Response to treatment

对治疗的反应
  • 文章类型: Journal Article
    肛门鳞状细胞癌(ASC)是一种罕见的胃肠道恶性肿瘤,在过去几十年中发病率有所增加。YKL-40是一种免疫调节剂和促血管生成因子,在几种恶性肿瘤中显示出有希望的预后和预测潜力。但ASC的可用数据有限。本研究旨在广泛评估YKL-40在ASC患者的多中心队列中的预后和预测作用。
    我们回顾性检索了2011年2月至2021年3月期间诊断的72例连续ASC病例。检测血清和组织中YKL-40蛋白的表达,后者在ASC肿瘤细胞和瘤周免疫细胞中。
    诊断时血清YKL-40水平升高与年龄增长有关(p=0.035),心血管/代谢合并症的存在(p=0.007),和任何原因的死亡(p=0.011)。此外,血清YKL-40水平升高与预后不良相关(HR:2.82,95%CI:1.01-7.84;p=0.047).YKL-40在ASC肿瘤细胞中的蛋白表达与低肿瘤分级显著相关(p=0.031),而肿瘤周围免疫细胞的表达增加与患者对放化疗的反应较差相关(p=0.007)。然而,ASC肿瘤细胞或肿瘤周围免疫细胞中的YKL-40蛋白表达对患者总生存期没有显著影响。
    总而言之,YKL-40产生相关的预后(血清水平)和预测性(肿瘤周围免疫细胞中的组织蛋白表达)生物标志物,并且可以显着改善ASC患者的临床管理。
    UNASSIGNED: Anal squamous cell carcinoma (ASC) is a rare gastrointestinal malignancy showing an increased incidence over the past decades. YKL-40 is an immune modulator and pro-angiogenetic factor that showed a promising prognostic and predictive potential in several malignancies, but limited data are available for ASC. This study aims to provide an extensive evaluation of the prognostic and predictive role of YKL-40 in a multicenter cohort of ASC patients.
    UNASSIGNED: We retrospectively retrieved 72 consecutive cases of ASC diagnosed between February 2011 and March 2021. Both serum and tissue protein expression of YKL-40 were assessed, the latter in ASC tumor cells and peritumor immune cells.
    UNASSIGNED: Increased YKL-40 serum levels at the time of diagnosis were associated with older age (p = 0.035), presence of cardiovascular/metabolic comorbidities (p = 0.007), and death for any cause (p = 0.011). In addition, high serum levels of YKL-40 were associated with a poor prognosis (HR: 2.82, 95% CI: 1.01-7.84; p = 0.047). Protein expression of YKL-40 in ASC tumor cells was significantly associated with low tumor grade (p = 0.031), while the increased expression in peritumor immune cells was associated with a worse response of patients to chemoradiotherapy (p = 0.007). However, YKL-40 protein expression in ASC tumor cells or peritumor immune cells did not significantly impact patient overall survival.
    UNASSIGNED: In conclusion, YKL-40 resulted a relevant prognostic (serum level) and predictive (tissue protein expression in peritumor immune cells) biomarker and can considerably improve ASC patient clinical management.
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  • 文章类型: Journal Article
    背景:对抗精神病药物的反应受到广泛的个体差异的影响,由于遗传和非遗传因素。在全基因组关联研究(GWAS)中,几种单核苷酸多态性(SNP)与抗精神病药的反应有关。多基因风险评分(PRS)是一种强大的工具,可以将多个风险等位基因的小影响汇总到单个度量中。材料和方法:我们研究了由SNP组成的PRS与GWAS研究(PRS反应)中对抗精神病药的反应之间的关联,该研究是在具有不同诊断(精神分裂症谱,双极,抑郁,神经认知,物质使用障碍和其他)。还测试了另外两个由先前与精神分裂症风险相关的SNP组成的PRS(PRS精神分裂症ia1和PRS精神分裂症ia2)与治疗反应的相关性。结果:考虑到整个队列,PRS反应与抗精神病药物的反应显着相关(OR=1.14,CI=1.03-1.26,p=0.010),精神分裂症患者的亚组,分裂情感障碍或双相情感障碍(OR=1.18,CI=1.02-1.37,p=0.022,N=235),精神分裂症或分裂情感障碍(OR=1.24,CI=1.04-1.47,p=0.01,N=176)和精神分裂症(OR=1.27,CI=1.04-1.55,p=0.01,N=149)。敏感性和特异性次优(精神分裂症62%,61%;精神分裂症谱56%,55%;精神分裂症谱加躁郁症60%,56%;所有患者63%,58%,分别)。PRS精神分裂症ia1和PRS精神分裂症ia2与治疗反应没有显着相关。结论:在真实世界队列中,GWAS研究定义的PRS反应与抗精神病药物的反应显着相关;然而,敏感性-特异性分析的结果排除了其在临床实践中作为预测工具的用途.
