Sirolimus-based graft-versus-host disease prophylaxis promotes the in vivo expansion of regulatory T cells and permits peripheral blood stem cell transplantation from haploidentical donors

Hematopoietic stem cell transplantation (HSCT) from human leukocyte antigen (HLA) haploidentical family donors is a promising therapeutic option for high-risk hematologic malignancies. Here we explored in 121 patients, mostly with advanced stage diseases, a sirolimus-based, calcineurin-inhibitor-free prophylaxis of graft-versus-host disease (GvHD) to allow the infusion of unmanipulated peripheral blood stem cell (PBSC) grafts from partially HLA-matched family donors (TrRaMM study, Eudract 2007-5477-54). Conditioning regimen was based on treosulfan and fludarabine, and GvHD prophylaxis on antithymocyte globulin Fresenius (ATG-F), rituximab and oral administration of sirolimus and mycophenolate. Neutrophil and platelet engraftment occurred in median at 17 and 19 days after HSCT, respectively, and full donor chimerism was documented in patients' bone marrow since the first post-transplant evaluation. T-cell immune reconstitution was rapid, and high frequencies of circulating functional T-regulatory cells (Treg) were documented during sirolimus prophylaxis. Incidence of acute GvHD grade II-IV was 35%, and occurrence and severity correlated negatively with Treg frequency. Chronic GvHD incidence was 47%. At 3 years after HSCT, transpant-related mortality was 31%, relapse incidence 48% and overall survival 25%. In conclusion, GvHD prophylaxis with sirolimus-mycophenolate-ATG-F-rituximab promotes a rapid immune reconstitution skewed toward Tregs, allowing the infusion of unmanipulated haploidentical PBSC grafts.

Mollusks (Gastropoda and Bivalvia) of the Multiple-Use Reserve Martín García Island, Río de la Plata River: biodiversity and ecology

The Island of Martin Garcia is located in the Upper Río de la Plata, to the south of mouth the Uruguay River. The aim of the present study was to analyse the biodiversity of the island freshwater mollusks and their relationships to environmental variables. Twelve sampling sites were selected, five were along the littoral section of the island and seven were Inland ponds. Seven major environmental variables were measured: water and air temperature, percentage of oxygen saturation, dissolved oxygen, electrical conductivity, total dissolved solids and pH. Twenty-seven mollusk species were found, Antillorbis nordestensis, Biomphalaria tenagophila tenagophila , B. t. guaibensis, B. straminea, B. peregrina, Drepanotrema kermatoides, D. cimex, D. depressissimum, Chilina fluminea, C. rushii, C. megastoma, Uncancylus concentricus, Hebetancylus moricandi, Stenophysa marmorata, Heleobia piscium, H. parchappii, Potamolithus agapetus, P. buschii, P. lapidum, Pomacea canaliculata, P. megastoma, Asolene platae, Corbicula fluminea, Eupera platensis, Pisidium sterkianum, P. taraguyense and Limnoperna fortunei. UPGMA clustering of species based on their occurrence in different ecological conditions revealed two main species groups. The Canonical Correspondence Analysis suggests that the species distribution is related to the physico-chemical condition of water. Axis two of the ordination diagram displayed the approximately 95.6% of the correlation between species and environmental variables. Dissolved oxygen, conductivity, water temperature and pH showed the highest fluctuations during the sampling period. The species richness (S) showed relationships mainly with water temperature and conductivity. The biodiversity of the gastropods and bivalves from Martín García Island amounts to up to 26 species. Among the Gastropoda, the Planorbidae family made the most sizeable contribution. The Lithogliphidae P. agapetus (26.28%) and P. buschii (9.50%) showed the highest relative frequencies of occurrence within the littoral environments, while the Planorbidae D. cimex (23.83%) and D. kermatoides (11.59%) likewise did so in the inland ponds.