Colony-stimulating factors

集落刺激因子
  • 文章类型: Journal Article
    猪病原体和人畜共患病原体猪链球菌在感染宿主中诱导加剧的炎症,导致败血症,脑膜炎,突然死亡。描述了几种猪链球菌的毒力因子,其中荚膜多糖(CPS)将其隐藏在免疫系统中,和suilysin表现出细胞毒性活性。尽管嗜中性粒细胞在猪链球菌感染后迅速募集,它们的杀菌功能似乎对细菌的活性较差。然而,在疾病期间,作为粒细胞集落刺激因子(G-CSF)和粒细胞-巨噬细胞集落刺激因子(GM-CSF)等介质,炎症环境可促进中性粒细胞活化,并增强其对细菌检测的反应性.因此,我们假设CPS和suilysin阻止了猪链球菌对中性粒细胞的有效激活,但是G-CSF和GM-CSF拯救中性粒细胞活化,导致S.suis淘汰。我们评估了猪中性粒细胞对猪链球菌的体外反应功能,并使用细菌的等基因突变体研究了CPS和suilysin对细胞活化的作用。我们还通过用重组蛋白引发细胞来研究G-CSF和GM-CSF对嗜中性粒细胞对猪链球菌反应的影响。我们的研究证实,CPS可以防止猪链球菌诱导的大多数中性粒细胞功能的激活,但参与中性粒细胞-细胞外陷阱(NETs)的释放。用G-CSF引发不影响细胞活化,但GM-CSF强烈促进IL-8的释放,表明它参与了免疫调节。然而,启动并不能增强杀菌功能。研究猪链球菌和嗜中性粒细胞之间的相互作用-宿主防御中的第一应答者-仍然是理解感染的免疫发病机制和开发与嗜中性粒细胞针对该细菌的防御相关的治疗策略的基础。
    The porcine pathogen and zoonotic agent Streptococcus suis induces an exacerbated inflammation in the infected hosts that leads to sepsis, meningitis, and sudden death. Several virulence factors were described for S. suis of which the capsular polysaccharide (CPS) conceals it from the immune system, and the suilysin exhibits cytotoxic activity. Although neutrophils are recruited rapidly upon S. suis infection, their microbicidal functions appear to be poorly activated against the bacteria. However, during disease, the inflammatory environment could promote neutrophil activation as mediators such as the granulocyte colony-stimulating factor granulocyte (G-CSF) and the granulocyte-macrophages colony-stimulating factor (GM-CSF) prime neutrophils and enhance their responsiveness to bacterial detection. Thus, we hypothesized that CPS and suilysin prevent an efficient activation of neutrophils by S. suis, but that G-CSF and GM-CSF rescue neutrophil activation, leading to S. suis elimination. We evaluated the functions of porcine neutrophils in vitro in response to S. suis and investigated the role of the CPS and suilysin on cell activation using isogenic mutants of the bacteria. We also studied the influence of G-CSF and GM-CSF on neutrophil response to S. suis by priming the cells with recombinant proteins. Our study confirmed that CPS prevents S. suis-induced activation of most neutrophil functions but participates in the release of neutrophil-extracellular traps (NETs). Priming with G-CSF did not influence cell activation, but GM-CSF strongly promote IL-8 release, indicating its involvement in immunomodulation. However, priming did not enhance microbicidal functions. Studying the interaction between S. suis and neutrophils-first responders in host defense-remains fundamental to understand the immunopathogenesis of the infection and to develop therapeutical strategies related to neutrophils\' defense against this bacterium.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:初级预防性粒细胞集落刺激因子(PP-CSF)与化疗方案一起使用,这些化疗方案具有高热性中性粒细胞减少症(FN)的风险。作为S1415CD的一部分,一个潜在的,务实试验评估自动订单对改善PP-CSF处方的影响,我们评估了患者对PP-CSF的基线知识,以及该知识在第一周期化疗后是否有所改善.
