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Wang WD, Hu F, Zhou DH, Gale RP, Lai YR, Yao HX, Li C, Wu BY, Chen Z, Fang JP, Chen SJ, Liang Y. Thalassaemia in China. Blood Rev 2023; 60:101074. [PMID: 36963988 DOI: 10.1016/j.blre.2023.101074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/15/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023]
Abstract
Because of successful thalassaemia prevention programmes in resource-rich countries and it's huge population China now has the greatest number of new cases of thalassaemia globally as well as more people with thalassaemia than any other country. 30 million Chinese have thalassaemia-associated mutations and about 300,000 have thalassaemia major or intermedia requiring medical intervention. Over the past 2 decades there has been tremendous economic growth in China including per capita spending on health care. There is now nation-wide availability and partial or full insurance for prenatal genetic testing, RBC-transfusions, iron-chelating drugs and haematopoietic cell transplants. Prenatal screening and educational programmes have reduced the incidence of new cases. However, substantial challenges remain. For example, regional differences in access to medical care and unequal economic development require innovations to reduce the medical, financial and psychological burdens of Chinese with thalassaemia and their families. In this review we discuss success in preventing and treating thalassaemia in China highlighting remaining challenges. Our discussion has important implications for resource-poor geospaces challenged with preventing and treating thalassaemia.
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Affiliation(s)
- Wei-da Wang
- Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Fang Hu
- Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Dun-Hua Zhou
- Children's Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Robert Peter Gale
- Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; Department of Immunology and Inflammation, Haematology Research Centre, Imperial College London, London, UK
| | - Yong-Rong Lai
- Department of Hematology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Hong-Xia Yao
- Department of Hematology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China
| | - Chunfu Li
- Nanfang-Chunfu Children's Institute of Hematology and Oncology, Taixin Hospital, Dongguan, China
| | - Bing-Yi Wu
- Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Zhu Chen
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jian-Pei Fang
- Children's Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
| | - Sai-Juan Chen
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Yang Liang
- Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
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Ma YY, Wei ZL, Xu YJ, Shi JM, Yi H, Lai YR, Jiang EL, Wang SB, Wu T, Gao L, Gao L, Kong PY, Wen Q, Bai H, Li Y, Cao YG, Li QC, Zhang ZM, Liu BC, Su Y, Lai XY, Ma X, Cheng TT, Luo Y, Zhang X, Zhang C. Poor pretransplantation minimal residual disease clearance as an independent prognostic risk factor for survival in myelodysplastic syndrome with excess blasts: A multicenter, retrospective cohort study. Cancer 2023; 129:2013-2022. [PMID: 36951498 DOI: 10.1002/cncr.34762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/15/2023] [Accepted: 01/18/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Minimal residual disease (MRD) is an important prognostic factor for survival in adults with acute leukemia. The role of pretransplantation MRD status in myelodysplastic syndrome with excess blasts (MDS-EB) is unknown. This study retrospectively analyzed the relationship between pretransplantation MRD status and long-term survival. MATERIALS AND METHODS Patients with MDS-EB who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) from March 5, 2005, to November 8, 2020, were included. The relationship between pretransplantation MRD status and long-term survival was analyzed using univariate and multivariate logistic regression models. RESULTS Of 220 patients with MDS-EB who underwent allo-HSCT, 198 were eligible for inclusion in this multicenter, retrospective cohort study. Complete remission was attained in 121 (61.1%) patients, and 103 patients underwent detection of MRD pretransplantation, with 67 patients being MRD-positive and 36 patients being MRD-negative. The median follow-up time was 16 months, the median age was 41 years (6-65 years), and 58% of the patients were men. The 3-year disease-free survival (DFS) and overall survival (OS) probabilities for all patients were 70.1% and 72.9%, respectively. For patients in complete remission, the 3-year DFS and OS probabilities were 72.2% and 74.8%, respectively. Further analysis found that the 3-year DFS rates of MRD-negative and MRD-positive patients were 85.6% and 66.5% (p = .045), respectively, whereas the 3-year OS rates were 91.3% and 66.4% (p = .035), respectively. Univariate and multivariate analyses showed that poor pretransplantation MRD clearance was an independent prognostic risk factor for DFS and OS. CONCLUSION Poor pretransplantation MRD clearance is an independent prognostic risk factor for long-term survival after allo-HSCT for patients with MDS-EB. PLAIN LANGUAGE SUMMARY Poor minimal residual disease clearance pretransplanation is an independent prognostic risk factor for long-term survival after allogeneic hematopoietic stem cell transplantation for patients with myelodysplastic syndrome with excess blasts.
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Affiliation(s)
- Ying-Ying Ma
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Shapingba District, Chongqing, China
| | - Ze-Liang Wei
- Department of Health Statistics, College of Preventive Medicine, Army Medical University, Shapingba District, Chongqing, China
| | - Ya-Jing Xu
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Diseases (Xiangya Hospital), Changsha, Hunan, China
- Hunan Clinical Medical Research Center of Hematologic Neoplasms, Changsha, Hunan, China
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Soochow, Jiangsu, China
| | - Ji-Min Shi
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hai Yi
- Department of Hematology, General Hospital of Western Theater Command, People's Liberation Army, Jinniu District, Chengdu, China
| | - Yong-Rong Lai
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Er-Lie Jiang
- Center of Hematopoietic Stem Cell Transplantation, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - San-Bin Wang
- Department of Hematology, 920th Hospital of Joint Logistics Support Force, Kunming, China
| | - Tao Wu
- Department of Hematology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu, China
| | - Lei Gao
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Shapingba District, Chongqing, China
| | - Li Gao
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Shapingba District, Chongqing, China
| | - Pei-Yan Kong
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Shapingba District, Chongqing, China
| | - Qin Wen
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Shapingba District, Chongqing, China
| | - Hai Bai
- Department of Hematology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu, China
| | - Yu Li
- Department of Hematology, 920th Hospital of Joint Logistics Support Force, Kunming, China
| | - Yi-Geng Cao
- Center of Hematopoietic Stem Cell Transplantation, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Qiao-Chuan Li
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Zhong-Ming Zhang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Bei-Cai Liu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yi Su
- Department of Hematology, General Hospital of Western Theater Command, People's Liberation Army, Jinniu District, Chengdu, China
| | - Xiao-Yu Lai
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xia Ma
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ting-Ting Cheng
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yi Luo
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xi Zhang
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Shapingba District, Chongqing, China
| | - Cheng Zhang
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Shapingba District, Chongqing, China
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Li C, Yang GH, Liu LJ, Chen YH, Zhou XM, Lai YR, Liu RR. [Allogeneic hematopoietic stem cell transplantation in Hb Mizuho of unstable hemoglobinopathy: a case report]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:524. [PMID: 37550215 PMCID: PMC10450552 DOI: 10.3760/cma.j.issn.0253-2727.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Indexed: 08/09/2023]
Affiliation(s)
- C Li
- Department of Hematology, First Affiliated Hospital of Guangxi Medical University, Nanning 530000, China
| | - G H Yang
- Department of Hematology, First Affiliated Hospital of Guangxi Medical University, Nanning 530000, China
| | - L J Liu
- Department of Hematology, First Affiliated Hospital of Guangxi Medical University, Nanning 530000, China
| | - Y H Chen
- Department of Hematology, First Affiliated Hospital of Guangxi Medical University, Nanning 530000, China
| | - X M Zhou
- Department of Hematology, First Affiliated Hospital of Guangxi Medical University, Nanning 530000, China
| | - Y R Lai
- Department of Hematology, First Affiliated Hospital of Guangxi Medical University, Nanning 530000, China
| | - R R Liu
- Department of Hematology, First Affiliated Hospital of Guangxi Medical University, Nanning 530000, China
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Xu LP, Lu DP, Wu DP, Jiang EL, Liu DH, Huang H, Sun ZM, Li NN, Liu QF, Zhang X, Lai YR, Song YP, Song XM, Liu SX, Zhang YC, Luo CJ, Xia LH, Niu T, Yu Y, Zhang XH, Tang XW, Luo Y, Huang XJ. Hematopoietic Stem Cell Transplantation Activity in China 2020-2021 During the SARS-CoV-2 Pandemic: A Report From the Chinese Blood and Marrow Transplantation Registry Group. Transplant Cell Ther 2023; 29:136.e1-136.e7. [PMID: 36402457 PMCID: PMC9671625 DOI: 10.1016/j.jtct.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/20/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
Between 2020 and 2021, 31,525 hematopoietic stem cell transplantations (HSCTs) were reported to the Chinese Blood and Marrow Transplantation Registry Group throughout mainland China. In this report, we describe the activity and current trends for HSCT in China during the SARS-CoV-2 pandemic. In 2020, a total of 13,415 cases of HSCT were reported from 166 transplantation teams, and 75% (10,042 cases) were allogeneic HSCTs. In 2021, a total of 18,110 cases of HSCT were reported from 174 transplantation teams, and 70% (12,744 cases) were allogeneic HSCTs. Haploidentical donor (HID) transplantation accounted for 63% (7977 cases) of allogeneic HSCTs in 2021. The most common indications for allogeneic HSCT for malignant disease were acute myeloid leukemia (37%) and acute lymphoblastic leukemia (23%), and the largest proportion of nonmalignant disease comprised aplastic anemia (13%). The peripheral blood stem cell source accounted for 41% of HIDs and 75% of matched sibling donors. The BuCy-based regimen (57%) was the most popular conditioning regimen for allogeneic HSCT, followed by the BuFlu-based regimen (28%) and total body irradiation-based regimen (11%). This survey provides comprehensive information about the current activities and might benefit clinical physicians' decision planning for HSCT.
