Hematopoietic stem cell

造血干细胞
  • 文章类型: Journal Article
    近年来,造血干细胞(HSC)基因治疗已显示出作为地中海贫血治疗方法的潜力。然而,尚未对地中海贫血中HSC基因治疗的各种基因治疗方法进行比较。本研究旨在评估HSC基因治疗方法在地中海贫血动物模型中的应用。在五个数据库中进行了系统评价:PubMed,EBSCOHost,科学直接,Scopus,和Proquest使用造血干细胞或造血干细胞或HSC的组合,地中海贫血,基因治疗或基因治疗和动物模型。仅包括2008年至2023年之间以英语出版的期刊。该文献包括六项分析在地中海贫血小鼠模型中使用HSC基因疗法的研究。本次审查评估的三个结果是全球水平,血液学参数,和红细胞(RBC)表型。使用HSC的地中海贫血基因治疗方法显示β-珠蛋白水平和RBC表型的显着改善。还观察到表型改善。这些结果表明在小鼠模型中对地中海贫血的基因治疗具有良好的功效。此外,在未来的研究中,应该进行更多的研究来评估HSC基因治疗在人类模型中的疗效.
    Hematopoietic stem cell (HSC) gene therapy has shown potential as a therapeutic approach for thalassemia in recent years. However, a comparison of the varying gene therapy methods of HSC gene therapy in thalassemia has never been reviewed. This study aims to evaluate the utilization of HSC gene therapy approaches in animal models of thalassemia. A systematic review was conducted in five databases: PubMed, EBSCOHost, Science Direct, SCOPUS, and Proquest using a combination of the terms hematopoietic stem cell or hematopoietic stem cell or HSC, thalassemia, genetic therapy or gene therapy and animal model. Only journals published in English between 2008 and 2023 were included. This literature included six studies analyzing the use of HSC gene therapy in thalassemic mice models. The three outcomes being assessed in this review were globin levels, hematological parameters, and red blood cell (RBC) phenotypes. Gene therapy approaches for thalassemia using HSC showed significant improvement in β-globin levels and RBC phenotypes. Phenotypic improvements were also observed. These outcomes indicate good efficacy in gene therapy for thalassemia in mice models. Furthermore, more studies assessing the efficacy of HSC gene therapy in the human model should be done in future studies.
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  • 文章类型: Journal Article
    炎症是宿主抵抗有害外部刺激的保护性反应,有助于组织修复和重塑。然而,过度的炎症严重威胁着患者的生命。由于抗炎作用,皮质类固醇,免疫抑制剂,单克隆抗体用于治疗各种炎症性疾病,但是抗药性,无反应,严重的副作用限制了它们的发展和应用。因此,在抗炎治疗中,开发其他替代疗法已变得至关重要。近年来,干细胞的深入研究使其成为治疗炎症性疾病的有希望的替代药物,干细胞的功能受多种信号调节,其中多巴胺信号传导是主要影响因素之一。在这次审查中,我们回顾了多巴胺对各种成体干细胞(神经干细胞,间充质基质细胞,造血干细胞,和癌症干细胞)及其信号通路,以及一些关键的多巴胺受体激动剂/拮抗剂的应用。此外,我们还回顾了各种成体干细胞在炎症性疾病中的作用,并讨论了多巴胺受体的潜在抗炎功能,为再生医学治疗炎症性疾病提供了新的治疗靶点。
    Inflammation is the host\'s protective response against harmful external stimulation that helps tissue repair and remodeling. However, excessive inflammation seriously threatens the patient\'s life. Due to anti-inflammatory effects, corticosteroids, immunosuppressants, and monoclonal antibodies are used to treat various inflammatory diseases, but drug resistance, non-responsiveness, and severe side effect limit their development and application. Therefore, developing other alternative therapies has become essential in anti-inflammatory therapy. In recent years, the in-depth study of stem cells has made them a promising alternative drug for the treatment of inflammatory diseases, and the function of stem cells is regulated by a variety of signals, of which dopamine signaling is one of the main influencing factors. In this review, we review the effects of dopamine on various adult stem cells (neural stem cells, mesenchymal stromal cells, hematopoietic stem cells, and cancer stem cells) and their signaling pathways, as well as the application of some critical dopamine receptor agonists/antagonists. Besides, we also review the role of various adult stem cells in inflammatory diseases and discuss the potential anti-inflammation function of dopamine receptors, which provides a new therapeutic target for regenerative medicine in inflammatory diseases.
