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1.
Transpl Immunol ; 87: 102115, 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39233094

RESUMEN

BACKGROUND: Severe combined immunodeficiency (SCID) is a heterogenous disorder with profound deficiency of T/B-cell functions. The best SCID therapy requires hematopoietic stem cell transplantation (HSCT) early in life. HSCT with conditioning is necessary to achieve a long-term reconstitution of B-cell functions. However, conditioning may aggravate pre-existing infection and cause transplant-related toxicity, especially in very young infants. Hence, the intensity of conditioning should be reduced to allow the reconstitution of immunity including B cells to the extent that prevents transplant-related toxicity and delayed complications. METHODS: An infant with a family history of X-linked SCID (X-SCID) was diagnosed with X-SCID disorder soon after birth. The infant exhibited cytomegalovirus (CMV) infection despite being strictly isolated. At 1.5 months of age, we performed an unrelated cord blood transplantation (CBT) with a less intensity conditioning regimen: fludarabine (125 mg/m2) + melphalan (80 mg/m2). We evaluated the efficacy of reconstitution by assessing B-cell function and growth and psychomotor development at 5 years and 7 months after CBT. RESULTS: The clinical course after CBT was uneventful after CBT. The CMV infection was fully controlled by ganciclovir or foscavir therapy, which was discontinued at day 55 after CBT. Furthermore, immunoglobulin (Ig) replacement therapy was also discontinued at 6 months after CBT. A sufficient proportion of CD27+ memory B cells was developed, which was essential for an effective vaccination and prevention of infections. While the B-cell chimerism became recipient-dominant, the Ig replacement therapy was substituted by very successful post-vaccine immunity acquisition after CBT. The analysis of the general developmental parameters showed that chemotherapy did not cause any delay in growth and psychomotor development. CONCLUSIONS: The CBT therapy with this conditioning regimen was well tolerated and induced an effective reconstitution of B-cell functions in an X-SCID infant under the 3 months of age.

3.
J Allergy Clin Immunol ; 151(6): 1634-1645, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36638922

RESUMEN

BACKGROUND: Allogenic hematopoietic stem cell transplantation (HSCT) and gene therapy (GT) are potentially curative treatments for severe combined immunodeficiency (SCID). Late-onset posttreatment manifestations (such as persistent hepatitis) are not uncommon. OBJECTIVE: We sought to characterize the prevalence and pathophysiology of persistent hepatitis in transplanted SCID patients (SCIDH+) and to evaluate risk factors and treatments. METHODS: We used various techniques (including pathology assessments, metagenomics, single-cell transcriptomics, and cytometry by time of flight) to perform an in-depth study of different tissues from patients in the SCIDH+ group and corresponding asymptomatic similarly transplanted SCID patients without hepatitis (SCIDH-). RESULTS: Eleven patients developed persistent hepatitis (median of 6 years after HSCT or GT). This condition was associated with the chronic detection of enteric viruses (human Aichi virus, norovirus, and sapovirus) in liver and/or stools, which were not found in stools from the SCIDH- group (n = 12). Multiomics analysis identified an expansion of effector memory CD8+ T cells with high type I and II interferon signatures. Hepatitis was associated with absence of myeloablation during conditioning, split chimerism, and defective B-cell function, representing 25% of the 44 patients with SCID having these characteristics. Partially myeloablative retransplantation or GT of patients with this condition (which we have named as "enteric virus infection associated with hepatitis") led to the reconstitution of T- and B-cell immunity and remission of hepatitis in 5 patients, concomitantly with viral clearance. CONCLUSIONS: Enteric virus infection associated with hepatitis is related to chronic enteric viral infection and immune dysregulation and is an important risk for transplanted SCID patients with defective B-cell function.