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Affiliation(s)
- Lan-Ping Xu
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Dao-Pei Lu
- Hebei Yanda Lu Daopei Hospital & Beijing Ludaopei Hospital, Langfang, Hebei & Beijing, China
| | - De-Pei Wu
- The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Disease, Soochow, China
| | - Er-Lie Jiang
- Blood Diseases Hospital, Chinese Academy of Medical Sciences, Tianjin, China
| | | | - He Huang
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zi-Min Sun
- The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Nai-Nong Li
- Fujian Medical University Union Hospital, Fujian Provincial Key Laboratory of Hematology, Fujian Institute of Hematology, Fuzhou, China
| | | | - Xi Zhang
- Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Yong-Rong Lai
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yong-Ping Song
- Henan Cancer Hospital, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Si-Xi Liu
- Shenzhen Children's Hospital, Shenzhen, China
| | - Yi-Cheng Zhang
- Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | | | - Ling-Hui Xia
- Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Ting Niu
- West China Hospital, Sichuan University, Chengdu, China
| | - Yu Yu
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiao-Hui Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiao-Wen Tang
- The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Disease, Soochow, China
| | - Yi Luo
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao-Jun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
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Wu YY, Liu BC, Liu LJ, Yuan SS, Wei JM, Wang LL, Wang PX, Liu JC, Lai YR, Li QC. [Clinical Analysis of Bloodstream Infection after Hematopoietic Stem Cell Transplantation]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2022; 30:292-297. [PMID: 35123642 DOI: 10.19746/j.cnki.issn.1009-2137.2022.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To analyze the clinical characteristics of bloodstream infection (BSI) in patients treated by hematopoietic stem cell transplantation (HSCT). METHODS The clinical characteristics, distribution of pathogenic bacteria causing BSI and drug sensitivity of 910 patients treated by HSCT in our department from January 2013 to June 2020 were retrospectively analyzed. RESULTS Among 910 HSCT patients, 111 patients were diagnosed as BSI within 100 days after transplantation, and 98 patients showed BSI during the period of agranulocytosis. Multivariate analysis showed that the usage of anti-thymocyte globulin (ATG), long duration of agranulocytosis and low infusion volume of mononuclear cell (MNC) were the independent risk factors affecting BSI after HSCT. Among 121 pathogenic bacteria isolated, 76 Gram-negative (G-) bacteria (62.8%), 40 Gram-positive (G+) bacteria (33.0%), and 5 fungi (4.1%) were detected out. The top three pathogens were Escherichia coli, Staphylococcus epidermidis and Pseudomonas aeruginosa. The drug-resistance rates of Escherichia coli and Klebsiella pneumoniae to carbapenems was 14.3% and 7.7%, respectively, and Pseudomonas aeruginosa was 66.7%. The susceptibility of G+ bacteria to vancomycin, linezolid and teicoplanin was 97.5%, 100% and 100%, respectively. The crude mortality rate of the patients with BSI at 100 days after HSCT was significantly higher than that of patients without BSI (P<0.001). CONCLUSION The usage of ATG, long duration of agranulocytosis and low infusion volume of MNC are independent risk factors for BSI after HSCT. The pathogens after HSCT are mainly G- bacteria. Pseudomonas aeruginosa is highly resistant to carbapenems. Key words ;
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Affiliation(s)
- Ying-Ying Wu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Bei-Cai Liu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Lian-Jin Liu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Shi-Si Yuan
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Jie-Min Wei
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Li-Lin Wang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Pei-Xi Wang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Ji-Cong Liu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Yong-Rong Lai
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Qiao-Chuan Li
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China,E-mail:
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Chang YJ, Wu DP, Lai YR, Huang XJ. Reply to M. Shibusawa et al. J Clin Oncol 2020; 38:4224-4225. [PMID: 33104441 DOI: 10.1200/jco.20.02841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ying-Jun Chang
- Ying-Jun Chang, PhD, Peking University People's Hospital, Beijing, China; De-Pei Wu, MD, PhD, The First Affiliated Hospital of Soochow University, Suzhou, China; Yong-Rong Lai, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; and Xiao-Jun Huang, MD, PhD, Peking University People's Hospital, Beijing, China
| | - De-Pei Wu
- Ying-Jun Chang, PhD, Peking University People's Hospital, Beijing, China; De-Pei Wu, MD, PhD, The First Affiliated Hospital of Soochow University, Suzhou, China; Yong-Rong Lai, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; and Xiao-Jun Huang, MD, PhD, Peking University People's Hospital, Beijing, China
| | - Yong-Rong Lai
- Ying-Jun Chang, PhD, Peking University People's Hospital, Beijing, China; De-Pei Wu, MD, PhD, The First Affiliated Hospital of Soochow University, Suzhou, China; Yong-Rong Lai, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; and Xiao-Jun Huang, MD, PhD, Peking University People's Hospital, Beijing, China
| | - Xiao-Jun Huang
- Ying-Jun Chang, PhD, Peking University People's Hospital, Beijing, China; De-Pei Wu, MD, PhD, The First Affiliated Hospital of Soochow University, Suzhou, China; Yong-Rong Lai, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; and Xiao-Jun Huang, MD, PhD, Peking University People's Hospital, Beijing, China
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Chang YJ, Wu DP, Lai YR, Liu QF, Sun YQ, Hu J, Hu Y, Zhou JF, Li J, Wang SQ, Li W, Du X, Lin DJ, Ren HY, Chen FP, Li YH, Zhang X, Huang H, Song YP, Jiang M, Hu JD, Liang YM, Wang JB, Xiao Y, Huang XJ. Antithymocyte Globulin for Matched Sibling Donor Transplantation in Patients With Hematologic Malignancies: A Multicenter, Open-Label, Randomized Controlled Study. J Clin Oncol 2020; 38:3367-3376. [PMID: 32650683 DOI: 10.1200/jco.20.00150] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE The role of antithymocyte globulin (ATG) in preventing acute graft-versus-host disease (aGVHD) after HLA-matched sibling donor transplantation (MSDT) is still controversial. PATIENTS AND METHODS We performed a prospective, multicenter, open-label, randomized controlled trial (RCT) across 23 transplantation centers in China. Patients ages 40-60 years with standard-risk hematologic malignancies with an HLA-matched sibling donor were randomly assigned to an ATG group (4.5 mg/kg thymoglobulin plus cyclosporine [CsA], methotrexate [MTX], and mycophenolate mofetil [MMF]) and a control group (CsA, MTX, and MMF). The primary end point of this study was grade 2-4 aGVHD on day 100. RESULTS From November 2013 to April 2018, 263 patients were enrolled. The cumulative incidence rate of grade 2-4 aGVHD was significantly reduced in the ATG group (13.7%; 95% CI, 13.5% to 13.9%) compared with the control group (27.0%; 95% CI, 26.7% to 27.3%; P = .007). The ATG group had significantly lower incidences of 2-year overall chronic GVHD (27.9% [95% CI, 27.6% to 28.2%] v 52.5% [95% CI, 52.1% to 52.9%]; P < .001) and 2-year extensive chronic GVHD (8.5% [95% CI, 8.4% to 8.6%] v 23.2% [95% CI, 22.9% to 23.5%]; P = .029) than the control group. There were no differences between the ATG and control groups with regard to cytomegalovirus reactivation, Epstein-Barr virus reactivation, 3-year nonrelapse mortality (NRM), 3-year cumulative incidence of relapse (CIR), 3-year overall survival, or 3-year leukemia-free survival. Three-year GVHD relapse-free survival was significantly improved in the ATG group (38.7%; 95% CI, 29.9% to 47.5%) compared with the control group (24.5%; 95% CI, 16.9% to 32.1%; P = .003). CONCLUSION Our study is the first prospective RCT in our knowledge to demonstrate that ATG can effectively decrease the incidence of aGVHD after MSDT in the CsA era without affecting the CIR or NRM.
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Affiliation(s)
- Ying-Jun Chang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, and Peking-Tsinghua Center for Life Sciences, Beijing, China
| | - De-Pei Wu
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yong-Rong Lai
- Department of Hematology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qi-Fa Liu
- Nanfang Hospital Affiliated to Southern Medical University, Guangzhou, China
| | - Yu-Qian Sun
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, and Peking-Tsinghua Center for Life Sciences, Beijing, China
| | - Jiong Hu
- State Key Laboratory for Medical Genomics, Department of Hematology, Shanghai Institute of Hematology, and Collaborative Innovation Center of Hematology, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Hu
- Union Hospital Affiliated With Huazhong University of Science and Technology, Wuhan, China
| | - Jian-Feng Zhou
- Department of Hematology, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Juan Li
- Department of Hematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shun-Qing Wang
- Department of Hematology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Wei Li
- The First Hospital of Jilin University, Changchun, China
| | - Xin Du
- Guangdong General Hospital, Guangzhou, China
| | - Dong-Jun Lin
- Third Hospital of Sun Yat-sen University, Guangzhou, China
| | - Han-Yun Ren
- Department of Hematology, Peking University First Hospital, Beijing, China
| | - Fang-Pin Chen
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, China
| | - Yu-Hua Li
- Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xi Zhang
- Xinqiao Hospital Affiliated to Third Military Medical University, Chongqing, China
| | - He Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Yong-Ping Song
- The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
| | - Ming Jiang
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Jian-Da Hu
- Fujian Medical University Union Hospital, Fuzhou, China
| | - Ying-Min Liang
- Tangdu Hospital Air Force Medical University, Xi'an, China
| | | | - Yang Xiao
- Southern Theater General Hospital of the Chinese People's Liberation Army, Guangzhou, China
| | - Xiao-Jun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, and Peking-Tsinghua Center for Life Sciences, Beijing, China
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Zhu FX, Wang XT, Ye ZZ, Gan ZP, Lai YR. Construction of a prognosis‑associated long noncoding RNA‑mRNA network for multiple myeloma based on microarray and bioinformatics analysis. Mol Med Rep 2020; 21:999-1010. [PMID: 32016443 PMCID: PMC7003030 DOI: 10.3892/mmr.2020.10930] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 04/10/2019] [Indexed: 02/07/2023] Open
Abstract
At present, the association between prognosis-associated long noncoding RNAs (lncRNAs) and mRNAs is yet to be reported in multiple myeloma (MM). The aim of the present study was to construct prognostic models with lncRNAs and mRNAs, and to map the interactions between these lncRNAs and mRNAs in MM. LncRNA and mRNA data from 559 patients with MM were acquired from the Genome Expression Omnibus (dataset GSE24080), and their prognostic values were calculated using the survival package in R. Multivariate Cox analysis was used on the top 20 most significant prognosis-associated mRNAs and lncRNAs to develop prognostic signatures. The performances of these prognostic signatures were tested using the survivalROC package in R, which allows for time-dependent receiver operator characteristic (ROC) curve estimation. Weighted correlation network analysis (WGCNA) was conducted to investigate the associations between lncRNAs and mRNAs, and a lncRNA-mRNA network was constructed using Cytoscape software. Univariate Cox regression analysis identified 39 lncRNAs and 1,445 mRNAs that were significantly associated with event-free survival of MM patients. The top 20 most significant survival-associated lncRNAs and mRNAs were selected as candidates for analyzing independent MM prognostic factors. Both signatures could be used to separate patients into two groups with distinct outcomes. The areas under the ROC curves were 0.739 for the lncRNA signature and 0.732 for the mRNA signature. In the lncRNA-mRNA network, a total of 143 mRNAs were positively or negatively associated with 23 prognosis-associated lncRNAs. NCRNA00201, LOC115110 and RP5-968J1.1 were the most dominant drivers. The present study constructed a model that predicted prognosis in MM and formed a network with the corresponding prognosis-associated mRNAs, providing a novel perspective for the clinical diagnosis and treatment of MM, and suggesting novel directions for interpreting the mechanisms underlying the development of MM.
