Blood:干细胞移植后补充维生素A可能能抑制移植物抗宿主病的发生

2017-05-23 MedSci MedSci原创

这些数据支持了研究人员的假设,即低水平的维生素A积极促进胃肠道发生移植物抗宿主病的概率。未来补充维生素A可能会改善移植结果。

维生素A是必需的膳食维生素,可以2种形式提供给人类:维生素A前体(视黄醇和视黄酯)和植物型维生素A类胡萝卜素。大部分身体的维生素A作为肝视黄酯储存在肝脏中。维生素A的血液水平被保持在狭窄范围内。维生素A前体和胡萝卜素必须被肠粘膜细胞代谢为视黄醛和视黄酸后才可以被细胞利用,成为支持生物功能的活性形式。 

在最新的一期Blood杂志上,Dana T. Lounder及其同事报道了他们的发现,在造血干细胞移植(Hematopoietic stem cell transplantation, HSCT)30天后,如果血液中维生素A水平低于中值,则会有显著升高的几率在胃肠道发生移植物抗宿主病(graft versus host diseases, GVHDs)的症状累积。

研究人员对于114例接受同种异体干细胞移植的患者进行了持续性的跟踪研究和观察,并且在移植后第30天,测量了血浆中游离维生素A水平。研究人员分析数据后发现,在血浆中维生素A水平低于中位数的患者其在移植后的100天,胃肠道发生移植物抗宿主病(GVHD)的概率升高为38%,相对于高于中位数的维生素A水平组的发病概率为12.4%(P = 0.0008)。在移植后一年后,低血浆维生素A组的治疗相关死亡率为17.7%,而高维生素A组的治疗相关死亡率为7.4%(P = 0.03) 。

同时维生素A水平低于中位数的患者其血液中检测到感染的几率增加,为24%。而高维生素A组的这一数据为8%(P = 0.03)。这一现象暗示了在血浆维生素A的组中的病人的胃肠道中,炎症反应增强,导致了增加的肠通透性。研究人员还发现,在维生素A水平低于中位数的儿童中,移植后30天后,血液中的T细胞上的负责指导细胞迁移到肠道中的CCR9蛋白增加(P = 0.03)。这一现象可能对于T细胞介导的植物抗宿主病(GVHD)在肠道中发生的概率升高有贡献。

这些数据支持了研究人员的假设,即低水平的维生素A积极促进胃肠道发生移植物抗宿主病的概率。未来补充维生素A可能会改善移植结果。

原始出处:
Dana T. Lounder et al. Lower levels of vitamin A are associated with increased gastrointestinal graft-versus-host disease in children. Blood 2017 129:2801-2807; doi: https://doi.org/10.1182/blood-2017-02-765826

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    2018-01-25 1e145228m78(暂无匿称)

    学习了谢谢作者分享!

    0

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    2017-06-25 xuyong535
  4. 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GetPortalCommentsPageByObjectIdResponse(id=201597, encodeId=ac1b20159e8e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170701/IMG595791009FB761316.jpg, createdBy=abd01695121, createdName=吴教授, createdTime=Tue May 23 09:04:45 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-05-24 wwzzly
  5. [GetPortalCommentsPageByObjectIdResponse(id=1658808, encodeId=241c1658808c0, content=<a href='/topic/show?id=c40ce798412' target=_blank style='color:#2F92EE;'>#细胞移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77984, encryptionId=c40ce798412, topicName=细胞移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4724938298, createdName=limedical1982, createdTime=Wed Jan 24 19:20:00 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281742, encodeId=1d66281e42f3, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, 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  6. 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    2017-05-24 wincls
  7. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201959, encodeId=fc0c201959b7, content=这个就有点意思了,希望再接再厉, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Wed May 24 08:11:13 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201939, encodeId=0399201939eb, content=学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDcVAydhtcpjiaxLrZD7Eb5YnKPgf7ypGpfyl7FflFyAenvQLbib6T0LPXIhXo9SPNPXYYFFJbEgykztwJ0HQ61I3F9GxIVKWsgQ/0, createdBy=f38d2052407, createdName=周周人, createdTime=Wed May 24 07:47:35 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201597, encodeId=ac1b20159e8e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170701/IMG595791009FB761316.jpg, createdBy=abd01695121, createdName=吴教授, createdTime=Tue May 23 09:04:45 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1658808, encodeId=241c1658808c0, content=<a href='/topic/show?id=c40ce798412' target=_blank style='color:#2F92EE;'>#细胞移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77984, encryptionId=c40ce798412, topicName=细胞移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4724938298, createdName=limedical1982, createdTime=Wed Jan 24 19:20:00 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281742, encodeId=1d66281e42f3, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201959, encodeId=fc0c201959b7, content=这个就有点意思了,希望再接再厉, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Wed May 24 08:11:13 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201939, encodeId=0399201939eb, content=学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDcVAydhtcpjiaxLrZD7Eb5YnKPgf7ypGpfyl7FflFyAenvQLbib6T0LPXIhXo9SPNPXYYFFJbEgykztwJ0HQ61I3F9GxIVKWsgQ/0, createdBy=f38d2052407, createdName=周周人, createdTime=Wed May 24 07:47:35 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201597, encodeId=ac1b20159e8e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170701/IMG595791009FB761316.jpg, createdBy=abd01695121, createdName=吴教授, createdTime=Tue May 23 09:04:45 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-05-24 131****2916

