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Zhou J, Pan H, Zhang J, Luo L, Cao Y, Wang L, Cheng Z, Zhang G. Identification of predictive markers of Pneumocystis jirovecii pneumonia in kidney transplant recipients. Transpl Immunol 2024; 85:102074. [PMID: 38945175 DOI: 10.1016/j.trim.2024.102074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 06/15/2024] [Accepted: 06/23/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Kidney transplantation has emerged as the most effective treatment for patients with uremia. Advances in immunosuppressant medications have significantly reduced the risk of rejection. However, a notable increase in opportunistic infections, such as Pneumocystis jirovecii pneumonia (PJP), demands special attention in clinical practice. Our study aims to evaluate risk factors and identify predictive markers associated with PJP in kidney transplantation recipients. METHODS We conducted a case-control study (1:2 ratio) involving kidney transplant recipients with and without PJP, matched based on the same surgical date. The study was carried out at Zhongnan Hospital of Wuhan University, China. RESULTS Ninety-three participants were enrolled at Zhongnan Hospital of Wuhan University, comprising 31 with PJP and 62 without PJP. All patients tested negative for HIV. Our findings indicate that PJP patients exhibited lower levels of serum albumin (P = 0.001), reduced counts of total and CD3+ (P < 0.001), CD4+ (P = 0.001), and CD8+ T lymphocytes (P < 0.001), and a lower rate of prophylactic trimethoprim-sulfamethoxazole (TMP-SMZ) usage compared to non-PJP patients (P = 0.02). Conversely, urea levels in PJP patients were significantly higher than in non-PJP controls (P < 0.001). We developed a model combining CD8+ T cell count (< 241.11/μL, P < 0.001) and ALB levels (< 35.2 g/L, P = 0.003), which demonstrated excellent discriminatory power in distinguishing PJP from non-PJP cases, with an area under the curve (AUC) of 0. 920 (95% CI, 0.856-0.989). CONCLUSIONS Our study suggests that a baseline CD8+ T cell count (< 241.11/μL) and serum ALB levels (< 35.2 g/L) offer robust predictive value for the occurrence of PJP infections in kidney transplant recipients.
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Affiliation(s)
- Jingrun Zhou
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Huaqin Pan
- Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplantation Intensive Care Unit, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan 430071, China; Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan 430071, China
| | - Jiarui Zhang
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Linjie Luo
- Department of Experimental Radiation Oncology & Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston 77030, USA
| | - Yumeng Cao
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Ling Wang
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Zhenshun Cheng
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan 430071, China.; Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment, Wuhan 430071, China..
| | - Guqin Zhang
- Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
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Zhao Z, Yan M, Pang H, Chen L, Tang X, Chen Z, Chen X, Sun H. Significance of Nutritional-Inflammatory Index as Predictors for Total Neoadjuvant Therapy-Induced Tumor Regression in Locally Advanced Rectal Cancer Patients. J Inflamm Res 2024; 17:3865-3878. [PMID: 38895140 PMCID: PMC11185252 DOI: 10.2147/jir.s462985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/08/2024] [Indexed: 06/21/2024] Open
Abstract
Purpose To evaluate the predictive capacity of the nutritional-inflammatory index and clinicopathological characteristics in patients with locally advanced rectal cancer (LARC) receiving total neoadjuvant therapy (TNT). Methods Data from 127 patients with LARC receiving TNT from January 2017 to January 2021 were retrospectively analyzed. Clinicopathological characteristics with different TNT-induced responses were compared. The Chi-square test and the Mann-Whitney test were used to analyze the association between pre-TNT factors and TNT-induced responses. Multivariable logistic regression analysis was used to construct a predictive model. Results In the cohort of 127 patients with LARC who underwent total neoadjuvant therapy (TNT), the mean age was 54.1 ± 11.4 years; 88 (69.3%) were male. Seventy patients (55.1%) exhibited a favorable response to TNT, while 57 patients (44.9%) demonstrated a poor response. Tumor characteristics, including diameter, distance from the anal verge, pre-TNT lymphocyte, pre-TNT hemoglobin, CA199, PLR, and HALP, exhibit correlations with TNT-induced tumor regression. Multivariate logistic regression analysis identified large tumor diameters (> 5.0 cm; p = 0.005, HR 2.958; 95% CI 1.382-6.335) and low HALP (≤ 40; p = 0.002, HR 0.261; 95% CI 0.111-0.612) as predictors of TNT-induced poor responses. Additionally, low levels of HALP were associated with an increased risk of recurrence in patients with LARC with TNT, but this was not statistically significant (p = 0.087, HR 2.008, 95% CI 0.906-4.447). Conclusion A large tumor diameter and low HALP predict poor tumor regression induced by the CAPOX-based TNT regimen in patients with LARC.
