P-Selectin

p - 选择素
  • 文章类型: Journal Article
    这项研究调查了P-选择素和Clara细胞分泌蛋白16(CC16)水平在儿童重症腺病毒(ADV)肺炎发病机理中的作用,并评估了其预测疾病的能力。51名儿童(年龄,本研究纳入厦门市儿童医院收治的1-5年)患有ADV肺炎的患者,分为轻度组(24例)和重度组(27例)。还包括一个对照组,其中包括在同一时期接受常规体检的同龄健康儿童(30名患者)。单因素分析表明,白细胞计数和C反应蛋白的水平,降钙素原,D-二聚体,与轻度组相比,重度组P-选择素升高,而CC16水平显著降低(p<0.05)。Logistic回归分析显示P-选择素和CC16水平是儿童重症ADV肺炎的独立危险因素。ROC曲线下的面积表明P-选择素和CC16对严重的ADV肺炎表现出很高的预测价值。P-选择素值大于898.58pg/mL,CC16值小于11.355ng/mL可预测严重的ADV肺炎。P-选择素和CC16水平与儿童ADV肺炎的严重程度相关。
    This study investigated the roles of P-selectin and Clara cell secretory protein 16 (CC16) levels in the pathogenesis of severe adenovirus (ADV) pneumonia in children and evaluated their ability to predict disease. Fifty-one children (age, 1-5 years) with ADV pneumonia who were admitted to Xiamen Children\'s Hospital were included in this study and divided into the mild group (24 patients) and severe group (27 patients). A control group comprising healthy children of the same age who underwent routine physical examinations during the same period (30 patients) was also included. The univariate analysis demonstrated that the levels of the white blood cell count and C-reactive protein, procalcitonin, d-dimer, and P-selectin were increased in a severe group compared with a mild group, while CC16 levels were significantly decreased (p < 0.05). The logistic regression analysis revealed that P-selectin and CC16 levels were independent risk factors for severe ADV pneumonia in children. The areas under the ROC curves suggested that P-selectin and CC16 exhibited high predictive value for severe ADV pneumonia. P-selectin values more than 898.58 pg/mL and CC16 values less than 11.355 ng/mL predicted severe ADV pneumonia. P-selectin and CC16 levels are correlated with the severity of ADV pneumonia in children.
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  • 文章类型: Journal Article
    系统性红斑狼疮(SLE)是一种异质性自身免疫性疾病,其特征是严重的器官损害且缺乏治愈性治疗。虽然各种免疫细胞类型,尤其是功能失调的B和T细胞和中性粒细胞,与疾病的发病机制有关,有限的研究集中在单核细胞在SLE中的作用。增加DNA细胞外陷阱,凋亡和坏死与狼疮发病有关。我们的目标是通过研究PSGL-1对单核细胞凋亡和细胞外陷阱(MET)中DNA挤压的控制,分析SLE单核细胞中P-选择蛋白糖蛋白配体1(PSGL-1)对疾病发病机理的贡献。来自活动性疾病患者(aSLE)的单核细胞表现出降低的PSGL-1水平。重要的是,SLE单核细胞中PSGL-1水平降低与几种临床特征相关,包括抗dsDNA自身抗体,狼疮抗凝药,临床肺部受累,和贫血。SLE患者的单核细胞比健康供体(HD)单核细胞对凋亡的敏感性更高,PSGL-1/P-选择素相互作用减少了HD的继发性坏死,但在aSLE单核细胞中则没有。关于MET,aSLE单核细胞比HD单核细胞表现出更高的产生MET的易感性。HD单核细胞与P-选择素的相互作用诱导Syk活化并降低MET中DNA的挤出水平。然而,在aSLE单核细胞中,PSGL-1/P-选择素相互作用不激活Syk或减少挤出DNA的量。我们的数据表明,在aSLE单核细胞中PSGL-1/P-选择素轴功能失调,在METs中不能减少继发性坏死或释放到细胞外培养基中的DNA量,可能导致狼疮的发病机制。
    Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease characterized by severe organ damage and lacking curative treatment. While various immune cell types, especially dysfunctional B and T cells and neutrophils, have been related with disease pathogenesis, limited research has focused on the role of monocytes in SLE. Increased DNA extracellular traps, apoptosis and necrosis have been related to lupus pathogenesis. Our goal is to analyze the contribution of P-selectin glycoprotein ligand 1 (PSGL-1) in SLE monocytes