Intratumoral interferon-α gene transfer enhances tumor immunity after allogeneic hematopoietic stem cell transplantation

One of the major challenges in the treatment of solid cancers by allogenic hematopoietic stem cell transfer (alloHSCT) is the specific enhancement of antitumor immunity. Interferon (IFN) is a cytokine with pleiotropic biological functions including an immunomoduration, and our preclinical studies have shown that an intratumoral IFN-α gene transfer induced strong local tumor control and systemic tumor-specific immunity. In the present study, we examined whether the IFN-α gene transfer could enhance recognition of tumor-associated antigens by donor T cells and augment the antitumor activity of alloHSCT. First, when a mouse IFN-α adenovirus vector (Ad-mIFN) was injected into subcutaneous xenografts of syngeneic renal and colon cancer cells, tumor growth was significantly suppressed in a dose-dependent manner. A significant tumor cell death and infiltration of immune cells was recognized in the Ad-mIFN-injected tumors, and the dendrtic cells isolated from the tumors showed a strong Th1-oriented response. The antitumor effect of Ad-mIFN was then examined in a murine model of minor histocompatibility antigen-mismatched alloHSCT. The intratumoral IFN-α gene transfer caused significant tumor suppression in the alloHSCT recipients, and this suppression was evident not only in the gene-transduced tumors but also in simultaneously inoculated distant tumors which did not receive the vector injection. A cytotoxicity assay showed specific tumor cell lysis by donor T cells responding to IFN-α. Graft-versus-host disease was not exacerbated serologically or clinically in the mice treated with IFN-α. This combination strategy deserves evaluation in future clinical trials for human solid cancers.     

造血干细胞移植治疗白血病患者负性因素干预措施的护理研究

目的针对造血干细胞移植治疗白血病患者不同阶段存在负性因素的特点进行干预并观察其临床效果。方法对96例白血病患者在造血干细胞移植前期-预处理期-移植期-移植后期的不同阶段负性因素实施心理支持,全环境保护方案,并发症的预防、观察与处理,健康教育等干预措施。结果减轻或消除负性因素对患者的影响,减少了并发症的发生,缩短留住无菌层流室的时间,提高白血病患者移植后的生活质量。结论制定一整套合理的、规范的、系统的护理流程,使患者获得最佳护理方案,有效减轻负性因素对患者的影响。     

异基因造血干细胞移植治疗耳道复发的急性早幼粒细胞白血病一例并文献复习

目的:探讨急性早幼粒细胞白血病(APL)髓外复发的相关因素及治疗。方法:对1例APL缓解后耳道复发患者的临床资料进行回顾性分析,并复习相关文献。结果:患者2015年8月诊断为APL(低危型),经诱导后达完全缓解,随后进行巩固、维持治疗,并多次行腰椎穿刺术及椎管内注射化疗药物预防中枢神经系统白血病。2017年3月发现左外耳道新生物,活检确诊外耳道髓系肉瘤,示髓外复发。随后出现骨髓复发。经诱导巩固化疗后行异基因造血干细胞移植,存活至今。结论:对于髓外复发的急性早幼粒细胞白血病,其预后较差,异基因造血干细胞移植治疗有较好疗效。     

造血干细胞移植术对肠道菌群结构的影响

目的监测造血干细胞移植术（Hematopoietic stem cell transplantation,HSCT）前后肠道菌群结构的动态变化。方法收集3例造血干细胞移植患者手术前后8个时间点的粪便样品,提取样品总DNA进行16S rRNA基因的V3区的bar coded 454焦磷酸测序,并用MANOVA、聚类分析、Pearson相关等统计方法对菌群结构的变化进行动态分析。结果 HSCT移植前,经过放、化疗及预防性抗生素治疗,患者的肠道菌群结构和组成发生显著的改变,多样性明显减少;移植4周后,菌群多样性有恢复的趋势,但菌群结构和组成与治疗前仍有明显的差异。整个HSCT过程中,Escherichia/Shigella及Enterococcus属变成肠道中最优势的细菌类群。结论肠道菌群结构在HSCT术前已发生显著的改变,机会致病菌Escherichia/Shigella及Enterococcus属成为HSCT患者肠道中最优势的细菌类群。     

