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Xu C, Qin X, Dai S, Shen Z, Yang Y, Huang Y, Sun S, Zheng S, Wu M, Chen G. Establishment of Biliary Atresia Prognostic Classification System via Survival-Based Forward Clustering - A New Biliary Atresia Classification. Indian J Pediatr 2023:10.1007/s12098-023-04915-z. [PMID: 38047995 DOI: 10.1007/s12098-023-04915-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/05/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVES To develop a machine learning algorithm with prognosis data to identify different clinical phenotypes of biliary atresia (BA) and provide instructions for choosing treatment schemes. METHODS Six hundred thirty-nine cases of type III BA were retrospectively collected from the Children's Hospital of Fudan University from Jan 1st, 2017 to Dec 1st, 2019 as a training dataset, and a survival-based forward clustering method, which can also be used to predict the subtype of a new patient was developed to identify BA subtypes. RESULTS A total of 2 clusters were identified (cluster 1 = 324 and cluster 2 = 315), where cluster 2 had a lower 2 y native liver survival post-Kasai rate. The infant patients in cluster 2 have higher weight, liver, and spleen volume, wider portal vein width, and older operative age; worse coagulation and liver function results; higher grade of liver fibrosis and detection rate of hepatic portal fibrous mass, and higher recent infection detection rate of herpes simplex virus type I. With the proposed prognostic classification system, the authors predicted the subtypes of the 187 cases of type III BA in a testing dataset collected from the whole year of 2020. The p-value computed from the log-rank testing for the Kaplan-Meier survival curves of the predicted two testing groups was 0.0113. CONCLUSIONS This classification system would be a convenient tool to choose appropriate treatment and accelerate the choice-making between clinicians and infant patients.
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Affiliation(s)
- Chen Xu
- Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Xing Qin
- School of Statistics and Information, Shanghai University of International Business and Economics, 1900 Wenxiang Road, Shanghai, 201620, China
| | - Shuyang Dai
- Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Zhen Shen
- Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Yifan Yang
- Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Yanlei Huang
- Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Song Sun
- Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Shan Zheng
- Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China.
| | - Mengyun Wu
- School of Statistics and Management, Shanghai University of Finance and Economics, 777 Guoding Road, Shanghai, 200433, China.
| | - Gong Chen
- Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China.
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Hunt RM, Elzayat MT, Markofski MM, Laughlin M, LaVoy EC. Characterization of transitional memory CD4+ and CD8+ T-cell mobilization during and after an acute bout of exercise. Front Sports Act Living 2023; 5:1120454. [PMID: 37139298 PMCID: PMC10149718 DOI: 10.3389/fspor.2023.1120454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/21/2023] [Indexed: 05/05/2023] Open
Abstract
T-cell subsets, including naïve (NA), central memory (CM), transitional memory (TM), effector memory (EM), and RA + effector memory (EMRA), differ in phenotype and function. T-cells are mobilized by exercise, with differences in the magnitude of mobilization between subsets. However, the response of TM T-cells to exercise has not yet been described. Further, T-cells expressing the late differentiation marker CD57 are known to be highly responsive to exercise, but the relative response of CD57 + and CD57- within T-cell subsets is unknown. We therefore aimed to characterize the exercise-induced mobilization of TM T-cells, as well as to compare the exercise response of CD57 + and CD57- cells within T-cell subsets. Methods Seventeen participants (7 female; aged 18-40 years) cycled 30 min at 80% of their estimated maximum heart rate. Venous blood obtained pre, post, and 1H post-exercise was analyzed by flow cytometry. CD45RA, CCR7, and CD28 expression within CD4 + and CD8+ T-cells identified NA, CM, TM, EM, and EMRA subsets. CD57 expression within EM, EMRA, and CD28+ T-cells was also quantified. The relative mobilization of each subset was compared by calculating fold change in cell concentration during (ingress, post/pre) and after exercise (egress,1H post/post). Cytomegalovirus (CMV) serostatus was determined by ELISA and was considered in models. Results TM CD8+ T-cell concentration was greater post-exercise than pre-exercise (138.59 ± 56.42 cells/µl vs. 98.51 ± 39.68 cells/µl, p < 0.05), and the proportion of CD8 + with a TM phenotype was elevated 1H post-exercise (1H: 32.44 ± 10.38% vs. Pre: 30.15 ± 8.77%, p < 0.05). The relative mobilization during and after exercise of TM T-cells did not differ from NA and CM but was less than EM and EMRA subsets. Similar results were observed within CD4+ T-cells. CD57 + subsets of CD28+ T-cells and of EM and EMRA CD8+ T-cells exhibited a greater relative mobilization than CD57- subsets (all p < 0.05). Conclusion These results indicate TM CD4 + and CD8+ T-cells are transiently mobilized into the blood with exercise, but not to as great of an extent as later differentiated EM and EMRA T-cells. Results also indicate CD57 identifies highly exercise responsive cells within CD8+ T-cell subsets.
