铁过载对大鼠骨髓及肝脾组织的影响

目的:通过腹腔注射右旋糖酐铁建立铁过载大鼠模型,观察过量补铁对大鼠骨髓及肝脾组织的影响。方法:雄性Wistar大鼠40只随机分为:正常对照组、低剂量铁组、中剂量铁组和高剂量铁组。经隔日腹腔注射每次分别给予右旋糖酐铁0.9 mg、0.3 mg、9mg、18 mg,共干预6周。观察各组大鼠的生长发育状况并检测相关指标。结果:四组大鼠白细胞计数、红细胞计数、血红蛋白浓度以及血小板计数差异均无统计学意义(P0.05)。骨髓外铁含量分析,中、高剂量铁组大鼠骨髓基质中均出现不同程度的铁蓄积,骨髓细胞外铁含量均显著高于正常对照组(P0.05)。与正常对照组比较,中、高剂量铁组大鼠肝脏系数分别升高52%和148%(P0.05),脾脏系数分别升高56%和100%(P0.05)。与正常对照组比较,中、高剂量铁组大鼠肝组织铁分别升高154%和303%(P0.05),脾组织铁分别升高40%和127%(P0.05),血清铁含量分别升高35%和165%(P0.05)。结论:过量补铁(腹腔给药)可使大鼠骨髓基质出现铁沉积,肝脏和脾脏脏器系数及其组织铁含量显著增加,导致铁在机体内过量蓄积。因此临床铁补充应防止过量长期用药。     

铁过载人群外周血相关指标变化分析

目的：探讨铁过载人群外周血相关指标的变化及血清铁蛋白(SF)和铁营养、血常规指标之间的关系,为铁过载的诊断及分类提供科学依据。方法：随机抽取196名铁正常人群(男SF:15~200μg/L、女SF：15~150μg/L)和226名铁过载人群(男SF:＞200μg/L、女SF:＞150μg/L)。采用放射免疫法检测SF浓度,检测铁营养状况和血常规指标,分析血清铁蛋白和铁营养、血常规指标之间的相关性。结果：铁过载人群血清铁浓度22.93μmol/L和转铁蛋白饱和度36%显著高于铁正常组的17.83μmol/L和28%(P<0.05),铁过载组人群不饱和铁结合力水平为40.69μmol/L和转铁蛋白浓度245.67mg/dL,显著低于正常组的46.97μmol/L和264.33 mg/dL(P<0.05),两组间总铁结合力水平的比较无显著差异(P>0.05);铁过载组红细胞计数平均为4.98×1012/L和血红蛋白含量平均为155g/L,显著高于铁正常组的4.82×1012/L和147g/L (P<0.05),铁过载组红细胞压积44%和平均红细胞血红蛋白含量31.17pg,显著高于铁正常组人群的42%和30.61pg (P<0.05),两组之间白细胞计数和血小板计数的比较无显著差异(P>0.05)。相关分析显示,血清铁蛋白与血清铁、转铁蛋白饱和度、红细胞计数、白细胞计数、血红蛋白、红细胞压积和平均红细胞血红蛋白含量呈显著正相关(P<0.05),与不饱和铁结合力、转铁蛋白水平和血小板计数呈显著负相关(P<0.05)。结论：中老年人群铁过载时,机体内血清铁、转铁蛋白饱和度、红细胞计数、血红蛋白、红细胞压积和平均红细胞血红蛋白含量均升高,不饱和铁结合力和转铁蛋白水平均降低;血清铁蛋白和血红蛋白呈显著正相关。因此,采用血常规检查和铁营养指标的联合检测来评价铁过载的程度,可为铁过载的早期发现、早期治疗提供科学依据。     