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Affiliation(s)
- Fang-Xiao Zhu
- Department of Rheumatology and Immunology, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi 541001, P.R. China
| | - Xiao-Tao Wang
- Department of Rheumatology and Immunology, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi 541001, P.R. China
| | - Zhi-Zhong Ye
- Shenzhen Futian Hospital for Rheumatic Diseases, Shenzhen, Guangdong 518040, P.R. China
| | - Zhao-Ping Gan
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Yong-Rong Lai
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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Qin F, Shi L, Li Q, Zhang Z, Liu L, Li J, Yang G, Lai YR. Immune recovery after in vivo T-cell depletion myeloablative conditioning hematopoietic stem cell transplantation in severe beta-thalassemia children. Eur J Haematol 2019; 103:342-350. [PMID: 31276236 DOI: 10.1111/ejh.13289] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The clinical outcome of hematopoietic stem cell transplantation (HSCT) in those with severe beta-thalassemia (β-TM) is closely related to post-transplantation immune reconstitution (IR). However, the data on the IR in these settings are scarce. METHODS A prospective analysis of the clinical outcome and IR in 47 children with severe β-TM who underwent in vivo T-cell depletion myeloablative conditioning and matched sibling donor HSCT was performed. Immune reconstitution, including immune cell subset counts, as well as the generation of new T and B cells assays after HSCT, was measured. RESULTS In the first year after HSCT, bacterial infections and cytomegalovirus (CMV) reactivation were observed in 70.2% and 36.2% of the patients, respectively. In the same period, poor CD4+ T-cell recovery was observed. The B cells recovered within 6 months. Natural killer (NK) cells recovered as early as 1 month, but their function was defective. Cord blood and bone marrow (CB + BM) group had slower T-cell recovery, and higher B cells and NK cells in comparison with peripheral blood and bone marrow (PB + BM) group. CONCLUSIONS The high incidence of infection within 1 year after in vivo T-cell depletion myeloablative conditioning HSCT in severe β-TM was consistent with poor IR.
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Affiliation(s)
- Fang Qin
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.,Department of Rheumatology and Immunology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lingling Shi
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qiaochuan Li
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhongming Zhang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lianjin Liu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jing Li
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Gaohui Yang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yong-Rong Lai
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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10
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Zhang ZM, Lai YR, Li QC, Luo L, Liu RR, Shi LL, Liu LJ. [Clinical analysis of autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation in thalassemia major]. Zhonghua Xue Ye Xue Za Zhi 2019; 39:908-911. [PMID: 30486586 PMCID: PMC7342357 DOI: 10.3760/cma.j.issn.0253-2727.2018.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
目的 探讨重型地中海贫血(地贫)患者异基因造血干细胞移植(allo-HSCT)后并发自身免疫性溶血性贫血(AIHA)诊断、治疗及转归,以提高地贫患者造血干细胞移植疗效。 方法 回顾性分析2007年7月至2017年12月共计291例行allo-HSCT重型地贫患者的临床资料。 结果 重型地贫allo-HSCT后AIHA发生率为1.72%(5/291);AIHA中位发生时间为移植后7(5~12)个月,5例移植后AIHA患者直接和间接Coombs试验均阳性,患者主要表现为头晕、乏力、面色苍白、皮肤巩膜黄染、酱油色尿。228例HLA相合同胞供者移植患者有1例(0.43%)移植后发生AIHA,而63例非亲缘供者移植患者有4例(6.36%)移植后发生AIHA。非亲缘供者移植患者AIHA发生率高于HLA相合同胞供者移植患者。1例患者单用泼尼松治疗死亡,4例患者采用甲泼尼龙联合利妥昔单抗治疗有效,目前生存良好,其中2例Coombs试验转阴。 结论 该组重型地贫患者allo-HSCT后AIHA发生率为1.72%,Coombs试验有助于诊断移植后AIHA,非亲缘供者移植病例移植后AIHA发生率高于HLA相合同胞供者移植组,利妥昔单抗联合糖皮质激素是治疗重型地贫allo-HSCT后AIHA的有效方法。
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Affiliation(s)
- Z M Zhang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medial University, Nanning 530021, China
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11
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Luo YC, Lai YR, Xia N, Yang PJ, Wen YM, Shen J, Liang YZ. [Research progress on metabolic endocrine diseases in patients with thalassemia]. Zhonghua Nei Ke Za Zhi 2019; 58:154-157. [PMID: 30704205 DOI: 10.3760/cma.j.issn.0578-1426.2019.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Y C Luo
- Department of Endocrinology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China
| | - Y R Lai
- Department of Hematology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - N Xia
- The Guangxi Zhuang Autonomous Region Health Commission, Nanning 530021, China
| | - P J Yang
- Department of Endocrinology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Y M Wen
- Department of Endocrinology, Guangxi International Zhuang's Hospital, Nanning 530201, China
| | - J Shen
- Department of Endocrinology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Y Z Liang
- Department of Endocrinology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China
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Deng DH, Sun N, Long Y, Cheng P, Lai YR. [Changes of plasma TF and TFPI in 20 cases thalassemia patients before and after splenectomy]. Zhonghua Xue Ye Xue Za Zhi 2017; 38:337-339. [PMID: 28468098 PMCID: PMC7342725 DOI: 10.3760/cma.j.issn.0253-2727.2017.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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13
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Zhao WH, Meng FY, Lai YR, Peng ZG, Ma J. [Promoter methylation and expression of death-associated protein kinase gene in acute leukemia]. Nan Fang Yi Ke Da Xue Xue Bao 2017; 37:407-410. [PMID: 28377362 PMCID: PMC6780430 DOI: 10.3969/j.issn.1673-4254.2017.03.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To study the clinical implications of death-associated protein kinase (DAPK) promoter methylation and DAPK gene expression in untreated patients with acute leukemia. METHODS Methylation-specific PCR and RT-PCR were employed to detect the DAPK gene methylation and mRNA expression in the bone marrow of 60 patients with acute myeloid leukemia (AML), 55 patients with acute lymphocytic leukemia (ALL), and 17 normal subjects. RESULTS The positivity rate of DAPK methylation was significantly higher in ALL patients (29.1%) than in AML patients group (5%) and normal subjects (0%) (P<0.01). No correlation was found between DAPK gene methylation and the clinical features in ALL patients (P>0.05). DAPK mRNA expression level differed significantly among the 3 groups (P=0.000), and was the highest in normal subjects and the lowest in ALL patients. In ALL patients, the expression level of DAPK mRNA showed a significant inverse correlation with DAPK promoter methylation (P<0.05). CONCLUSION The methylation rate of DAPK gene is higher in untreated ALL patients than in AML patients and normal subjects. DAPK gene methylation is not correlated with the clinical features of ALL patients but is probably related with the low gene expression level of DAPK in these patients.
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Affiliation(s)
- Wei-Hua Zhao
- Department of Hematology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.E-mail:
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14
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Sun NA, Cheng P, Deng DH, Liu RR, Lai YR. Analysis of the genetic variants associated with recurrent thromboembolism in a patient with hemoglobin H disease following splenectomy: A case report. Biomed Rep 2016; 5:23-26. [PMID: 27347400 PMCID: PMC4906919 DOI: 10.3892/br.2016.674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 04/09/2016] [Indexed: 01/24/2023] Open
Abstract
Reports of recurrent thromboembolism in thalassemia, particularly in hemoglobin H (HbH) disease associated with congenital thrombophilic mutations, are scarce. However, several mutations were detected in a 22-year-old woman with HbH disease. The patient experienced the first thrombotic event at the age of 20 years and had four recurrent thromboses in a short time interval, despite receiving anticoagulant treatment. The present study reports a case with six nucleotide substitutions, including a missense 565C>T (Arg189Trp) mutation and two synonymous mutations, 66T>C (Pro22Pro) and 423G>T (Ser141Ser), identified in the protein C gene. The other three mutations, 947G>A (Arg316His), 981A>G (Val327Val), and 775C>A (rs13146272), were identified in the protein S, antithrombin and cytochrome P450, family 4, subfamily V, polypeptide 2 genes, respectively. These findings suggest that if thrombotic events repeatedly occur in a patient with thalassemia, not only the risk factors associated with a hypercoagulable state, but the acquired and congenital thrombophilia should be screened for.
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Affiliation(s)
- N A Sun
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Peng Cheng
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Dong-Hong Deng
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Rong-Rong Liu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Yong-Rong Lai
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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15
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Zhao WH, Meng FY, Lai YR, Peng ZG, Ma J. [Effect of DAPK overexpression on biological behaviors and caspase-3 expression in HL-60 cells]. Nan Fang Yi Ke Da Xue Xue Bao 2016; 36:729-732. [PMID: 27222195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To explore the effect of DAPK overexpression on the biological behaviors and caspase-3 expression in HL-60 cells. METHODS The expression of DAPK mRNA was detected by RT-PCR leukemia cell lines K562, Molt4, U937, and HL-60 cells. HL-60 cells were transfected by a eukaryotic expression vector pReceiver-M29-DAPK via LipofectamineTM 2000, and the impact of DAPK overexpression on cell apoptosis, cell cycle, cell differentiation and caspase-3 expression were analyzed. RESULTS DAPK mRNA expression was positive in K562, Molt4 and U937 cells but negative in HL-60 cells. Significantly increased cell apoptosis was observed in pReceiver-M29-DAPK-transfected HL-60 cells by flow cytometry and Hoechst33342 staining. The cell cycle distribution and differentiation showed no significant changes after the transfection. The expression of caspase-3 was significantly increased in the cells after transfection. CONCLUSION DAPK gene overexpression promotes apoptosis of HL-60 cells without affecting the cell cycle and differentiation. Caspase-3 may be involved in the regulation of cell apoptosis.
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Affiliation(s)
- Wei-Hua Zhao
- Department of Hematology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.E-mail:
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16
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Taher AT, Cappellini MD, Aydinok Y, Porter JB, Karakas Z, Viprakasit V, Siritanaratkul N, Kattamis A, Wang C, Zhu Z, Joaquin V, Uwamahoro MJ, Lai YR. Optimising iron chelation therapy with deferasirox for non-transfusion-dependent thalassaemia patients: 1-year results from the THETIS study. Blood Cells Mol Dis 2015; 57:23-9. [PMID: 26852651 DOI: 10.1016/j.bcmd.2015.11.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 11/09/2015] [Accepted: 11/09/2015] [Indexed: 02/02/2023]
Abstract
Efficacy and safety of iron chelation therapy with deferasirox in iron-overloaded non-transfusion-dependent thalassaemia (NTDT) patients were established in the THALASSA study. THETIS, an open-label, single-arm, multicentre, Phase IV study, added to this evidence by investigating earlier dose escalation by baseline liver iron concentration (LIC) (week 4: escalation according to baseline LIC; week 24: adjustment according to LIC response, maximum 30mg/kg/day). The primary efficacy endpoint was absolute change in LIC from baseline to week 52. 134 iron-overloaded non-transfusion-dependent anaemia patients were enrolled and received deferasirox starting at 10mg/kg/day. Mean actual dose±SD over 1year was 14.70±5.48mg/kg/day. At week 52, mean LIC±SD decreased significantly from 15.13±10.72mg Fe/g dw at baseline to 8.46±6.25mg Fe/g dw (absolute change from baseline, -6.68±7.02mg Fe/g dw [95% CI: -7.91, -5.45]; P<0.0001). Most common drug-related adverse events were gastrointestinal: abdominal discomfort, diarrhoea and nausea (n=6 each). There was one death (pneumonia, not considered drug related). With significant and clinically relevant reductions in iron burden alongside a safety profile similar to that in THALASSA, these data support earlier escalation with higher deferasirox doses in iron-overloaded non-transfusion-dependent anaemia patients.
