Low IL-23 levels in peripheral blood and bone marrow at diagnosis of acute leukemia in children increased with the elimination of leukemic burden

IL-23 is an IL-12 cytokine family member with pleiotropic functions that regulates tumour growth in various cancer types, exhibiting both anti-tumorigenic and pro-tumorigenic properties. Preclinical studies have shown a potential anti-leukemic action on childhood B-ALL cells. The study involved 65 children with acute leukemia [59 patients with acute lymphoblastic leukemia (ALL) and 6 patients with acute myeloid leukemia (AML)] and 27 healthy controls. Using an enzyme-linked immunosorbent assay, we aimed to determine the IL-23 levels in the peripheral blood (PB) and bone marrow (BM) of patients at diagnosis and at the end of the induction therapy (EIT). PB IL-23 levels were lower in leukemia patients compared to the healthy controls. In all acute leukemia patients, IL-23 levels were significantly lower at diagnosis both in PB (P = .015) and in BM (P = .037) compared to the PB and BM concentrations at the EIT. The same pattern was present in both subgroups of ALL and AML patients. The high leukemic burden at diagnosis was related with lower IL-23 levels, which were increased with the disease remission. Considering the anti-leukemic potential of this cytokine, the elevation of the IL-23 concentration at the disease remission indicates a beneficial role of IL-23 in paediatric acute leukemia.     

Effect of emodin on long non-coding RNA-mRNA networks in rats with severe acute pancreatitis-induced acute lung injury

Long non-coding RNAs (lncRNAs) contribute to disease pathogenesis and drug treatment effects. Both emodin and dexamethasone (DEX) have been used for treating severe acute pancreatitis-associated acute lung injury (SAP-ALI). However, lncRNA regulation networks related to SAP-ALI pathogenesis and drug treatment are unreported. In this study, lncRNAs and mRNAs in the lung tissue of SAP-ALI and control rats, with or without drug treatment (emodin or DEX), were assessed by RNA sequencing. Results showed both emodin and DEX were therapeutic for SAP-ALI and that mRNA and lncRNA levels differed between untreated and treated SAP-ALI rats. Gene expression profile relationships for emodin-treated and control rats were higher than DEX-treated and -untreated animals. By comparison of control and SAP-ALI animals, more up-regulated than down-regulated mRNAs and lncRNAs were observed with emodin treatment. For DEX treatment, more down-regulated than up-regulated mRNAs and lncRNAs were observed. Functional analysis demonstrated both up-regulated mRNA and co-expressed genes with up-regulated lncRNAs were enriched in inflammatory and immune response pathways. Further, emodin-associated lncRNAs and mRNAs co-expressed modules were different from those associated with DEX. Quantitative polymerase chain reaction demonstrates selected lncRNA and mRNA co-expressed modules were different in the lung tissue of emodin- and DEX-treated rats. Also, emodin had different effects compared with DEX on co-expression network of lncRNAs Rn60_7_1164.1 and AABR07062477.2 for the blue lncRNA module and Nrp1 for the green mRNA module. In conclusion, this study provides evidence that emodin may be a suitable alternative or complementary medicine for treating SAP-ALI.     

Unfolded protein response regulates P53 expression in the pulmonary endothelium

Lung endothelial barrier dysfunction leads to severe pathologies, including the lethal Acute Respiratory Distress Syndrome. P53 has been associated with anti‐inflammatory activities. The current study employs a variety of unfolded protein response (UPR) activators and inhibitors to investigate the regulation of P53 by UPR in lung cells. The bovine cells that were exposed to the UPR inductors brefeldin A, dithiothreitol, and thapsigargin; demonstrated elevated expression levels of P53 compared to the vehicle‐treated cells. On the contrary, the UPR inhibitors N‐acetyl cysteine, kifunensine, and ATP‐competitive IRE1α kinase‐inhibiting RNase attenuator; produced the opposite effects. The outcomes of the present study reveal a positive regulation between UPR and P53. Since it has been shown that a mild induction of the unfolded protein response opposes inflammation, we suggest that P53 is involved in those protective activities in the lung.     

