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Han L, Shi X, Wang S, Wang Q, Xia A, Cao J, Xu K, Cheng H. Complex association of mean corpuscular volume and outcomes in patients with aplastic anemia treated with cyclosporine A plus androgen or cyclosporine A alone. Clin Exp Med 2025; 25:165. [PMID: 40377721 PMCID: PMC12084278 DOI: 10.1007/s10238-025-01652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2025] [Accepted: 03/26/2025] [Indexed: 05/18/2025]
Abstract
The aim of this study was to explore the prognostic value of mean corpuscular volume (MCV) in newly diagnosed aplastic anemia (AA) patients treated with cyclosporine A (CsA) plus androgen or CsA alone. The clinical data of 181 newly diagnosed patients with aplastic anemia from April 2008 to September 2020 in the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. According to the MCV levels, the patients were divided into a high-MCV group (107/181) and a normal-MCV group (74/181). We investigated the effect of MCV outcomes in patients with AA. Between the high-MCV and normal-MCV groups, neutrophil count, red blood cell count, platelet count, reticulocyte count, disease severity, lymphocytes, and granulocytes were significantly different (P < 0.05). The overall response rates (CR + PR) were 69.16% and 59.46% in the high-MCV and normal-MCV groups, respectively. The duration of response was not significantly different between MCV groups. The high-MCV patients had an improved 5-year overall survival and progression-free survival compared to the normal-MCV patients (94.40% vs. 68.10%; 71.80% vs. 60.30%, P < 0.001). Regarding hemogram restoration, the leukocyte, neutrophil, hemoglobin, and platelet recovery was accelerated in the high-MCV group (P < 0.05). Furthermore, MCV levels were positively correlated with reticulocyte count, reticulocyte percentage, high-fluorescence reticulocyte, medium-fluorescence reticulocyte, and immature reticulocyte fraction; on the other hand, MCV levels were negatively correlated with low fluorescent reticulocyte. In conclusion, aplastic anemia patients with a high MCV were a better prognostic factor, and the patients with high MCV may have better residual bone marrow hematopoietic function than those with normal MCV.
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Affiliation(s)
- Li Han
- Faculty of Clinical Medicine, Xuzhou Medical University, Xuzhou, China
| | - XueDong Shi
- Faculty of Clinical Medicine, Xuzhou Medical University, Xuzhou, China
| | - ShuQi Wang
- Faculty of Clinical Medicine, Xuzhou Medical University, Xuzhou, China
| | - QiuShuang Wang
- Faculty of Clinical Medicine, Xuzhou Medical University, Xuzhou, China
| | - AnQi Xia
- Faculty of Clinical Medicine, Xuzhou Medical University, Xuzhou, China
| | - Jiang Cao
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Quanshan District, Xuzhou City, 221002, Jiangsu Province, China
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - KaiLin Xu
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Quanshan District, Xuzhou City, 221002, Jiangsu Province, China.
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China.
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China.
| | - Hai Cheng
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Quanshan District, Xuzhou City, 221002, Jiangsu Province, China.
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China.
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China.
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Wu G, Li X, Ren X, Huang J, Zhang X, Liang T, Sun L, Hao M, Kuang Z, Li X, Zhang Q, Xu L, Zheng Y, Xie W. Heterogeneity in Health-Related Quality of Life of Patients with Aplastic Anemia: A Latent Profile Analysis. Patient Prefer Adherence 2025; 19:673-684. [PMID: 40129650 PMCID: PMC11930844 DOI: 10.2147/ppa.s505521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Accepted: 03/04/2025] [Indexed: 03/26/2025] Open
Abstract
Purpose Concerns over health-related quality of life (HRQOL) in patients with aplastic anemia (AA) have been increasing worldwide. However, most researches on HRQOL in AA patients have ignored individual-level variability. Thus, our study was designed to explore practical classification of HRQOL and related variables among AA patients. Methods A cross-sectional study was conducted from May 2022 to March 2023, utilizing convenience sampling to enroll AA patients. Data of HRQOL, sociodemographic characteristics, and clinical variables were collected. Latent profile analysis (LPA) was used to analyze the latent categories of HRQOL in AA patients, utilizing scores from eight subscales of the Medical Outcomes Study 36-Item Short Form Health Survey version 2.0. Results A total of 229 patients completed the survey and were included in the analysis. The LPA results showed significantly individual differences and identified three subgroups of HRQOL: Group 1, poor HRQOL with role emotional limitation (n=54, 23.58%); Group 2, moderate HRQOL with role physical limitation (n=56, 24.45%), and Group 3, good HRQOL (n=119, 51.97%), respectively among AA patients. Childless, no comorbidities, transfusion independence, no AA-related symptoms, and higher annual household income were associated with Group 3, whereas higher Eastern Cooperative Oncology Group performance status (ECOG-PS) scores were associated with Group 1. Conclusion The findings of our study revealed significant heterogeneity in HRQOL among AA patients, providing valuable information for tailoring interventions to meet individual needs, especially for those in the poor HRQOL with role emotional limitation group. To improve their quality of life, healthcare professionals should fully take into account how the HRQOL subgroups are affected by AA-related symptoms, household annual income, ECOG-PS score, children, comorbidities, and transfusion-dependence.
