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1.
Rai TS Dhandapany PS Ahluwalia TS Bhardwaj M Bahl A Talwar KK Nair K Rathinavel A Khullar M 《Molecular and cellular biochemistry》2008,311(1-2):67-72
Aim The study was carried to determine the association of angiotensin converting enzyme (ACE) insertion/deletion (I/D) polymorphism
with the risk of hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), and restrictive cardiomyopathy (RCM). Methods and results A total of 174 patients diagnosed with cardiomyopathy (118 with HCM, 51 with DCM, and 5 with RCM) and 164 ethnically, age-
and gender-matched controls were included in the study. ACE I/D genotyping was performed by PCR. In total, 25.86% of the patients
were in New York Heart Association (NYHA) class III and IV at presentation. A total of 67.24% patients had dyspnea, 56.89%
had angina pectoris, and 25.28% of the patients had at least one event of syncope. Frequency of occurrence of the disease
was more in male patients compared to female patients (P < 0.05). After adjustment for age, sex, body mass index (BMI), and smoking habit, the prevalence of ACE DD genotype, and
ACE ‘D’ allele was significantly higher in patients as compared to controls and was associated with increased risk (DD: OR
2.11, 95% CI 1.27–3.52, P < 0.05; ‘D’: OR 1.91, 95% CI 1.08–3.35, P < 0.05). The mean septal thickness was higher for DD and ID genotypes (20.40 ± 3.73 mm and 21.82 ± 5.35 mm, respectively)
when compared with II genotype (18.63 ± 6.69 mm) in HCM patients, however, the differences were not significant statistically
(P > 0.05). The DCM patients with ID genotype showed significantly decreased left ventricular ejection fraction (LVEF) at enrolment
(26.50 ± 8.04%) (P = 0.04). Conclusion Our results suggest that D allele of ACE I/D polymorphism significantly influences the HCM and DCM phenotypes. 相似文献
2.
目的：应用血流向量图（VFM）对扩张性心肌病（DCM）患者收缩期左室心腔血液流场变化情况进行检测,初步探讨VFM技术在评价DCM患者左心室收缩功能方面的临床价值。方法：选择临床诊断为DCM患者30例作为病例组,另选30例体检健康者作为对照组。在血流向量图条件下测量两组取样线上收缩期负向总流量（SystoleQ-,SQ-）在涡流条件下测量涡流的最大流量（Qmax）、半值面积（S）、涡流半径（r）以及涡流强度（Qmax／S）,并比较两组差异。应用Simpson双平面法获取左心室射血分数（EF）,并与SQ-、Qmax／S进行相关性分析。结果：两组比较病例组基底段、中间段、心尖段收缩期负向总流量SQ-、两组组内比较基底段、中间段、心尖段收缩期负向总流量SQ．均呈逐渐递减变化趋势（P均〈0．01）。收缩期涡流最大流量Qmax及涡流强度Qmax／S测值均低于对照组（P〈0．01）;收缩期涡流半值面积S、涡流半径r均大于对照组（P〈0．01）：Qmax／S与EF呈正相关,（r=0．78,P〈0．01）;结论：VFM技术可以定量分析DCM患者左室心腔内血流流场的变化情况,有望为临床提供一种较为准确检测DCM患者左心功能的新方法。 相似文献
3.
Current decision‐guiding algorithms in cancer drug treatment are based on decades of research and numerous clinical trials. For the majority of patients, this data is successfully applied for a systemic disease management. For a number of patients however, treatment stratification according to clinically based risk criteria will not be sufficient. The most effective treatment options are ideally identified prior to the start of clinical drug therapy. This review will discuss the implementation of three‐dimensional (3D) cell culture models as a preclinical testing paradigm for the efficacy of clinical cancer treatment. Patient tumor‐derived cells in 3D cultures duplicate the individual tumor microenvironment with a minimum of confounding factors. Clinical implementation of such personalized tumor models requires a high quality of methodological and clinical validation comparable to other biomarkers. A non‐systematic literature search demonstrated the small number of prospective studies that have been conducted in this area of research. This may explain the current reluctance of many physicians and insurance providers in implementing this type of assay into the clinical diagnostic routine despite potential benefit for patients. Achieving valid and reproducible results with a high level of evidence is central in improving the acceptance of preclinical 3D tumor models. 相似文献
4.