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Affiliation(s)
- Rebekah M. Hunt
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, TX, United States
| | - Mahmoud T. Elzayat
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, TX, United States
| | - Melissa M. Markofski
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, TX, United States
| | - Mitzi Laughlin
- Houston Methodist Orthopedics and Sports Medicine, Houston Methodist, Houston, TX, United States
| | - Emily C. LaVoy
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, TX, United States
- Correspondence: Emily C. LaVoy
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Donovan T, Bain AL, Tu W, Pyne DB, Rao S. Influence of Exercise on Exhausted and Senescent T Cells: A Systematic Review. Front Physiol 2021; 12:668327. [PMID: 34489717 PMCID: PMC8417807 DOI: 10.3389/fphys.2021.668327] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/29/2021] [Indexed: 11/17/2022] Open
Abstract
The impaired effector function of exhausted and senescent T cells is implicated in cancer progression and inadequate vaccine responses. Exercise has been shown to improve cancer therapy and vaccine efficacy, most likely by improving immune function. However, given inconsistent terminology and definitions, the interactions between exercise and exhausted and senescent T cells remain unclear. We therefore performed a systematic review to investigate the effect of exercise on senescent and exhausted CD8+ T cell populations clearly defined by protein surface markers. Thirty articles were included, with the majority (n = 24) reporting senescent T cell populations defined according to a variety of surface markers. Repeated exercise was shown to be beneficial through limiting the accumulation of senescent and exhausted CD8+ T cells. This outcome is likely related to exercise-induced preferential mobilization of senescent T cells promoting apoptosis in the peripheral blood compartment. Future studies need to determine the clinical relevance of this effect in cancer prevention and vaccine efficacy. Data regarding exercise and exhausted T cells are limited due to a lack of available high-quality studies. Future studies require the control of confounding variables such as sex and cytomegalovirus (CMV) status, and consistent definitions of exhausted and senescent T cell populations to improve comparisons between studies and interventions.
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Affiliation(s)
- Thomasina Donovan
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.,Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Amanda L Bain
- Gene Regulation and Translational Medicine Laboratory, Immunology Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Wenjuan Tu
- Gene Regulation and Translational Medicine Laboratory, Immunology Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - David B Pyne
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Sudha Rao
- Gene Regulation and Translational Medicine Laboratory, Immunology Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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Cao Dinh H, Bautmans I, Beyer I, Onyema OO, Liberman K, De Dobbeleer L, Renmans W, Vander Meeren S, Jochmans K, Delaere A, Knoop V, Njemini R. Six weeks of strength endurance training decreases circulating senescence-prone T-lymphocytes in cytomegalovirus seropositive but not seronegative older women. IMMUNITY & AGEING 2019; 16:17. [PMID: 31367217 PMCID: PMC6657061 DOI: 10.1186/s12979-019-0157-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 07/12/2019] [Indexed: 12/03/2022]
Abstract
Background Ageing is associated with a decline in immune function termed immunosenescence. This process is characterized amongst others by less naive T-cells and more senescent phenotypes, which have been implicated in the pathogenesis of many age-related diseases. Thus far, reports regarding the long-term adaptation effects of exercise on T-cell phenotypes are scant and largely equivocal. These inconsistencies may be due to potential contributors to immunosenescence, particularly cytomegalovirus infection, which is considered a hallmark of T-cell senescence. Therefore, we sought to investigate the impact of cytomegalovirus serostatus on the distribution of peripheral T-cell subsets following long-term exercise in older women. Methods One hundred women (aged 65 years and above) were randomized to 3 times/weekly training at either intensive strength training (3 × 10 repetitions at 80% of one-repetition maximum, n = 31), strength endurance training (2 × 30 repetitions at 40% of one-repetition maximum, n = 33), or control (passive stretching exercise, n = 36) for 6 weeks. All training sessions were supervised by trained instructors to minimize the risk of injury and to ensure that the participants adhered to the training protocol throughout the entire range of motion. The T-cell percentages and absolute blood counts were determined before and after 6 weeks (24 h–48 h after the last training session) using flow cytometry and a haematology analyser. Cytomegalovirus antibodies were measured in serum using Architect iSystem and cytomegalovirus serostatus was balanced in the three intervention groups. C-reactive protein was measured using immunonephelometry. Results We report for the first time that 6 weeks of strength