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Session 4: mRNA and Self-Amplifying RNA (saRNA): Opportunities for Disease Prevention and Therapy. 会议 4:mRNA 和自扩增 RNA(saRNA):疾病预防和治疗的机遇。
IF 1.4 4区 医学 Q3 PATHOLOGY Pub Date : 2024-11-22 DOI: 10.1177/01926233241298572
Rani S Sellers, Lila Ramaiah, Sue-Jean Hong, Prashant Nambiar, Eric Jacquinet, Shan Naidu

The unprecedented speed of developing vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the COVID-19 pandemic, has propelled mRNA technologies into the public eye. The versatility of mRNA technology, often referred to as "plug and play," offers immense promise for rapidly updating vaccines to address newer variants of respiratory diseases and combat emerging infectious diseases and lethal pathogens, such as the Ebolavirus. However, the potential applications of mRNA technology extend well beyond prophylactic vaccines. This session explored the two primary mRNA platforms: nonreplicating mRNA and self-amplifying mRNA (variably referred to as saRNA, samRNA, or SAM). Presentation topics were on current research efforts aimed at broadening the applications of mRNA modalities beyond vaccines. Topics included opportunities for delivering mRNA via intra-tumoral and inhalational routes, immunological and systemic inflammatory responses elicited by these modalities, and regulatory considerations involved in the development and licensing of these technologies.

针对造成 COVID-19 大流行的严重急性呼吸系统综合症冠状病毒 2(SARS-CoV-2)的疫苗开发速度前所未有,这使 mRNA 技术成为公众关注的焦点。mRNA 技术通常被称为 "即插即用",它的多功能性为快速更新疫苗以应对呼吸道疾病的新变种以及对抗新出现的传染病和致命病原体(如埃博拉病毒)带来了巨大的希望。然而,mRNA 技术的潜在应用远不止于预防性疫苗。本次会议探讨了两种主要的 mRNA 平台:非复制 mRNA 和自扩增 mRNA(又称 saRNA、samRNA 或 SAM)。演讲主题是当前旨在将 mRNA 模式的应用范围扩大到疫苗之外的研究工作。主题包括通过瘤内和吸入途径递送mRNA的机会、这些模式引起的免疫和全身炎症反应,以及这些技术的开发和许可所涉及的监管考虑因素。
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引用次数: 0
Systemic Toxicity of Recombinant Adeno-Associated Virus Gene Therapy Vectors. 重组腺相关病毒基因疗法载体的全身毒性。
IF 1.4 4区 医学 Q3 PATHOLOGY Pub Date : 2024-11-22 DOI: 10.1177/01926233241298892
Basel T Assaf

Recombinant adeno-associated virus (rAAV) vectors have emerged as a promising tool for gene therapy. However, the systemic administration of rAAV vectors is not without risks, particularly for dose levels >1 × 1014 viral genome per kilogram of body weight (vg/kg). rAAV-associated toxicities can variably manifest either acutely or in a delayed manner. Acute toxicities often present shortly after administration and can include severe immune responses, hepatotoxicity, and thrombotic microangiopathy (TMA). Delayed toxicities, on the other hand, may emerge weeks to months post-treatment, potentially involving chronic liver damage or prolonged immune activation. Thrombotic microangiopathy is often associated with complement activation and endothelial damage. The activation of the complement system can additionally trigger a cascade of inflammatory responses, exacerbating systemic toxicity. While many of these toxicities are reversible with appropriate medical intervention, there have been instances where the adverse effects were severe enough to lead to fatalities. Both human and animal studies have reported these adverse effects, highlighting the critical importance of thorough preclinical testing. However, a differential toxicity profile associated with systemic AAV administration exists between humans and nonhuman primates (NHPs), in which certain toxicities reported in humans are yet to be observed in NHPs, and vice versa. This review aims to explore the recent literature on systemic rAAV toxicities, focusing on dose levels, the role of the complement activation pathway, endothelial injury, TMA, hepatotoxicity, and the bidirectional translational safety profiles from both human and animal studies.

