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1.
BMC Infect Dis ; 19(1): 770, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481020

RESUMO

BACKGROUND: We sought to assess reporting in China's Pneumonia of Unknown Etiology (PUE) passive surveillance system for emerging respiratory infections and to identify ways to improve the PUE surveillance system's detection of respiratory infections of public health significance. METHODS: From February 29-May 29, 2016, we actively identified and enrolled patients in two hospitals with acute respiratory infections (ARI) that met all PUE case criteria. We reviewed medical records for documented exposure history associated with respiratory infectious diseases, collected throat samples that were tested for seasonal and avian influenza, and interviewed clinicians regarding reasons for reporting or not reporting PUE cases. We described and analyzed the proportion of PUE cases reported and clinician awareness of and practices related to the PUE system. RESULTS: Of 2619 ARI admissions in two hospitals, 335(13%) met the PUE case definition; none were reported. Of 311 specimens tested, 18(6%) were seasonal influenza virus-positive; none were avian influenza-positive. < 10% PUE case medical records documented whether or not there were exposures to animals or others with respiratory illness. Most commonly cited reasons for not reporting cases were no awareness of the PUE system (76%) and not understanding the case definition (53%). CONCLUSIONS: Most clinicians have limited awareness of and are not reporting to the PUE system. Exposures related to respiratory infections are rarely documented in medical records. Increasing clinicians' awareness of the PUE system and including relevant exposure items in standard medical records may increase reporting.

2.
J Hematol Oncol ; 12(1): 88, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481121

RESUMO

BACKGROUND: Low-dose post-transplant cyclophosphamide (PTCy) in conjunction with anti-thymocyte globulin (ATG) appears as a potentially effective graft-versus-host disease (GVHD) prevention strategy in haploidentical hematopoietic cell transplant (haplo-HCT). Our study aims to assess the efficacy of this regimen. METHODS: We extended our prospective study in patients treated with low-dose PTCy (14.5 mg/kg on days 3 and 4) in ATG/granulocyte colony-stimulating factor (G-CSF)-based regimen and compared the results to the contemporary cohort of patients without low-dose PTCy (ATG cohort). Both study cohort and control are transplanted from maternal donor or collateral relatives. RESULTS: We identified 239 consecutive patients (ATG-PTCy cohort = 114; ATG cohort = 125). All patients but one in ATG cohort achieved myeloid engraftment by day 30 post-HCT. We found that both the cumulative incidence of 100-day grade III-IV aGvHD and non-relapse-mortality (NRM) in the ATG-PTCy cohort was significantly reduced than that in the ATG group (5% vs 18%; P = 0.003; and 6% vs 15%; P= 0.045); the 2-year cumulative incidences of relapse and overall survival were comparable between the two cohorts (13% vs 14%; P = 0.62; and 83% vs 77%; P = 0.18, respectively). Furthermore, GVHD-free, relapse-free survival (GRFS) was significantly improved in the ATG-PTCy arm (63% vs 48%; P = 0.039). In multivariate analysis, the joint treatment resulted in lower grade II-IV acute GVHD (HR 0.58; P = 0.036), grade III-IV aGvHD (HR 0.28; P = 0.006), chronic GVHD (HR 0.60; P = 0.047), NRM (HR 0.26; P = 0.014), and higher GRFS (HR 0.59; P = 0.021) but slower myeloid and platelet recovery (HR 0.29 and 0.30; both P < 0.001). CONCLUSIONS: These results suggested that ATG/PTCy (low-dose) can reduce both acute and chronic GVHD as compared with standard ATG-based prophylaxis using maternal donor or collateral relatives at particular high GVHD risk.

3.
Arch Insect Biochem Physiol ; : e21612, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31482645

RESUMO

Zn72D encodes the Drosophila zinc finger protein Zn72D. It was first identified to be involved in phagocytosis and indicated to have a role in immunity. Then it was demonstrated to have a function in RNA splicing and dosage compensation in Drosophila melanogaster. In this study, we discovered a new function of Zn72D in male fertility. We showed that knockdown of Zn72D in fly testes caused an extremely low egg hatch rate. Immunofluorescence staining of Zn72D knockdown testes exhibited scattered spermatid nuclei and no actin cones or individualization complexes (ICs) during spermiogenesis, whereas the early-stage germ cells and the spermatocytes were observed clearly. There were no mature sperms in the seminal vesicles of Zn72D knockdown fly testes, although a few sperms could be found close to the seminal vesicle. We further showed that many cytoskeleton-related genes were significantly downregulated in fly testes due to Zn72D knockdown. Taken together these findings suggest that Zn72D may have an important function in spermatogenesis by sustaining the cytoskeleton-based morphogenesis and individualization thus ensuring the proper formation of sperm in D. melanogaster.

