[Resistance mutation patterns of hepatitis B virus in patients with suboptimal response to adefovir dipivoxil therapy after lamivudine resistance]

OBJECTIVE

To investigate the resistance mutation patterns of hepatitis B virus(HBV) during adefovir dipivoxil (ADV) monotherapy or combination therapy after lamivudine(LAM) resistance.

METHODS

Serum samples from fifteen patients with suboptimal viral response to ADV therapy after LAM resistance were collected. The RT region of HBV P gene was PCR-applied, cloned and sequenced, and the mutation patterns in relation to resistance were analyzed.

RESULTS

The ADV resistance mutation patterns of A181T+N236T, A181V, A181T were selected in ADV monotherapy group. The LAM resistance mutation patterns of M204V+L180M, M204V+L180M+L229V, M204I+L80I, M204V+L180M+V207I were detected in the combination therapy group. 20% of clones from three serum samples were detected double resistance to LAM and entecavir (ETV) in the combination therapy group, the resistance patterns were M204I+L80I+T184I (2/10), M204V+L180M+T184S (2/10), and M204V+L180M+G173L+S202G (2/10) respectively. I269L clones were detected in two serum samples from both two groups and P109S clones also detected in the one from monotherapy group.

CONCLUSIONS

In the patients with suboptimal viral response to ADV therapy after LAM resistance, the ADV resistance mutation patterns of A181T+N236T, A181V and A181T could easily be selected during ADV monotherapy; while in the patients with combination therapy, the LAM resistance mutation patterns of M204V+L180M, M204V+L180M+L229V, M204I+L80I, and M204V+L180M+V207I were predominant, the ETV resistance mutation T184I/S and S202G could be selected. The mutation patterns of I269L and P109S may impact the responses to ADV therapy in some patients.

[Induction of dendritic cells from intra-operative lost blood and their effects on CIK against liver cancer cells in vitro]

OBJECTIVE

To investigate the practical possibility of inducing dendritic cells (DCs) from mononuclear cells in the lost blood during operation of hepatocellular carcinoma (HCC) patients, and attempted to find a new source of precursor cells for the personalized immunotherapy based on DCs.

METHODS

Collected lost blood during hepatectomy from 9 HCC patients and human cord blood from 8 cases of healthy donors undergoing caesarean section. Their mononuclear cells were divided into monocytes and nonadherent lymphocytes. RhGM-CSF and rhIL-4 were administered to induce the monocytes differentiation into DCs, and then loaded with different antigens (lysate antigen of autologous liver cancer cells and cell line SMMC-7721 cells). The lymphocytes were induced into cytokine-induced killer cells (CIK) with IL-2, CD3-Ab, gamma-IFN and PHA. MTT assay was performed to detect the proliferation rate of T lymphocytes mediated by DC and the cytotoxicity of CIK to liver cancer cells.

RESULTS

DCs induced from monocytes of the intra-operative lost blood possessed typical morphology and phenotypes. Compared with the DCs from cord blood, the DCs from intra-operative lost blood expressed lower level of surface markers, but both could effectively induce proliferation of CIK and enhance the cytotoxicity of activated CIK against liver cancer cells at similar levels. When the DCs from lost blood and their counterpart from cord blood were both loaded with autologous tumor cell antigen, the proliferation rates of CIK were (388.9 +/- 137.3)% and (315.1 +/- 44.5)%, respectively, and the killing rates against tumor cells were (87.1 +/- 8.0)% and (90.0 +/- 5.1)%, respectively. When the two similar DC groups were loaded with lysate antigen of SMMC-7721 cells, the proliferation rates of CIK were (239.9 +/- 48.7)% and (226.3 +/- 32.3)%, respectively, and the killing rates against tumor cells were (76.4 +/- 7.9)% and (81.1 +/- 4.3)%, respectively. There were no significant differences between those two DC groups. The data also showed that the proliferation and cytotoxicity of CIK induced by DCs loaded with autologous antigen were higher than that of DCs loaded with SMMC-7721 antigen.