Asunto(s)
Infecciones por Enterovirus , Trasplante de Células Madre Hematopoyéticas , Hepatitis , Inmunodeficiencia Combinada Grave , Virosis , Humanos , Inmunodeficiencia Combinada Grave/terapia , Inmunodeficiencia Combinada Grave/etiología , Linfocitos T CD8-positivos , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Trasplante de Células Madre Hematopoyéticas/métodos , Virosis/etiología , Hepatitis/etiología
4.
Hum Vaccin Immunother ; 18(5): 2088971, 2022 11 30.
Artículo en Inglés | MEDLINE | ID: mdl-35704795

RESUMEN

BACKGROUND: After trauma and central nervous system (CNS) injury, trauma-induced immune deficiency syndrome (TIDS) and CNS injury-induced immune deficiency syndrome (CIDS) may negatively affect responses to T-cell-dependent vaccines, such as pneumococcal conjugate vaccine (PCV) recommended after basilar fracture. This study (NCT02806284) aimed to investigate whether there after neurotrauma is a correlation between T-cell-dependent and independent vaccine responses and, thus, if B-cell activity is similarly depressed and whether the T-cell-dependent response is possible to predict. METHODS: Adult patients with basilar fracture (n = 33) and those undergoing pituitary gland surgery (n = 23) were within 10 days vaccinated with a T-cell-dependent vaccine against Haemophilus influenzae type b (Hib) and a T-cell-independent pneumococcal polysaccharide vaccine (PPSV). Samples reflecting the systemic inflammatory response and pre- and post-vaccination antibody levels after 3-6 weeks against Hib and PPSV were collected and determined by enzyme immunoassays. RESULTS: High and significant correlations were detected in the responses to different pneumococcal serotypes, but none between the Hib and PPSV responses. No differences in trauma scores, C-reactive protein, IL-6, IL-10, pentraxin 3, fractalkine or calprotectin plasma concentrations or in ex vivo TNF-α, IL-6 or IL-10 responses to endotoxin were found between Hib vaccination responders and non-responders. CONCLUSIONS: There was no correlation between the pneumococcal responses and that to Hib, indicating that B-cell function is not similarly depressed as T-cell function. Grading of the trauma or parameters reflecting the innate immune response could not predict the T-cell-dependent vaccine response. There is a need of further studies evaluating the vaccine response after neurotrauma.


Asunto(s)
Vacunas contra Haemophilus , Haemophilus influenzae tipo b , Adulto , Humanos , Anticuerpos Antibacterianos , Interleucina-10 , Interleucina-6 , Vacunas Neumococicas , Linfocitos T , Vacunas Conjugadas
5.
Diabetes Obes Metab ; 24(11): 2081-2089, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-35676799

RESUMEN

AIMS: The contribution of endogenous glucagon-like peptide (GLP)-1 to ß-cell function after Roux-en-Y gastric bypass surgery (RYGB) is well established in normoglycaemic individuals, but not in those with postoperative hyperglycaemia. We, therefore, studied the effect of GLP-1 on ß-cell function in individuals with varying degrees of type 2 diabetes mellitus (T2D) control after RYGB. MATERIALS AND METHODS: Glucose, insulin secretion rates, ß-cell glucose sensitivity and glucagon were measured during an oral glucose tolerance test before (saline only) and at 3, 12 and 24 months after RYGB with and without infusion of the GLP-1 receptor blocker exendin9-39 (EX9). The cohort was retrospectively classified based on T2D remission (REM) status at the latest study time point: REM (n = 5), persistent T2D (n = 8), or impaired glucose tolerance (n = 16). RESULTS: EX9 blunted the increase in ß-cell glucose sensitivity at 3 months (-44.1%, p < .001) and 12 months (-43.3%, p < .001), but not at 24 months (-12.4%, p = .243). EX9 enhanced postprandial glucagon concentrations by 62.0% at 3 months (p = .008), 46.5% at 12 months (p = .055), and 30.4% at 24 months (p = .017). EX9 counterintuitively decreased glucose concentrations at 3 months in the entire cohort (p < .001) but had no effect on glycaemia at 12 and 24 months in persistent T2D and impaired glucose tolerance; it minimally worsened glycaemia in REM at 12 months. CONCLUSIONS: GLP-1 blockade reversed the improvement in ß-cell function observed after RYGB, but this effect varied temporally and by REM status. GLP-1 blockade transiently and minimally worsened glycaemia only in REM, and lowered postprandial glucose values at 3 months, regardless of REM status.


