The Dynamics of Histone Modifications during Mammalian Zygotic Genome Activation.

Mammalian fertilization initiates the reprogramming of oocytes and sperm, forming a totipotent zygote. During this intricate process, the zygotic genome undergoes a maternal-to-zygotic transition (MZT) and subsequent zygotic genome activation (ZGA), marking the initiation of transcriptional control and gene expression post-fertilization. Histone modifications are pivotal in shaping cellular identity and gene expression in many mammals. Recent advances in chromatin analysis have enabled detailed explorations of histone modifications during ZGA. This review delves into conserved and unique regulatory strategies, providing essential insights into the dynamic changes in histone modifications and their variants during ZGA in mammals. The objective is to explore recent advancements in leading mechanisms related to histone modifications governing this embryonic development phase in depth. These considerations will be useful for informing future therapeutic approaches that target epigenetic regulation in diverse biological contexts. It will also contribute to the extensive areas of evolutionary and developmental biology and possibly lay the foundation for future research and discussion on this seminal topic.

Molecular study of a large cohort of 109 haemophilia patients from Cuba using a gene panel with next generation sequencing-based technology.

INTRODUCTION: In several countries, molecular diagnosis of haemophilia A (HA) and B (HB) is hampered by a lack of resources for DNA analysis. The advent of next-generation sequencing (NGS) has enabled gene analysis at a reasonable cost. AIM: Describe a collaboration between Cuban and Spanish researchers to identify candidate variants and investigate the molecular epidemiology of 106 Cuban haemophilia patients using NGS. PATIENTS/METHODS: The molecular analysis protocol included well-established LR-PCR procedures to detect F8 inversions, NGS with a 30-gene panel to sequence F8 and F9, and multiplex ligation-dependent probe amplification to identify large structural variants. RESULTS: One-hundred and thirty-one candidate variants were identified along F8, F9, and VWF; 72 were unique and 28 (39%) had not been previously recorded. Putative variants were identified in 105/106 patients. Molecular characterization enabled confirmation and reclassification of: 90 HA (85%), 15 HB (14%), and one type 2N VWD (1%). Null variants leading to non-production of FVIII or FIX were common in severe HA (64%), moderate HA (74%), and severe HB (60%), whereas missense variants were frequent in mild HA (57%) and moderate or mild HB (83%). Additional variants in VWF were identified in 16 patients. CONCLUSION: This is the first description of the molecular epidemiology of HA and HB in Cuba. Variants identified in index cases will be of value for local implementation of familial studies and prenatal diagnosis using the molecular approaches available in Cuba. The results of this protocolled genetic study improved the accuracy of the clinical diagnosis and will facilitate management of these patients.

Refractory pemphigus vulgaris and high-intensity extracorporeal photopheresis: A case report.

A 41-year-old man with oral pemphigus vulgaris (PV) presented to our clinic with a history of no response to numerous immunosuppressant agents and was referred for extracorporeal photopheresis (ECP) therapy. Although the patient underwent a high-intensity ECP regimen for five months, which included two different photopheresis systems, his oral dysesthesia continued to interfere with oral intake, leading to continued weight loss and other adverse events. The intervention was associated with changes in several immune cell subpopulations without modifying the anti-epidermal antibody titers, aligned with his poor clinical outcome. To the best of the authors' knowledge, this is the first report to examine immunophenotyping of a PV patient who was refractory to previous immunosuppression and recalcitrant to high-intensity ECP therapy.

Wide Range Applications of Spirulina: From Earth to Space Missions.

Spirulina is the most studied cyanobacterium species for both pharmacological applications and the food industry. The aim of the present review is to summarize the potential benefits of the use of Spirulina for improving healthcare both in space and on Earth. Regarding the first field of application, Spirulina could represent a new technology for the sustainment of long-duration manned missions to planets beyond the Lower Earth Orbit (e.g., Mars); furthermore, it could help astronauts stay healthy while exposed to a variety of stress factors that can have negative consequences even after years. As far as the second field of application, Spirulina could have an active role in various aspects of medicine, such as metabolism, oncology, ophthalmology, central and peripheral nervous systems, and nephrology. The recent findings of the capacity of Spirulina to improve stem cells mobility and to increase immune response have opened new intriguing scenarios in oncological and infectious diseases, respectively.

