demonstrated the feasibility of B-cell epitope prediction. Sequence alignments indicated that the epitopes recognized by MAbs are highly conserved among BTV serotypes, but not among the other members of the genus Orbivirus, such as the African horse sickness virus (AHSV), epizootic hemorrhagic disease virus (EHDV), and Chuzan disease virus (CV). Importantly, we identified specific MAbs that recognized all BTV serotypes tested as well as MAbs that recognized only BTV12, suggesting that these NS1-specific MAbs could serve as a basis for BTV diagnostic approaches. The generation and identification of NS1 protein epitopes will provide the foundation for further studies about the function and structure of NS1 and novel epitope-based vaccines.

Analysis of murine B-cell epitopes on Eastern equine encephalitis virus glycoprotein E2.

The Eastern equine encephalitis virus (EEEV) E2 protein is one of the main targets of the protective immune response against EEEV. Although some efforts have done to elaborate the structure and immune molecular basis of Alphaviruses E2 protein, the published data of EEEV E2 are limited. Preparation of EEEV E2 protein-specific antibodies and define MAbs-binding epitopes on E2 protein will be conductive to the antibody-based prophylactic and therapeutic and to the study on structure and function of EEEV E2 protein. In this study, 51 EEEV E2 protein-reactive monoclonal antibodies (MAbs) and antisera (polyclonal antibodies, PAbs) were prepared and characterized. By pepscan with MAbs and PAbs using enzyme-linked immunosorbent assay, we defined 18 murine linear B-cell epitopes. Seven peptide epitopes were recognized by both MAbs and PAbs, nine epitopes were only recognized by PAbs, and two epitopes were only recognized by MAbs. Among the epitopes recognized by MAbs, seven epitopes were found only in EEEV and two epitopes were found both in EEEV and Venezuelan equine encephalitis virus (VEEV). Four of the EEEV antigenic complex-specific epitopes were commonly held by EEEV subtypes I/II/III/IV (1-16aa, 248-259aa, 271-286aa, 321-336aa probably located in E2 domain A, domain B, domain C, domain C, respectively). The remaining three epitopes were EEEV type-specific epitopes: a subtype I-specific epitope at amino acids 108-119 (domain A), a subtype I/IV-specific epitope at amino acids 211-226 (domain B) and a subtype I/II/III-specific epitope at amino acids 231-246 (domain B). The two common epitopes of EEEV and VEEV were located at amino acids 131-146 and 241-256 (domain B). The generation of EEEV E2-specific MAbs with defined specificities and binding epitopes will inform the development of differential diagnostic approaches and structure study for EEEV and associated alphaviruses.

The clinical significance of CD4+ CD25+ Foxp3+ regulatory T cell and interleukin-10,transforming growth factor-β1 in patients with steroid-resistant asthma / 中国医师进修杂志

Objective To study the clinical significance of CD4 + CD25+ Foxp3 + regulatory T cell (Treg) and interleukin 10 (IL-10),transforming growth factor-β1 (TGF-β 1) in patients with steroidresistant asthma (SRA).Methods Seventy-nine patients with asthma were divided into SRA group (31cases) and steroid-sensitive (SSA) group (48 cases).Forty-five healthy subjects were selected simultaneously as control group.CD4+ CD25+ Foxp3 +Treg level was detected by flow cytometry and serum IL-10 and TGF-β1 levels were detected by enzyme-linked immunosorbent assay.Results The percentage of CD4 + CD25 +Foxp3 +Treg in CD4+ T cell and its absolute value in SRA group and SSA group were 0.0225 ± 0.0063,(1.09 ± 0.23) × 107/L and 0.0345 ± 0.0094,(1.35 ± 0.14) × 107/L,they were significandy lower than those in control group [0.0537 ± 0.0128,(2.06 ± 0.27) × 107/L],and SRA group was significandy lower than SSA group,there were statistical differences (P ＜ 0.05).The levels of serum TGF-β1 in SRA group and SSA group were significantly lower than those in control group [(138.12 ± 23.26),(176.25 ± 40.37) ng/L vs.(281.22 ±47.15) ng/L],there was statistical difference (P ＜0.05).The levels of serum IL-10 in SRA group was significantly lower than that in control group [(516.43 ± 86.33)ng/L vs.(763.02 ± 90.19) ng/L],there was statistical difference (P ＜ 0.05).There was no statistical difference in the level of serum IL-10 between SSA group and control group (P ＞ 0.05).The levels of serum IL-10 and TGF-β 1 in SRA group were significantly lower than those in SSA group,there were statistical differences (P ＜ 0.05).The levels of serum IL-10 and TGF-β1 had positive correlation with CD4 + CD25 + Foxp3 +Treg in SRA group and SSA group (P ＜ 0.01).Conclusion The interaction among CD4+ CD25+ Foxp3 +Treg,IL-10 and TGF-β1 may play an important role in the SRA occurrence and development,while by increasing peripheral blood CD4 + CD25 + Foxp3 +Treg number and stabilizing its function can increase IL-10 and TGF-β1 expression,which may be an important way to treat SRA.