Asunto(s)
Diabetes Mellitus Tipo 2 , Derivación Gástrica , Intolerancia a la Glucosa , Glucemia , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/cirugía , Glucagón , Péptido 1 Similar al Glucagón , Receptor del Péptido 1 Similar al Glucagón , Glucosa , Humanos , Insulina , Estudios Retrospectivos
7.
Front Pediatr ; 9: 738799, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34805040

RESUMEN

Autosomal dominant hyper-IgE syndrome (AD-HIES) is a rare inherited primary immunodeficient disease (PIDs), which is caused by STAT3 gene mutations. Previous studies indicated a defective Toll-like receptor (TLR) 9-induced B cell response in AD-HIES patients, including proliferation, and IgG production. However, the other TLRs-mediated B cell responses in AD-HIES patients were not fully elucidated. In this study, we systematically studied the B cell response to TLRs signaling pathways in AD-HIES patients, including proliferation, activation, apoptosis, cytokine, and immunoglobulin production. Our results showed that the TLRs-induced B cell proliferation and activation was significantly impaired in AD-HIES patients. Besides, AD-HIES patients had defects in TLRs-induced B cell class switch, as well as IgG/IgM secretion and IL-10 production in B cells. Taken together, we first systematically reported the deficiency of TLRs driven B cell response in AD-HIES patients, which help to have a better understanding of the pathology of AD-HIES.

8.
Clin Exp Pharmacol Physiol ; 47(9): 1509-1516, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32415755

RESUMEN

We sought to determine whether adjusting the indices used to assess beta cell function by anthropometric markers of obesity improves their clinical value in a diabetic population. We conducted a cross-sectional survey of 3732 diabetic patients who underwent a 100 g carbohydrate meal test. Insulin secretion was estimated using HOMA-B of steady state as well as △C0-30 /△G0-30 , △AUCc30-120 /△AUCG30-120 and CPIn for dynamic state. Body weight index, waist circumference, waist-hip ratio and body surface area were recorded. The final analysis included 2873 T2DM patients. Correlation analyses showed that there was a poor correlation between diabetic duration and CPI30 (r = -.040, P < .05), and there were no remarkable changes in the correlation coefficient after CPI30 was divided by BMI, WC, WHR, or body surface area, respectively. The same was found for the correlation between HbA1c and CPI120 with these measures. The main determinants of diabetic duration were age (ß = 0.388, P < .001), log HOMA-IR (ß = -0.328, P < .001), CPI30 (ß = -0.045, P = .011). There were no remarkable changes in ß weights between diabetic duration and CPI30 when it was corrected with anthropometric markers in the multiple stepwise linear regression analyses. The same was found between HbA1c and CPI120 . CPI30 and CPI120 are more practical indexes. Correcting the indices used to estimate the beta cell function by anthropometric markers of obesity may not improve their correlations with diabetic duration or HbA1c in a diabetic population.


Asunto(s)
Antropometría , Glucemia/metabolismo , Péptido C/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Células Secretoras de Insulina/metabolismo , Obesidad/diagnóstico , Pruebas de Función Pancreática , Adulto , Anciano , Biomarcadores/sangre , Estudios Transversales , Diabetes Mellitus Tipo 2/sangre , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/fisiopatología , Valor Predictivo de las Pruebas
9.
Artículo en Inglés | MEDLINE | ID: mdl-31803138

