[Clinical analysis of 164 cases Coombs test positive autoimmune hemolytic anemia]

OBJECTIVE

To analyze the clinical features and treatment outcomes of autoimmune hemolytic anemia (AIHA).

METHODS

Coombs test positive AIHA patients were retrospectively analyzed.

RESULTS

Patients with AIHA were predominantly female, secondary AIHA accounted for 49% of the total cases, mainly associated with connective tissue diseases. In most cases of AIHA, the anti-red cell antibodies were IgG plus C3, while patients with IgG plus IgM had more severe clinical manifestations. The response rate of adrenocortical hormones and cyclosporin A (CsA) was 90.9%.

CONCLUSION

Adrenocorticosteroids is still the first choice of therapy for AIHA, CsA can improve the response rate.

[Immunophenotyping study on the blood cells of the patients with paroxysmal nocturnal hemoglobinuria]

OBJECTIVE

To detect the expression of glycosyl-phosphatidyl-inositol (GPI) anchored protein on the blood cell membrane and its implication in the diagnosis of paroxysmal nocturnal hemoglobinuria (PNH).

METHODS

The GPI anchored protein was detected by indirect immunofluorescence method with a panel of monoclonal antibodies (CD55, CD59, CD16, CD58, HIR2, CD15, CD2) in 22 PNH patients.

RESULTS

The abnormal granulocytes and erythrocytes with deficient GPI anchored proteins were identified in all PNH patients whether the routine hemolysis tests for PNH, including Ham test and mCLST, were positive or negative. However, lymphocytes with PNH-defect were found in only 14 patients.

CONCLUSION

GPI anchored protein assay provided sensitive and specific method for the diagnosis of PNH.

A rapid method for screening vaccinia virus recombinants

A rapid and small-scale method for screening vaccinia virus recombinants employing micrococcal nuclease is described. This protocol utilizes the differential sensitivity of cellular and viral DNA to the nuclease, which can be selectively activated by addition of Ca2+ and inactivated by elimination of Ca2+. Two to five micrograms of viral DNA can be obtained from one infected L cell plate (50 mm) after overnight incubation.

[The Role of CBS in Injury Time Estimation after Brain Contusion]

OBJECTIVES

To observe the changes of cystathionine β-synthase （CBS） expression in the cerebral cortex after brain contusion at different times.

METHODS

An experimental model of traumatic brain injury （TBI） in mice was established by an improved weight-drop device. Then Western blotting and immunohistochemical examination were used to detect the CBS expression in cerebral cortex around injury at different time points （1 h, 6 h, 12 h, 1 d, 2 d, 3 d, 7 d）.

RESULTS

The results of Western blotting revealed that the expression level of CBS was down-regulated and reached its lowest level at the 3rd days after injury, and then restored to normal level after 7 days. The results of immunohistochemistry showed that CBS was present in the normal brain cortex. CBS expression gradually decreased at the 3rd days after injury, and then restored to normal level after 7 days.

CONCLUSIONS

CBS has the potential to be a reference index for time estimation after brain contusion in forensic practice.

[Effect of concentrated growth factors on the treatment of degree II furcation involvements of mandibular molars]

OBJECTIVE

Concentrated growth factors (CGF), a new generation of platelet concentrate products, appears to have more abundant growth factors because of its special centrifugation process. However, there are few studies supporting this. This study was designed to evaluate the effect of CGFs in the treatment of II° furcations of mandibular molars.

METHODS

In the present study, thirty-one II° furcation involvements in twenty mandiblular molars were included and randomly divided into two groups. The furcation involvements in the experimental group were treated with bone graft therapy combined with CGFs, and the furcation involvements in the control group were treated with bone graft therapy alone. The clinical examination and cone beam computed tomography (CBCT) were performed at baseline and 1 year post-surgery for the two groups. The changes of clinical and CBCT data at baseline and 1 year post-surgery were compared between the experimental group and the control group.

