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Association between IRF1 Gene Expression and Liver Enzymes in HBV-infected Liver Transplant Recipients with and without Experience of Rejection. 乙肝病毒感染肝移植受者有或无排斥反应时IRF1基因表达与肝酶的关系
IF 0.7 Q3 Medicine Pub Date : 2018-01-01 Epub Date: 2018-05-01
S H Nabavizadeh, S Janfeshan, M H Karimi, A Eidi, R Yaghobi, A Afshari, B Geramizadeh, S A Malek-Hosseini, F Kafilzadeh

Background: Liver function indices and anti-viral immune regulatory markers can both improve graft outcomes, which lead to better post-transplantation management and increase the possibility of surveillance in liver transplant recipients with chronic hepatitis B virus (HBV) infection.

Objective: To determine the association between the interferon regulatory factor 1 (IRF1) mRNA levels and liver enzymes in HBV-infected liver transplant recipients with and without experience of rejection.

Methods: A total of 46 chronic HBV-infected patients who had undergone liver transplant surgery was divided into 2 groups of recipients "with rejection" and "without rejection.". Blood samples were collected form each patient on days 1, 4, and 7 post-transplantation. A SYBER GREEN real-time PCR was used to evaluate the expression level of IRF1 in liver recipients. Liver enzyme activities were also measured in all patients.

Results: The expression of IRF1 in the patients with rejection was up-regulated at all 3 follow-up days compared with those without rejection. The serum levels of ALT and AST were more than normal levels at 3 follow-up times in both study groups. Significant differences were found in IRF1 gene expression levels and also serum ALT levels between those with and without rejection after 7 days post-transplantation.

Conclusion: The IRF1 expression and serum ALT levels were increased significantly in patient with rejection compared to those without rejection. IRF1, an inflammatory factor, may also intensify induction of inflammatory pathways in engrafted liver and promote liver inflammation and injuries leading to liver enzymes elevation in patients with graft rejection.

背景:慢性乙型肝炎病毒(HBV)感染肝移植受者肝功能指标和抗病毒免疫调节标志物均可改善移植预后,从而改善移植后管理,增加监测的可能性。目的:探讨有或无排斥反应的乙肝病毒感染肝移植受者干扰素调节因子1 (IRF1) mRNA水平与肝酶的关系。方法:将46例接受肝移植手术的慢性乙肝病毒感染者分为“有排斥反应”组和“无排斥反应”组。在移植后第1、4和7天采集每位患者的血样。采用SYBER GREEN实时荧光定量PCR检测IRF1在肝受体中的表达水平。同时测量所有患者的肝酶活性。结果:与无排斥反应的患者相比,有排斥反应的患者IRF1的表达在所有3天的随访中均上调。两组患者随访3次血清ALT、AST水平均高于正常水平。移植后7天,有排斥反应和无排斥反应的患者IRF1基因表达水平和血清ALT水平均有显著差异。结论:排斥反应患者IRF1表达及血清ALT水平明显高于无排斥反应患者。IRF1作为一种炎症因子,也可能在移植物排斥患者中加强对移植肝脏炎症通路的诱导,促进肝脏炎症和损伤,导致肝酶升高。
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引用次数: 0
Retraction Note. 收缩。
IF 0.7 Q3 Medicine Pub Date : 2018-01-01 Epub Date: 2018-05-01

[This retracts the article on p. 41 in vol. 9, PMID: 29531646.].

[本文撤回了第9卷第41页的文章,PMID: 29531646]。
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引用次数: 0
Delayed Hemorrhage in Kidney Transplantation: A Life-threatening Condition. 肾移植迟发性出血:一种危及生命的疾病。
IF 0.7 Q3 Medicine Pub Date : 2018-01-01 Epub Date: 2018-02-01
S Gooran, A Javid, G Pourmand

One of the most catastrophic complications of kidney transplantation is non-traumatic delayed bleeding caused by arterial dissection and pseudoaneurysm, endangering the survival of the graft and the patient. Herein, we discuss the management of this condition in 3 cases. The patients included 2 men, 30 and 47 years old, and a 33-year-old woman, who developed a massive hemorrhage in the second week after kidney transplant. All our patients were diabetic for more than 5 years. Massive hemorrhage occurred in the second week without any trauma or precipitating factor. A combination of antibiotic therapy, surgery and interventional procedures was required and all three transplanted kidneys inevitably had to be removed. Although there were trivial signs of infection, considerable pus and infectious and necrotic tissue were drained during graft nephrectomy. A high index of suspicion is necessary for the timely diagnosis of arterial dissection and aneurysm. Aggressive treatment with arterial drug-eluting stents and surgical drainage are necessary in order to prevent potentially fatal complications.

