Hepatology:肝硬化患者骨髓情况研究

2016-08-05 Mechront 译 MedSci原创

背景和目的:骨髓(BM)免疫和造血细胞的储层,是组织修复和再生的关键。但是肝硬化患者所有这些功能都严重改变。我们的目的是探讨在肝硬化患者骨髓的细胞和功能状态。方法:研究了肝硬化患者(n = 168)和对照组(n = 44)的组织学、细胞和分子的变化。对造血干细胞(HSC)和相关小细胞、间充质干细胞(MSCs)、Schwann细胞、神经纤维和血管内皮细胞进行免疫组织化学研究。此外还对外周血和骨髓血浆

背景和目的:骨髓(BM)免疫和造血细胞的储层,是组织修复和再生的关键。但是肝硬化患者所有这些功能都严重改变。我们的目的是探讨在肝硬化患者骨髓的细胞和功能状态。

方法:研究了肝硬化患者(n = 168)和对照组(n = 44)的组织学、细胞和分子的变化。对造血干细胞(HSC)和相关小细胞、间充质干细胞(MSCs)、Schwann细胞、神经纤维和血管内皮细胞进行免疫组织化学研究。此外还对外周血和骨髓血浆中的细胞因子和生长因子进行了分析。

结果:肝硬化患者骨髓CD34+造血干细胞和MELD评分之间呈负相关(ρ=-0.582, p<0.001),和Child评分呈负相关(p<0.038)。肝硬化患者具有较高MELD (>15)的BMs与更低的MELD (≤15)相比,造血干细胞、MSCs、Schwann细胞和神经纤维显著增加,IL1β (p=0.004)、TNF-α (p=0.040)、IFN-γ (p=0.03)显著增加,抑瘤素M(p=0.04)、干细胞因子(SCF)(p=0.05)和基质细胞衍生因子(SDF-1)(p=0.03)显著下降。CD34细胞群体是脓毒症发展的预测(p<0.001),单位损失增加脓毒症的概率16%。肝硬化患者伴有较低的造血干细胞,与更低的血红蛋白(p= 0.05)和血小板计数(p= 0.05)有关,表明早期移植物功能障碍。

结论:日益严重的肝硬化引起造血龛紊乱和造血干细胞的损失,导致了血液和免疫障碍,减少潜在的再生。恢复骨髓功能可为肝硬化的治疗提供新的治疗选择。

原始出处:

Bihari C.et al.Bone Marrow Stem Cells and its Niche Components are Adversely Affected in Advanced Cirrhosis of Liver.Hepatology. 2016 Aug 3. doi: 10.1002/hep.28754. [Epub ahead of print]

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    2016-09-23 1e10c84am36(暂无匿称)

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    2016-08-09 doctorJiangchao

    继续学习

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    2016-08-09 doctorJiangchao

    继续关注

    0

  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Sat Aug 06 09:36:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=96351, encodeId=42b49635121, content=肝硬化治疗上新的思路和突破, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160803/IMG57A185CE577478201.jpg, createdBy=bad41730551, createdName=小青虫, createdTime=Sat Aug 06 09:18:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=96304, encodeId=b50c96304bb, content=学习了,赞一个!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sat Aug 06 08:48:00 CST 2016, time=2016-08-06, status=1, ipAttribution=)]
    2016-08-07 1e0b9de5m54(暂无匿称)

    新话题

    0

  5. 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createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Sat Aug 06 09:36:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=96351, encodeId=42b49635121, content=肝硬化治疗上新的思路和突破, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160803/IMG57A185CE577478201.jpg, createdBy=bad41730551, createdName=小青虫, createdTime=Sat Aug 06 09:18:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=96304, encodeId=b50c96304bb, content=学习了,赞一个!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sat Aug 06 08:48:00 CST 2016, time=2016-08-06, status=1, ipAttribution=)]
    2016-08-07 青荷

    好文章,学习了

    0

  6. 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createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Sat Aug 06 09:36:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=96351, encodeId=42b49635121, content=肝硬化治疗上新的思路和突破, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160803/IMG57A185CE577478201.jpg, createdBy=bad41730551, createdName=小青虫, createdTime=Sat Aug 06 09:18:00 CST 2016, time=2016-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=96304, encodeId=b50c96304bb, content=学习了,赞一个!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sat Aug 06 08:48:00 CST 2016, time=2016-08-06, status=1, ipAttribution=)]
    2016-08-07 gwc384
  7. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sat Aug 06 08:48:00 CST 2016, time=2016-08-06, status=1, ipAttribution=)]
    2016-08-06 oo902

    赞一个,学习好文章

    0

  8. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sat Aug 06 08:48:00 CST 2016, time=2016-08-06, status=1, ipAttribution=)]
    2016-08-06 医路开来

    恢复骨髓能治病,

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=133855, encodeId=52b31338551a, content=深度好文,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 23 20:14:00 CST 2016, time=2016-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97121, encodeId=8b6a9e121ab, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sat Aug 06 08:48:00 CST 2016, time=2016-08-06, status=1, ipAttribution=)]
    2016-08-06 小青虫

    肝硬化治疗上新的思路和突破

    0

  10. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sat Aug 06 08:48:00 CST 2016, time=2016-08-06, status=1, ipAttribution=)]
    2016-08-06 1dd8a7c5m95(暂无匿称)

    学习了,赞一个!!

    0

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近期有研究表明,非酒精性脂肪性肝病(NAFLD)是多种族肝硬化的最常见原因。南加州大学凯克医学院的Veronica Wendy Setiawan博士研究了白人、黑人、拉美裔美国人、日本人和夏威夷土著人的慢性肝病(CLD)和肝硬化患病率的潜在病因。该队列包括106458名参与者,在1999-2012年间进行评估。数据显示,总体而言,5783例患者有CLD,其中2208人也有肝硬化。黑人和夏威夷土著人

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近期有研究表明,肝硬化患者上消化道出血住院治疗,使用抗生素可降低30%的30天死亡率。来自华盛顿大学的Lauren Beste博士和同事们对6451例上消化道出血(平均年龄为60.6岁)住院治疗的肝硬化患者进行了回顾性研究。他们收集了患者有关基线特征、病因、给予抗生素的信息、30天再入院率和死亡率等数据。研究者在入院前8小时和48小时内使用抗生素定义为研究中的“抗生素使用”。及时的抗生素管理发生在

Hepatology:非选择性β受体阻滞剂不会肝硬化患者的死亡率

发表在Hepatology的数据显示,晚期肝硬化伴腹水的患者,使用非选择性β受体阻滞剂,并不会导致全因死亡率或肝硬化相关死亡率的增加。 研究人员对2006-2008年进行了3个沙他伐坦临床试验数据进行了分析,涉及1198例肝硬化伴腹水患者,随访1年时间。使用Cox回归分析比较非选择性β-受体阻滞剂使用与否患者(使用者有559人)的全因死亡率和肝硬化相关死亡率。进行分析时对患者的年龄、性别、M

原发性胆汁性肝硬化预后判断及其治疗方案

作者:   首都医科大学附属北京佑安医院    黄春洋,刘燕敏原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)是一种慢性肝内胆汁淤积性疾病,表现为进行性非化脓性小胆管炎,最终可发展为肝硬化、肝癌,甚至肝衰竭。目前国内外专家联名发表建议将“原发性胆汁性肝硬化”更名为“原发性胆汁性胆管炎”(primary biliary cholang

Clin Gastroenterol Hepatol:肝硬化再入院率及原因分析

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