The role of anemia in congestive heart failure and chronic kidney insufficiency: the cardio renal anemia syndrome

Anemia is a major problem in patients with chronic kidney insufficiency. The development of recombinant human erythropoietin has enabled physicians to correct this anemia. Although anemia has not been considered to be a common or important contributor to congestive heart failure, anemia of any cause can lead to cardiac damage and eventually congestive heart failure. Our joint renal-cardiac heart failure team found that anemia was indeed very common in congestive heart failure and was associated with severe, medication-resistant cardiac failure. Correction of the anemia with erythropoietin and intravenous iron led to a marked improvement in patients' functional status and their cardiac function, and to a marked fall in the need for hospitalization and for high-dose diuretics; renal function usually improved or at least stabilized. Subsequent investigations by others have confirmed many of our observations. We call this interrelationship between congestive heart failure, chronic kidney insufficiency, and anemia the Cardio-Renal Anemia syndrome. Treatment of the anemia in congestive heart failure may prove vital in preventing progression of both the heart failure and the associated renal disease.     

Erythropoietin therapy in patients with chronic renal failure.

Symptomatic anemia is a common complication of chronic renal failure. Treatment is now possible with the availability of recombinant human erythropoietin (epoetin alfa). Previous experimental studies have suggested that correcting the anemia of chronic renal failure may be harmful in that renal failure may be accelerated. Although experience with this drug has been primarily restricted to its use in patients with end-stage renal disease, several recent trials have been reported in patients with varying degrees of chronic renal failure. We review these studies with particular reference to the progression of renal failure and the drug''s reported side effects. We conclude that the use of epoetin is beneficial and well tolerated and that there is no compelling evidence for the acceleration of renal failure associated with its use in patients.     

NGF基因重组慢病毒载体的构建及其在人脐带血间充质干细胞的表达

目的:构建神经生长因子(NGF)的慢病毒表达载体,并观察其转染人脐带间充质干细胞后的表达情况。方法:采用实时定量PCR(RT-PCR)方法获取NGF基因编码片段,并将构建的慢病毒载体质粒与包装质粒和包膜质粒共转染293T细胞,包装生产慢病毒。应用相同滴度的慢病毒转导等量间充质干细胞(MSCs),观察转染后细胞的生长形态及生长曲线,再采用RT-PCR、Western Blot方法检测NGF m RNA、蛋白质的表达水平。结果:经PCR、酶切和测序结果证明成功构建NGF基因重组慢病毒载体。同时NGF基因重组慢病毒载体能够成功转染人脐带间充质干细胞,转染率达95.35%,转染后干细胞在NGF m RNA及蛋白质的表达方面较对照组明显升高,同时经倒置显微镜观察及生长曲线实验证实转染后干细胞的生长与对照组相比无明显差异。结论:重组NGF的慢病毒表达载体能够高效的转染人脐带间充质干细胞,基因转染后干细胞的增殖分化能力与未转染细胞差异无统计学意义,可作为一种高效的干细胞转染方法。     

Pure red-cell anemia due to recombinant human erythropoietin and its status in oncology practice

A special form of anemia was observed during the treatment with recombinant human erythropoietin having been applied for more than 15 years. The pure red-cell anemia due to antibodies against erythropoietin was described in chronic renal failure patients. Since oncological patients are also treated with rhuEPO it is interesting to know whether this side effect could be observed in the patients with solid tumors as well. It should be considered in tumorous patients when coexistence of antibodies against rhuEPO with pure red-cell aplasia is demonstrated, and its other causes as immunological disease, thymoma, viral infections (eg. Parvovirus B12, Hepatitis B or C) are excluded. The author collected literature data and found the absence of reports on this side effect in cases of treatment with rhuEPO in cancer patients. The rhuEPO treatment is a safe method for the cure of cancer anemia as antibodies against rhuEPO have not been shown together with PRCA among cancer patients. The possible explanation could be the shorter application time in cancer compared to the chronic renal failure patients. The side effect observed in chronic renal failure patients calls the attention to the precise compliance with the instructions of the manufacturers.     