肾移植最严重的并发症之一是由动脉夹层和假性动脉瘤引起的非外伤性迟发性出血,危及移植物和患者的生存。在此,我们讨论3例这种情况的处理。患者包括两名男性,年龄分别为30岁和47岁,以及一名33岁的女性,她在肾移植后第二周出现大出血。所有患者均患有糖尿病5年以上。第二周发生大出血,无外伤或促发因素。需要结合抗生素治疗、手术和介入治疗,移植的三个肾脏不可避免地必须切除。虽然有轻微的感染迹象,但在移植肾切除术期间,大量的脓液和感染坏死组织被排出。高的怀疑指数对于及时诊断动脉夹层和动脉瘤是必要的。积极治疗动脉药物洗脱支架和手术引流是必要的,以防止潜在的致命并发症。
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引用次数: 0
A Survey of Infection in Allogenic Hematopoietic Stem Cell Transplantation in Patients with Acute Myeloid Leukemia. 急性髓系白血病患者同种异体造血干细胞移植感染的调查。
IF 0.7 Q3 Medicine Pub Date : 2018-01-01 Epub Date: 2018-08-01
S R Safayi, F Shahi, M Ghalamkari, M Mirzania, M Khatuni, F Hirmandi Niasar

Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially cure for acute myeloid leukemia (AML). Patients who undergone HSCT are at increased risk of infection due to impaired immunity.

Objective: To evaluate the rate of bacterial, viral and fungal infection and its relationship with 2-year overall survival of AML patients who had undergone HSCT.

Methods: This was a retrospective cross-sectional study of 49 patients who underwent allogenic bone marrow transplantation (BMT) from full-matched donors at BMT Center, Imam Khomeini Hospital Complex, Tehran, Iran, from 2006 to 2013. All autologous transplantations and promyelocytic leukemia (PML) transplantations were excluded.

Results: All patients, except for one, had fever for a mean of 7 days post-transplantation and received broad-spectrum antibiotic. The rate of severe sepsis was 6.1%. None of the patients developed fungal infection during admission. The rate of admission due to sepsis after discharge was 27% in the alive group (mean onset of 54 days), and 73% in the deceased group (mean onset of 52 days) (p<0.05). The most common site of infection was lung (70%). The rate of cytomegalovirus (CMV) antigenemia (positive PP65) was 20% during the 2-year period after HSCT.

Conclusion: The rate of infection was a negative prognostic factor for 2-year overall survival. The rate of CMV antigenemia is less than similar studies (51%), which could be due to full-matched donor-recipients requiring less immunosuppression.

背景:同种异体造血干细胞移植(HSCT)是治疗急性髓性白血病(AML)的潜在方法。由于免疫功能受损,接受造血干细胞移植的患者感染风险增加。目的:探讨急性髓系白血病患者行HSCT后的细菌、病毒和真菌感染率及其与2年总生存率的关系。方法:这是一项回顾性横断面研究,对2006年至2013年在伊朗德黑兰伊玛目霍梅尼医院BMT中心接受完全匹配供体同种异体骨髓移植(BMT)的49例患者进行了回顾性研究。排除所有自体移植和早幼粒细胞白血病(PML)移植。结果:除1例患者外,所有患者在移植后平均7天出现发热,并接受了广谱抗生素治疗。严重脓毒症发生率为6.1%。所有患者入院时均未发生真菌感染。活组患者出院后脓毒症住院率为27%(平均发病54天),死组患者出院后脓毒症住院率为73%(平均发病52天)。结论:感染发生率是影响患者2年总生存率的一个不利因素。巨细胞病毒抗原血症的发生率低于类似研究(51%),这可能是由于供体-受体完全匹配需要较少的免疫抑制。
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引用次数: 0
Prevalence of CYP2C19 Genetic Polymorphism among Normal People and Patients with Hepatic Diseases. 正常人与肝病患者CYP2C19基因多态性的研究
IF 0.7 Q3 Medicine Pub Date : 2018-01-01 Epub Date: 2018-02-01
Z Hashemizadeh, S A Malek-Hosseini, P Badiee

Background: Patients with hepatic diseases are treated with numerous drugs metabolized by cytochrome P450.

Objective: To evaluate the frequencies of CYP2C19 variant alleles (*2, *3, and *17), genotypes, and phenotypes, and the relationship between the frequency of these alleles and the underlying hepatic diseases among patients with advanced liver diseases who were candidates for liver transplantation.

