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1.
Mol Pharm ; 21(3): 1342-1352, 2024 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-38295278

RESUMEN

Rift Valley fever virus (RVFV) could cause an emergency illness characterized by fever, muscle pain, and even death in humans or ruminants. However, there are no approved antiviral drugs that prevent or treat RVFV infection. While therapeutic antibodies have shown promising potential for prevention or treatment in several studies, many studies are ongoing, especially in the field of infectious diseases. Among these studies, the mRNA-LNP platform shows great potential for application, following the COVID-19 pandemic. Previously, we have obtained a neutralizing antibody against RVFV, which was named A38 protein and verified to have a high binding and neutralization ability. In this study, we aimed to identify an effectively optimized sequence and expressed the prioritized mRNA-encoded antibody in vitro. Notably, we effectively expressed mRNA-encoded protein and used the mRNA-LNP platform to generate A38-mRNA-LNP. Pharmacokinetic experiments were conducted in vivo and set up in two groups of mRNA-A38 group and A38 protein group, which were derived from mRNA-LNP and plasmid DNA-expressed proteins, respectively. A38-mRNA-LNPs were administrated by intramuscular injection, A38 proteins were administrated by intravenous administration, and their unique ability to maintain long-lasting protein concentrations by mRNA-encoded protein was demonstrated with the mRNA-encoded protein providing a longer circulating half-life compared to injection of the free A38 protein. These preclinical data on the mRNA-encoded antibody highlighted its potential to prevent infectious diseases in the future.


Asunto(s)
Enfermedades Transmisibles , Liposomas , Nanopartículas , Fiebre del Valle del Rift , Virus de la Fiebre del Valle del Rift , Animales , Humanos , Virus de la Fiebre del Valle del Rift/genética , Fiebre del Valle del Rift/prevención & control , Pandemias , Anticuerpos Antivirales
2.
Ann Hematol ; 102(3): 621-628, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36633638

RESUMEN

Renal impairment (RI) used to exclude multiple myeloma (MM) patients from autologous stem cell transplantation (ASCT) for safety concerns. Here, we retrospectively reviewed 34 consecutively transplanted patients with creatinine clearance < 60 ml/min at ASCT in recent 5 years at our institution. Busulfan/cyclophosphamide and high-dose melphalan were both employed as conditioning regimens. We found 62% grade 1-2 oral mucositis, 12% grade 3 oral mucositis, 48% grade 3 infection, 8% grade ≥ 4 infection, 50% grade 1 transient creatinine increase, 15% cardiac adverse events, and 12% engraftment syndrome. One case of secondary platelet graft failure and 1 case of transplantation-related mortality were observed. Interleukin-6 concentration was elevated among patients with increased body temperature and/or N-terminal pro-brain natriuretic peptide during engraftment, and close monitoring of these markers may help to predict susceptibility to cardiac events and engraftment syndrome. Adverse events occurred frequently, but the majority were manageable in this cohort. ASCT would further deepen the anti-myeloma efficacy and slightly ameliorated renal function. With a median follow-up of 26.2 months post transplantation (range: 1.6-74.8 months), the median progression-free survival (PFS) and overall survival (OS) post-transplantation of patients undergoing first-line transplantation were not reached; the median PFS post-transplantation of patients undergoing rescue transplantation was 19.2 months and the median OS was not reached.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Mieloma Múltiple , Estomatitis , Humanos , Estudios Retrospectivos , Creatinina , Trasplante Autólogo , Melfalán , Acondicionamiento Pretrasplante , Trasplante de Células Madre
3.
Platelets ; 33(8): 1132-1138, 2022 Nov 17.
Artículo en Inglés | MEDLINE | ID: mdl-35348422

RESUMEN

Triggering receptor expressed on myeloid cells (TREM) like transcript-1 (TLT-1) is a membrane protein receptor found in α-granules of megakaryocytes and platelets. Upon platelet activation TLT-1 is rapidly relocated to the surface of platelets. In plasma, a soluble form of TLT-1 (sTLT-1) is present. Plasma levels of sTLT-1 are significantly elevated in thrombotic diseases. In the present study, we investigated to whether TLT-1 reflects platelet activation in pregnant women with preeclampsia. We studied 30 preeclamptic patients who were matched with 30 normotensive pregnant women and 30 non-pregnant controls. Basal TLT-1, P-selectin, and CD63 expressions on platelets were analyzed with the use of flow-cytometry (FCM). Platelet reactivity was induced by thrombin receptor activation peptide and determined by FCM. Plasma concentrations of sTLT-1 and soluble P-selectin (sP-selectin) were measured by an enzyme-linked immunosorbent assay. Results show that basal platelet expression of TLT-1, P-selectin and CD63 were increased in women with preeclampsia (PE) compared with normotensive pregnant women (NP). Platelets from PE women and NP women were more responsive compared to from nonpregnant women controls (NC), and which was demonstrated by increased expression of TLT-1, P-selectin, and CD63 upon stimulation in vitro. Plasma concentration of sTLT-1 was greater in PE women compared to NP women and NC women. Plasma sP-selectin level was higher in pregnant women than in nonpregnant women, but there were no significant differences between PE and NP women. In summary, our results revealed that platelet activation is prominent in preeclampsia, TLT-1 reflects platelet activation and may be a useful indicator for preeclampsia.


