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Unveiling Dynamic Changes and Regulatory Mechanisms of T Cell Subsets in Sepsis Pathogenesis. 揭示败血症发病机制中 T 细胞亚群的动态变化和调控机制
IF 7.2 Q1 IMMUNOLOGY Pub Date : 2024-02-01 eCollection Date: 2024-01-01 DOI: 10.2147/ITT.S448691
Chunhui Jiang, Jiani Chen, Tong Sun, Jiaqin Xu, Hongguo Zhu, Jiaxi Chen

Purpose: The pathogenesis of T cell subsets in sepsis during the body's resistance to infection is currently unknown. We aimed to investigate the dynamics and molecular mechanisms of T cells during the development of sepsis.

Patients and methods: Perform single-cell data analysis on peripheral blood mononuclear cells (PBMCs) specimen samples from seven healthy controls, five early-stage sepsis patients, and four late sepsis patients, and the atlas were mapped and analyzed using reference mapping to identify the T cell subpopulations specific to early sepsis. Expression network upstream to investigate the changes of regulatory transcription factors and pathways by pySCENIC.

Results: Twenty-two CD4+ T-cell subpopulations and 10 CD8+ T-cell subpopulations were identified by mapping analysis. At the early stage of sepsis, we observed altered ratios of multiple immune cells in PBMCs. Three cell types CD4 Tn cells, CD8 (GZMK+ early Tem), and CD8 (ZNF683+CXCR6- Tm) showed an upward trend (p < 0.05) in the early stages of sepsis compared to normal and returned to normal levels after two weeks. In addition, we found the presence of four sepsis-specific transcription factors (MXI1, CHD1, ARID5A, KLF9) in these three types of cells, which were validated in two external datasets. The differentially expressed genes in CD4 Tn cells, CD8 (GZMK+ early Tem), and CD8 (ZNF683+CXCR6- Tm) cells between the healthy group and the early-stage sepsis group are commonly enriched in the allograft rejection pathway. In addition, it was found that CD8 cells exhibit a trend towards differentiation into CD8 Temra cells in sepsis.

Conclusion: We successfully depicted the dynamic changes of T cell subsets during sepsis onset and progression, which provides important clues for an in-depth understanding of T cells' function and regulatory mechanisms during sepsis pathogenesis.

目的:目前尚不清楚机体抵抗感染过程中败血症中T细胞亚群的发病机制。我们旨在研究脓毒症发生过程中T细胞的动态变化和分子机制:对7名健康对照组、5名早期脓毒症患者和4名晚期脓毒症患者的外周血单核细胞(PBMCs)标本进行单细胞数据分析,并利用参考图谱对图谱进行映射和分析,以确定早期脓毒症特有的T细胞亚群。通过pySCENIC上游表达网络研究调控转录因子和通路的变化:结果:通过图谱分析确定了 22 个 CD4+ T 细胞亚群和 10 个 CD8+ T 细胞亚群。在败血症早期,我们观察到 PBMCs 中多种免疫细胞的比例发生了变化。三种细胞类型 CD4 Tn 细胞、CD8(GZMK+ early Tem)和 CD8(ZNF683+CXCR6- Tm)在脓毒症早期与正常相比呈上升趋势(p < 0.05),两周后恢复到正常水平。此外,我们还发现这三种细胞中存在四种败血症特异性转录因子(MXI1、CHD1、ARID5A、KLF9),这在两个外部数据集中得到了验证。健康组与早期脓毒症组之间的CD4 Tn细胞、CD8细胞(GZMK+ early Tem)和CD8细胞(ZNF683+CXCR6- Tm)中的差异表达基因通常富集在异体移植排斥途径中。此外,研究还发现脓毒症患者的 CD8 细胞有向 CD8 Temra 细胞分化的趋势:我们成功地描绘了脓毒症发病和发展过程中T细胞亚群的动态变化,为深入了解脓毒症发病过程中T细胞的功能和调控机制提供了重要线索。
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引用次数: 0
Inhibition Effect of Pancreatic Exocrine Insufficiency on Immune Checkpoint Inhibitor Treatment in Pancreatic Cancer: A Retrospective Study. 胰腺外分泌失调对胰腺癌免疫检查点抑制剂治疗的抑制作用:一项回顾性研究
IF 7.2 Q1 IMMUNOLOGY Pub Date : 2024-02-01 eCollection Date: 2024-01-01 DOI: 10.2147/ITT.S442247
Qiankun Luo, Yifei Dong, Pan Liu, Chao He, Lei Chen, Kailun Zhang, Changjie Pan, Yahui Gao, Tao Qin