Derepression of the Iroquois Homeodomain Transcription Factor Gene IRX3 Confers Differentiation Block in Acute Leukemia

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Urinary desmosine as a biomarker in acute lung injury

Acute lung injury (ALI) is a complex disorder associated with an acute inflammatory response thought to contribute to tissue injury. Desmosine, a cross-linking amino acid present in elastin, is released during matrix degradation and cleared by the kidney. Results from animal models and human disease studies have suggested that ALI is associated with the release of desmosine, resulting in increased urinary desmosine. A radioimmunoassay was used to monitor urinary desmosine levels over 10 days in ten patients with ALI. The concentration of desmosine was measured with and without acid hydrolysis. Baseline urinary desmosine was increased in two of ten patients. The concentration of desmosine at baseline did not appear to be related to age, gender, neutrophil elastase (NE)/α₁-antiprotease complex concentration or P_aO₂/F_iO₂ ratio. No meaningful changes in desmosine levels were noted after removal from mechanical ventilation. Baseline desmosine concentrations did not appear to correlate with the risk of death. The limited sensitivity, predictive correlations and dynamic modulation would suggest that urine desmosine has a limited role as a biomarker for ALI. Hydrolysis of urine samples appears necessary for optimal measurement of urine desmosine.     

番茄叶水提物急性毒性及其对急性炎症的影响

本文观察了番茄叶水提物对小鼠的急性毒性及其对脂多糖诱导急性炎症模型大鼠的影响。采用经典的急性毒性试验方法,观察小鼠口服给予番茄叶水提物的死亡率,按寇氏法计算半数致死量(LD50)。50只SD大鼠随机分为正常组、模型组、阳性药泼尼松5 mg/kg组与番茄叶水提物3.19、1.59 g/kg组,连续给药10 d,每天一次。以腹腔注射脂多糖(LPS)建立急性炎症模型,ELISA法测定血清白细胞介素1(IL-1)、白细胞介素6(IL-6)、肿瘤坏死因子(TNF-α)。结果显示,番茄叶水提物单次灌胃给药的LD50为46.44g/kg,95%可信限为39.52～54.60 g/kg。3.19 g/kg番茄叶水提物可明显降低LPS诱导的急性炎症小鼠血清IL-1、IL-6和TNF-α水平。番茄叶水提物抑制LPS诱导急性炎症的作用机制可能与其降低血清炎症因子水平有关。     

Magnesium and iron contents of leukemic lymphocytes in acute leukemias and hemolytic anemia

In this study, magnesium and iron concentrations were measured in lymphocytes from patients with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and hemolytic anemia (HA) before and after chemotherapy treatment. The results were compared with those of control subjects. Magnesium concentrations were significantly lower in the patient groups, compared with control values. However, no significant differences, except in the HA group, were found among magnesium concentrations of the patient groups them-selves. Iron level values were at physiological range in all groups. Similarly, no statistically significant differences were found between lymphocyte magnesium concentrations before and after chemotherapy treatment in the patient groups. Fe⁺³ values were higher in the ALL and HA groups with respect to the group before chemotherapy.     

中枢神经系统急性低氧反应的个体差异及其评定

为了观察急性低氧条件下中枢神经系统机能状态的改变,用改进了的方法测定了健康人乘车抵达海拔4700m高原现场前后,和在实验室内吸入低氧混合气体(相当于海拔4500～4700m)前后的“光单纯反应时”。在两种条件下,所得结果基本相同:人体中枢神经系统对急性低氧的反应有明显个体差异,可区别出稳定型、兴奋型和抑制型三类。其中抑制型现场和实验室分别有83％及75％的人出现急性低氧反应,其他两型合并统计,分别有79％及80％的人基本无反应。反应时抑制型的人急性低氧反应的发生率高。反应时测定方法用来评定急性低氧反应出现程度,其结果与症状学评定法相比,在两种条件下,吻合率分别为81％及78％,不吻合率分别为19％及22％,其中假阳性率分别为6％及10％,假阴性率分别为14％及12％。     