Asunto(s)
Selectina-P , Preeclampsia , Plaquetas/metabolismo , Femenino , Humanos , Células Mieloides/metabolismo , Selectina-P/metabolismo , Péptidos , Activación Plaquetaria , Embarazo , Receptores Inmunológicos , Receptores de Trombina/metabolismo
4.
Sensors (Basel) ; 21(15)2021 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-34372403

RESUMEN

To facilitate the broader use of EMG signal whitening, we studied four whitening procedures of various complexities, as well as the roles of sampling rate and noise correction. We separately analyzed force-varying and constant-force contractions from 64 subjects who completed constant-posture tasks about the elbow over a range of forces from 0% to 50% maximum voluntary contraction (MVC). From the constant-force tasks, we found that noise correction via the root difference of squares (RDS) method consistently reduced EMG recording noise, often by a factor of 5-10. All other primary results were from the force-varying contractions. Sampling at 4096 Hz provided small and statistically significant improvements over sampling at 2048 Hz (~3%), which, in turn, provided small improvements over sampling at 1024 Hz (~4%). In comparing equivalent processing variants at a sampling rate of 4096 Hz, whitening filters calibrated to the EMG spectrum of each subject generally performed best (4.74% MVC EMG-force error), followed by one universal whitening filter for all subjects (4.83% MVC error), followed by a high-pass filter whitening method (4.89% MVC error) and then a first difference whitening filter (4.91% MVC error)-but none of these statistically differed. Each did significantly improve from EMG-force error without whitening (5.55% MVC). The first difference is an excellent whitening option over this range of contraction forces since no calibration or algorithm decisions are required.


Asunto(s)
Articulación del Codo , Codo , Algoritmos , Electromiografía , Humanos , Contracción Isométrica , Contracción Muscular , Músculo Esquelético , Postura
5.
BMC Pregnancy Childbirth ; 20(1): 774, 2020 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-33308174

RESUMEN

BACKGROUND: The fetal adrenal gland is a highly vascularized organs and develops two recognizable distinct zones in uetro, inner fetal zone (FZ) and outer definitive zone (DZ). Based on the region supplied, middle adrenal artery (MAA) mainly contribute to FZ while inferior adrenal artery (IAA) mainly to the inferior part of DZ. The purpose of this study was to establish reference ranges of adrenal artery Doppler indices of IAA and MAA, and assess zonal difference of blood supply to fetal adrenal gland. METHODS: The pulsatility index (PI), resistance index (RI), and systolic:diastolic ratio (S/D) of the IAA and MAA were obtained serially at 4-week intervals in normal fetuses. The MAA and IAA were referred based on the course and location in the gland: IAA referring the artery that mainly branches from the renal artery and walks along the renal upper pole, distributing the inferoposterior part of DZ in the adrenal gland while MAA as arterial blood flowing along the single central adrenal vein in the medial part of the gland. Multilevel modeling was performed to establish the gestational age-associated reference ranges for IAA and MAA. Differences in Doppler indices between the IAA and MAA were assessed. RESULTS: One hundred sixty-eight fetuses with 843 observations were included. The IAA had a higher detection rate than the MAA (100% vs 89.2%, p < 0.05). The resistance of IAA had a reduction around 35 weeks of gestation and that of MAA remained unchanged throughout the second half of pregnancy. Lower PI, RI and S/D were observed in the MAA than in the IAA (p < 0.05) from 752 paired measurements. CONCLUSION: There is a zonal difference in blood supply in favor of the fetal zone, which may correspond to its unique function. Reference ranges of Doppler parameters in adrenal artery maybe beneficial for further evaluation of fetal hemodynamics.


Asunto(s)
Glándulas Suprarrenales/irrigación sanguínea , Flujo Pulsátil/fisiología , Arterias Umbilicales/diagnóstico por imagen , Glándulas Suprarrenales/diagnóstico por imagen , Glándulas Suprarrenales/embriología , Adulto , Femenino , Humanos , Estudios Longitudinales , Arteria Cerebral Media/diagnóstico por imagen , Arteria Cerebral Media/embriología , Embarazo , Valores de Referencia , Ultrasonografía Doppler en Color , Ultrasonografía Prenatal , Arterias Umbilicales/embriología
6.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(3): 318-325, 2019 05 25.
Artículo en Zh | MEDLINE | ID: mdl-31496165

RESUMEN

Proteins are the physical basis of life and perform all kinds of life activities. Proteins have different orientations and function in different tissues. The same protein, located in different subcellular regions, can perform different and even opposite functions. Both functional and structural proteins are capable of undergoing re-localization which can directly or indirectly participate in signal transduction. Due to abnormal transduction of signals during carcinogenesis, the proteins originally expressed in the cytoplasm are translocated into the nucleus and lead to functional changes in the tumor tissue. The changes of protein localization are affected by many factors, including the interaction between proteins, expression level of proteins and the cleaved intracellular domain of transmembrane protein.