RESULTS

At baseline, there were no significant differences between the two groups in the probing depth (PD), vertical clinical attachment loss (CAL-V) and horizontal clinical attachment loss (CAL-H): PD (7.36±2.32) mm (the experimental group) vs. (7.53±2.06) mm (the control group); CAL-V (8.69±1.65) mm (the experimental group) vs. (8.81±1.53) mm (the control group); CAL-H (5.24±2.01) mm (the experimental group) vs. (5.35±2.14) mm (the control group). At the end of 1 year post-surgery, the clinical parameters of both groups were significantly improved (P<0.001). For the experimental group, the average vertical attachment gain was (2.78±1.66) mm, and the vertical attachment loss was improved significantly compared with the baseline (P<0.001); the average horizontal attachment gain was (2.10±1.89) mm, and the horizontal attachment loss were improved significantly compared with the baseline (P<0.001). Furthermore, the improvement degree of the experimental group was significantly higher than that of the control group (P<0.001). At baseline, there were no statistical differences in the vertical bone loss (BL-V) or horizontal bone loss (BL-H) between the two groups (P>0.05): BL-V (5.08±2.17) mm (the experimental group) vs. (5.84±2.65) mm (the control group); BL-H (5.85±2.13) mm (the experimental group) vs. (6.01±2.27) mm (the control group). At 1 year post-surgery, both groups showed significant radiographic bone gain at vertical and horizontal directions compared with baseline (P<0.001). For the experimental group, the average vertical radiographic bone gain was (2.20±1.98) mm, the horizontal radiographic bone gain was (2.51±2.18) mm, the vertical and horizontal radiographic bone loss were both significantly reduced compared with the baseline (P<0.001). For the control group, the average vertical radiographic bone gain was (1.89±2.15) mm, the horizontal radiographic bone gain was (1.30±2.47) mm, the vertical and horizontal radiographic bone losses were both significantly reduced compared with the baseline (P<0.001). And the experimental group showed significantly higher bone gain at vertical and horizontal directions compared with the control group (P<0.001).

CONCLUSION

Within the limitation of the present study, CGFs showed positive role in the treatment of II° furcation involvements of mandibular molars.

Alveolar epithelial cells shape lipopolysaccharide-induced inflammatory responses and reprogramming of alveolar macrophages

Alveolar macrophages (AMs) are sentinels in the airways, where they sense and respond to invading microbes and other stimuli. Unlike macrophages in other locations, AMs can remain responsive to Gram-negative lipopolysaccharides (LPS) after they have responded to LPS in vivo (they do not develop "endotoxin tolerance"), suggesting that the alveolar microenvironment may influence their responses. Although alveolar epithelial cells (AECs) normally limit AMs' innate responses, preventing inflammation induced by harmless antigens in the lung, how AECs influence the innate responses of AMs to infectious agents has been uncertain. Here we report that (1) after exposure to aspirated (intranasal instillation) LPS, AMs increase their responses to TLR agonists and elevate their phagocytic and bactericidal activities in mice; (2) Aspirated LPS pre-exposure increases host resistance to pulmonary infection caused by Gram-negative bacteria and the protection effect lasts for at least 35 days; (3) LPS stimulation of AECs both increases AMs' innate immune responses and prevents AMs from developing tolerance in vitro; (4) Upon LPS stimulation, AMs secreted TNF-α induces AECs to release GM-CSF, which potentiates AMs' response. These experiments have revealed a previously unappreciated role that AECs may play in boosting the innate responses of AMs and promoting resistance to pulmonary infections.

Identification of splenic IRF7 as a nanotherapy target for tele-conditioning myocardial reperfusion injury

The sequestration of nanoparticles by mononuclear phagocyte system is a challenge for the use of nanotherapy for treating cardiovascular diseases due to the conventionally perceived loss of therapeutic potency. Here, we revitalize cardiovascular nanotherapy by unlocking an alternative route in which nanomedicines are redirected to the spleen, leveraging its potential as a highly efficient and targeted site for remote conditioning, or tele-conditioning myocardial reperfusion injury. The theoretical foundation underpinning is the splenogenic nature of recruited monocytes upon myocardial reperfusion in the acute stage, which is confirmed through murine heterotopic spleen transplantation. Single-cell RNA-seq analysis identifies IRF7 as a pivotal mediator in the spleen-heart communication network that is initially induced in the spleen and orchestrates functional changes in myocardial macrophages. Spleen-related induction of IRF7 is also valid in human myocardial reperfusion scenarios. In addition, in a murine preclinical model of male mice, temporal inhibition of splenic IRF7 through the designed spleen-targeting erythrosome engineered with the targeting peptide RP182, termed as STEER nanoparticles, mitigates the acute-stage innate immune responses and improves the cardiac function in the long term. In contrast, systemic inhibition, genetic knockout of IRF7 or absolute depletion of splenic monocytes does not have therapeutic benefits, indicating the superiority of nanoparticle-based targeted treatment. These findings establish the spleen as a naturally favored site for nanoparticle-based treatments, offering promising avenues for managing myocardial reperfusion injury.