Methods: The Study was conducted on 120 patients suffering from various hepatic disorders, candidates for liver transplantation, and 52 healthy volunteers. DNA was extracted from blood samples and analyzed by TaqMan SNP genotyping assay. The CYP2C19 genotypes were classified into poor, extensive, intermediate, and ultra-rapid metabolizer phenotypes.

Results: Viral hepatitis was the most common cause of liver disease among studied patients. The frequencies of CYP2C19 alleles *1, *17, and *2 were 66.7% (160/240), 20.8% (50/240) and 12.5% (30/240), respectively. Allele CYP2C19*3 was not found in the studied population. The most prevalent genotypes were CYP2C19 *1/*1 (47.5%) and *1/*17 (24.2%). The predicted CYP2C19 phenotypes were extensive metabolizer (47.5%), heterozygote extensive metabolizer (45.9%), ultra-rapid metabolizer (5%), and poor metabolizer (1.6%). There was no significant difference between the frequencies of CYP2C19 genotypes between healthy people and patients. The distribution of CYP2C19 genotype frequencies was not significantly associated with the underlying disease conditions (p=0.472).

Conclusion: The distribution of CYP2C19 genotype frequencies in Iranian healthy people and patients with various hepatic diseases was not significantly different. This may allow the physicians to predict a tailoring dose regimens based on the individual's metabolic capacity, decrease the risk of harmful side effects of the drugs, and optimize the treatment.

背景:肝脏疾病患者需要多种由细胞色素P450代谢的药物治疗。目的:评价晚期肝病肝移植候选者中CYP2C19变异等位基因(*2、*3、*17)的频率、基因型和表型,以及这些等位基因的频率与潜在肝脏疾病的关系。方法:对120例各种肝脏疾病患者、肝移植候选者和52名健康志愿者进行研究。从血样中提取DNA,采用TaqMan SNP基因分型法进行分析。CYP2C19基因型分为贫代谢型、广泛代谢型、中间代谢型和超快速代谢型。结果:病毒性肝炎是研究患者中最常见的肝脏疾病原因。CYP2C19等位基因*1、*17和*2的频率分别为66.7%(160/240)、20.8%(50/240)和12.5%(30/240)。在研究人群中未发现CYP2C19*3等位基因。最常见的基因型为CYP2C19 *1/*1(47.5%)和*1/*17(24.2%)。预测CYP2C19表型为广泛代谢型(47.5%)、杂合子广泛代谢型(45.9%)、超快速代谢型(5%)和不良代谢型(1.6%)。CYP2C19基因型频率在健康人与患者之间无显著差异。CYP2C19基因型频率分布与基础疾病无显著相关性(p=0.472)。结论:CYP2C19基因型频率在伊朗健康人与各种肝病患者中的分布无显著差异。这可能使医生能够根据个体的代谢能力预测量身定制的剂量方案,降低药物有害副作用的风险,并优化治疗。
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引用次数: 0
Efficient Production of Hepatocyte-like Cells from Human-induced Pluripotent Stem Cells by Optimizing Growth Factors. 优化生长因子诱导人多能干细胞高效生成肝细胞样细胞。
IF 0.7 Q3 Medicine Pub Date : 2018-01-01 Epub Date: 2018-05-01
Z Jafarpour, M Soleimani, S Hosseinkhani, M H M H, P Yaghmaei, N Mobarra, B Geramizadeh

Background: Generating hepatocytes with complete liver functions is still a challenge and developing more functional hepatocytes is needed.

Objective: To compare various differentiation factors and protocols and introducing a preferable protocol to differentiate human-induced pluripotent stem cells (hiPSCs) into hepatocyte-like cells (HLCs).

Methods: After 3 days of the endoderm differentiation of hiPSCs, the cells were incubated with 5 hepatocyte differentiation culture media, protocols (P), for 14 days-P1: hepatocyte growth factor and fibroblast growth factor-4 (FGF-4) for the first week and oncostatin-M and dexamethasone for the second week; P2: similar to P1 but FGF4 was used in both the first and second weeks; P3: similar to P1 but FGF-4 was not used; P4: similar to P1 but FGF-4 and dexamethasone were not used; and P5: similar to P1 but FGF-4 and oncostatin-M were not used. After 17 days, characterization was done by qRT-PCR, immunofluorescence and ELISA.

Results: The mRNA expression levels of hepatocyte markers (albumin, cytokeratin-18, tyrosine aminotransferase, hepatocyte nuclear factor-4α, cytochrome-P450 7A1) increased significantly (p<0.05) in the differentiated cells by 5 different protocols. Furthermore, significant protein expression and secretion of albumin were detected in the differentiated cells by 5 different protocols. In P3, the differentiated cells had the highest exhibit of hepatocyte characteristics and in P4 they had the lowest. Moreover, in P1 and P2 similar results were observed.