Asunto(s)
Núcleo Celular , Citoplasma , Proteínas de la Membrana , Carcinogénesis/patología , Línea Celular Tumoral , Núcleo Celular/metabolismo , Citoplasma/metabolismo , Regulación Neoplásica de la Expresión Génica , Humanos , Proteínas de la Membrana/metabolismo , Dominios Proteicos , Transporte de Proteínas/fisiología , Transducción de Señal
7.
Ann Hematol ; 97(11): 2061-2070, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30091024

RESUMEN

Neutropenic patients with hematological diseases are prone to severe infections. Granulocyte transfusion therapy (GTX) is considered as a logical therapeutic approach for these problems. However, the efficacy and complications of GTX have not been well identified. We retrospectively analyzed the clinical outcomes of GTX therapy in our hospital from 2009 to 2015. After 117 granulocyte transfusions for 47 patients, 72.3% of these patients' infections were effectively improved, and the overall survival rates at 30 and 120 days were 66.0 and 57.5%, respectively. The patients who experienced neutrophil recovery within 10 days after their therapy initiation had a better response and long-term survival period (14/15, 93.3%, vs 20/32, 62.5%, P = 0.037). Higher-dose granulocytes (> 2.55 × 108/kg) might improve the effective rate of infection in the patients who had more than 10 days neutrophil recovery time (17/23, 73.9%, vs 3/9, 33.3%, P = 0.049). In addition, GTX benefited the patients who suffered from pulmonary bacterial infections (16/20, 80%) compared with the bloodstream infection group (7/12, 58.3%) and skin or mucous infection group (1/5, 20%). The primary data showed that GTX did not affect the incidence of graft-versus-host disease (GVHD) and cytomegalovirus viremia when patients received further HSCT treatment. Collectively, GTX was an adjunct treatment modality for severely neutropenic patients who were likely to experience hematopoietic recovery. More randomized trials are needed to verify the efficacy and complications of GTX therapy.


Asunto(s)
Transfusión de Leucocitos , Neutropenia/terapia , Neumonía Bacteriana/terapia , Enfermedades Cutáneas Bacterianas/terapia , Adolescente , Adulto , Anciano , Niño , Supervivencia sin Enfermedad , Femenino , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Neutropenia/sangre , Neutropenia/complicaciones , Neutropenia/microbiología , Neumonía Bacteriana/sangre , Neumonía Bacteriana/etiología , Neumonía Bacteriana/microbiología , Estudios Retrospectivos , Enfermedades Cutáneas Bacterianas/sangre , Enfermedades Cutáneas Bacterianas/etiología , Enfermedades Cutáneas Bacterianas/microbiología , Tasa de Supervivencia
8.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 45(4): 335-341, 2016 05 25.
Artículo en Zh | MEDLINE | ID: mdl-27868405

RESUMEN

Objective: To investigate the expression of CD10 in tumor-associated fibroblasts (TAF) in colorectal adenomas and its relation to cancerization and recurrence of adenoma. Methods: Tissue samples of low-grade adenoma (n=50), high-grade adenoma (n=50) and colorectal adenocarcinoma (n=50) were collected, and tissue samples at the distal margin of corresponding colorectal lesions were taken as controls. The expression of CD10 in the stromal TAFs, and the expressions of ß-catenin, Ki-67, p53 and CyclinD1 in tumor cells were detected by immunohistochemistry (Envision). The correlation of CD10 expression in stromal TAFs with the expressions of ß-catenin, Ki-67, p53 and CyclinD1 in tumor cells was analyzed by Spearmen. One hundred samples of low-grade colorectal adenoma were collected, including 57 non-recurrent cases and 43 recurrent cases (16 cases of recurrent adenoma and 27 cases of recurrent adenocarcinoma); the expression of stromal TAF CD10 were determined and compared among groups. Results: There was no TAF in normal colorectal mucosa. The expression rates of TAF CD10 in low-grade adenoma, high-grade adenoma and colorectal adenocarcinoma were 22%, 50% and 78%, respectively (all P<0.05). The expression of Ki-67 and ß-catenin in low-grade adenoma, high-grade adenoma, colorectal adenocarcinoma was on a rising trend (all P<0.01). The expression of CyclinD1 in high-grade adenoma was higher than that in colorectal adenocarcinoma and low-grade adenoma (all P>0.05). The expression of p53 in colorectal adenocarcinoma and high-grade adenoma was higher than that in low grade adenoma (all P<0.01). The expression of TAF CD10 was correlated with the expression of p53, Ki-67 and ß-catenin-nucleus(r=0.264、0.307、0.320, all P<0.01),but not correlated with CyclinD1 and ß-catenin-membrane (r=0.012、-0.073, all P>0.05). The TAF CD10 level was significantly higher in low-grade adenoma with recurrence than that in those without recurrence (P<0.05).The expression of CD10 in recurrent colorectal adenocarcinoma was higher than that in recurrent adenoma (P<0.05). Conclusion: The expression of TAF CD10 is increased gradually in the process of adenoma-cancer, indicating that it may play an important role in the canceration of adenoma. Adenomas with high expression of CD10 TAF are likely to be recurrent and cancerized, and detection of TAF CD10 combined with p53, Ki-67 and ß-catenin may be of value in predicting canceration or recurrence of colorectal adenoma.