CONCLUSION

Mononuclear cells separated from intra-operative lost blood of HCC patients can be induced into mature DCs, which can effectively activate CIK and significantly increase its killing effect on the liver cancer cells, and may become a new source of DCs to study and develop vaccines for clinical application.

Combining local regional therapy and systemic therapy: Expected changes in the treatment landscape of recurrent hepatocellular carcinoma

Improvements in early screening, new diagnostic techniques, and surgical treatment have led to continuous downward trends in hepatocellular carcinoma (HCC) morbidity and mortality rates. However, high recurrence and refractory cancer after hepatectomy remain important factors affecting the long-term prognosis of HCC. The clinical characteristics and prognosis of recurrent HCC are heterogeneous, and guidelines on treatment strategies for recurrent HCC are lacking. Therapies such as surgical resection, radiofrequency ablation, and transhepatic arterial chemoembolization are effective for tumors confined to the liver, and targeted therapy is a very important treatment for unresectable recurrent HCC with systemic metastasis. With the deepening of the understanding of the immune microenvironment of HCC, blocking immune checkpoints to enhance the antitumor immune response has become a new direction for the treatment of HCC. In addition, improvements in the tumor immune microenvironment caused by local treatment may provide an opportunity to improve the therapeutic effect of HCC treatment. Ongoing and future clinical trial data of combined therapy may develop the new treatment scheme for recurrent HCC. This paper reviews the pattern of recurrent HCC and the characteristics of the immune microenvironment, demonstrates the basis for combining local treatment and systemic treatment, and reports current evidence to better understand current progress and future approaches in the treatment of recurrent HCC.

Influencing factors and predictive model of postoperative infection in patients with primary hepatic carcinoma

BACKGROUND

The purpose of this study was to explore the risk factors for postoperative infection in patients with primary hepatic carcinoma (PHC), build a nomogram prediction model, and verify the model to provide a better reference for disease prevention, diagnosis and treatment.

METHODS

This single-center study included 555 patients who underwent hepatobiliary surgery in the Department of Hepatobiliary Surgery of Tianjin Third Central Hospital from January 2014 to December 2021, and 32 clinical indicators were selected for statistical analysis. In this study, Lasso logistic regression was used to determine the risk factors for infection after liver cancer resection, establish a predictive model, and construct a visual nomogram. The consistency index (C-index), calibration curve, and receiver operating characteristic (ROC) curve were used for internal validation, and decision curve analysis (DCA) was used to analyze the clinical applicability of the predictive model. The bootstrap method was used for intramodel validation, and the C-index was calculated to assess the model discrimination.

RESULTS

Among the 555 patients, 279 patients met the inclusion criteria, of whom 48 had a postoperative infection, with an incidence rate of 17.2%. Body mass index (BMI) (P = 0.022), alpha-fetoprotein (P = 0.023), total bilirubin (P = 0.016), intraoperative blood loss (P < 0.001), and bile leakage (P < 0.001) were independent risk factors for infection after liver cancer surgery. The nomogram was constructed and verified to have good discriminative and predictive ability. DCA showed that the model had good clinical applicability. The C-index value verified internally by the bootstrap method results was 0.818.

CONCLUSION

Postoperative infection in patients undergoing hepatectomy may be related to risk factors such as BMI, preoperative AFP level, TBIL level, intraoperative blood loss and bile leakage. The prediction model of the postoperative infection nomogram established in this study can better predict and estimate the risk of postoperative infection in patients undergoing hepatectomy.

[Construction of anti-lung tumor gene differentially expressed bank of wild mouse]

OBJECTIVE

To construct the anti-lung tumor gene differentially expressed bank of wild mouse and to explore the mechanisms of the TW wild mouse suppressing the occurring of lung tumor.

METHODS

Using suppression subtractive hybridization (SSH) technique, the differentially expressed genes between TAF1 mouse and A/wy mouse were selected out and the subtracted cDNA bank was constructed. 166 clones were performed DNA sequencing and then were assayed by blast programme.

RESULTS

Among the blast results of 166 differentially expressed clones, 87 known genes (mRNA or cDNA) were in homology with 134 clones and were divided into 7 classifications according to the biological role.14 DNA fragments were in homology with 32 clones, in which 20 clones were in homology with 9 mouse DNA sequences, 2 clones were in homology with one bacterial gene sequences and 3 clones were clone vector.