RESUMEN

Objective: To evaluate the association between insulin-dose adjusted A1C (IDAA1c) and microvascular complications (MC) and hypoglycemia in a representative Brazilian population of Type 1 diabetes mellitus (T1DM) patients. Research Design and Methods: This was a cross-sectional study based on a previous study, "Microvascular Complications in Type 1 Diabetes: a comparative analysis of patients treated with autologous nonmyeloablative hematopoietic stem-cell transplantation (AHST) and conventional medical therapy (CT)". The 168 patients in that study (144 from CT plus 24 from AHST) were re-subdivided into two groups, according to their IDAA1c values (30 patients had IDAA1c ≤ 9; 138 had IDAA1c > 9). Then, the prevalence of MC (diabetic renal disease, neuropathy, and retinopathy), hypoglycemia (blood glucose <60 mg/dL), and severe hypoglycemic (episode of hypoglycemia that required the assistance of another person to treat) events were compared between the groups. The groups were well-matched on these factors: duration of disease, sex, and age at the time of diagnosis of T1DM. Results: After an average of 8 years after diagnosis, only 6.6% (2/30) of the patients from IDAA1c ≤ 9 group developed any MC, whereas 21.0% (29/138) from the IDAA1c > 9 group had at least one complication (p = 0.044). Regarding hypoglycemic events, the proportion of individuals who reported at least 1 episode of hypoglycemia in the last month was 43.3 and 64.7% from the IDAA1c ≤ 9 and IDAA1c > 9 groups, respectively (p = 0.030). Regarding severe hypoglycemia, the proportion of patients presenting at least one episode in the last month and the rate of episode/patient/month were similar between groups (6.7 vs. 13.2%; p = 0.535; and 0.1/patient/month vs. 0.25/patient/month; p = 0.321). Conclusion: In a representative Brazilian population of T1DM patients, those with IDAA1c ≤ 9 presented a lower frequency of MC, as well as fewer episodes of hypoglycemia, in the month prior to the analysis.

10.
Immunol Rev ; 292(1): 164-179, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31559645

RESUMEN

The interest in regulatory B cells (Bregs) began in the 1970s with the evidence that B cells could downregulate the immune system by the production of "inhibitory" antibodies. Subsequently, a series of results from different studies have emphasized that B cells have antibody-independent immunoregulatory functions. Since then, different subsets of B cells with regulatory functions and their development and mechanisms of action have been identified both in human and in animal models of inflammation, transplantation, and autoimmunity. The present review outlines the suggested pathways by which Bregs develop, describes the different subsets of Bregs with their phenotypes and function as well as their role in transplantation, highlighting the differences between human and animal studies throughout.


Asunto(s)
Autoinmunidad/inmunología , Subgrupos de Linfocitos B/inmunología , Linfocitos B Reguladores/inmunología , Inflamación/inmunología , Trasplante/métodos , Animales , Subgrupos de Linfocitos B/metabolismo , Humanos , Inflamación/metabolismo , Fenotipo , Transducción de Señal/inmunología , Inmunología del Trasplante
11.
Endocrinol Metab (Seoul) ; 33(2): 147-159, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29947172

RESUMEN

Autoimmune diabetes is a heterogeneous disease which can arise at any age. Subjects with adult-onset autoimmune diabetes who do not necessitate insulin-therapy for at least 6 months after diagnosis are demarcated as having latent autoimmune diabetes in adults (LADA). This condition is more heterogeneous than young-onset autoimmune diabetes and shares clinical and metabolic characteristics with both type 2 and type 1 diabetes. Patients with LADA are considered by having highly variable ß-cell destruction, different degrees of insulin resistance and heterogeneous titre and pattern of islet autoantibody, suggesting different pathophysiological pathways partially explaining the heterogeneous phenotypes of LADA. To date the heterogeneity of LADA does not allow to establish a priori treatment algorithm and no specific guidelines for LADA therapy are available. These subjects are mostly treated as affected by type 2 diabetes, a factor that might lead to the progression to insulin-dependency quickly. A personalised medicine approach is necessary to attain optimal metabolic control and preserve ß-cell function to decrease the risk of long-term diabetes complications. Recent data concerning the use of oral antidiabetic agents as dipeptidyl peptidase 4 inhibitors and glucagon-like peptide 1 receptor agonists indicate up-and-coming results in term of protect C-peptide levels and improving glycaemic control. This review summarises current knowledge on LADA, emphasising controversies regarding its pathophysiology and clinical features. Moreover, we discuss data available about novel therapeutic approaches that can be considered for prevention of ß-cell loss in LADA.