4.
Nanoscale ; 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31482918

RESUMO

microRNAs are a type of evolutionarily conserved small non-coding RNA with a length of 18-25 nucleotides. In recent years, increasing studies have shown that the content of specific miRNAs in the blood changes significantly during the occurrence and development of major diseases such as cardiovascular disease and cancer. Therefore, miRNAs may serve as important new biomarkers that can be used for disease diagnosis in the future. Here, we improved the polyethylene glycol layer on the surface of a traditional silicon sphere to specifically capture miRNAs by means of a full-function microplate detector, at 100 microliters. The detection limit for specific miRNAs per liter of plasma can reach 1 fM, and simultaneous detection of 96 samples can be achieved. Compared with the traditional real-time PCR technology, our detection eliminates the complex steps of miRNA extraction, reverse transcription, amplification, etc. and avoids more human error in the detection process. Using the full-featured microwell detector, we can rapidly detect specific miRNAs in plasma, which can be used in the diagnosis of cardiovascular diseases in the future.

5.
JAMA Dermatol ; 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31483437

RESUMO

Importance: A prediction model for new-onset nonmelanoma skin cancer could enhance prevention measures, but few patient data-driven tools exist for more accurate prediction. Objective: To use machine learning to develop a prediction model for incident nonmelanoma skin cancer based on large-scale, multidimensional, nonimaging medical information. Design, Setting, and Participants: This study used a database comprising 2 million randomly sampled patients from the Taiwan National Health Insurance Research Database from January 1, 1999, to December 31, 2013. A total of 1829 patients with nonmelanoma skin cancer as their first diagnosed cancer and 7665 random controls without cancer were included in the analysis. A convolutional neural network, a deep learning approach, was used to develop a risk prediction model. This risk prediction model used 3-year clinical diagnostic information, medical records, and temporal-sequential information to predict the skin cancer risk of a given patient within the next year. Stepwise feature selection was also performed to investigate important and determining factors of the model. Statistical analysis was performed from November 1, 2016, to October 31, 2018. Main Outcomes and Measures: Sensitivity, specificity, and area under the receiver operating characteristic (AUROC) curve were used to evaluate the performance of the models. Results: A total of 1829 patients (923 women [50.5%] and 906 men [49.5%]; mean [SD] age, 65.3 [15.7] years) with nonmelanoma skin cancer and 7665 random controls without cancer (3951 women [51.5%] and 3714 men [48.4%]; mean [SD] age, 47.5 [17.3] years) were included in the analysis. The 1-year incident nonmelanoma skin cancer risk prediction model using sequential diagnostic information and drug prescription information as a time-incorporated feature matrix could attain an AUROC of 0.89 (95% CI, 0.87-0.91), with a mean (SD) sensitivity of 83.1% (3.5%) and mean (SD) specificity of 82.3% (4.1%). Carcinoma in situ of skin (AUROC, 0.867; -2.80% loss) and other chronic comorbidities (eg, degenerative osteopathy [AUROC, 0.872; -2.32% loss], hypertension [AUROC, 0.879; -1.53% loss], and chronic kidney insufficiency [AUROC, 0.879; -1.52% loss]) served as more discriminative factors for the prediction. Medications such as trazodone, acarbose, systemic antifungal agents, statins, nonsteroidal anti-inflammatory drugs, and thiazide diuretics were the top-ranking discriminative features in the model; each led to more than a 1% decrease of the AUROC when eliminated individually (eg, trazodone AUROC, 0.868; -2.67% reduction; acarbose AUROC, 0.870; -2.50 reduction; and systemic antifungal agents AUROC, 0.875; -1.99 reduction). Conclusions and Relevance: The findings of this study suggest that a risk prediction model may have potential predictive factors for nonmelanoma skin cancer. This model may help health care professionals target high-risk populations for more intensive skin cancer preventive methods.