CONCLUSION

With SSH technique, the anti-lung tumor gene differentially expressed bank of wild mouse are successfully constructed.

Hv1-deficiency protects β cells from glucotoxicity through regulation of NOX4 level

High glucose (HG)-induced oxidative stress contributes to the dysfunction of pancreatic β cells in diabetes. The voltage-gated proton channel Hv1 has been proposed to support reactive oxygen species (ROS) production during respiratory bursts. However, the effect of Hv1 on glucotoxicity in pancreatic β cells is not clear yet. In this study, we examined the protective effects of Hv1-deficiency in HG cultured β cells. Following 48 h of treatment with 30 mM high glucose, Hv1 KO β cells showed higher cell viability, lower cell apoptosis and a more stable insulin gene expression level compared to WT β cells. In both control and HG cultured β cells, deficiency of Hv1 decreased the glucose- and PMA-induced ROS production. Finally, HG incubation led to NOX4 upregulation in WT β cells, which could be inhibited by HV1 deficiency. In conclusion, Hv1-deficiency prevents the HG treatment-induced NOX4 upregulation and protects β cells from glucotoxicity.

The expression of serum M30 and M65 in chronic hepatitis B patients with non-alcoholic fatty liver disease

OBJECTIVE

Chronic hepatitis B patients with fatty liver disease are gradually increasing. We aim to investigate the serum fragment level of cytokeratin 18 (CK-18), M30 and M65, in chronic hepatitis B (CHB) patients with and non-alcoholic fatty liver disease (NAFLD).

PATIENTS AND METHODS

Serum M30 and M65 levels were measured by ELISA assay in 46 CHB patients with NAFLD and 42 CHB patients without NAFLD. The association of serum M30 levels in 46 CHB patients with NAFLD and biochemistry and pathological indexes were investigated.

RESULTS

The serum M30 levels in CHB with NAFLD group were 614.48 ± 471.43 U/L, which were significantly higher than non NAFLD group (374.50 ± 231.04 U/L, p < 0.01). But there were no differences in serum M65 levels between NAFLD group (369.41 ± 262.21 U/L) and non-NAFLD group (296.50 ± 231.44 U/L, p = 0.172). We observed significantly higher serum M30 levels in CHB with NAFLD patients with positive HBV-DNA (752.36 ± 554.79 U/L) as compared with patients with negative HBV-DNA (400.0 ± 171.64 U/L, p < 0.05). While the M65 levels have no significant difference (p = 0.285). For CHB patient with NAFLD patients, the M30 level was positively correlated with ALT, AST, HBVDNA, TG, FBG, histology inflammation score, fibrosis score and steatosis (p < 0.01).

CONCLUSIONS

Serum M30 levels in CHB with NAFLD patients are significantly higher than CHB patients without NAFLD, especially for HBV-DNA positive patients. It could be a reference value for evaluating the inflammation degree of CHB with NAFLD.

[Using chengqi prescription to prevent hepatic ischemia/reperfusion injury after liver transplantation in rats]

OBJECTIVE

To study the effect of Chengqi prescription in preventing hepatic ischemia/reperfusion injury after liver transplantation in rats.

METHODS

Rat in situ liver transplantation model was used, donor liver was preserved in Ringer's solution for 4 hrs under 4 degrees C, then divided randomly into Chinese medicine group (Chengqi prescription), polymyxin B group, mannitol group, normal saline group and sham operation control group, each group further subdivided into two subgroups: 1 hr group and 4 hrs group after transplantation. The serum ALT and liver injury index was determined.

RESULTS

In preventing hepatic ischemia/reperfusion injury after liver transplantation, the Chengqi prescription was polymyxin B showed more effective than that of mannitol and normal saline, and the effect of Chengqi prescription was higher than that of polymyxin B (P < 0.05).

CONCLUSION

Chengqi prescription was effective in preventing hepatic ischemia/reperfusion injury after liver transplantation in rat.