    Background: Response to antipsychotics is subject to a wide interindividual variability, due to genetic and non-genetic factors. Several single nucleotide polymorphisms (SNPs) have been associated with response to antipsychotics in genome-wide association studies (GWAS). Polygenic risk scores (PRS) are a powerful tool to aggregate into a single measure the small effects of multiple risk alleles. Materials and methods: We studied the association between a PRS composed of SNPs associated with response to antipsychotics in GWAS studies (PRSresponse) in a real-world sample of patients (N = 460) with different diagnoses (schizophrenia spectrum, bipolar, depressive, neurocognitive, substance use disorders and miscellaneous). Two other PRSs composed of SNPs previously associated with risk of schizophrenia (PRSschizophrenia1 and PRSschizophrenia2) were also tested for their association with response to treatment. Results: PRSresponse was significantly associated with response to antipsychotics considering the whole cohort (OR = 1.14, CI = 1.03-1.26, p = 0.010), the subgroup of patients with schizophrenia, schizoaffective disorder or bipolar disorder (OR = 1.18, CI = 1.02-1.37, p = 0.022, N = 235), with schizophrenia or schizoaffective disorder (OR = 1.24, CI = 1.04-1.47, p = 0.01, N = 176) and with schizophrenia (OR = 1.27, CI = 1.04-1.55, p = 0.01, N = 149). Sensitivity and specificity were sub-optimal (schizophrenia 62%, 61%; schizophrenia spectrum 56%, 55%; schizophrenia spectrum plus bipolar disorder 60%, 56%; all patients 63%, 58%, respectively). PRSschizophrenia1 and PRSschizophrenia2 were not significantly associated with response to treatment. Conclusion: PRSresponse defined from GWAS studies is significantly associated with response to antipsychotics in a real-world cohort; however, the results of the sensitivity-specificity analysis preclude its use as a predictive tool in clinical practice.
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  • 文章类型: Journal Article
    目前尚无共识来确定哪些晚期黑色素瘤患者将从靶向治疗中受益。免疫疗法,或者两者的结合,强调了确定晚期黑色素瘤治疗的早期反应生物标志物的关键需求。这篇综述的目的是提供科学依据,以强调代谢成像在评估黑色素瘤对靶向和/或免疫治疗的反应中的潜在作用。为此,提供了当前黑素瘤治疗的简要概述。然后,介绍了目前有关黑色素瘤代谢的知识,重点介绍了黑色素瘤细胞代谢与BRAF靶向治疗以及免疫检查点抑制治疗中涉及的信号通路之间的主要交叉.最后,总结了使用代谢成像和/或谱分析评估黑色素瘤治疗反应的临床前和临床研究,特别关注PET(正电子发射断层扫描)成像和13C-MRS(磁共振波谱)方法。
    There is currently no consensus to determine which advanced melanoma patients will benefit from targeted therapy, immunotherapy, or a combination of both, highlighting the critical need to identify early-response biomarkers to advanced melanoma therapy. The goal of this review is to provide scientific rationale to highlight the potential role of metabolic imaging to assess response to targeted and/or immune therapy in melanoma cancer. For that purpose, a brief overview of current melanoma treatments is provided. Then, current knowledge with respect to melanoma metabolism is described with an emphasis on major crosstalks between melanoma cell metabolism and signaling pathways involved in BRAF-targeted therapy as well as in immune checkpoint inhibition therapies. Finally, preclinical and clinical studies using metabolic imaging and/or profiling to assess response to melanoma treatment are summarized with a particular focus on PET (Positron Emission Tomography) imaging and 13C-MRS (Magnetic Resonance Spectroscopy) methods.