在分子水平上认识铁过载

人体主要通过两个路径实现对铁含量的调控:一是肝释放的铁调素控制肠黏膜细胞对铁的吸收;二是铁蛋白含量超标,促进肠膜细胞脱落。在肠炎症状态下,细胞膜通透性发生改变,以上两种调控功能都会受到影响。铁过载是长期积累的结果。人体内铁元素没有明确的排出机制,可以反复利用,因此随着年龄的增长,体内的含铁量会越来越多,铁过载已成为危害人类健康的重要因素。铁过载与疾病的关系主要包括三方面:一是铁过载诱发自由基反应,破坏细胞的正常功能;二是铁过载会造成铁沉积,导致溶酶体膜破裂,使细胞发生"自残";三是三价铁离子(Fe³⁺)会灭活超氧阴离子,使氧气丧失作为最终电子受体的功能,在氧充足的情况下,不能有效地进行氧化反应。本文对铁蛋白与非蛋白络合铁在细胞中的平衡和非蛋白络合铁过剩与相关疾病的关系根源及其临床意义进行了综述。     

去铁酮联合去铁胺治疗重型地中海贫血患儿的疗效及对血糖代谢和铁代谢的影响

目的:探讨去铁酮联合去铁胺治疗重型地中海贫血患儿的疗效及对血糖代谢和铁代谢的影响。方法:选取2015年3月～2017年12月期间海南省妇女儿童医学中心儿科收治的127例重型地中海贫血患儿,根据数表法将患儿随机分为对照组(n=63)和研究组(n=64),其中对照组在基础治疗的基础上给予去铁胺治疗,研究组在对照组的基础上联合去铁酮治疗。比较两组患儿临床疗效、治疗前后的血糖代谢和铁代谢情况,记录两组患儿治疗期间不良反应发生情况。结果:研究组患儿治疗后临床总有效率为73.44%(47/64),高于对照组患儿的55.56%(35/63)(P0.05)。两组患儿治疗后血糖代谢正常率均升高,且研究组高于对照组(P0.05)。两组患儿治疗后血清铁蛋白(SF)降低,尿铁排泄量(UIE)升高(P0.05);研究组治疗后SF低于对照组,UIE高于对照组(P0.05)。两组不良反应发生率比较无统计学差异(P0.05)。结论:去铁酮联合去铁胺治疗重型地中海贫血患儿,安全有效,可改善机体铁代谢,提高血糖代谢正常比例,具有一定的临床应用价值。     

铁过载状态下衰老细胞自发转化为肿瘤

在衰老与肿瘤关系研究中,始终存在一个令人困惑的问题,即衰老细胞如何逾越死亡壁垒,成功转化为肿瘤细胞.本文以"衰老是氧化损伤累积的结果"为依据,着重分析了活性氧的产生、演变和造成损伤的全过程,在此基础上对衰老的发生发展提出了新的认识:衰老进程不是取决于活性氧的源头——超氧阴离子自由基的生成量,而是主要取决于细胞中能够催化...     

骨髓移植不是白血病治疗的唯一方案

白血病一直是一个沉重的话题。近年来，白血病越来越密切地和捐献骨髓联系在了一起，似乎骨髓移植成了治疗白血病的灵丹妙药。然而，白血病是不是真的只能依靠骨髓移植的方法治疗呢？     

铁过载引起的疾病：一种“沉默”的疾病

铁是人体生命必需的微量元素,但摄入过多也会对身体健康造成危害。在广大公众心目中．往往只认识到铁提供给人体营养价值的一面,而忽视了铁过量的潜在危害。铁过量会影响心脏、肝脏、内分泌系统和其他器官的正常功能。介绍了血色病、神经退行性疾病、癌症等与铁过载有关的疾病,以期引起人们对铁代谢的全面认识。     

铁过载促进小鼠肝组织发生蛋白质酪氨酸硝化

蛋白质酪氨酸硝化是一种蛋白质翻译后的修饰,其存在会影响酶的催化活性,细胞信号转导和细胞骨架结构．在铁过载情况下,存在引起蛋白质酪氨酸硝化的有利环境,但目前尚无实验证实．本文运用腹腔注射右旋糖苷铁造成小鼠铁过载模型,通过免疫印迹法发现,在铁过载情况下,肝中诱导型一氧化氮合酶表达显著高于正常对照小鼠;铁过载小鼠肝中总体蛋白质硝化程度高于正常小鼠;铁过载引起的蛋白质酪氨酸硝化有一定的选择性,在铁过载小鼠肝中发现一些新的被硝化蛋白质条带（约 57 kD、 35 kD）．上述结果证实,铁过载会促进肝蛋白质酪氨酸硝化．     

