cord blood

脐带血
  • 文章类型: Journal Article
    母亲吸烟与新生儿的不良健康结局有关,但其影响新生儿健康的程度尚未通过汇总脐带血DNA甲基化(DNAm)评分进行量化。这里,在欧洲白人和南亚人群中,我们研究了利用脐带血DNAm评分作为发现样本来捕获孕妇吸烟的表观遗传特征及其对新生儿的影响的可行性.
    我们首先检查了个体CpG与怀孕期间吸烟之间的关联,和吸烟暴露在两个欧洲白人出生队列中(n=744)。利用已建立的CpG来吸烟,我们构建了孕妇吸烟的脐带血表观遗传评分,该评分在一个欧洲裔队列中得到验证(n=347).然后测试这个分数与吸烟状况的关系,怀孕期间二次吸烟,在独立的欧洲白人(n=397)和南亚出生队列(n=504)中测量出生后后代的健康结果。
    先前报道的几个母亲吸烟基因得到了支持,具有来自GFI1基因的最强和最一致的关联信号(6个CpG,p<5×10-5)。表观遗传母亲吸烟评分与怀孕期间的吸烟状况密切相关(OR=1.09[1.07,1.10],p=5.5×10-33)以及每周自我报告吸烟暴露的更多小时(1.93[1.27,2.58],p=7.8×10-9)在欧洲白人中。然而,它与南亚人自我报告的暴露无关(p>0.05),可能是由于该组中缺乏吸烟。相同的分数始终与较小的出生尺寸(-0.37±0.12cm,p=0.0023)在南亚队列中,出生体重较低(-0.043±0.013kg,组合队列中的p=0.0011)。
    这项脐带血表观遗传评分可以帮助识别暴露于母亲吸烟的婴儿,并评估其对生长的长期影响。值得注意的是,这些结果表明,孕妇吸烟的DNAm特征与新生儿身材矮小和低出生体重之间存在一致的关联,在欧洲白人母亲谁表现出一定程度的吸烟和南亚母亲谁自己不是积极的吸烟者。
    本研究由加拿大健康研究院代谢组学研究团队资助:MWG-146332。
    UNASSIGNED: Maternal smoking has been linked to adverse health outcomes in newborns but the extent to which it impacts newborn health has not been quantified through an aggregated cord blood DNA methylation (DNAm) score. Here, we examine the feasibility of using cord blood DNAm scores leveraging large external studies as discovery samples to capture the epigenetic signature of maternal smoking and its influence on newborns in White European and South Asian populations.
    UNASSIGNED: We first examined the association between individual CpGs and cigarette smoking during pregnancy, and smoking exposure in two White European birth cohorts (n=744). Leveraging established CpGs for maternal smoking, we constructed a cord blood epigenetic score of maternal smoking that was validated in one of the European-origin cohorts (n=347). This score was then tested for association with smoking status, secondary smoking exposure during pregnancy, and health outcomes in offspring measured after birth in an independent White European (n=397) and a South Asian birth cohort (n=504).
    UNASSIGNED: Several previously reported genes for maternal smoking were supported, with the strongest and most consistent association signal from the GFI1 gene (6 CpGs with p<5 × 10-5). The epigenetic maternal smoking score was strongly associated with smoking status during pregnancy (OR = 1.09 [1.07, 1.10], p=5.5 × 10-33) and more hours of self-reported smoking exposure per week (1.93 [1.27, 2.58], p=7.8 × 10-9) in White Europeans. However, it was not associated with self-reported exposure (p>0.05) among South Asians, likely due to a lack of smoking in this group. The same score was consistently associated with a smaller birth size (-0.37±0.12 cm, p=0.0023) in the South Asian cohort and a lower birth weight (-0.043±0.013 kg, p=0.0011) in the combined cohorts.
