Efficient Editing of an Adenoviral Vector Genome with CRISPR/Cas9

Immunotherapy based on genetic modification of T cells has played an important role in the treatment of tumors and viral infections. Moreover, adenoviral vectors engineered with improved safety due to their inability to integrate into the host genome have been key in the clinical application of T cell therapy. However, the commonly used adenoviral vector Ad5 exhibits low efficiency of infection of human T cells and the details of the intracellular trafficking pathway of adenoviral vectors in human primary T cells remains unclear. Resolution of these issues will depend on successful modification of the adenoviral vector. To this end, here we describe the successful establishment of a simple and efficient method for editing adenoviral vectors in vitro using the CRISPR-Cas9 gene editing system to target the adenoviral fiber gene. Electronic supplementary materialThe online version of this article (10.1007/s12088-020-00905-3) contains supplementary material, which is available to authorized users.     

Efecto positivo de la terapia de luz brillante sobre el estado de ánimo y la calidad del sueño en las personas mayores institucionalizadas

IntroductionBright light exposure during the day has a positive effect on health and its deficit can cause multiple physiological and cognitive disorders, including depression. The aim of this study was to evaluate the effect of bright light therapy (BLT) on the quality of sleep and mood emotional state; cognitive status, global deterioration and quality of life in institutionalized elderly.Material and methodsThis is a study with repeated measures design. Thirty-seven older people admitted to a nursing home. The study lasted 3 weeks. The first week, the reference values were established with the Oviedo Sleep Questionnaire, Yesavage Depression Scale, Mini-Mental, Global Scale of Impairment and European Quality of Life Questionnaire. During the second week, they were exposed to BLT (7,000-10,000 lx at eye level) between 9:30 a.m. and 11:00 a.m. During the third week, all the data were re-evaluated.ResultsAll variables improved significantly after the application of light therapy. Sleep (COS) pre-test 4.1 ± 1.49, post-test 4.9 ± 1.46, p: 0.01), mood (pre-test 3.65 ± 2.78, post-test 2.65 ± 2.9, p: 0.01), cognitive state (pre-test 22.72 ± 6.53, post-test 24 ± 5.92, p: 0.001), state of global deterioration (pre-test 3.10 ± 1.26, post-test 2.72 ± 5.92, p: 0.001) and health-related quality of life (pre-test 6.93 ± 1.86, post-test 7.82 ± 1.62, p: 0.001).ConclusionsSleep quality, mood, cognitive status, global deterioration status and quality of life significantly improved after the application of light bright therapy.     

光免疫治疗的抗肿瘤研究进展

光免疫治疗是一种新兴的肿瘤靶向光疗手段,它将单克隆抗体的肿瘤特异性与光吸收剂的光毒性相结合,可以快速且极具免疫原选择性地诱导靶肿瘤细胞的死亡。由于靶向性强,光免疫治疗的副作用小。而且因为该疗法诱导的免疫原性死亡会引起垂死肿瘤细胞周围未成熟树突状细胞的快速成熟,继而将肿瘤抗原提呈给CD8+T细胞,导致治疗后CD8+T细胞的激活和增殖,增强宿主抗肿瘤免疫反应。不仅如此,光免疫治疗还能通过增强纳米药物的肿瘤组织穿透性而提高疗效。鉴于光免疫治疗的优良应用前景,文中从其免疫激活机制、超级高渗透长滞留效应、新进展与联合治疗等方面进行综述,旨在为其深入研究和临床转化提供参考。     

Hyaluronic acid optimises therapeutic effects of hydrogen peroxide‐induced oxidative stress on breast cancer

Distinguishing the multiple effects of reactive oxygen species (ROS) on cancer cells is important to understand their role in tumour biology. On one side, ROS can be oncogenic by promoting hypoxic conditions, genomic instability and tumorigenesis. Conversely, elevated levels of ROS‐induced oxidative stress can induce cancer cell death. This is evidenced by the conflicting results of research using antioxidant therapy, which in some cases promoted tumour growth and metastasis. However, some antioxidative or ROS‐mediated oxidative therapies have also yielded beneficial effects. To better define the effects of oxidative stress, in vitro experiments were conducted on 4T1 and splenic mononuclear cells (MNCs) under hypoxic and normoxic conditions. Furthermore, hydrogen peroxide (H₂O₂; 10–1,000 μM) was used as an ROS source alone or in combination with hyaluronic acid (HA), which is frequently used as drug delivery vehicle. Our result indicated that the treatment of cancer cells with H₂O₂ + HA was significantly more effective than H₂O₂ alone. In addition, treatment with H₂O₂ + HA led to increased apoptosis, decreased proliferation, and multiphase cell cycle arrest in 4T1 cells in a dose‐dependent manner under normoxic or hypoxic conditions. As a result, migratory tendency and the messenger RNA levels of vascular endothelial growth factor, matrix metalloproteinase‐2 (MMP‐2), and MMP‐9 were significantly decreased in 4T1 cells. Of note, HA treatment combined with 100–1,000 μM H₂O₂ caused more damage to MNCs as compared to treatment with lower concentrations (10–50 μM). Based on these results, we propose to administer high‐dose H₂O₂ + HA (100–1000 μM) for intratumoural injection and low doses for systemic administration. Intratumoural route could have toxic and inhibitory effects not only on the tumour but also on residential myeloid cells defending it, whereas systemic treatment could stimulate peripheral immune responses against the tumour. More in vivo research is required to confirm this hypothesis.     