Robin Augustine Sumama Nuthana Kalva Rashid Ahmad Alap Ali Zahid Shajia Hasan Ajisha Nayeem Lana McClements Anwarul Hasan 《Translational oncology》2021,14(4):101015
After cardiovascular disease, cancer is the leading cause of death worldwide with devastating health and economic consequences, particularly in developing countries. Inter-patient variations in anti-cancer drug responses further limit the success of therapeutic interventions. Therefore, personalized medicines approach is key for this patient group involving molecular and genetic screening and appropriate stratification of patients to treatment regimen that they will respond to. However, the knowledge related to adequate risk stratification methods identifying patients who will respond to specific anti-cancer agents is still lacking in many cancer types. Recent advancements in three-dimensional (3D) bioprinting technology, have been extensively used to generate representative bioengineered tumor in vitro models, which recapitulate the human tumor tissues and microenvironment for high-throughput drug screening. Bioprinting process involves the precise deposition of multiple layers of different cell types in combination with biomaterials capable of generating 3D bioengineered tissues based on a computer-aided design. Bioprinted cancer models containing patient-derived cancer and stromal cells together with genetic material, extracellular matrix proteins and growth factors, represent a promising approach for personalized cancer therapy screening. Both natural and synthetic biopolymers have been utilized to support the proliferation of cells and biological material within the personalized tumor models/implants. These models can provide a physiologically pertinent cell–cell and cell–matrix interactions by mimicking the 3D heterogeneity of real tumors. Here, we reviewed the potential applications of 3D bioprinted tumor constructs as personalized in vitro models in anticancer drug screening and in the establishment of precision treatment regimens. 相似文献
5.
近年来,超声(ultrasound, US)、CT冠状动脉造影(CT coronary angiography, CCTA)、血管内超声(intravenous ultrasound,IVUS)、光学相干断层成像(optical coherence tomography, OCT)、多层螺旋CT成像(multi-slice computed tomography, MSCT)、单光子发射计算机断层成像(single-photon emission computed tomography, SPECT)、正电子发射计算机断层成像(positron emission computed tomography, PET)及心脏磁共振(cardiac magnetic resonance, CMR)等多种心血管成像技术能够提供与冠脉病变及心肌形态和功能相关的解剖学、血流动力学、细胞生物学及病理生理学等方面的重要信息,在缺血性心肌病的临床诊疗及预后评估中发挥着日益重要的作用。然而,如何恰当选择的多模态心血管影像技术是临床医师面临的一大难题。因此,本文在归纳总结主要心血管成像技术临床应用进展的基础上,对多模态心血管影像学在缺血性心肌病相关的冠脉解剖与斑块成像、心肌功能、心肌灌注及心肌活性显像中的临床应用价值进行综述。旨在帮助临床医师客观认识各种成像技术的优势与不足,从而制定最优化的选择方案。 相似文献
6.