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Affiliation(s)
- Guibin Wu
- Diagnostic and Therapeutic Center for Anemic Diseases, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
| | - Xiao Li
- Diagnostic and Therapeutic Center for Anemic Diseases, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
| | - Xiang Ren
- Diagnostic and Therapeutic Center for Anemic Diseases, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
| | - Jinbo Huang
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
- Regenerative Medicine Clinic, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
| | - Xiaoxiao Zhang
- Diagnostic and Therapeutic Center for Anemic Diseases, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
| | - Taimei Liang
- Diagnostic and Therapeutic Center for Anemic Diseases, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
| | - Lina Sun
- Diagnostic and Therapeutic Center for Anemic Diseases, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
| | - Mengmeng Hao
- Diagnostic and Therapeutic Center for Anemic Diseases, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
| | - Zhexiang Kuang
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
- Regenerative Medicine Clinic, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
| | - Xinli Li
- Diagnostic and Therapeutic Center for Anemic Diseases, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
| | - Qianqian Zhang
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
- Nursing Department, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
| | - Li Xu
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
- Nursing Department, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
| | - Yizhou Zheng
- Diagnostic and Therapeutic Center for Anemic Diseases, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
| | - Wenjun Xie
- Tianjin Institutes of Health Science, Tianjin, People’s Republic of China
- Nursing Department, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People’s Republic of China
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Qi S, Du Y, Sun M, Zhang L, Chen Z, Xiong H. Aberrant myelomonocytic CD56 expression predicts response to cyclosporine therapy in pediatric patients with moderate aplastic anemia. Front Pediatr 2023; 11:1272593. [PMID: 38152649 PMCID: PMC10751928 DOI: 10.3389/fped.2023.1272593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023] Open
Abstract
Objects This study aimed to investigate the expression patterns and clinical significance of neural cell adhesion molecule-positive (CD56+) myelomonocytes in pediatric patients with moderate aplastic anemia (mAA). Methods Fifty-six pediatric patients with mAA were enrolled in this study. The patients' clinical characteristics, laboratory data, and response to cyclosporine therapy were obtained. CD56 expression on bone marrow myelomonocytic cells was investigated using flow cytometry. The association between aberrant CD56 expression and cyclosporine response was evaluated by a multivariate analysis. Results CD56+ myelomonocytes were detected in 43% of the mAA cases. Aberrant CD56 expression was frequent on immature CD45dimCD16dim granulocytes and mature CD45brightCD14bright monocytes. Compared with patients with CD56- myelomonocytes (CD56- patients), patients with CD56+ myelomonocytes (CD56+ patients) were in moderate hematological condition and had a distinct bone marrow cellular composition profile, which included an increased proportion of myeloid cells and CD56bright natural killer cells and a reduced proportion of CD4+ T cells, CD8+ T cells, and B cells. The multivariate analysis determined that CD56+ myelomonocytes were a favorable factor for achieving response at 6 months after cyclosporine therapy. There was a trend towards a lower 3-year rate of evolution to severe aplastic anemia or relapse among the CD56+ patients (8%) than the CD56- patients (22%). Conclusion CD56+ patients had an increased myeloid compartment and better prognosis compared with CD56- patients. The findings demonstrated the favorable role of CD56+ myelomonocytes in aplastic anemia progression.