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  • 文章类型: Journal Article
    牙周炎是一种影响牙周组织的慢性感染性疾病,具有多因素病因,除了局部炎症,组织损伤,和骨吸收。一种称为C反应蛋白的全身性炎症的血清学标志物与许多病理状况的风险增加有关。包括心血管疾病.
    评估健康个体和患有牙周疾病的受试者的血清C-反应蛋白水平,并比较患有牙周疾病的受试者术前和术后的血清C-反应蛋白水平。
    该研究对年龄在35至60岁之间的60名受试者进行。健康牙周炎者30例为第1组(对照组),诊断为成人牙周炎者30例为第2组(实验组)。使用牙龈指数进行牙周检查,菌斑指数,牙周袋深度,和罗素指数。在治疗前和治疗后2个月的基线访视之间,检测第1组和第2组之间以及第2组之间的CRP水平。
    这项研究的结果表明,牙周病与体内炎症标志物CRP之间存在显着联系,以及牙周炎治疗后血清CRP水平显着下降的趋势。在基线,C反应蛋白之间呈正相关,探测袋深度,和罗素指数。
    由于CRP是心血管疾病的关键介质,牙周疾病中C-反应蛋白水平升高提示牙周炎与心血管疾病之间存在显著联系.早期牙周治疗可能会降低已经存在的心血管疾病的严重程度。这表明牙周检查应与心血管检查一起成为常规实践的一部分。
    UNASSIGNED: Periodontitis is a chronic infectious disease affecting periodontium having multifactorial etiology, can cause significant systemic challengein addition to localized inflammation, tissue damage, and bone resorption. A serological marker of systemic inflammation known as C-reactive protein has been linked to an increased risk for a number of pathological conditions, including cardiovascular diseases.
    UNASSIGNED: To estimate levels of serum C-reactive protein in healthy individuals and subjects with periodontal diseases and to compare serum C-reactive protein levels in subjects having periodontal disease pre-operatively & post-operatively.
    UNASSIGNED: The study was conducted on 60 subjects age ranging from 35 to 60 years. 30 individuals with healthy periodontium were in group 1 (control group) and the remaining 30 were diagnosed as adult periodontitis were in group 2 (experimental group). Periodontal examination done using gingival index, plaque index, periodontal pocket depth, and Russel\'s index. CRP levels were examined between group 1 and group 2 and in group 2 between baseline visit before treatment and 2 months after treatment.
    UNASSIGNED: The findings of this study show a significant connection between periodontal disease and the inflammatory marker CRP in the body, as well as a tendency for a significant decrease in serumCRP levels following periodontitis therapy. At baseline, there was a positive correlation among C-reactive protein, probing pocket depth, and Russell\'s index.
    UNASSIGNED: As CRP is a key mediator for cardiovascular disease, an increase in C- reactive protein levels in periodontal diseases suggests a significant connection between periodontitis and cardiovascular diseases. Early periodontal treatment might decrease the severity of cardiovascular disease that already exists. This suggests that periodontal examination should be part of routine practicealong with cardiovascular examination.
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  • 文章类型: Journal Article
    背景和目的:新辅助化疗(NAC)和放化疗(NCRT)已证明胃癌的生存率提高。然而,最佳新辅助治疗方案尚不清楚.我们试图评估局部胃癌新辅助治疗的围手术期和组织病理学结果。
    方法:国家癌症数据库查询了接受NAC或NCRT切除T2-T4和/或淋巴结阳性胃癌(2006-2018)的患者。Logistic和泊松回归评估围手术期(30天再入院,30天和90天死亡率,住院时间[LOS])和组织病理学结果(病理完全缓解[PCR],边距状态,和阴性病理淋巴结[ypN0])。Kaplan-Meier方法和Cox回归评估总生存期(OS)。
    结果:在9831名患者中,4221(42.9%)接受了NAC,5610(57.1%)接受了NCRT。围手术期结局无差异,除接受NCRT治疗的患者LOS增加外(发生率比1.09,95%置信区间[CI]1.03-1.16).接受NCRT的患者更有可能实现PCR,切缘阴性切除,和ypN0(均p<0.05)。NAC和NCRT的中位OS分别为36.8个月和33.6个月(p<0.001)。NCRT独立预测操作系统较差(与NAC,危险比1.10,95%CI1.03-1.18)。
    结论:尽管NAC与OS改善相关,但NCRT与更好的组织学肿瘤反应相关。需要通过新辅助治疗后的组织学评估更好地了解预后。
    BACKGROUND AND OBJECTIVES: Neoadjuvant chemotherapy (NAC) and chemoradiation (NCRT) have demonstrated improved survival for gastric cancer. However, the optimal neoadjuvant treatment remains unclear. We sought to evaluate perioperative and histopathologic outcomes among neoadjuvant treatments for locoregional gastric cancer.