Application of mass cytometry to characterize hematopoietic stem cells in apheresis products of patients with hematological malignancies.

INTRODUCTION: Hematopoietic stem cell transplantation (HSCT) is a widely used therapy, but its success largely depends on the number and quality of stem cells collected. Current evidence shows the complexity of the hematopoietic system, which implies that, in the quality assurance of the apheresis product, the hematopoietic stem cells are adequately characterized and quantified, in which mass cytometry (MC) can provide its advantages in high-dimensional analysis. OBJECTIVE: This research aimed to characterize and enumerate CD45dim/CD34+ stem cells using the MC in apheresis product yields from patients with chronic lymphoid malignant diseases undergoing autologous transplantation at the Abu Dhabi Stem Cells Center. METHODS: An analytical and cross-sectional study was performed on 31 apheresis products from 15 patients diagnosed with multiple myeloma (n = 9) and non-Hodgkin lymphomas (n = 6) eligible for HSCT. The MC was employed using the MaxPar Kit for stem cell immunophenotyping. The analysis was performed manually in the Kaluza and unsupervised by machine learning in Cytobank Premium. RESULTS: An excellent agreement was found between mass and flow cytometry for the relative and absolute counts of CD45dim/CD34+ cells (Bland-Altman bias: -0.029 and -64, respectively), seven subpopulations were phenotyped and no lineage bias was detected for any of the methods used in the pool of collected cells. A CD34+/CD38+/CD138+ population was seen in the analyses performed on four patients with multiple myeloma. CONCLUSIONS: The MC helps to characterize subpopulations of stem cells in apheresis products. It also allows cell quantification by double platform. Unsupervised analysis allows results completion and validation of the manual strategy. The proposed methodology can be extended to apheresis products for purposes other than HSCT.

Effects of Ramadan Fasting on Extracorporeal Photopheresis Outcomes.

Although there are many studies on the impact of Ramadan fasting on health in the medical literature, the effects have not been explored in Muslim patients undergoing extracorporeal photopheresis (ECP). This report aimed to describe the potential effects of Ramadan fasting on ECP treatment outcomes. Patients undergoing ECP were prospectively evaluated before and during the month of Ramadan 1443 AH (2022 AD) at the Abu Dhabi Stem Cells Center (ADSCC), United Arab Emirates. The following ECP outcomes were assessed: treatment completion, adverse events reported, body mass index (BMI), and laboratory test results, including complete blood count (CBC), C-reactive protein (CRP), and other systemic immune-inflammatory biomarkers (SIIBs). No statistically significant differences were found in most of the variables analyzed in the three patients who underwent ECP before and during the holy month. Two non-fasting patients were not able to complete the Ramadan ECP schedule, and one fasting patient experienced a vascular access event during his first procedure in Ramadan. These findings suggest that fasting during Ramadan could add further risk factors and develop serious complications related to the ECP treatment. Therefore, we suggest that fasting should be avoided during photopheresis treatment, and we provided recommendations to achieve the best possible clinical outcomes.

Viability assessment of human peripheral blood-derived stem cells after three methods of nebulization.

BACKGROUND AND OBJECTIVES: Drug delivery by nebulization has become a crucial strategy for treating different respiratory and lung diseases. Emerging evidence implicates stem cell therapy as a promising tool in treating such conditions, not only by alleviating the related symptoms but by improving the prognosis. However, delivery of human peripheral blood-derived stem cells (hPBSCs) to the respiratory airways remains an innovative approach yet to be realized. This study is an analytic, translational, and in vitro research to assess the viability and morphological changes of identified cell populations in hPBSCs cocktail derived from COVID-19 patients. METHODS AND RESULTS: Peripheral blood (PB) samples were obtained from patients enrolled in the SENTAD-COVID Study (ClinicalTrials.gov Reference: NCT04473170). hPBSCs cocktails (n=15) were provided by the Cells Processing Laboratory of Abu Dhabi Stem Cells Center, and were nebulized by three different methods of nebulization: compressor (jet), ultrasonic, and mesh. Our results reported that nucleated CD45dim cell count was significantly lower after the three nebulization methods, but nucleated CD45- cells show a significant decrease only after mesh nebulization. Mesh-nebulized samples had a significant reduction in viability of both CD45dim and CD45- cells. CONCLUSIONS: This study provides evidence that stem cells derived from PB of COVID-19 patients can be nebulized without substantial loss of cell viability, cell count, and morphological changes using the compressor nebulization. Therefore, we recommend compressor nebulizers as the preferable procedure for hPBSCs delivery to the respiratory airways in further clinical settings.