Ming Zhang Jin Wei Yali Li Hu Shan Rui Yan Lin Lin Qiuhong Zhang Jiahong Xue 《Biochemical and biophysical research communications》2014
Background
Calreticulin (CRT), a Ca2+-binding chaperone of the endoplasmic reticulum, can also be found in several other locations including the cytosol, nucleus, secretory granules, the outer side of the plasma membrane, and the extracellular matrix. Whether CRT is localized at mitochondria of cardiomyocytes and whether such localization is affected under DCM are still unclear.Methods and results
The DCM model was generated in rats by the daily oral administration of furazolidone for thirty weeks. Echocardiographic and hemodynamic studies demonstrated enlarged left ventricular dimensions and reduced systolic and diastolic function in DCM rats. Immuno-electron microscopy and Western blot showed that CRT was present in cardiomyocyte mitochondria and the mitochondrial content of CRT was increased in DCM hearts (P < 0.05). Morphometric analysis showed notable myocardial apoptosis and mitochondrial swelling with fractured or dissolved cristae in the DCM hearts. Compared with the control group, the mitochondrial membrane potential level of the freshly isolated cardiac mitochondria and the enzyme activities of cytochrome c oxidase and succinate dehydrogenase in the model group were significantly decreased (P < 0.05), and the myocardial apoptosis index and the caspase activities of caspase-9 and caspase-3 were significantly increased (P < 0.05). Pearson linear correlation analysis showed that the mitochondrial content of CRT had negative correlations with the mitochondrial function, and a positive correlation with myocardial apoptosis index (P < 0.001). The protein expression level of cytochrome c and the phosphorylation activity of STAT3 in the mitochondrial fraction were significantly decreased in the model group compared with the control group (P < 0.05).Conclusions
These data demonstrate that CRT is localized at cardiomyocyte mitochondria and its mitochondrial content is increased in DCM hearts. 相似文献7.
Jes-Niels Boeckel Maximilian M?bius-Winkler Marion Müller Sabine Rebs Nicole Eger Laura Schoppe Rewati Tappu Karoline E.Kokot Jasmin M.Kneuer Susanne Gaul Diana M.Bordalo Alan Lai Jan Haas Mahsa Ghanbari Philipp Drewe-Boss Martin Liss Hugo A.Katus Uwe Ohler Michael Gotthardt Ulrich Laufs Katrin Streckfuss-B?meke Benjamin Meder 《基因组蛋白质组与生物信息学报(英文版)》2022,20(1):129-146
Alternative mRNA splicing is a fundamental process to increase the versatility of the genome.In humans,cardiac mRNA splicing is involved in the pathophysiology of heart failure.Mutations in the splicing factor RNA binding motif protein 20(RBM20) cause severe forms of cardiomyopathy.To identify novel cardiomyopathy-associated splicing factors,RNA-seq and tissue-enrichment analyses were performed,which identified up-regulated expression of Sam68-Like mammalian protein 2(SLM2) in the left ventricle... 相似文献
8.
目的:评估心脏磁共振(cardiac magnetic resonance,CMR)功能成像在缺血性心肌病临床诊断中的价值。方法:使用飞利浦3.0T磁共振仪,对32例临床确诊的缺血性心肌病患者进行CMR平扫及钆对比剂动态增强扫描。应用Cardiac MR Analysis软件进行相关后处理分析,计算左室射血分数、室壁增厚率等心功能参数并与超声心动图检查结果相比较。采用17节段分段法分析心脏形态学、心肌组织运动、局部灌注、延迟增强等特点,评价其临床应用价值。结果:所有患者的心功能参数均降低,包括左室射血分数、每搏输出量、心输出量和室壁增厚率,心脏磁共振和超声心动图的测量结果并无明显差异(49%±5.3%vs 52%±8.2%;42.8 mL±8.9 mLvs 45.7 mL±10.6 mL; 3.5 L/min±0.6 L/min vs 3.8 L/min±0.9 L/min; 28%±4%. vs 31%±6%)(P0.05)。所有患者中存在室壁运动异常的为184段(184/544);其中心肌血流灌注信号减低的有136段(136/184),呈现心肌延迟强化的有98段(98/136)。结论:CMR功能成像对于缺血性心肌病的临床诊疗及预后评估可提供与心肌形态及功能相关的重要信息。 相似文献
9.