小鼠造血干细胞增殖和分化的分子生物学证据

本文采用Ｙ染色体特异的性别决定基因（Ｓｒｙ）作为新的细胞遗传标志,通过ＰＣＲ技术来追踪观察造血干细胞的增殖与分化性能。该方法具有简便、灵敏和特异等优点。雌性受体小鼠输注雄鼠骨髓细胞和１３天脾结节（ＣＦＵ－Ｓ１３）细胞后,Ｓｒｙ ＰＣＲ测试受体小鼠的ＣＦＵ－Ｓ结果表明,它们均为供体来源的ＸＹ细胞。用Ｓｒｙ ＰＣＲ骨髓细胞和骨髓中脾结节生成细胞（ＣＰＵ－Ｓ）的长期重建造血能力,结果表明,在存活雌性小鼠     

全身放疗在造血干细胞移植中的研究进展

全身照射疗法(TBI)是一种姑息治疗,该方法已经成功地应用在慢性淋巴细胞白血病或滤泡性淋巴瘤等无干细胞支持的放射敏感的疾病中。目前,在血液系统恶性疾病中造血干细胞移植是较为有效的治疗手段之一,其中全身放射治疗与大剂量化疗是造血干细胞移植疗法的经典预处理方案。TBI方法主要应用在造血移植环境中,具有较强的周期非特异性抗肿瘤效应和免疫抑制效能。TBI给予干细胞移植病人超过正常骨髓的辐射耐受量,通过重建病人的造血和免疫来达到治疗目的。     

BMP signaling and stem cell regulation

Stem cells play an essential role in cellular specialization and pattern formation during embryogenesis and in tissue regeneration in adults. This is mainly due to a stem cell's ability to replenish itself (self-renewal) and, at the same time, produce differentiated progeny. Realization of these special stem cell features has changed the prospective of the field. However, regulation of stem cell self-renewal and maintenance of its potentiality require a complicated regulatory network of both extracellular cues and intrinsic programs. Understanding how signaling regulates stem cell behavior will shed light on the molecular mechanisms underlying stem cell self-renewal. In this review, we focus on comparing the progress of recent research regarding the roles of the BMP signaling pathway in different stem cell systems, including embryonic stem cells, germline stem cells, hematopoietic stem cells, and intestinal stem cells. We hope this comparison, together with a brief look at other signaling pathways, will bring a more balanced view of BMP signaling in regulation of stem cell properties, and further point to a general principle that self-renewal of stem cells may require a combination of maintenance of proliferation potential, inhibition of apoptosis, and blocking of differentiation.     

超细支气管镜检查在2例异基因造血干细胞移植后BOS的临床应用价值

目的：探讨超细支气管镜检查在异基因造血干细胞移植（Allo-HSCT）后闭塞性细支气管炎综合征（BOS）中的诊断和治疗作用。方法：回顾性分析2例移植术后3月诊断为BOS患者的临床资料,分析BOS的诊断和治疗特点。结果：我院2例患者从Allo-HSCT到诊断为BOS时间均为移植后3月内,临床表现活动后胸闷气促,肺功能呈混合性通气功能障碍,超细支气管镜检查直视下,观察到左右多部位6级及以上细支气管管腔口薄膜样增生物阻塞管腔,使用活检钳机械扩张或冷冻等方式可以打通闭塞气道,术中、后未发生检查相关并发症,经治疗后患者症状较前明显改善,其中1例患者后续随访其气管镜镜下见原闭塞细支气管管腔治疗后呈持续开放状态。结论：超细支气管镜检查可有效诊断Allo-HSCT后发生BOS,还可通过呼吸介入治疗打开细支气管达到短期肺功能改善。     

IL-33转基因小鼠骨髓造血干／祖细胞向髓系细胞分化的能力增强

目的：利用IL-33转基因小鼠研究IL-33对造血干/祖细胞的增殖和分化影响。方法利用流式细胞仪分析IL-33转基因小鼠及同窝野生对照小鼠的外周血、脾脏、骨髓细胞的免疫表型及造血干细胞分化不同阶段细胞的数量变化;利用体外成克隆实验和细胞周期分析研究IL-33对于造血干细胞增殖能力的影响。结果与野生型小鼠相比,IL-33转基因小鼠B细胞和T细胞在外周血中都明显降低,粒细胞在外周血和骨髓中都有明显增加;IL-33转基因小鼠的骨髓造血干细胞和多能祖细胞数量减少,共同淋系祖细胞数量减少,共同髓系祖细胞和粒单系祖细胞数量增加;IL-33转基因小鼠的造血干细胞处于S-G2-M的细胞增多;体外单克隆实验发现IL-33转基因小鼠造血干细胞形成的集落数增加。结论 IL-33转基因小鼠造血干细胞增殖能力增强,更易向髓系细胞分化。     