12.
Pediatr Endocrinol Diabetes Metab ; 2018(3): 111-117, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30786675

RESUMEN

INTRODUCTION: Studies using vitamin D for preservation of residual b-cell function (RBCF) and improvement of glycaemic control in type 1 diabetes (T1D) have shown inconsistent results. The possible causes of the discrepancies in the results are related to the dosage, type, and duration of vitamin D supplementation, C-peptide concentration at entry into the study, and the influence of glycaemic control on RBCF during supplementation. AIM OF THE STUDY: To evaluate the effect of cholecalciferol supplementation on RBCF and glycaemic control in children with T1D. MATERIAL AND METHODS: Forty-two children aged 6-12 years and within 1-2 years of diagnosis of T1D received cholecalciferol 3000 IU/day for one year (Group A). Thirty patients were recruited as controls (Group B). The mean changes in stimulated C-peptide levels, HbA1c, fasting blood glucose (FBG), mean blood glucose (MBG), and mean total daily insulin (TDI) dose from baseline to the study endpoint were calculated. RESULTS: Children in Group A showed lower mean FBG, MBG, HbA1c, and lesser TDI as compared to Group B at all follow-up visits. However, the differences in these parameters between the two groups reached statistical significance towards the study endpoint. Within group A, the decline in C-peptide levels from baseline to the endpoint was minor (-0.13 ±0.11, p-value = 0.16) as compared to a substantial decline in Group B (-0.41 ±0.07, p-value = 0.00). Comparison of the mean decrease in stimulated C-peptide levels from baseline to the endpoint between the two groups was also statistically significant (-0.13 ±0.11 vs. -0.41 ±0.07, p-value = 0.00). The mean decrease in FBG and MBG in Group A were greater, whereas the comparison of the mean decrease in HbA1c between the groups reached statistical significance at the study endpoint (p-value = 0.04). The decrease in the TDI was, however, similar in the two groups (p-value = 0.10). CONCLUSIONS: Sustained serum 25-(OH)D concentrations with cholecalciferol supplementation for one year improves metabolic control and slows the decline of RBCF in children with T1D. Larger studies with longer duration and cholecalciferol dosage stratification are suggested.


Asunto(s)
Colecalciferol/farmacología , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Suplementos Dietéticos , Deficiencia de Vitamina D/tratamiento farmacológico , Vitamina D/análogos & derivados , Niño , Colecalciferol/uso terapéutico , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/etiología , Femenino , Humanos , Masculino , Vitamina D/sangre , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones
13.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-715524

RESUMEN

Autoimmune diabetes is a heterogeneous disease which can arise at any age. Subjects with adult-onset autoimmune diabetes who do not necessitate insulin-therapy for at least 6 months after diagnosis are demarcated as having latent autoimmune diabetes in adults (LADA). This condition is more heterogeneous than young-onset autoimmune diabetes and shares clinical and metabolic characteristics with both type 2 and type 1 diabetes. Patients with LADA are considered by having highly variable β-cell destruction, different degrees of insulin resistance and heterogeneous titre and pattern of islet autoantibody, suggesting different pathophysiological pathways partially explaining the heterogeneous phenotypes of LADA. To date the heterogeneity of LADA does not allow to establish a priori treatment algorithm and no specific guidelines for LADA therapy are available. These subjects are mostly treated as affected by type 2 diabetes, a factor that might lead to the progression to insulin-dependency quickly. A personalised medicine approach is necessary to attain optimal metabolic control and preserve β-cell function to decrease the risk of long-term diabetes complications. Recent data concerning the use of oral antidiabetic agents as dipeptidyl peptidase 4 inhibitors and glucagon-like peptide 1 receptor agonists indicate up-and-coming results in term of protect C-peptide levels and improving glycaemic control. This review summarises current knowledge on LADA, emphasising controversies regarding its pathophysiology and clinical features. Moreover, we discuss data available about novel therapeutic approaches that can be considered for prevention of β-cell loss in LADA.


Asunto(s)
Adulto , Humanos , Autoanticuerpos , Péptido C , Complicaciones de la Diabetes , Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Diagnóstico , Inhibidores de la Dipeptidil-Peptidasa IV , Péptido 1 Similar al Glucagón , Hipoglucemiantes , Insulina , Resistencia a la Insulina , Islotes Pancreáticos , Fenotipo , Características de la Población
14.
Artículo en Inglés | MEDLINE | ID: mdl-29218029