    UNASSIGNED: This cord blood epigenetic score can help identify babies exposed to maternal smoking and assess its long-term impact on growth. Notably, these results indicate a consistent association between the DNAm signature of maternal smoking and a small body size and low birth weight in newborns, in both White European mothers who exhibited some amount of smoking and in South Asian mothers who themselves were not active smokers.
    UNASSIGNED: This study was funded by the Canadian Institutes of Health Research Metabolomics Team Grant: MWG-146332.
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  • 文章类型: Journal Article
    母亲肥胖是一个健康问题,可能会使新生儿在以后的生活中出现医疗问题的风险很高。了解母亲肥胖的跨代效应,我们进行了一项多组学研究,使用DNA甲基化和基因表达在CD34+/CD38-/Lin-脐带血造血干细胞(uHSCs)和代谢组学的脐带血,全部来自檀香山Kapiolani妇女和儿童医学中心的多种族队列(n=72),夏威夷(2016年至2018年收集)。
    差异甲基化(DM)分析揭示了孕妇孕前肥胖组的整体超甲基化模式(BH调整p<0.05),在调整了主要临床混杂因素后。综合功能分析显示细胞周期相关基因的启动子高度甲基化,蛋白质合成,免疫信号,和脂质代谢。利用Shannon熵对uHSCs甲基化,我们发现受母亲肥胖影响的uHSC的静止期明显较高。此外,多组学数据的整合-包括甲基化,基因表达,代谢组学提供了脂肪生成功能障碍的进一步证据,促红细胞生成素的生产,细胞分化,和DNA修复,与表观遗传水平的发现一致。
    这项研究揭示了孕前母亲肥胖与子代uHSCs的多组学水平分子变化之间的显着相关性,特别是在DNA甲基化中。
    UNASSIGNED: Maternal obesity is a health concern that may predispose newborns to a high risk of medical problems later in life. To understand the transgenerational effect of maternal obesity, we conducted a multi-omics study, using DNA methylation and gene expression in the CD34+/CD38-/Lin- umbilical cord blood hematopoietic stem cells (uHSCs) and metabolomics of the cord blood, all from a multi-ethnic cohort (n=72) from Kapiolani Medical Center for Women and Children in Honolulu, Hawaii (collected between 2016 and 2018).
    UNASSIGNED: Differential methylation (DM) analysis unveiled a global hypermethylation pattern in the maternal pre-pregnancy obese group (BH adjusted p<0.05), after adjusting for major clinical confounders. Comprehensive functional analysis showed hypermethylation in promoters of genes involved in cell cycle, protein synthesis, immune signaling, and lipid metabolism. Utilizing Shannon entropy on uHSCs methylation, we discerned notably higher quiescence of uHSCs impacted by maternal obesity. Additionally, the integration of multi-omics data-including methylation, gene expression, and metabolomics-provided further evidence of dysfunctions in adipogenesis, erythropoietin production, cell differentiation, and DNA repair, aligning with the findings at the epigenetic level.
    UNASSIGNED: This study reveals the significant correlation between pre-pregnancy maternal obesity and multi-omics level molecular changes in the uHSCs of offspring, particularly in DNA methylation.
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  • 文章类型: Journal Article
    食物过敏和湿疹是儿童期最早的过敏表型。这些疾病可能与IgE介导的或非IgE介导的对变应原的反应有关。TNFRSF17是B细胞成熟的关键分子,在两种类型的反应中都很重要。我们进行了一项研究,比较了儿童早期特应性致敏和过敏性表型的TNFRSF17的相对表达和甲基化状态。在招募的200名妇女和174名儿童中,有可用的临床数据(通过变态反应者和抗原特异性IgE测量进行的体格检查),78个脐带血样品包括在基因表达分析中(通过RT-PCR以GAPDH作为参考的相对基因表达)和96个样品包括微阵列DNA甲基化数据(全基因组甲基化谱Infinium甲基化EPIC)。在儿童早期发生食物过敏和/或湿疹的儿童中,观察到脐带血中单个cg04453550和TNFRSF17上游平均甲基化模式的改变。相对表达反映了甲基化谱的变化。IgE对食物和/或吸入性过敏原的致敏特性与TNFRSF17的甲基化或表达无显著关联。总之,出生时脐带血TNFRSF17上游位点的甲基化与儿童早期食物过敏和湿疹相关.