    方法:成年乳腺癌患者,结直肠,2016年1月至2020年4月,S1415CD纳入了非小细胞肺癌起始化疗方案.八个问题评估脑脊液适应症的知识,风险,好处,和自付费用被纳入基线调查和第一个化疗周期结束时的随访调查.反应由试验组分层,化疗是否低,中间,或高FN风险。
    结果:在3605名符合条件的患者中,3580人(99.3%)完成基线调查,和3420(95.5%)完成了后续调查。在基线,803名(22.4%)患者对所有8个问题回答“不知道”,和所有患者平均2.75正确的问题。在后续行动中,高FN风险组的知识增加了0.34(p<0.001),但其他FN风险组的知识下降。在多变量分析中,接受高FN风险方案和年龄较小与知识改善显著相关.
    结论:化疗患者对PP-CSF的认识不足,在接受高FN风险化疗的患者中,PP-CSF的改善幅度不大。进一步努力告知患者风险,好处,PP-CSF的成本可能是有保证的,特别是对于那些需要预防的人。
    背景:NCT02728596,2016年4月6日。
    OBJECTIVE: Primary prophylactic granulocyte colony-stimulating factors (PP-CSFs) are prescribed alongside chemotherapy regimens that carry a significant risk of febrile neutropenia (FN). As part of S1415CD, a prospective, pragmatic trial evaluating the impact of automated orders to improve PP-CSF prescribing, we evaluated patients\' baseline knowledge of PP-CSF and whether that knowledge improved following the first cycle of chemotherapy.
    METHODS: Adult patients with breast, colorectal, or non-small-cell lung cancer initiating chemotherapy were enrolled in S1415CD between January 2016 and April 2020. Eight questions assessing knowledge of CSF indications, risks, benefits, and out-of-pocket costs were included in a baseline survey and in a follow-up survey at the end of the first cycle of chemotherapy. Responses were stratified by the trial arm and whether chemotherapy was low, intermediate, or high FN risk.
    RESULTS: Of the 3605 eligible patients, 3580 (99.3%) completed the baseline survey, and 3420 (95.5%) completed the follow-up survey. At baseline, 803 (22.4%) patients responded \"Don\'t know\" to all 8 questions, and all patients averaged 2.75 correct questions. At follow-up, knowledge increased by 0.34 in the high-FN-risk group (p < 0.001) but declined for the other FN-risk groups. In multivariate analysis, receiving a high-FN-risk regimen and younger age were significantly associated with knowledge improvement.
    CONCLUSIONS: Chemotherapy patients had poor knowledge of PP-CSF that improved only modestly among recipients of high-FN-risk chemotherapy. Further efforts to inform patients about the risks, benefits, and costs of PP-CSF may be warranted, particularly for those in whom prophylaxis is indicated.
    BACKGROUND: NCT02728596, April 6, 2016.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    邻苯二甲酸酯是医疗级塑料和其他日常产品中存在的常见增塑剂。邻苯二甲酸二乙基己酯(DEHP)已被认为是引发和加剧心血管功能障碍的致病危险因素。G-CSF是在整个身体的许多组织中发现的糖蛋白,并且目前在临床实践中被应用并且已经在充血性心力衰竭中进行了测试。我们旨在深入研究DEHP对成年雄性白化病大鼠心肌组织学和生化结构的影响,以及G-CSF可能改善作用的潜在机制。48只成年雄性白化大鼠分为对照组,DEHP组,DEHP+G-CSF组及DEHP-恢复组。我们测量了天冬氨酸氨基转移酶(AST)的血清水平,肌酸激酶同工酶(CK-MB)和乳酸脱氢酶(LDH)。左心室切片进行光学和电子显微镜检查,和Desmin的免疫组织化学染色,激活的Caspase-3和CD34。DEHP显著增加酶水平,显著扭曲了心肌纤维的正常结构,下调Desmin蛋白水平并增强纤维化,和凋亡。与DEHP组相比,G-CSF处理显著降低了酶水平。它增强了CD34阳性干细胞募集到受伤的心肌,因此,除了增加Desmin蛋白表达水平外,还通过抗纤维化和抗凋亡作用改善了大多数心肌纤维的超微结构特征。由于持续的DEHP作用,恢复组显示出部分改善。总之,G-CSF的给药有效地纠正了组织病理学,通过干细胞募集DEHP给药后心肌的免疫组织化学和生化改变,Desmin蛋白调节,抗纤维化和抗凋亡机制。