Introduction: Chemotherapy combined with immune checkpoint inhibitors (ChIM) is used to treat advanced pancreatic ductal adenocarcinoma (PDAC). However, the efficacy of ChIM is similar to that of chemotherapy alone.

Methods: To assess potential factors affecting the effectiveness of ChIM, we analyzed the clinical data of 359 patients with PDAC who visited the hospital during June 2017 to December 2022.

Results: Surgical resection, diabetes, and ChIM were risk factors for pancreatic exocrine insufficiency (PEI). The adjusted odds ratio of ChIM was 2.63 (95% confidence interval (CI) 1.492-4.626) (P = 0.001). The incidence of PEI in the ChIM group (76.9%) was significantly higher than that of the chemotherapy group (60.2%) (P = 0.004). Survival analysis showed that ChIM did not improve the survival rate of patients with PDAC (hazard ratio (HR) 0.92, 0.707-1.197) (P = 0.534) in comparison with that of the chemotherapy group. However, in patients without PEI, those receiving ChIM showed a higher 1-year overall survival (OS) rate of 70.8% (two-sided, P = 0.045) and a median OS of 22.0 months (95% CI 11.5-32.5). Moreover, pancreatic enzyme replacement therapy significantly improved the OS of patients with PDAC (HR = 0.73, 95% CI = 0.561-0.956) (P = 0.022).

Conclusion: Immune checkpoint inhibitors (ICIs) increased the incidence of PEI in patients with PDAC. The OS was not different between patients receiving chemotherapy and ChIM due to irregular PERT treatment. The finding show that pancreatic enzyme replacement therapy may improve the response rate of patients with PDAC to ICIs.

简介:化疗联合免疫检查点抑制剂(ChIM)被用于治疗晚期胰腺导管腺癌(PDAC)。然而,ChIM的疗效与单独化疗相似:为了评估影响ChIM疗效的潜在因素,我们分析了2017年6月至2022年12月期间来院就诊的359例PDAC患者的临床数据:手术切除、糖尿病和ChIM是胰腺外分泌功能不全(PEI)的风险因素。ChIM的调整后几率比为2.63(95%置信区间(CI)为1.492-4.626)(P = 0.001)。ChIM 组的 PEI 发生率(76.9%)明显高于化疗组(60.2%)(P = 0.004)。生存分析显示,与化疗组相比,ChIM 并未改善 PDAC 患者的生存率(危险比 (HR) 0.92,0.707-1.197)(P = 0.534)。然而,在无 PEI 的患者中,接受 ChIM 治疗的患者 1 年总生存率(OS)高达 70.8%(双侧,P = 0.045),中位 OS 为 22.0 个月(95% CI 11.5-32.5)。此外,胰酶替代疗法可显著改善PDAC患者的OS(HR = 0.73,95% CI = 0.561-0.956)(P = 0.022):结论:免疫检查点抑制剂(ICIs)会增加PDAC患者的PEI发生率。结论:免疫检查点抑制剂(ICIs)增加了PDAC患者PEI的发生率,但由于PERT治疗不规范,接受化疗和ChIM治疗的患者的OS没有差异。研究结果表明,胰酶替代疗法可提高PDAC患者对ICIs的反应率。
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引用次数: 0
In-vivo Immunomodulatory Activities of Essential Oils of Artemisia abyssinica and Lepidium sativum in Mice. 阿比西尼亚蒿和莴苣精油在小鼠体内的免疫调节活性
IF 6.2 Q1 IMMUNOLOGY Pub Date : 2024-01-23 eCollection Date: 2024-01-01 DOI: 10.2147/ITT.S448317
Kassahun Dires Ayenew, Amare Ayalew, Yehualashet Teshome Wondmkun, Abate Wondesen Tsige, Addis Wolde, Yihenew Sewale, Gebremedhin Desta Belihu, Engidashet Fekade, Habtemariam Alekaw Habteweld

Background: Ethiopians use Artemisia abyssinica and Lepidium sativum as immunity enhancers. However, there is no scientific validation conducted so far regarding this claim. The aim of this study was to investigate the in-vivo immunomodulatory activities of essential oils of A. abyssinica and L. sativum in mice.