构建稳定表达RFP及嘌呤霉素抗性的K562细胞株

目的构建稳定表达红色荧光蛋白（red fluorescent protein,RFP）和嘌呤霉素（puromycin）抗性的K562．PM．RFP细胞株,便于慢性粒细胞性白血病研究中K562细胞的观察和筛选。方法采用PCR法获得RFP片段,将其插入到慢病毒pGC-FU-3FLAG-IRES—Puromycin载体中获得pGC—PM—RFP重组质粒,经脂质体转染到293T细胞中获得慢病毒LV—PM—RFP,有限稀释法检测慢病毒在293T细胞中的转染效率,用包装获得的慢病毒感染K562细胞,经嘌呤霉素筛选获得RFP阳性的K562-PM—RFP细胞株。结果PCR及测序结果证实目的基因RFP正确克隆至慢病毒质粒中,经慢病毒LV—PM-RFP感染的K562细胞能在嘌呤霉素抗性培养基中存活,并稳定表达RFP。结论成功构建了慢病毒重组质粒pGC—PM-RFP,并获得了携带RFP及嘌呤霉素抗性基因的K562-PM—RFP细胞株。     

携带人二氢叶酸还原酶基因慢病毒表达载体构建及鉴定

目的:构建携带人二氢叶酸还原酶(DHFR)基因的慢病毒表达载体pWPI。方法:采用PCR方法扩增二氢叶酸还原酶cDNA全长,与EZ-T克隆载体连接,HindIII及BamHI-HF限制性内切酶双酶切回收的PCR片段并补平其缺口。慢病毒系统载体使用pWPI系统,采用PmeI酶切载体后回收片段,将其磷酸化,T4酶连接载体与目的基因。表达载体鉴定均采用核苷酸序列测定,重组质粒采用脂质体转染293T包装细胞后获得包装的病毒颗粒。结果:成功扩增二氢叶酸还原酶全长并连接入pWPI载体构建成重组表达载体DHFR-pWPI,重组质粒测序结果显与DHFR基因的同源性达100%,按标准生产程序转染293T后有DHFR基因的表达。结论:成功采用慢病毒载体系统构建了二氢叶酸还原酶重组慢病毒转基因,为探讨DHFR在肿瘤多药耐药过程中的分子机理奠定基础。     

MAC-T Cells as a Tool to Evaluate Lentiviral Vector Construction Targeting Recombinant Protein Expression in Milk

Prior to generating transgenic animals for bioreactors, it is important to evaluate the vector constructed to avoid poor protein expression. Mammary epithelial cells cultured in vitro have been proposed as a model to reproduce the biology of the mammary gland. In the present work, three lentiviral vectors were constructed for the human growth hormone (GH), interleukin 2 (IL2), and granulocyte colony-stimulating factor 3 (CSF3) genes driven by the bovine β-casein promoter. The lentiviruses were used to transduce mammary epithelial cells (MAC-T), and the transformed cells were cultured on polystyrene in culture medium with and without prolactin. The gene expression of transgenes was evaluated by PCR using cDNA, and recombinant protein expression was evaluated by Western-blotting using concentrated medium and cellular extracts. The gene expression, of the three introduced genes, was detected in both induced and non induced MAC-T cells. The human GH protein was detected in the concentrated medium, whereas CSF3 was detected in the cellular extract. Apparently, the cellular extract is more appropriate than the concentrated medium to detect recombinant protein, principally because concentrated medium has a high concentration of bovine serum albumin. The results suggest that MAC-T cells may be a good system to evaluate vector construction targeting recombinant protein expression in milk.     

Single dose recombinant human erythropoietin reduces transforming growth factor beta in patients on chronic haemodialysis.