endurance training significantly decreased senescence-prone T-cells along with a small increase in the number of CD8– naive T-cells in blood. The absolute counts of senescent-like T-cells decreased by 44% (from 26.03 ± 35.27 to 14.66 ± 21.36 cells/μL, p < 0.01) and by 51% (from 6.55 ± 12.37 to 3.18 ± 6.83 cells/μL, p < 0.05) for the CD8+ and CD8– T-cell pools, respectively. Intriguingly, these changes were observed in cytomegalovirus seropositive, but not cytomegalovirus seronegative individuals. Conclusions In conclusion, the present study shows that strength endurance training leads to a reduction in circulating senescence-prone T-cells in cytomegalovirus seropositive older women. It remains to be established if monitoring of peripheral senescence-prone T-cells may have utility as cellular biomarkers of immunosenescence. Electronic supplementary material The online version of this article (10.1186/s12979-019-0157-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hung Cao Dinh
- 1Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.,2Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.,5Department of Internal Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Ivan Bautmans
- 1Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.,2Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.,3Department of Geriatric Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium
| | - Ingo Beyer
- 1Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.,2Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.,3Department of Geriatric Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium
| | - Oscar Okwudiri Onyema
- 1Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.,2Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium
| | - Keliane Liberman
- 1Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.,2Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium
| | - Liza De Dobbeleer
- 1Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.,2Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium
| | - Wim Renmans
- 4Laboratory of Hematology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium
| | - Sam Vander Meeren
- 4Laboratory of Hematology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium
| | - Kristin Jochmans
- 4Laboratory of Hematology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium
| | - Andreas Delaere
- 1Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.,2Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium
| | - Veerle Knoop
- 1Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.,2Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium
| | - Rose Njemini
- 1Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.,2Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium
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A single exercise bout augments adenovirus-specific T-cell mobilization and function. Physiol Behav 2018; 194:56-65. [DOI: 10.1016/j.physbeh.2018.04.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/25/2018] [Accepted: 04/28/2018] [Indexed: 11/19/2022]
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LaVoy EC, Hussain M, Reed J, Kunz H, Pistillo M, Bigley AB, Simpson RJ. T-cell redeployment and intracellular cytokine expression following exercise: effects of exercise intensity and cytomegalovirus infection. Physiol Rep 2017; 5:5/1/e13070. [PMID: 28087817 PMCID: PMC5256156 DOI: 10.14814/phy2.13070] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 11/13/2016] [Indexed: 11/24/2022] Open
Abstract
The magnitude of lymphocytosis following exercise is directly related to exercise intensity. Infection with cytomegalovirus (CMV) also augments lymphocytosis after exercise. It is not known if the enhanced T-cell response to exercise due to CMV depends on exercise intensity. Furthermore, exercise-induced changes in T-cell expression of type I and type II cytokines are thought to be intensity dependent, but direct comparisons are lacking. The aim of this experiment was to determine if CMV affects the exercise-induced redistribution of T-cell subsets at varying intensities, and determine the effect of exercise intensity on CD8+ T-cell cytokine expression. Seventeen cyclists (nine CMV seropositive; CMV+) completed three 30 min cycling trials at -5, +5, and +15% of blood lactate threshold (LT). T-cell subsets in blood and intracellular expression of type I (IL-2, interferon(IFN)-γ) and type II (IL-4, IL-10) cytokines by CD8+ T cells pre, post, and 1-h post-exercise were assessed by flow cytometry. Independently of CMV, T-cell subset redistribution was greater after +15%LT compared to -5%LT (P < 0.05). Independently of intensity, CMV- mobilized more low- (CD27+ CD28+) and medium- (CD27+ CD28-) differentiated T cells than CMV+, whereas CMV+ mobilized more high (CD27- CD28-) differentiated T cells. The numbers of IL-2+, IFN-γ+, IL-4+, and IL-10+ CD8+ T cells increased after exercise above LT Only type I cytokine expression was influenced by exercise intensity (P < 0.05). In conclusion, T-cell redeployment by exercise is directly related to exercise intensity, as are changes in the number of CD8+ T-cells expressing type I cytokines. Although CMV+ mobilized more high-differentiated T cells than CMV-, this occurred at all intensities. Therefore, the augmenting effect of CMV on T-cell mobilization is independent of exercise intensity.