靶向肿瘤血管生成的天然产物研究进展

血管生成在肿瘤的发生发展过程中起着非常重要的作用。促血管生成因子及其受体可以通过调节血管生成促进肿瘤发生发展。因此,发现和开发靶向血管生成因子药物已经成为治疗肿瘤的重要策略。近年来,天然产物因其结构多样、毒副作用低及作用机制独特等优势已然成为开发抗肿瘤药物的主要来源。本文归纳阐述了近年来靶向血管生成因子具有抗肿瘤活性的天然产物研究进展,为进一步发现和开发靶向肿瘤血管生成的天然药物提供重要的理论依据。     

门诊和住院运动锻炼为核心的整体管理对慢性心力衰竭患者心脏康复治疗效果影响的临床研究*

目的: 探讨门诊运动康复和住院运动康复对慢性心力衰竭（CHF）患者心脏康复治疗效果的影响。方法: 选择2015 年9 月至2018 年9 月间在北京康复医院临床诊断为CHF患者36 例,按照随机原则和患者参与意愿分为3组：对照组（n=12）：进行除运动锻炼治疗之外的常规心脏康复指导;住院运动康复组（n=12）和门诊运动康复组(n=12）：患者在我院分别住院或门诊进行运动锻炼为核心的心脏康复。根据心肺运动试验（CPET）制定个体化运动处方。功率车运动强度为无氧阈以上Δ50%功率负荷,30 min/d,每周5 d,共12 周。治疗前、后分别评估患者CPET指标、超声心动图指标、6 min步行距离（6MWD）、生活质量（QoL）评分等。结果: 所有CHF患者安全无并发症完成症状限制性CPET,运动康复组患者安全完成全程12 周运动康复。组间比较显示,治疗前,3组患者CPET指标、超声心动图指标、6MWD和QoL均无明显差异（P>0.05）。治疗后,住院和门诊运动康复组患者无氧阈（ml/min, ml/（min·kg）, %pred）、峰值摄氧量（ml/min, ml/（min·kg）, %pred）、峰值氧脉搏（ml/beat）、峰值功率（W, %pred）、左心室射血分数、6MWD较对照组升高（P<0.05）,QoL 评分较对照组降低（P<0.05）;门诊运动康复组和住院运动康复组之间比较,CPET指标、超声心动图指标、6MWD和QoL评分等均无明显差异（P>0.05）。治疗前后比较显示,对照组患者治疗后上述指标与治疗前比较,差异均无统计学意义（P>0.05）;治疗后住院运动康复组和门诊运动康复组患者无氧阈（ml/min, ml/（min·kg））、峰值摄氧量（ml/min, ml/（min·kg）, %pred）、峰值氧脉搏（ml/beat, %pred）、峰值功率（W/min、%pred）、左心室射血分数和6MWD均较治疗前升高（P<0.05）,QoL 评分较治疗前降低（P<0.05）。结论: 门诊运动康复可显著改善CHF患者心肺功能、运动耐力和生活质量,与住院运动康复效果无明显差异。门诊康复作为心脏康复一种有效的治疗模式,值得大力推广。     