重组腺相关病毒(rAAV)载体已成为一种前景广阔的基因治疗工具。然而,rAAV 载体的全身给药并非没有风险,尤其是当剂量水平大于每公斤体重 1 × 1014 病毒基因组(vg/kg)时。急性毒性通常在用药后不久出现,可包括严重的免疫反应、肝毒性和血栓性微血管病(TMA)。而延迟毒性则可能在治疗后数周至数月出现,可能涉及慢性肝损伤或长期免疫激活。血栓性微血管病通常与补体激活和内皮损伤有关。补体系统的激活还会引发一系列炎症反应,加剧全身毒性。虽然这些毒性中的许多在适当的医疗干预下是可逆的,但也有不良反应严重到导致死亡的情况。人类和动物研究都曾报告过这些不良反应,这凸显了全面临床前试验的极端重要性。然而,人与非人灵长类动物(NHPs)之间存在着与全身性 AAV 给药相关的不同毒性特征,其中某些在人身上报告的毒性尚未在 NHPs 身上观察到,反之亦然。本综述旨在探讨有关全身性 rAAV 毒性的最新文献,重点关注剂量水平、补体激活途径的作用、内皮损伤、TMA、肝毒性以及人类和动物研究的双向转化安全性概况。
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引用次数: 0
Opinion on the Importance of Sharing Toxicologic Pathology Data for Educational and/or Scientific Purposes. 关于为教育和/或科学目的共享毒理病理学数据的重要性的意见。
IF 1.4 4区 医学 Q3 PATHOLOGY Pub Date : 2024-11-18 DOI: 10.1177/01926233241296122
Eveline de Rijk, Phaedra Cole, Anna-Lena Frisk, Frederic Gervais, Joost Lensen, Barbara Lenz, Lars Mecklenburg, Flavia Pasello Dos Santos, Annette Romeike, Catherine Ross

Sharing pathology data is critical for educational and scientific purposes. Since most pharmaceutical or (agro)chemical companies outsource nonclinical safety assessment studies to contract research organizations (CROs), the pathology data of those studies are not owned by the investigator but is the legal property of the respective company sponsoring the work. Although some companies have installed policies that govern sharing of pathology data, many companies generally do not allow the external use of data by either the CRO-based study pathologist or the sponsor pathologist. Policies for governing the external use of data vary significantly. In this article, we present an overview of the different approaches taken across different companies (CROs, pharmaceutical/chemical companies, or other institutes) for sharing pathology material for educational and/or scientific purposes. The results of a survey and interviews with legal departments of different companies will be presented (anonymously) and discussed. In addition, the importance of sharing pathology data is addressed, as well as the challenges and opportunities this presents. Suggestions will be provided regarding what material should be made available and what will be needed to achieve agreement for this to happen.

共享病理数据对于教育和科学目的至关重要。由于大多数制药或(农)化学公司都将非临床安全性评估研究外包给合同研究组织 (CRO),因此这些研究的病理数据不归研究者所有,而是赞助这项工作的各公司的合法财产。尽管有些公司制定了管理病理数据共享的政策,但许多公司通常不允许基于合同研究组织的研究病理学家或赞助商病理学家将数据用于外部用途。管理外部使用数据的政策差异很大。本文概述了不同公司(CRO、制药/化学公司或其他机构)为教育和/或科研目的共享病理资料所采取的不同方法。我们将介绍(匿名)一项调查的结果,并与不同公司的法律部门进行访谈和讨论。此外,还将讨论共享病理资料的重要性以及由此带来的挑战和机遇。还将就哪些资料应予以提供以及为此达成一致所需的条件提出建议。
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引用次数: 0
Historical Control Background Incidence of Spontaneous Nonneoplastic Lesions of Sprague Dawley Rats in 104-Week Carcinogenicity Studies. 在为期 104 周的致癌性研究中,Sprague Dawley 大鼠自发性非肿瘤性病变的历史控制背景发生率。
IF 1.4 4区 医学 Q3 PATHOLOGY Pub Date : 2024-10-29 DOI: 10.1177/01926233241289116
Marie Bockenstedt, Amit Kumar, Victoria Laast, Alok Sharma