Safety and efficacy of autologous non-hematopoietic enriched stem cell nebulization in COVID-19 patients: a randomized clinical trial, Abu Dhabi 2020.

BACKGROUND: The novel SARS-CoV-2 has caused the coronavirus disease 2019 (COVID-19) pandemic. Currently, with insufficient worldwide vaccination rates, identifying treatment solutions to reduce the impact of the virus is urgently needed. METHOD: An adaptive, multicentric, open-label, and randomized controlled phase I/II clinical trial entitled the "SENTAD-COVID Study" was conducted by the Abu Dhabi Stem Cells Center under exceptional conditional approval by the Emirates Institutional Review Board (IRB) for COVID-19 Research Committee from April 4th to July 31st, 2020, using an autologous peripheral blood non-hematopoietic enriched stem cell cocktail (PB-NHESC-C) administered by compressor (jet) nebulization as a complement to standard care therapy. The primary endpoints include safety and efficacy assessments, adverse events, the mortality rate within 28 days, and the time to clinical improvement as measured by a 2-point reduction on a seven-category ordinal scale or discharge from the hospital whichever occurred first. RESULTS: The study included a total of 139 randomized COVID-19 patients, with 69 in the experimental group and 70 in the control group (standard care). Overall survival was 94.20% for the cocktail-treated group vs. 90.27% for the control group. Adverse events were reported in 50 (72.46%) patients receiving PB-NHESC-C and 51 (72.85%) in the control group (p = 0.9590), with signs and symptoms commonly found in COVID-19. After the first 9 days of the intervention, 67.3% of cocktail-treated patients recovered and were released from hospitals compared to 53.1% (RR = 0.84; 95% CI, 0.56-1.28) in the control group. Improvement, i.e., at least a 2-point reduction in the severity scale, was more frequently observed in cocktail-treated patients (42.0%) than in controls (17.0%) (RR = 0.69; 95% CI, 0.56-0.88). CONCLUSIONS: Cocktail treatment improved clinical outcomes without increasing adverse events. Thus, the nebulization of PB-NHESC-C was safe and effective for treatment in most of these patients. TRIAL REGISTRATION: ClinicalTrials.gov. NCT04473170. It was retrospectively registered on July 16th, 2020.

Las donaciones de sangre en Cuba desde una perspectiva histórica / Blood donations in Cuba from a historical perspective

Introducción: Las donaciones de sangre constituyen una actividad sanitaria de importancia estratégica, su historia ha evolucionado junto a la del sistema de salud cubano. Objetivo: Describir el comportamiento de las donaciones de sangre desde una perspectiva histórica, según las etapas del desarrollo del sistema sanitario cubano. Métodos: Se realizó una investigación por el método histórico-lógico sobre los antecedentes históricos y la actualidad de las donaciones de sangre. La información se obtuvo mediante la entrevista y las revisiones bibliográfica y documental. Resultados: Durante la seudorepública se fundaron las primeras instituciones de salud para las donaciones y transfusiones de sangre, su administración se fundamentaba en las recolecciones provenientes de los donantes remunerados y familiares. En el período revolucionario se logró un programa de sangre organizado e integrado al sistema de salud, por primera vez unificado y de alcance nacional, con la participación coordinada entre el personal del nivel primario de atención y las organizaciones sociales. Esto permitió el creciente y considerable incremento de la disponibilidad de sangre y el desarrollo de la medicina transfusional, las especialidades médico-quirúrgicas y la industria médico-farmacéutica cubanas. Además, se consolidó la práctica de donar sangre como un acto voluntario. Conclusiones: La donación de sangre en Cuba constituye una actividad trazadora que muestra el desarrollo del sistema sanitario cubano en sus diferentes etapas y es reflejo de la voluntad política del gobierno, el pueblo y sus instituciones(AU)