目的建立cTnT^R141W扩张型心肌病的转基因小鼠模型。方法把cTnT^R141W基因插入-αMHC启动子下游,构建转基因表达载体,通过显微注射法建立cTnT^R141W转基因C57BL/6J小鼠。PCR鉴定cTnT^R141W转基因小鼠的基因表型,实时PCR检测基因的拷贝数,Northern blotting检测基因表达,光学显微镜和超声检测cTnT^R141W转基因小鼠心脏的病理改变。结果建立了3个系的cTnT^R141W转基因小鼠。3个系的基因拷贝数分别是15、20和59拷贝。cTnT^R141W基因在心脏组织的表达水平高于内源性cTnT。病理分析显示cTnT^R141W转基因小鼠心房心室明显大于野生型,心室壁明显变薄,心肌细胞不均匀肥大,心肌间质纤维增多。超声检查显示心室腔明显扩大,收缩期容积和舒张期容积显著增大,射血分数、短轴缩短率、室壁运动度明显降低。结论cTnT^R141W转基因小鼠的全心扩大,室壁变薄,心肌细胞肥大,间质纤维化以及心肌收缩力下降,说明成功建立了cTnT^R141W转基因小鼠扩张型心肌病模型,为研究扩张型心肌病发病机制和药物研发提供了有价值的动物模型。 相似文献
10.
摘要 目的：探究黄芪甲苷（AS-Ⅳ）对阿霉素诱导的扩张型心肌病（DCM）大鼠心肌纤维化和Th17细胞分化的影响。方法：采用剂量为2.5 mg/kg的阿霉素腹腔注射诱导构建DCM大鼠模型,将DCM大鼠分为模型组、黄芪甲苷低剂量组（低AS-Ⅳ组）、黄芪甲苷中剂量组（中AS-Ⅳ组）和黄芪甲苷高剂量组（高AS-Ⅳ组）,每组10只;另设置10只健康SD大鼠为对照组。低AS-Ⅳ组、中AS-Ⅳ组和高AS-Ⅳ组大鼠每日灌胃给予剂量为20 mg/kg、40 mg/kg和80 mg/kg的AS-Ⅳ,每日1次,共给药6周;对照组和模型组大鼠同时给予等体积生理盐水灌胃。给药结束后,超声检测各组大鼠心脏功能指数：左室收缩末期内径（LVESD）、左室舒张末期内径（LVEDD）和左室射血分数（LVEF）。采用苏木精-伊红（HE）染色和Masson染色检测大鼠心肌组织病理变化,流式细胞术检测大鼠脾脏组织Th17细胞水平,ELISA法检测大鼠血清中IL-17、IL-21和TNF-α水平,qRT-PCR检测大鼠心肌组织RORγt和FoxP3基因表达水平,Western blot检测大鼠心肌组织α-SMA、collagenⅠ、TGF-β1、RORγt和FoxP3蛋白表达水平。结果：HE和Masson染色结果显示,模型组大鼠心肌组织出现炎性细胞浸润,细胞肥大,间质组织中蓝色染色胶原沉积量增加。与模型组比较,低AS-Ⅳ组、中AS-Ⅳ组和高AS-Ⅳ组大鼠心肌组织中炎性细胞浸润和细胞肥大情况逐渐缓解,胶原沉积量减少。与对照组比较,模型组大鼠LVESD和LVEDD指标均升高（P<0.05）,LVEF指标降低（P<0.05）;心肌组织α-SMA、collagen Ⅰ、TGF-β1和RORγt水平均升高（P<0.05）,FoxP3水平降低（P<0.05）;脾脏组织Th17细胞比例升高（P<0.05）;血清中IL-17、IL-21和TNF-α水平均升高（P<0.05）。与模型组比较,低AS-Ⅳ组、中AS-Ⅳ组和高AS-Ⅳ组大鼠LVESD和LVEDD指标均降低（P<0.05）,LVEF指标升高（P<0.05）;心肌组织α-SMA、collagen Ⅰ、TGF-β1和RORγt水平均降低（P<0.05）,FoxP3水平升高（P<0.05）;脾脏组织Th17细胞比例均降低（P<0.05）;血清中IL-17、IL-21和TNF-α水平均降低（P<0.05）。结论：AS-Ⅳ对阿霉素诱导的DCM大鼠具有良好的治疗效果,其机制可能与抗心肌组织纤维化和抑制Th17细胞分化相关。 相似文献
11.