    Food allergy and eczema are the earliest allergic phenotypes in childhood. These diseases could be related to either IgE-mediated or non-IgE-mediated reactions to the allergen. TNFRSF17 is a key molecule in B cell maturation and is important in both types of responses.We conducted a study comparing the relative expression and the methylation status at the TNFRSF17 in regard to the child\'s early atopic sensitisation and allergic phenotypes.In the recruited population of 200 women and 174 children with available clinical data (physical examination by allergist and antigen-specific IgE measurements), 78 cord blood samples were included in the gene expression analysis (relative gene expression with GAPDH as reference by RT-PCR) and 96 samples with microarray DNA methylation data (whole genome methylation profile Infinium MethylationEPIC).The altered TNFRSF17 methylation pattern in the cord blood at both single cg04453550 and mean methylation at upstream of TNFRSF17 was observed in children who developed food allergy and/or eczema in early childhood. The change in methylation profile was mirrored by the relative expression. The profile of IgE sensitisation to food and/or inhalant allergens was not significantly associated with either methylation or expression of TNFRSF17.In conclusion, methylation at the upstream sites at TNFRSF17 in the cord blood at birth is associated with food allergy and eczema early in childhood.
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  • 文章类型: Journal Article
    目的:胎球蛋白B是一种与葡萄糖稳态和脂质代谢有关的肝细胞/脂肪因子。我们试图评估妊娠期糖尿病(GDM)中脐带血胎球蛋白B水平是否发生变化,以及与胎儿生长因子和脂质的关系。
    在一项对上海出生队列中153对GDM和正常血糖妊娠的母亲的巢式病例对照研究中,我们评估了脐带血胎球蛋白B与胎儿生长因子和脂质的关系[高密度脂蛋白(HDL),低密度脂蛋白(LDL),总胆固醇(TC)和甘油三酯(TG)]。
    结果:GDM新生儿脐血胎球蛋白B浓度高于正常血糖的母亲(平均值±SD:2.35±0.96vs2.05±0.73mg/L,P=0.012),与LDL呈正相关(r=0.239,P<0.0001),TC(r=0.230,P=0.0001),胰岛素样生长因子-Ⅰ[IGF-Ⅰ(r=0.137,P=0.023)]和IGF-Ⅱ(r=0.148,P=0.014)浓度。根据母体和新生儿特征进行调整,观察到类似的关联。
    结论:这项研究首次证明胎球蛋白B水平在GDM的胎儿期升高,并且胎球蛋白B会影响人类胎儿时期的脂质代谢健康。胎球蛋白B的分泌与胰岛素样生长因子(IGF-Ⅰ和IGF-Ⅱ)的分泌有关。
    OBJECTIVE: Fetuin-B is a hepatokine/adipokine implicated in glucose homeostasis and lipid metabolism. We sought to assess whether cord blood fetuin-B levels are altered in gestational diabetes mellitus (GDM) and the association with fetal growth factors and lipids.
    UNASSIGNED: In a nested case-control study of 153 pairs of neonates of mothers with GDM and euglycemic pregnancies in the Shanghai Birth Cohort, we assessed cord blood fetuin-B in relation to fetal growth factors and lipids [high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterols (TC) and triglycerides (TG)].
    RESULTS: Cord blood fetuin-B concentrations were higher in the newborns of GDM vs. euglycemic mothers (mean ± SD: 2.35±0.96 vs 2.05±0.73 mg/L, P=0.012), and were positively correlated with LDL (r=0.239, P<0.0001), TC (r=0.230, P=0.0001), insulin-like growth factor-Ⅰ [IGF-Ⅰ (r=0.137, P=0.023)] and IGF-Ⅱ (r=0.148, P=0.014) concentrations. Similar associations were observed adjusting for maternal and neonatal characteristics.