Asunto(s)
Adenocarcinoma/química , Adenocarcinoma/genética , Adenoma/química , Adenoma/genética , Biomarcadores de Tumor/análisis , Fibroblastos Asociados al Cáncer/química , Neoplasias Colorrectales/química , Neoplasias Colorrectales/genética , Neprilisina/análisis , Carcinogénesis/química , Ciclina D1/análisis , Progresión de la Enfermedad , Humanos , Inmunohistoquímica , Antígeno Ki-67/análisis , Clasificación del Tumor , Recurrencia Local de Neoplasia/química , Valor Predictivo de las Pruebas , Proteína p53 Supresora de Tumor/análisis , beta Catenina/análisis
9.
J Electromyogr Kinesiol ; 75: 102864, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38310768

RESUMEN

Advanced single-use dynamic EMG-torque models require burdensome subject-specific calibration contractions and have historically been assumed to produce lower error than generic models (i.e., models that are identical across subjects and muscles). To investigate this assumption, we studied generic one degree of freedom (DoF) models derived from the ensemble median of subject-specific models, evaluated across subject, DoF and joint. We used elbow (N = 64) and hand-wrist (N = 9) datasets. Subject-specific elbow models performed statistically better [5.79 ± 1.89 %MVT (maximum voluntary torque) error] than generic elbow models (6.21 ± 1.85 %MVT error). However, there were no statistical differences between subject-specific vs. generic models within each hand-wrist DoF. Next, we evaluated generic models across joints. The best hand-wrist generic model had errors of 6.29 ± 1.85 %MVT when applied to the elbow. The elbow generic model had errors of 7.04 ± 2.29 %MVT when applied to the hand-wrist. The generic elbow model was statistically better in both joints, compared to the generic hand-wrist model. Finally, we tested Butterworth filter models (a simpler generic model), finding no statistical differences between optimum Butterworth and subject-specific models. Overall, generic models simplified EMG-torque training without substantive performance degradation and provided the possibility of transfer learning between joints.


Asunto(s)
Articulación del Codo , Músculo Esquelético , Humanos , Músculo Esquelético/fisiología , Electromiografía , Torque , Codo/fisiología , Articulación del Codo/fisiología , Articulaciones
10.
Leuk Lymphoma ; 65(6): 816-824, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38475670

RESUMEN

Cytomegalovirus (CMV) reactivation increases treatment-related mortality (TRM) after allogeneic hematopoietic cell transplantation (allo-HCT). We analyzed 141 adult acute leukemia (AL) patients suffered allo-HCT between 2017 and 2021, who developed CMV viremia post-HCT and treated with valganciclovir or foscarnet, to evaluate effectiveness and safety of both drugs. Viremia clearance rates (14 and 21 d post treatment) and toxicities were similar in two groups. However, valganciclovir was associated with a lower cumulative incidence of CMV recurrence within 180 days (16.7% vs. 35.7%, p=0.029) post CMV clearance. Finally, 2-year TRM was lower in valganciclovir group (9.7% ± 0.2% vs. 26.2% ± 0.3%, p = 0.026), result a superior 2-year overall survival (OS; 88.1% ± 5.2% vs. 64.4% ± 5.5%, p = 0.005) and leukemia-free survival (LFS; 82.0% ± 5.9% vs. 58.9% ± 5.6%, p = 0.009). Valganciclovir might decrease CMV viremia recurrence and led to better long-term outcome than foscarnet in adult AL patients developed CMV viremia post-HCT. Considering the inherent biases of retrospective study, well-designed trials are warranted to validate our conclusion.


Asunto(s)
Antivirales , Infecciones por Citomegalovirus , Citomegalovirus , Foscarnet , Trasplante de Células Madre Hematopoyéticas , Trasplante Homólogo , Valganciclovir , Viremia , Humanos , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Infecciones por Citomegalovirus/etiología , Valganciclovir/uso terapéutico , Masculino , Femenino , Viremia/tratamiento farmacológico , Adulto , Antivirales/uso terapéutico , Foscarnet/uso terapéutico , Persona de Mediana Edad , Citomegalovirus/efectos de los fármacos , Estudios Retrospectivos , Adulto Joven , Anciano , Leucemia Mieloide Aguda/terapia , Leucemia Mieloide Aguda/complicaciones , Leucemia Mieloide Aguda/mortalidad , Resultado del Tratamiento , Leucemia/terapia , Leucemia/complicaciones , Leucemia/mortalidad
11.
J Electromyogr Kinesiol ; 69: 102753, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36731399

RESUMEN

Bilateral movement is widely used for calibration of myoelectric prosthesis controllers, and is also relevant as rehabilitation therapy for patients with motor impairment and for athletic training. Target tracking and/or force matching tasks can be used to elicit such bilateral movement. Limited descriptive accuracy data exist in able-bodied subjects for bilateral target tracking or dominant vs non-dominant dynamic force matching tasks requiring more than one degree of freedom (DoF). We examined dynamic trajectory (0.75 Hz band-limited, white, uniform random) constant-posture, hand open-close, wrist pronation-supination target tracking and matching tasks. Tasks were normalized to maximum voluntary contraction (MVC), spanning a ± 30% MVC force range, in four 1-DoF and 2-DoF tasks: (1, 2) unilateral dominant limb tracking with/without visual feedback, and (3, 4) bilateral dominant/non-dominant limb tracking with mirror visual feedback. In 12 able-bodied subjects, unilateral tracking error with visual feedback averaged 10-15 %MVC, but up to 30 %MVC without visual feedback. Bilateral matching error averaged âˆ¼10 %MVC and was affected little by visual feedback type, so long as feedback was provided. In 1-DoF bilateral tracking, the dominant side had statistically lower error than the non-dominant side. In 2-DoF bilateral tracking, the side providing mirror visual feedback exhibited lower error than the opposite side. In 2-DoF tasks (assumed to be more challenging than their constituent 1-DoF tracking tasks), hand grip force errors grew disproportionately larger than those of each wrist DoF. In unilateral 1-DoF tasks, both hand vs target and wrist vs target latency averaged 250-350 ms. In unilateral 2-DoF tasks, wrist vs target latency also averaged 250-350 ms, while hand vs target latency averaged > 500 ms. These results provide guidance on bilateral 2-DoF hand-wrist performance in target tracking, and dominant vs non-dominant force matching tasks.