6.
Hypertension ; : HYPERTENSIONAHA11913458, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31476913

RESUMO

Pulmonary hypertension (PH) is a severe disease with multiple etiologies. In addition to genetics, recent studies have revealed the epigenetic modulation in the initiation and progression of PH. In this review, we summarize the epigenetic mechanisms in the pathogenesis of PH, specifically, DNA methylation, histone modifications, and microRNAs. We further emphasize the diagnostic and therapeutic potential of these epigenetic hallmarks in PH. Finally, we highlight the developmental reprogramming in adult-onset PH because of adverse perinatal exposures such as intrauterine growth restriction and extrauterine growth restriction. Therefore, epigenetic modifications provide promise for the therapy and prevention of PH.

7.
J Hematol Oncol ; 12(1): 87, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477147

RESUMO

BACKGROUND: Haploidentical transplantation has been proposed as an effective treatment for severe aplastic anemia (SAA). The majority of patients have more than one HLA-haploidentical donor. Herein, we compared the outcomes between different donor-recipient relationships for optimal haploidentical donor selection in acquired SAA. METHODS: We conducted a multicenter study based on a registered database of 392 patients with SAA treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT) between 2006 and 2018. In total, 223 patients received grafts from father donors, 47 from mother donors, 91 from siblings, 29 from children, and 2 from collateral donors. RESULTS: Of the 381 patients who survived more than 28 days, 379 (99.5%) recipients were engrafted. The 2-year overall survival (OS) was 86.6 ± 2.5%, 87.1 ± 4.9%, 84.3 ± 3.9%, and 92.2 ± 5.1% for recipients of father, mother, sibling, and child grafts, respectively, (P = 0.706). The 2-year failure-free survival (FFS) was 82.8 ± 2.7%, 86.7 ± 5.1%, 80.8 ± 4.2%, and 92.5 ± 5.1% for recipients of father, mother, sibling, and child grafts, respectively, (P = 0.508). There was no difference in the incidence of either acute or chronic graft-versus-host disease (GVHD) among the different donor sources in multivariate analyses. There were also no differences in the OS or FFS among the different donor sources in the Cox regression analysis. However, OS was significantly better in the patients with a shorter history of aplastic anemia (< 12 months), better performance status (ECOG scores 0-1), or moderate graft mononuclear cell (MNC) counts (6-10 × 108/kg), and in female recipients with male donors. The FFS was also higher in patients with a shorter history of aplastic anemia (< 12 months) and better performance status (ECOG scores 0-1). CONCLUSIONS: Fathers, mothers, siblings, and children are all suitable haploidentical donors for patients with SAA.

8.
Artigo em Inglês | MEDLINE | ID: mdl-31483594

RESUMO

A microreactor which can confine chemical reactions exclusively in tiny vessels with the volume of ~ 0.015 µm3 is introduced. Aluminum inversed hollow nanocone arrays (IHNAs) are fabricated by a simple and efficient colloidal lithography method. Ag and Au nanoparticles (NPs), as well as polypyrrole grow exclusively in the conic cavities under light illumination. The photocatalytic effect arising from the plasmonic enhanced electric fields (E-fields) of IHNAs boosts the reactions and in charge of the submicron site-selectivity. By inhibiting light to IHNAs partially, various hierarchical patterns at the macro-, micro-, and submicro-scale are obtained, inspiring a facile patterning technique by varying light source. In addition, the Al IHNA films are transferred to flexible and curved substrates with unchanged performances, showing high flexibility for wide applications. The microreactors based on the IHNAs will contribute to the control of chemical reactions at different dimensions and offer great potentials in developing novel nanofabrication techniques.

9.
Oncol Rep ; 2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31485632

RESUMO

As a member of the myotubularin family, myotubularin related protein 3 (MTMR3) has been demonstrated to participate in tumor development, including oral and colon cancer. However, little is known about its functional roles in breast cancer. In the present study, the expression of MTMR3 in breast cancer was evaluated by immunohistochemical staining of tumor tissues from 172 patients. Online data was then used for survival analysis from the PROGgeneV2 database. In vitro, MTMR3 expression was silenced in MDA­MB­231 cells via lentiviral shRNA transduction. MTT, colony formation and flow cytometry assays were performed in the control and MTMR3­silenced cells to evaluate the cell growth, proliferation and cell cycle phase distribution, respectively. Western blotting was used to evaluate the protein expression levels of autophagy­related markers. The results demonstrated that the expression of MTMR3 in breast cancer tissues was significantly increased compared with adjacent normal tissues. MTMR3 was highly expressed in triple­negative breast cancer and was associated with disease recurrence. MTMR3 knockdown in MDA­MB­231 cells inhibited cell proliferation and induced cell cycle arrest and autophagy. The present results indicated that MTMR3 may have an important role in promoting the progression of breast cancer, and its inhibition may serve as a promising therapeutic target for breast cancer treatment.