    Phthalates are common plasticizers present in medical-grade plastics and other everyday products. Di-ethylhexyl phthalate (DEHP) has been noted as a causative risk factor for the initiation and augmentation of cardiovascular functional disorders. G-CSF is a glycoprotein found in numerous tissues throughout the body and is currently applied in clinical practice and has been tested in congestive heart failure. We aimed to examine in depth the effect of DEHP on the histological and biochemical structure of the cardiac muscle in adult male albino rats and the mechanisms underlying the possible ameliorative effect of G-CSF. Forty-eight adult male albino rats were divided into control group, DEHP group, DEHP+ G-CSF group and DEHP-recovery group. We measured serum levels of aspartate aminotransferase (AST), creatine kinase MB isoenzyme (CK-MB) and lactate dehydrogenase (LDH). Left ventricular sections were processed for light and electron microscope examination, and immunohistochemical staining of Desmin, activated Caspase-3 and CD34. DEHP significantly increased enzyme levels, markedly distorted the normal architecture of cardiac muscle fibers, downregulated Desmin protein levels and enhanced fibrosis, and apoptosis. G-CSF treatment significantly decreased the enzyme levels compared to DEHP group. It enhanced CD34 positive stem cells recruitment to injured cardiac muscle, therefore improved the ultrastructural features of most cardiac muscle fibers via anti-fibrotic and anti-apoptotic effects in addition to increased Desmin protein expression levels. The recovery group showed partial improvement due to persistent DEHP effect. In conclusion, administration of G-CSF effectively corrected the histopathological, immunohistochemical and biochemical alterations in the cardiac muscle after DEHP administration by stem cells recruitment, Desmin protein regulation, antifibrotic and antiapoptotic mechanisms.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    集落刺激因子3受体(CSF3R)控制中性粒细胞的生长,最丰富的白细胞类型。在健康的中性粒细胞中,信号传导依赖于CSF3R与其配体的结合,CSF3.CSF3R单个氨基酸突变,T618I,相反,允许构成,不依赖配体的细胞生长,并导致一种罕见的癌症,称为慢性中性粒细胞白血病。然而,疾病的机制还不清楚。这里,我们调查了为什么这种苏氨酸到异亮氨酸的替代是慢性中性粒细胞白血病的主要突变,以及它是如何导致中性粒细胞生长失控的.使用蛋白质结构域作图,我们证明了含有残基618的单个CSF3R结构域对于配体非依赖性活性是足够的。然后,我们应用了针对该结构域的无偏突变筛选策略,发现激活突变在通常由天冬酰胺占据的位点富集,苏氨酸,和丝氨酸残基-通常被糖基化的三个氨基酸。我们通过质谱证实了多个CSF3R残基的糖基化,包括在WT苏氨酸618处存在GalNAc和Gal-GalNAc聚糖。使用相同的方法应用于其他细胞表面受体,我们发现了一个激活突变,S489F,在白细胞介素-31受体α链中。合并,这些结果表明糖基化热点残基在调节受体信号传导中的作用,其突变可导致不依赖配体,不受控制的活动和人类疾病。
    The colony-stimulating factor 3 receptor (CSF3R) controls the growth of neutrophils, the most abundant type of white blood cell. In healthy neutrophils, signaling is dependent on CSF3R binding to its ligand, CSF3. A single amino acid mutation in CSF3R, T618I, instead allows for constitutive, ligand-independent cell growth and leads to a rare type of cancer called chronic neutrophilic leukemia. However, the disease mechanism is not well understood. Here, we investigated why this threonine to isoleucine substitution is the predominant mutation in chronic neutrophilic leukemia and how it leads to uncontrolled neutrophil growth. Using protein domain mapping, we demonstrated that the single CSF3R domain containing residue 618 is sufficient for ligand-independent activity. We then applied an unbiased mutational screening strategy focused on this domain and found that activating mutations