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Affiliation(s)
- Ali T Taher
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
| | | | - Yesim Aydinok
- Department of Paediatric Haematology, Ege University Hospital, Izmir, Turkey
| | - John B Porter
- Department of Haematology, University College London, London, UK
| | - Zeynep Karakas
- Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey
| | - Vip Viprakasit
- Department of Pediatrics and Internal Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Noppadol Siritanaratkul
- Department of Pediatrics and Internal Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Antonis Kattamis
- First Department of Pediatrics, University of Athens, Athens, Greece
| | | | - Zewen Zhu
- Novartis Pharmaceuticals, East Hanover, NJ, USA
| | | | | | - Yong-Rong Lai
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
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Lai YY, Huang XJ, Li J, Zou P, Xu ZF, Sun H, Shao ZH, Zhou DB, Chen FP, Liu ZG, Zhu HL, Wu DP, Wang C, Zhang Y, Li Y, Hou M, Du X, Wang X, Li W, Lai YR, Zhou J, Zhou YH, Fang MY, Qiu L, Wang XM, Zhang GS, Jiang M, Liang YM, Zhang LS, Chen XQ, Bai H, Lin JY. Standardized fluorescence in situ hybridization testing based on an appropriate panel of probes more effectively identifies common cytogenetic abnormalities in myelodysplastic syndromes than conventional cytogenetic analysis: a multicenter prospective study of 2302 patients in China. Leuk Res 2015; 39:530-5. [PMID: 25823643 DOI: 10.1016/j.leukres.2015.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 01/22/2015] [Accepted: 02/10/2015] [Indexed: 02/05/2023]
Abstract
In an attempt to establish the advantages of fluorescence in situ hybridization (FISH) studies over conventional cytogenetic (CC) analysis, a total of 2302 de novo MDS patients from 31 Chinese institutions were prospectively selected in the present study for both CC and standardized FISH analysis for +8, -7/7q-, -5/5q-, 20q- and-Y chromosomal abnormalities. CC analysis was successful in 94.0% of the patients; of these patients, 35.9% of the cases were abnormal. FISH analysis was successful in all 2302 patients and detected at least one type of common cytogenetic abnormality in 42.7% of the cases. The incidences of +8, -7/7q-, -5/5q-, 20q- and-Y chromosomal abnormalities by FISH were 4.1% to 8.7% higher than those by CC. FISH identified abnormalities in 23.6% of the patients exhibiting normal CC results and revealed that 20.7% of the patients with adequate normal metaphases (≥20) had abnormal clones. FISH identified cytogenetic abnormalities in 50.4% of the patients with failed CC analysis. In summary, our multicenter studies emphasised and confirmed the importance of applying standardized FISH testing based on an appropriate panel of probes to detect common cytogenetic abnormalities in Chinese de novo MDS patients, particularly those with normal or failed CC results.
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Affiliation(s)
- Yue-Yun Lai
- Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Beijing, China
| | - Xiao-Jun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Beijing, China.
| | - Juan Li
- Department of Hematology, First Affiliated Hospital of Zhongshan University, Guangzhou, China
| | - Ping Zou
- Department of Hematology, Wuhan Union Hospital, Wuhan, China
| | - Ze-Feng Xu
- Institute of Hematology and Hospital of Blood Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Hui Sun
- Department of Hematology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zong-Hong Shao
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Dao-Bin Zhou
- Department of Hematology, Peking Union Medical College Hospital, Beijing, China
| | - Fang-Ping Chen
- Department of Hematology, Xiangya Hospital of Central-South University, Changsha, China
| | - Zhuo-Gang Liu
- Department of Hematology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Huan-Ling Zhu
- Department of Hematology, West China Hospital of Sichuan University, Chengdu, China
| | - De-Pei Wu
- Department of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chun Wang
- Department of Hematology, Shanghai First People's Hospital, Shanghai, China
| | - Yin Zhang
- Department of Hematology, Henan Province People's Hospital, Zhengzhou, China
| | - Yan Li
- Department of Hematology, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Ming Hou
- Department of Hematology, Qilu Hospital of Shandong University, Jinan, China
| | - Xin Du
- Department of Hematology, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital of Shandong University, Jinan, China
| | - Wei Li
- Department of Hematology, First Affiliated Hospital of Jilin University, Changchun, China
| | - Yong-Rong Lai
- Department of Hematology, First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Jin Zhou
- Department of Hematology, First Clinical College of Harbin Medical University, Harbin, China
| | - Yu-Hong Zhou
- Department of Hematology, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Mei-Yun Fang
- Department of Hematology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lin Qiu
- Harbin Institute of Hematology and Oncology, Harbin, China
| | - Xiao-Min Wang
- Department of Hematology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Guang-Sen Zhang
- Department of Hematology, Second Xiangya Hospital of Central-South University, Changsha, China
| | - Ming Jiang
- Department of Hematology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ying-Min Liang
- Department of Hematology, Tangdu Hospital, Fourth Military Medical University, Xian, China
| | - Lian-Sheng Zhang
- Department of Hematology, Second Hospital of Lanzhou University, Lanzhou, China
| | - Xie-Qun Chen
- Department of Hematology, Xijing Hospital Affiliated to the Fourth Military Medical University, Xian, China
| | - Hai Bai
- Department of Hematology, Lanzhou General Hospital of Lanzhou Command, Lanzhou, China
| | - Jin-Ying Lin
- Department of Hematology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Wang M, Liu RR, Wang CJ, Kang W, Yang GH, Zhong WN, Lai YR. Combined histological and hematological assessment of iron-induced organ damage in a gerbil model of iron overload. Am J Transl Res 2015; 7:385-392. [PMID: 25901205 PMCID: PMC4399101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 01/05/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Previous studies with gerbil models have suggested that excessive iron exposure causes cardiomyopathy and hepatic injury, but pathological analysis was not comprehensive, preventing a detailed understanding of how the metal induces this damage. METHODS AND RESULTS Gerbils received single intraperitoneal injections of iron dextran (200 mg/kg) or saline and were then analyzed comprehensively for hematological and histological signs of organ damage. These tests included hematology parameters and determination of liver iron concentration, malondialdehyde levels and glutathione peroxidase activity; examination of heart and liver tissue stained with hematoxylin and eosin, Prussian-blue and Masson stain; and electron microscopy analysis of heart and liver ultrastructure. Iron-overloaded animals showed significantly different hematology parameters and significantly higher liver iron concentrations than saline-injected animals, as well as significantly higher malondialdehyde levels and significantly lower glutathione peroxidase activity. Histology analyses showed cellular damage, iron deposits, and both myocardial and liver fibrosis, while electron microscopy of heart and liver sections showed abundant iron deposition lysosomes, and disordered and swollen mitochondria. All these pathological changes increased with exposure time. CONCLUSIONS This comprehensive assessment of iron overload in a gerbil model suggests that excessive iron deposition induces extensive cellular damage, particularly fibrosis in heart and liver. This damage may be the direct result of iron-mediated lipid peroxide damage and of iron deposition that cause compression of myocardial and liver cells, as well as vascular occlusion.
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Affiliation(s)
- Man Wang
- Department of Hematology, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, PR China
| | - Rong-Rong Liu
- Department of Hematology, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, PR China
| | - Cong-Jun Wang
- Department of General Surgery, Third Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, PR China
| | - Wei Kang
- Department of Radiology, Tumor Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, PR China
| | - Gao-Hui Yang
- Department of Hematology, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, PR China
| | - Wu-Ning Zhong
- Department of Radiology, Tumor Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, PR China
| | - Yong-Rong Lai
- Department of Hematology, First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, PR China
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Li HY, Deng DH, Huang Y, Ye FH, Huang LL, Xiao Q, Zhang B, Ye BB, Lai YR, Mo ZN, Liu ZF. Favorable prognosis of biallelic CEBPA gene mutations in acute myeloid leukemia patients: a meta-analysis. Eur J Haematol 2015; 94:439-48. [PMID: 25227715 DOI: 10.1111/ejh.12450] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2014] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Increasing number of studies suggested that biallelic CEBPA (bi CEBPA) mutations were associated with favorable prognosis in patients with acute myeloid leukemia (AML), but the results remain inconclusive. We therefore present a meta-analysis to evaluate the prognostic value of bi CEBPA mutations in patients with AML. METHODS A comprehensive literature search was undertaken through August 2014 looking for eligible studies. Pooled hazard ratios (HRs) estimates and 95% confidence intervals (95% CIs) in overall survival (OS) and event-free survival (EFS) were used to calculate estimated effect. RESULTS Ten studies covering a total of 6219 subjects were included in this analysis. Overall, bi CEBPA mutations were associated with favorable clinical outcome in patients with AML (HR for EFS: 0.41, 95% CI: 0.32-0.52; for OS: 0.37, 95% CI: 0.27-0.50), in cytogenetically normal (CN)-AML (HR for EFS: 0.38, 95% CI: 0.29-0.49; for OS: 0.32, 95% CI: 0.23-0.43). When took the cohort of monoallelic CEBPA (mo CEBPA) mutated and wild-type CEBPA (wt CEBPA) AML as a reference group, bi CEBPA mutated AML also shown beneficial outcomes (HR for OS: 0.52, 95% CI: 0.37-0.72). No significant difference was found between mo CEBPA mutation and wt CEBPA in patients with AML or CN-AML (P > 0.05). CONCLUSION Bi CEBPA mutations in patients with AML are strongly associated with a favorable prognosis, which suggested that bi CEBPA mutations would potentially serve as a novel prognostic marker in AML.