10.
Echocardiography ; 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31487058

RESUMO

Unilateral absence of the pulmonary artery (UAPA) is a rare congenital cardiovascular malformation that can present as an isolated lesion or may be associated with other congenital heart malformations. Several studies have reported UAPA after birth. To our knowledge, the absence of the right pulmonary artery in the fetus has not been reported. Here, we report a rare case of fetal right pulmonary artery absence with aortic coarctation, which was confirmed by postpartum ultrasound and computed tomography angiography (CTA). Our case demonstrates that fetal echocardiography, especially the three-vessel view, is beneficial for the prenatal diagnosis of pulmonary artery malformations.

11.
Am J Chin Med ; : 1-14, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488033

RESUMO

Baicalein (BAI) is a natural flavonoid. It has been shown that BAI has anticancer effects, but the molecular mechanism is still unclear. The aim of the current study was to confirm whether or not BAI triggers autophagy and induces AMPK activation in glioma U251 cells. The Ad-mcherry-GFP-LC3B adenovirus experiments indicated that BAI induces glioma cell autophagy. Western blotting showed that the level of LC3II expression increased with the time and concentration of BAI. Following treatment with chloroquine, the expression of LC3 was enhanced Immunofluorescence also confirmed this result. At the same time, cleaved caspase-3, DAPI staining, and JC-1 staining revealed that apoptosis was also induced in the induction of autophagy. In addition, we found that BAI activates phosphorylation of AMPK, which is further confirmed using compound C in this process. When the phosphorylation of AMPK was inhibited, autophagy, and apoptosis were also inhibited. In conclusion, BAI induces autophagy and apoptosis through AMPK pathway. Surprisingly, our research provides new insight with the function of anticancer of BAI, and the potential of the promotion in glioma cell apoptosis might be related to autophagy activation. These results demonstrate the anticancer activity of BAI, which can be used as potential therapeutic agents for cancer therapy.

13.
Oncogene ; 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488872

RESUMO

Chronic myeloid leukemia (CML) originates from normal hematopoietic stem cells acquiring BCR-ABL fusion gene, specific BCR-ABL inhibitors (e.g., imatinib mesylate, IM) have greatly improved patient management. However, some patients are still suffering from relapse and drug resistance, which urges better understanding of the growth/survival mechanisms of CML stem/progenitor cells. In the present study, the role and its underlying mechanism of heterogeneous nuclear ribonucleoprotein D-like (HNRPDL) in CML cells were investigated. Firstly, overexpression of HNRPDL promoted the growth of murine BaF3 cells in vitro and induced leukemia in vivo, which was enhanced by co-expression of BCR-ABL. Conversely, HNRPDL silencing inhibited colony-forming cell (CFC) production of CML CD34+ cells and attenuated BCR-ABL induced leukemia. In addition, HNRPDL modulated imatinib response of K562 cells and HNRPDL silencing sensitized CML CD34+ cells to imatinib treatment. Mechanistically, we found the stability of pre-B-cell leukemia homeobox 1 (PBX1) mRNA was sustained by HNRPDL through its binding to a specific motif (ACUAGC) in 3'-untranslated region (3'-UTR) of PBX1. The expression of PBX1 was significantly higher in CML CD34+ cells than that in control cells and PBX silencing inhibited the growth of CML cells and sensitized them to imatinib treatment. In contrast, overexpression of PBX1 elevated the CFC production of normal hematopoietic CD34+ cells and "rescued" HNRPDL silencing induced growth inhibition and imatinib sensitization. Taken together, our data have demonstrated that HNRPDL transforms hematopoietic cells and a novel HNRPDL/PBX1 axis plays an important role in human CML CD34+ cells.