are enriched at sites normally occupied by asparagine, threonine, and serine residues-the three amino acids which are commonly glycosylated. We confirmed glycosylation at multiple CSF3R residues by mass spectrometry, including the presence of GalNAc and Gal-GalNAc glycans at WT threonine 618. Using the same approach applied to other cell surface receptors, we identified an activating mutation, S489F, in the interleukin-31 receptor alpha chain. Combined, these results suggest a role for glycosylated hotspot residues in regulating receptor signaling, mutation of which can lead to ligand-independent, uncontrolled activity and human disease.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    当涉及到预防与新城疫病毒(NDV)感染相关的临床症状和死亡率时,疫苗接种非常有效。然而,最近的证据证明,正在出现更多的高毒力菌株,它们绕过现有的免疫保护,对全球家禽业构成严重威胁。这里,一种新型的获救腺病毒5共表达的鸡粒细胞单核细胞集落刺激因子(ChGM-CSF)生物佐剂和C22-血凝素-神经氨酸酶(HN)增强了鸡的免疫遗传抗性,从而提高了关键的新一代疫苗在体外和体内的免疫效力.因此,重组腺病毒(rAdv)-ChGM-CSF-HN免疫鸡的血凝抑制(HI)滴度(log2)更大,更持久,和比LaSota和rAdv-HN接种的鸟类更持久的NDV特异性抗体。此外,在rAdv-ChGM-CSF-HN接种后,体液和适应性免疫条件被证明是和谐的,并且均匀地增强了α干扰素(IFN-α)的表达,IFN-β,IFN-γ,白细胞介素-1β(IL-1β),IL-2、IL-16、IL-18和IL-22。挑战后,控制挑战(CC),野生型腺病毒(WTAdv),rAdv-ChGM-CSF组出现了独特的NDV临床表现,显著的病毒脱落,高组织病毒载量,总体和微观病变,7天内死亡率为100%。LaSota,rAdv-HN,rAdv-ChGM-CSF-HN组均健康,生存率为100%。rAdv-ChGM-CSF-HN组在攻击后5天(dpc)迅速调节并停止病毒脱落,并且组织病毒载量低于所有组。因此,ChGM-CSF的抗病毒活性在面临挑战时提供了强大的免疫保护,并令人信服地减少了病毒复制.我们先进的创新理念,将ChGM-CSF与田间循环菌株表位相结合,可能会导致保险箱的发展,基因型匹配,可以在全球根除这种疾病的通用转基因疫苗,减少贫困和粮食不安全。重要性我们研究了开发的功能性合成重组腺病毒的生物学特性,显示出高度的安全性,热稳定性,和遗传稳定性达20代。通过体外和体内测试证明,拟议疫苗的免疫原性,它使用由甘氨酸和丝氨酸支持的ThoseaAsigna病毒衣壳蛋白的T2A肽,有助于高效地生成多顺反子矢量,能够在rAdv-ChGM-CSF-HN中表达两种功能蛋白,优于同类疫苗。此外,腺病毒可用于生产与毒力场循环菌株表位相匹配的疫苗。因为在动物中没有检测到预先存在的人类腺病毒免疫,腺病毒疫苗的效力看起来很有希望。此外,它确保活载体不携带编码卡那霉素抗生素的抗性基因。因此,经过生物学改进的人重组腺病毒疫苗是有益且重要的。
    When it comes to the prevention of clinical signs and mortality associated with infection of the Newcastle disease virus (NDV), vaccination has been very effective. However, recent evidence has proven that more highly virulent strains are emerging that bypass existing immune protection and pose a serious threat to the global poultry industry. Here, a novel rescued adenovirus 5-coexpressed chicken granulocyte monocyte colony-stimulating factor (ChGM-CSF) bio-adjuvant and C22-hemagglutinin-neuraminidase (HN) boosted chickens\' immunological genetic resistance and thus improved the immunological effectiveness of the critical new-generation vaccine in vitro and in vivo. Accordingly, the hemagglutination inhibition (HI) titers (log2) of the recombinant adenovirus (rAdv)-ChGM-CSF-HN-immunized chickens had greater, more persistent, and longer-lasting NDV-specific antibodies than the La Sota and rAdv-HN-inoculated birds. Moreover, humoral and adaptive immunological conditions were shown to be in harmony after rAdv-ChGM-CSF-HN inoculation and uniformly enhanced the expression of alpha interferon (IFN-α), IFN-β, IFN-γ, interleukin-1β (IL-1β), IL-2, IL-16, IL-18, and IL-22. Postchallenge, the control challenge (CC), wild-type adenovirus (wtAdv), and rAdv-ChGM-CSF groups developed unique NDV clinical manifestations, significant viral shedding, high tissue viral loads, gross and microscopic lesions, and 