[Investigation of polyanhydride-glucan as stem cell carriers]

The purpose of this study with regard to the effects of polyanhydride--three-dimensional vector-glucan material on the fetal liver stem cell adhesion and proliferation was to find a new carrier. The methods of two-step collagenase perfusion digestion and liquid Percoll discontinuous density gradient centrifugation were used for the separation of fetal liver stem cells. The fetal liver stem cells were selected and cultivated in the polyanhydride-three-dimensional vector-glucan material. Inverted microscope was used to observe cell adhesion and growth status. Also performed were: Calculation of the rate of cell adhesion; MTT assay of the cells in each group absorbance value (OD value); collecting and counting the cells on the carrier scaffold. Then the cell carriers histological sections (HE staining) were observed. On the 7th day of cell culture, the cells were subjected to immunofluorescence staining and flow cytometry.

RESULTS

polyanhydride-three-dimensional vector-glucan promoted liver stem cells growth and adhesion. There were active functions of the liver stem cells within carrier materials. In the three-dimensional surface and the internal culture of liver stem cell, proliferation was sustained. After 40 days, the polyanhydride co-culture-three-dimensional vector-glucan showed no sign of toxicity to stem cells. Human fetal liver stem cells attached to the polyanhydride--three-dimensional vector-glucan stent. The cell proliferation went on well and exhibited sustained expression of markers; 7 days training led up to an increase of 19.7 percent in the number of cells. Conclusively, polyanhydride-three-dimensional vector-glucan can be used for promoting the proliferation of liver stem cells, and liver stem cells can be used as vectors in liver tissue engineering.

[Identification of the regions of copy number amplification associated with hepatocellular carcinoma]

OBJECTIVE

To screen and determine the regions of copy number variation (CNV) associated with hepatocellular carcinoma (HCC) using SNP array and fluorescence quantitative PCR.

METHODS

The CNV from HCC cell line TJ3ZX-01 was analyzed using GeneChip Human Mapping 500K SNP array. According to the data obtained by SNP array analysis, four candidate amplification regions were verified in 41 primary HCC samples by fluorescence quantitative PCR.

RESULTS

Four regions of copy number amplification at 1q21.2, 1q22 approximately 23.1, 7p22.1 and 22q13.1 were detected by SNP array analysis. The four candidate amplicons occurred in 56.1% (23/41) of HCC samples at 1q21.2; 80.5% (33/41) at 1q22 approximately 23.1; 75.6% (31/41) at 7p22.1 and 31.7% (13/41) at 22q13.1 analyzed with sequence tagged site (STS) markers by quantitative PCR.

CONCLUSION

In four candidate amplification regions selected by SNP array analysis and detected by fluorescence quantitative PCR, three amplification regions show increased copy number in more than 50.0% HCC tissues. This result indicates that these amplification regions are associated with pathogenesis of hepatocellular carcinoma.

Therapeutic Potential of Stem Cell-Derived Extracellular Vesicles in Liver Injury

Liver injury caused by various factors significantly impacts human health. Stem cell transplantation has potential for enhancing liver functionality, but safety concerns such as immune rejection, tumorigenesis, and the formation of emboli in the lungs remain. Recent studies have shown that stem cells primarily exert their effects through the secretion of extracellular vesicles (EVs). EVs have been shown to play crucial roles in reducing inflammation, preventing cell death, and promoting liver cell proliferation. Additionally, they can function as carriers to deliver targeted drugs to the liver, thereby exerting specific physiological effects. EVs possess several advantages, including structural stability, low immunogenicity, minimal tumorigenicity targeting capabilities, and convenient collection. Consequently, EVs have garnered significant attention from researchers and are expected to become alternative therapeutic agents to stem cell therapy. This article provides a comprehensive review of the current research progress in the use of stem cell-derived EVs in the treatment of liver injury.

[Detection of methylation in hepatocellular carcinoma using SYBR Green fluorescent quantitative PCR]

OBJECTIVE

To establish a quantitative technique for assaying gene methylation in hepatocellular carcinoma (HCC) and evaluate its feasibility for clinical application.