Methods: The extraction was carried out using the earlier techniques. By hydro distilling fresh seeds and aerial portions of A. abyssinica and L. sativum, respectively, essential oils were obtained. Essential oils of both plants were tested at 100, 200 and 400 mg/kg. The rate of carbon clearance, humoral antibody titer, delayed type hypersensitivity response, spleen and thymus indices were evaluated in mice according to scientific protocols. The carbon clearance assay was determined using carbon ink. Sheep red blood cell was used as an antigen for other tests.

Results: Essential oils of A. abyssinica and L. sativum at 400 mg/kg significantly increased the rate of carbon clearance from the body of mice (p<0.05). The maximum carbon clearance rate was achieved for A. byssinica essential oil at 400 mg/kg. Both essential oils raised the level of HAT to SRBC in comparison to the vehicle and cyclophosphamide administered groups. The largest (84.668±1.951) mean secondary HAT to SRBC was generated by L. sativum essential oil at 400 mg/kg (p<0.001). A. abyssinica essential oil at 200 and 400 mg/kg significantly increased the level of thymus index compared to the model group (p<0.05 and 0.01 respectively). The levamisole group experienced the highest increase in thymus index (p<0.001). Essential oil of L. sativum at 400 mg/kg also increased the level of thymus index. The spleen index in mice was improved by the essential oils only at the highest dose levels (400 mg/kg).

Conclusion: It can be inferred that the essential oils of L. sativum and A. abyssinica have immunostimulant properties.