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  • 文章类型: Meta-Analysis
    基因疗法(GT)已成为造血系统疾病的一种有希望的治疗选择,特别是原发性免疫缺陷(PID)。造血干细胞(HSC)由于其支持长期造血的能力而受到关注。在这项研究中,本文对HSC基因编辑最有效的转化医学方法进行了综述。我们在各种数据库中进行了系统的文献检索,包括Cochrane,LILAC,Scielo,和Pubmed(MEDLINE),涵盖1989年1月至6月10日期间,2023年。我们的目的是确定评估HSC基因编辑效率的文章和专注于PID的临床试验。我们的研究方案已在国际前瞻性系统审查注册中心(PROSPERO;注册号CRD42022349850)注册。在我们搜索的470项研究中,77符合纳入标准。其中,61项研究包括在系统评价(SR)的策略1(使用HSC-GT-HSC的基因治疗)中。我们对其中17项研究进行了荟萃分析。此外,16项研究被归类为策略2(PID临床试验)。虽然临床试验已经证明了GT-HSC的潜在益处,基因编辑的安全性和有效性仍然面临重大挑战。在基础和临床研究中已经探索了用于基因递送的各种病毒和非病毒方法,病毒载体是HSC治疗中最常用的方法。虽然很有希望,诸如CRISPR/Cas之类的最新技术尚未为整个免疫系统的长期有效恢复做好准备。
    Gene therapy (GT) has emerged as a promising treatment option for disorders in the hematopoietic system, particularly primary immunodeficiencies (PID). Hematopoietic stem cells (HSCs) have gained attention due to their ability to support long-term hematopoiesis. In this study, we present a summary of research evaluating the most effective method of gene editing in HSCs for translational medicine. We conducted a systematic literature search in various databases, including Cochrane, LILACs, SciELO, and PubMed (MEDLINE), covering the period from January 1989 to June 10, 2023. The aim of this study was to identify articles that assessed the efficiency of gene editing in HSCs and clinical trials focusing on PID. Our research protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number CRD42022349850). Of the 470 studies identified in our search, 77 met the inclusion criteria. Among these, 61 studies were included in strategy 1 (gene therapy using HSC [GT-HSC]) of the systematic review (SR). We performed a meta-analysis on 17 of these studies. In addition, 16 studies were categorized under strategy 2 (clinical trials for PID). While clinical trials have demonstrated the potential benefits of GT-HSC, the safety and efficacy of gene editing still pose significant challenges. Various viral and nonviral approaches for gene delivery have been explored in basic and clinical research, with viral vectors being the most commonly used method in HSC therapeutics. Although promising, recent technologies such as CRISPR/Cas are not yet ready for efficient long-term restoration of the immune system as a whole.
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  • 文章类型: Review
    背景:在包括输血在内的情况下,CD36缺陷型个体可能通过抗原暴露于CD36而产生抗CD36抗体。因此,从CD36阳性供体到CD36阴性患者的异基因造血干细胞移植(HSCT)仍然是一个挑战。
    方法:一名64岁的急性髓系白血病患者在化疗期间难以输注血小板。检测血清中不含抗HLA抗体的抗CD36抗体,血小板和单核细胞CD36表达缺失证实I型CD36缺乏。病人完全缓解,并接受CD36阴性血小板输注维持治疗。然而,他很快就复发了,因此接受了来自CD36阳性无关供体的外周血干细胞移植(PBSCT)。抗CD36抗体滴度在移植前有所下降,PBSCT课程顺利。患者没有任何与CD36状态不匹配相关的并发症。
    结论:在CD36缺乏症患者中出现同种异体HSCT的少数报道表明,抗CD36抗体可能与几种移植后并发症有关,如血小板恢复延迟,输血难治性,与输血相关的急性肺损伤。我们目前的病例证实,从CD36阳性供体到阴性患者的干细胞移植是可行的,当它包括仔细事先评估抗CD36抗体滴度和干预以减弱它们时。
    BACKGROUND: CD36-deficient individuals may produce anti-CD36 antibodies through antigenic exposure to CD36, in situations including blood transfusions. Therefore, allogeneic hematopoietic stem cell transplantation (HSCT) from CD36-positive donors to CD36-negative patients remains a challenge.