RESUMEN

OBJECTIVE: To explore the impact on microvascular complications, long-term preservation of residual B-cell function and glycemic control of patients with type 1 diabetes treated with autologous nonmyeloablative hematopoietic stem-cell transplantation (AHST) compared with conventional medical therapy (CT). RESEARCH DESIGN AND METHODS: Cross-sectional data of patients treated with AHST were compared with patients who received conventional therapy from the Brazilian Type 1 Diabetes Study Group, the largest multicenter observational study in type 1 diabetes mellitus in Brazil. Both groups of patients had diabetes for 8 years on average. An assessment comparison was made on the presence of microvascular complications, residual function of B cell, A1c, and insulin dose of the patients. RESULTS: After a median of 8 years of diagnosis, none of the AHST-treated patients (n = 24) developed microvascular complications, while 21.5% (31/144) had at least one (p < 0.005) complication in the CT group (n = 144). Furthermore, no case of nephropathy was reported in the AHST group, while 13.8% of CT group (p < 0.005) developed nephropathy during the same period. With regard of residual B-cell function, the percentage of individuals with predicted higher C-peptide levels (IDAA1C ≤ 9) was about 10-fold higher in the AHST group compared with CT (75 vs. 8.3%) (p < 0.001) group. Among AHST patients, 54.1% (13/24) had the HbA1c < 7.0 compared with 13.1% in the CT (p < 0.001) group. CONCLUSION: Patients with newly diagnosed type 1 diabetes treated with AHST presented lower prevalence of microvascular complications, higher residual B-cell function, and better glycemic control compared with the CT group.

15.
Trends Mol Med ; 23(8): 721-736, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28694140

RESUMEN

B lymphocytes are essential for an efficient immune response against a variety of pathogens. A large fraction of hematologic malignancies is of B cell origin, suggesting that the development and activation of B cells need to be tightly regulated. In recent years, increasing evidence has emerged demonstrating that microRNAs (miRNAs) - a class of non-coding RNAs that control gene expression - are involved in the regulation of B cell development and function. We provide here an overview of the current knowledge on the role of miRNAs and their relevant targets in B cell development, B cell activation, and B cell malignant transformation.


Asunto(s)
Linfocitos B/metabolismo , Transformación Celular Neoplásica/metabolismo , Linfoma de Células B/metabolismo , MicroARNs/metabolismo , ARN Neoplásico/metabolismo , Animales , Linfocitos B/patología , Transformación Celular Neoplásica/patología , Humanos , Linfoma de Células B/patología
16.
Diabetes Metab Res Rev ; 33(6)2017 09.
Artículo en Inglés | MEDLINE | ID: mdl-28371189

RESUMEN

BACKGROUND: The aim of the study was to investigate the different B-cell responses after a glucagon stimulation test (GST) versus mixed meal tolerance test (MMTT). METHODS: We conducted GST and MMTT in 10 healthy people (aged 25-40 years) and measured C-peptide, gastric inhibitory peptide (GIP) and glucagon-like peptide-1 (GLP-1) at different time points after the administration of 1 mg i.v. glucagon for GST or a liquid mixed meal for MMTT. RESULTS: The GST stimulated C-peptide showed a mean increase of 147.1%, whereas the mean increase of MMTT stimulated C-peptide was 99.82% (Δincrease = 47.2%). Maximum C-peptide level reached with the MMTT was greater than that obtained with the GST (C-pept max MMTT = 2.35 nmol/L vs C-pep max GST = 1.9 nmol/L). A positive and linear correlation was found between the GST incremental area under the curve C-peptide and the MMTT incremental area under the curve C-peptide (r = 0.618, P = .05). After GST, there was no increment of GIP and glucagon like peptide-1 levels compared to baseline levels. A positive and linear correlation between GIP and C-peptide levels was observed only for the MMTT (r = 0.922, P = .008) indicating that in the GST, the C-peptide response is independent of the incretin axis response. CONCLUSIONS: Although the 2 stimulation tests may elicit a similar response in C-peptide secretion, B-cell response to MMTT depends on a functionally normal incretin axis. These results may have implications when investigating the B-cell response in people with diabetes and for studies in which stimulated C-peptide secretion is used as primary or secondary outcome for response to therapy.