Introduction: Blood donations are health care activity of a strategic importance. Their history has evolved together with the Cuban health system. Objective: To describe the behaviour of blood donations from a historical perspective according to the development stages of the Cuban health system. Method: It was carried out a research by the logic-historical method on the historical background and the current data on blood donations. The information was collected through interviews and the bibliographic and documentary reviews. Results: During the pseudo-republic times, the first institutions for blood donations and transfusions were created, and their managements was supported with the collections of paid donors and relatives. In the Revolution period, it was achieved an organized blood donation program which was integrated to the health system and for the fist time unified and of national scope, with coordinated participation between the staff of the first level of care and the social organizations. This allowed the significant increase of the availability of blood and the development of the Cuban transfusion medicine, medical-surgical specialties and medical-pharmaceutical industry. In addition, it was strengthen the practice of blood donation as a voluntary act. Conclusions: Blood donation in Cuba is a trace activity that shows the development of the Cuban health system in its different stages and it is a reflection of the political will of the Government, the people and the institutions(AU)

Exosomas: terapia celular regenerativa libre de células / Exosomes: "cell-free" regenerative cell therapy

La terapia celular basada en células mesenquimales/estromales se aplica ampliamente en la medicina moderna, aun cuando no todos los mecanismos de supervivencia y diferenciación están identificados. Sin embargo, hace pocos años se comenzaron a encontrar elementos extracelulares que generan nuevos paradigmas. En el presente trabajo se explican las principales características y funciones atribuidas a los exosomas, nanopartículas constituidas por microvesículas secretadas por las células con efecto en la matriz extracelular, y su repercusión como alternativa hacia una medicina regenerativa libre de células. Estas estructuras participan de forma notoria y crucial en la comunicación intercelular, lo que ha supuesto un cambio en el concepto de las funciones y el papel que desempeñan estas vesículas en los organismos vivos, en particular en la restauración de tejidos dañados y la respuesta inflamatoria e inmunológica. Se comentan algunos ejemplos de la repercusión biotecnológica de los exosomas en empresas y el mercado biofarmaceútico(AU)

Mesenchymal/stromal cell ;based therapy is widely applied in modern medicine, even though not all survival and differentiation mechanisms are identified. However, a few years ago, extracellular elements began to be found that generate new paradigms. The present work explains the main characteristics and functions attributed to exosomes, nanoparticles made up of microvesicles secreted by with an effect on the extracellular matrix, and their impact as an alternative towards cell-free regenerative medicine. These structures participate, notoriously and critically, in intercellular communication, which has led to a change in the concept of the functions and role that these vesicles play within living organisms, particularly in the restoration of damaged tissues and the inflammatory and immunological response. Some examples of the exosomes' biotechnological impact on companies and the biopharmaceutical market are discussed(AU)

Por un programa nacional de colecta y criopreservación de células de sangre de cordón en Cuba / Toward a national program for the collection and criopreservation of cord blood cells in Cuba

Durante los últimos 50 años, el trasplante alogénico de células progenitoras hematopoyéticas (CPH) se convirtió en un tratamiento cada vez más utilizado en la curación de hemopatías malignas y enfermedades no malignas y genéticas, como la drepanocitosis y algunas inmunodeficiencias primarias. Sin embargo, la ausencia de donantes adecuados, por no contar los pacientes con hermanos u otros familiares histocompatibles, ha motivado la búsqueda de fuentes alternativas en donantes no relacionados para garantizar la eficacia y seguridad del trasplante. Una fuente alternativa muy utilizada es la sangre de cordón umbilical (SCU); que ahora se convierte también en una fuente de células para la medicina regenerativa. Los programas de colecta y criopreservación en bancos de SCU (BSCU) se han convertido en una realidad en muchos países dada la importancia de estos tratamientos y debido a sus múltiples ventajas. Sin embargo, estas instalaciones están sujetas a regulaciones nacionales e internacionales, amparadas en estándares y procesos de acreditación. Contar con un programa de colecta y un BSCU público en Cuba es una necesidad para el desarrollo del Sistema Nacional de Salud que resolverá los problemas actuales de carencia de donantes y el intercambio internacional en la lucha por una salud pública mejor(AU)