铁过载对Wnt信号诱导的ST2细胞成骨分化的作用及机制

该研究探究铁过载对Wnt信号诱导的小鼠骨髓基质细胞(ST2)成骨分化的作用及其可能的机制.采用柠檬酸铁铵(FAC)模拟铁过载微环境,用碱性磷酸酶(ALP)染色及生化定量检测成骨分化水平,qRT-PCR检测成骨分化标志基因Alp、Runx2、Osx、Coll以及Wnt信号靶基因Smad6、CyclinD1、Lef1、BM...     

中老年人群铁过载与膳食营养及生活方式关系分析

目的：分析中老年体检人群机体铁过载与膳食营养及生活方式的关系,为深入探讨铁过载对人群健康的影响及疾病预防提供参考。方法：采用病例对照研究方法,抽取120例铁过载人群和183例铁营养状况正常人群进行营养健康问卷调查,调查内容包括基本情况、生活方式以及膳食结构等。运用条件Logistic回归进行铁过载影响因素分析。结果：在研究的中老年人群中,病例组吸烟者（30.0%）、饮酒者（52.5%）、喜食红肉者（27.5%）所占比例明显高于对照组（15.8%、33.3%、14.8%）,而病例组饮茶者（54.2%）和运动锻炼者（47.5%）所占比例明显低于对照组（65.5%和66.7%）,差异有统计学意义（P＜0.05）。通过比较2组饮食习惯发现病例组进食畜肉类频率高于对照组（Z=3.500,P<0.001）,而进食杂粮、薯类、豆类及其制品、奶类及其制品、蛋类、蔬菜和水果的频率均低于对照组（Z值分别为3.911、2.664、3.255、2.335、2.089、5.791和6.689,P＜0.05）。对以上因素进行多因素Logistic回归,提示吸烟（OR=2.040,95% CI：1.057~3.935）,每天进食畜肉类食物（OR=2.473,95% CI：1.368~4.469）是铁过载的独立危险因素;每天进食蔬菜（OR=0.240,95% CI：0.115~0.500）,每天进食水果（OR=0.448,95% CI：0.245~0.819）是铁过载的独立保护因素。结论：中老年人群铁过载与膳食营养及生活方式密切相关,因此,中老年人群应做到定期进行健康体检,同时加强运动锻炼和形成良好的生活饮食习惯,预防和减少铁过载的发生。     

Immune reconstitution in patients with Fanconi anemia after allogeneic bone marrow transplantation

Background aimsFanconi anemia is an autosomal recessive or X-linked genetic disorder characterized by bone marrow (BM) failure/aplasia. Failure of hematopoiesis results in depletion of the BM stem cell reservoir, which leads to severe anemia, neutropenia and thrombocytopenia, frequently requiring therapeutic interventions, including hematopoietic stem cell transplantation (HSCT). Successful BM transplantation (BMT) requires reconstitution of normal immunity.MethodsIn the present study, we performed a detailed analysis of the distribution of peripheral blood subsets of T, B and natural killer (NK) lymphocytes in 23 patients with Fanconi anemia before and after BMT on days +30, +60, +100, +180, +270 and +360. In parallel, we evaluated the effect of related versus unrelated donor marrow as well as the presence of graft-versus-host disease (GVHD).ResultsAfter transplantation, we found different kinetics of recovery for the distinct major subsets of lymphocytes. NK cells were the first to recover, followed by cytotoxic CD8⁺ T cells and B cells, and finally CD4⁺ helper T cells. Early lymphocyte recovery was at the expense of memory cells, potentially derived from the graft, whereas recent thymic emigrant (CD31⁺ CD45RA⁺) and naive CD4⁺ or CD8⁺ T cells rose only at 6 months after HSCT, in the presence of immunosuppressive GVHD prophylactic agents. Only slight differences were observed in the early recovery of cytotoxic CD8⁺ T cells among those cases receiving a graft from a related donor versus an unrelated donor. Patients with GVHD displayed a markedly delayed recovery of NK cells and B cells as well as of regulatory T cells and both early thymic emigrant and total CD4⁺ T cells.ConclusionsOur results support the utility of post-transplant monitoring of a peripheral blood lymphocyte subset for improved follow-up of patients with Fanconi anemia undergoing BMT.     