    METHODS: A 64-year-old man with acute myeloid leukemia became refractory to platelet transfusions during chemotherapy. Anti-CD36 antibodies without anti-HLA antibodies were detected in serum, and the absence of CD36 expression on platelets and monocytes confirmed type I CD36 deficiency. The patient achieved complete remission, and received maintenance therapy with CD36-negative platelet transfusions. However, he relapsed soon afterward, and thus underwent peripheral blood stem cell transplantation (PBSCT) from a CD36-positive unrelated donor. The anti-CD36 antibody titer had decreased before the transplant, and the PBSCT-course was uneventful. The patient has been well without any complications associated with CD36 status mismatch.
    CONCLUSIONS: The few reports of allogeneic HSCT in patients with CD36 deficiency have suggested that anti-CD36 antibodies could be involved in several post-transplant complications, such as delayed platelet recovery, transfusion refractoriness, and transfusion-related acute lung injury. Our present case confirmed that stem cell transplantation from CD36-positive donors to negative patients is feasible, when it includes careful prior assessment of anti-CD36 antibody titers and interventions to attenuate them.
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  • 文章类型: Video-Audio Media
    衰老是由时间相关的细胞和功能损伤决定的生物学过程。导致生物体的生活水平下降。最近,老龄化调查取得了前所未有的进展,特别是检测到衰老速率至少在一定程度上通过进化保留的遗传途径和生物过程进行调节。造血干细胞(HSC)在生物体的整个生命周期内维持血液生成。衰老过程影响HSC的许多自然特征,导致他们的能力下降,独立于他们的微环境。新的研究表明,HSC对年龄依赖性应激敏感,随着衰老逐渐失去自我更新和再生潜力。microRNAs(miRNAs)是短的,转录后抑制翻译或通过序列特定连接刺激靶转录物的靶mRNA切割的非编码RNA。miRNA控制各种生物途径和过程,如衰老。一些miRNA在衰老中差异表达,引起人们对它们用作衰老过程的调节剂的担忧。miRNA在HSC的控制中起重要作用,并且还可以调节与特定细胞类型中的组织衰老相关的过程。在这次审查中,我们展示了年龄依赖性改变的贡献,包括DNA损伤,表观遗传景观,新陈代谢,和外在因素,影响HSC在衰老过程中的功能。此外,我们研究了调节HSCs衰老和年龄相关疾病的特定miRNA。视频摘要。
    Aging is a biological process determined through time-related cellular and functional impairments, leading to a decreased standard of living for the organism. Recently, there has been an unprecedented advance in the aging investigation, especially the detection that the rate of senescence is at least somewhat regulated via evolutionarily preserved genetic pathways and biological processes. Hematopoietic stem cells (HSCs) maintain blood generation over the whole lifetime of an organism. The senescence process influences many of the natural features of HSC, leading to a decline in their capabilities, independently of their microenvironment. New studies show that HSCs are sensitive to age-dependent stress and gradually lose their self-renewal and regeneration potential with senescence. MicroRNAs (miRNAs) are short, non-coding RNAs that post-transcriptionally inhibit translation or stimulate target mRNA cleavage of target transcripts via the sequence-particular connection. MiRNAs control various biological pathways and processes, such as senescence. Several miRNAs are differentially expressed in senescence, producing concern about their use as moderators of the senescence process. MiRNAs play an important role in the control of HSCs and can also modulate processes associated with tissue senescence in specific cell types. In this review, we display the contribution of age-dependent alterations, including DNA damage, epigenetic landscape, metabolism, and extrinsic factors, which affect HSCs function during aging. In addition, we investigate the particular miRNAs regulating HSCs senescence and age-associated diseases. Video Abstract.