    CONCLUSIONS: The study is the first to demonstrate that fetuin-B levels are elevated in fetal life in GDM, and that fetuin-B affects lipid metabolic health during fetal life in humans. The secretion of fetuin-B appears to be related to the secretion of insulin-like growth factors (IGF-Ⅰ and IGF-Ⅱ).
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  • 文章类型: Journal Article
    富血小板血浆(PRP),含有高浓度血小板的血液制品,由于其抗炎和再生特性,已越来越多地用于治疗多种疾病。在临床应用中,PRP通常从患者自身的外周血中获得,但从脐带血中提取的同种异体PRP也因其独特的优势而备受关注。本综述的主要目的是总结截至2024年4月脐带血来源的PRP(CB-PRP)在疾病治疗中的研究和临床应用。本文还讨论了CB-PRP和自体PRP(A-PRP)的差异。对PubMed®和Clinicaltrials.gov的彻底搜索确定了13篇文章和4项临床试验。迄今为止,CB-PRP主要在骨科领域进行了研究,皮肤病学,神经学,妇产科和眼科。这可能是因为这项研究相对新颖。考虑到A-PRP和CB-PRP特性的差异,认为CB-PRP在未来更广泛的应用中可能会有更多的希望。
    Platelet-rich plasma (PRP), a blood product containing high concentrations of platelets, has been increasingly used for the treatment of a number of diseases because of its anti-inflammatory and regenerative properties. PRP is generally obtained from the patient\'s own peripheral blood when used in clinical applications, but allogeneic PRP extracted from umbilical cord blood has also attracted attention due to its unique advantages. The main purpose of this narrative review was to summarize the research and clinical application of cord blood-derived PRP (CB-PRP) in the treatment of diseases up to April 2024. This review also discusses the differences between CB-PRP and autologous PRP (A-PRP). A thorough search of PubMed® and Clinicaltrials.gov identified 13 articles and four clinical trials. To date, CB-PRP has been primarily studied in the fields of orthopaedics, dermatology, neurology, obstetrics/gynaecology and ophthalmology. This is likely to be because this research is relatively novel. Considering the differences between the characteristics of A-PRP and CB-PRP, it is thought that CB-PRP might hold more promise for broader applications in the future.
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  • 文章类型: Journal Article
    背景:围产期缺氧可能导致凝血功能障碍。围产期胎儿/新生儿的血流量或氧气减少会导致骨髓和肝功能受损,导致血小板减少症,凝血和纤溶因子合成受损,并增加小血管中血小板的破坏。本研究的目的是通过脐带血样本中的非活化血栓弹性测定法(NATEM)评估围产期缺氧新生儿的止血状态。
    方法:在本观察性队列研究中纳入了在我们的产科出生1.5年的134例缺氧新生儿,189例健康新生儿作为对照组。参与研究是自愿的,父母在招募前签署了知情同意书。入院时记录人口统计学和临床数据,并对脐带血样本进行NATEM方法。评估了以下NATEM值:凝血时间(CT),α角(α角),凝块形成时间(CFT),凝块振幅在5和10分钟。(A5,A10),最大凝块硬度(MCF),60分钟时的凝块溶解指数。CT(LI60)后,和最大凝块弹性(MCE)。采用SASforWindows9.4软件平台进行统计分析。
    结果:与健康新生儿相比,围产期缺氧的新生儿显示纤溶潜能降低,如增加的LI60所示,这种差异具有统计学意义(LI60:94(92-96)vs93(91-95),p值=0.0001)。其余NATEM变量之间没有统计上的显着差异。
    结论:我们的研究结果表明,与健康新生儿相比,低氧新生儿的纤溶潜能降低,这表明NATEM可以作为及时识别这组新生儿止血功能障碍的有效工具。
    BACKGROUND: Perinatal hypoxia may result in coagulation dysfunction. Diminished blood flow or oxygen to the fetus/neonate during the perinatal period can cause bone marrow and liver function impairment, leading to thrombocytopenia, impaired synthesis of clotting and fibrinolytic factors, and increased destruction of platelets in the small blood vessels. The goal of the present study was to evaluate the hemostatic status of newborns with perinatal hypoxia via the non-activated thromboelastometry (NATEM) assay in cord blood samples.