to disease pathogenesis by investigating the control exerted by PSGL-1 on monocyte apoptosis and DNA extrusion in extracellular traps (METs). Monocytes from active disease patients (aSLE) exhibited reduced levels of PSGL-1. Importantly, lower PSGL-1 levels in SLE monocytes associated with several clinical characteristics, including anti-dsDNA autoantibodies, lupus anticoagulant, clinical lung involvement, and anemia. Monocytes from SLE patients showed higher susceptibility to apoptosis than healthy donors (HD) monocytes and PSGL-1/P-selectin interaction decreased secondary necrosis in HD but not in aSLE monocytes. Regarding METs, aSLE monocytes exhibited higher susceptibility to generate METs than HD monocytes. The interaction of HD monocytes with P-selectin induced Syk activation and reduced the levels of DNA extruded in METs. However, in aSLE monocytes, PSGL-1/P-selectin interaction did not activate Syk or reduce the amount of extruded DNA. Our data suggest a dysfunctional PSGL-1/P-selectin axis in aSLE monocytes, unable to reduce secondary necrosis or the amount of DNA released into the extracellular medium in METs, potentially contributing to lupus pathogenesis.
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  • 文章类型: Journal Article
    已显示P-选择蛋白通过促进调节性T细胞(Treg)浸润到肿瘤中来增强小鼠肿瘤的生长和转移。理论上,P-选择素拮抗剂可以抑制该过程。聚乙二醇海藻酸钠(PSS)是一种类肝素的海洋药物,最初在中国被批准用于治疗心血管疾病。以前,我们报道PSS在体外是一种有效的P-选择素拮抗剂。然而,目前尚不清楚PSS是否能在体内调节Treg浸润及其对肺转移的影响。我们的结果表明,30mg/kg的PSS显着抑制了肺转移并改善了总生存率。具有与阳性对照LMWH相当的效力。机制研究表明,PSS通过直接与活化血小板的P-选择素结合来阻断肿瘤细胞的粘附和活化血小板。与模型组相比,处理21天后,PSS将肺中Treg的百分比降低了63%,同时增加了CD8T细胞(1.59倍)和颗粒酶BCD8T细胞(2.08倍)的百分比,以产生系统性肿瘤抑制的适应性反应。研究表明,P-选择素拮抗剂,PSS,通过抑制调节性T细胞(Treg)浸润到肿瘤中来抑制肺转移。
    P-selectin has been shown to enhance growth and metastasis of mouse tumors by promoting regulatory T cell (Treg) infiltration into the tumors. Theoretically, a P-selectin antagonist could suppress the process. Popylene glycol alginate sodium sulfate (PSS) is a heparin-like marine drug, which was originally approved to treat cardiovascular disease in China. Previously, we reported that PSS was an effective P-selectin antagonist in vitro. However, it is unknown whether PSS can regulate Treg infiltration and its effect on lung metastasis in vivo. Our results showed that PSS at 30 mg/kg significantly suppressed lung metastasis and improved overall survival, with potency comparable to the positive control LMWH. Mechanistic study indicated that PSS blocked tumor cells adhesion and activated platelets by directly binding with activated platelet\'s P-selectin. Compared to the model group, PSS decreased the percent of Tregs by 63 % in lungs after treating for 21 days while increasing CD8+ T cells (1.59-fold) and Granzyme B+ CD8 T cells (2.08-fold)\' percentage for generating an adaptive response for systemic tumor suppression. The study indicated that the P-selectin antagonist, PSS, suppressed lung metastasis by inhibiting the infiltration of regulatory T cells (Treg) into the tumors.