Abstract 4183: MicroRNA-7 targeting PSME3 inhibits the growth of non-small cell lung cancer

MicroRNAs (miRNAs) are a family of small non-coding RNAs that function as important regulators of multiple target genes and participate in diverse biological roles in carcinogenesis..In this study, we found that the expression of miR-7 was downregulated not only in cell lines, but also in human NSCLC tissues compared to the matched adjacent tissues, which exhibited positive correlation with tumor volume.Restoration of its expression through miR-7 mimics in NSCLC cell lines including A549 and H1299 cells inhibited cell proliferation, colony formation, and cell cycle progression in vitro. More importantly, the tumorigenicity in nude mice was reduced after administration of miR-7 in vivo, strongly indicating that miR-7 is a main tumor suppressor miRNA in NSCLC. In advance, through a series of analysis derived from bioinformatics prediction, western blot and luciferase assay, we identified a novel target of miR-7, PSME3 (a proteasome activator) to be enrolled in the regulation with tumor. Expression of PSME3 in NSCLC tumor samples was significantly upregulated compared to adjacent non-tumor tissues, exhibiting a strong inverse relation with that of miR-7. In addition, knockdown of PSME3 gene induced similar effects to overexpression of miR-7 in NSCLC cells. All these findings strongly imply that the overexpression of PSME3 resulted from miR-7 downexpression in NSCLC plays an important role in promoting cancer cell progress, and consequently results in NSCLC growth. Thus, strategies targeting PSME3 and/or miR-7 may be the promising molecular therapy in NSCLC treatment.

Citation Format: Yiwei Chu. MicroRNA-7 targeting PSME3 inhibits the growth of non-small cell lung cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4183. doi:10.1158/1538-7445.AM2013-4183

[Experimental study of dahuang zhechong pills in the treatment of immunological liver fibrosis in rats]

OBJECTIVE

To study the effect of DHZC on liver fibrosis.

METHOD

Immuno-injured fibrosis in rats was induced by bovine serum albumin and DHZC was given during and after the model production respectively. Hepatic collagen contents, pathology of liver and serum hyaluronic acid were measured. Colchicine was used as control.

RESULT

It shows that the liver fibrosis rates of the DHZC treated group during and after the model production were 72.7% and 71.2% respectively, while those of the untreated and colchicine group were 92.3%-100%. Compared with the untreated group, there was a remarkable decrease of hepatic collagen contents in the DHZC-treated rats.

CONCLUSION

DHZC have thus been proved helpful in reversing liver fibrosis to some extent.

[Antilymphocyte globulin combining with cyclosporine A in the treatment of severe aplastic anemia]

OBJECTIVE

To explore more effective regimen for severe aplastic anemia (SAA).

METHODS

A prospective, randomized clinical trial was conducted to determine whether the outcome of SAA patients treated with the combination of antilymphocyte globulin(ALG) and cyclosporine A(CsA) (intensive immunosuppressive therapy, IIST) was better than that with ALG alone (non-intensive immunosuppressive therapy, NIIST).

RESULTS

The response rate of IIST group(83.7%) was significantly higher than that of NIIST group(57.6%), with a lower risk of early mortality and a shorter time to red cell transfusion independence. Furthermore, the recovery of bone marrow BFU-E and CFU-GM of the responding patients was more complete in IIST group than in NIIST group.

CONCLUSIONS

The treatment outcome was better with IIST than with NIIST for SAA.

Knockdown of eIF3a ameliorates cardiac fibrosis by inhibiting the TGF-β1/Smad3 signaling pathway

Cardiac fibroblasts are key effector cells in the pathogenesis of cardiac fibrosis. The eukaryotic translation initiation factor (eIF) 3a is the largest subunit of the eIF3 complex and has been involved in renal fibrosis. However, the precise role of eIF3a in myofibroblast differentiation and cardiac fibrosis remains unknown. Accordingly, in our present study, we tested the expression of eIF3a in transforming growth factor β1 (TGF-β1)-induced rat CFs and found that eIF3a was upregulated in TGF-β1-induced rat CFs. Then the role and mechanism of eIF3a in cardiac fibrosis were explored. Our results found that the eIF3a expression was significantly up-regulated in TGF-β1-induced CFs. Knockdown of eIF3a significantly inhibited TGF-β1-induced CF proliferation, as well as suppressed the expression levels of α-smooth muscle actin (α-SMA) and SM22α. Mechanistically, knockdown of eIF3a attenuated TGF-β1-induced Smad3 activation in CFs. In summary, our present study firstly demonstrated that silencing eIF3a might alleviate TGF-β1-induced cardiac fibrogenesis in CFs by inhibiting Smad3 activation, and suggest that eIF3a may be positioned as a new and promising target for the prevention and treatment of cardiac fibrosis.