During the last 50 years, stem cell (SC) allogenic transplant has been an everyday most used form of treatment for the cure of malignant hemopathies and other non-malignant diseases and genetic disorders, such as sickle cell disease and some primary immunodeficiency. Nevertheless, the lack of adequate donors caused by patients without histocompatible brothers or relatives has made it necessary to look for alternatives in non-related donors to guarantee the efficacy and security of transplants. A commonly used source is cord blood (CB); nowadays also known as a source of SC for regenerative medicine. Collection and cryopreservation in CB banks (CBB) have become a reality in many countries due to the importance of these treatments, and to their multiple advantages. Nevertheless, these facilities are subject to national and international regulations, guided by standards and accreditation process. Having a public CBB in Cuba is a need for the development of our National Health System which will allow us to solve the actual donor problem and will allow the international exchange in the struggle for a better public health care(AU)

Cinco décadas de la biología molecular y la citogenética aplicadas a la hematología cubana / Five decades of molecular biology and cytogenetic applied to cuban hematology

La biología molecular (BM) es una ciencia que ha revolucionado el desarrollo científico en los últimos años. En el Instituto de Hematología e Inmunología (IHI) también ha evolucionado progresivamente conforme al avance tecnológico y adecuándose cada vez más al contexto científico internacional. Su historia se remonta al año 1966, con la creación del IHI y posteriormente del laboratorio de BM. En el año 2012, el departamento de BM y el laboratorio de citogenética, pasaron a formar parte de lo que hoy es el Centro de Tecnologías de Avanzada, un área con tecnología de punta que ha permitido actualizar la mayoría de las técnicas moleculares que se empleaban previamente, lo que garantiza mayor rapidez y confiabilidad de los resultados. Se introdujeron y perfeccionaron técnicas como la extracción y cuantificación de ácidos nucleicos, la electroforesis capilar y el FISH (del inglés: Fluorescence In Situ Hybridization) y se adquirieron modernas máquinas termocicladoras para la reacción en cadena de la polimerasa (PCR , siglas en inglés), materiales y reactivos. Con este esfuerzo mancomunado en estos 50 años, se han podido beneficiar hasta la fecha: 5 460 pacientes, estudiados en el laboratorio de BM, donde se determinan actualmente 10 marcadores moleculares, 12 estudios de FISH; además del cariotipo convencional y los estudios de quimerismo. Se ha alcanzado una media anual de 317 pacientes estudiados, en los últimos 5 años. Se cuenta con profesionales de alta calificación, lo que ha posibilitado liderar y colaborar en proyectos de investigación nacionales e internacionales, publicar innumerables artículos científicos, obtener premios relevantes y formar a los residentes de la especialidad de Hematología. Las perspectivas comprenden la incorporación de la PCR en tiempo real y la secuenciación para completar un nivel de diagnóstico a la altura de cualquier prestigioso centro internacional y así poder ofrecer un servicio de calidad a los pacientes(AU)

Molecular biology (MB) is a science that has revolutionized scientific development in recent years. It has also increasing progressively at the Institute of Hematology and Immunology (IHI) as adapting to technological advances and international scientific context. Its history dates back to 1966, with the IHI creation and subsequently the MB laboratory. Since then they have been many achievements in the field of diagnosis and research in Hematology. In 2012, the MB department with the cytogenetic laboratory was part of the Center for Advanced Technologies; an area with modern technology that has allowed change old studies by updated molecular techniques, ensuring greater speed and reliability of results. Techniques such as extraction and quantification of nucleic acids (NA), capillary electrophoresis and the FISH (Fluorescence in Situ Hybridization) were introduced, and modern thermocyclers for polymerase chain reaction (PCR), materials and reagents were acquired too. In these 50 years, 5 460 patients have been benefited to date. We study about 10 molecular markers, 12 FISH study, in addition to conventional karyotyping and chimerism studies in the MB lab at this moment. It has gone an annual average of 317 patients in the last 5 years. We have highly qualified professionals, which has made possible to lead and collaborate on national and international research, publishing numerous scientific articles, obtain relevant prizes of science and technology forum and directly contribute to the residents' formation in Hematology. Our future perspectives include the new technologies incorporation such as real-time PCR and sequencing, to complete a similar diagnostic level to any prestigious international center so we can provide quality service to our patients(AU)