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  • 文章类型: Journal Article
    结肠癌的最普遍形式在全球癌症相关死亡中也排名很高。传统的化疗药物不能提供足够的治疗效果,和晚期结肠癌对化疗有相当大的抵抗力。作为口服激酶抑制剂,索拉非尼(SOR)抑制肿瘤细胞的生长,新血管的形成,和癌细胞的死亡。不幸的是,索拉非尼的有限生物利用度,快速新陈代谢,溶解性差严重限制了其临床应用。我们开发了靶向P-选择素和SOR的纳米颗粒,以岩藻依聚糖(FU)作为配体。SOR-CS-FU-NP是通过静电相互作用用壳聚糖和FU涂覆聚乳酸-共-乙交酯纳米颗粒而开发的。SOR-CS-FU-NP的平均粒径为209.98±1.25nm,多分散指数(PDI)为0.229±0.022。SOR-CS-FU纳米颗粒表现出连续释放模式长达120小时。SOR-CS-FU纳米颗粒在HCT116结直肠癌细胞中表现出的细胞毒性比游离SOR大8倍。罗丹明-CS-FU-NP的细胞吸收是游离罗丹明的3倍,是罗丹明-CS-NP的19倍。在SOR-CS-FU-NP中也显示出增强的活性氧(ROS)产生和线粒体膜电位损伤。对细胞死亡的研究发现,SOR-CS-FU-NP的凋亡指数是游离SOR的7.5倍。之后,SOR-CS-FU-NP对细胞迁移有更显著的抑制作用,导致约5%的伤口闭合。当暴露于开发的NP时,在非癌症VERO细胞系中未显示毒性。一起来看,这些结果为生物相容性SOR-CS-FU-NP制备了达沙替尼靶向递送结直肠癌的有效载体提供了有力证据.
    The most prevalent form of colon cancer also ranks high among cancer-related deaths globally. Traditional chemotherapy drugs do not provide sufficient therapeutic efficacy, and advanced colon cancer demonstrates considerable resistance to chemotherapy. As an oral kinase inhibitor, sorafenib (SOR) suppresses the growth of tumour cells, the formation of new blood vessels, and the death of cancer cells. Unfortunately, sorafenib\'s limited bioavailability, rapid metabolism, and poor solubility have severely limited its clinical use. We developed nanoparticles targeting P-selectin and SOR, with fucoidan (FU) as a ligand. The SOR-CS-FU-NPs were developed by coating polylactide-co-glycolide nanoparticles with chitosan and FU through electrostatic interaction. The SOR-CS-FU-NPs exhibited an average particle diameter of 209.98 ± 1.25 nm and a polydisperse index (PDI) of 0.229 ± 0.022. The SOR-CS-FU nanoparticles exhibited a continuous release pattern for up to 120 h. The SOR-CS-FU nanoparticles exhibited cytotoxicity 8 times greater than free SOR in HCT116 colorectal cancer cells. The cellular absorption of Rhodamine-CS-FU-NPs was three times more than that of free Rhodamine and 19 times greater than that of Rhodamine-CS-NPs. Enhanced reactive oxygen species (ROS) generation and mitochondrial membrane potential damage were also shown in SOR-CS-FU-NPs. An investigation of cell death found that SOR-CS-FU-NPs had an apoptosis index that was 7.5 times greater than free SOR. After that, the SOR-CS-FU-NPs demonstrated a more significant inhibition of cell migration, leading to a wound closure of about 5 %. No toxicity was shown in the non-cancer VERO cell line when exposed to the developed NPs. Taken together, these results provide strong evidence that biocompatible SOR-CS-FU-NPs fabricated effective carriers for the targeted delivery of dasatinib to colorectal cancer.