背景:埃塞俄比亚人将阿比西尼亚蒿和莴苣用作免疫增强剂。然而,迄今为止还没有对这一说法进行科学验证。本研究旨在调查阿比西尼亚蒿和莴苣精油在小鼠体内的免疫调节活性:方法:采用早期技术进行提取。方法:采用先前的技术进行萃取,通过水蒸馏分别获得 A. abyssinica 和 L. sativum 的新鲜种子和气生部分的精油。两种植物精油的测试剂量分别为 100、200 和 400 mg/kg。按照科学规程对小鼠的碳清除率、体液抗体滴度、迟发型超敏反应、脾脏和胸腺指数进行了评估。碳清除率测定使用碳墨。其他测试使用绵羊红细胞作为抗原:结果:400 毫克/千克的 A. abyssinica 和 L. sativum 精油能显著提高小鼠体内的碳清除率(pA. byssinica 精油 400 毫克/千克,L. sativum 精油 400 毫克/千克)。与给药组和环磷酰胺给药组相比,两种精油都能提高 HAT 到 SRBC 的水平。与模型组相比,ppL.sativum精油(400 mg/kg)产生的对SRBC的次级HAT平均值最大(84.668±1.951)(ppL.abyssinica精油(200和400 mg/kg)显著提高了胸腺指数水平,ppL.sativum精油(400 mg/kg)也提高了胸腺指数水平)。只有在最高剂量水平(400 毫克/千克)时,小鼠的脾脏指数才会得到精油的改善:结论:可以推断,L. sativum 和 A. abyssinica 的精油具有免疫刺激特性。
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引用次数: 0
CD69 is a Promising Immunotherapy and Prognosis Prediction Target in Cancer CD69 是一种前景看好的癌症免疫疗法和预后预测靶点
IF 7.2 Q1 IMMUNOLOGY Pub Date : 2024-01-01 DOI: 10.2147/ITT.S439969
Yuchen Li, Yinfeng Gu, Pengyue Yang, Yan Wang, Xibao Yu, Yangqiu Li, Zhenyi Jin, Ling Xu
Abstract Immunotherapy utilizing T cells that attack tumors is a promising strategy for treatment, but immune suppressive T cell subsets, such as regulatory T cell (Treg), and immune checkpoint molecules, including programmed death-1 (PD-1), can suppress the intensity of a T cell immune reaction and thereby impair tumor clearance. Cluster of differentiation 69 (CD69), known as an early leukocyte activation marker, can be used as a measure or early marker of T cell activation. In recent years, the functions of CD69 in the regulation of Treg/Th17 (T helper cell 17) differentiation and in the tissue retention of T cells have attracted considerable interest. These functions are related to the role of CD69 in immune suppression in tumor environments (TME). In this review, we first summarized current perspectives in the biological function of CD69 and demonstrated that CD69 acts as a regulator of T cell activation, differentiation, retention, and exhaustion. Then, we discussed recent advances in understanding of CD69 deficiency and anti-CD69 antibody administration and shed light on the value of targeting on CD69 for cancer immunotherapy and prognosis prediction.
摘要 利用T细胞攻击肿瘤的免疫疗法是一种很有前景的治疗策略,但免疫抑制性T细胞亚群(如调节性T细胞(Treg))和免疫检查点分子(包括程序性死亡-1(PD-1))会抑制T细胞免疫反应的强度,从而影响肿瘤的清除。分化簇 69(CD69)被称为早期白细胞活化标志物,可作为 T 细胞活化的测量指标或早期标志物。近年来,CD69在调节Treg/Th17(T辅助细胞17)分化和T细胞组织滞留方面的功能引起了人们的极大兴趣。这些功能与 CD69 在肿瘤环境(TME)中的免疫抑制作用有关。在这篇综述中,我们首先总结了目前有关 CD69 生物功能的观点,并证明 CD69 是 T 细胞活化、分化、保留和衰竭的调节因子。然后,我们讨论了对 CD69 缺乏和抗 CD69 抗体应用的最新理解进展,并阐明了靶向 CD69 在癌症免疫疗法和预后预测中的价值。
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引用次数: 0
Extended-Release Tofacitinib Therapy for a MDA5 Antibody-Positive Amyopathic Dermatomyositis Patient with Early-Stage Interstitial Lung Disease 对一名患有早期间质性肺病的 MDA5 抗体阳性肌病性皮肌炎患者的缓释托法替尼疗法
IF 7.2 Q1 IMMUNOLOGY Pub Date : 2023-12-01 DOI: 10.2147/itt.s445971
Chrong-Reen Wang, Wei-Chieh Lin, T. Wong
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引用次数: 0
NOTCH1 Mutations Predict Superior Outcomes of Immune Checkpoint Blockade in Non-Small Cell Lung Cancer NOTCH1突变可预测免疫检查点阻断疗法在非小细胞肺癌中的卓越疗效
IF 7.2 Q1 IMMUNOLOGY Pub Date : 2023-12-01 DOI: 10.2147/ITT.S433555
Qingyuan Huang, Hang Cao, Q. Yao, Xiaoyan Zhou, Hang Li, Q. Bai, Hong Hu
Background NOTCH1 is frequently mutated in non-small cell lung cancer (NSCLC), and also is a poor therapeutic target. It is of clinical importance to investigate the effects of NOTCH1 mutations on anti-tumor immunity and response to immune checkpoint blockade (ICB). Methods An observational study with targeted sequencing in 963 NSCLC patients at our center were performed (FUSCC cohort). Data of the Cancer Genome Atlas Pan-Lung Cancer study (TCGA cohort) were analyzed, and gene set enrichment analysis (GSEA) was performed. The Samstein et al cohort included 350 patients with advanced NSCLC undergoing genomic profiling with the MSK-IMPACT assay, and receiving at least one dose of ICB therapy. Results NOTCH1 mutations were more common in smokers and patients with squamous-cell carcinoma (SCC) (all P value <0.05). For patients