100% mortality within 7 days. The La Sota, rAdv-HN, and rAdv-ChGM-CSF-HN groups were healthy and had 100% survival rates. The rAdv-ChGM-CSF-HN group swiftly regulated and stopped viral shedding and had lower tissue viral loads than all groups at 5 days postchallenge (dpc). Thus, the antiviral activity of ChGM-CSF offered robust immune protection in the face of challenge and reduced viral replication convincingly. Our advance innovation concepts, combining ChGM-CSF with a field-circulating strain epitope, could lead to the development of a safe, genotype-matched, universal transgenic vaccine that could eradicate the disease globally, reducing poverty and food insecurity. IMPORTANCE We studied the biological characterization of the developed functional synthetic recombinant adenoviruses, which showed a high degree of safety, thermostability, and genetic stability for up to 20 passages. It was demonstrated through both in vitro and in vivo testing that the immunogenicity of the proposed vaccine, which uses the T2A peptide from the Thosea asigna virus capsid protein supported by glycine and serine, helps with efficiency to generate a multicistronic vector, enables expression of two functional proteins in rAdv-ChGM-CSF-HN, and is superior to that of comparable vaccines. Additionally, adenovirus can be used to produce vaccines matching the virulent field-circulating strain epitope. Because there is no preexisting human adenoviral immunity detected in animals, the potency of adenoviral vaccines looks promising. Also, it ensures that the living vector does not carry the resistance gene that codes for the kanamycin antibiotic. Accordingly, a human recombinant adenoviral vaccine that has undergone biological improvements is beneficial and important.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:目前,对于面临癌症治疗的青春期前男孩,尚无确定的生育力保留选择。已提出粒细胞集落刺激因子(G-CSF)治疗在白消安治疗的成年小鼠的烷基化化疗模型中对精原细胞损失具有化学保护作用。先前已表明暴露于烷化剂样化疗顺铂导致未成熟人睾丸组织中生殖细胞数量减少,我们在这里研究G-CSF是否可以防止顺铂诱导的未成熟的人和小鼠(胎儿和青春期前)睾丸组织的生殖细胞丢失。
    方法:使用器官型体外培养系统来确定临床相关浓度的G-CSF在顺铂暴露的未成熟睾丸组织中的作用。培养人胎儿(n=14个胎儿)和小鼠青春期前(n=4窝)睾丸组织块并暴露于顺铂或载体对照24小时,并在暴露后72和240小时进行分析。联合G-CSF和顺铂暴露组探索了不同浓度和持续时间的G-CSF补充到培养基中(包括之前接受G-CSF的组,顺铂暴露期间和之后)。此外,研究了单独补充G-CSF的效果。通过AP2γ和MAGE-A4对人类生殖细胞和(前)精原细胞的表达来鉴定总生殖细胞和亚群的存活,分别,以及MVH和PLZF,分别用于小鼠生殖细胞和假定的精原干细胞(SSC),被量化了。
    结果:暴露于顺铂导致人胎儿和小鼠青春期前睾丸组织中生殖细胞数量在暴露后240小时减少。通过使用任何暴露方案与G-CSF联合暴露,生殖细胞数量未得到保留(之前,在顺铂暴露期间或之后)。单独连续补充G-CSF14天没有改变人或小鼠未成熟睾丸组织中的生殖细胞组成。
    结论:这项研究表明,在体外系统中,暴露于G-CSF并不能防止顺铂诱导的未成熟人和小鼠睾丸组织的生殖细胞损失。
    BACKGROUND: Currently there are no established fertility preservation options for pre-pubertal boys facing cancer treatment. Granulocyte-colony stimulating factor (G-CSF) treatment has been proposed to be chemoprotective against spermatogonial cell loss in an alkylating chemotherapy model of busulfan treated adult mice. Having previously shown that exposure to the alkylating-like chemotherapy cisplatin resulted in a reduction in germ cell numbers in immature human testicular tissues, we here investigate whether G-CSF would prevent cisplatin-induced germ cell loss in immature human and mouse (fetal and pre-pubertal) testicular tissues.