单倍体造血干细胞移植对儿童重型再生障碍性贫血治疗的并发症分析

目的分析儿童重型再生障碍性贫血(SAA)单倍体造血干细胞移植和同胞全相合移植并发症发生率。方法回顾性分析2010年1月1日至2018年12月31日于苏州大学附属儿童医院进行治疗的SAA患儿(56例),分为治疗组(单倍体造血干细胞移植,35例),对照组(同胞全相合移植,21例)。其中患儿年龄、诊断距离移植时间、总单个核细胞数、总CD34+细胞数、中位随访时间、粒细胞植入时间、血小板植入时间及等级资料[供受体血型相合程度、急性移植物抗宿主病(aGVHD)分级、广泛性慢性移植物抗宿主病(cGVHD)分级、出血性膀胱炎分级、渗漏综合征分级]采用Mann-Whitney U检验。性别、疾病种类、供体与受体性别、预处理方案、CD20单抗的使用、HLA配型、供体来源、移植物来源、植入综合征、巨细胞病毒(CMV)血症、EB病毒(EBV)血症、死亡人数、植入失败人数和骨髓增殖不良人数使用卡方检验进行组间分析。生存曲线以及累积发生率用Kaplan-Meier法绘制,并使用Log-rank检验分析组间差异。结果与对照组比较,治疗组CD19+B细胞的重建延迟,而CD16+CD56+NK细胞数量移植后6个月开始增加,逐渐达到对照组的水平。与对照组比较,治疗组aGVHD、cGVHD、植入综合征和骨髓增殖不良累积发生率(14.29﹪±7.64﹪比57.14﹪±8.36﹪,11.67﹪±7.75﹪比61.59﹪±9.65﹪,9.53﹪±6.41﹪比74.86﹪±7.43﹪,0.0﹪比14.29﹪±5.91﹪)均升高,差异具有统计学意义(P<0.05),两组CMV与EBV感染,5年总体生存率(OS)、无失败生存率(FFS)、无GVHD失败存活率(GFFS)、Ⅲ-Ⅳ度aGVHD及广泛性cGVHD累积发生率比较差异无统计意义(P>0.05)。结论单倍体移植是治疗儿童SAA的有效治疗方案,但与同胞全合造血干细胞移植比较,其GVHD发生率较高,植入综合征和骨髓增殖不良的发生率较高,优化单倍体移植方案有望降低并发症,提高儿童重型再生障碍性贫血的生活质量。     

Membrane glycolipids in stem cells

Stem cells, such as embryonic stem cells, hematopoietic stem cells, neural stem cells, mesenchymal stem cells, and very small embryonic-like stem cells, are undifferentiated cells that are endowed with a high potential for proliferation and the capacity for self-renewal with retention of pluri/multipotency to differentiate into their progenies. Recently, studies regarding the biological functions of glycolipids and cell surface microdomains (caveolae, lipid rafts, or glycolipid-enriched microdomains) in stem cells are emerging. In this review, we introduce the expression patterns of glycolipids and the functional roles of cell surface microdomains in stem cells.     

Hematopoietic stem cells in research and clinical applications: The "CD34 issue"

In this paper, experimental findings concerning the kinetics of hematopoietic reconstitution are compared to corresponding clinical data. Although not clearly apparent, the transplantation practice seems to confirm the basic proposals of experimental hematology concerning hematopoietic reconstitution resulting from successive waves of repopulation stemming from different subpopulations of progenitor and stem cells. One of the "first rate" parameters in clinical transplantations in hematology; i.e. the CD34+ positive cell dose, has been discussed with respect to the functional heterogeneity and variability of cell populations endowed by expression of CD34. This parameter is useful only if the relative proportion of stem and progenitor cells in the CD34+ cell population is more or less maintained in a series of patients or donors. This proportion could vary with respect to the source, pathology, treatment, processing procedure, the graft ex vivo treatment and so on. Therefore, a universal dose of CD34+ cells cannot be defined. In addition, to avoid further confusion, the CD34+ cells should not be named "stem cells" or "progenitor cells" since these denominations only concern functionally characterized cell entities.