Asunto(s)
Péptido C/metabolismo , Diabetes Mellitus Tipo 2/diagnóstico , Técnicas de Diagnóstico Endocrino , Polipéptido Inhibidor Gástrico/farmacología , Péptido 1 Similar al Glucagón/farmacología , Glucagón/administración & dosificación , Células Secretoras de Insulina/efectos de los fármacos , Comidas , Adulto , Estudios Cruzados , Diabetes Mellitus Tipo 2/fisiopatología , Ingestión de Alimentos/fisiología , Femenino , Humanos , Células Secretoras de Insulina/fisiología , Masculino , Estimulación Química
17.
EBioMedicine ; 16: 106-114, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28153771

RESUMEN

Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous subtype of non-Hodgkin lymphoma. In addition to clinical and immunophenotypic characteristics, recurrent gene mutations have recently been identified in patients with DLBCL using next-generation sequencing technologies. The aim of this study is to investigate the clinical relevance of B-cell function gene mutations in DLBCL. Clinical analysis was performed on 680 Chinese DLBCL patients (146 non-CR and 534 CR cases) treated with six cycles of 21-day R-CHOP (Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone), alone or followed by two additional doses of rituximab consolidation on patients' own intention. Somatic mutations of B-cell function genes were further screened on 275 (71 non-CR and 204 CR) cases with available tumor samples by targeted sequencing, including genes involved in B-cell receptors (BCRs) pathway (CARD11, LYN, CD79A, and CD79B), Toll-like receptors (TLRs) pathway (MYD88), and tumor necrotic factor receptor (TNFR) pathway (TRAF2 and TNFAIP3). B-cell function gene mutations occurred in 44.0% (121/275) of DLBCL patients. The TLRs and TNFR related gene mutations were more frequently observed in non-CR patients (p=0.019 and p=0.032, respectively). BCRs related gene mutations, as well as revised IPI (R-IPI) and double BCL-2/MYC expression, were independently related to short progression-free survival in DLBCL after CR. The adverse prognostic effect of BCRs related gene mutations could be overcome by two additional doses of rituximab consolidation. These results highlight the molecular heterogeneity of DLBCL and identify a significant role of B-cell function gene mutations on lymphoma progression and response to rituximab in DLBCL.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Linfocitos B/metabolismo , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Linfoma de Células B Grandes Difuso/genética , Mutación , Secuencia de Aminoácidos , Ciclofosfamida/administración & dosificación , Supervivencia sin Enfermedad , Doxorrubicina/administración & dosificación , Esquema de Medicación , Femenino , Humanos , Linfoma de Células B Grandes Difuso/patología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Factor 88 de Diferenciación Mieloide/genética , Prednisona/administración & dosificación , Pronóstico , Inducción de Remisión , Estudios Retrospectivos , Rituximab/administración & dosificación , Homología de Secuencia de Aminoácido , Resultado del Tratamiento , Proteína 3 Inducida por el Factor de Necrosis Tumoral alfa/genética , Vincristina/administración & dosificación
18.
China Pharmacy ; (12): 1958-1961, 2017.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-607944

RESUMEN

OBJECTIVE:To observe the effectiveness and safety of liraglutide combined with insulin and glipizide in the treat-ment of subclinical hypothyroidism(SCH)complicated with type 2 diabetes in the elderly patients. METHODS:Totally 82 elderly patients with SCH complicated with type 2 diabetes were selected from our hospital during Dec. 2013-Dec. 2015,and then divided into trial group(40 cases)and control group(42 cases)according to random number table. Control group was given Insulin in-jection+Glipizide tablets. Trial group was additionally given Liraglutide injection 0.6 mg,sc,qd,on the basis of control group. Treatment courses of 2 groups lasted for 12 weeks. The levels of blood glucose [fasting glucose,postprandial 1 h and 2 h glucose,mean of daily differences(MODD),mean amplitude of glycemic excursions(MAGE)],glycosylated hemoglo-bin,body weight,total cholesterol,blood pressure [systolic blood pressure(SBP),diastolic blood pressure(DBP)],thyroid stimulating hormone(TSH)and homeostasis model assessment(HOMA-B)were observed in 2 groups before and after treat-ment. The occurrence of ADR was recorded. RESULTS:Totally 4 patients of control group withdrew from the study,and no one withdrew from the study in trial group. Before treatment,there was no statistical significance in the levels of blood glu-cose,glycosylated hemoglobin,body weight,total cholesterol,blood pressure,TSH and HOMA-B (P>0.05). After treat-ment,body weight and total cholesterol level of trial groups were significantly decreased and lower than those of control group,with statistical significance (P0.05). CONCLUSIONS:Liraglutide com-bined with insulin and glipizide for elderly patients with SCH complicated with type 2 diabetes can effectively reduce blood glucose level,keep blood glucose stable,control the increase of body weight and improve islet B cell function with good safety.