Andreas J. Rieth Claudia Jung Henning Gall Andreas Rolf Veselin Mitrovic Christian W. Hamm 《Biomarkers》2013,18(7):652-658
AbstractBackground: The course of newly diagnosed dilated cardiomyopathy (DCM) varies from persistent reduction of left ventricular ejection fraction (LVEF) to recovery or even worsening. The aim of the present study was to examine the prognostic value of selected biomarkers with regard to changes in LVEF.Methods: Main inclusion criterion was LVEF ≤45% with exclusion of coronary artery or valvular heart disease. The primary endpoint was LVEF ≤35% in the follow-up echocardiogram. Galectin-3, N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) were related to the endpoint.Results: Data from 80 DCM patients (55 male, mean age 53 years) were analyzed. Median LVEF was 25% (IQR 25–30). The endpoint was met for 24 patients (30%). These had higher baseline levels of galectin-3 (median 20.3?ng/mL [IQR 14.3–26.9] vs. 14.7?ng/mL [IQR 10.9–17.7], p?=?0.007) and NT-proBNP (3089?pg/mL [IQR 1731–6694] vs. 1498?pg/mL [IQR 775–3890]; p?=?0.004) in univariate Cox regression analysis. ROC analysis revealed that CRP (median 0.4?mg/dL [IQR 0.2–1.2]) was also related to the endpoint (p?=?0.043).Conclusion: Higher levels of galectin-3, NT-proBNP, and CRP were associated with LVEF ≤35% in our cohort. An approach utilizing a combination of biomarkers for patient management should be assessed in further studies. 相似文献
12.
摘要 目的：研究扩张型心肌病（DCM）患者左心室球形指数（LVSI）、单核细胞计数与高密度脂蛋白胆固醇（HDL-C）比值（MHR）和血清半乳糖凝集素-3（Gal-3）的变化,并分析其与DCM患者心功能的关系。方法：选择2018年1月-2022年10月在我院接受治疗的DMC患者68例作为研究组,并选取同期50例健康体检者作为对照组。研究组患者根据出院6个月份是否发生主要不良心血管事件分为MACE组和No-MACE组。比较各组间左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）、LVSI、单核细胞计数、HDL-C、MHR以及血清Gal-3。结果：（1）研究组患者LVEF显著低于对照组,而研究组患者LVEDD、LVESD以及LVSI均显著高于对照组（P<0.05）。（2）研究组患者单核细胞计数、HDL-C、MHR以及Gal-3均显著高于对照组（P<0.05）。（3）不同心功能分级DCM患者LVEF、LVEDD、LVESD、单核细胞计数和HDL-C组间比较无显著差异（P>0.05）,但LVSI、MHR和血清Gal-3组间比较差异显著（P<0.05）。（4）MACE组患者LVSI、MHR和Gal-3均显著高于No-MACE组患者（P<0.05）。结论：LVSI、MHR和血清Gal-3在扩张型心肌病患者中升高,并与患者心功能分级有关,可作为DCM患者心功能恶化评价指标。 相似文献
13.
A PRKAG2 mutation causes biphasic changes in myocardial AMPK activity and does not protect against ischemia 总被引：2，自引：0，他引：2
Banerjee SK Ramani R Saba S Rager J Tian R Mathier MA Ahmad F 《Biochemical and biophysical research communications》2007,360(2):381-387
Dominant mutations in the gamma2 regulatory subunit of AMP-activated protein kinase (AMPK), encoded by the gene PRKAG2, cause glycogen storage cardiomyopathy. We sought to elucidate the effect of the Thr400Asn (T400N) human mutation in a transgenic mouse (TGT400N) on AMPK activity, and its ability to protect the heart against ischemia-reperfusion injury. TGT400N hearts had markedly vacuolated myocytes, excessive accumulation of glycogen, hypertrophy, and preexcitation. Early activation of myocardial AMPK, followed by depression, and then recovery to wild-type levels was observed. AMPK activity correlated inversely with glycogen content. Partial rescue of the phenotype was observed when TGT400N mice were crossbred with TGalpha2DN mice, which overexpress a dominant negative mutant of the AMPK alpha2 catalytic subunit. TGT400N hearts had greater infarct sizes and apoptosis when subjected to ischemia-reperfusion. Increased AMPK activity is responsible for glycogen storage cardiomyopathy. Despite high glycogen content, the TGT400N heart is not protected against ischemia-reperfusion injury. 相似文献
14.