特罗凯靶向治疗联合培美曲塞和顺铂对非小细胞肺癌患者血清肿瘤标志物、免疫球蛋白和T淋巴细胞亚群的影响

摘要 目的：探讨特罗凯靶向治疗联合培美曲塞和顺铂对非小细胞肺癌（NSCLC）患者血清肿瘤标志物、免疫球蛋白和T淋巴细胞亚群的影响。方法：选取2018年2月~2020年2月期间我院接收的NSCLC患者80例,采用抽签法分为对照组、观察组两组,各40例。对照组给予培美曲塞和顺铂化疗方案治疗,观察组在对照组基础上联合特罗凯靶向治疗,对比两组总有效率、血清肿瘤标志物、免疫球蛋白、T淋巴细胞亚群及不良反应发生率。结果：对比两组不良反应无差异（P>0.05）。治疗3个疗程后,对照组、观察组的临床总有效率分别为37.50%、60.00%,观察组的总有效率高于对照组（P<0.05）。治疗3个疗程,观察组CD3⁺、CD4⁺、CD4⁺/CD8⁺高于对照组,CD8⁺低于对照组（P<0.05）。治疗3个疗程,观察组免疫球蛋白G（IgG）、免疫球蛋白A（IgA）、免疫球蛋白M（IgM）高于对照组（P<0.05）。治疗3个疗程,观察组细胞角蛋白19片段（CYFRA21-1）、糖类抗原50（CA50）、癌胚抗原（CEA）低于对照组（P<0.05）。结论：特罗凯靶向治疗联合培美曲塞和顺铂治疗NSCLC患者,疗效较好,可能与该方案可降低患者血清肿瘤标志物含量、调节免疫应答等因素有关。     

不同介入时间和不同疗程高压氧治疗对脑出血模型大鼠动物学行为及促血管新生因子表达的影响

摘要 目的：探讨不同介入时间和不同疗程高压氧治疗对脑出血大鼠动物学行为及促血管新生因子表达的影响。方法：240只SD大鼠随机分为假手术组、脑出血组、高压氧组,每组各80只。采用胶原酶诱导建立脑出血大鼠模型,建模成功后根据高压氧介入时间分为6 h介入组、1 d介入组、2 d介入组、3 d介入组等亚组。分别治疗1周、2周、3周、4周,采用Longa评分法、平衡木评分法、Berderson评分法评估大鼠动物学行为,采用qRT-PCR检测大鼠脑组织血管内皮生长因子（VEGF）、缺氧诱导因子-1α（HIF-1α）mRNA表达。结果：不同介入时间、不同疗程,脑出血组、高压氧组脑出血大鼠动物学行为评分、脑组织VEGF mRNA与HIF-1α mRNA表达均高于假手术组（P<0.05）。治疗1周、2周、3周、4周,不同介入时间高压氧组脑出血大鼠动物学行为评分低于脑出血组,脑组织VEGF mRNA、HIF-1α mRNA表达高于脑出血组（P<0.05）。高压氧介入时间越早,治疗疗程越长,脑出血大鼠动物学行为评分越低,脑组织VEGF mRNA、HIF-1α mRNA表达越高,差异均有统计学意义（P<0.05）。结论：高压氧治疗能够改善脑出血大鼠动物学行为、促进促血管新生因子表达,且以脑出血后6 h介入、疗程4周效果最佳。     

基因治疗慢病毒载体的转导增强策略*

基于慢病毒载体的体外基因治疗已在临床试验中取得良好的效果,有望治愈一些造血系统的单基因遗传病。通过提高靶细胞转导效率和减少转导中病毒载体量,基因治疗有效性、安全性和成本都可以得到改善。不同包膜糖蛋白伪型慢病毒载体通过与细胞膜表面的不同受体结合,促进病毒黏附和入胞,增强不同靶细胞的病毒转导效率。此外病毒转导增强剂可以在病毒进入细胞过程或进入后发挥作用,在提高转导效率的同时使靶转导基因在体内长期稳定表达。通过对这两类方法的总结回顾,旨在为慢病毒载体的转导效率提供新的优化策略,使基因治疗得到更广泛的应用。     

经鼻高流量氧疗对慢性阻塞性肺疾病急性加重期患者血气指标、膈肌功能及炎性反应的影响

摘要 目的：探讨经鼻高流量氧疗对慢性阻塞性肺疾病急性加重期（AECOPD）患者血气指标、膈肌功能及炎性反应的影响。方法：回顾性分析2018年2月~2020年8月我院收治的119例AECOPD患者的临床资料。根据不同氧疗方法分为传统组59例和研究组60例,传统组给予传统氧疗,研究组给予经鼻高流量氧疗。对比两组治疗前后血气指标、膈肌功能及炎性反应的变化情况,观察两组不良反应发生率、治疗后再插管率、喘急胸闷和咳痰困难消失率。结果：研究组治疗后动脉血二氧化碳分压（PaCO₂） 较传统组低,血氧饱和度（SaO₂）、动脉血氧分压（PaO₂）高于传统组（均P<0.05）。研究组治疗后膈肌浅快呼吸指数（D-RSBI）、平静呼吸膈肌移动度（DEq）低于传统组（均P<0.05）。研究组治疗后血清白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α 低于传统组（均P<0.05）。研究组治疗后再插管率低于传统组,喘急胸闷消失率、咳痰困难消失率高于传统组（均P<0.05）。两组的不良反应总发生率组间对比无统计学差异（P>0.05）。结论：与传统氧疗相比,经鼻高流量氧疗应用于AECOPD患者可有效改善血气指标、膈肌功能,减轻炎性反应,改善患者的临床症状。