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Affiliation(s)
- Zhou Zhao
- Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China
| | - Menghua Yan
- Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China
| | - Huayang Pang
- Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China
| | - Lihui Chen
- Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China
| | - Xi Tang
- Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China
| | - Zhixiong Chen
- Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China
| | - Xiufeng Chen
- Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China
| | - Hao Sun
- Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China
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Jo JH, Jalil GN, Kim WS, Moon JO, Lee SD, Kwon CH, Lee HG. Effects of Rumen-Protected L-Tryptophan Supplementation on Productivity, Physiological Indicators, Blood Profiles, and Heat Shock Protein Gene Expression in Lactating Holstein Cows under Heat Stress Conditions. Int J Mol Sci 2024; 25:1217. [PMID: 38279240 PMCID: PMC10816680 DOI: 10.3390/ijms25021217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/28/2024] Open
Abstract
In this study, we examined the effects of rumen-protected L-tryptophan supplementation on the productivity and physiological metabolic indicators in lactating Holstein cows under heat stress conditions. The study involved eight early lactating Holstein cows (days in milk = 40 ± 9 days; milk yield 30 ± 1.5 kg/day; parity 1.09 ± 0.05, p < 0.05), four cows per experiment, with environmentally controlled chambers. In each experiment, two distinct heat stress conditions were created: a low-temperature and low-humidity (LTLH) condition at 25 °C with 35-50% humidity and a high-temperature and high-humidity (HTHH) condition at 31 °C with 80-95% humidity. During the adaptation phase, the cows were subjected to LTLH and HTHH conditions for 3 days. This was followed by a 4-day heat stress phase and then by a 7-day phase of heat stress, which were complemented by supplementation with rumen-protected L-tryptophan (ACT). The findings revealed that supplementation with ACT increased dry matter intake as well as milk yield and protein and decreased water intake, heart rate, and rectal temperature in the HTHH group (p < 0.05). For plateletcrit (PCT, p = 0.0600), the eosinophil percentage (EOS, p = 0.0880) showed a tendency to be lower, while the monocyte (MONO) and large unstained cells (LUC) amounts were increased in both groups (p < 0.05). Albumin and glucose levels were lower in the HTHH group (p < 0.05). The gene expressions of heat shock proteins 70 and 90 in the peripheral blood mononuclear cells were higher in the ACT group (HTHH, p < 0.05). These results suggest that ACT supplementation improved productivity, physiological indicators, blood characteristics, and gene expression in the peripheral blood mononuclear cells of early lactating Holstein cows under heat-stress conditions. In particular, ACT supplementation objectively relieved stress in these animals, suggesting that L-tryptophan has potential as a viable solution for combating heat-stress-induced effects on the cattle in dairy farming.
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Affiliation(s)
- Jang-Hoon Jo
- Department of Animal Science and Technology, Sanghuh College of Life Sciences, Konkuk University, Seoul 05029, Republic of Korea; (J.-H.J.); (G.N.J.)
| | - Ghassemi Nejad Jalil
- Department of Animal Science and Technology, Sanghuh College of Life Sciences, Konkuk University, Seoul 05029, Republic of Korea; (J.-H.J.); (G.N.J.)
| | - Won-Seob Kim
- Department of Animal Science, Michigan State University, East Lansing, MI 48824, USA;
| | - Jun-Ok Moon
- Institute of Integrated Technology, CJ CheilJedang, Suwon 16495, Republic of Korea;
| | - Sung-Dae Lee
- Animal Nutrition and Physiology Team, National Institute of Animal Science, Rural Development Administration, Wanju 55365, Republic of Korea;
| | - Chan-Ho Kwon
- Department of Animal Science, Kyungpook National University, Sangju 37224, Republic of Korea;
| | - Hong-Gu Lee
- Department of Animal Science and Technology, Sanghuh College of Life Sciences, Konkuk University, Seoul 05029, Republic of Korea; (J.-H.J.); (G.N.J.)