A distinct DNA methylation signature defines pediatric pre-B cell acute lymphoblastic leukemia

Pre-B cell acute lymphoblastic leukemia (ALL) is the most prevalent childhood malignancy and remains one of the highest causes of childhood mortality. Despite this, the mechanisms leading to disease remain poorly understood. We asked if recurrent aberrant DNA methylation plays a role in childhood ALL and have defined a genome-scale DNA methylation profile associated with the ETV6-RUNX1 subtype of pediatric ALL. Archival bone marrow smears from 19 children collected at diagnosis and remission were used to derive a disease specific DNA methylation profile. The gene signature was confirmed in an independent cohort of 86 patients. A further 163 patients were analyzed for DNA methylation of a three gene signature. We found that the DNA methylation signature at diagnosis was unique from remission. Fifteen loci were sufficient to discriminate leukemia from disease-free samples and purified CD34+ cells. DNA methylation of these loci was recurrent irrespective of cytogenetic subtype of pre-B cell ALL. We show that recurrent aberrant genomic methylation is a common feature of pre-B ALL, suggesting a shared pathway for disease development. By revealing new DNA methylation markers associated with disease, this study has identified putative targets for development of novel epigenetic-based therapies.     

大鼠急性坏死型胰腺炎病理特征评定方法的研究

目的　以大鼠胆源性胰腺炎模型为对象 ,比较国外相关的评分标准 ,探讨这一实验模型合理、准确的病理学评定方法。方法　 4 8只SD大鼠分善宁 (16只 )、对照 (2 1只 )和假手术 (11只 )不同处理组 ,胰胆管内注射牛磺胆酸钠诱发大鼠急性坏死型胰腺炎 ,参照Schmidt等普通病理学评分标准并加以改进 ,结合电镜超微结构观察等 ,评定不同标准的病理组织学评分的准确性。结果　急性坏死型胰腺炎大鼠解剖时见大量红色腹腔渗液 ,最多者达体重的 6 % ;光镜下见胰腺组织明显出血、腺细胞坏死 ;小叶破坏 ,结构紊乱 ,小叶间隔大量红细胞 ;肝脏、心脏、肺和肾脏也出现组织充血、出血等。不同处理组的 4项组织学评分标准显示Schmidt方法不能显示组间出血的严重程度 ,炎症、水肿、坏死 3项过于繁冗。以高倍镜下间隔红细胞数平均值和分级评分比较 ,组间出血显示显著性差异。结论　 1)腹腔大量红色渗液、胰腺组织出血坏死、微血管内微血栓形成和胰外多器官损伤等是这一模型的特征 ;2 )在简化Schmidt评分标准中水肿、坏死、炎症等 3项和出血指标以及间隔红细胞数和分级统计的基础上 ,作者提出新的标准 ,以更为准确合理地评定大鼠急性坏死型胰腺炎的病理组织学特征。     

胰腺外分泌细胞的适应性细胞保护作用

用5％牛磺胆酸钠-胰蛋白酶溶液作为强刺激物直接注入大鼠胰导管系统,制成急性出血坏死性胰腺炎模型。若于48h前向胰导管内预先给予0.1％、0.2％或0.4％的低浓度牛磺胆酸钠-胰蛋白酶溶液作为弱刺激物,能使随后给予的强刺激物所致的损伤大大减轻,使病鼠死亡率由对照组的100％分别降低到27％、17％和17％;血清淀粉酶浓度升高的幅度由对照组的4680U/100ml血清降低到1990、2180和2710U/100ml血清。胰腺组织学切片检查可见,病变由急性出血坏死性胰腺炎转变为轻度急性胰腺炎或向慢性胰腺炎转化。这项结果提示:预先给予弱刺激可使胰腺外分泌细胞对随后给予的强刺激产生适应性细胞保护作用,其机制尚待探索。     