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Affiliation(s)
- Shanshan Qi
- Laboratory of Pediatric Hematology, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yu Du
- Department of Hematology, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Sun
- Laboratory of Pediatric Hematology, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lin Zhang
- Department of Hematology, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi Chen
- Department of Hematology, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Xiong
- Laboratory of Pediatric Hematology, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Department of Hematology, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Chang H, He G, Fu R, Li F, Han B, Li T, Liu L, Mittal H, Jin H, Zhang F. Efficacy and safety of eltrombopag in Chinese patients with refractory or relapsed severe aplastic anemia. Sci Rep 2023; 13:18955. [PMID: 37919313 PMCID: PMC10622422 DOI: 10.1038/s41598-023-45607-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/21/2023] [Indexed: 11/04/2023] Open
Abstract
For patients with severe aplastic anemia (SAA) in China who have had an insufficient response to the first-line treatment with hematopoietic stem cell transplantation or immunosuppressive therapy, there is no established standard of care other than transfusion support and treatment of infections. This non-randomized, open-label, Phase II multicenter trial investigated the efficacy and safety of eltrombopag in 20 adult Chinese patients with refractory or relapsed (r/r) SAA. The primary endpoint of hematologic response rate at Week 26, defined as the proportion of patients who met any of the International Working Group criteria, was observed in 70% (14/20) of patients, with more than 50% of these having at least bi-lineage response. Reduced red blood cell and platelet transfusion at Week 26 were observed in 57% (8/14) and 80% (8/10) of patients, respectively. Safety findings were consistent with the established safety profile of eltrombopag and no new safety signals were reported. None of the patients discontinued eltrombopag because of safety concerns. Although the sample size was small, this is the first prospective study to show that eltrombopag is efficacious and has a favorable safety profile in a Chinese patient population with r/r SAA.Trial registration: This trial is registered on ClinicalTrials.gov (NCT03988608); registered 17 June 2019.
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Affiliation(s)
- Hong Chang
- West China Hospital of Sichuan University, Chengdu, China
| | - Guangsheng He
- The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Rong Fu
- Tianjin Medical University General Hospital, Tianjin, China
| | - Fei Li
- The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Bing Han
- Peking Union Medical College Hospital, Beijing, China
| | - Tao Li
- Novartis Pharma Co., Ltd., Beijing, China
| | - Lei Liu
- Novartis Pharma Co., Ltd., Beijing, China
| | - Hemant Mittal
- Novartis Healthcare Private Limited, Hyderabad, India
| | - Hantao Jin
- Novartis Pharma Co., Ltd., Beijing, China
| | - Fengkui Zhang
- Institute of Hematology & Blood Disease Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
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Xu M, Liu T, Ye M, Tan X, Sun Q. The Use of an Iterative Strategy of Cognitive Interview and Expert Consultation to Revise the Quality of Life Scale for Patients with Aplastic Anemia (QLS-AA). Patient Prefer Adherence 2023; 17:1741-1749. [PMID: 37489164 PMCID: PMC10363392 DOI: 10.2147/ppa.s418773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023] Open
Abstract
Background Aplastic anemia is characterized by anemia, hemorrhage and infection, and is accompanied by a variety of complications and psychological burden. Therefore, the quality of life of AA patients is not optimistic. Our team is committed to developing an assessment tool for the quality of life of AA patients, and adopting an iterative strategy of cognitive interview and expert consultation to solve the challenges encountered in item revision. Purpose We aim to use the strategy of cognitive interview and expert consultation to inform revision of the QLS-AA into a user-friendly tool with unambiguous items and improve the content validity of the scale. Methods We used an iterative strategy of cognitive interview and expert consultation. Two rounds of cognitive interview were conducted to identify problems with item comprehension, recall and other cognitive processes. As well as, a multi-disciplinary group of expert consultation was consulted to review the rationality of item revisions. Results In the first round of cognitive interview, 16 participants responded to 107 items. Among them, the most common problems were "clarification" and "item duplication". Based on the results of the first round of interview, an expert consultation was organized. A total of 16 amendments were put forward by the expert and 14 were adopted. In the second round of cognitive interviews, A total of 5 participants were included and 64 items were evaluated. Two items were suggested to be revised, and the remaining items were accurately understood and recognized by all participants. Couclusion This study highlights the key issues to consider when incorporating patient perspectives into quality measurement. The revision of QLS-AA through the strategy of cognitive interview and expert consultation may provide valuable insights into the measurement of quality of life in aplastic patients. Trial Registration Number ChiCTR2100047575.