Microscopic observation data collected from approximately 1800 male and female Sprague Dawley (SD) control rats used on 104-week carcinogenicity studies performed at North American Labcorp Early Development, Inc, Madison, WI, were retrospectively evaluated for spontaneous nonneoplastic findings. This study provides incidence of the most common spontaneous nonneoplastic microscopic findings in each organ system of SD rats encountered during 104-week carcinogenicity studies. Some of the most common spontaneous background findings were cardiomyopathy; chronic progressive nephropathy; uterine cystic endometrial hyperplasia; prostate inflammation; pulmonary alveolar macrophage infiltrates; hepatocyte vacuolation, bile duct hyperplasia, and basophilic foci in the liver; pancreatic fibrosis; splenic extramedullary hematopoiesis and pigment; decreased lymphocytes and epithelial hyperplasia in the thymus; ventral brain compression; cystic degeneration and hyperplasia of the adrenal cortex; and mammary gland hyperplasia. The most common nonneoplastic findings in male SD rats were chronic progressive nephropathy (80.9%) and rodent progressive cardiomyopathy (73.2%). The most common nonnenoplastic findings in female SD rats were cystic degeneration of the adrenal cortex (64.7%) and ventral compression of the brain due to pituitary neoplasms (62.7%).

在威斯康星州麦迪逊市的北美实验室早期开发公司(North American Labcorp Early Development, Inc)进行的为期 104 周的致癌性研究中,从约 1800 只雌雄 Sprague Dawley (SD) 对照组大鼠身上收集了显微镜观察数据,并对这些数据进行了回顾性评估,以确定是否存在自发性非肿瘤性结果。本研究提供了在 104 周致癌性研究期间 SD 大鼠各器官系统中最常见的自发性非肿瘤性显微镜检查结果的发生率。一些最常见的自发性背景发现包括心肌病、慢性进行性肾病、子宫囊性内膜增生、前列腺炎症、肺泡巨噬细胞浸润、肝细胞空泡化、胆管增生和肝脏嗜碱性病灶;胰腺纤维化;脾髓外造血和色素沉着;淋巴细胞减少和胸腺上皮增生;大脑腹侧受压;肾上腺皮质囊性变性和增生;乳腺增生。雄性 SD 大鼠最常见的非肿瘤性病变是慢性进行性肾病(80.9%)和啮齿动物进行性心肌病(73.2%)。雌性SD大鼠最常见的非肿瘤性病变是肾上腺皮质囊性变性(64.7%)和垂体肿瘤导致的大脑腹侧压迫(62.7%)。
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引用次数: 0
Exogenous Growth Hormone Exacerbates Post-Irradiation Atherosclerosis in Susceptible Epicardial Coronary Arteries 外源性生长激素加剧易受辐射影响的心外膜冠状动脉辐射后动脉粥样硬化
IF 1.5 4区 医学 Q3 PATHOLOGY Pub Date : 2024-09-10 DOI: 10.1177/01926233241277454
Krystal J. Vail, J. Daniel Bourland, Gregory O. Dugan, Benny J. Chen, Thomas B. Clarkson, J. Mark Cline, Giselle C. Meléndez
Cardiac exposure to ionizing radiation can damage both the microvasculature and coronary arteries, as well as increase the long-term risk of heart disease, myocardial fibrosis, and conduction abnormalities. Therapeutic agents capable of promoting recovery from radiation injury to the heart are limited. Growth hormone is linked to improved cardiac function following injury. Here, we leveraged a cynomolgus macaque model to determine the long-term outcomes of recombinant human growth hormone (rhGH) therapy on the heart following low-dose ionizing radiation. Macaques were exposed to 2 Gy radiation, treated with rhGH for one month, and assessed after 2 years. Overall, plasma lipid profile, cardiac function, and coronary artery disease were similar between rhGH and placebo treated animals. However, a subgroup of rhGH-treated animals exhibited more extensive atherosclerotic plaques in the coronary arteries. Together, these findings indicate that transient human growth hormone therapy subsequent to a single low dose of ionizing radiation involving the heart does not result in long-term changes to plasma cholesterol but may promote exacerbated coronary artery disease in a subset of individuals.