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  • 文章类型: Journal Article
    肥胖与心血管疾病之间的相关性早已被人们所理解,然而,很少有研究试图确定肥胖饮食对血小板活化或功能的影响。由于血小板驱动凝块形成,心血管事件的终点,我们的目的是通过流式细胞术评估血小板活化标志物,阐明肥胖饮食对血小板表型的纵向影响.男性,断奶小鼠喂食西方饮食(30%千卡蔗糖,40%大卡脂肪,8.0%钠)或对照饮食(7%千卡蔗糖,10%大卡脂肪,0.24%钠)。在12、16和20周的饮食中,收集血小板并染色以显示糖蛋白Ibα(GPIbα),胶原刺激后P-选择素和αIIbβ3(血小板特异性整联蛋白)的构象活性状态。在所有时间点,西方饮食广泛降低了血小板中GPIbα和αIIbβ3的表达,而P-选择素水平不受影响。然而,在GPIb-亚群中,通过西方饮食减少P-选择素。因此,西方饮食持续使血小板向钝化的活化反应,如活性αIIbβ3和P-选择素表面表达降低所示。这项研究首次了解了饮食对血小板活化的影响,并揭示了血小板活化易受饮食干预的影响。
    The correlation between obesity and cardiovascular disease has long been understood, yet scant investigations endeavored to determine the impact of an obesogenic diet on platelet activation or function. As platelets drive clot formation, the terminus of cardiovascular events, we aimed to elucidate the longitudinal effect of an obesogenic diet on platelet phenotype by assessing markers of platelet activation using flow cytometry. Male, weanling mice were fed either a Western diet (30% kcal sucrose, 40% kcal fat, 8.0% sodium) or Control diet (7% kcal sucrose, 10% kcal fat, 0.24% sodium). At 12, 16 and 20 weeks on diets, platelets were collected and stained to visualize glycoprotein Ibα (GPIbα), P-selectin and the conformationally active state of αIIbβ3 (a platelet specific integrin) after collagen stimulation. At all time points, a Western diet reduced GPIbα and αIIbβ3 expression in platelets broadly while P-selectin levels were unaffected. However, P-selectin was diminished by a Western diet in the GPIbα- subpopulation. Thus, a Western diet persistently primed platelets towards a blunted activation response as indicated by reduced active αIIbβ3 and P-selectin surface expression. This study provides a first look at the influence of diet on platelet activation and revealed that platelet activation is susceptible to dietary intervention.
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  • 文章类型: Journal Article
    在冠状动脉旁路移植术(CABG)期间,外科手术,特别是心脏主要动脉的操作,诱导显著的炎症状态,可能损害血小板功能,达到需要输注血小板的程度。鉴于储存的血小板是生物介质的主要来源,这项研究调查了血小板输注对主要促聚集的影响,血小板的促炎和免疫调节标志物。20名患者的血小板,10人接受血小板输注,10人没有,在手术前24小时的五个时间点进行流式细胞术,其中P-选择素和CD40配体(CD40L)表达和PAC-1结合(激活特异性抗GPIIb/GPIIIa抗体)分析,立即,2h,术后24h和1周。还使用蛋白质印迹法进行血小板内转化生长因子-β-1(TGF-β1)的分析。血小板输注患者P-选择素水平升高,手术后2小时的CD40L和血小板内TGF-β1与未输血者相比(p<0.05)。输血患者术后24小时PAC-1结合增加(p<0.05)。鉴于输血后血小板TGF-β1的显着升高,一周后输血患者的P-sel/CD40L降低非常有趣。这项研究首次显示了血小板输注对促炎,CABG患者血小板的促聚集和免疫调节状态,表现为立即,中期和延迟后果。虽然促炎性疾病的增加表现为血小板输注的直接作用,促聚集情况出现在输血后24小时.手术后一周,显示输注患者的血小板促炎标志物减弱,这可能是由于TGF-β1的免疫调节作用。
    During coronary artery bypass grafting (CABG), the surgical procedure, particularly the manipulation of the major arteries of the heart, induces a significant inflammatory state that may compromise platelet function to the extent that platelet transfusion is required. Given stored platelets as a major source of biological mediators, this study investigates the effects of platelet transfusion on the major pro-aggregatory, pro-inflammatory and