Asunto(s)
Fuerza de la Mano , Muñeca , Humanos , Muñeca/fisiología , Fuerza de la Mano/fisiología , Músculo Esquelético/fisiología , Extremidad Superior , Mano/fisiología
12.
Artículo en Inglés | MEDLINE | ID: mdl-36875964

RESUMEN

Most transradial prosthesis users with conventional "Sequential" myoelectric control have two electrode sites which control one degree of freedom (DoF) at a time. Rapid EMG co-activation toggles control between DoFs (e.g., hand and wrist), providing limited function. We implemented a regression-based EMG control method which achieved simultaneous and proportional control of two DoFs in a virtual task. We automated electrode site selection using a short-duration (90 s) calibration period, without force feedback. Backward stepwise selection located the best electrodes for either six or 12 electrodes (selected from a pool of 16). We additionally studied two, 2-DoF controllers: "Intuitive" control (hand open-close and wrist pronation-supination controlled virtual target size and rotation, respectively) and "Mapping" control (wrist flexion-extension and ulnar-radial deviation controlled virtual target left-right and up-down movement, respectively). In practice, a Mapping controller would be mapped to control prosthesis hand open-close and wrist pronation-supination. Eleven able-bodied subjects and 4 limb-absent subjects completed virtual target matching tasks (fixed target moves to a new location after being "matched," and subject immediately pursues) and fixed (static) target tasks. For all subjects, both 2-DoF controllers with 6 optimally-sited electrodes had statistically better target matching performance than Sequential control in number of matches (average of 4-7 vs. 2 matches, p< 0.001) and throughput (average of 0.75-1.25 vs. 0.4 bits/s, p< 0.001), but not overshoot rate and path efficiency. There were no statistical differences between 6 and 12 optimally-sited electrodes for both 2-DoF controllers. These results support the feasibility of 2-DoF simultaneous, proportional myoelectric control.

13.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 30(2): 361-366, 2022 Apr.
Artículo en Zh | MEDLINE | ID: mdl-35395964

RESUMEN

OBJECTIVE: To analyze and compare the effects of leukapheresis on hemostatic function in patients with hyperleukocytic leukemia. METHODS: A total of 139 patients with AML, ALL and CML who underwent leukapheresis from June 2009 to February 2020 and did coagulation test before and after operation were included in this study. The clearance efficiency of each group and the difference among three groups were evaluated, as well as hemostatic function including platelet counts, coagulation indicators, CDSS score and incidence of adverse events. The difference of hemostatic function caused by leukapheresis in different leukemia patients were compared. RESULTS: After leukapheresis, the WBC counts were decreased significantly in the three groups of patients (P<0.001), and the clearance efficiency was highest in ALL patients. However, the platelet counts also were decreased significantly (AML:P<0.001, ALL: P<0.001, CML: P<0.01) in the three groups of patients, particularly for acute leukemia patients with a positive correlation with WBC clearance efficiency(r=0.284). After leukapheresis, fibrinogen decreased, PT and APTT prolonged. For acute leukemia patients, higher CDSS score was related to an elevated incidence of bleeding events (P<0.05). CONCLUSION: Leukapheresis is an effective method to decrease the leukemic burden, but it is necessary to monitor the impact on hemostatic function. It is recommended to assess the CDSS socre for acute leukemia patients, in order to identify the predictive value for bleedings.


Asunto(s)
Hemostáticos , Leucemia Mieloide Aguda , Enfermedad Aguda , Coagulación Sanguínea , Pruebas de Coagulación Sanguínea , Hemorragia , Humanos , Leucaféresis/métodos , Leucemia Mieloide Aguda/terapia
14.
Front Cell Infect Microbiol ; 12: 865170, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35651756