Short-term effects of recombinant human erythropoietin on serum levels of transforming growth factor beta-1, interleukin 1-alpha, interleukin 3, interferon gamma, and tumour necrosis factor alpha in patients with chronic renal failure on chronic haemodialysis were investigated. Recombinant human erythropoietin was applied subcutaneously in a dose of 75 IU/kg on 19 patients. Serum levels of transforming growth factor beta-1, interleukin 1-alpha, interleukin 3, interferon gamma, tumour necrosis factor alpha and erythropoietin, red blood cell parameters: red blood cell count, haemoglobin, haematocrit, and erythrocyte indices were determined before and after recombinant human erythropoietin single application. Transforming growth factor beta-1 serum levels were decreased after recombinant human erythropoietin (22.70 +/- 1.51 ng/ml versus 18.77 +/- 1.70 ng/ml (p < 0.01). None of the other investigated parameters was influenced significantly by recombinant human erythropoietin. Recombinant human erythropoietin in patients with chronic renal failure on chronic haemodialysis may influence anaemia not only through its stimulating effect on erythropoiesis, but also by direct oxygen-independent decrease of at least one of the negative regulators of erythropoiesis--the transforming growth factor beta.     

Netrin-1慢病毒表达载体的构建及鉴定

目的:构建携带有Netrin-1基因的逆转录病毒载体,为研究Netrin-1在神经发育中的作用奠定基础。方法:PCR扩增Netrin-1基因片段后,将其克隆入慢病毒表达载体pLXSN;通过PCR、酶切、测序鉴定重组质粒。重组质粒转染PA317包装细胞后获得包装的病毒颗粒。病毒颗粒感染人脑胶质瘤细胞SW038-C2,经Western blot证明重组病毒在真核细胞内表达Netrin-1的情况。结果:经PCR扩增、酶切和测序验证,重组质粒构建正确,命名为pLX-NT。Western blot证明在感染细胞泳道有一特异性条带。结论:成功构建了能表达Netrin-1的慢病毒载体。     

Gene therapy for rat renal anemia with implantation of erythropoietin-transgenic myoblasts

To investigate whether an erythropoietin (EPO) gene-based therapy could serve as an alternative to the repeated injection of rhEPO in treatment to renal anemia, the genetically modified myoblasts of rats, named Myo/ EPO, were implanted through intramuscular injection to model rats with renal anemia. The hemoglobin (Hb) and hematocrit (HCT) of the rats increased from (92.5 ±3.0) g/L and 0.29±0.04 to the peak values of (103.8 ±5.0) g/L and 0. 32 ±0. 04 respectively 14 d after implantation, and sustained the pre-implantation level for 90 d. Otherwise, the control rats implanted with Myo/X, which carried the parent retroviral vector, gradually became severe in anemia. The PCR detection for hEPO cDNA in the rat muscle adjacent to injection sites indicated that the Myo/EPO cells survived for a long period in the muscle of rats. The results primarily demonstrate that myoblast gene transfer of EPO is effective for the treatment of rat renal anemia.     

TRAIL 慢病毒载体构建及其在肝癌细胞中的表达

目的:构建携带TRAIL基因的慢病毒表达载体并实现其在肝癌细胞株HepG2中的稳定高表达。方法:构建TRAIL重组慢病毒表达载体pCDH-CMV-TRAIL-EF1-GFP-T2A-Puro,脂质体法将重组慢病毒载体和包装质粒混合物共转染293T细胞,包装产生慢病毒颗粒,纯化并测定病毒滴度。利用Western blotting检测TRAIL蛋白在HepG2中的表达。结果:酶切以及测序证实,成功构建TRAIL基因重组慢病毒载体,纯化的慢病毒滴度为1.02×104ifμ/μL。利用嘌呤霉素筛选获得稳定表达TRAIL的细胞系,经Western blot方法检测到TRAIL蛋白的稳定高表达。结论:成功构建了带有TRAIL基因的慢病毒载体,并实现其在HepG2的稳定高表达。     

Molecular cloning and expression of the cDNA encoding feline granulocyte colony-stimulating factor.

Both genomic DNA and cDNA of the feline granulocyte colony-stimulating factor (G-CSF) gene were cloned from CRFK cells. Southern blot analysis showed that the haploid genome contains a single copy of the G-CSF gene. The RT-PCR analysis of several feline cell lines revealed expression of G-CSF mRNA in response to lipopolysaccharide stimulation. Sequence analysis of genomic and cDNA clones indicated that the intron-exon junction structure is conserved between the human and the feline G-CSF genes. The G-CSF coding region encodes a predicted protein of 195 amino acids including a signal sequence of 21 amino acids. The feline G-CSF amino acid sequence shares a high degree of identity with the canine (90.8%), human (87.4%), ovine (83.9%), bovine (82.8%), porcine (80.5%), murine (70.7%) and rat (66.8%) G-CSF. The feline G-CSF expressed in insect cells using recombinant baculovirus vector was biologically active as measured in a proliferation assay using NFS-60 cells and an induction assay of leukocytes in cats.     