MiRNA s in oesophageal squamous cancer

Oesophageal cancer is a common cancer worldwide with a very poor prognosis. Oesophageal squamous cell carcinoma (OSCC) is the major subtype of oesophageal cancer but also one of the least studied cancers worldwide. Although the molecular genetics of OSCC have been widely studied, the molecular mechanism of OSCC carcinogenesis is not completely understood. MicroRNA (miRNA) is now essential to understanding the molecular mechanism of cancer progression. Recent findings include the following: 1) recent findings regarding the functions of miRNA; 2) some of the latest findings on expression profile of miRNA involved in OSCC; 3) miRNAs and their target genes and molecular mechanisms in OSCC; and 4) the therapeutic-clinical potential of miRNAs in OSCC. We can make full use of this knowledge to guide us to evaluate and improve the patient's condition and choose the most fitting medical treatment or explore new approaches to improve the survival ratio of OSCC patients.

Genomic profiling and associated B cell lineages delineate the efficacy of neoadjuvant anti-PD-1-based therapy in oesophageal squamous cell carcinoma

BACKGROUND

Neoadjuvant chemoimmunotherapy has offered novel therapeutic options for patients with locally advanced oesophageal squamous cell carcinoma (ESCC). Depicting the landscape of genomic and immune profiles is critical in predicting therapeutic responses.

METHODS

We integrated whole-exome sequencing, single-cell RNA sequencing, and immunofluorescence data of ESCC samples from 24 patients who received neoadjuvant treatment with PD-1 inhibitors plus paclitaxel and platinum-based chemotherapy to identify correlations with therapeutic responses.

FINDINGS

An elevation of small insertions and deletions was observed in responders. DNA mismatch repair (MMR) pathway alternations were highly frequent in patients with optimal responses and correlated with tumour infiltrating lymphocytes (TILs). Among the TILs in ESCC, dichotomous developing trajectories of B cells were identified, with one lineage differentiating towards LMO2+ germinal centre B cells and another lineage differentiating towards CD55+ memory B cells. While LMO2+ germinal centre B cells were enriched in responding tumours, CD55+ memory B cells were found to correlate with inferior responses to combination therapy, exhibiting immune-regulating features and impeding the cytotoxicity of CD8+ T cells. The comprehensive evaluation of transcriptomic B cell lineage features was validated to predict responses to immunotherapy in patients with cancer.

INTERPRETATION

This comprehensive evaluation of tumour MMR pathway alternations and intra-tumoural B cell features will help to improve the selection and management of patients with ESCC to receive neoadjuvant chemoimmunotherapy.

FUNDING

National Science Foundation of China (82373371, 82330053), Eastern Scholar Program at Shanghai Institutions of Higher Learning, National Science and Technology Major Project of China (2023YFA1800204, 2020YFC2008402), and Science and Technology Commission of Shanghai Municipality (22ZR1410700, 20ZR1410800).

[Immunorelated pancytopenia]

OBJECTIVE

A report of a group of patients with pancytopenia which might be related to abnormal immunity.

METHODS

The clinical and laboratory features of 29 patients with positive bone marrow mononuclear cell (BMMNC) Coombs tests were analyzed.

RESULTS

Most of these cases were pancytopenia with normal or decreased bone marrow cellularities and increased normoblasts. They were all found to have negative results of conventional hemolysis tests and hematopoietic nutrient determination and had no evidence of malignant clonal hematopoiesis. However, all of them showed positive BMMNC-Coombs test and good response to corticosteroids.

CONCLUSION

Immunorelated pancytopenia might be caused by abnormal immunity (especially autoantibody) mediated destruction or abnormal function of blood cells. It is beneficial to differentiate immunorelated pancytopenia from aplastic anemia or myelodysplastic syndromes.