RESUMEN

Background: Haploidentical donor hematopoietic cell transplantation (haplo-HCT) has become a preferred option for patients without HLA-matched donors, but it increases the risk of viral reactivations. Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are common viruses post-HCT, but limited data have been reported in the setting of haplo-HCT. Methods: We conducted a retrospective study enrolling acute leukemia patients who received haplo-HCT with myeloablative conditioning regimen employing ATG in our center from July 2014 to July 2017. All the patients enrolled were EBV-IgM and EBV-DNA negative but EBV-IgG positive, and so were their donors. The same went for CMV as well. Results: In total, 602 patients were recruited consisting of 331 with acute myeloid leukemia (AML) and 271 with acute lymphoblastic leukemia (ALL). One-year cumulative incidences of EBV (22.9% ± 2.4% vs. 27.4% ± 2.8%, P = 0.169) and CMV (24.7% ± 2.4% vs. 29.4% ± 2.8%, P = 0.190) reactivation were comparable between AML and ALL. EBV and CMV were independent risk factors for each other. In the AML group, male recipients [HR = 1.275, 95% CI (1.001-1.624), P = 0.049] and acute graft-versus-host disease [HR = 1.592, 95% CI (1.001-2.533), P = 0.049] were independent risk factors for EBV reactivation and CMV reactivation, respectively. CMV rather than EBV reactivation was related to a trend of worsened treatment-related mortality (TRM) (15.6% ± 0.1% vs. 10.2% ± 0.0%, P = 0.067) and progression-free survival (PFS) (60.6% ± 4.1% vs. 70.3% ± 2.3%, P = 0.073), while significant impacts were revealed only in the subgroup analysis. CMV reactivation resulted in a remarkable inferior 2-year overall survival (OS) (64.2% ± 5.7% vs. 77.6% ± 3.2%, P = 0.038) and PFS (55.0% ± 5.9% vs. 71.9% ± 3.4%, P = 0.042) in ALL patients. On the other hand, in the EBV+/CMV- subgroup, relapse was lower in ALL patients (8.2% ± 0.2% vs. 32.4% ± 0.8%, P = 0.010) compared with AML patients, which led to a superior 2-year OS (82.0% ± 6.2% vs. 60.3% ± 8.8%, P = 0.016) and PFS (74.5% ± 7.0% vs. 57.5% ± 8.4%, P = 0.036). Conclusion: We concluded that EBV and CMV reactivations were frequent in acute leukemia patients after haplo-HCT, with possibly distinctive risk factors from HLA-matched HCT. There could be a potential interaction between EBV and CMV, but impacts on transplant outcomes remained complex.


Asunto(s)
Infecciones por Citomegalovirus , Infecciones por Virus de Epstein-Barr , Leucemia Mieloide Aguda , Citomegalovirus , Infecciones por Virus de Epstein-Barr/complicaciones , Herpesvirus Humano 4 , Humanos , Leucemia Mieloide Aguda/complicaciones , Leucemia Mieloide Aguda/terapia , Masculino , Estudios Retrospectivos , Activación Viral/fisiología
15.
Leuk Lymphoma ; 63(11): 2636-2644, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-35731036

RESUMEN

Leukapheresis is an effective adjuvant therapy for leukemia patients with hyperleukocytosis, but few studies have reported recent data with modern modalities and comparisons among different leukemia types. We conducted a retrospective study on leukapheresis among 420 patients with AML, ALL and CML in four local centers. WBC counts decreased significantly (p < 0.001) postleukapheresis in all three cohorts. Clearance efficiency was higher in acute leukemia patients than CML patients (p < 0.01). Concomitant leukocytoreduction drugs improved WBC reduction only in AML patients (p < 0.05). Leukocyte, hemoglobin and platelet levels preleukapheresis might affect the clearance efficiency in AML and/or ALL patients. Hematological toxicities were the major concerns, but most of them were mild, and only 11 patients died of all causes within one week postleukapheresis. In conclusion, leukapheresis can safely reduce the leukemic burden, especially for patients with acute leukemias.


Asunto(s)
Leucaféresis , Leucemia Mieloide Aguda , Humanos , Estudios Retrospectivos , Leucocitosis/terapia , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/terapia , Leucemia Mieloide Aguda/complicaciones , Recuento de Leucocitos , Enfermedad Aguda
16.
Artículo en Inglés | MEDLINE | ID: mdl-35349446

RESUMEN

Recent research has advanced two degree-of-freedom (DoF), simultaneous, independent and proportional control of hand-wrist prostheses using surface electromyogram signals from remnant muscles as the control input. We evaluated two such regression-based controllers, along with conventional, sequential two-site control with co-contraction mode switching (SeqCon), in box-block, refined-clothespin and door-knob tasks, on 10 able-bodied and 4 limb-absent subjects. Subjects operated a commercial hand and wrist using a socket bypass harness. One 2-DoF controller (DirCon) related the intuitive hand actions of open-close and pronation-supination to the associated prosthesis hand-wrist actions, respectively. The other (MapCon) mapped myoelectrically more distinct, but less intuitive, actions of wrist flexion-extension and ulnar-radial deviation. Each 2-DoF controller was calibrated from separate 90 s calibration contractions. SeqCon performed better statistically than MapCon in the predominantly 1-DoF box-block task (>20 blocks/minute vs. 8-18 blocks/minute, on average). In this task, SeqCon likely benefited from an ability to easily focus on 1-DoF and not inadvertently trigger co-contraction for mode switching. The remaining two tasks require 2-DoFs, and both 2-DoF controllers each performed better (factor of 2-4) than SeqCon. We also compared the use of 12 vs. 6 optimally-selected EMG electrodes as inputs, finding no statistical difference. Overall, we provide further evidence of the benefits of regression-based EMG prosthesis control of 2-DoFs in the hand-wrist.