immunomodulatory markers of platelets. Platelets from 20 patients, 10 who received platelet transfusion and 10 without, were subjected to flow cytometery where P-selectin and CD40 ligand (CD40L) expressions and PAC-1 binding (activation-specific anti GPIIb/GPIIIa antibody) analysed at five-time points of 24 h before surgery, immediately, 2 h, 24 h and 1 week after surgery. Analysis of intra-platelet transforming growth factor-beta-1 (TGF-β1) was also conducted using western blotting. Patients with platelet transfusion showed increased levels of P-selectin, CD40L and intra-platelet TGF-β1 2-h after surgery compared to those without transfusion (p < 0.05). PAC-1 binding was increased 24 h after surgery in transfused patients (p < 0.05). Given the significant post-transfusion elevation of platelet TGF-β1, P-sel/CD40L reduction in transfused patients a week after was of much interest. This study showed for the first time the significant effects of platelet transfusion on the pro-inflammatory, pro-aggeregatory and immunomodulatory state of platelets in CABG patients, which manifested with immediate, midterm and delayed consequences. While the increased pro-inflammatory conditions manifested as an immediate effect of platelet transfusion, the pro-aggregatory circumstances emerged 24 h post-transfusion. A week after surgery, attenuations of pro-inflammatory markers of platelets in transfused patients were shown, which might be due to the immunomodulatory effects of TGF-β1.
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  • 文章类型: Journal Article
    ACKR3,一种非典型趋化因子受体,与血栓前事件和心血管事件的发展有关。我们设计了,合成,并评价了一系列新型小分子ACKR3激动剂。广泛的结构-活性关系研究产生了几种有希望的激动剂,其效力范围从低微摩尔到纳摩尔,例如,23(EC50=111nM,Emax=95%)和27(EC50=69nM,Emax=82%)在β-抑制蛋白募集试验中。与ACKR2、CXCR3和CXCR4相比,这些化合物对ACKR3具有选择性。在流式细胞术实验中对几种激动剂进行了其P-选择素表达降低的研究。特别是,化合物23和27显示出最高的血小板聚集抑制效力,高达80%和97%,分别。最有前途的化合物,特别是27,表现出良好的溶解性,代谢稳定性,并且没有细胞毒性,提示治疗血小板介导的血栓形成的潜在工具化合物。
    ACKR3, an atypical chemokine receptor, has been associated with prothrombotic events and the development of cardiovascular events. We designed, synthesized, and evaluated a series of novel small molecule ACKR3 agonists. Extensive structure-activity relationship studies resulted in several promising agonists with potencies ranging from the low micromolar to nanomolar range, for example, 23 (EC50 = 111 nM, Emax = 95%) and 27 (EC50 = 69 nM, Emax = 82%) in the β-arrestin-recruitment assay. These compounds are selective for ACKR3 versus ACKR2, CXCR3, and CXCR4. Several agonists were subjected to investigations of their P-selectin expression reduction in the flow cytometry experiments. In particular, compounds 23 and 27 showed the highest potency for platelet aggregation inhibition, up to 80% and 97%, respectively. The most promising compounds, especially 27, exhibited good solubility, metabolic stability, and no cytotoxicity, suggesting a potential tool compound for the treatment of platelet-mediated thrombosis.