Acute necrotizing encephalopathy: A comparison between influenza and non-influenza cases

The aim of this study was to clarify the difference between influenza and non-influenza cases in clinical symptoms, laboratory and neuroimaging findings, and outcome in children with ANE. We retrospectively studied 22 children with ANE. Eleven of them had virological proof of influenza infection and the other 11 were judged as non-influenza infection. There was no significant difference between influenza and non-influenza cases in sex, antipyretics use and neurological symptoms. Although laboratory data were not different between the two groups, brainstem lesions were relatively more frequent in influenza cases than in non-influenza cases. Outcome was not different between the two groups. The results of our study suggest that the pathogenesis of acute necrotizing encephalopathy will not be dependent on infectious agents.     

Adrenalectomy and Dexamethasone Treatment Alter the Patterns of Basal and Acute Phase Response-induced Expression of Acute Phase Protein Genes in Rat Liver

Hormonal requirements for full hepatic expression of ₂-macroglobulin (₂M), ₁-acid glycoprotein (AGP), haptoglobin (Hp) and γ-fibrinogen (Fb) were assessed at the level of mRNA. Prior to exposure to turpentine-induced inflammation, rats were either depleted of glucocorticoids by adrenalectomy or supplemented with an excess of dexamethasone. Adrenalectomy alone did not affect the basal level of acute phase protein (APP) expression except for ₂M mRNA, the level of which was enhanced. In contrast, dexamethasone treatment alone promoted full induction of ₂M, significant, but not maximal increase of AGP and Hp mRNAs and suppression of Fb. In adrenalectomized rats, acute phase (AP)-cytokines, released in response to inflammation, promoted full expression of Fb and Hp and increased the level of AGP mRNA whereas ₂M mRNA remained at the basal level. Inflammation in dexamethasone pretreated rats elicited changes which, in comparison to mRNA values for dexamethasone unpretreated inflamed rats, were seen as overexpression of ₂M, full expression of AGP and incomplete expression of Hp, whereas Fb mRNA remained at the basal level. These data suggest that glucocorticoids are the principal inducers of ₂M and AP-cytokines of Fb. For full induction of AGP, additive actions of glucocorticoids and AP-cytokines are required whereas expression of Hp is predominantly controlled by AP-cytokines.     

Ursodeoxycholic acid protects against lung injury induced by fat embolism syndrome

Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is a life‐threatening disease with a high mortality rate, which was a common complication of fat embolism syndrome (FES). Ursodeoxycholic acid (UDCA) has been reported to exert potent anti‐inflammatory effects under various conditions. In vivo, perinephric fat was injected via tail vein to establish a rat FES model, the anti‐inflammatory effects of UDCA on FES‐induced lung injury were investigated through histological examination, ELISA, qRT‐PCR, Western blot and immunofluorescence. In vitro, human lung microvascular endothelial cells (HPMECs) were employed to understand the protective effects of UDCA. The extent of ALI/ARDS was evaluated and validated by reduced PaO₂/FiO₂ ratios, increased lung wet/dry (W/D) ratios and impaired alveolar‐capillary barrier, up‐regulation of ALI‐related proteins in lung tissues (including myeloperoxidase [MPO], vascular cell adhesion molecule 1 [VCAM‐1], intercellular cell adhesion molecule‐1 [ICAM‐1]), elevated protein concentration and increased proinflammatory cytokines levels (TNF‐α and IL‐1β) in bronchoalveolar lavage fluid (BALF). Pre‐treatment with UDCA remarkably alleviated these pathologic and biochemical changes of FES‐induced ALI/ARDS; our data demonstrated that pre‐treatment with UDCA attenuated the pathologic and biochemical changes of FES‐induced ARDS, which provided a possible preventive therapy for lung injury caused by FES.     