心脏暴露于电离辐射会损伤微血管和冠状动脉,并增加患心脏病、心肌纤维化和传导异常的长期风险。能够促进心脏从辐射损伤中恢复的治疗药物非常有限。生长激素与损伤后心脏功能的改善有关。在这里,我们利用猕猴模型来确定重组人生长激素(rhGH)疗法对低剂量电离辐射后心脏的长期影响。猕猴受到2 Gy辐射,接受一个月的rhGH治疗,两年后进行评估。总体而言,接受rhGH和安慰剂治疗的动物的血浆脂质状况、心脏功能和冠状动脉疾病情况相似。然而,一部分接受过rhGH治疗的动物的冠状动脉出现了更广泛的动脉粥样硬化斑块。总之,这些研究结果表明,对心脏进行单次低剂量电离辐射后的短暂人体生长激素治疗不会导致血浆胆固醇的长期变化,但可能会促使一部分人的冠状动脉疾病恶化。
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引用次数: 0
Toxicologic Pathology Forum*: mRNA Vaccine Safety–Separating Fact From Fiction 毒理病理学论坛*:mRNA 疫苗安全性--分清事实与虚构
IF 1.5 4区 医学 Q3 PATHOLOGY Pub Date : 2024-09-10 DOI: 10.1177/01926233241278298
Rani S. Sellers, Philip R. Dormitzer
SARS-CoV-2 spread rapidly across the globe, contributing to the death of millions of individuals from 2019 to 2023, and has continued to be a major cause of morbidity and mortality after the pandemic. At the start of the pandemic, no vaccines or anti-viral treatments were available to reduce the burden of disease associated with this virus, as it was a novel SARS coronavirus. Because of the tremendous need, the development of vaccines to protect against COVID-19 was critically important. The flexibility and ease of manufacture of nucleic acid–based vaccines, specifically mRNA-based products, allowed the accelerated development of COVID-19 vaccines. Although mRNA-based vaccines and therapeutics had been in clinical trials for over a decade, there were no licensed mRNA vaccines on the market at the start of the pandemic. The rapid development of mRNA-based COVID-19 vaccines reduced serious complications and death from the virus but also engendered significant public concerns, which continue now, years after emergency-use authorization and subsequent licensure of these vaccines. This article summarizes and addresses some of the safety concerns that continue to be expressed about these vaccines and their underlying technology.
从 2019 年到 2023 年,SARS-CoV-2 在全球迅速蔓延,导致数百万人死亡,在大流行之后,它仍然是发病和死亡的主要原因。大流行之初,由于该病毒是一种新型 SARS 冠状病毒,因此没有疫苗或抗病毒治疗方法来减轻与之相关的疾病负担。由于需求量巨大,开发可预防 COVID-19 的疫苗就显得至关重要。以核酸为基础的疫苗,特别是以 mRNA 为基础的产品的灵活性和易制造性使 COVID-19 疫苗的开发得以加速。尽管基于 mRNA 的疫苗和疗法已进行了十多年的临床试验,但在大流行开始时,市场上还没有获得许可的 mRNA 疫苗。基于 mRNA 的 COVID-19 疫苗的快速开发减少了病毒造成的严重并发症和死亡,但也引起了公众的极大关注,这种关注在这些疫苗获得紧急使用授权和随后的许可多年后的今天仍在继续。本文总结并讨论了人们对这些疫苗及其基础技术的安全性持续表达的一些担忧。
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引用次数: 0
Intra-abdominal Abscesses in Two Göttingen Minipigs. 两只哥廷根小型猪的腹内脓肿
IF 1.4 4区 医学 Q3 PATHOLOGY Pub Date : 2024-08-01 Epub Date: 2024-10-17 DOI: 10.1177/01926233241289112
Nanna Grand, Gitte Jeppesen, Abraham Nyska

Minipigs are valued alternatives to dogs and non-human primates in non-clinical safety and toxicity studies, and Göttingen minipigs are bred specifically for experimental purposes. They are bred under barrier conditions and monitored regularly for many pathogens and opportunistic agents, and spontaneous disease is rare when compared to what is seen in production pigs. Knowledge of spontaneous background lesions is important when toxicological pathologists evaluate microscopic findings in pre-clinical toxicity studies to avoid interference with study data interpretation. In this brief communication, intra-abdominal granulomas/abscesses were seen in Göttingen minipigs. The minipigs did not show any clinical signs, but nodules were present in the abdominal peritoneum at necropsy. Microscopic evaluation revealed chronic inflammation, with abscess or granuloma formation. Areas of inflammation, occasionally associated with the presence of the Splendore-Hoeppli material, were surrounded by a fibrotic capsule. Special stains were applied to investigate for the presence of microorganisms.