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Suzuki Y, Naito T, Shibata K, Hosokawa S, Kawakami J. Associations of plasma aprepitant and its N-dealkylated metabolite with cachexia status and clinical responses in head and neck cancer patients. Cancer Chemother Pharmacol 2023; 91:481-490. [PMID: 37140601 DOI: 10.1007/s00280-023-04537-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/23/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE Oral aprepitant has a large interindividual variation in clinical responses in advanced cancer. This study aimed to characterize plasma aprepitant and its N-dealkylated metabolite (ND-AP) based on the cachexia status and clinical responses in head and neck cancer patients. METHODS Fifty-three head and neck cancer patients receiving cisplatin-based chemotherapy with oral aprepitant were enrolled. Plasma concentrations of total and free aprepitant and ND-AP were determined at 24 h after a 3-day aprepitant treatment. The clinical responses to aprepitant and degrees of cachexia status were assessed using a questionnaire and Glasgow Prognostic Score (GPS). RESULTS Serum albumin level was negatively correlated with the plasma concentrations of total and free aprepitant but not ND-AP. The serum albumin level had a negative correlation with the metabolic ratio of aprepitant. The patients with GPS 1 or 2 had higher plasma concentrations of total and free aprepitant than those with GPS 0. No difference was observed in the plasma concentration of ND-AP between the GPS classifications. The plasma interleukin-6 level was higher in patients with GPS 1 or 2 than 0. The absolute plasma concentration of free ND-AP was higher in patients without the delayed nausea, and its concentration to determine the occurrence was 18.9 ng/mL. The occurrence of delayed nausea had no relation with absolute plasma aprepitant. CONCLUSION Cancer patients with a lower serum albumin and progressive cachectic condition had a higher plasma aprepitant level. In contrast, plasma free ND-AP but not aprepitant was related to the antiemetic efficacy of oral aprepitant.
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Affiliation(s)
- Yusuke Suzuki
- Department of Hospital Pharmacy, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Takafumi Naito
- Department of Hospital Pharmacy, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3192, Japan.
- Department of Pharmacy, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
| | - Kaito Shibata
- Department of Hospital Pharmacy, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Seiji Hosokawa
- Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Junichi Kawakami
- Department of Hospital Pharmacy, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3192, Japan
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Kot M, Neglur PK, Pietraszewska A, Buzanska L. Boosting Neurogenesis in the Adult Hippocampus Using Antidepressants and Mesenchymal Stem Cells. Cells 2022; 11:cells11203234. [PMID: 36291101 PMCID: PMC9600461 DOI: 10.3390/cells11203234] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/06/2022] [Accepted: 10/12/2022] [Indexed: 11/16/2022] Open
Abstract
The hippocampus is one of the few privileged regions (neural stem cell niche) of the brain, where neural stem cells differentiate into new neurons throughout adulthood. However, dysregulation of hippocampal neurogenesis with aging, injury, depression and neurodegenerative disease leads to debilitating cognitive impacts. These debilitating symptoms deteriorate the quality of life in the afflicted individuals. Impaired hippocampal neurogenesis is especially difficult to rescue with increasing age and neurodegeneration. However, the potential to boost endogenous Wnt signaling by influencing pathway modulators such as receptors, agonists, and antagonists through drug and cell therapy-based interventions offers hope. Restoration and augmentation of hampered Wnt signaling to facilitate increased hippocampal neurogenesis would serve as an endogenous repair mechanism and contribute to hippocampal structural and functional plasticity. This review focuses on the possible interaction between neurogenesis and Wnt signaling under the control of antidepressants and mesenchymal stem cells (MSCs) to overcome debilitating symptoms caused by age, diseases, or environmental factors such as stress. It will also address some current limitations hindering the direct extrapolation of research from animal models to human application, and the technical challenges associated with the MSCs and their cellular products as potential therapeutic solutions.
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Affiliation(s)
- Marta Kot
- Correspondence: ; Tel.: +48-22-60-86-563
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