    METHODS: 134 hypoxic neonates born in our maternity unit over a 1.5-year period were enrolled in this observational cohort study, and 189 healthy neonates served as the control group. Participation in the study was voluntary and parents signed informed consent prior to recruitment. Demographic and clinical data were recorded on admission, and the NATEM method was performed on cord blood samples. The following NATEM values were evaluated: clotting time (CT), alpha angle (α-angle), clot formation time (CFT), clot amplitude at 5 and 10 min. (A5, A10), maximum clot firmness (MCF), clot lysis index at 60 min. after CT (LI60), and maximum clot elasticity (MCE). Statistical analysis was conducted utilizing the SAS for Windows 9.4 software platform.
    RESULTS: Neonates with perinatal hypoxia exhibited decreased fibrinolytic potential in comparison to healthy neonates, as indicated by increased LI60, and this difference was statistically significant (LΙ60: 94 (92-96) Vs 93 (91-95), p value = 0.0001). There were no statistically significant differences noted among the remaining NATEM variables.
    CONCLUSIONS: Our findings indicate decreased fibrinolytic potential in hypoxic neonates in comparison to healthy neonates, suggesting that NATEM could serve as an effective tool for promptly identifying hemostasis dysfunction in this group of neonates.
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  • 文章类型: Journal Article
    目的:孤独症谱系障碍(ASD)与脂质代谢异常有关,例如多不饱和脂肪酸(PUFA)中omega-6与omega-3的高总比率。PUFA通过细胞色素P450(CYP)代谢为环氧脂肪酸;然后,二羟基脂肪酸是由可溶性环氧化物水解酶产生的。这项研究检查了脐带血中PUFA代谢物与儿童ASD症状和适应功能之间的关系。
    方法:本前瞻性队列研究利用脐带血对CYP通路的PUFA代谢物进行定量。自闭症诊断观察时间表(ADOS-2)和Vineland适应行为量表,第二版(VABS-II)用于评估6岁儿童随后的ASD症状和适应功能。分析包括200名儿童和他们的母亲。
    结果:花生四烯酸衍生的二醇,发现11,12-diHETrE会影响ASD症状严重程度,影响ADOS-2校准的严重程度评分和VABS-II评估的社会化领域的损害(P=0.0003;P=0.004,分别)。高水平的11,12-diHETrE影响ASD症状的社会影响(P=0.002),而低水平的8,9-diHETrE影响重复/限制性行为(P=0.003)。值得注意的是,diHETrE和ASD症状之间的关联具有特异性,尤其是女孩。
    结论:这些发现表明,胎儿期diHETrE的动力学在出生后儿童的发育轨迹中很重要。鉴于二醇代谢物在体内神经发育中的作用完全没有特征,这项研究的结果为diHETrE和ASD病理生理学的作用提供了重要的见解。
    OBJECTIVE: Autism spectrum disorder (ASD) is associated with abnormal lipid metabolism, such as a high total ratio of omega-6 to omega-3 in polyunsaturated fatty acids (PUFAs). PUFAs are metabolized to epoxy fatty acids by cytochrome P450 (CYP); then, dihydroxy fatty acid is produced by soluble epoxide hydrolase. This study examined the association between PUFA metabolites in the cord blood and ASD symptoms and adaptive functioning in children.