14.
Shanghai Kou Qiang Yi Xue ; 28(3): 293-296, 2019 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-31489419

RESUMO

PURPOSE: To design an oral health self-efficacy scale for patients with dental implants and to evaluate their reliability and validity. METHODS: Based on literature review, we designed and developed a self-efficacy energy table that met the characteristics of implant patients. The scale consisted of 16 items which were divided into 3 dimensions, including self-efficacy of dental implant surgery, self-efficacy of postoperative supportive care, and self-efficacy of oral hygiene habits. The reliability and validity of the scale were evaluated by factor analysis in 102 outpatients with dental implants using SPSS 13.3 software package. RESULTS: A total of 4 common factors were extracted from the scale, and the cumulative contribution rate was 75.35%. The overall Cronbach's α coefficient of the scale was 0.910, and the retest correlation coefficient was 0.882, which belonged to high-signal scale. CONCLUSIONS: The oral health self-efficacy energy scale for implant patients with independent design has high reliability and validity. It can provide targeted guidance for oral health education for implant patients and improve the success rate of implant surgery.

15.
J Food Biochem ; 43(9): e12981, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489654

RESUMO

The chemical constituents in Trifolium repens L. were comprehensively studied by UPLC in this work, and a total number of 308 compounds were detected with 169 ones identified. The possible fragmentation pathways were proposed and fragmentation rules were summarized. On the basis of the concluded strategies, the characterized compounds could be classified into organic acids and their derivatives, alkaloids, amino acids, peptides, flavonoids, oligosaccharides, coumarins, and other types of compounds. This approach provided a rapid way for the identification of constituents in T. repens L., and even in other complex analytes. Among the separation and identification of the constituents, three compounds of great amount were isolated and characterized by NMR. The expression of iNOS and COX-2 in LPS-induced RAW 264.7 cells was suppressed by the pretreatment with three isolated constituents. The results implied they may potentially serve as a remedy for the therapy of inflammation. PRACTICAL APPLICATIONS: This work provided a rapid method for the identification of the complex analyte, which could be used in TCM, natural food and so on. The summarized fragmentation rule could be applied for the analysis of several types of compounds, such as organic acids and their derivatives, alkaloids, amino acids and peptides, flavonoids, oligosaccharides, coumarins, and so on. Most of natural plants contain these kinds of compounds, so these rules could have wide applications. Except the phytochemical investigation, T. repens L. displayed anti-inflammation activity according to the reported literature, and the three isolated constituents may potentially serve as a remedy for the therapy of inflammation referring to the result of this research.

16.
Plant Physiol ; 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31471454

RESUMO

Cellular redox status plays critical roles in cell division and differentiation, but the underlying mechanism is unclear. Here we explored the effect of redox status on stem cell identity in distal stem cells (DSCs) of Arabidopsis thaliana roots. Treatment with the reductive reagent glutathione (GSH) and the oxidative reagent H2O2 inhibited DSC differentiation, as did endogenously altering reactive oxygen species production via various mutations. This suggests that both highly reductive and oxidative environments inhibit specification of stem cell identity. Among mutants of components in the CLAVATA3/ENDOSPERM SURROUNDING REGION 40 (CLE40)-ARABIDOPSIS CRINKLY4 (ACR4)/CLAVATA1 (CLV1)-WUSCHEL RELATED HOMEOBOX5 (WOX5) module, both reductive and oxidative reagents influenced DSC differentiation in wox5-1 and clv1-1, but not in acr4-2 or cle40 mutant plants. The stability of the receptor-like kinase ACR4 is modulated by redox status through endocytosis in root tips. ACR4 with multiple cysteine mutations in the tumor necrosis factor receptor (TNFR) extracellular domain failed to undergo endocytosis. ACR4 with a complete deletion of the TNFR domain was localized directly to endosomes, bypassing the plasma membrane. Both mutations affected DSC differentiation, but not seed filling. Conversely, the intracellular domain of the ACR4 protein is partially required for seed filling, but not for DSC differentiation. Our study uncovers an important biological role of the TNFR domain in redox-mediated endocytosis of ACR4 in root DSC differentiation.