Conclusion: Since P3 gave us the best results among all protocols, we recommend it as an efficient protocol to differentiate the functional HLCs from hiPSCs, which can improve cell therapies.

背景:生成具有完整肝功能的肝细胞仍然是一个挑战,需要开发更多的功能肝细胞。目的:比较人诱导多能干细胞(human induced pluripotent stem cells, hiPSCs)向肝细胞样细胞(hepatocyte-like cells, HLCs)分化的各种分化因子和分化方案,提出一种较好的分化方案。方法:hiPSCs内胚层分化3 d后,用5种肝细胞分化培养基(P)孵育14 d - p1:第一周用肝细胞生长因子和成纤维细胞生长因子-4 (FGF-4),第二周用癌他汀- m和地塞米松;P2:与P1相似,但第一周和第二周均使用FGF4;P3:与P1相似,但未使用FGF-4;P4:与P1相似,但未使用FGF-4和地塞米松;P5:与P1相似,但不使用FGF-4和oncostatin-M。17 d后,采用qRT-PCR、免疫荧光和ELISA进行鉴定。结果:肝细胞标志物(白蛋白、细胞角蛋白-18、酪氨酸转氨酶、肝细胞核因子-4α、细胞色素- p450 7A1) mRNA表达水平显著升高(p)。结论:P3在所有方案中效果最好,我们推荐P3作为区分功能性hlc和hiPSCs的有效方案,可以改善细胞治疗。
{"title":"Efficient Production of Hepatocyte-like Cells from Human-induced Pluripotent Stem Cells by Optimizing Growth Factors.","authors":"Z Jafarpour,&nbsp;M Soleimani,&nbsp;S Hosseinkhani,&nbsp;M H M H,&nbsp;P Yaghmaei,&nbsp;N Mobarra,&nbsp;B Geramizadeh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Generating hepatocytes with complete liver functions is still a challenge and developing more functional hepatocytes is needed.</p><p><strong>Objective: </strong>To compare various differentiation factors and protocols and introducing a preferable protocol to differentiate human-induced pluripotent stem cells (hiPSCs) into hepatocyte-like cells (HLCs).</p><p><strong>Methods: </strong>After 3 days of the endoderm differentiation of hiPSCs, the cells were incubated with 5 hepatocyte differentiation culture media, protocols (P), for 14 days-P1: hepatocyte growth factor and fibroblast growth factor-4 (FGF-4) for the first week and oncostatin-M and dexamethasone for the second week; P2: similar to P1 but FGF4 was used in both the first and second weeks; P3: similar to P1 but FGF-4 was not used; P4: similar to P1 but FGF-4 and dexamethasone were not used; and P5: similar to P1 but FGF-4 and oncostatin-M were not used. After 17 days, characterization was done by qRT-PCR, immunofluorescence and ELISA.</p><p><strong>Results: </strong>The mRNA expression levels of hepatocyte markers (albumin, cytokeratin-18, tyrosine aminotransferase, hepatocyte nuclear factor-4α, cytochrome-P450 7A1) increased significantly (p<0.05) in the differentiated cells by 5 different protocols. Furthermore, significant protein expression and secretion of albumin were detected in the differentiated cells by 5 different protocols. In P3, the differentiated cells had the highest exhibit of hepatocyte characteristics and in P4 they had the lowest. Moreover, in P1 and P2 similar results were observed.</p><p><strong>Conclusion: </strong>Since P3 gave us the best results among all protocols, we recommend it as an efficient protocol to differentiate the functional HLCs from hiPSCs, which can improve cell therapies.</p>","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37024369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intrathecal Autologous Bone Marrow-Derived Hematopoietic Stem Cell Therapy in Neurological Diseases. 鞘内自体骨髓来源的造血干细胞治疗神经系统疾病。
IF 0.7 Q3 Medicine Pub Date : 2018-01-01 Epub Date: 2018-11-01
M Zakerinia, A Kamgarpour, H Nemati, H R Zare, M Ghasemfar, A R Rezvani, M Karimi, H Nourani Khojasteh, M Dehghani, R Vojdani, S Haghighat, N Namdari, J Rekabpoor, M Tavazo, S Amirghofran, Z Amirghofran, G A Yosefipour, M Ramzi

Background: Cellular transplantation is a promising treatment strategy for neurological diseases.

Objective: To report the results of intrathecal hematopoietic stem cell therapy in different neurological diseases in the past 6 years in a single center.