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  • 文章类型: Journal Article
    造血干细胞(HSC)命运的调节,包括沉默,自我更新或分化为血细胞,对于维持人体血液系统的稳态和预防白血病至关重要。Notch1是Notch信号通路的关键受体,在HSC的这些特性中起着重要的调节作用,特别是在维持HSC的干性方面。近几十年来,Notch1的泛素化修饰已经逐渐显现出来,并证实影响HSCs的增殖和分化。因此,详细阐明Notch1及其泛素化修饰可能有助于提高对HSC特性维持和白血病发病机制的认识.此外,它可能有助于确定特定白血病的潜在治疗靶点,并为HSC移植(HSCT)提供潜在的预后指标.在本次审查中,描述了Notch1与HSC之间的关联以及Notch1的泛素化修饰与HSC之间的联系。此外,还检查了Notch1或泛素化Notch1介导的异常HSC与T细胞急性淋巴细胞白血病(T-ALL)之间的关联,为临床应用提供了有希望的方向。
    Regulation of the fate of hematopoietic stem cells (HSCs), including silencing, self-renewal or differentiation into blood line cells, is crucial to maintain the homeostasis of the human blood system and prevent leukemia. Notch1, a key receptor in the Notch signaling pathway, plays an important regulatory role in these properties of HSCs, particularly in the maintenance of the stemness of HSCs. In recent decades, the ubiquitination modification of Notch1 has been gradually revealed, and also demonstrated to affect the proliferation and differentiation of HSCs. Therefore, a detailed elucidation of Notch1 and its ubiquitination modification may help to improve understanding of the maintenance of HSC properties and the pathogenesis of leukemia. In addition, it may aid in identifying potential therapeutic targets for specific leukemias and provide potential prognostic indicators for HSC transplantation (HSCT). In the present review, the association between Notch1 and HSCs and the link between the ubiquitination modification of Notch1 and HSCs were described. In addition, the association between abnormal HSCs mediated by Notch1 or ubiquitinated Notch1and T-cell acute lymphoblastic leukemia (T-ALL) was also examined, which provides a promising direction for clinical application.
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  • 文章类型: Journal Article
    BACKGROUND: Hematopoietic stem cell (HSC) transplantation (HSCT) is being accepted as a standard of care in various inflammatory diseases. The treatment of rheumatoid arthritis (RA) has been closely evolving with the understanding of disease pathogenesis. With the rising resistance to the traditional disease-modifying anti-rheumatic drugs and targeted biological therapy, researchers are in pursuit of other methods for disease management. Since the ultimate goal of the ideal treatment of RA is to restore immune tolerance, HSCT attracts much attention considering its reparative, paracrine, and anti-inflammatory effects. However, a systematic review of studies on HSCT in RA is lacking.
    OBJECTIVE: To investigate the role of HSCT in the management of RA.
    METHODS: A detailed search of PubMed, Scopus, EMBASE, Cochrane, and the Web of Science databases was made to identify the relevant articles till September 2020 following Cochrane and PRISMA guidelines. We extracted data including the number of patients, source of hematopoietic stem cells, their mobilization and conditioning regimens, results, and complications from the eligible studies. Results were dichotomized into success (ACR 50/70) and failure (ACR 20) based on the improvement from baseline characteristics. The methodological quality of the included studies was also assessed. Analysis was performed using OpenMeta[Analysis] software.