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Affiliation(s)
- Hong-Ying Li
- Hematology Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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20
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Lai YR, Chen YH, Hu DM, Jiang M, Liu QF, Liu L, Hou J, Schwarzenberger P, Li QC, Zhang ZM, Liu KY, Huang XJ. Multicenter phase II study of a combination of cyclosporine a, methotrexate and mycophenolate mofetil for GVHD prophylaxis: results of the Chinese Bone Marrow Transplant Cooperative Group (CBMTCG). J Hematol Oncol 2014; 7:59. [PMID: 25139202 PMCID: PMC4237802 DOI: 10.1186/s13045-014-0059-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 07/31/2014] [Indexed: 01/18/2023] Open
Abstract
Background Improvement of current GVHD prophylactic therapies remains an important goal in the allo-HSCT. We have described a novel prophylaxis regimen in a single institution trial. The Chinese Bone Marrow Transplant Cooperative Group (CBMTCG) initiated a phase II multicenter study. Methods The study was designed as a prospective, single arm phase II open-label, multicenter clinical trial. The primary endpoint was improvement of aGVHD by 25% over historical control (40%) in Chinese patients. 508 patients were enrolled. All of the patients received cyclosporine A (CsA), methotrexate (MTX) and mycophenolate mofetil (MMF) (0.5-1.0 g daily for 30 days) as GVHD prophylaxis regimen. Results The primary endpoint was met with cumulative incidences of grades 2 to 4 and grades 3 to 4 aGVHD of 23.2% and 10.3%, respectively. Incidence for cGVHD was 67.4%. The non-relapse mortality (NRM) rate was 18.4% at 2 years. The probabilities of leukemia free survival (LFS) for non-advanced stage and advanced stage patients at 2 years were 69.7% and 44.8% respectively (p = 0.000). Recipient age ≥ 40 years, advanced stage and Busulfan-Fludarabine(BuFlu) conditioning regimen were identified as major risk factors for aGVHD. Recipient age ≥ 40 years, BuFlu conditioning regimens, female donor/male recipient and prior aGVHD were associated with cGVHD. Despite lower RM (relapse mortality), patients with grade 2–4 aGVHD had higher NRM and worse OS and LFS compared to patients with grade 0–1 aGVHD. In contrast, patients with cGVHD had better OS and LFS and lower RM compared to patients without cGVHD. Conclusion The novel GVHD regimen decreased the risk for aGVHD by 42% without improving the risk for cGVHD compared to historical controls. Development of aGVHD was associated with worse OS and LFS as well as higher NRM. In contrast, cGVHD was associated with improved OS and LFS likely attributed to a GVL effect.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Xiao-Jun Huang
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
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Wu Q, Li X, Lai Y, Peng Z, Liao Y. Chronic kidney disease after autologous stem cell transplantation: analysis of a single center experience. Int Urol Nephrol 2014; 46:1403-10. [PMID: 24668138 DOI: 10.1007/s11255-014-0683-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 02/24/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE Chronic kidney disease (CKD) after allogeneic hematopoietic stem cell transplantation (HSCT) has increasingly been reported. However, CKD after autologous HSCT, especially changes in renal pathology, has rarely been reported. This study aimed to evaluate the frequency of CKD among patients who received autologous HSCT for hematological and nonhematological disorders, and analyze its clinical and pathological features. METHODS We performed a retrospective study to evaluate the frequency of CKD after autologous HSCT and analyzed clinical and pathological features of CKD. Clinical records of patients who underwent autologous HSCT at the First Affiliated Hospital of Guangxi Medical University between May 2000 and November 2010 were screened. Clinical data of those with kidney injury on presentation and follow-up were acquired from hospital records. RESULTS A total of 41 patients who received autologous HSCT were identified. CKD developed in six patients (14.6%). Among the six patients, all had various degrees of proteinuria and three patients had nephrotic syndrome. Impaired renal function occurred in three patients. Three patients with nephrotic syndrome received only prednisone. Two patients obtained complete remission, and one had partial remission. What is particularly worth mentioning is, in two patients who received renal biopsy in our study, the pathological changes were mesangial proliferative glomerulonephritis. CONCLUSIONS Mesangial proliferative glomerulonephritis may not be as uncommon as previously thought in CKD patients after autologous HSCT. Presentation of nephrotic syndrome is common in CKD after HSCT and prednisone alone are effective.
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Affiliation(s)
- QiaoYuan Wu
- Department of Nephrology, The First Affiliated Hospital, Guangxi Medical University, No. 22, Shuang Yong Lu, Nanning, 530021, Guangxi, China
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22
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Mao ZF, Mo XA, Qin C, Lai YR, Hackett ML. Incidence of thymoma in myasthenia gravis: a systematic review. J Clin Neurol 2012; 8:161-9. [PMID: 23091524 PMCID: PMC3469795 DOI: 10.3988/jcn.2012.8.3.161] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Revised: 07/24/2012] [Accepted: 07/24/2012] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose Myasthenia gravis (MG) is usually comorbid with thymoma. More accurate estimates of the incidence thymoma in MG will help inform patients and their physicians, facilitate health policy discussions, provide etiologic clues, and optimize the management of MG. Methods We conducted a systematic review search of relevant English-language studies published between 1960 and 2012 using MEDLINE and Embase. We identified additional studies by reviewing the bibliographies of the retrieved articles and hand searched the main neurology journals. Only incidence studies and case series of unselected MG patients in which information about thymoma were included. Results Out of 2206 potentially relevant studies, 49 met the inclusion criteria. Although there was a considerable degree of heterogeneity, the pooled estimate of the incidence of thymoma in MG was 21% (95% confidence interval, 20-22%). The pooled incidence was significantly higher for surgery-based studies than for population- and hospital-based studies. A large proportion of the reported thymomas were noninvasive. Furthermore, thymoma appears to occur significantly more frequently among male MG patients and those older than 40 years at the onset of MG. Conclusions Thymoma is common in MG patients, but appears to be found more often in male MG patients and those older than 40 years at the onset of MG. Further research is needed to expand our understanding of these association conditions.
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Affiliation(s)
- Zhi-Feng Mao
- Institute of Neurology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People's Republic of China
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23
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Liu Y, Cheng P, Liu ZF, Liu RR, Lai YR. [Methylation status of γ-globin gene promoter in β-thalassemia major]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2012; 20:642-645. [PMID: 22739173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study was aimed to detect and identify the promoter CpG island methylation of γ-globin gene in peripheral blood mononuclear cells from patients with β-thalassemia major and healthy adult in Guangxi province, as well as to analyze the difference of promoter methylation rate of each CpG sites between them, and then to screen the promoter CpG island main methylation sites which maybe influence γ-globin expression. The template DNA was modified by bisulfite genomic sequencing PCR; the promoter sequences of γ-globin gene were amplified by technique Touchdown PCR, and then the PCR products were cloned and sequenced for obtaining methylation status of each CpG sites in target fragments, and then the accurate methylation sites and levels were detected quantitatively. The results indicated that the 4 CpG methylation sites locating at 28, 122, 231 and 234 bp in sequences were hypermethylated. As compared with healthy adults, the DNA methylation rate of 122 and 231 bp CpG sites in patients with β-thalassemia major was obviously lower, however, methylation rates of 28 and 234 bp sites were not significantly different between patients and healthy adults. It is concluded that the methylation sites 28, 122, 231 and 234 bp of γ-globin gene promoter are found both in patients with β-thalassemia major and healthy adults. The 122 and 231 bp sites are identified preliminarily to be involved in the regulation of γ-globin expression. This study provides the experimental evidence for alleviating the clinical symptoms of β-thalassemia major and targeting gene treatment through the regulation of γ-globin.
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Affiliation(s)
- Ying Liu
- Department of Hematology, Guangxi Medical University, Nanning, Guangxi Province, China
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24
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Abstract
The course of myasthenia gravis (MG) may get complicated by the development of other autoimmune diseases. Estimates of the frequency of autoimmune diseases will help inform patients and physicians, direct health policy discussion, provide etiologic clues, and optimize the management of MG. However, the frequency of autoimmune diseases in people with MG is still uncertain. A systematic search for English language studies was conducted by MEDLINE and EMBASE from 1960 through 2010. Incidence studies and case series of all MG subtypes with information about autoimmune diseases were included; 25 studies met the inclusion criteria. Although there was considerable heterogeneity, the pooled estimate of the coexisting autoimmune diseases in MG was 13% (95% confidence interval, 12%-14%). Autoimmune thyroid disease seems to occur more frequently than other autoimmune conditions in MG patients. Heterogeneity in study estimates could be explained by ascertainment bias and case mix. Furthermore, autoimmune diseases occurred significantly more often in females and anti-acetylcholine receptor seropositive MG patients. Patients with MG have an increased frequency of coexisting autoimmune diseases. Autoimmune diseases seem to occur more often in female and seropositive MG patients. Further research is needed to expand our understanding of these associations.
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Affiliation(s)
- Zhi-Feng Mao
- Department of Neurology, Third Affiliated Hospital, Guangxi Medical University, Nanning, PR China.
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25
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Liu RR, Ma J, Zhang XH, Luo JM, Li HP, Liang JQ, Li Z, Wang MY, Su P, Lai YR. [A 3-year clinical trial of deferasirox in heavily iron-overloaded patients with Beta-thalassemia major]. Zhonghua Xue Ye Xue Za Zhi 2010; 31:817-820. [PMID: 21223738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To evaluate the efficacy and safety of deferasirox in heavily iron-overloaded patients with beta-thalassemia major. METHODS A single arm, open-label clinical trial was conducted to evaluate the efficacy and safety of deferasirox in the treatment for 23 patients with beta-thalassemia major and heavily iron-overloaded in 3 years follow-up. RESULTS The 23 patients never received regular chelation before enrolling this trial [the mean baseline of serum ferritin was (5433.96 ± 2873.90) µg/L]. In this trial, a deferasirox dose of 20 mg×kg(-1)×d(-1) could stabilize serum ferritin levels, while of ≥ 30 mg×kg(-1)×d(-1) reduced the levels and achieved negative iron balance. There were no serious adverse events related to the drug. Most common adverse events were mild increases of liver enzyme and serum creatinine levels. Overall, 23 patients could tolerate the drug on schedule and all completed the trial. CONCLUSION As a new oral iron chelator, deferasirox has a significant efficacy for the treatment of iron overload. The effectiveness is dependent on the courses of treatment and the dose of deferasirox. The single-dose used is safe and tolerated, so deferasirox can remarkably improve life quality of patients.
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Affiliation(s)
- Rong-Rong Liu
- Department of Hematology, First Hospital, Guangxi Medical University Nanning 530021, China
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26
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Bi J, Guo AL, Lai YR, Li B, Zhong JM, Wu HQ, Xie Z, He YL, Lv ZL, Lau SH, Wang Q, Huang XH, Zhang LJ, Wen JM, Guan XY. Overexpression of clusterin correlates with tumor progression, metastasis in gastric cancer: a study on tissue microarrays. Neoplasma 2010; 57:191-7. [PMID: 20353268 DOI: 10.4149/neo_2010_03_191] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Clusterin (CLU) is expressed in a wide variety of human tissues and fluids. Overexpression of cytoplasmic clusterin (sCLU) has been implicated in cancer development and progression. The aim of the present study is to evaluate the association of sCLU overexpression with clinicopathological features of human gastric carcinomas (GC).We constructed a gastric cancer tissue microarray containing 173 primary gastric carcinomas and 70 paired non-neoplastic mucosa specimens. The expression of sCLU was studied by immunohistochemistry. The correlations between sCLU expression and clinicopathological features, p53 abnormality, as well as Ki67 activation were analyzed. Overexpressions of sCLU was detected in 28.5% (n=165) of primary GCs by immunohistochemical staining, but not in non-neoplastic mucosa. Clinical association study found that overexpression of sCLU was significantly correlated with lymph-node metastasis (p < 0.001), tumor invasion (p < 0.001) and TNM stage (p < 0.001). In Kaplan-Meier survival analysis, overexpression of sCLU was significantly correlated with unfavorable survival in advanced GCs (p < 0.03). Furthermore, the association of sCLU with abnormal expression of p53 was ascertained. These results suggested that overexpression of sCLU was involved in the progression of GC and it's oncogenic function might be associated with p53 abnormality. Overexpression of sCLU seems to be related with patient's shorter survival in late stage GC.