The injured lung: clinical issues and experimental models

Exposure of military and civilian populations to inhaled toxic chemicals can take place as a result of deliberate release (warfare, terrorism) or following accidental releases from industrial concerns or transported chemicals. Exposure to inhaled toxic chemicals can result in an acute lung injury, and in severe cases acute respiratory distress syndrome, for which there is currently no specific medical therapy, treatment remaining largely supportive. This treatment often requires intensive care facilities that may become overwhelmed in mass casualty events and may be of limited benefit in severe cases. There remains, therefore, a need for evidence-based treatment to inform both military and civilian medical response teams on the most appropriate treatment for chemically induced lung injury. This article reviews data used to derive potential clinical management strategies for chemically induced lung injury.     

Bioassay responses to sediment elutriates and multivariate data analysis for hazard assessment of sediment-bound chemicals

A sediment study, involving both chemical and biological analyses, was carried out in the Hamburg harbour area. A total of 71 stations were sampled during 1988 and the sediments extracted using a 1:4 sediment:water ratio either with or without an addition of a water-soluble detergent to solubilize organic compounds. The resulting extracts were applied in algal and bacterial assays to measure toxicity. A principal components analysis showed that no single bioassay explained all the variation in toxicity among the locations studied. Hierarchical cluster analysis was used to rank sediments into four groups based on their toxicity. The relationship of toxic responses to the chemistry of the sediments was determined using varimax factor analysis. One factor was loaded with algal responses and mercury contents of sediments, another with bacterial responses and Lindane contents of sediments.     

急性心肌梗死的静脉溶栓治疗

溶栓是治疗急性心肌梗死最有前途的方法。梗死相关动脉的尽快开通是保护心肌、提高患生存率的关键。本旨在概述已得到认可的溶栓剂和相关的临床试验,包括链激酶、尿激酶、重组组织型纤溶酶原激活剂等。辅助治疗如肝素、水蛭素、血小板糖蛋白Ⅱb／Ⅲa受体拮抗剂也在本综述之列。     

Acute symptomatic gastritis due to Helicobacter heilmannii

Helicobacter heilmannii is a Gram-negative spiral-shaped organism predominantly associated with zoonotic infection. Human pathology has also been described, but acute symptoms with complete resolution have been infrequently reported. We present a 50-year-old man in whom H. heilmannii gastritis presented as an acute febrile illness and was successfully treated with antibiotics and proton pump inhibitor. Epidemiology, diagnosis, and treatment of similar cases are reviewed.     

龙津降纤酶治疗急性缺血性卒中临床疗效观察

目的 观察龙津降纤酶对急性缺血性情卒中的治疗效果。方法 选择诊断明确的急性因性卒中病人８０例,随机分为２组,对照组４０例,５％葡萄糖液５００ｍｌ加血塞通小射液０．４ｇ静脉滴注,连用１４天,降纤酶组４０例,入院后第１～３天分别给降酶１０ｕ加入生理盐水１００ｍｌ,静脉主１ｈ以上,按临床神经功能缺失程度评分标准于治疗前及治疗在进行疗效评定。结果 降纤酶组总有效率达９２．５％,显效率为７２．５％,明显优于     

降纤酶治疗急性脑梗死29例临床观察

目的 为探讨国产降纤酶治疗脑梗死的确切疗效和安全性。方法 我科参加了由全国脑防办牵头并在全国４０多家大医院神经科参加的多中心随机、双盲对照难证工作。结果 降纤酶对急性脑死总有效率达６１％,用降纤酶第２天血纤蛋白原开始下降,第４天下降明显,以后基本无变化,而对照组在治疗邱血纤维蛋白原基本无变化;从用降纤酶后总的趋势来看,ＰＴ有延长;牟神经功能恢复而对照组在治疗后血纤维蛋白原基本无变化;从用降纤酶后总