Abnormal iron delivery to the bone marrow in neonatal hypotransferrinemic mice

Hypotransferrinemic (HP) mice have a splicing defect inthe transferrin gene, resulting in <1% of the normal plasma levels of transferrin. They have severe anemia, suggesting that transferrin is essential for iron uptake by erythroid cells in the bone barrow. To clarify the significance of transferrin on iron delivery to the bone marrow, iron concentration and ⁵⁹Fe distribution were determined in 7-day-old HP mice. Iron concentration in the femur, bone containing the bone marrow, of HP mice was approximately twice higher than in wild type mice. Twenty-four h after injection of ⁵⁹FeCl₃, ⁵⁹Fe concentration in the bone and bone marrow of HP mice was also twice higher than in wild type mice. The present findings indicate that iron is abnormally delivered to the bone marrow of HP mice. However, the iron seems to be unavailable for the production of hemoglobin. These results suggest that transferrin-dependent iron uptake by erythroid cells in the bone marrow is essential for the development of erythrocytes.     

NK cells in allogeneic bone marrow transplantation

NK cells, until recently an ignored subset of lymphocytes, have begun to emerge as important cytotoxic effectors. It is now accepted that NK cells together with T cells constitute major actors in graft-versus-leukemia reaction after allogeneic bone marrow transplantation (BMT). Over the last several years the mechanisms regulating the activation of NK cells have been the subject of intense investigations encouraged by the clinical implications that these studies will have. This article provides a general overview of NK-cells biology and regulation pertinent to their function in allogeneic BMT, followed by a review of the in vivo preclinical and clinical evidence for the beneficial effect of NK cells in the adoptive immunotherapy of leukemia.     

运动诱导的低铁状态大鼠骨髓细胞铁摄入的变化

本文观察了运动性低铁状态大鼠骨髓细胞转铁蛋白 (Tf)结合铁和非Tf结合铁摄入的变化。大鼠随机分为 6个月的运动组 (EG)和对照组 (SG)。SG平均每个幼红细胞Tf受体数为 890 15 0± 16 4849个 ,而在EG为 2 17536 0± 46 2 737个 (P <0 0 5 ) ,但受体的解离常数不受运动影响。EG中Tf的内吞平台和胞内铁聚积速度显著高于SG ,胞浆和胞内膜性成分中Tf结合铁和Fe(Ⅱ )摄入增加。EG的胞浆内Fe(Ⅱ )摄入的米氏常数值降低 ;细胞膜性成分中Fe(Ⅱ )摄入的最大速度增加。上述结果表明 ,运动不仅通过增加Tf受体的表达促进Tf结合铁的内吞 ,而且增强非Tf结合铁的内吞途径。尽管这些变化的机制尚不清楚 ,但它们有利于运动时血红素的合成     

Monoclonal antibodies to carbohydrate antigens in autologous bone marrow transplantation