SPARC基因过表达对SKM-1细胞凋亡的影响

构建SPARc基因过表达载体,转染人骨髓增生异常综合征（myelodysplastic syndrome,MDS）-u／胞系SKM-1细胞,探讨SPARc基因过表达对!＆MDS细胞系SKM一1细胞凋亡的影响。XpcD—NA．SPARC为引物,PCR扩增SPARc基因;将靶基因克隆入慢病毒载体pGC—GV,构建含有删Rc基因的重组慢病毒载体pGC—GV-SPARC,测序检测正确性;将构建载体pGC-GV-5黝尺C砗专染人MDs细胞系SKM-1,流式细胞术检测转染效率,RT-PCR检测sKM-1细胞中SPARCmRNA表达,Westernblot检测SPARC蛋白表达,MTS法测定小剂量阿糖胞苷（30ng／mL）对实验组增殖抑制的影响,AnnexinV检测．洲尺c基因转染后对人SKM-1细胞凋亡的影响。结果显示,构建含有SPARc基因的重组慢病毒载体pGC-GV-SPARC转染效率为（64．25±1．42）％;转染后,SPARCmRNA及蛋白表达在靶细胞中较对照组增多。小剂量阿糖胞苷对转染组的增殖抑制率明显高于其他组。SPARC基因转染后人SKM-1细胞凋亡率较未转染组明显增高,加入阿糖胞苷后人SKM-1细胞凋亡率较对照组明显增高。由此说明,作者成功构建了携带．＆SPARc基因的慢病毒载体,转染．NSKM-1细胞系后稳定表达SPARC基因,SPARC过表达可抑制细胞增殖,且联合小剂量阿糖胞苷（30ng／mL）更有效地抑制SKM-1细胞的增殖,并诱导其凋亡。     

Effect of recombinant human erythropoietin on the anemia of chronic renal failure

Phase I and Phase II studies of recombinant human erythropoietin (rhEpo) were conducted in normal volunteers and in anemic patients with chronic renal failure on maintenance hemodialysis. Three hundred U/person of rhEpo was administered intravenously to healthy normal volunteers in the Phase I study, resulting in no subjective or objective changes. In the Phase II study, 66 patients with chronic renal failure on maintenance hemodialysis with less than 20% hematocrit values were treated with rhEpo in doses of 50 U/kg to 200 U/kg two or three times a week. Hematocrit values increased significantly during the 12 weeks, and the patients' conditions improved. Patients previously requiring blood transfusions became transfusion-independent during our study. There were no obvious side effects, thus indicating the safety and efficacy of rhEpo in the anemia of chronic renal failure.     

利用慢病毒载体构建稳定过表达人VEGF_(165)的小鼠巨噬细胞系

目的:通过构建人血管内皮生长因子165(humanVEGF_(165),hVEGF_(165)的慢病毒载体,感染小鼠单核巨噬细胞RAW264.7,建立稳定高表达人VEGF165的小鼠巨噬细胞系。方法:将聚合酶链反应(PCR)扩增得到的hVEGF_(165)和慢病毒载体pLVX-IRES-ZsGreen1双酶切后连接,构建慢病毒表达载体pLVX-hVEGF_(165)-IRES-ZsGreen1。再经双酶切和测序鉴定后,进行病毒包装及浓缩。将该慢病毒载体感染RAW264.7细胞,利用绿色荧光蛋白ZsGreen1进行2次流式分选。用Realtime-PCR、WesternBlot分别检测各组细胞中hVEGF165的mRNA和蛋白表达;ELISA分别检测细胞上清中人VEGF和小鼠VEGF的含量。结果:酶切及测序结果示慢病毒表达载体pLVX-hVEGF165-IRES-ZsGreen1构建正确;流式分选后得到高纯度的ZsGreen1-hVEGF_(165)-RAW264.7细胞。Realtime-PCR、WesternBlot显示该细胞特异高表达hVEGF_(165)基因和蛋白(P均0.01)。ELISA显示该细胞分泌人和小鼠VEGF均显著增加(P均0.01)。结论:成功构建hVEGF_(165)慢病毒表达载体,并建立稳定高表达hVEGF_(165)的小鼠巨噬细胞系。为深入研究该细胞的功能、机制及应用提供充足稳定的细胞来源。     