Methods: From October 2011 to September 2018, 220 patients with various neurological diseases were transplanted intrathecally by their bone marrow stem cells. To have a longer follow up, we only reported the first 80 patients, transplanted up to July 2015-10 patients had spinal cord injuries and paralysis, 12 had advanced Parkinson's disease, 28 had cerebral palsy, 7 had hypoxic brain damage, 2 had autism, 4 had multiple sclerosis, 5 had progressive cerebellar atrophy, and 12 had other neurological diseases. The patients were admitted to the Bone Marrow Transplant Unit. On the first day, 50-200 (median 100) mL bone marrow was aspirated from the patients' posterior iliac crests, mixed with 120 mL culture media (RPMI), and 12 mL heparin. The samples were then transferred to immunology lab in cold box. Mononuclear cells (MNCs) were separated by a Ficoll-Hypaque gradient, washed, and suspended in ringers. Cell viability was assessed with trypan blue viability test. Transplantation was performed 3-4 hours after bone marrow collection. 5-10 mL of the cerebrospinal fluids were aspirated and about 20 mL MNCs (containing stem cells) in ringers were injected intrathecally (IT). The patients were laid down on their back for 4-5 hours. The median number of MNCs was 4×107 (range 1-450×107). The median viability of the cells was 90% (range 60%-98%). The patients received intravenous ceftriaxone every 12 hours and were discharged from the hospital few days after autologous stem cell therapy.

Results: We noted clinical improvements in 9 of 12 patients with Parkinson's disease, 20 of 28 patients with cerebral palsy, 6 of 7 patients with hypoxic brain damage, 2 of 4 patients with multiple sclerosis, and 4 of 5 patients with cerebellar atrophy. The improvements were noted after 2-4 weeks of cell therapy. There were no improvements in patients with spinal cord injury and complete paralysis and those with autism. There were variable improvements in other patients treated.

Conclusion: Most patients with advanced Parkinson's disease, cerebral palsy, hypoxic brain damage, progressive cerebellar atrophy, and kernicterus neuropathy reported clinical effects of this safe intervention resulting in better functioning and an increased quality of life.