Asunto(s)
Miembros Artificiales , Muñeca , Electromiografía , Mano/fisiología , Humanos , Músculo Esquelético/fisiología , Muñeca/fisiología , Articulación de la Muñeca/fisiología
17.
Zhonghua Yi Xue Za Zhi ; 91(40): 2863-7, 2011 Nov 01.
Artículo en Zh | MEDLINE | ID: mdl-22333552

RESUMEN

OBJECTIVE: To explore the actions of keratinocyte growth factor (KGF) in leukemic mice allogeneic umbilical cord blood cell transplantation (UCBT) and elucidate its mechanism. METHODS: Peripheral blood drawn from the litters of C57BL/6 females was used as umbilical cord blood (UCB) graft. BALB/c mice were randomly divided into 7 groups (n = 12 each). The grouping was as follows. Control group 1, inoculated with leukemia. Control group 2, inoculated with leukemia at -4 d and total body irradiation (TBI) treatment. Control group 3, TBI treatment and reconstituted with 2 × 10(6) UCB-TNCs. Control group 4, injected with PBS subcutaneously, TBI treatment and reconstituted with UCB-TNCs with platelet transfusion. Control group 5, inoculated with leukemia, injected with PBS subcutaneously, TBI treatment and reconstituted with UCB-TNCs with platelet transfusion. Experiment group 1, injected with KGF subcutaneously, TBI treatment and reconstituted with UCB-TNCs with platelet transfusion. Experiment group 2, inoculated with leukemia, injected with KGF subcutaneously, TBI treatment and reconstituted with UCB-TNCs with platelet transfusion. The survival status, pathohistological changes, splenic lymphoid cell subsets and thymic output post-UCBT were compared between groups. RESULTS: The survival time of control group 1 was (11.1 ± 1.5) days and all died of leukemia. The survival time of control group 2 was (11.5 ± 2.5) days and all died of aplasia. Five of 12 mice of control group 3 survived for 100 days and 7 mice died of visceral hemorrhage. Four of 12 mice of control group 5 survived for 100 days and 8 mice died of leukemia with a survival rate of 33.3%. Nine of 12 mice of experiment group 2 survived for 100 days and 3 mice died of leukemia with a survival rate of 75.0%. The survival was prolonged in experiment group 2 mice as compared with that of control group 5 mice (χ² = 4.996, P = 0.0254). The splenic T, NK and B cell counts in control group 4 mice at +35 d were (9.32 ± 0.48) × 106, (1.59 ± 0.11) × 106 and (18.74 ± 2.01) × 106 respectively. While in group 6 mice at +35 d were (13.20 ± 1.14) × 106, (1.75 ± 0.12) × 106 and (20.36 ± 0.86) × 106 respectively. The counts of T cell and NK cell of group 6 were higher than those of group 4 (both P < 0.05). The level of signal joint T-Cell receptor excision circles (sjTRECs) in control group 4 mice was (167 ± 17) copies per 105 cells while that of experiment group 1 mice (228 ± 24) copies per 105 cells. They were higher than that of control mice (P = 0.002). CONCLUSION: Hematopoietic stem/precursor cells are abundant in full-term murine fetal peripheral blood. The infusion of KGF reduces the post-UCBT relapse of leukemia through the enhancement of thymic output.


Asunto(s)
Trasplante de Células Madre de Sangre del Cordón Umbilical/métodos , Factor 7 de Crecimiento de Fibroblastos/uso terapéutico , Leucemia/terapia , Animales , Femenino , Factor 7 de Crecimiento de Fibroblastos/administración & dosificación , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Trasplante Homólogo
18.
Biol Blood Marrow Transplant ; 16(5): 647-52, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20025986

RESUMEN

Cytomegalovirus (CMV) can be classified into 4 subgroups based on genotype variation of the glycoprotein B (gB) encoded by UL55 gene. Little is known about the CMV gB genotype distribution and its clinical implication in patients who receive hematopoietic stem cell transplant (HSCT) in China. In this study, which comprises 101 HSCT patients with CMV infection, we have found that 36 patients (35.64%) were infected with CMV genotype gB1, 3 patients (2.97%) with gB2, 39 patients (38.61%) with gB3, 1 patient (0.99%) with gB4, and 17 patients (16.83%) were infected with mixed CMV genotypes. We also found that CMV gB3 was associated with a high risk of CMV pneumonitis; nevertheless, there were no significant differences among patients with gB genotypes with respect to the other CMV diseases; no significant differences between patients with gB genotypes with respect to type II-IV acute graft-verses-host disease (aGVHD) and chronic GVHD (cGVHD) was found either. Interestingly, 5 patients (4.95%) were infected with a CMV variant that lacked a signature RsaI digestion site determined by Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), subsequent cloning and sequencing identified this CMV RsaI minus variant to be novel, herein designated as gB5. Overall, these findings suggest that CMV gB1 and gB3 are prevalent among HSCT recipients with CMV infections, and gB3 CMV infection is a risky indicator for CMV pneumonitis; furthermore, a novel CMV variant in a subset of Chinese HSCT recipients is identified and designated as gB5.