    METHODS: The National Cancer Database queried patients who received NAC or NCRT followed by resection for T2-T4 and/or node-positive gastric cancer (2006-2018). Logistic and Poisson regression assessed perioperative (30-day readmission, 30- and 90-day mortality, length of stay [LOS]) and histopathologic outcomes (pathologic complete response [PCR], margin status, and negative pathologic lymph nodes [ypN0]). Kaplan-Meier methods and Cox regression assessed overall survival (OS).
    RESULTS: Of 9831 patients, 4221 (42.9%) received NAC and 5610 (57.1%) NCRT. There were no differences in perioperative outcomes, apart from patients treated with NCRT exhibiting increased LOS (incidence rate ratio 1.09, 95% confidence interval [CI] 1.03-1.16). Patients who received NCRT were more likely to achieve PCR, margin-negative resection, and ypN0 (all p < 0.05). Median OS was 36.8 months for NAC and 33.6 months for NCRT (p < 0.001). NCRT independently predicted worse OS (vs. NAC, hazard ratio 1.10, 95% CI 1.03-1.18).
    CONCLUSIONS: NCRT was associated with better histologic tumor response although NAC was associated with improved OS. Better understanding prognostication through histologic assessment following neoadjuvant therapy is needed.
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  • 文章类型: Journal Article
    背景:阿尔茨海默病(AD)是一种具有病理学和临床进展变异性的神经系统疾病。AD患者从β淀粉样蛋白去除疗法的个体水平益处可能不同。
    方法:将随机森林模型应用于EMERGE试验,以创建个体水平治疗反应(ITR)评分,该评分代表高剂量阿杜卡尼单抗相对于安慰剂的个体水平益处。此ITR评分用于测试治疗效果(HTE)异质性的存在。
    结果:我们在临床痴呆评分-方框总和(CDR-SB;P=0.034)中发现了HTE的统计学证据。在ITR评分前25%的组中观察到的CDR-SB益处比其余75%高0.79分(P=0.020)。值得注意的是,最高的治疗反应者海马体积较低,较高的血浆磷酸化tau181和较短的临床AD在基线时的持续时间。
    结论:这项ITR分析为未来AD研究和药物开发中的精准医学提供了概念证明。
    结论:新的试验表明,在减缓早期阿尔茨海默病(AD)的认知功能下降方面,淀粉样β(Aβ)去除对人群水平的益处。这项工作证明了aducanumab在早期AD中的个体水平治疗效果的显着异质性。Aβ去除疗法的最大临床反应者具有更严重的神经退行性过程的模式。
    Alzheimer\'s disease (AD) is a neurological disorder with variability in pathology and clinical progression. AD patients may differ in individual-level benefit from amyloid beta removal therapy.
    Random forest models were applied to the EMERGE trial to create an individual-level treatment response (ITR) score which represents individual-level benefit of high-dose aducanumab relative to the placebo. This ITR score was used to test the existence of heterogeneity in treatment effect (HTE).
    We found statistical evidence of HTE in the Clinical Dementia Rating-Sum of Boxes (CDR-SB;P =  0.034). The observed CDR-SB benefit was 0.79 points greater in the group with the top 25% of ITR score compared to the remaining 75% (P = 0.020). Of note, the highest treatment responders had lower hippocampal volume, higher plasma phosphorylated tau 181 and a shorter duration of clinical AD at baseline.
    This ITR analysis provides a proof of concept for precision medicine in future AD research and drug development.
    Emerging trials have shown a population-level benefit from amyloid beta (Aβ) removal in slowing cognitive decline in early Alzheimer\'s disease (AD). This work demonstrates significant heterogeneity of individual-level treatment effect of aducanumab in early AD. The greatest clinical responders to Aβ removal therapy have a pattern of more severe neurodegenerative process.