Erythropoietin: current status

Understanding the regulation of red blood cell production has been greatly enhanced by the cloning and expression of the gene for human erythropoietin (Epo) and its receptor. The availability of recombinant human erythropoietin (rhEpo) for administration to patients has ushered in a new era in molecular medicine. Intravenous or subcutaneous administration of rhEpo can reliably cure the anemia of chronic renal failure and may be effective in the treatment of anemias secondary to chronic inflammation, malignancy, and marrow suppression from chemotherapy. In addition, rhEpo therapy will probably play a prominent role in transfusion medicine, both in preparing patients for auto-transfusions as well as in minimizing red cell transfusion requirements in the post-operative period.     

大鼠miR-126慢病毒表达载体的构建及其在肝星状细胞中的表达

目的：肝星状细胞（hepaticstellatecell,HSC）激活并发生表型改变是肝纤维化形成的关键,本实验期待通过构建慢病毒mo—miR．126,并体外转染Hsc,为研究miR．126在肝纤维化中的作用奠定实验基础。方法：PCR扩增miR-126的前体,构建miR．126的重组表达载体pCDH．CMV-MCS．EFl．copGFP-miR．126,脂质体法转染包装细胞293TN细胞,包装产生慢病毒,以293TN细胞绿色荧光蛋白（greenfluorescentprotein,GFP）的表达水平测定病毒滴度,构建重组慢病毒（Lentivims,LV）载体（Lv．miR．126）,体外转染活化的HSC．T6,荧光显微镜观察荧光阳性细胞百分率,real—timePCR检测miR一126转入水平。结果：经PCR扩增检测阳性菌落和测序证实,成功构建携带大鼠miR一126基因重组慢病毒载体。倒置荧光显微镜下观察可见包装细胞293TN呈绿色荧光,并测得滴度108〉ifu／ml。荧光显微镜下HSC的荧光阳性率在95％以上。Real—timePCR检测证实miR-126转染后获得了较高的表达。结论：成功构建大鼠慢病毒载体Lv—miR-126,并可在体外高效稳定表达,为本研究后续对miR-126靶点验证和功能研究奠定实验基础。     

Construction of a Single Lentiviral Vector Containing Tetracycline-Inducible Alb-uPA for Transduction of uPA Expression in Murine Hepatocytes

The SCID-beige/Alb-uPA mouse model is currently the best small animal model available for viral hepatitis infection studies [1]. But the construction procedure is often costly and time-consuming due to logistic and technical difficulties. Thus, the widespread application of these chimeric mice has been hampered [2]. In order to optimize the procedure, we constructed a single lentiviral vector containing modified tetracycline-regulated system to control Alb-uPA gene expression in the cultured hepatocytes. The modified albumin promoter controlled by tetracycline (Tet)-dependent transactivator rtTA2S-M2 was integrated into a lentiviral vector. The full-length uPA cDNA was inserted into another lentiviral vector containing PTight, a modified Tet-responsive promoter. Two vectors were then digested by specific enzymes and ligated by DNA ligase 4. The ligated DNA fragment was inserted into a modified pLKO.1 cloning vector and the final lentiviral vector was then successfully constructed. H2.35 cell, Lewis lung carcinoma, primary kidney, primary hepatic interstitial and CT26 cells were infected with recombinant lentivirus at selected MOI. The expression of uPA induced by DOX was detectable only in the infected H2.35 cells, which was confirmed by real-time PCR and Western blot analysis. Moreover, DOX induced uPA expression on the infected H2.35 cells in a dose-dependent manner. The constructed single lentiviral vector has many biological advantages, including that the interested gene expression under “Tet-on/off” system is controlled by DOX in a dose-depending fashion only in murine liver cells, which provides an advantage for simplifying generation of conditional transgenic animals.