Aislamiento y caracterización de células mesenquimales derivadas de tejido adiposo / Isolation and characterization of mesenchymal cells from adipose tissue

Introducción : Existe un creciente interés científico en el potencial terapéutico de las células madre mesenquimales derivadas de tejido adiposo ( ADSCs, en inglés). Estas células son abundantes en el tejido adiposo, son de fácil obtención y con un alto potencial de diferenciación hacia linajes celulares especializados incluyendo adipocitos, osteocitos, condrocitos, miocitos, cardiomiocitos, tenocitos, vasos sanguíneos y neuronas. Este trabajo se desarrolló con el objetivo de implementar en el laboratorio un procedimiento para aislar y cultivar ADSCs, con características que corresponden a las informadas para este linaje celular. Método: los precursores de células adiposas humanas se obtuvieron de tejido subcutáneo abdominal. Las células se separaron enzimáticamente del tejido y se decantaron por centrifugación, luego de cultivadas, se caracterizaron en su capacidad de diferenciación y por su marcadores fenotípicos. Resultados: Las ADSCs aisladas se replicaron en estas condiciones de cultivo y mantuvieron un fenotipo estable durante todo el período de estudio. Se comprobó su potencial adipogénico y osteogénico in vitro, como corresponde a las células madre mesenquimales. El estudio por citometría de flujo mostró que estas células expresan CD73, CD90 y CD105 y son negativas para los marcadores de linaje hematopoyético CD34 y CD45.En los ensayos de inhibición in vitro, las ADSCs demostraron su capacidad para inhibir la proliferación de células T humanas. Conclusiones : La caracterización fenotípica y funcional de las ADSCs obtenidas a partir del tejido adiposo abdominal demuestra que es posible la obtención mediante cultivo in vitro de células mesenquimales humanas sin inducir diferenciación espontánea, manteniendo su integridad funcional y altos niveles de proliferación, lo que sienta las bases para el inicio de ensayos preclínicos y su uso futuro en la terapia celular en nuestro país(AU)

Introduction : There is growing scientific interest in the therapeutic potential of stem cells derived from adipose tissue (ADSCs). These cells are abundant in adipose tissue, are readily available and have a high potential fordifferentiation into specialized cell lineages including adipocytes, osteocytes, chondrocytes, myocytes, cardiomyocytes, tenocyte, endothelial cells and neurons. The aim of this work was to isolate, cultivate andcharacterize ADSCs. Methods : human adipose precursor cells were obtained from abdominal subcutaneous tissue. Cells were enzymatically separated from the tissue and decanted by centrifugation, cultured and finally analyzed. Results : The ADSCs were able to replicate in our culture conditions. The cells maintained their phenotype in different passages throughout the study period, confirming its feasibility for in vitro culture. Also the ADSCs were induced to adipogenic and osteogenic differentiation, verifying its potential as mesenchymal stem cells in vitro. The flow cytometric study showed that these cells expressed CD73, CD90 and CD105 (markers of mesenchymal cells) and they were negative for CD34 and CD45 (hematopoieticcell markers). The ADSCs were able to inhibit in vitro the proliferation of T cells. Conclusions : It is possible to obtain ADSCs by in vitro cultivation without adipogenic induction, maintaining its functional integrity and high proliferation; this cell could be an important tool for the cellular therapy in our country(AU)

Razones para un banco de sangre de cordón umbilical en el Instituto de Hematología e Inmunología de Cuba / Reasons for a cord blood bank at the Institute of Hematology and Immunology, Cuba