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Affiliation(s)
- J Bi
- Laboratory of Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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Liu RR, Ma J, Chen P, Mo WN, Lin WX, Lai YR. [The regulation effect of liposomal transfection of antisense oligonucleotide on the alpha-globin in patients with severe beta-thalassemia]. Zhonghua Xue Ye Xue Za Zhi 2009; 30:385-389. [PMID: 19951531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To study the effect of liposomal transfection of antisense oligonucleotide (ASON) on the erythroid cell alpha-globin gene in the patients with severe beta-thalassemia, and provide a new idea for beta-thalassemia gene therapy. METHODS A highly effective ASON targeting alpha-globin gene was transfected into severe beta-thalassemic erythroid cells cultured in vitro by liposomal at an optimal concentration. The expression level of alpha, beta, gamma-globin gene, the level of hemoglobin, and the excess alpha-globin chains precipitates in ASON group and control group were carefully analyzed by quantitative real-time PCR(Q-RT-PCR), high performance liquid chromatography (HPLC), and electron microscope, respectively. RESULTS The mRNA expression of alpha-globin gene was significantly lower in ASON group (9.04 +/- 0.29) than in control group (24.23 +/- 0.29) (P<0.01). Simultaneously, the disequilibrium between alpha- and beta-, gamma-globin gene expression was partly modified by ASON, the ratios of ASON group and control group being 0.79 +/- 0.02 and 2.26 +/- 0.06 respectively (P<0.01). HPLC demonstrated that the levels of HbA2 and HbF increased with downregulation of alpha-globin gene in beta-thalassemic erythroid cells, particularly HbF. The precipitates of alpha-globin chains in ASON group were lessened under electron microscope, particularly in early erythroblast while no change in the control group. CONCLUSION The high effective ASON contributes to inhibit the alpha-globin gene expression of severe beta-thalassemic erythroid cells, partly modify the disequilibrium between alpha-, beta- and gamma-globin gene expression and obviously reduce the precipitates of alpha-globin chains in erythroid cells. It might provide a new idea for gene therapy of beta-thalassemia.
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Affiliation(s)
- Rong-Rong Liu
- Department of Hematology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
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28
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Liu RR, Lai YR, Ma J. [Effect of liposomal transfection of antisense oligodeoxynucleotide on alpha-globin gene expression and proliferation of K562 cells]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2007; 15:1065-1069. [PMID: 17956692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The objective of study was to investigate the effect of liposomal transfection of antisense oligodeoxynucleotide (ASON) on alpha-globin gene expression and proliferation of K562 cells, to explore the new way of gene therapy in beta-thalassemia. Targeted ASON of alpha-globin was designed and synthesized, and compared with positive control [sense oligodeoxynucleotide (SON) group] and blank control. By liposomal transfection, ASON, SON was co-cultured with K562. The efficiency of transfection was assayed by fluorescence microscopy and flow cytometry (FCM), the alpha-globin gene expression of K562 was measured by real-time PCR, and the proliferation of K562 was determined by Cell Count Kit-8 assay. The results indicated that the highest efficiency was at 24 hours after liposomal transfection, the gene expression level of alpha-globin in ASON group was significantly lower than that in SON group and blank control (p < 0.01). The proliferation of K562 cells was obviously inhibited, meanwhile the above effect showed the dose-dependent manner. It is concluded that the liposomal transfection of ASON inhibits the alpha-globin gene expression of K562 cells, which may be the new target for gene therapy in beta-thalassemia.
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Affiliation(s)
- Rong-Rong Liu
- Department of Hematology, The First Affiliated Hospital, Guangxi Medical University, Nanning 530021, China
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Luo J, Peng ZG, Chen Y, Lai YR, Lu YY, Song SJ. [Gene of DNA-dependent protein kinase catalylic subunit in chronic myeloid leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2007; 15:248-52. [PMID: 17493325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This study was aimed to investigate the expression and regulation mechanism of DNA-dependent protein kinase catalylic subunit (DNA-PKcs) in chronic myeloid leukemia (CML) and its role in blast crisis of CML. Expression of DNA-PKcs mRNA was detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and DNA-PKcs protein by Western blot in 62 CML patients and K562, as compared to those of 23 normal individual controls. In 26 CML patients received allogeneic peripheral blood stem cell transplantation (allo-PBSCT) and 4 CML patients treated with imatinib, the expression of bcr-abl mRNA and DNA-PKcs protein was detected by RT-PCR and Western blot, respectively. After treatment with imatinib in mononuclear cell (MNC) of CML patients and K562 in vitro, expression of DNA-PKcs mRNA was detected by RT-PCR and DNA-PKcs protein level, tyrosine phosphorylation of bcr-abl fusion protein were detected by Western blot. The results showed that the expression of DNA-PKcs protein was significantly lower in CML and K562 than those in normal control (P<0.05). In 26 CML patients received allo-PBSCT and 4 CML patients treated with imatinib, the expression of DNA-PKcs protein was enhanced while the expression of bcr-abl mRNA decreased. After treatment of MNC of CML and K562 with imatinib in vitro, the expression of DNA-PKcs protein was enhanced while tyrosine phosphorylation of bcr-abl fusion protein decreased. It is concluded that the expression of DNA-PKcs protein is down-regulate by bcr-abl fusion gene, and the bcr-abl fusion gene down-regulate the expression of DNA-PKcs protein by post-transcriptional mechanism; the decrease of DNA-PKcs protein expression may be one of mechanisms underlying the acute transformation of CML.
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MESH Headings
- Adult
- Aged
- Benzamides
- Bone Marrow Cells/metabolism
- DNA-Activated Protein Kinase/biosynthesis
- DNA-Activated Protein Kinase/genetics
- Female
- Fusion Proteins, bcr-abl/biosynthesis
- Fusion Proteins, bcr-abl/genetics
- Humans
- Imatinib Mesylate
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Male
- Middle Aged
- Peripheral Blood Stem Cell Transplantation
- Piperazines/therapeutic use
- Pyrimidines/therapeutic use
- RNA, Messenger/biosynthesis
- RNA, Messenger/genetics
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Affiliation(s)
- Jun Luo
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
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30
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Lim SC, Goh SK, Lai YR, Tee WW, Koh A, Xu XH, Wu YS, Yap E, Subramaniam T, Sum CF. Relationship between common functional polymorphisms of the p22phox gene (-930A > G and +242C > T) and nephropathy as a result of Type 2 diabetes in a Chinese population. Diabet Med 2006; 23:1037-41. [PMID: 16922713 DOI: 10.1111/j.1464-5491.2006.01916.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Genetic determinants are important in diabetic nephropathy (DN). Oxidative stress has also emerged as an important pathogenic factor in DN and vascular NADH oxidase is a major source of reactive oxygen species (ROS). Previous small studies reported a strong but contradictory association between functional genetic variation of p22(phox), an important subcomponent of NADH oxidase, and DN. We investigated the association between two common functional single nucleotide polymorphisms (SNPs) (-930 A > G and +242 C > T) and DN in a much larger group of Chinese patients with Type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS Case-control study of Chinese subjects with long-standing T2DM (> 10 years). Cases (n = 306) were subjects with a spot urinary albumin : creatinine ratio (ACR) of > 113 mg/mmol or elevated serum creatinine. Control subjects (n = 306) had ACR < 3.3 mg/mmol and normal serum creatinine. Genotyping was carried out by standard PCR and restriction fragment length polymorphism analysis. RESULTS Gender distribution, age, duration of diabetes and HbA(1c) were similar in cases and control subjects. Distribution of genotypes in the control subjects for both SNPs was consistent with the Hardy-Weinberg equilibrium. Distribution of genotypes did not differ significantly between cases and control subjects for both polymorphisms-+2424C > T: cases CC 84.6%, CT 15.0%, TT 0.4% and control subjects CC 87.6%, CT 11.8%, TT 0.6% (P = 0.45); -930 A > G: cases AA 40.5%, AG 41.8%, GG 17.7% and control subjects AA 38.2%, AG 49.0%, GG 12.8% (P = 0.12). Distribution of alleles was also similar-+2424 C > T: cases C 92.2%, T 7.8% and control subjects C 93.5%, T 6.5% (P = 0.66); -930 A > G cases A 61.4%, G 38.6% and control subjects A 62.7%, G 37.3% (P = 0.38). We estimated that our study has approximately 80% power to detect a relative risk of 1.65 (for +242 C > T) and 1.35 (for -930 A > G) conferred by the minor allele, respectively. CONCLUSIONS In contrast with previous small studies, our data suggest that these SNPs do not confer significantly increased susceptibility to DN secondary to T2DM in Chinese subjects.
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Affiliation(s)
- S C Lim
- Department of Medicine, Alexandra Hospital, Singapore.