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  • 文章类型: Journal Article
    背景:耐药性的发展和高死亡率是非小细胞肺癌(NSCLC)中观察到的主要问题。因此,高度需要指示和预测朝向这些不利方向的疾病发展的生物标志物。许多研究表明,miRNA表达的变化可能与治疗反应和疾病预后有关。因此表明其具有广泛的临床应用的潜在生物标志物价值。本研究的目的是研究miR-181a-5p的表达水平。miR-630及其在NSCLC肿瘤组织和血浆样本中的靶标;并分析其与NSCLC患者对治疗的反应和疾病预后的关系。
    方法:该研究是在美国国家癌症研究所胸外科和肿瘤科接受手术治疗的NSCLC患者中获得的89个配对组织样本和血浆样本中进行的。使用TaqManmiRNA特异性引物通过qRT-PCR进行miR-181a-5p和miR-630表达的分析。而BCL2,LMO3,PTEN,SNAI2、WIF1表达水平用KAPASYBRFASTqPCR试剂盒鉴定。每个样品一式三份检查并按照2-ΔΔCt方法计算。当p值小于0.05时,认为差异具有统计学意义。
    结果:发现与对照样品相比,NSCLC组织和血浆样品中的miR-181a-5p和miR-630表达水平显着降低。此外,miR-181a-5p在肿瘤组织和血浆中低表达的患者比miRNA高表达的患者具有更长的PFS率.肿瘤中miR-630表达降低与NSCLC患者更好的OS显著相关。此外,miR-181a-5p的表达,以及肿瘤组织中的miR-630,是NSCLC患者OS的统计学显著变量。此外,在NSCLC患者血浆样本中,循环miR-181a-5p可被评估为OS和PFS的显著独立预后因素.
    结论:我们的发现表明miR-181a-5p和miR-630表达水平具有预测和预测的潜力,因此可以改善NSCLC患者的个体化治疗和预后。循环miR-181a-5p作为NSCLC的非侵入性生物标志物具有潜在的临床价值。
    BACKGROUND: The development of drug resistance and high mortality rates are the major problems observed in non-small cell lung cancer (NSCLC). Biomarkers indicating and predicting disease development towards these unfavorable directions are therefore on high demand. Many studies have demonstrated that changes in miRNAs expression may be associated with a response to treatment and disease prognosis, thus suggesting its potential biomarker value for a broad spectrum of clinical applications. The aim of the present study was to investigate the expression level of miR-181a-5p, miR-630, and its targets in NSCLC tumor tissue and plasma samples; and to analyze its association with NSCLC patient\'s response to treatment and disease prognosis.
    METHODS: The study was performed in 89 paired tissue specimens and plasma samples obtained from NSCLC patients who underwent surgical treatment at the Department of Thoracic Surgery and Oncology of the National Cancer Institute. Analysis of miR-181a-5p and miR-630 expression was performed by qRT-PCR using TaqMan miRNA specific primers. Whereas BCL2, LMO3, PTEN, SNAI2, WIF1 expression levels were identified with KAPA SYBR FAST qPCR Kit. Each sample was examined in triplicate and calculated following the 2-ΔΔCt method. When the p-value was less than 0.05, the differences were considered statistically significant.
    RESULTS: It was found that miR-181a-5p and miR-630 expression levels in NSCLC tissue and plasma samples were significantly decreased compared with control samples. Moreover, patients with low miR-181a-5p expression in tumor tissue and plasma had longer PFS rates than those with high miRNA expression. Decreased miR-630 expression in tumor was statistically significantly associated with better NSCLC patients\' OS. In addition, the expression of miR-181a-5p, as well as miR-630 in tumor tissue, are the statistically significant variables for NSCLC patients\' OS. Moreover, in NSCLC patient plasma samples circulating miR-181a-5p can be evaluated as significant independent prognostic factors for OS and PFS.
    CONCLUSIONS: Our findings indicate the miR-181a-5p and miR-630 expression levels have the potential to prognose and predict and therefore improve the treatment individualization and the outcome of NSCLC patients. Circulating miR-181a-5p has the potential clinical value as a non-invasive biomarker for NSCLC.