在非临床安全性和毒性研究中,迷你猪是狗和非人灵长类动物的重要替代品,哥廷根迷你猪是专门为实验目的而饲养的。小猪在隔离条件下饲养,并定期监测多种病原体和机会性病原体,与生产猪相比,小猪很少发生自发性疾病。当毒理学病理学家评估临床前毒性研究中的显微镜检查结果时,了解自发性背景病变非常重要,可避免干扰研究数据的解释。在本简讯中,哥廷根小型猪腹腔内肉芽肿/脓肿。小猪没有出现任何临床症状,但在尸体解剖时腹腔腹膜出现结节。显微镜评估显示存在慢性炎症,并有脓肿或肉芽肿形成。炎症区域偶尔会出现 Splendore-Hoeppli 物质,周围有纤维化包囊。采用特殊染色法检查是否存在微生物。
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引用次数: 0
Classic Lesions of the Biliary Tree. 胆管的典型病变
IF 1.4 4区 医学 Q3 PATHOLOGY Pub Date : 2024-08-01 Epub Date: 2024-08-27 DOI: 10.1177/01926233241257912
John M Cullen, David Malarkey, John R Foster

Abnormal findings in the biliary tree are frequently encountered in response to acute and chronic exposures to various compounds. The more common findings are described here in an overview of previous publications such as the INHAND Proliferative and Nonproliferative Lesions of the Rodent Liver and the Liver-Nonneoplastic Lesion Atlas NTP with comments regarding current considerations. This was presented at the 2023 Annual Meeting of the Society of Toxicologic Pathology. Histologic descriptions and some discussions regarding the pathogenesis of the various categories of non-neoplastic lesions in the biliary tree are presented. Discussions regarding the use of the term oval cell versus ductular reaction and the potentially neoplastic nature of cholangiofibrosis are presented in some detail.

急性和慢性接触各种化合物时,经常会在胆管中发现异常。本文概述了以前的出版物,如《INHAND 啮齿动物肝脏的增生性和非增生性病变》和《NTP 肝脏非肿瘤性病变图谱》,并对当前的考虑因素进行了评论,从而描述了更常见的发现。这是在毒理学病理学学会 2023 年年会上发表的论文。报告介绍了组织学描述以及有关胆道树各类非肿瘤性病变发病机制的一些讨论。还详细讨论了卵圆形细胞与导管反应这一术语的使用以及胆管纤维化的潜在肿瘤性质。
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引用次数: 0
A Minimal Approach to Demonstrate Concordance of Digital and Conventional Microscopy in Toxicologic Pathology. 在毒理病理学中展示数字显微镜和传统显微镜一致性的最低限度方法。
IF 1.4 4区 医学 Q3 PATHOLOGY Pub Date : 2024-07-01 Epub Date: 2024-06-03 DOI: 10.1177/01926233241255125
Charlotte Lempp, Stefanie Arms, Christof Albert Bertram, Robert Klopfleisch, Bernd-Wolfgang Igl, Leonie Hezler, Thomas Nolte, Gabriele Pohlmeyer-Esch

Digitalization of pathology workflows has undergone a rapid evolution and has been widely established in the diagnostic field but remains a challenge in the nonclinical safety context due to lack of regulatory guidance and validation experience for good laboratory practice (GLP) use. One means to demonstrate that digital slides are fit for purpose, that is, provide sufficient quality for pathologists to reach a diagnosis, is conduction of comparison studies, which have been published both, for veterinary and human diagnostic pathology, but not for toxicologic pathology. Here, we present an approach that uses study material from nonclinical safety studies and that allows for the statistical comparison of concordance rates for glass and digital slide evaluation while minimizing time and effort for the involved personnel. Using a benchmark study design, we demonstrate that evaluation of digital slides fits the purpose of nonclinical safety evaluation. These results add to reports of successful workflow validations and support the full adaptation of digital pathology in the regulatory field.

