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Vagal Nerve Activity Predicts Prognosis in Diffused Large B-Cell Lymphoma and Multiple Myeloma. J Clin Med 2023; 12:jcm12030908. [PMID: 36769556 PMCID: PMC9917757 DOI: 10.3390/jcm12030908] [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: 12/28/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
This study examined the prognostic role of vagal nerve activity in patients with relapsed/refractory diffused large B-cell lymphoma (R/R-DLBCL) treated with chimeric antigen receptor cell therapy (CAR-T) and in patients with multiple myeloma (MM) undergoing an autologous hematopoietic cell transplantation (AutoHCT). Participants included 29 patients with R/R-DLBCL and 37 patients with MM. Inclusion criteria were: (1) age over 18; (2) diagnosed with DLBCL or MM; (3) being treated with CAR-T or AutoHCT; and (4) having an ECG prior to cell transfusion. The predictor was vagal nerve activity indexed by heart rate variability (HRV) and obtained retroactively from 10 s ECGs. The main endpoint for R/R-DLBCL was overall survival (OS), and for MM the endpoint was progression-free survival (PFS). Data of 122 patients were obtained, 66 of whom were included in the study. In DLBCL, HRV significantly predicted OS independently of confounders (e.g., performance status, disease status at cell therapy), hazard ratio (HR), and 95% confidence interval (HR = 0.20; 95%CI: 0.06-0.69). The prognostic role of disease severity was moderated by HRV: among severely disease patients, 100% died with low HRV, while only 37.5% died with high HRV. In MM, HRV significantly predicted PFS (HR = 0.19; 95%CI: 0.04-0.90) independently of confounders. Vagal nerve activity independently predicts prognosis in patients with R/R-DLBCL and with MM undergoing cell therapy. High vagal activity overrides the prognostic role of disease severity. Testing the effects of vagal nerve activation on prognosis in blood cancers is recommended.
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Ollikainen RK, Kotkaranta PH, Kemppainen J, Teppo HR, Kuitunen H, Pirinen R, Turpeenniemi-Hujanen T, Kuittinen O, Kuusisto MEL. Different chemokine profile between systemic and testicular diffuse large B-cell lymphoma. Leuk Lymphoma 2021; 62:2151-2160. [PMID: 33856274 DOI: 10.1080/10428194.2021.1913150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Although treatment for diffuse large B-cell lymphoma (DLBCL) has taken some notable steps in the 2000s, there are still subgroups of patients suffering from high mortality and relapse rates. To further improve treatment outcomes, it is essential to discover new mechanisms of chemotherapy resistance and create new treatment approaches to overcome them. In the present study, we analyzed the expression of chemokines and their ligands in systemic and testicular DLBCL. From our biopsy sample set of 21 testicular and 28 systemic lymphomas, we were able to demonstrate chemokine profile differences and identify associations with clinical risk factors. High cytoplasmic CXCL13 expression had correlations with better treatment response, lower disease-related mortality, and limited stage. This study suggests that active CXCR5/CXCL13 signaling could overtake the CXCR4/CXCL12 axis, resulting in a better prognosis.
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Affiliation(s)
- Riina K Ollikainen
- Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Department of Oncology and Radiotherapy and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Pyry H Kotkaranta
- Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Department of Oncology and Radiotherapy and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Janette Kemppainen
- Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Department of Oncology and Radiotherapy and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Hanna-Riikka Teppo
- Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Department of Oncology and Radiotherapy and Medical Research Center, Oulu University Hospital, Oulu, Finland.,Department of Pathology, Oulu University Hospital, Oulu, Finland
| | - Hanne Kuitunen
- Department of Oncology and Radiotherapy and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Risto Pirinen
- Department of Pathology, North Karelia Central Hospital, Joensuu, Finland
| | - Taina Turpeenniemi-Hujanen
- Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Department of Oncology and Radiotherapy and Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Outi Kuittinen
- Department of Oncology and Radiotherapy and Medical Research Center, Oulu University Hospital, Oulu, Finland.,Department of Oncology, Faculty of Health Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Milla E L Kuusisto
- Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Department of Oncology and Radiotherapy and Medical Research Center, Oulu University Hospital, Oulu, Finland.,Department of Hematology, Oulu University Hospital, Oulu, Finland
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Huang Q, Zhang F, Fu H, Shen J. Epigenetic regulation of miR-518a-5p-CCR6 feedback loop promotes both proliferation and invasion in diffuse large B cell lymphoma. Epigenetics 2020; 16:28-44. [PMID: 32600091 DOI: 10.1080/15592294.2020.1786317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
To investigate the detailed functions and underlying mechanisms of miR-518a-5p/CCR6 in diffuse large B cell lymphoma (DLBCL) is needed. In this study, CCR6 expression levels were tested both in DLBCL cell lines and specimens. Through bioinformatics analysis and quantitative real-time PCR (qRT-PCR) validation, CCR6's targeted miRNA was obtained. Dual luciferase assay was used to verify their targeted relationship. Futhermore, using qRT-PCR, western blot, CCK8, Transwell assays, flow cytometry, pyrosequencing, chromatin immunoprecipitation, and azacitidine/C646 treatment, the detailed functions and underlying mechanisms of CCR6 and its targeted miRNA in DLBCL were detected. We found that negative correlation existed between CCR6 and miR-518a-5p in DLBCL. Both up-regulated miR-518a-5p and down-regulated CCR6 inhibited cell proliferation and invasion in vitro. Experiment then verified the regulatory relationship between miR-518a-5p and CCR6. JAK2 and STAT6 levels were reduced in DLBCL cells transfected with miR-518a-5p mimic or CCR6 small interfering RNA. Interestingly, we showed for the first time that a hyper-methylated condition existed at the promoter region of miR-518a-5p and azacitidine changed levels of miR-518a-5p in a time- and concentration-dependent manner. Finally, we found an enriched histone H3 on lysine 27 acetylation existed in the promoter of CCR6, whose expression could also be changed via C646 in a time- and concentration-dependent manner. The above results suggest that miR-518a-5p-CCR6 feedback loop plays a critical role in DLBCL development. The overexpression of CCR6 is mainly mediated by epigenetic modification through transcriptional and post-transcriptional activation, which provides new directions for DLBCL treatment.
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Affiliation(s)
- Qian Huang
- Department of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital , Fuzhou, Fujian, People's Republic of China
| | - Feng Zhang
- Department of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital , Fuzhou, Fujian, People's Republic of China
| | - Haiying Fu
- Department of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital , Fuzhou, Fujian, People's Republic of China
| | - Jianzhen Shen
- Department of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital , Fuzhou, Fujian, People's Republic of China
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