who did not receive ICB therapy (TCGA cohort), the overall survival (OS) of NOTCH1-mutant and -WT patients were comparable (log-rank P = 0.72), while for patients who received ICB therapy in the Samstein et al cohort, NOTCH1-mutant patients had significantly superior OS than WT patients (log-rank P = 0.041). On multivariate Cox analysis, the predictive value of NOTCH1 mutations reached marginal statistical significance (HR, 0.42; 95% CI, 0.17–1.04; P = 0.059). The median of TMB for NOTCH1-mutant tumors was significantly higher than that for NOTCH1-WT tumors, and GSEA revealed that NOTCH1 mutations manifested various defects in the repair of DNA damage. NOTCH1-mutant tumors displayed an inflamed tumor microenvironment (TME), manifesting as increased PD-L1 expression and tumor-infiltrating CD8+ T cells. Conclusion NOTCH1 mutations define a molecular subtype of NSCLC, which are more common in smokers and patients with SCC, are characterized with higher TMB, inflamed TME, and display improved survival of ICB therapy for NSCLC patients.
背景NOTCH1在非小细胞肺癌(NSCLC)中经常发生突变,也是一个较差的治疗靶点。研究NOTCH1突变对抗肿瘤免疫和免疫检查点阻断(immune checkpoint blockade, ICB)应答的影响具有重要的临床意义。方法对963例非小细胞肺癌患者进行靶向测序观察性研究(FUSCC队列)。对癌症基因组图谱泛肺癌研究(TCGA队列)数据进行分析,并进行基因集富集分析(GSEA)。Samstein等人的队列包括350例晚期NSCLC患者,他们接受了MSK-IMPACT测定的基因组分析,并接受了至少一剂量的ICB治疗。结果NOTCH1突变在吸烟者和鳞状细胞癌(SCC)患者中更为常见(P值均<0.05)。对于未接受ICB治疗的患者(TCGA队列),notch1突变患者和-WT患者的总生存期(OS)相当(log-rank P = 0.72),而在Samstein等队列中,接受ICB治疗的患者,notch1突变患者的OS显著优于WT患者(log-rank P = 0.041)。多变量Cox分析显示,NOTCH1突变的预测价值达到了边际统计学意义(HR, 0.42;95% ci, 0.17-1.04;P = 0.059)。NOTCH1突变肿瘤的TMB中位数明显高于NOTCH1- wt肿瘤,GSEA显示NOTCH1突变在DNA损伤修复中表现出多种缺陷。notch1突变肿瘤表现为炎症性肿瘤微环境(TME),表现为PD-L1表达增加和肿瘤浸润CD8+ T细胞。结论NOTCH1突变定义了NSCLC的一个分子亚型,该亚型在吸烟者和SCC患者中更为常见,其特征是TMB升高,TME发炎,并且ICB治疗可提高NSCLC患者的生存率。
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引用次数: 0
Managing Cardiovascular Risk in Systemic Lupus Erythematosus: Considerations for the Clinician 管理系统性红斑狼疮的心血管风险:临床医生的注意事项
IF 7.2 Q1 IMMUNOLOGY Pub Date : 2023-12-01 DOI: 10.2147/ITT.S377076
Teresa Semalulu, Achieng Tago, Kevin Zhao, Konstantinos Tselios
Abstract A significant improvement in the survival of patients with systemic lupus erythematosus (SLE) over recent decades is largely attributed to the impact of disease-modifying therapies on end-organ damage. Thus, cardiovascular disease now represents the leading cause of mortality in SLE. Various disease-specific mechanisms are responsible for advanced atherosclerosis, as they lead to premature endothelial dysfunction, arterial stiffness, arterial wall thickening, and plaque formation. Consequently, in the assessment of cardiovascular risk in SLE, we must not only consider traditional risk factors (ie, age, gender, dyslipidemia) but also the additional role of non-traditional risk factors such as persistent disease activity and prolonged corticosteroid use. Cardiovascular risk assessment incorporates general cardiovascular screening, as existing risk prediction scores underestimate cardiovascular risk in this patient population. There is also an expanding role of imaging modalities in screening. Risk reduction strategies integrate unique considerations for the use of low-dose aspirin and more stringent hypertension targets. Hydroxychloroquine is the only disease-modifying therapy with known cardiovascular benefit in SLE, though this is a promising area of study.
近几十年来,系统性红斑狼疮(SLE)患者生存率的显著提高主要归因于疾病修饰疗法对终末器官损伤的影响。因此,心血管疾病现在是SLE患者死亡的主要原因。各种疾病特异性机制是导致晚期动脉粥样硬化的原因,因为它们导致过早的内皮功能障碍、动脉僵硬、动脉壁增厚和斑块形成。因此,在评估SLE的心血管风险时,我们不仅要考虑传统的风险因素(如年龄、性别、血脂异常),还要考虑非传统风险因素的额外作用,如持续的疾病活动性和长期使用皮质类固醇。心血管风险评估包括一般的心血管筛查,因为现有的风险预测评分低估了这一患者群体的心血管风险。成像方式在筛查中的作用也在扩大。降低风险策略结合了使用低剂量阿司匹林和更严格的高血压目标的独特考虑。羟基氯喹是唯一已知对SLE心血管有益的疾病改善疗法,尽管这是一个有前景的研究领域。
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引用次数: 0
The Methylation in B7-H4 and BTLA Genes are Associated with the Risk of Pulmonary Tuberculosis. B7-H4和BTLA基因甲基化与肺结核发病风险相关
IF 7.2 Q1 IMMUNOLOGY Pub Date : 2023-11-24 eCollection Date: 2023-01-01 DOI: 10.2147/ITT.S434403
Xue-Qian Cai, Qian Huang, Tian-Ping Zhang