病理工作流程的数字化经历了快速的发展,并在诊断领域得到了广泛应用,但由于缺乏良好实验室规范(GLP)使用的监管指导和验证经验,在非临床安全方面仍面临挑战。要证明数字切片适用于目的,即为病理学家提供足够的诊断质量,一种方法是进行对比研究,这种研究已在兽医和人类病理诊断领域发表,但尚未在毒理病理领域发表。在此,我们介绍一种使用非临床安全性研究材料的方法,该方法可对玻璃切片和数字切片评估的一致率进行统计比较,同时最大限度地减少相关人员的时间和精力。通过基准研究设计,我们证明了数字幻灯片评估符合非临床安全性评估的目的。这些结果是对成功的工作流程验证报告的补充,支持了数字病理学在监管领域的全面应用。
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引用次数: 0
Ginsenoside Rh2 Regulates the Calcium/ROS/CK1α/MLKL Pathway to Promote Premature Eryptosis and Hemolysis in Red Blood Cells. 人参皂苷 Rh2 调节钙/ROS/CK1α/MLKL 通路,促进红细胞过早嗜酸化和溶血
IF 1.4 4区 医学 Q3 PATHOLOGY Pub Date : 2024-07-01 Epub Date: 2024-08-16 DOI: 10.1177/01926233241268846
Sumiah A Alghareeb, Jawaher Alsughayyir, Mohammad A Alfhili

Ginsenoside Rh2 (GRh2) exhibits significant potential as an anticancer agent; however, progress in developing chemotherapeutic drugs is impeded by their toxicity toward off-target tissues. Specifically, anemia caused by chemotherapy is a debilitating side effect and can be caused by red blood cell (RBC) hemolysis and eryptosis. Cells were exposed to GRh2 in the antitumor range and hemolytic and eryptotic markers were examined under different experimental conditions using photometric and cytofluorimetric methods. GRh2 caused Ca2+-independent, concentration-responsive hemolysis in addition to disrupted ion trafficking with K+ and Cl- leakage. Significant increases in cells positive for annexin-V-fluorescein isothiocyanate, Fluo4, and 2,7-dichlorofluorescein were noted upon GRh2 treatment coupled with a decrease in forward scatter and acetylcholinesterase activity. Importantly, the cytotoxic effects of GRh2 were mitigated by ascorbic acid and by blocking casein kinase 1α (CK1α) and mixed lineage kinase domain-like (MLKL) signaling. In contrast, Ca2+ omission, inhibition of KCl efflux, and isosmotic sucrose aggravated GRh2-induced RBC death. In whole blood, GRh2 selectively targeted reticulocytes and lymphocytes. Altogether, this study identified novel mechanisms underlying GRh2-induced RBC death involving Ca2+ buildup, loss of membrane phospholipid asymmetry and cellular volume, anticholinesterase activity, and oxidative stress. These findings shed light on the hematologic toxicity of GRh2 which is crucial for optimizing its utilization in cancer treatment.

人参皂苷 Rh2(GRh2)作为一种抗癌剂具有巨大的潜力;然而,其对非靶组织的毒性阻碍了化疗药物的开发进展。具体来说,化疗引起的贫血是一种使人衰弱的副作用,可由红细胞(RBC)溶血和红细胞增多引起。将细胞暴露于抗肿瘤范围内的 GRh2,在不同的实验条件下使用光度法和细胞荧光法检测溶血和红细胞凋亡标记物。除了K+和Cl-渗漏导致的离子运输紊乱外,GRh2还引起了不依赖于Ca2+的浓度反应性溶血。经 GRh2 处理后,附件素-V-异硫氰酸荧光素、Fluo4 和 2,7-二氯荧光素阳性细胞显著增加,同时前向散射和乙酰胆碱酯酶活性降低。重要的是,抗坏血酸和阻断酪蛋白激酶 1α(CK1α)和混合系激酶域样(MLKL)信号传导可减轻 GRh2 的细胞毒性作用。相反,Ca2+缺失、KCl外流抑制和等渗蔗糖会加剧GRh2-诱导的红细胞死亡。在全血中,GRh2 选择性地靶向网织红细胞和淋巴细胞。总之,本研究发现了 GRh2 诱导 RBC 死亡的新机制,包括 Ca2+ 堆积、膜磷脂不对称和细胞体积损失、抗胆碱酯酶活性和氧化应激。这些发现揭示了 GRh2 的血液学毒性,这对优化其在癌症治疗中的应用至关重要。
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引用次数: 0
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