    METHODS: Organotypic in vitro culture systems were utilised to determine the effects of clinically-relevant concentrations of G-CSF in cisplatin-exposed immature testicular tissues. Human fetal (n = 14 fetuses) and mouse pre-pubertal (n = 4 litters) testicular tissue pieces were cultured and exposed to cisplatin or vehicle control for 24 hrs and analysed at 72 and 240 hrs post-exposure. Combined G-CSF and cisplatin exposure groups explored varying concentrations and duration of G-CSF supplementation to the culture medium (including groups receiving G-CSF before, during and after cisplatin exposure). In addition, effects of G-CSF supplementation alone were investigated. Survival of total germ cell and sub-populations were identified by expression of AP2γ and MAGE-A4 for human gonocytes and (pre)spermatogonia, respectively, and MVH and PLZF, for mouse germ cells and putative spermatogonial stem cells (SSCs) respectively, were quantified.
    RESULTS: Exposure to cisplatin resulted in a reduced germ cell number in human fetal and mouse pre-pubertal testicular tissues at 240 hrs post-exposure. Germ cell number was not preserved by combined exposure with G-CSF using any of the exposure regimens (prior to, during or after cisplatin exposure). Continuous supplementation with G-CSF alone for 14 days did not change the germ cell composition in either human or mouse immature testicular tissues.
    CONCLUSIONS: This study demonstrates that exposure to G-CSF does not prevent cisplatin-induced germ cell loss in immature human and mouse testicular tissues in an in vitro system.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Letter
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Randomized Controlled Trial
    目的:初级预防性集落刺激因子(PP-CSF)用于减少发热性中性粒细胞减少症(FN),但其对中度FN风险方案的益处尚不确定。在一个务实的,常规条目(SOE)PP-CSF干预的随机试验,我们进行了一项子研究,以评估接受中危方案的患者使用SOE的有效性.
    方法:Tracer是一项整群随机试验,其中实践被随机分配到常规护理或基于指南的SOE干预。在初级研究中,针对高FN风险方案的自动PP-CSF订单和针对低风险方案与常规治疗相比使用PP-CSF的警报,我们以3:1的比例随机分配至SOE.二级1:1随机分组将24个干预点分配给SOE开处方,或警告不对中等风险方案开PP-CSF。临床医生被允许超越国有企业。乳房患者,结直肠,或非小细胞肺癌纳入研究.使用混合效应逻辑回归模型来测试随机站点之间的差异。
    结果:在2016年1月至2020年4月之间,846名接受中危方案的合格患者被登记为SOE处方(12个部位:n=542)或警告不处方PP-CSF(12个部位:n=304)。在随机分配到SOE的站点中,PP-CSF的使用率更高(37.1%对9.9%,赔率比,5.91;95%CI,1.77至19.70;P=.0038)。FN的比率较低且在臂之间相同(3.7%v3.7%)。
    结论:尽管在接受一线中危方案的患者中,对PP-CSF实施SOE干预显著增加了PP-CSF的使用,FN率很低,两组之间没有差异。尽管这一指南知情的国有企业影响了处方,结果表明,SOE和PP-CSF均未提供足够的获益,足以证明对所有接受一线中危治疗方案的患者均可使用.
    Primary prophylactic colony-stimulating factors (PP-CSFs) are prescribed to reduce febrile neutropenia (FN) but their benefit for intermediate FN risk regimens is uncertain. Within a pragmatic, randomized trial of a standing order entry (SOE) PP-CSF intervention, we conducted a substudy to evaluate the effectiveness of SOE for patients receiving intermediate-risk regimens.