Asunto(s)
Citomegalovirus/genética , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Proteínas del Envoltorio Viral/genética , Adolescente , Adulto , China/epidemiología , Infecciones por Citomegalovirus/etiología , Femenino , Genotipo , Enfermedad Injerto contra Huésped/virología , Neoplasias Hematológicas/complicaciones , Neoplasias Hematológicas/terapia , Humanos , Masculino , Persona de Mediana Edad , Neumonía/virología , Prevalencia , Adulto Joven
19.
Br J Haematol ; 150(5): 543-53, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20629663

RESUMEN

Toll like receptors (TLRs) are the major agents for innate immunity that recognize invading microbial products and regulate the growth of normal and malignant human B lymphocytes. Multiple myeloma (MM) is a clonal plasma cell malignancy, though the regulatory role of TLRs in MM plasma cells has been reported, the molecular mechanism remains unclear. We first compared the transcripts of TLR1 to TLR10 in MM patients and healthy donors and found that TLR2, -4 and -9 transcripts were higher in bone marrow mononuclear cells (BMMCs) from patients than those from donors; in addition the expression of TLR4 and TLR9 were higher in MM cells than normal cells as demonstrated by flow cytometric analyses. The ligands of these two TLRs were capable to promote the growth of MM cells and protect them from serum-deprivation-induced apoptosis but not normal plasma cells, which could be attenuated with anti-IL6 neutralizing antibodies or blockage of NF-kappaB activities. Further investigation demonstrated that these TLR ligands could trigger the nuclear translocation of NF-kappaB p65 and the activated NF-kappaB was sufficient to increase the expression of IL6 transcript in MM cells. These data suggested that activated NF-kappaB signalling probably plays a crucial role for the ligands of TLR4 and TLR9 to promote the growth and survival of MM cells partially through IL6 autocrine.


Asunto(s)
Regulación Neoplásica de la Expresión Génica , Mieloma Múltiple/metabolismo , FN-kappa B/metabolismo , Receptores Toll-Like/biosíntesis , Adulto , Anciano , Células de la Médula Ósea/efectos de los fármacos , Células de la Médula Ósea/metabolismo , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Islas de CpG , Femenino , Humanos , Interleucina-6/biosíntesis , Ligandos , Lipopolisacáridos/farmacología , Masculino , Persona de Mediana Edad , Mieloma Múltiple/inmunología , Mieloma Múltiple/patología , Células Plasmáticas/metabolismo , ARN Mensajero/genética , ARN Neoplásico/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Transducción de Señal/efectos de los fármacos , Receptores Toll-Like/genética , Receptores Toll-Like/fisiología , Células Tumorales Cultivadas , Adulto Joven
20.
J Clin Endocrinol Metab ; 105(12)2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-32946562

RESUMEN

OBJECTIVE: To characterize the inferior adrenal artery (IAA) pulsatility index (PI) in intrauterine growth-restricted (IUGR) fetuses without brain sparing. METHODS: Twenty-three IUGR fetuses with a normal Doppler cerebroplacental ratio (CPR) and 23 normal controls were included in this prospective cross-sectional study. The PI of the IAA was recorded using routine transabdominal Doppler ultrasound. The differences in Doppler characteristics, perinatal outcomes, and steroidogenesis in the umbilical vein at birth (adrenocorticotropic hormone [ACTH] and cortisol [F] levels) were compared between the 2 groups. The correlations between IAA-PI and steroidogenesis were assessed in the IUGR group. RESULTS: IAA-PI was significantly lower in IUGR fetuses than in normal controls (0.85 vs 1.18 at first scan, 0.78 vs 0.92 at last scan; both P < 0.001). The plasma F and ACTH levels in IUGR cases were significantly higher than those of the normal controls (18.2 vs 12.4 µg/dL and 280.5 vs 125.6 pg/mL for F and ACTH, respectively; both P < 0.001). There were negative correlations between IAA-PI and plasma F values and between IAA-PI and ACTH values in the IUGR group (r = -0.774 and -0.82 at first scan, r = -0.525 and -0.45 at last scan, respectively; P < 0.001). CONCLUSION: Increased adrenal gland blood flow with concomitant increases in ACTH and F levels were observed in IUGR fetuses. IAA-PI is useful to assess early blood redistribution and may be beneficial for evaluating the steroidogenic response in high-risk pregnancies.


Asunto(s)
Corticoesteroides/biosíntesis , Glándulas Suprarrenales/irrigación sanguínea , Arterias/fisiología , Retardo del Crecimiento Fetal , Feto/irrigación sanguínea , Venas Umbilicales/metabolismo , Adolescente , Corticoesteroides/sangre , Hormona Adrenocorticotrópica/biosíntesis , Hormona Adrenocorticotrópica/sangre , Adulto , Arterias/diagnóstico por imagen , Circulación Sanguínea/fisiología , Velocidad del Flujo Sanguíneo/fisiología , Estudios de Casos y Controles , China , Estudios Transversales , Femenino , Retardo del Crecimiento Fetal/diagnóstico por imagen , Retardo del Crecimiento Fetal/metabolismo , Retardo del Crecimiento Fetal/fisiopatología , Feto/diagnóstico por imagen , Feto/metabolismo , Indicadores de Salud , Humanos , Hidrocortisona/biosíntesis , Hidrocortisona/sangre , Recién Nacido , Masculino , Embarazo , Flujo Pulsátil , Ultrasonografía Doppler , Ultrasonografía Prenatal , Venas Umbilicales/diagnóstico por imagen , Adulto Joven
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