Durante los últimos 45 años, el trasplante alogénico de células progenitoras hematopoyéticas ha sido una modalidad de tratamiento cada vez más utilizada en la curación de hemopatías malignas y otras enfermedades genéticas como la drepanocitosis y algunas inmunodeficiencias primarias. Sin embargo, la falta de donantes adecuados, por carecer los pacientes de hermanos que puedan ser histocompatibles, ha hecho necesaria la búsqueda de alternativas en donantes no relacionados para garantizar la eficacia y seguridad del trasplante. Una fuente muy utilizada es la sangre de cordón umbilical (SCU); el primer trasplante con SCU se realizó en 1989 y en los últimos 25 años este tipo de trasplante se ha aplicado ampliamente en los países desarrollados. Los bancos de SCU se han convertido en una reserva de importancia para estos tratamientos y para la terapia celular regenerativa, por sus múltiples ventajas. Contar con un banco público de SCU en Cuba es una necesidad para el desarrollo del Sistema Nacional de Salud que permitiría unir nuestros esfuerzos a la comunidad científica internacional en la lucha por una salud pública mejor para nuestro pueblo y otros pueblos del mundo, en particular para la América Latina

During the last 45 years, alogenic stem cell transplant has been an every day most used form of treatment for the cure of malignant hemopathies and other genetic disorders such as sickle cell disease and some primary immunodeficiencies. Nevertheless, the lack of adequate donors caused by not having the patients possible histocompatible relatives has made it necessary to look for alternatives in non relateddonors to guarantee the efficacy and security of the transplant. A commonly used source is cord blood (CB); the first transplant was made in 1989 and in the last 25 years it has been widely applied in developed countries. CB banks have become an important reserve for these treatments and for regenerative cell therapy, due to their multiple advantages. Having a public CB bank in Cuba is a need for the development of our National Health System which will allow us to join our efforts with the international scientific community in the struggle for a better health care for our people and other countries of the world, particularly Latin America

Una mirada al diagnóstico de laboratorio de las enfermedades autoinmunes / A look to laboratory diagnosis of autoimmune diseases

Las enfermedades autoinmunes (EA) son provocadas por un daño intrínseco del sistema inmunológico como consecuencia de la pérdida de la autotolerancia que condiciona respuestas anormales frente estructuras propias, lo que genera un daño tisular que perdura en el tiempo. Las causas son multifactoriales y la predisposición genética es poligénica, lo que provoca proteínas diferentes en las células inmunológicamente activas o en las orgánicas. Puesto que el espectro de enfermedades es muy amplio, se clasifican en sistémicas cuando los anticuerpos atacan antígenos presentes en más de un órgano o tejido, y en órgano-específicas cuando el daño involucra a un tejido en particular. Para un diagnóstico correcto de laboratorio de las EA, hay que partir de la identificación de los síntomas clínicos del paciente, su asociación con cada enfermedad y su correspondencia con la detección de los autoanticuerpos. Eso hace que los exámenes de laboratorio sean de gran importancia en la evaluación de los pacientes ya que pueden confirmar el diagnóstico, estimar la gravedad de la enfermedad, ayudar a establecer un pronóstico y ser útiles para dar seguimiento a su evolución. Los componentes del estudio en el laboratorio deben incluir un hemograma completo con recuento diferencial de leucocitos, un panel metabólico completo, marcadores inflamatorios, el estudio de los autoanticuerpos por diversos métodos, las nuevas tecnologías Multiplex y la citometría de flujo. En esta mirada al diagnóstico se comentan algunos de los componentes y se abordan elementos de juicio sobre su utilidad clínica

Autoimmune diseases (AD) are caused by an intrinsic damage of the immune system as a consequence of the loss of autotolerance, conditioning abnormal responses against proper structures giving a lasting in time tissue damage. Causes are multifactorial and the genetic predisposition is polygenic, provoking protein differences in immunological active cells or in organic cells. Although, there is a great diseases spectrum, they have been classified in systemic when antibodies attack antigens present in more than one organ or tissue; and organ-specific when the damage is involving a particular tissue. For a proper laboratory diagnosis of AD, identification of patient's symptoms is the starting point, as well as its association with each disease and the correspondence with autoantibody detection. It makes laboratory exams of great importance in the evaluation of patients, as they can be used to confirm the diagnosis, to estimate severity of the disease, and for the follow up of its evolution. Components of the laboratory study should include a complete hemogram with differential cellular count, a complete metabolic panel, inflammatory markers, the study of auto antibodies by several methods, as well as new Multiplex technologies and flow cytometry. In this look to the diagnosis, comments about some components and elements of judge about their clinical usefulness are pointed out