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Affiliation(s)
- Min Xu
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Ting Liu
- The School of Nursing, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Menghua Ye
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Xiaoxue Tan
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Qiuhua Sun
- The School of Nursing, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
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Ni R, Fan L, Zhang L, Song Y, Wang H, Wang A, Liu B. A mouse model of irradiation and spleen-thymus lymphocyte infusion induced aplastic anemia. HEMATOLOGY (AMSTERDAM, NETHERLANDS) 2022; 27:932-945. [PMID: 36004514 DOI: 10.1080/16078454.2022.2113356] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The immune-induced aplastic anemia (AA) mouse model has been used for the study of AA. However, there were no uniform conditions for establishing a model and no assessment of immunological homeostasis. Our study aimed to identify the conditions of establishing a model and assess the AA model in immunology and pathology. METHODS We induced an AA mouse model by the combination between sublethal irradiation and spleen-thymus lymphocyte infusion. The success of establishing the AA model was identified by blood routine tests and pathology of bone marrow. The frequency of Th17 and Treg cells was measured by flow cytometry. The frequency of CD34+ and CD41+ cells was detected by immunohistochemical technique.IL-6, IL-8, IL-17, TNF-α and IFN-γ were evaluated by ELISA. RESULTS The 137Cs sublethal irradiation (5 Gy) and spleen-thymus lymphocyte infusion (5 × 106) induced the AA mouse model successfully. The AA mice had a long lifetime and manifested pancytopenia and bone marrow failure. The percentage of Th17 cells increased and the percentage of Treg cells decreased distinctly in AA mice. The area of hematopoietic tissues and count of CD34+ cells and CD41+ cells were significantly reduced in AA mice.The level of cytokines, IL-6, IL-8, IL-17, TNF-α and IFN-γ, was increased significantly in peripheral blood and bone marrow. CONCLUSION Our data suggest that the improved AA mouse model conforms to the diagnosis standard of AA and simulates the immune internal environment of human AA. The AA mouse model has a longer lifetime and unbalances of Th17/Treg cells caused the destruction of CD34+ cells and CD41+ cells, which was immune-mediated pathogenesis to adapt to long-term research.
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Affiliation(s)
- Runfeng Ni
- Department of traditional Chinese medicine, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Leiwei Fan
- Department of traditional Chinese medicine, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Le Zhang
- Department of traditional Chinese medicine, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Yanqi Song
- Department of traditional Chinese medicine, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Haijin Wang
- Department of traditional Chinese medicine, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Aidi Wang
- Department of traditional Chinese medicine, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Baoshan Liu
- Department of traditional Chinese medicine, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
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Yu W, Yang W. Interlukin-27 rs153109 polymorphism confers the susceptibility and prognosis of aplastic anemia in Chinese population. Int J Lab Hematol 2021; 44:150-156. [PMID: 34528397 DOI: 10.1111/ijlh.13700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/15/2021] [Accepted: 08/29/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Accumulating evidence has indicated that interleukin (IL)-27 and its gene polymorphisms exert pivotal impact on several autoimmune disorders. This research intended to investigate the relationship between IL-27 rs153109 polymorphism with risk and prognosis for aplastic anemia. METHODS IL-27 rs153109 polymorphism was detected with polymerase chain reaction-ligase detection reaction in 238 patients with aplastic anemia and 215 normal individuals. Enzyme-linked immunosorbent assays were applied to measure the plasma level of IL-27. RESULTS Frequencies of rs153109 AA and GG genotype were statistically higher in aplastic anemia patients compared to controls. Similar results were observed when further divided patients into nonsevere and severe ones. That means carriers of AA and GG genotype are accompanied by an increased risk of developing aplastic anemia. Plasma IL-27 levels of aplastic anemia patients were remarkably elevated than normal group and had positive relation with disease severity. Furthermore, patients with AA genotype had obviously higher IL-27 levels than ones with AG and GG genotype. Moreover, patients carrying AA genotype exhibited a poorer reaction to immunosuppressive therapy and were more prone to clonal evolution. CONCLUSION IL-27 rs153109 polymorphism confers genetic predisposition to aplastic anemia and influences disease prognosis, potentially by regulating IL-27 expression, which help broaden potential pathogenesis of aplastic anemia. Specifically, for patients with AA genotype, more aggressive therapeutic strategies such as hematopoietic stem cells transplantation are warranted.