    RESULTS: We included 17 studies (1 randomized controlled trial, 11 prospective, and 5 retrospective studies) with 233 patients for analysis. HSCT provided a significantly beneficial overall improvement in the clinical grades of ACR criteria (Z = 11.309, P < 0.001). However, the remission was noted only till 24 mo and later on the significance of the result was lost (Z = 1.737, P = 0.082). A less than 1% treatment-related mortality was noted from the included studies. No major drug-related toxicities were noted in any of the included studies. All patients who underwent allogeneic HSCT received immunosuppression in the conditioning regimen to counteract the graft-vs-host reaction which made them vulnerable to infections. It is noted that the source of hematopoietic stem cells did not play a role in altering the functional outcome and both autologous (Z = 9.972, P < 0.001) and allogenic (Z = 6.978, P < 0.001) sources produced significant improvement in the outcome compared to the pre-operative state despite having a significant heterogeneity among the studies reporting them (I 2 = 99.4, P < 0.001).
    CONCLUSIONS: Although the available literature is encouraging towards the use of HSCT in refractory cases with significant improvement from baseline till 2 years, the inclusion of HSCT into the standard of care of RA needs further exploration.
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  • 文章类型: Journal Article
    最近的全基因组研究表明,衰老或慢性炎症可导致正常组织中细胞的克隆扩增。在过去的十年中,克隆造血一直是研究最深入的克隆扩增形式。不确定潜能的克隆造血(CHIP)是在没有血液系统恶性肿瘤病史的老年人中观察到的与年龄有关的现象。CHIP中最常见的突变基因是DNMT3A,TET2和ASXL1与白血病的发生有关。重要的是,CHIP一直是许多研究的焦点,因为它是髓系恶性肿瘤的独立危险因素。心血管疾病(CVD),和全因死亡率。人类CHIP的动物模型显示,与CHIP相关的突变会改变造血干细胞和祖细胞(HSPC)的数量和功能,并促进白血病转化。此外,由感染或衰老引起的慢性炎症赋予CHIP相关突变HSPC适应性优势.髓系细胞,如具有CHIP相关突变的巨噬细胞,加速慢性炎症,并与炎症细胞因子水平升高有关。CHIP和慢性炎症之间的这种正反馈回路促进了动脉粥样硬化和慢性心力衰竭的发展,从而增加了CVD的风险。值得注意的是,具有CHIP相关突变的HSPC不仅可以改变先天免疫细胞,还可以改变获得性免疫细胞。这表明CHIP参与实体癌或免疫疾病的发展,如再生障碍性贫血。在这次审查中,我们概述了芯片的最新发现。我们还讨论了治疗CHIP和预防髓样转化和CVD进展的潜在干预措施。
    Recent genome-wide studies have revealed that aging or chronic inflammation can cause clonal expansion of cells in normal tissues. Clonal hematopoiesis has been the most intensively studied form of clonal expansion in the last decade. Clonal hematopoiesis of indeterminate potential (CHIP) is an age-related phenomenon observed in elderly individuals with no history of hematological malignancy. The most frequently mutated genes in CHIP are DNMT3A, TET2, and ASXL1, which are associated with initiation of leukemia. Importantly, CHIP has been the focus of a number of studies because it is an independent risk factor for myeloid malignancy, cardiovascular disease (CVD), and all-cause mortality. Animal models recapitulating human CHIP revealed that CHIP-associated mutations alter the number and function of hematopoietic stem and progenitor cells (HSPCs) and promote leukemic transformation. Moreover, chronic inflammation caused by infection or aging confers a fitness advantage to the CHIP-associated mutant HSPCs. Myeloid cells, such as macrophages with a CHIP-associated mutation, accelerate chronic inflammation and are associated with increased levels of inflammatory cytokines. This positive feedback loop between CHIP and chronic inflammation promotes development of atherosclerosis and chronic heart failure and thereby increases the risk for CVD. Notably, HSPCs with a CHIP-associated mutation may alter not only innate but also acquired immune cells. This suggests that CHIP is involved in the development of solid cancers or immune disorders, such as aplastic anemia. In this review, we provide an overview of recent findings on CHIP. We also discuss potential interventions for treating CHIP and preventing myeloid transformation and CVD progression.