目的:了解扩张型心肌病患者恶性心律失常(MVA)与心率变异性(heart rate variability,HRV)的关系,探讨扩心病患者体内自主神经变化的临床意义。方法:选择扩心病患者48例作为研究对象,同时按照年龄配对,取48例正常者作为对照组,对其行24小时动态心电图检查,依据其是否出现恶性心律失常分为恶性室性心律失常(MVA+)组及单纯扩张型心肌病(MVA-)组,分析组间HRV的差异。结果:与对照组比较,单纯扩张型心肌病(MVA-)组HRV时域指标(SDNN、SDANN、RMSSD)均有降低(P<0.05)L与(MVA-)组相比,恶性室性心律失常(MVA+)组HRV相关指标进一步降低(P<0.05)。结论:自主神经功能异常是扩张型心肌病患者恶性心律失常的重要危险因子,可能可以用HRV预测其发生恶性心律失常危险性。 相似文献
15.
Instead of assessing the overall fit of candidate models like the traditional model selection criteria, the focused information criterion focuses attention directly on the parameter of the primary interest and aims to select the model with the minimum estimated mean squared error for the estimate of the focused parameter. In this article we apply the focused information criterion for personalized medicine. By using individual‐level information from clinical observations, demographics, and genetics, we obtain the personalized predictive models to make the prognosis and diagnosis individually. The consideration of the heterogeneity among the individuals helps reduce the prediction uncertainty and improve the prediction accuracy. Two real data examples from biomedical research are studied as illustrations. 相似文献
16.
Beat Schmutz Karen J. Reynolds John P. Slavotinek 《Computer methods in biomechanics and biomedical engineering》2013,16(5):305-312
The development and validation of a virtual generic 3D model of the distal femur using computer graphical methods is presented. The synthesis of the generic model requires the following steps: acquisition of bony 3D morphology using standard computed tomography (CT) imaging; alignment of 3D models reconstructed from CT images with a common coordinate system; computer graphical sectioning of the models; extraction of bone contours from the image sections; combining and averaging of extracted contours; and 3D reconstruction of the averaged contours. The generic models reconstructed from the averaged contours of six cadaver femora were validated by comparing their surface geometry on a point to point basis with that of the CT reconstructed reference models. The mean errors ranged from 0.99 to 2.5 mm and were in agreement with the qualitative assessment of the models. 相似文献
17.
Recently, personalized medicine has received great attention to improve safety and effectiveness in drug development. Personalized medicine aims to provide medical treatment that is tailored to the patient's characteristics such as genomic biomarkers, disease history, etc., so that the benefit of treatment can be optimized. Subpopulations identification is to divide patients into several different subgroups where each subgroup corresponds to an optimal treatment. For two subgroups, traditionally the multivariate Cox proportional hazards model is fitted and used to calculate the risk score when outcome is survival time endpoint. Median is commonly chosen as the cutoff value to separate patients. However, using median as the cutoff value is quite subjective and sometimes may be inappropriate in situations where data are imbalanced. Here, we propose a novel tree‐based method that adopts the algorithm of relative risk trees to identify subgroup patients. After growing a relative risk tree, we apply k‐means clustering to group the terminal nodes based on the averaged covariates. We adopt an ensemble Bagging method to improve the performance of a single tree since it is well known that the performance of a single tree is quite unstable. A simulation study is conducted to compare the performance between our proposed method and the multivariate Cox model. The applications of our proposed method to two public cancer data sets are also conducted for illustration. 相似文献
18.