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Affiliation(s)
- Emily C LaVoy
- Department of Health & Human Performance, University of Houston, Houston, Texas
| | - Maryam Hussain
- Department of Arts & Sciences, University of Delaware, Newark, Delaware
| | - Justin Reed
- Department of Health & Human Performance, University of Houston, Houston, Texas
| | - Hawley Kunz
- Department of Health & Human Performance, University of Houston, Houston, Texas
| | - Mira Pistillo
- Department of Health & Human Performance, University of Houston, Houston, Texas
| | - Austin B Bigley
- Department of Health & Human Performance, University of Houston, Houston, Texas
| | - Richard J Simpson
- Department of Health & Human Performance, University of Houston, Houston, Texas
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Simpson RJ, Kunz H, Agha N, Graff R. Exercise and the Regulation of Immune Functions. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2015; 135:355-80. [PMID: 26477922 DOI: 10.1016/bs.pmbts.2015.08.001] [Citation(s) in RCA: 291] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Exercise has a profound effect on the normal functioning of the immune system. It is generally accepted that prolonged periods of intensive exercise training can depress immunity, while regular moderate intensity exercise is beneficial. Single bouts of exercise evoke a striking leukocytosis and a redistribution of effector cells between the blood compartment and the lymphoid and peripheral tissues, a response that is mediated by increased hemodynamics and the release of catecholamines and glucocorticoids following the activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis. Single bouts of prolonged exercise may impair T-cell, NK-cell, and neutrophil function, alter the Type I and Type II cytokine balance, and blunt immune responses to primary and recall antigens in vivo. Elite athletes frequently report symptoms associated with upper respiratory tract infections (URTI) during periods of heavy training and competition that may be due to alterations in mucosal immunity, particularly reductions in secretory immunoglobulin A. In contrast, single bouts of moderate intensity exercise are "immuno-enhancing" and have been used to effectively increase vaccine responses in "at-risk" patients. Improvements in immunity due to regular exercise of moderate intensity may be due to reductions in inflammation, maintenance of thymic mass, alterations in the composition of "older" and "younger" immune cells, enhanced immunosurveillance, and/or the amelioration of psychological stress. Indeed, exercise is a powerful behavioral intervention that has the potential to improve immune and health outcomes in the elderly, the obese, and patients living with cancer and chronic viral infections such as HIV.
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Affiliation(s)
- Richard J Simpson
- Department of Health and Human Performance, Laboratory of Integrated Physiology, University of Houston, Houston, Texas, USA.
| | - Hawley Kunz
- Department of Health and Human Performance, Laboratory of Integrated Physiology, University of Houston, Houston, Texas, USA
| | - Nadia Agha
- Department of Health and Human Performance, Laboratory of Integrated Physiology, University of Houston, Houston, Texas, USA
| | - Rachel Graff
- Department of Health and Human Performance, Laboratory of Integrated Physiology, University of Houston, Houston, Texas, USA
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