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  • 文章类型: Journal Article
    Hematopoietic stem cells (HSCs) are a group of cells being produced during embryogenesis to preserve the blood system. They might also be differentiated to non-hematopoietic cells, including neural, cardiac and myogenic cells. Therefore, they have vast applications in the treatment of human disorders. Considering the restricted quantities of HSCs in the umbilical cord blood, inadequate mobilization of bone marrow stem cells, and absence of ethnic dissimilarity, ex vivo expansion of these HSCs is an applicable method for obtaining adequate amounts of HSCs. Several molecules such as NR-101, zVADfmk, zLLYfmk, Nicotinamide, Resveratrol, the Copper chelator TEPA, dmPGE2, Garcinol, and serotonin have been used in combination of cytokines to expand HSCs ex vivo. The most promising results have been obtained from cocktails that influence multipotency and self-renewal features from different pathways. In the current manuscript, we provide a concise summary of the effects of diverse small molecules on expansion of cord blood HSCs.
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  • 文章类型: Case Reports
    探讨异基因造血干细胞移植(allo-HSCT)治疗人类疱疹病毒8型(HHV8)阳性多中心Castleman病(MCD)患者的长期临床疗效。
    河南省人民医院收治一名17岁女性患者,因发热住院半个月,头痛,2010年10月5日浅表淋巴结肿大。淋巴结活检病理诊断发现HHV8阳性混合细胞Castleman病。CHOP和Hyper-CVAD-B给药后,病人还在发热,我们管理了随后的COAP,两节VAD(长春新碱,阿霉素,地塞米松),患者接受CR。CR后六个月,病人复发了,我们给予VAD和两个疗程的硼替佐米+地塞米松化疗,然后病人接受了PR.之后,患者在接受Bu/Cy+依托泊苷+Smoustin预处理后,接受了人类白细胞抗原(HLA)匹配的非亲缘供者的allo-HSCT.移植物抗宿主病(GVHD)预防,由ATG(7.5mg/kg,qd,静脉滴注)从d-5到d-2,环孢菌素(3mg/kg/d,qd,ivdrip,24小时)从第1天开始,MMF(0.5g,tid,po.)从第+1天到第+28天开始,MTX(每次15mg,ivdrip,d+1、+4、+7、+11)。患者接受3.5×106/LCD34+细胞和8.1×108/LMNC。
    粒细胞移植发生在第+12天,血小板移植发生在第+14天。骨髓活检显示三系造血在第33天恢复正常,嵌合状态:97.6%。移植成功,随访7年。
    Allo-HSCT可能治愈难治性/复发性HHV8+MCD患者。
    To investigate the long-term clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for patients with human herpes virus 8 (HHV8)-positive multicentric Castleman\'s disease (MCD).
    A 17-year-old female patient was admitted to Henan Provincial People\'s Hospital with the complaint of febrile for half a month, headache, and enlarged superficial lymph nodes on October 5, 2010. HHV8-positive mixed cellular Castleman\'s disease was found by pathological diagnosis of lymph nodes biopsy. After the administration of CHOP and Hyper-CVAD-B, the patient was still febrile, we administrated the followed COAP, two courses of VAD(Vincristine, Adriamycin, Dexamethasone), the patient received CR. Six months after CR, the patient relapsed, we administrated VAD and two courses of bortezomide+dexamethasone chemotherapy, and then the patient received PR. After that, the patient underwent allo-HSCT from his human leukocyte antigen (HLA)-matched unrelated donor after conditioning with Bu/Cy+Etoposide+Smoustin.graft-vs-host disease (GVHD) prophylaxis, which consisted of ATG (7.5 mg/kg, qd, ivdrip) from d-5 to d-2, cyclosporine (3 mg/kg/d, qd, ivdrip, for 24 h) started from day-1, MMF(0.5 g, tid, po.) started from day+1 to +28, and MTX (15 mg per time, ivdrip, d+1,+4,+7,+11). She received 3.5×106/L CD34+cells and 8.1×108/LMNC.
    Granulocyte engraftment occurred on day+12, platelet engrafted on day+14. Bone marrow biopsy showed normalization of trilineage hematopoiesis on day+33, chimerism: 97.6%. The transplantation was successful and followed up for 7 years with CR.
    Allo-HSCT might cure patients with refractory/relapsed HHV8+ MCD.
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