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Affiliation(s)
- Wei Yu
- Department of International Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wu Yang
- Department of International Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
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Yu H, Zhao Y, Pan X, Liu C, Fu R. Upregulated Expression of Profilin1 on Dendritic Cells in Patients With Severe Aplastic Anemia. Front Immunol 2021; 12:631954. [PMID: 34220798 PMCID: PMC8242247 DOI: 10.3389/fimmu.2021.631954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 05/17/2021] [Indexed: 02/04/2023] Open
Abstract
Severe aplastic anemia (SAA) is a life-threatening form of bone marrow failure that is associated with very high mortality. Dendritic cells (DCs) are antigen presenting cells (APCs) with powerful movement ability, which is an important factor affecting immune function. The expression of profilin1 (Pfn1) plays an important role in the regulation of cell movement ability. We detected the expression of Pfn1 mRNA in the bone marrow (BM) myeloid dendritic cells (mDCs) from patients with SAA using RT-PCR. Next, we examined Pfn1 expression on mDCs using flow cytometry (FCM). We also assessed the relationship between Pfn1 expression and cytokine levels. Our data showed increased Pfn1 mRNA expression in patients with SAA. The expression of Pfn1 in BM mDCs increased in SAA patients. The expression of Pfn1 on mDCs and cytokines (TNF-α and IFN-γ) were positively correlated in the serum of untreated patients with SAA. Taken together, we found that the expression of Pfn1 on mDCs of SAA patients increased, which may affect the function of mDCs. Profilin 1 may be involved in the immunopathogenesis of SAA.
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Affiliation(s)
- Hong Yu
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yang Zhao
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaofeng Pan
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Chunyan Liu
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Rong Fu
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China
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Yu H, Liu H, Zhao Y, Wang H, Liu C, Qi W, Liu Z, Sun Y, Gao S, Tao J, Fu R, Shao Z. Upregulated expression of leukocyte immunoglobulin-like receptor A3 in patients with severe aplastic anemia. Exp Ther Med 2021; 21:346. [PMID: 33732319 PMCID: PMC7903422 DOI: 10.3892/etm.2021.9777] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/03/2020] [Indexed: 01/19/2023] Open
Abstract
Severe aplastic anemia (SAA) is a rare and potentially life-threatening disease characterized by pancytopenia and bone marrow (BM) hypoplasia. In a previous study by our group, increased expression of leukocyte immunoglobulin-like receptors A (LILRA), LILRA3 in myeloid dendritic cells (mDCs) and LILRA5 in CD34+ cells in SAA was detected using proteomics techniques, highlighting their potential role in disease pathogenesis. In the present study, the expression of LILRA1-6 mRNA was assessed in the BM mononuclear cells of patients with SAA using reverse transcription-quantitative (RT-q)PCR. The expression of homogenic LILRA3 and LILRA5 isoform on mDCs, as well as CD34+, CD3+CD8+, CD19+ and CD14+ cells, was detected using flow cytometry. mDCs were then induced, cultured and sorted. The expression of LILRA3 was confirmed using RT-qPCR and western blot analyses. The serum levels of soluble LILRA3 were measured using ELISA. Furthermore, the relationship between LILRA3 expression and disease severity was assessed. The results indicated increased LILRA3 mRNA expression in patients with SAA. The percentage of LILRA3+ in BM mDCs and CD34+ cells was increased. Compared with controls, the relative LILRA3 mRNA expression and the relative protein intensity were highly increased in SAA mDCs. The serum LILRA3 levels in patients with SAA were also increased. The proportion of LILRA3+CD11C+ human leukocyte antigen (HLA)-DR+/CD11C+HLA-DR+ cells was positively correlated with the ratio of LILRA3+CD34+/CD34+ cells and the expression of LILRA3 mRNA. Taken together, the expression of LILRA3 on mDCs of patients with SAA was increased, which may affect the function of mDCs. LILRA3 may have a significant role in the immune pathogenesis of SAA.