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  • 文章类型: Journal Article
    为了开发准确和可访问的预测方法,以评估手术前NICT后的病理反应,我们进行了一项回顾性研究,纳入了我们中心的137例食管鳞状细胞癌(ESCC)患者,这些患者在2019年1月至2022年3月期间接受了两个周期的NICT手术.我们收集临床参数以评估原发肿瘤的动态变化。进行单变量和多变量分析以确定这些参数与原发性肿瘤的病理反应之间的相关性。随后,我们使用多元逻辑回归构建了pCR和MPR的预测模型。MPR预测模型2使用自举进行内部验证,并使用我们中心的独立队列进行外部验证。单变量逻辑分析显示,在具有不同病理反应的患者中,反映肿瘤消退的临床参数存在显着差异。基于这些评估的临床模型显示出出色的预测性能,训练队列的pCRC指数为0.879,MPRC指数为0.912,而测试队列的MPRC指数也达到了0.912。值得注意的是,阈值截止为0.74的MPR预测模型2表现出92.7%的特异性和大于70%的灵敏度,表明低估残留肿瘤的比率较低。总之,我们的研究证明了基于临床评估的模型在病理反应预测中的高准确性,在诱导免疫化疗后帮助做出有关器官保存和放疗调整的决策。
    To develop accurate and accessible prediction methods for assessing pathologic response following NICT prior to surgery, we conducted a retrospective study including 137 patients with esophageal squamous cell carcinoma (ESCC) who underwent surgery after two cycles of NICT between January 2019 and March 2022 at our center. We collected clinical parameters to evaluate the dynamic changes in the primary tumor. Univariate and multivariate analyses were performed to determine the correlations between these parameters and the pathologic response of the primary tumor. Subsequently, we constructed prediction models for pCR and MPR using multivariate logistic regression. The MPR prediction Model 2 was internally validated using bootstrapping and externally validated using an independent cohort from our center. The univariate logistic analysis revealed significant differences in clinical parameters reflecting tumor regression among patients with varying pathologic responses. The clinical models based on these assessments demonstrated excellent predictive performance, with the training cohort achieving a C-index of 0.879 for pCR and 0.912 for MPR, while the testing cohort also achieved a C-index of 0.912 for MPR. Notably, the MPR prediction Model 2, with a threshold cut-off of 0.74, exhibited 92.7% specificity and greater than 70% sensitivity, indicating a low rate of underestimating residual tumors. In conclusion, our study demonstrated the high accuracy of clinical assessment-based models in pathologic response prediction, aiding in decision-making regarding organ preservation and radiotherapy adjustments after induction immunochemotherapy.
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  • 文章类型: Journal Article
    尽管开发了针对T细胞共刺激和细胞因子TNF的治疗方法,IL-12/23和IL-17,临床试验中不到一半的患者达到高水平的临床反应。这个事实,以及缺乏预后生物标志物代表了主要未满足的临床需求,需要进一步研究疾病的病理生理学。髓样细胞是PsA炎症机制的关键组成部分,作为PsA靶组织活检中高度普遍的免疫群体,如皮肤和滑膜。通过它们的抗原呈递能力和它们的促血管生成和促炎特性,骨髓细胞可能导致PsA的持续炎症,导致治疗抗性疾病。为此,我们最近显示,与健康受试者相比,PsA患者血液中单核细胞的扩增.重要的是,我们还在高活性患者中发现了未成熟的骨髓细胞群,难治性疾病,表明PsA中存在“紧急骨髓生成”过程。
    在本研究协议中,我们旨在破译活动性PsA患者的“髓样特征”,并探讨未成熟髓样细胞在疾病病理生理学中的作用及其作为预后生物标志物的潜力.
    为了解决这个问题,我们将从PsA患者中分离和分析单核细胞和未成熟的骨髓细胞-在6个月的治疗课程之前和之后-重点关注应答者和非应答者之间的差异。在这种情况下,我们将对这些细胞进行彻底的表型和功能分析,在已经建立的全血RNA-seq数据集中识别它们的表达特征,并研究它们在靶组织中的存在,如皮肤和滑液。
    这项研究将通过进一步定义未成熟骨髓细胞在PsA中的参与来阐明骨髓细胞在疾病传播中的作用。
    UNASSIGNED: Despite the development of treatments targeting T cell co-stimulation and cytokines TNF, IL-12/23, and IL-17, less than half of patients within clinical trials achieve high levels of clinical response. This fact, as well as the absence of prognostic biomarkers represents major unmet clinical needs that necessitate further investigation of the disease pathophysiology. Myeloid cells are critical components of PsA inflammatory mechanisms, being a highly prevalent immune population in biopsies of PsA target tissues, such as the skin and the synovium. Through their antigen-presenting capacity and their pro-angiogenic and pro-inflammatory properties myeloid cells could contribute to persistent inflammation in PsA leading to treatment-resistant disease. To this end, we have recently shown the expansion of monocytes in the blood of PsA patients compared to healthy subjects. Importantly, we have also identified an immature myeloid cell population in patients with highly active, refractory disease, indicating the presence of an \"emergency myelopoiesis\" process in PsA.