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  • 文章类型: Journal Article
    背景:二氧化钛纳米颗粒(TiO2NP)广泛用于医学应用。然而,尚未完全评估相关健康风险,特别是诱导动脉血栓形成(AT)的潜力。
    方法:使用健康成年男性的外周血样本和体内小鼠模型检查了由TiO2NP诱导的血小板功能和动脉血栓形成的易感性的变化。分别。
    结果:这里,使用从健康志愿者中新鲜分离的人血小板(hPLTs),我们证明TiO2NP处理通过磷脂酰丝氨酸暴露和微泡生成触发了hPLT的促凝血活性。此外,TiO2NP处理增加糖蛋白IIb/IIIa和P-选择素的水平,导致hPLT的聚集和活化,提供模仿生理的条件加剧了这种情况,包括引入凝血酶,胶原蛋白,和高剪切应力。有趣的是,TiO2NP处理后,hPLTs中的细胞内钙水平增加,这对TiO2NP诱导的hPLT促凝血活性至关重要,激活和聚合。此外,使用小鼠体内模型,我们进一步证实TiO2NP治疗小鼠血小板(mPLT)计数减少,血流中断,并加剧颈动脉血栓形成,mPLT沉积增强。
    结论:一起,我们的研究提供了TiO2NP引起的健康风险被忽视的证据,特别是TiO2NP治疗增加促凝血活性,通过钙依赖性机制激活和聚集血小板,从而增加AT的风险。
    BACKGROUND: Titanium dioxide nanoparticles (TiO2NPs) are widely used in medical application. However, the relevant health risk has not been completely assessed, the potential of inducing arterial thrombosis (AT) in particular.
    METHODS: Alterations in platelet function and susceptibility to arterial thrombosis induced by TiO2NPs were examined using peripheral blood samples from healthy adult males and an in vivo mouse model, respectively.
    RESULTS: Here, using human platelets (hPLTs) freshly isolated from health volunteers, we demonstrated TiO2NP treatment triggered the procoagulant activity of hPLTs through phosphatidylserine exposure and microvesicles generation. In addition, TiO2NP treatment increased the levels of glycoprotein IIb/IIIa and P-selectin leading to aggregation and activation of hPLTs, which were exacerbated by providing physiology-mimicking conditions, including introduction of thrombin, collagen, and high shear stress. Interestingly, intracellular calcium levels in hPLTs were increased upon TiO2NP treatment, which were crucial in TiO2NP-induced hPLT procoagulant activity, activation and aggregation. Moreover, using mice in vivo models, we further confirmed that TiO2NP treatment a reduction in mouse platelet (mPLT) counts, disrupted blood flow, and exacerbated carotid arterial thrombosis with enhanced deposition of mPLT.
    CONCLUSIONS: Together, our study provides evidence for an ignored health risk caused by TiO2NPs, specifically TiO2NP treatment augments procoagulant activity, activation and aggregation of PLTs via calcium-dependent mechanism and thus increases the risk of AT.
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  • 文章类型: Journal Article
    镰状细胞病是一种灾难性的炎症性疾病,其特征是微血管血管闭塞,导致高发病率和死亡率增加。P-选择素,细胞粘附分子,在镰状细胞病的发病机制和严重程度中起着至关重要的作用。它的表达和与配体PSGL-1的结合参与各种机制,这些机制有助于炎症和免疫反应。导致镰状细胞病的并发症。临床前数据已证实P-选择素抑制在减轻血管闭塞事件和疾病严重程度方面的功效。目前正在进行临床试验,以评估P-选择素靶向疗法的安全性和有效性,并承认与其使用相关的挑战和局限性。尽管其在减少镰状细胞疾病的严重程度方面的作用已得到证实,未来的研究应该集中在确定粘连级联中的其他新靶点,并探索联合疗法。进行试验和解决可及性问题是充分利用P选择素抑制剂作为开创性治疗选择的潜力的关键步骤。这篇综述着重于理解p选择素的作用及其与炎症分子的相互作用,提供有关分子病因的见解。病理生理学,以及镰状细胞病的潜在治疗靶点。
    Sickle cell disease is a catastrophic inflammatory disorder characterized by microvascular vaso-occlusion, leading to high morbidity and increased mortality. P-selectin, a cell adhesion molecule, plays a crucial role in the pathogenesis and severity of sickle cell disease. Its expression and binding with its ligand PSGL-1 is involved in various mechanisms that contribute to inflammation and immune response, resulting in complications in sickle cell disease. Preclinical data have verified the efficacy of P-Selectin inhibition in mitigating vaso-occlusive events and severity of disease. Currently clinical trials are ongoing to evaluate the safety and efficiency of P-Selectin-targeted therapies and concede the challenges and limitations associated with their use. Despite of its proven role in reducing severity in sickle cell disease, future research should focus on identifying other novel targets within the adhesion cascade and explore combination therapies. Conducting trials and addressing concerns about accessibility are crucial steps towards fully harnessing the potential of P selectin inhibitors as a groundbreaking treatment option. This review focuses on understanding the role of p selectin and its interactions with molecules involved in inflammation providing insights about the molecular etiology, pathophysiology, and potential therapeutic targets in sickle cell disease.