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Affiliation(s)
- Hong Yu
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Hui Liu
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Yang Zhao
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Huaquan Wang
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Chunyan Liu
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Weiwei Qi
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Zhaoyun Liu
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Yingying Sun
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Shan Gao
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Jinglian Tao
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Rong Fu
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Zonghong Shao
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
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Huang CF, Huang JJ, Mi NN, Lin YY, He QS, Lu YW, Yue P, Bai B, Zhang JD, Zhang C, Cai T, Fu WK, Gao L, Li X, Yuan JQ, Meng WB. Associations between serum uric acid and hepatobiliary-pancreatic cancer: A cohort study. World J Gastroenterol 2020; 26:7061-7075. [PMID: 33311950 PMCID: PMC7701939 DOI: 10.3748/wjg.v26.i44.7061] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/10/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Uric acid is the end product of purine metabolism. Previous studies have found that serum uric acid (SUA) levels are associated with the total cancer risk. However, due to the dual effect of uric acid on cancer, the relationship between the SUA levels and most specific-site cancer remains unclear.
AIM To investigate the associations between the SUA levels and incidence of hepatobiliary-pancreatic cancer.
METHODS In this prospective cohort study, 444462 participants free of cancer from the UK Biobank were included. The SUA levels were measured at baseline, and the incidence of hepatobiliary-pancreatic cancer was determined by contacting the cancer registry. The hazard ratios (HRs) and 95% confidence intervals (CIs) between the SUA levels and hepatobiliary-pancreatic cancer were investigated using multiple adjusted Cox regression models adjusted for potential confounders.
RESULTS In total, 920 participants developed liver, gallbladder, biliary tract or pancreatic cancer during a median of 6.6 yrs of follow-up. We found that the HR of pancreatic cancer in the highest SUA group was 1.77 (95%CI: 1.29-2.42) compared with that in the lowest group. After stratifying by gender, we further found that SUA was associated with an increased risk of pancreatic cancer only among the females (highest quartile vs lowest quartile HR 2.04, 95%CI: 1.35-3.08). Among the males, the SUA levels were positively associated with the gallbladder cancer risk (highest quartile vs lowest quartile HR 3.09, 95%CI: 1.28-7.46), but a U-shaped association with the liver cancer risk was observed (P-nonlinear = 0.03).
CONCLUSION SUA is likely to have gender-specific effects on hepatobiliary-pancreatic cancer. High SUA levels are a risk factor for pancreatic cancer in females and gallbladder cancer in males. A U-shaped association with the liver cancer risk was identified.
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Affiliation(s)
- Chong-Fei Huang
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
| | - Jun-Jun Huang
- Scientific Research and Planning Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Ning-Ning Mi
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Yan-Yan Lin
- Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
| | - Qiang-Sheng He
- Clinical Research Center and Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
| | - Ya-Wen Lu
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
| | - Ping Yue
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
| | - Bing Bai
- Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
| | - Jin-Duo Zhang
- Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
| | - Chao Zhang
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
| | - Teng Cai
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
| | - Wen-Kang Fu
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
| | - Long Gao
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
| | - Xun Li
- Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
- The Fifth Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Jin-Qiu Yuan
- Clinical Research Center and Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
| | - Wen-Bo Meng
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
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Liu J, Lu XY, Cheng L, Yang Y, Lin SY, Yin H, Liu XQ, Wu XM, He GS. Clinical outcomes of immunosuppressive therapy for severe aplastic anemia patients with absolute neutrophil count of zero. Hematology 2019; 24:492-497. [PMID: 31221029 DOI: 10.1080/16078454.2019.1631424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Jia Liu
- Department of hematology, The First people’s Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, People’s Republic of China
- Department of hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, People’s Republic of China
| | - Xing-Yu Lu
- Department of hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, People’s Republic of China
| | - Lang Cheng
- Department of hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, People’s Republic of China
| | - Yan Yang
- Department of Hematology, The Affiliated Hospital of Jilin University, Changchun, People’s Republic of China
| | - Sheng-Yun Lin
- Department of Hematology, Zhejiang Province Hospital of TCM, The First Affiliated Hospital of Zhejiang TCM University, Hangzhou, People's Republic of China
| | - Hua Yin
- Department of hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, People’s Republic of China
| | - Xiao-Qing Liu
- Department of hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, People’s Republic of China
| | - Xue-Mei Wu
- Department of hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, People’s Republic of China
| | - Guang-Sheng He
- Department of hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, People’s Republic of China
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