    UNASSIGNED: In this research protocol, we aim to decipher the pro-inflammatory \"myeloid signature\" in patients with active PsA and explore the role of immature myeloid cells in disease pathophysiology and their potential as prognostic biomarkers.
    UNASSIGNED: To address this, we will isolate and analyse monocytes and immature myeloid cells from PsA patients -before and after a 6-month treatment course- focusing on differences between responders and non-responders. In this context, we will perform a thorough phenotypic and functional analysis of these cells, identify their expression signature in an already established whole blood RNA-seq dataset and investigate their presence in target tissues, such as the skin and synovial fluid.
    UNASSIGNED: This study will elucidate the role of myeloid cells in disease propagation by further defining the involvement of immature myeloid cells in PsA.
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  • 文章类型: Journal Article
    过敏性肺炎(HP)是一种与暴露相关的间质性肺病,具有两种表型-纤维化和非纤维化。遗传易感性是影响疾病发病和纤维化发展的重要因素。几个基因被认为与肺中的纤维化级联有关。最公认和最普遍的是常见的MUC5B基因启动子区多态性变异体rs35705950。我们研究的目的是建立MUC5B基因次要等位基因在HP患者人群中的频率,并发现MUC5B启动子区多态性与肺纤维化发展之间的关系,病程的严重程度,以及HP患者对治疗的反应。对86例连续的HP患者进行了MUC-5B基因的遗传变异rs35705950的测试。人口统计,放射学,并收集功能参数。T等位基因的存在与肺纤维化的关系,肺功能测试参数,并对治疗反应进行分析。研究组的次要等位基因频率为17%,基因型GG在69.8%的受试者和GT/TT在30.2%的受试者中分布。GT/TT表型患者的基线用力肺活量(FVC)显着降低,并且随着时间的推移,FVC的下降频率显着增加。与GG相比,GT/TT变体携带者在高分辨率计算机断层扫描(HRCT)中的肺纤维化患病率并未显着增加。具有T等位基因的患者倾向于对免疫调节治疗的反应较差,并且更频繁地接受抗纤维化药物。结论:HP患者MUC5B多态性频率较高。T等位基因可能表明病程更差,更糟糕的免疫调节治疗反应,早期需要抗纤维化治疗。
    Hypersensitivity pneumonitis (HP) is an exposure-related interstitial lung disease with two phenotypes-fibrotic and non-fibrotic. Genetic predisposition is an important factor in the disease pathogenesis and fibrosis development. Several genes are supposed to be associated with the fibrosing cascade in the lungs. One of the best-recognized and most prevalent is the common MUC5B gene promoter region polymorphism variant rs35705950. The aim of our study was to establish the frequency of the minor allele of the MUC5B gene in the population of patients with HP and to find the relationship between the MUC5B promoter region polymorphism and the development of lung fibrosis, the severity of the disease course, and the response to the treatment in patients with HP. Eighty-six consecutive patients with HP were tested for the genetic variant rs35705950 of the MUC-5B gene. Demographic, radiological, and functional parameters were collected. The relationship between the presence of the T allele and lung fibrosis, pulmonary function test parameters, and the treatment response were analyzed. The minor allele frequency in the study group was 17%, with the distribution of the genotypes GG in 69.8% of subjects and GT/TT in 30.2%. Patients with the GT/TT phenotype had significantly lower baseline forced vital capacity (FVC) and significantly more frequently had a decline in FVC with time. The prevalence of lung fibrosis in high-resolution computed tomography (HRCT) was not significantly increased in GT/TT variant carriers compared to GG ones. The patients with the T allele tended to respond worse to immunomodulatory treatment and more frequently received antifibrotic drugs. In conclusions: The frequency of MUC5B polymorphism in HP patients is high. The T allele may indicate a worse disease course, worse immunomodulatory treatment response, and earlier need for antifibrotic treatment.
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