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  • 文章类型: Journal Article
    在动物模型上进行的研究已经确定了几种骨髓纤维化的治疗靶标,最严重的骨髓增殖性肿瘤。不幸的是,许多在临床前环境中有效的药物在临床中测试时疗效不大.这种差异表明,这种疾病的治疗需要联合治疗。为了使可能的组合合理化,将目前用于这些患者的药物(JAK1/2抑制剂Ruxolitinib)在Gata1low模型中的疗效与针对其他异常的药物进行比较,如p27kip1(Aplidin),TGF-β(SB431542,抑制ALK5下游转化生长因子β(TGF-β)信号和TGF-β陷阱AVID200),P-选择素(RB40.34),和CXCL1(Reparixin,抑制CXCL1受体CXCR1/2)。通过表达端点进行比较,这项研究已经发表或回顾性获得,作为相应车辆中数值的倍数变化。在这个模型中,只有Ruxolitinib被发现减少脾脏大小,只有Aplidin和SB431542/AVID200增加血小板计数,除AVID200外,所有抑制剂均降低了纤维化和微血管密度。最大的影响是由瑞帕利辛发挥的,这也降低了TGF-β的含量。这些药物均未减少石骨症。这些结果表明,未来的骨髓纤维化疗法应考虑将JAK1/2抑制剂与靶向造血干细胞(p27Kip1)或促炎环境(TGF-β或CXCL1)的药物联合使用。
    Studies conducted on animal models have identified several therapeutic targets for myelofibrosis, the most severe of the myeloproliferative neoplasms. Unfortunately, many of the drugs which were effective in pre-clinical settings had modest efficacy when tested in the clinic. This discrepancy suggests that treatment for this disease requires combination therapies. To rationalize possible combinations, the efficacy in the Gata1low model of drugs currently used for these patients (the JAK1/2 inhibitor Ruxolitinib) was compared with that of drugs targeting other abnormalities, such as p27kip1 (Aplidin), TGF-β (SB431542, inhibiting ALK5 downstream to transforming growth factor beta (TGF-β) signaling and TGF-β trap AVID200), P-selectin (RB40.34), and CXCL1 (Reparixin, inhibiting the CXCL1 receptors CXCR1/2). The comparison was carried out by expressing the endpoints, which had either already been published or had been retrospectively obtained for this study, as the fold change of the values in the corresponding vehicles. In this model, only Ruxolitinib was found to decrease spleen size, only Aplidin and SB431542/AVID200 increased platelet counts, and with the exception of AVID200, all the inhibitors reduced fibrosis and microvessel density. The greatest effects were exerted by Reparixin, which also reduced TGF-β content. None of the drugs reduced osteopetrosis. These results suggest that future therapies for myelofibrosis should consider combining JAK1/2 inhibitors with drugs targeting hematopoietic stem cells (p27Kip1) or the pro-inflammatory milieu (TGF-β or CXCL1).
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