[Effects of AT-I on murine cytokins productions and NK cell activity in vivo]

Antitumor-I (AT-I) is a traditional Chinese medicine, which known to be combined with chemotherapeutic agent on antitumor effects. In this paper, the effections of AT-I on interleukin-2 (IL-2) and interleukin-6 (IL-6) was detected and NK cell activity were observed in normal and tumor-bearing BALB/c mice in vivo. The results showed that AT-I could enhance IL-2 and IL-6 production in normal mice, and IL-2 product in tumor-bearing mice. The results suggest that AT-I at a appropriate dose could modulate immunofunctions, so known as a biological response modifier (BRM).

[Colony formation of bone marrow hematopoietic progenitor cells in patients with severe aplastic anemia and its relation to the results of immunosuppressive therapy]

OBJECTIVE

To explore the defect of hematopoietic stem cell and analyze the relationship between the colony formation capacity of bone marrow hematopoietic progenitor cells and the results of immunosuppressive therapy (IST) in severe aplastic anemia (SAA) patients.

METHODS

Methylcellulose semisolid culture was used.

RESULTS

Thirty patients with SAA at diagnosis were studied. In 90% of the patients, the CFU-E and CFU-GM yields were strikingly decreased and in 56.7% of the patients there was no colony formation at all. Nevertheless, there was still 10% of the patients having normal CFU-E, BFU-E or/ and CFU-GM yields. After IST, 59.1% of the patients showed colony formation improvement. The difference between the results obtained pre- and post-IST(for CFU-E and BFU-E, P < 0.01, for CFU-GM, P < 0.05) was significant. In the majority of the patients, the colony formation capacities were still under the normal post-IST. Moreover, 22.7% of the patients remained no colony formation post-IST. The IST response rates between the patients with or without colony formation had no statistically difference (80% versus 50%, P < 0.05). The increment of colony formation appeared later than the therapeutic effect did, but frequently concurred with the appearance of magkaryocytes in the bone marrow smear.

CONCLUSION

In the majority of SAA patients, the hematopoietic stem cells or progenitors were defective perhaps caused by immune damage; IST can improve the hematopoiesis in vitro and in vivo of SAA patients.

Classical Monocytes Shuttling for Precise Delivery of Nanotherapeutics to Glioblastoma

Glioblastoma (GBM) is the most aggressive brain tumor for which current therapies have limited efficacy. Immunosuppression and difficulties in accessing tumors with therapeutic agents are major obstacles for GBM treatments. Classical monocytes (CMs) possess the strongest infiltration among myeloid cells recruited into tumors during tumorigenesis. In this study, CMs are utilized to deliver the small-molecule CUDC-907 encapsulated in nanoparticles (907-NPs@CMs) for GBM therapy. Hitchhiking on CMs enables more 907-NPs to successfully penetrate the blood-brain barrier (BBB) and reach the interior of tumors. Results demonstrate that 907-NPs@CMs significantly improve the survival rates by suppressing tumor growth and reversing the immunosuppression of tumor microenvironment (TME). Furthermore, the high delivery efficiency of CMs reduces the amount of CUDC-907 required for treatments, reducing the physiological toxicity and off-target effects caused by high doses. 907-NPs@CMs is a safe and versatile therapeutic system that provides a platform for targeted drug delivery to tumors and the ability to treat GBM through a combination of chemotherapy and immunotherapy.

Tumour-reactive plasma cells in antitumour immunity: current insights and future prospects

Tumour-reactive plasma cells (TRPCs) have been reported to be positively associated with the long-term survival of patients with various cancers. However, unlike tumour-specific antigen (TSA)-induced T cells which have precise effects against tumours, plasma cells require TSA to obtain specific responses. Therefore, the search for a TSA suitable for B-cell recognition is urgent. In this review, we discuss the functions of tumour-reactive plasma cells. Further, this review also explores the concept of screening for neoantigen-reactive plasma cells, drawing inspiration from T-cell screening methods. While challenges exist, such as epitope prediction and efficient screening, the development of novel techniques may lead to the discovery of highly specific plasma cells for adoptive cell therapy. In conclusion, tumour-reactive plasma cells are emerging as powerful players in cancer immunotherapy. Their ability to produce antibodies against a variety of antigens, especially neoantigens, opens new avenues for personalised treatments. Overcoming challenges in epitope prediction and screening will be crucial in harnessing the full potential of these plasma cells for the benefit of cancer patients.