Differential diagnosis of hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM) is clinically challenging but important for treatment management. This study aims to phenotype HHD and HCM in 3D + time domain by using a multiparametric motion-corrected personalized modeling algorithm and cardiac magnetic resonance (CMR). 44 CMR data, including 12 healthy, 16 HHD and 16 HCM cases, were examined. Multiple CMR phenotype data consisting of geometric and dynamic variables were extracted globally and regionally from the models over a full cardiac cycle for comparison against healthy models and clinical reports. Statistical classifications were used to identify the distinctive characteristics and disease subtypes with overlapping functional data, providing insights into the challenges for differential diagnosis of both types of disease. While HCM is characterized by localized extreme hypertrophy of the LV, wall thickening/contraction/strain was found to be normal and in sync, though it was occasionally exaggerated at normotrophic/less severely hypertrophic regions during systole to preserve the overall ejection fraction (EF) and systolic functionality. Additionally, we observed that hypertrophy in HHD could also be localized, although at less extreme conditions (i.e. more concentric). While fibrosis occurs mostly in those HCM cases with aortic obstruction, only minority of HHD patients were found affected by fibrosis. We demonstrate that subgroups of HHD (i.e. preserved and reduced EF: HHDpEF & HHDrEF) have different 3D + time CMR characteristics. While HHDpEF has cardiac functions in normal range, dilation and heart failure are indicated in HHDrEF as reflected by low LV wall thickening/contraction/strain and synchrony, as well as much reduced EF. 相似文献
19.
Acute lymphoblastic leukemia (ALL) is a common childhood cancer in which nearly one-quarter of patients experience a disease relapse. However, it has been shown that individualizing therapy for childhood ALL patients by adjusting doses based on the blood concentration of active drug metabolite could significantly improve treatment outcome. An adaptive model predictive control (MPC) strategy is presented in which maintenance therapy for childhood ALL is personalized using routine patient measurements of red blood cell mean corpuscular volume as a surrogate for the active drug metabolite concentration. A clinically relevant mathematical model is developed and used to describe the patient response to the chemotherapeutic drug 6-mercaptopurine, with some model parameters being patient-specific. During the course of treatment, the patient-specific parameters are adaptively identified using recurrent complete blood count measurements, which sufficiently constrain the patient parameter uncertainty to support customized adjustments of the drug dose. While this work represents only a first step toward a quantitative tool for clinical use, the simulated treatment results indicate that the proposed mathematical model and adaptive MPC approach could serve as valuable resources to the oncologist toward creating a personalized treatment strategy that is both safe and effective. 相似文献
20.
Andrea Di Luca Clemens Van Blitterswijk Lorenzo Moroni 《Birth defects research. Part C, Embryo today : reviews》2015,105(1):34-52
The osteochondral (OC) interface is not only the interface between two tissues, but also the evolution of hard and stiff bone tissue to the softer and viscoelastic articular cartilage covering the joint surface. To generate a smooth transition between two tissues with such differences in many of their characteristics, several gradients are recognizable when moving from the bone side to the joint surface. It is, therefore, necessary to implement such gradients in the design of scaffolds to regenerate the OC interface, so to mimic the anatomical, biological, and physicochemical properties of bone and cartilage as closely as possible. In the past years, several scaffolds were developed for OC regeneration: biphasic, triphasic, and multilayered scaffolds were used to mimic the compartmental nature of this tissue. The structure of these scaffolds presented gradients in mechanical, physicochemical, or biological properties. The use of gradient scaffolds with already differentiated or progenitor cells has been recently proposed. Some of these approaches have also been translated in clinical trials, yet without the expected satisfactory results, thus suggesting that further efforts in the development of constructs, which can lead to a functional regeneration of the OC interface by presenting gradients more closely resembling its native environment, will be needed in the near future. The aim of this review is to analyze the gradients present in the OC interface from the early stage of embryonic life up to the adult organism, and give an overview of the studies, which involved gradient scaffolds for its regeneration. Birth Defects Research (Part C) 105:34–52, 2015. © 2015 Wiley Periodicals, Inc. 相似文献