    这个就有点意思了,希望再接再厉

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1658808, encodeId=241c1658808c0, content=<a href='/topic/show?id=c40ce798412' target=_blank style='color:#2F92EE;'>#细胞移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77984, encryptionId=c40ce798412, topicName=细胞移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4724938298, createdName=limedical1982, createdTime=Wed Jan 24 19:20:00 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281742, encodeId=1d66281e42f3, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201959, encodeId=fc0c201959b7, content=这个就有点意思了,希望再接再厉, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Wed May 24 08:11:13 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201939, encodeId=0399201939eb, content=学习。, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDcVAydhtcpjiaxLrZD7Eb5YnKPgf7ypGpfyl7FflFyAenvQLbib6T0LPXIhXo9SPNPXYYFFJbEgykztwJ0HQ61I3F9GxIVKWsgQ/0, createdBy=f38d2052407, createdName=周周人, createdTime=Wed May 24 07:47:35 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201597, encodeId=ac1b20159e8e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170701/IMG595791009FB761316.jpg, createdBy=abd01695121, createdName=吴教授, createdTime=Tue May 23 09:04:45 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-05-24 周周人

    学习。

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=201597, encodeId=ac1b20159e8e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170701/IMG595791009FB761316.jpg, createdBy=abd01695121, createdName=吴教授, createdTime=Tue May 23 09:04:45 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-05-23 吴教授

    学习了

    0

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Nature:重大突破!日本完成世界首例异体诱导性多能干细胞移植临床试验!:临床大发现

3月28日,一名60多岁的日本男子成为了世界上首个接受异体诱导性多能干细胞(iPSCs)移植的人!如果后续研究证明治疗取得了不错的效果的话,那么这毫无疑问是iPSCs临床应用的又一个里程碑,是iPSCs治疗走向标准化和通用化的重要转折点。

NEJM:骨髓增生异常综合征进行干细胞移植后的预后相关因素

基因突变驱动着骨髓增生异常综合征(MDS)的发病机制,并与临床表型密切相关。因此,基因突变可以预测同种异体造血干细胞移植后的临床结果。近期,一项发表在权威杂志NEJM上的研究对1514名MDS患者在移植前获得的样本进行了靶向突变分析,这些患者在2005年至2014年期间登记在国际血液和骨髓移植研究中心。此项研究评估了突变与移植结局的关联,包括总生存期、复发、和非复发死亡。研究结果显示:在调整显着临

Cancer:AML患者自体干细胞移植后仍面临着疾病复发的风险

白血病复发是导致急性髓系白血病(AML)患者接受自体造血干细胞移植后治疗失败的首要原因。它通常发生在移植后的前两年内。本次回顾性研究旨在随访移植两年后疾病未复发的幸存者,并评估存在的危险因素的特点。研究共纳入了3567名(中位年龄,45岁)在第一(86%的患者)或第二(14%的患者)次完全缓解时接受自体移植的AML患者。32%的患者干细胞来源于骨髓,68%的患者干细胞来源于外周血。中位随访时间为6

盘点:干细胞移植重要研究进展一览

关于干细胞移植的研究一直层出不穷,对于其研究的热度反应了干细胞治疗的前景和问题,这里梅斯小编整理今年以来关于干细胞移植相关的重要研究进展与大家分享。【1】Gut:干细胞移植治疗暴发性肝衰竭取得新突破暴发性肝衰竭病死率高达80%,原位肝移植是目前最有效的治疗方法之一,由于供肝短缺、费用昂贵,亟需寻找治疗FHF的有效替代疗法。干细胞移植被认为是治疗FHF的新希望。浙江大学医学院附属第一医院传染病诊