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31
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Han JY, Zeng RP, Cheng G, Hu B, Li H, Lai YR. [Quantitative analysis of human globin gene expression in beta-thalassemia using real-time RT-PCR]. Yi Chuan 2005; 27:57-64. [PMID: 15730961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Whole blood samples were collected from 100 normal healthy adults, from umbilical cord of 33 newborn infants, 111 individuals with beta-thalassemia minor (beta(T)/beta(A),alphaalpha/alphaalpha) and 39 with beta-thalassemia major (beta(T)/beta(T),alphaalpha/alphaalpha). Prior to quantitative analysis of globin gene expression, DNA was extracted from all blood samples and used for beta-thalassemia genotype analysis. Different types of beta globin gene mutations were analyzed using reverse dot blotting (RDB) method. Total RNA were extracted and subjected to real-time RT-PCR for quantitative measurement of alpha, beta and gamma globin mRNA using three sets of primers and fluorescent-labeled probes, designed according to the sequences of alpha, beta and gamma human globin gene. Real-time RT-PCR was performed in ABI 7700 system. Following the real-time RT-PCR, the mean values of alpha, beta and gamma globin mRNA were calculated and the ratios of alpha/beta, alpha/(beta + gamma ) and gamma /(beta + gamma ) were determined to characterize the relative expression levels of different globin genes among normal adult, infant, beta-thalassemia minor and beta-thalassemia major patients. The resultant data were analyzed using SPSS 10.0 software to determine statistical significance of human globin gene expression among normal controls and beta-thalassemia patients. Due to vast variations of the mean globin gene mRNA levels among different groups, log conversion of alpha/beta + 1, alpha/(beta + gamma ) + 1 and gamma /(beta + gamma ) +1 was used for statistical analyses and intergroup comparison. The alpha/beta globin gene mRNA ratios were determined to be 4.62+/-1.20, 7.81+/-2.89, 13.51+/-5.12, and 188.24+/-374.04 for normal healthy adult (beta(A)/beta(A),alphaalpha/alphaalpha), infant (beta(A)/beta(A),alphaalpha/alphaalpha), beta- thalassemia minor (beta(T)/beta(A),alphaalpha/alphaalpha) and beta-thalassemia major(beta(T)/beta(T),alphaalpha/alphaalpha) respectively. The alpha/(beta+ gamma ) ratios were 4.43+/-1.17, 0.56+/-0.49, 9.62+/-4.37, and 2.14+/-1.58 for normal healthy adult (beta(A)/beta(A),alphaalpha/alphaalpha), infant (beta(A)/beta(A),alphaalpha/alphaalpha), beta- thalassemia minor (beta(T)/beta(A),alphaalpha/alphaalpha) and beta- thalassemia major(beta(T)/beta(T),alphaalpha/alphaalpha) respectively. The gamma /(beta+ gamma ) ratios were 0.04+/-0.03, 0.92+/-0.06, 0.28+/-0.18, and 0.95+/-0.04 for normal healthy adult (beta(A)/beta(A),alphaalpha/alphaalpha), infant (beta(A)/beta(A),alphaalpha/alphaalpha), beta- thalassemia minor (beta(T)/beta(A),alphaalpha/alphaalpha) and beta- thalassemia major (beta(T)/beta(T),alphaalpha/alphaalpha) respectively. Following statistical analyses, the alpha/beta and alpha/(beta+ gamma ) globin gene mRNA ratios were significantly different among four different groups (normal adult, normal infant, beta- thalassemia minor and beta- thalassemia major). The gamma /(beta + gamma ) globin gene mRNA ratio was significantly different among all groups except for between infant and beta- thalassemia major patients. Human beta globin gene mRNA levels decrease progressively and dramatically from normal adults to beta-thalassemia patients with beta-thalassemia major having the lowest levels. On the other hand, the gamma globin gene mRNA levels increase progressively from normal adult to beta-thalassemia patients with beta-thalassemia major having the highest levels. Infants have relatively lower levels of beta but higher levels of gamma globin gene mRNA as compared to those in normal adults. Thus, the relative expression levels of alpha, beta or gamma globin genes varied but inter-related among different ages of normal individuals and different beta-thalassemia genotypes.
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Affiliation(s)
- Jun-Ying Han
- Department of Medical Genetics, Sun Yat-sen Medical College, Sun Yat-Sen University, Guangzhou 510080, China.
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Zhang YQ, Xu SB, Lin YC, Li Q, Zhang X, Lai YR. Antagonistic effects of 3 sesquiterpene lactones from Atractylodes macrocephala Koidz on rat uterine contraction in vitro. Acta Pharmacol Sin 2000; 21:91-6. [PMID: 11263255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
AIM To study the effects of three sesquiterpene lactones: atractylenolide I (8,9-dehydroasterolide, B), 4,15-epoxy-8 beta-hydroxyasterolide (C), and atractylenolide III (8 beta-hydroasterolide, D) from Atractylodes macrocephala Koidz, on rat isolated uterus smooth muscle. METHODS Rat isolated uteri bathed in De Jalon I solution were used; acetylcholine (ACh), CaCl2, and oxytocin (Oxy) were used to evoke the contraction of uterus. RESULTS B, C, and D 28 or 56 mumol.L-1 inhibited the spontaneous movement of uterus, reducing their rest force, contractile force, and movement ability. B 28 or 56 mumol.L-1 also slowed down the frequency of uterus spontaneous contraction, but C or D did not. B, C, or D 28 and 56 mumol.L-1 inhibited the uterine spasm induced by Oxy and ACh. Likewise, Ver 0.28 mumol.L-1, B, C, and D 28 or 56 mumol.L-1 relieved the contraction mediated by CaCl2 in high-KCl solution, but B, C, or D had not marked influence on the maximal response of uterus to CaCl2. CONCLUSION B, C, and D inhibit the movement of uterus smooth muscle, and the mechanism is related to the inhibition of cholinergic system as well as Ca2+ movement.
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Affiliation(s)
- Y Q Zhang
- Laboratory of Pharmacy & Pharmacology, Department of Pharmacy, School of Life Sciences, Guangzhou 510275, China
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Sugawara N, Ohta T, Lai YR, Sugawara C, Yuasa M, Nakamura M, Tamura M. Iron depletion prevents adenine nucleotide decomposition and an increase of xanthine oxidase activity in the liver of the Long Evans Cinnamon (LEC) rat, an animal model of Wilson's disease. Life Sci 1999; 65:1423-31. [PMID: 10503961 DOI: 10.1016/s0024-3205(99)00378-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The Long Evans Cinnamon (LEC) rat, which accumulates excess Cu in the liver as in patients with Wilson's disease, is a mutant strain displaying spontaneous hepatitis. It was reported that Fe, like Cu, increases in the liver and that the severity of hepatitis is modified by Fe in the diet. In this experiment, oxidative stress increased by Fe was investigated before the onset of hepatitis. To examine the effect of Fe on the progress into hepatitis, LEC female rats were fed an Fe-regular (Fe 214 microg/g; Fe(+) group) or an Fe-restricted (Fe 14 microg/g; Fe(-) group) diet from 53 days of age for 35 days. Fischer rats were also fed as control animals. Adenine nucleotide decomposition was determined as an index of oxidative stress based on xanthine oxidase activity. The size of the hepatic pool of adenine nucleotides (ATP+ADP+AMP) was significantly smaller in LEC rats than Fischer rats. The energy charge (ATP+0.5ADP)/(ATP+ADP+AMP) was smaller in Fe(+) groups than in Fe(-) groups. In the LEC rat liver, the Fe concentration in the Fe(+) group was 160% of that in Fe(-) group and the correlation coefficient between the hepatic Fe concentration and the energy charge was significant. In this strain, an increase of xanthine oxidase activity resulted in an increase of xanthine, an oxidized metabolite of hypoxanthine in the liver. The results suggest the involvement of the Fe in the progression into hepatitis in the LEC rat, even if the dietary Fe concentration is similar to that of commercial diet.
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Affiliation(s)
- N Sugawara
- Department of Public Health, Sapporo Medical University, Japan
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Sugawara N, Ikeda T, Lai YR, Sugawara C. The effect of subcutaneous tetrathiomolybdate administration on copper and iron metabolism, including their regional redistribution in the brain, in the Long-Evans Cinnamon rat, a bona fide animal model for Wilson's disease. Pharmacol Toxicol 1999; 84:211-7. [PMID: 10361977 DOI: 10.1111/j.1600-0773.1999.tb01485.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The present work was performed to examine the effect of tetrathiomolybdate on Cu and Fe metabolism, especially redistribution of Cu and Fe in the brains of Long-Evans Cinnamon rats, with inherently abnormal Cu deposition in the liver. The drug was injected subcutaneously at 5 mg/kg of body weight twice a week for 65 days (total dose of 20 mg) into 40-day-old Long-Evans Cinnamon rats. In Long-Evans Cinnamon rats treated with tetrathiomolybdate, the hepatic Cu concentration was 60 microg/g wet weight, compared to 170 microg/g in untreated rats. In seven brain regions (cerebellum, medulla oblongata, hypothalamus, striatum, midbrain, hippocampus and cortex) of the Long-Evans Cinnamon rats treated with tetrathiomolybdate. the Cu concentration (1.5 to 2.3 microg/g) was slightly lower (1.6 to 2.7 microg/g) than in untreated rats. A significant difference between the two groups was found only in the midbrain. Brain Fe concentrations in regions other than the striatum were not changed significantly by the tetrathiomolybdate injections. The hepatic Fe concentration was about 120 microg/g in Long-Evans Cinnamon rats without tetrathiomolybdate. Tetrathiomolybdate injection further increased the concentration to about 250 microg/g. Our results indicated that subcutaneous tetrathiomolybdate injection did not have an effect that stimulated redistribution of Cu and Fe in the seven brain regions examined, although hepatic Cu was markedly decreased and the removed Cu was deposited in kidneys, spleen and testes. The increased hepatic Fe level should be taken into account when considering side effects of the compound.
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Affiliation(s)
- N Sugawara
- Department of Public Health, School of Medicine, Sapporo Medical University, Japan.
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Sugawara N, Lai YR, Sugawara C. Therapeutic effects of tetrathiomolybdate on hepatic dysfunction occurring naturally in Long-Evans Cinnamon (LEC) rats: a bona fide animal model for Wilson's disease. Res Commun Mol Pathol Pharmacol 1999; 103:177-87. [PMID: 10461684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Long-Evans Cinnamon (LEC) rats were fed a diet containing 7 ppm Cu and 30 ppm Cu from 60 days after birth. Fischer (Fischer group) and LEC (LEC-control group) rats fed a 7 ppm Cu diet showed normal growth throughout the whole period (60 to 125 days after birth). On the other hand, LEC rats fed the 30 ppm Cu diet had decreased body weight and showed slight jaundice at around 100 days after birth. Tetrathiomolybdate (TTM, 10 mg/kg bw) was injected sub-cutaneously at 101 and 105 days after birth into half of the LEC rats fed the 30 ppm Cu diet. LEC rats given TTM (LEC+TTM group) recovered their body weight and the jaundice rapidly disappeared. However, LEC rats without TTM (LEC-TTM group) had sharply decreased body weight and showed severe jaundice at 103 days after birth. The hepatic Cu concentration in LEC+TTM rats (460 micrograms/g) exceeded that of LEC-control rats (330 micrograms/g) at 125 days after birth. Our data suggest that TTM is effective for treatment of acute hepatic injury in the LEC rat.