METHODS

Following bisulfite modification and PCR amplification, the fragments of CDKN2A and ACTB were cloned into plasmids to generate calibration curves using SYBR Green quantitative PCR, and then these two genes were quantitatively analyzed in 41 cases of HCC specimen.

RESULTS

The amplification curve, dissociation curve, calibration curve and electrophoresis analysis showed that SYBR Green fluorescent quantitative PCR could assay 10(2)-10(8) copies/microL of recombinant plasmids with high specificity, high sensitivity and a wide detection range. The tests on 41 cases of HCC specimens further confirmed its feasibility for quantitative analysis of methylation.

CONCLUSION

SYBR Green fluorescent PCR is an easy, fast and high-throughout quantitative tool, and it can be used for methylation analysis in basic research or clinical assay.

[Expression and clinical significance of surfactant protein D mRNA in peripheral blood of lung cancer patients]

BACKGROUND AND OBJECTIVES

The sensitive detection of circulating tumor cells in lung cancer patients is very important for prognosis and selection of appropriate treatment modalities. Based on recent promising data, the authors established reverse transcriptase (RT)-PCR with primers specific for surfactant protein D (SP-D) gene to detect circulating tumor cells in the peripheral blood of lung cancer patients, and to initiatively discuss its clinical significance.

METHODS

The expression of SP-D mRNA was analyzed by an improved nested RT-PCR in the peripheral blood of 26 lung cancer patients with metastases, 37 lung cancer patients without metastases, 15 benign pneumonia patients, and 15 healthy volunteers.

RESULTS

1) The sensitivity of the method was 1 x 10(-6), with high level of specificity. 2) Using this method, the positive detection rate of the expression of SP-D mRNA was 92.3% (24/26) and 24.3% (9/37) in the peripheral blood of lung cancer patients with and without metastases, respectively. While no sample was positive for SP-D mRNA expression in the benign pneumonia patients and in the healthy volunteers.

CONCLUSIONS

SP-D mRNA might be a valuable marker to detect circulating tumor cells in the peripheral blood of lung cancer patients. This method may be a valuable tool for early identification of metastases in asymptomatic lung cancer patients. Furthermore, it can also provide important clinical information for the evaluation of prognosis and in the selection of appropriate treatment strategies.

Expression of 10 circulating cytokines/chemokines in HBV-related liver disease

BACKGROUND

Cytokines/chemokines play essential roles in the occurrence and progression of hepatitis B virus (HBV) infection. This study aimed to observe the expression patterns of 10 related cytokines/chemokines in the serum of healthy individuals, self-limited patients and HBV-infected patients at different stages of disease (chronic hepatitis B (CHB), liver cirrhosis (LC), hepatocellular dysplastic nodules (DNs) and hepatocellular carcinoma (HCC)) and to analyze the relationships of these cytokines/chemokines with disease progression.

METHODS

The levels of six cytokines (FGF-2, IFN-α2, IL-4, IL-6, IL-10 and VEGF-A) and four chemokines (GRO-α, IL-8, IP-10 and MCP-1) were quantified using Luminex multiplex technology.

RESULTS

There were no significant differences in the expression of the 10 cytokines/chemokines between healthy individuals and self-limited patients. The levels of IL-4, IL-6, and IL-8 increased significantly in the CHB and LC groups. IL-10 was highly expressed in the HCC group. The level of IP-10 was significantly greater in all liver disease groups (CHB, LC, DN and HCC) than in the HI and SL-HBV groups, while the level of GRO was significantly lower in all liver disease groups than in the HI and SL-HBV groups. The levels of the 10 cytokines/chemokines were not significantly different between the preoperative group and the two-day postoperative group. Significant increases in the levels of IL-4, VEGF-A and IL-8 and significant decreases in those of IL-10 and GRO-α were observed 3 months after surgery. Correlation analysis revealed that most of the cytokines/chemokines with significant correlation differences were positively correlated before and after HCC surgery.

CONCLUSION

Our results highlight the fluctuating status of specific cytokines in HBV infection-related disease progression. It is speculated that these cytokines may be used as serum markers to monitor dynamic changes during the progression of HBV-related liver disease and to predict patient prognosis.