Background: The important roles of B7 homologous body 4 (B7-H4), B and T lymphocyte attenuator (BTLA) in patients with pulmonary tuberculosis (PTB) have been reported. This study aims to evaluate the association among B7-H4 and BTLA genes polymorphism, methylation and PTB susceptibility.

Methodology: Here, we assessed the possible relationship of 10 single nucleotide polymorphisms (SNPs) in B7-H4, BTLA genes with PTB susceptibility in a Chinese population (496 PTB patients and 502 controls) by SNPscan technique. Then, the B7-H4, BTLA genes methylation levels among 98 PTB patients and 97 controls were detected using MethylTarget technique.

Results: This study found no significant differences in allele and genotype frequencies of B7-H4 gene rs10754339, rs10801935, rs10923223, rs1937956, rs3738414, BTLA gene rs1982809, rs2971205, rs75368388, rs9288953 variants between PTB patients and controls. Haplotype analysis suggested that the lower frequencies of B7-H4 AATTG haplotype, BTLA GATT haplotype and the higher frequency of BTLA AGTC haplotype were found in PTB patients when compared with controls. We also found that the frequency of BTLA gene rs9288953 C allele was significantly increased in PTB patients with drug resistance. Moreover, the methylation levels of B7-H4 and BTLA genes in PTB patients were greater than that in controls, and rs10754339 variant in B7-H4 gene could affect its methylation level in PTB patients.

Conclusion: B7-H4, BTLA genes polymorphism might not affect PTB susceptibility, while the abnormal methylation levels of B7-H4, BTLA genes were associated with the genetic background of PTB.

背景:B7同源体4 (B7- h4)、B和T淋巴细胞衰减剂(BTLA)在肺结核(PTB)患者中的重要作用已有报道。本研究旨在探讨B7-H4和BTLA基因多态性、甲基化与肺结核易感性的关系。方法:在此,我们通过SNPscan技术评估了中国人群(496例PTB患者和502例对照)中B7-H4、BTLA基因的10个单核苷酸多态性(snp)与PTB易感性的可能关系。然后,利用MethylTarget技术检测98例肺结核患者和97例对照者的B7-H4、BTLA基因甲基化水平。结果:本研究发现B7-H4基因rs10754339、rs10801935、rs10923223、rs1937956、rs3738414、BTLA基因rs1982809、rs2971205、rs75368388、rs9288953变异的等位基因和基因型频率在PTB患者与对照组之间无显著差异。单倍型分析表明,PTB患者中B7-H4 AATTG单倍型频率较低,BTLA GATT单倍型频率较高,BTLA AGTC单倍型频率较高。我们还发现BTLA基因rs9288953 C等位基因的频率在耐药PTB患者中显著升高。PTB患者中B7-H4和BTLA基因的甲基化水平高于对照组,B7-H4基因rs10754339变异可能影响其在PTB患者中的甲基化水平。结论:B7-H4、BTLA基因多态性可能与PTB易感性无关,而B7-H4、BTLA基因甲基化异常水平与PTB遗传背景相关。
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引用次数: 0
Selinexor Synergistically Promotes the Antileukemia Activity of Venetoclax in Acute Myeloid Leukemia by Inhibiting Glycolytic Function and Downregulating the Expression of DNA Replication Genes. Selinexor通过抑制糖酵解功能和下调DNA复制基因的表达协同促进Venetoclax在急性髓系白血病中的抗白血病活性。
IF 7.2 Q1 IMMUNOLOGY Pub Date : 2023-11-23 eCollection Date: 2023-01-01 DOI: 10.2147/ITT.S429402
Jiqian Jiang, Yan Wang, Dan Liu, Xiaoyu Wang, Yingqiao Zhu, Juan Tong, Erling Chen, Lei Xue, Na Zhao, Tingting Liang, Changcheng Zheng