    TrACER was a cluster randomized trial where practices were randomized to usual care or a guideline-based SOE intervention. In the primary study, sites were randomized 3:1 to SOE of automated PP-CSF orders for high FN risk regimens and alerts against PP-CSF use for low-risk regimens versus usual care. A secondary 1:1 randomization assigned 24 intervention sites to either SOE to prescribe or an alert to not prescribe PP-CSF for intermediate-risk regimens. Clinicians were allowed to over-ride the SOE. Patients with breast, colorectal, or non-small-cell lung cancer were enrolled. Mixed-effect logistic regression models were used to test differences between randomized sites.
    Between January 2016 and April 2020, 846 eligible patients receiving intermediate-risk regimens were registered to either SOE to prescribe (12 sites: n = 542) or an alert to not prescribe PP-CSF (12 sites: n = 304). Rates of PP-CSF use were higher among sites randomized to SOE (37.1% v 9.9%, odds ratio, 5.91; 95% CI, 1.77 to 19.70; P = .0038). Rates of FN were low and identical between arms (3.7% v 3.7%).
    Although implementation of a SOE intervention for PP-CSF significantly increased PP-CSF use among patients receiving first-line intermediate-risk regimens, FN rates were low and did not differ between arms. Although this guideline-informed SOE influenced prescribing, the results suggest that neither SOE nor PP-CSF provides sufficient benefit to justify their use for all patients receiving first-line intermediate-risk regimens.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    假体周围关节感染(PJI),全关节置换的毁灭性并发症,发病机制尚不完全清楚,有时在临床上与其他原因的关节成形术失败区分可能具有挑战性。我们在93个切除的关节置换术表面的标本中表征了人类基因表达,比较感染和非感染相关关节成形术失败受试者的转录组。差异基因表达分析证实了28个先前报道的PJI潜在生物标志物,包括杀菌/通透性增加蛋白(BPI),cathelicidin抗菌肽(CAMP),C-C-基序趋化因子配体3(CCL3),4(CCL4)和C-X-C-基序趋化因子配体2(CXCL2),集落刺激因子2受体β(CSF2RB),集落刺激因子3(CSF3),α-防御素(DEFA4),IgG受体1B(CD64B)的Fc片段,细胞间粘附分子1(ICAM1),干扰素γ(IFNG),白细胞介素13受体亚基α2(IL13RA2),白细胞介素17D(IL17D),白细胞介素1(IL1A,IL1B,IL1RN),白细胞介素2受体(IL2RA,IL2RG),白细胞介素5受体(IL5RA),白细胞介素6(IL6),白细胞介素8(IL8),脂多糖结合蛋白(LBP),脂质运载蛋白(LCN2),乳酸脱氢酶C(LDHC),乳转铁蛋白(LTF),基质金属肽酶3(MMP3),肽酶抑制剂3(PI3),和血管内皮生长因子A(VEGFA),并确定了三种新的分子,用于检测PJI的潜在诊断用途,即C-C基序趋化因子配体CCL20,凝血因子VII(F7),和B细胞受体FCRL4。葡萄球菌与葡萄球菌以外的细菌和金黄色葡萄球菌与表皮葡萄球菌引起的感染的比较分析显示白细胞介素13(IL13)的表达升高,IL17D,和葡萄球菌感染中的MMP3,以及IL1B,与表皮葡萄球菌感染相比,金黄色葡萄球菌中的IL8和血小板因子PF4V1。过度表达基因的通路分析表明,宿主免疫反应的激活以及细胞维持和修复功能,以响应感染因子的入侵。所提供的数据为诊断PJI和区分由不同感染因子引起的PJI提供了新的潜在靶标。
    Periprosthetic joint infection (PJI), a devastating complication of total joint replacement, is of incompletely understood pathogenesis and may sometimes be challenging to clinically distinguish from other causes of arthroplasty failure. We characterized human gene expression in 93 specimens derived from surfaces of resected arthroplasties, comparing transcriptomes of subjects with infection- versus non-infection-associated arthroplasty failure. Differential gene expression analysis confirmed 28 previously reported potential biomarkers of PJI, including bactericidal/permeability increasing protein (BPI), cathelicidin antimicrobial peptide (CAMP), C-C-motif chemokine ligand 3 (CCL3), 4(CCL4) and C-X-C-motif chemokine ligand 2 (CXCL2), colony stimulating factor 2 receptor beta (CSF2RB), colony stimulating factor 3 (CSF3), alpha-defensin (DEFA4), Fc fragment of IgG receptor 1B (CD64B), intercellular adhesion molecule 1 (ICAM1), interferon gamma (IFNG), interleukin 13 receptor subunit alpha 2 (IL13RA2), interleukin 17D (IL17D), interleukin 1 (IL1A, IL1B, IL1RN), interleukin 2 receptors (IL2RA, IL2RG), interleukin 5 receptor (IL5RA), interleukin 6 (IL6), interleukin 8 (IL8), lipopolysaccharide binding protein (LBP), lipocalin (LCN2), lactate dehydrogenase C (LDHC), lactotransferrin (LTF), matrix metallopeptidase 3 (MMP3), peptidase inhibitor 3 (PI3), and vascular endothelial growth factor A (VEGFA), and identified three novel molecules of potential diagnostic use for detection of PJI, namely C-C-motif chemokine ligand CCL20, coagulation factor VII (F7), and B cell receptor FCRL4. Comparative analysis of infections caused by staphylococci versus bacteria other than staphylococci and Staphylococcus aureus versus Staphylococcus epidermidis showed elevated expression of interleukin 13 (IL13), IL17D, and MMP3 in staphylococcal infections, and of IL1B, IL8, and platelet factor PF4V1 in S. aureus compared to S. epidermidis infections. Pathway analysis of over-represented genes suggested activation of host immune response and cellular maintenance and repair functions in response to invasion of infectious agents. The data presented provides new potential targets for diagnosis of PJI and for differentiation of PJI caused by different infectious agents.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    怀孕意味着两个人之间微妙的免疫平衡,随着母体能力和胎儿需求的不断变化和适应。我们对707名孕妇的1149份纵向血清样本进行了细胞因子分析,以绘制从妊娠早期到足月及以后的免疫学变化图。22种细胞因子和C反应蛋白(CRP)的血清水平在整个妊娠过程中遵循不同但特征性的轨迹,与分阶段的免疫适应一致。Eotaxin在整个怀孕期间表现出特别强劲的下降。当妊娠进展到足月后,细胞因子水平急剧上升,随着分娩的临近,这种增加被放大。产妇肥胖,吸烟和有大胎儿的怀孕显示,在整个怀孕期间,不同的细胞因子持续增加。与妊娠晚期细胞因子水平较高的未产妇女相比,多产妇女在妊娠早期的细胞因子水平升高。胎儿性别影响妊娠前三个月的细胞因子水平,女性胎儿的妊娠水平升高。这些发现揭示了怀孕的重要免疫动力学,证明母体和胎儿因素如何影响母体全身细胞因子,并作为正常妊娠中细胞因子谱的综合参考。
    Pregnancy implies delicate immunological balance between two individuals, with constant changes and adaptions in response to maternal capacity and fetal demands. We performed cytokine profiling of 1149 longitudinal serum samples from 707 pregnant women to map immunological changes from first trimester to term and beyond. The serum levels of 22 cytokines and C-reactive protein (CRP) followed diverse but characteristic trajectories throughout pregnancy, consistent with staged immunological adaptions. Eotaxin showed a particularly robust decrease throughout pregnancy. A strong surge in cytokine levels developed when pregnancies progressed beyond term and the increase was amplified as labor approached. Maternal obesity, smoking and pregnancies with large fetuses showed sustained increase in distinct cytokines throughout pregnancy. Multiparous women had increased cytokine levels in the first trimester compared to nulliparous women with higher cytokine levels in the third trimester. Fetal sex affected first trimester cytokine levels with increased levels in pregnancies with a female fetus. These findings unravel important immunological dynamics of pregnancy, demonstrate how both maternal and fetal factors influence maternal systemic cytokines, and serve as a comprehensive reference for cytokine profiles in normal pregnancies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号