背景:细胞移植是一种很有前途的神经系统疾病治疗策略。目的:报道近6年来单个中心鞘内造血干细胞治疗不同神经系统疾病的结果。方法:2011年10月至2018年9月,对220例神经系统疾病患者行鞘内骨髓干细胞移植。为了进行更长的随访,我们只报道了截止2015年7月移植的前80例患者——10例脊髓损伤和瘫痪,12例晚期帕金森病,28例脑瘫,7例缺氧脑损伤,2例自闭症,4例多发性硬化症,5例进行性小脑萎缩,12例其他神经系统疾病。患者被送入骨髓移植科。第一天,从患者髂后嵴抽取50-200 mL(中位数100)mL骨髓,与120 mL培养基(RPMI)和12 mL肝素混合。然后将样品置于冷箱中转移到免疫学实验室。单个核细胞(MNCs)通过Ficoll-Hypaque梯度分离,洗涤,悬浮在林格液中。采用台盼蓝活力法测定细胞活力。骨髓采集后3 ~ 4小时进行移植。抽吸5-10 mL脑脊液,鞘内注射约20 mL环状细胞(含干细胞)。患者平躺4-5小时。跨国公司的中位数为4×107(范围1-450×107)。细胞存活率中位数为90%(范围为60%-98%)。患者每12小时静脉注射一次头孢曲松,并在自体干细胞治疗后几天出院。结果:12例帕金森病患者中有9例、28例脑瘫患者中有20例、7例缺氧脑损伤患者中有6例、4例多发性硬化症患者中有2例、5例小脑萎缩患者中有4例临床改善。在细胞治疗2-4周后,这种改善被注意到。脊髓损伤、完全瘫痪和自闭症患者没有任何改善。其他接受治疗的患者也有不同程度的改善。结论:大多数患有晚期帕金森病、脑瘫、缺氧脑损伤、进行性小脑萎缩和核黄疸神经病变的患者报告了这种安全干预的临床效果,导致功能改善和生活质量提高。
{"title":"Intrathecal Autologous Bone Marrow-Derived Hematopoietic Stem Cell Therapy in Neurological Diseases.","authors":"M Zakerinia,&nbsp;A Kamgarpour,&nbsp;H Nemati,&nbsp;H R Zare,&nbsp;M Ghasemfar,&nbsp;A R Rezvani,&nbsp;M Karimi,&nbsp;H Nourani Khojasteh,&nbsp;M Dehghani,&nbsp;R Vojdani,&nbsp;S Haghighat,&nbsp;N Namdari,&nbsp;J Rekabpoor,&nbsp;M Tavazo,&nbsp;S Amirghofran,&nbsp;Z Amirghofran,&nbsp;G A Yosefipour,&nbsp;M Ramzi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cellular transplantation is a promising treatment strategy for neurological diseases.</p><p><strong>Objective: </strong>To report the results of intrathecal hematopoietic stem cell therapy in different neurological diseases in the past 6 years in a single center.</p><p><strong>Methods: </strong>From October 2011 to September 2018, 220 patients with various neurological diseases were transplanted intrathecally by their bone marrow stem cells. To have a longer follow up, we only reported the first 80 patients, transplanted up to July 2015-10 patients had spinal cord injuries and paralysis, 12 had advanced Parkinson's disease, 28 had cerebral palsy, 7 had hypoxic brain damage, 2 had autism, 4 had multiple sclerosis, 5 had progressive cerebellar atrophy, and 12 had other neurological diseases. The patients were admitted to the Bone Marrow Transplant Unit. On the first day, 50-200 (median 100) mL bone marrow was aspirated from the patients' posterior iliac crests, mixed with 120 mL culture media (RPMI), and 12 mL heparin. The samples were then transferred to immunology lab in cold box. Mononuclear cells (MNCs) were separated by a Ficoll-Hypaque gradient, washed, and suspended in ringers. Cell viability was assessed with trypan blue viability test. Transplantation was performed 3-4 hours after bone marrow collection. 5-10 mL of the cerebrospinal fluids were aspirated and about 20 mL MNCs (containing stem cells) in ringers were injected intrathecally (IT). The patients were laid down on their back for 4-5 hours. The median number of MNCs was 4×10<sup>7</sup> (range 1-450×10<sup>7</sup>). The median viability of the cells was 90% (range 60%-98%). The patients received intravenous ceftriaxone every 12 hours and were discharged from the hospital few days after autologous stem cell therapy.</p><p><strong>Results: </strong>We noted clinical improvements in 9 of 12 patients with Parkinson's disease, 20 of 28 patients with cerebral palsy, 6 of 7 patients with hypoxic brain damage, 2 of 4 patients with multiple sclerosis, and 4 of 5 patients with cerebellar atrophy. The improvements were noted after 2-4 weeks of cell therapy. There were no improvements in patients with spinal cord injury and complete paralysis and those with autism. There were variable improvements in other patients treated.</p><p><strong>Conclusion: </strong>Most patients with advanced Parkinson's disease, cerebral palsy, hypoxic brain damage, progressive cerebellar atrophy, and kernicterus neuropathy reported clinical effects of this safe intervention resulting in better functioning and an increased quality of life.</p>","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37224692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Incidence of Cytomegalovirus Glycoprotein B Genotypes in Kidney Transplant Recipients in Iran. 伊朗肾移植受者巨细胞病毒糖蛋白B基因型的发病率
IF 0.7 Q3 Medicine Pub Date : 2018-01-01 Epub Date: 2018-11-01
A R Soleimani, M Jafari, A Piroozmand, H Nikoueinejad, H Akbari, B Einollahi

Background: Cytomegalovirus (CMV) is the most common opportunistic viral infection in kidney transplant recipients. CMV classification is usually based on its glycoprotein B (gB) genotypes, which divides the virus into 4 strains (gB1-4).

Objective: To determine the incidence of CMV genotypes in Iran and their relation to various clinical factors.

Methods: We studied 80 renal transplant recipients admitted to our transplant referral center between 2014 and 2015. All of the studied patients were monitored every 1-2 weeks for CMV infection by immunofluorescence method. There were 34 CMV-infected patients whose sera were studied with sequencing technique to identify the 4 CMV genotypes. All patients were followed up to 6 months after transplantation.

Results: gB1 was the most common genotype (35.3%); it was followed by gB3 and gB4 (each with 17.6 %), gB2, and mixed gB1,3 and gB1,2 (each with 14.7%). Age (p=0.037), time of infection after transplantation (p=0.011), and biopsy-proven rejection (p=0.012) were associated with CMV genotype. After adjusting for covariates, significant associations were found between genotype gB1 and family relationship (p=0.047) as well as HLA mismatch (p=0.014); genotype gB3 and family relationship (p=0.011); and genotype gB4 and age (p=0.019).

Conclusion: The most common CMV gB genotype in CMV-infected kidney transplant recipients in Iran was gB1. We recommend considering related therapeutic applications in the management of such patients.