Introduction: The BCL-2 inhibitor venetoclax has been widely used in the treatment of acute myeloid leukemia (AML); however, AML patients treated with venetoclax gradually develop resistance. The exportin-1 (XPO1) inhibitor selinexor can synergistically promote the antileukemia activity of venetoclax, but the mechanism remains unclear.

Methods and results: Annexin V/7-aminoactinomycin D assays were used to examine the effects of a combination of venetoclax and selinexor (VEN+SEL) on AML cell lines and primary AML cells. RNA sequencing and oxygen consumption rate (OCR) and extracellular acidification rate (ECAR) determinations by a Seahorse XF analyzer were employed to investigate the molecular mechanism of the toxicity of the VEN+SEL combination to AML cells. The cytotoxicity of NK cell combined with VEN+SEL combination was assessed in vitro using flow cytometry. VEN+SEL enhanced the apoptosis of AML cells (KG-1A and THP-1) and primary AML samples in vitro. The ECAR and OCR results demonstrated that the VEN+SEL combination significantly inhibited glycolytic function. RNA sequencing of THP-1 cells demonstrated that DNA replication-related genes were downregulated after treatment with the VEN+SEL combination.

Conclusion: This study indicated that selinexor can synergistically enhance the antileukemia activity of venetoclax in AML cells in vitro by inhibiting glycolytic function and downregulating DNA replication-related genes. Based on our experimental data, combining selinexor with venetoclax is an appropriate advanced treatment option for AML patients.