Normal and malignant myeloid cells express a highly immunogenic oligosaccharide, lacto-n-fucopentaose-III (LNF-III), that has been identified by numerous monoclonal antibodies (MoAb). We have been interested in the use of a particular monoclonal antibody to LNF-III, PM-81, in the treatment of patients with acute myelogenous leukemia using the antibody to treat bone marrow in vitro. Following in vitro treatment of bone marrow with PM-81 and another MoAb, AML-2-23, the remaining cells are used as an autograft in a patient treated with high-dose chemotherapy and radiotherapy. In order to enhance the ability of the MoAb to lyse leukemic cells in the remission bone marrow, we have explored the effect of neuraminidase treatment on leukemia cells. In this paper we describe that myeloid leukemia cells expressing low levels of LNF-III by immunofluorescence can be shown to have high levels of LNF-III after neuraminidase treatment. In addition, we show that normal bone marrow progenitor cells do not have cryptic LNF-III antigen, thus allowing the application of this finding to the clinical setting. Moreover, we have shown that leukemia colony-forming cells from one patient with acute myelogenous leukemia express cryptic LNF-III and that after exposure to neuraminidase there was an increased ability of PM-81 in the presence of complement to eliminate these colony forming cells. These data indicate that the LNF-III moiety is almost universally expressed on myeloid leukemia cells and their progenitors but not expressed on normal progenitors. Thus, it may be possible to enhance leukemia cell kill in vitro by neuraminidase treatment of bone marrow.     

The role of busulfan in bone marrow transplantation

High-dose busulfan is an important component in many conditioning protocols for hematopoietic stem cell transplantation (HSCT) or bone marrow transplantation (BMT) in both adults and children. During the past 12y several studies have reported the wide inter-invidual variability in busulfan disposition. Age, disease status, hepatic function, circadian rhythmicity, drug interactions and bioavailability, were identified as factors contributing to the high inter-individual variability found in busulfan disposition. Traditionally, a standard busulfan dose of 4mg/kg/d for four days is used in most BMT/HSCT protocols. Many investigations have pointed out the pharmacodynamic relationship between a high busulfan systemic exposure and the occurrence of BMT related toxicity including hepatic veno-occlusive disease (VOD), interstitial pneumonia and alopecia in adult patients. However, studies in young patients have shown a high rate of graft failure and subsequently relapse which most probably is due to the low systemic exposure despite the standard dose schedule. In children and infants VOD was not observed with the standard doses. Increasing interest for the drug and new modification strategies for children led to higher rate of VOD and CNS toxicity when busulfans was administered according to the body surface area. More pharmacodynamic studies are required to establish the relation between the systemic exposure to busulfan and the therapeutic efficacy, especially in young children undergoing BMT or HSCT. In the present time an accurate and effective busulfan plasma level monitoring combined with dose adjustment based on the known pharmacological parameters may improve the clinical outcome for patients undergoing BMT.     

骨髓基质细胞的特征及其在细胞和基因治疗中的应用

骨髓基质细胞是一类独特的间质干细胞,可分化为多种非造血系的组织。骨髓基质细胞具有贴壁生长的特性,因而易于在体外分离和扩增;另外骨髓基质细胞可在体内外表达多种治疗性的外湖目的基因。因此,骨髓基质细胞被认为是一种理想的治疗性细胞的基因治疗中的靶细胞。本文对骨髓基质细胞的研究进展及其在细胞和基因治疗中的应用作一综述。     

Timing of transplantation of autologous bone marrow derived mesenchymal stem cells for treating myocardial infarction

It is still unclear whether the timing of intracoronary stem cell therapy affects the therapeutic response in patients with myocardial infarction.The natural course of healing the infarction and the presence of putative homing signals within the damaged myocardium appear to favor cell engraftment during the transendothelial passage in the early days after reperfusion.However,the adverse inflammatory environment,with its high oxidative stress,might be deleterious if cells are administered too early after reperfusion.Here we highlight several aspects of the timing of intracoronary stem cell therapy.Our results showed that transplantation of bone marrow mesenchymal stem cells at 2 4 weeks after myocardial infarction is more favorable for reduction of the scar area,inhibition of left ventricular remodeling,and recovery of heart function.Coronary injection of autologous bone marrow mesenchymal stem cells at 2 4 weeks after acute myocardial infarction is safe and does not increase the incidence of complications.