17.
J Mol Model ; 25(9): 287, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31471647

RESUMO

To investigate the effect of doping defects on properties of pentaerythritol tetranitrate (PETN), the "perfect" and doping defective crystal models of PETN containing pentaerythritol (PE), pentaerythritol mononitrate (PEMonoN), pentaerythritol dinitrate (PEDiN), and pentaerythritol trinitrate (PETRIN) were established, respectively. Molecular dynamics (MD) method was applied to perform simulations, and sensitivity, detonation performance, and mechanical properties were calculated and compared. The results indicate that compared with PETN (1 1 0) supercell model, the interaction energy of trigger bond and cohesive energy density of the doped defect models decreased by 2.21~12.43 kJ mol-1 and 0.0219~0.0421 kJ cm-3, respectively, indicating that the sensitivity of defective models increases and the safety decreases. The density, detonation velocity, and detonation pressure of the doped defect model decreased by 0.018~0.061 g cm-3, 77.833~272.809 m s-1, and 0.746~2.544 GPa, respectively, and the oxygen balance is declined, indicating that the energy density of PETN decreased and the power decreased. Doped defects also cause the elastic modulus, bulk modulus, and shear modulus of PETN to decrease by 0.75~2.16 GPa, 0.44~0.89 GPa, and 0.30~0.89 GPa, respectively. The ratio of bulk modulus to shear modulus and Cauchy pressure increased by 0.05~0.28 GPa and 0.09~1.13 GPa, respectively, indicating that the deformation resistance, fracture strength, and hardness of the doped defect model decrease, stiffness decreases, and flexibility and ductility increase.

18.
J Sci Food Agric ; 2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31471904

RESUMO

BACKGROUND: Rapid and accurate diagnosis of nitrogen (N) status in field crops is of great significance for site-specific N fertilizer management. This study aimed to evaluate the potential of hyperspectral imaging coupled with chemometrics for the qualitative and quantitative diagnosis of N status in tea plants under field condition. RESULTS: Hyperspectral data from mature leaves of tea plants with different N application rates were preprocessed by standard normal variate (SNV). Partial least squares discriminative analysis (PLS-DA), and least squares - support vector machines (LS-SVM) were used for the classification of different N status. Furthermore, partial least squares regression (PLSR) was used for the prediction of nitrogen content. The results showed that the LS-SVM model yielded better performance with correct classification rates of 82% and 92% in prediction sets for the diagnosis of different N application rates and N status, respectively. The PLSR model for leaf N content (LNC) got excellent performance with correlation coefficients of 0.924, root mean square error of 0.209, and residual predictive deviation of 2.686 in prediction set. In addition, the important wavebands of PLSR model were interpreted based on regression coefficients. CONCLUSION: Overall, our results suggested that the hyperspectral imaging technique can be an effective and accurate tool for qualitative and quantitative diagnosis of N status in tea plants. This article is protected by copyright. All rights reserved.

19.
J Orthop Res ; 2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31471919

RESUMO

Giant cell tumor of bone (GCTB) is a locally aggressive destructive bone lesion. The management of pulmonary metastasis and local recurrence after the surgical treatment of GCTB remains a challenge. Pathologically, stromal cells in GCTB are known as primary neoplastic cells and are recognized as incompletely differentiated preosteoblasts. Therefore, inducing GCTB stromal cells to differentiate into cells with a mature osteoblastic phenotype may stop tumor growth and recurrence. In this study, we aimed to investigate how simvastatin, a clinically approved and commonly used statin that has been known to promote the maturation of cells of the osteogenic lineage, affects GCTB stromal cells. We found that simvastatin effectively inhibited cell viability by suppressing proliferation and by inducing apoptosis in GCTB stromal cells. Moreover, simvastatin treatment upregulated the expression of genes related to osteogenic maturation, such as runt-related transcription factor 2 (RUNX2), osteopontin (OPN) and osteocalcin (OCN), and increased the mineralization of the extracellular matrix in GCTB stromal cells. Ingenuity Pathway Analysis was used to discover that the vitamin D receptor pathway was involved in the simvastatin-induced osteogenic differentiation of GCTB stromal cells by upregulating the 1,25-dihydroxyvitamin D metabolism. Taken together, this in vitro study demonstrates the antitumor and differentiation-promoting effects of simvastatin on GCTB stromal cells and suggests the possibility of using simvastatin as an adjuvant therapy for GCTB. These findings support further clinical investigation of the efficacy of using simvastatin as an adjuvant therapy for GCTB to reduce recurrence and distant metastasis after surgical treatment. This article is protected by copyright. All rights reserved.

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