BCL-2抑制剂venetoclax已广泛应用于急性髓性白血病(AML)的治疗;然而,接受venetoclax治疗的AML患者逐渐产生耐药性。exportin-1 (XPO1)抑制剂selinexor可协同促进venetoclax的抗白血病活性,但其机制尚不清楚。方法和结果:采用Annexin V/7-氨基放线菌素D检测venetoclax和selinexor (VEN+SEL)联合用药对AML细胞系和原代AML细胞的影响。采用Seahorse XF分析仪进行RNA测序、耗氧率(OCR)和细胞外酸化率(ECAR)测定,探讨VEN+SEL联合对AML细胞毒性的分子机制。体外流式细胞术评价NK细胞联合VEN+SEL的细胞毒性。VEN+SEL在体外促进AML细胞(KG-1A和THP-1)和原代AML样本的凋亡。ECAR和OCR结果显示,VEN+SEL联合显著抑制糖酵解功能。对THP-1细胞的RNA测序结果显示,VEN+SEL联合治疗后,THP-1细胞的DNA复制相关基因下调。结论:本研究提示selinexor可通过抑制糖酵解功能和下调DNA复制相关基因,协同增强venetoclax在体外AML细胞中的抗白血病活性。基于我们的实验数据,selinexor联合venetoclax是AML患者合适的高级治疗选择。
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引用次数: 0
Comparative Efficacy and Safety of Neoadjuvant Immunotherapy with Chemotherapy versus Chemotherapy Alone in Non-Small Cell Lung Cancer: A Propensity Score and Inverse Probability Treatment Weighting Analysis 非小细胞肺癌新辅助免疫治疗联合化疗与单独化疗的疗效和安全性比较:倾向评分和逆概率治疗加权分析
Q1 IMMUNOLOGY Pub Date : 2023-11-01 DOI: 10.2147/itt.s437911
Junfeng Zhao, Shaoyu Hao, Ying Li, Xiaoman Liu, Zhaoxuan Liu, Chunhui Zheng, Dan Han
Purpose: This study aimed to compare the efficacy and safety of neoadjuvant chemotherapy (NCT) and neoadjuvant immunotherapy combined with chemotherapy (NICT) combined with radical lung cancer resection for the treatment of patients with resectable non-small cell lung cancer (NSCLC). To adjust for confounding factors, we innovatively adopted two matching methods: propensity score (PS) and inverse probability of treatment weighting (IPTW). Patients and Methods: We conducted a retrospective analysis of the clinicopathological features and prognosis of patients with resectable NSCLC treated with NCT or NICT combined with radical lung cancer resection using propensity score matching (PSM) at a ratio of 1:1 and IPTW to balance potential bias. Results: After PSM, 116 pairs of patients who had undergone NCT or NICT were selected for the final analysis. The pathological complete remission (pCR) and major pathological remission (MPR) rates were significantly better in the NICT group than in the NCT group (pCR rate of 44.8% vs 2.6%, P < 0.001; MPR rate of 66.4% vs 20.7%, P < 0.001). No significant difference was seen between the NICT and NCT groups in terms of postoperative complications (12.1% vs 9.5%, P =0.182). Patients in the NICT group had significantly better disease-free survival (DFS) and overall survival(OS) than those in the NCT group ([3-year DFS: 75.2% vs 43.3%, P < 0.001] and [3-year OS: 91.5% vs 58.0%, P < 0.001]). Among all patients, those with postoperative pathology of pCR had better DFS ( P < 0.001) and OS ( P = 0.009). Patients with postoperative pathology of MPR had better DFS ( P < 0.001) and OS ( P < 0.001). The IPTW method yielded similar pathologic and prognostic results. Conclusion: Patients with resectable NSCLC treated with NICT had better pathological responses and prognosis, than those treated with NCT, and the safety profiles of NICT and NCT were similar. Keywords: neoadjuvant immunotherapy, neoadjuvant chemotherapy, non-small cell lung cancer, propensity score matching, inverse probability of treatment weighting, lung cancer resection, immune checkpoint inhibitor
目的:本研究旨在比较新辅助化疗(NCT)与新辅助免疫治疗联合化疗(NICT)联合根治性肺癌切除术治疗可切除的非小细胞肺癌(NSCLC)患者的疗效和安全性。为了调整混杂因素,我们创新地采用了倾向得分(PS)和处理加权逆概率(IPTW)两种匹配方法。患者和方法:我们采用倾向评分匹配(PSM),以1:1的比例和IPTW来平衡潜在的偏倚,回顾性分析可切除的NSCLC患者接受NCT或NICT联合根治肺癌切除术的临床病理特征和预后。结果:PSM后,116对接受过NCT或NICT的患者被选中进行最终分析。NICT组病理完全缓解(pCR)和主要病理缓解(MPR)率显著优于NCT组(pCR率44.8% vs 2.6%, P < 0.001;MPR率66.4% vs 20.7%, P < 0.001)。NICT组和NCT组在术后并发症方面无显著差异(12.1% vs 9.5%, P =0.182)。NICT组患者的无病生存期(DFS)和总生存期(OS)明显优于NCT组([3年DFS: 75.2% vs 43.3%, P < 0.001]和[3年OS: 91.5% vs 58.0%, P < 0.001])。在所有患者中,术后病理pCR者的DFS (P < 0.001)和OS (P = 0.009)较好。术后病理有MPR的患者有较好的DFS (P < 0.001)和OS (P < 0.001)。IPTW方法获得了类似的病理和预后结果。结论:NICT治疗可切除NSCLC患者的病理反应和预后优于NCT治疗,NICT和NCT的安全性相似。关键词:新辅助免疫治疗,新辅助化疗,非小细胞肺癌,倾向评分匹配,治疗加权逆概率,肺癌切除,免疫检查点抑制剂
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ImmunoTargets and Therapy
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