19.
China Pharmacy ; (12): 2073-2076, 2017.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-609908

RESUMEN

OBJECTIVE:To evaluate the improvement effects of sitagliptin on islet B-cell function in type 2 diabetic patients systematically,and to provide evidenced-based reference. METHODS:Retrieved from PubMed,Cochrane library,EMBase, CJFD,Wanfang database,VIP and CBM,RCTs about sitagliptin alone or combined with routine plan(trial group)vs. placbo alone or combined with routine plan(control group)in the treatment of type 2 diabetes were collected. Two reviewers independent-ly screened studies according to exclusion and inclusion criteria,extracted data,and assessed the methodological quality according to Cochrane Manual 5.1.0. Meta-analysis was performed by using RevMan 5.3 software. RESULTS:A total of 5 RCTs were includ-ed,involving 1253 patients. The result of Meta-analysis showed that changes of islet B cell function index(Homa-B)[sitagliptin alone group:MD=9.21,95%CI(4.16,14.25),P<0.001;drug combination group:MD=7.24,95%CI(0.80,13.68),P=0.03] and changes of insulin resistance index(Homa-IR)[sitagliptin alone group:MD=-0.40,95%CI(-0.44,-0.36),P<0.001;drug combination group:MD=-0.35,95%CI(-0.63,-0.07),P=0.02] of trial group were significantly better than those of control group,with statistical significance. CONCLUSIONS:Sitagliptin shows certain therapeutic efficacy in improving islet B cell func-tion and insulin resistance.

20.
Toxicology ; 368-369: 172-182, 2016 Aug 10.
Artículo en Inglés | MEDLINE | ID: mdl-27590929

RESUMEN

The aryl hydrocarbon receptor (AHR) has been extensively characterized for the essential role it plays in mediating the toxic responses elicited by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Despite similarities across animal species, species-specific differences exist in the profile of toxicity and sensitivity to TCDD owing, in part, to differences in the AHR. Newer reports have implicated the importance of AHR in the development and regulation of the immune system. Our present studies seek to further explore the essential role of AHR in lymphoid tissue composition, B cell function and the immunological responses after TCDD administration using the recently established AHR KO rats. Comprehensive immune cell phenotyping showed a decrease in the CD8+ T cell, CD11c+ populations and an increase in NKT cells in 3-week-old AHR KO rats compared to the WT controls. The lipopolysaccharide-induced IgM response and proliferation was markedly suppressed in the WT but not in the AHR KO B cells in the presence of TCDD. However, the percentage of LPS-activated IgM+ B cells was significantly higher in the AHR KO B cells as compared to that of WT suggesting the role of AHR in regulating the IgM response. The use of an AHR antagonist further alluded to the endogenous role of AHR in regulating B cell responses in the rat. Overall, the studies report for the first time, comprehensive immune cell phenotyping of the AHR KO rat and the endogenous role of AHR in the regulation of B cell function in the rat.


Asunto(s)
Linfocitos B/efectos de los fármacos , Células T Asesinas Naturales/efectos de los fármacos , Dibenzodioxinas Policloradas/toxicidad , Receptores de Hidrocarburo de Aril/metabolismo , Animales , Linfocitos B/inmunología , Antígeno CD11c/metabolismo , Linfocitos T CD8-positivos/metabolismo , Proliferación Celular , Células Cultivadas , Relación Dosis-Respuesta a Droga , Femenino , Técnicas de Inactivación de Genes , Inmunoglobulina M/inmunología , Inmunofenotipificación , Masculino , Células T Asesinas Naturales/inmunología , Ratas , Especificidad de la Especie
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