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Affiliation(s)
- N Sugawara
- Department of Public Health, School of Medicine, Sapporo Medical University, Japan
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Sugawara N, Lai YR, Sugaware C, Arizono K. Decreased hepatobiliary secretion of inorganic mercury, its deposition and toxicity in the Eisai hyperbilirubinemic rat with no hepatic canalicular organic anion transporter. Toxicology 1998; 126:23-31. [PMID: 9585089 DOI: 10.1016/s0300-483x(97)00170-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Eisai hyperbilirubinemic (EHB) rats, a new mutant strain inbred from Sprague-Dawley (SD) rats, show no inherent expression of the canalicular multidrug resistance protein (cMrp) and lack canalicular multispecific organic anion transporter (cMOAT) activity. A sample of 203Hg (40 microCi with 40 microg Hg/kg) was injected intravenously (i.v.) into four male SD and EHB rats. Biliary excretion of reduced-glutathione (GSH) was 426 and 2 microg/bile for 15 min in the SD and EHB rats, respectively. Biliary excretion of 203Hg for 45 min in EHB rats significantly decreased to 1/4 of that of the SD rats. However, there was no difference in the hepatic uptake of 203Hg between the two strains. Other rats were injected subcutaneously (s.c.) with HgCl2 solution (at 0.2 and 1.6 mg/kg) containing 203Hg. Some 4 days after the injection of 0.2 mg/kg, about 3 and 13% of the total dose was found in the liver in SD and EHB rats, respectively. The hepatic supernatant Hg was recovered mainly in the void volume of a Sephadex column. Some 2 days after the injection of 1.6 mg/kg, these values were 3 and 23% in SD and EHB rats, respectively. The increased retention stimulated hepatic metallothionein (MT) induction and increased the proportion of Hg in the MT region on the Sephadex column. On the other hand, biliary excretion of 203Hg for 15 min in EHB rats was about 1/6-1/4 of that in SD rats. With the injection of 1.6 mg/kg, hepatic and renal functions worsened in EHB rats. In particular, severe necrosis was found in the renal tubules. Our results suggest that biliary secretion of inorganic Hg may be partly regulated by the ATP-dependent transport system, the glutathione S-conjugate export pump (GS-X pump) composed of Mrp and MOAT. Significantly decreased excretion stimulates hepatic retention of inorganic Hg. However, the hepatic lesions are less predictive. The MT induction may reduce the toxicity of metal to the liver cells.
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Affiliation(s)
- N Sugawara
- Department of Public Health, Sapporo Medical University, Japan.
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Lai YR, Sugawara N. Outputs of hepatic copper and cadmium stimulated by tetrathiomolybdate (TTM) injection in Long-Evans Cinnamon (LEC) rats pretreated with cadmium, and in Fischer rats pretreated with copper and cadmium. Toxicology 1997; 120:47-54. [PMID: 9160108 DOI: 10.1016/s0300-483x(97)03636-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The Long-Evans Cinnamon (LEC) rat, an inbred mutant rat derived from the Long-Evans strain, is characterized by spontaneous hepatitis due to gross accumulation of hepatic Cu. The accumulation, accompanied by marked induction of metallothionein (MT), is believed to be due to the inherent lack of output of Cu into the bile duct and blood vessels. In this study, the acute effect of tetrathiomolybdate (TTM), a chelator for output of hepatic Cu and Cd in LEC rats treated with Cd, was investigated. Female LEC rats were injected subcutaneously with Cd (Cd; 1.0 mg/kg) to induce Cd, Cu-MT. Fischer rats were treated with Cd (Cd; 1.0 mg/kg) and Cu (Cu; 3.0 mg/kg). Forty-eight hours after the injections of metals, TTM (5 mg/kg bw) was injected intravenously under anesthesia. The TTM injection rapidly stimulated biliary excretions of Cu (at a microgram/ml level) and Cd (at a ng/ml level). Furthermore, Cu and Cd concentrations were increased in serum sampled 60 min after the TTM injection. The increase of biliary Cu excretion was not accompanied by increased biliary excretion of MT. The TTM injection caused the hepatic Cu concentrations to decrease from 306 +/- 2 to 262 +/- 12 and from 43 +/- 6 to 20 +/- 5 micrograms/g in LEC and Fischer rats, respectively. The hepatic Cd concentration was not decreased by TTM treatment. Hepatic MT and Cu, but not Cd, concentrations in the MT fraction were also reduced by TTM injection. Our results showed that TTM can rapidly remove Cu from MT to increase bile and blood Cu levels. The output of Cd stimulated by TTM injection may be related to MT reduction resulting from removal of MT-bound Cu. Our results indicate that to avoid the toxic effect of Cu, TTM injection is an effective initial treatment, although it remains to be established how metals, including Cu, are finally metabolized.
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Affiliation(s)
- Y R Lai
- Department of Public Health, School of Medicine, Sapporo Medical University, Japan
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Sugawara N, Lai YR, Arizono K, Kitajima T, Inoue H. Lack of biliary excretion of Cd linked to an inherent defect of the canalicular isoform of multidrug resistance protein (cMrp) does not abnormally stimulate accumulation of Cd in the Eisai hyperbilirubinemic (EHB) rat liver. Arch Toxicol 1997; 71:336-9. [PMID: 9137813 DOI: 10.1007/s002040050395] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A new mutant, the Eisai hyperbilirubinemic (EHB) rat, shows no inherent expression of the canalicular isoform of the multidrug resistance protein (cMrp) in the liver. It has defective biliary secretion of organic anions such as bilirubin glucuronides, bromosulfophthalein (BSP), cysteinyl leukotrienes, glutathione (GSH) and bile acid sulfate and glucuronides. When rats were injected intravenously with CdCl2, biliary excretion of Cd over 30 min was 0.28% and 0.004% of the total dose in Sprague-Dawley (SD) and EHB rats, respectively. Six SD rats and five EHB rats were fed a diet containing Cd. Bile Cd was detected at the level of 2 ng/20 min in SD rats, but not in EHB rats. There was no significant difference of hepatic Cd concentration between SD and EHB rats. Furthermore, there were no significant differences of renal and intestinal Cd, and hepatic and renal metallothionein (MT) concentrations between the SD and EHB groups. Biliary excretion of reduced-GSH for 20 min was 1.3 +/- 0.3 mg and 3.6 +/- 0.9 micrograms in SD and EHB rats, respectively. Our results suggest that hepatobiliary excretion of exogenous Cd is mediated mainly via carrier transport, including a cMrp or GSH carrier, but that the lack of the transport pathway does not contribute to abnormal accumulation of Cd in the liver.
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Affiliation(s)
- N Sugawara
- Department of Public Health, Sapporo Medical University, Japan
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Sugawara N, Lai YR, Arizono K, Ariyoshi T. Biliary excretion of exogenous cadmium, and endogenous copper and zinc in the Eisai hyperbilirubinuric (EHB) rat with a near absence of biliary glutathione. Toxicology 1996; 112:87-94. [PMID: 8792851 DOI: 10.1016/0300-483x(96)03353-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Mutant Eisai hyperbilirubinuric (EHB) rats derived from an inbred strain of Sprague-Dawley (SD) rats are characterized by a near absence of biliary excretion of glutathione (GSH) due to inherently impaired ATP-driven organic anion transport. Cd (0.1 mg/kg bw from CdCl2) was injected intravenously into EHB rats and control SD rats. Output of biliary excretion of Cd was followed over 15-min intervals up to 60 min. Cd was excreted rapidly and reached the maximum level (73.2 ng/15 min) in the period from 15 to 30 min in SD rats. Its excretion in EHB rats, however was one-fortieth (only 1.8 ng/15 min) of that in SD rats. Biliary concentrations of two endogenous metals, Cu and Zn were also measured. The output of Cu in EHB rat bile (50 ng/15 min before Cd injection) was about one-fifth of that in SD rat bile (270 ng/15 min). The output was not influenced by the Cd injection in the two groups. There was a slight difference of Zn output between the two groups. The biliary excretion of GSH was 500 to 700 micrograms/15 min and only 1 to 2 micrograms/15 min in SD and EHB rats, respectively. Sixty min after Cd injection, the Cd concentrations in the serum, liver and kidney were slightly higher in EHB rats than in SD rats. There was no difference in the hepatic metallothionein (MT-I and-II) concentration between SD (34 micrograms/g liver) and EHB (33 micrograms/g liver) rats. The renal Cu concentration was about four times in the higher in the EHB rat than in the SD rat. These results suggest that reduced biliary excretion of Cd is mainly, but that of Cu is only partly, based in reduced canalicular transport of GSH due to lack of an ATP-driven organic anion transport system, not MT induction in EHB rats. It seems likely that biliary excretion of Cd is regulated mainly by the canalicular anion transport in rats.
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Affiliation(s)
- N Sugawara
- Department of Public Health, Sapporo Medical University, Japan
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Abstract
An inherent defect of biliary Cu excretion and subsequent Cu deposition in the liver have been found in Long-Evans Cinnamon (LEC) rats, which are promising models of Wilson disease. LEC and Fischer rats were given water containing Cd (CdCl2) at a level of 5 ppm for 30 days. Regardless of drinking Cd water, LEC rats showed a very high concentration of Cu (200 to 250 microgram/g) and Cu-metallothionein (Cu-MT) (18 mg/g) in the liver. There was no difference of Cd accumulation in the liver between the two strains exposed to Cd (2.6 and 2.7 microgram/g in the Fischer and LEC groups, respectively). However, the renal Cd concentration was slightly but significantly higher in LEC rats (3.5 microgram/g) than in Fischer rats (2.0 microgram/g). The ratio of renal Cd contents to the sum of renal and hepatic Cd contents was significantly higher in LEC rats (0.25) than in Fischer rats (0.15). The serum Cd concentration in Cd-treated LEC rats increased threefold compared to Cd-treated Fischer rats. It seems likely that Cd from the liver is transported into the kidney in the form of Cd, Cu-MT. There was no difference in uptake of Cd in the hepatic MT fraction between the two strains. Although biliary Cu excretion in LEC rats was significantly lower than that in Fischer rats, reduced excretion of Cd into bile was not found in LEC rats. The gross amounts of Cu and Cu-MT influenced the accumulation of Cd in the kidney rather than in the liver when Cd was given orally at a low level to LEC rats. Our results suggest tht Cu and Cd do not share the same sites of hepatobiliary excretion in rats, although the main route of their excretion is via bile.
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Affiliation(s)
- N Sugawara
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan
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Abstract
The effect of ethanol on pharmacokinetics of paraquat was studied in rabbits by intravenous (i.v.) bolus injection of ethanol 0.5 g/kg (or normal saline, in the control group) followed by an i.v. dose of paraquat 20 mg/kg. A greater apparent volume of distribution (Vd), faster distribution rate constants and lower peak plasma concentration (P < 0.01) of paraquat were observed in the ethanol-treated than that in the control rabbits. The total clearance of paraquat was not significantly different between the two groups. The effect of ethanol on the intestinal absorption of paraquat was estimated by in situ intestinal perfusion technique in rats. The perfusate contained paraquat 50 micrograms/ml alone or with 1% or 2% ethanol. Inulin 320 micrograms/ml was added to the perfusate for the measurement of water net flux. The absorption clearance of paraquat as well as the absorption of water increased (P < 0.01) about two-fold in the presence of ethanol. The results of this study suggest that ethanol may potentiate paraquat toxicity by increasing intestinal absorption and tissue distribution. The critical lethal plasma concentration of paraquat is supposed to be lower in the presence of ethanol owing to increased volume of distribution.
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Affiliation(s)
- H Y Yu
- School of Pharmacy, Department of Legal Medicine, College of Medicine, National Taiwan University, Taipei, R.O.C
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