背景:巨细胞病毒(CMV)是肾移植受者最常见的机会性病毒感染。CMV的分类通常基于其糖蛋白B (gB)基因型,将病毒分为4个毒株(gB1-4)。目的:了解伊朗地区巨细胞病毒基因型的发病率及其与各种临床因素的关系。方法:对2014 - 2015年间我院移植转诊中心收治的80例肾移植受者进行研究。采用免疫荧光法每1-2周监测患者巨细胞病毒感染情况。对34例CMV感染患者的血清进行测序,鉴定出4种CMV基因型。所有患者随访至移植后6个月。结果:gB1基因型最多见,占35.3%;其次是gB3和gB4(各占17.6%),gB2和混合gb1,3和gb1,2(各占14.7%)。年龄(p=0.037)、移植后感染时间(p=0.011)和活检证实的排斥反应(p=0.012)与CMV基因型相关。校正协变量后,发现gB1基因型与家庭关系(p=0.047)和HLA错配(p=0.014)存在显著相关;基因型gB3与家族关系(p=0.011);基因型gB4与年龄的关系(p=0.019)。结论:伊朗CMV感染肾移植受者中最常见的CMV gB基因型为gB1。我们建议在此类患者的管理中考虑相关的治疗应用。
{"title":"The Incidence of Cytomegalovirus Glycoprotein B Genotypes in Kidney Transplant Recipients in Iran.","authors":"A R Soleimani,&nbsp;M Jafari,&nbsp;A Piroozmand,&nbsp;H Nikoueinejad,&nbsp;H Akbari,&nbsp;B Einollahi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cytomegalovirus (CMV) is the most common opportunistic viral infection in kidney transplant recipients. CMV classification is usually based on its glycoprotein B (gB) genotypes, which divides the virus into 4 strains (gB1-4).</p><p><strong>Objective: </strong>To determine the incidence of CMV genotypes in Iran and their relation to various clinical factors.</p><p><strong>Methods: </strong>We studied 80 renal transplant recipients admitted to our transplant referral center between 2014 and 2015. All of the studied patients were monitored every 1-2 weeks for CMV infection by immunofluorescence method. There were 34 CMV-infected patients whose sera were studied with sequencing technique to identify the 4 CMV genotypes. All patients were followed up to 6 months after transplantation.</p><p><strong>Results: </strong>gB1 was the most common genotype (35.3%); it was followed by gB3 and gB4 (each with 17.6 %), gB2, and mixed gB1,3 and gB1,2 (each with 14.7%). Age (p=0.037), time of infection after transplantation (p=0.011), and biopsy-proven rejection (p=0.012) were associated with CMV genotype. After adjusting for covariates, significant associations were found between genotype gB1 and family relationship (p=0.047) as well as HLA mismatch (p=0.014); genotype gB3 and family relationship (p=0.011); and genotype gB4 and age (p=0.019).</p><p><strong>Conclusion: </strong>The most common CMV gB genotype in CMV-infected kidney transplant recipients in Iran was gB1. We recommend considering related therapeutic applications in the management of such patients.</p>","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37224694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence of Transfusion-transmitted Virus (TTV) Infection and its Association with Renal Post-transplantation Complications in Iran. 伊朗输血传播病毒(TTV)感染的患病率及其与肾移植后并发症的关系。
IF 0.7 Q3 Medicine Pub Date : 2018-01-01 Epub Date: 2018-08-01
H Akbari, A Piroozmand, E Dadgostar, H Nikoueinejad, Z Chitsazian, B Einollahi, J Amini Mahabadi

Background: Transfusion-transmitted virus (TTV) is a single-stranded DNA virus. Renal transplant patients have a higher risk of TTV infection.

Objective: To evaluate the prevalence of TTV and its correlation with post-renal transplantation complications in a population of Iranian patients.

Methods: A cross-sectional study was performed on 120 renal transplant recipients. TTV infection in the peripheral blood samples was detected by semi-nested polymerase chain reaction (semi-nested PCR). Then, the relationship between TTV and renal post-transplant complications was examined.

Results: 34.2% renal transplant recipients were positive for TTV. There was a significant correlation between the presence of TTV and diabetes, acute transplant rejection, and urinary tract infection. We did not find any direct correlation between the presence of TTV infection and hypertension, hyperlipidemia, respiratory tract infection, and cytomegalovirus infection.

Conclusion: We found an increased rate of TTV infection in renal transplant recipients associated with post-transplantation complications. TTV may be an important risk factor for some post-renal transplantation complications.

背景:输血传播病毒(TTV)是一种单链DNA病毒。肾移植患者感染TTV的风险更高。目的:评估伊朗人群中TTV的患病率及其与肾移植后并发症的相关性。方法:对120例肾移植受者进行横断面研究。采用半巢式聚合酶链反应(semi-nested PCR)检测外周血TTV感染情况。然后,研究TTV与肾移植后并发症之间的关系。结果:肾移植受者TTV阳性率为34.2%。TTV的存在与糖尿病、急性移植排斥反应和尿路感染之间存在显著相关性。我们没有发现TTV感染与高血压、高脂血症、呼吸道感染和巨细胞病毒感染之间有任何直接相关性。结论:我们发现肾移植受者的TTV感染率增加并伴有移植后并发症。TTV可能是一些肾移植术后并发症的重要危险因素。
{"title":"Prevalence of Transfusion-transmitted Virus (TTV) Infection and its Association with Renal Post-transplantation Complications in Iran.","authors":"H Akbari,&nbsp;A Piroozmand,&nbsp;E Dadgostar,&nbsp;H Nikoueinejad,&nbsp;Z Chitsazian,&nbsp;B Einollahi,&nbsp;J Amini Mahabadi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Transfusion-transmitted virus (TTV) is a single-stranded DNA virus. Renal transplant patients have a higher risk of TTV infection.</p><p><strong>Objective: </strong>To evaluate the prevalence of TTV and its correlation with post-renal transplantation complications in a population of Iranian patients.</p><p><strong>Methods: </strong>A cross-sectional study was performed on 120 renal transplant recipients. TTV infection in the peripheral blood samples was detected by semi-nested polymerase chain reaction (semi-nested PCR). Then, the relationship between TTV and renal post-transplant complications was examined.</p><p><strong>Results: </strong>34.2% renal transplant recipients were positive for TTV. There was a significant correlation between the presence of TTV and diabetes, acute transplant rejection, and urinary tract infection. We did not find any direct correlation between the presence of TTV infection and hypertension, hyperlipidemia, respiratory tract infection, and cytomegalovirus infection.</p><p><strong>Conclusion: </strong>We found an increased rate of TTV infection in renal transplant recipients associated with post-transplantation complications. TTV may be an important risk factor for some post-renal transplantation complications.</p>","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41126979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Access to Liver Transplantation and Patient Survival among Asian Populations: Pre-Share 35 vs Post-Share 35 亚洲人群肝移植可及性和患者生存率:共享前35 vs共享后35
IF 0.7 Q3 Medicine Pub Date : 2017-02-15 DOI: 10.4172/2375-4273.1000187
Yefei Zhang
Background: Studies addressing ethnic disparities and trends in liver transplantation for Asian population are scant. Objective: To examine the impact of Share 35 policy on Asian patients’ access to liver transplantation and outcomes since its implementation in June 2013. Methods: A total of 11,910 adult white and Asian patients who were registered for deceased donor liver transplantation between 2012 and 2015, was identified from the United Network for Organ Sharing database. Logistic regression and proportional hazard models with adjustment for demographic, clinical and geographic factors were used to model the access to liver transplantation and patient survival. Stratification on pre- and post-Share 35 periods was performed to compare the first 18 months of Share 35 policy to an equivalent period. Results: Comparison of the pre- and post-Share 35 periods showed a significant decrease in time on waiting list and higher proportions of patients receiving liver transplantation for Asian patients. Asians shared similar transplant rates as whites (OR: 1.15, 95% CI: 0.80–1.67) but experienced significantly longer waiting time (HR: 0.56, 95% CI: 0.34–0.92) before they received liver transplantation after Share 35 policy took effect. No significant post-transplantation survival difference was observed between Asians and whites at the 18-month outcome. Conclusion: Although benefited from the Share 35 policy, Asian patients are still at greater risk of disparities in access to liver transplantation.
背景:关于亚洲人群肝移植的种族差异和趋势的研究很少。目的:探讨Share 35政策自2013年6月实施以来对亚洲患者获得肝移植和预后的影响。方法:从美国器官共享网络数据库中检索2012年至2015年间登记的11910例死亡供肝移植的成年白人和亚洲患者。采用Logistic回归和比例风险模型,调整人口统计学、临床和地理因素,对肝移植的可及性和患者生存进行建模。对Share 35前后时期进行分层,将Share 35政策的前18个月与等效时期进行比较。结果:share 35前后的比较显示,亚洲患者的等待时间显著减少,接受肝移植的患者比例更高。亚洲人的移植率与白人相似(OR: 1.15, 95% CI: 0.80-1.67),但在Share 35政策生效后,他们在接受肝移植前的等待时间明显更长(HR: 0.56, 95% CI: 0.34-0.92)。在移植后18个月的结果中,亚洲人和白人之间没有观察到明显的生存差异。结论:尽管受益于Share 35政策,但亚洲患者在获得肝移植方面仍面临更大的风险差异。
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引用次数: 4
期刊
International Journal of Organ Transplantation Medicine
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