    METHODS: This prospective cohort study utilized cord blood to quantify PUFA metabolites of the CYP pathway. The Autism Diagnostic Observation Schedule (ADOS-2) and Vineland Adaptive Behaviors Scales, Second Edition (VABS-II) were used to assess subsequent ASD symptoms and adaptive functioning in children at 6 years. The analysis included 200 children and their mothers.
    RESULTS: Arachidonic acid-derived diols, 11,12-diHETrE was found to impact ASD symptom severity on the ADOS-2-calibrated severity scores and impairment in the socialization domain as assessed by the VABS-II (P = 0.0003; P = 0.004, respectively). High levels of 11,12-diHETrE impact social affect in ASD symptoms (P = 0.002), while low levels of 8,9-diHETrE impact repetitive/restrictive behavior (P = 0.003). Notably, there was specificity in the association between diHETrE and ASD symptoms, especially in girls.
    CONCLUSIONS: These findings suggest that the dynamics of diHETrE during the fetal period is important in the developmental trajectory of children after birth. Given that the role of diol metabolites in neurodevelopment in vivo is completely uncharacterized, the results of this study provide important insight into the role of diHETrE and ASD pathophysiology.
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  • 文章类型: Journal Article
    背景:脐带血移植(UCBT)改善了缺乏完全匹配供体的患者的移植途径。先前的国际血液和骨髓移植研究中心(CIBMTR)显示,黑人患者的总体生存率(OS)低于白人患者。当前的研究借鉴了一个更大的现代队列,并比较了怀特,Latinx,黑色,亚洲患者。
    目的:比较健康的社会决定因素的结果。
    方法:我们设计了一项使用CIBMTR数据的回顾性研究。美国患者年龄在1至80岁之间;根据CIBMTR的报告,983人接受了单UCBT和1529人接受了双UCBT,在清髓性(N=1752)或降低强度条件(N=759)治疗急性髓系白血病后,急性淋巴样白血病,或者骨髓增生异常.主要结果是2年OS。次要结果包括无病生存率,移植相关死亡率(TRM),急性和慢性移植物抗宿主病(GVHD),和GVHD免费,无复发生存率(GRFS)。
    结果:对于1705名成年人,在单变量分析中,白人的两年OS为41.5%(99%CI,37.6-45.3),拉丁裔36.1%(99%CI,28.2-44.5),黑人的45.8%(99%CI,36.7-55.1),亚洲人占44.5%(99%CI,33.6-55.6)。在对成年人的多变量分析中,与黑人患者相比,Latinx患者的OS较差(p=0.0005,HR1.45,99%CI1.18-1.79)。随着时间的推移,所有种族/族裔群体的操作系统都得到了改善。不同种族/族裔群体的GVHD发生率相当。在807个孩子中,在单因素分析中,白人的2年OS为66.1%(99%CI,59.7-72.2),拉丁裔57.1%(99CI,49-64.9),黑人占46.8%(99CI,35.3-58.4),亚洲人占53.8%(99CI,32.7-74.2)。在多变量分析中,在种族/族裔群体中,OS无差异(p=0.051).与白人(p=0.0016,HR2.25,99%CI1.36-3.74)和Latinx(p=0.0016,HR2.17,99%CI1.43-3.30)相比,黑人的III/IV级急性GVHD更高。从相似种族和种族的捐赠者那里获得UCB单位没有生存优势,对于任何种族/族裔群体,对于儿童和成人。黑人和拉丁裔成年患者更有可能生活在被定义为高贫困的地区。来自高贫困地区的患者OS较差(p=0.03),由于较高的TRM率(p=0.04)。教育水平,保险类型并不影响整体生存率,GVHD,TRM或其他移植结果。贫困率较高地区的儿童有较高的TRM,不分种族和民族(p=0.02)。公共健康保险,比如医疗补助,也与较高的TRM相关(p=0.02)。然而,贫困不会影响儿科OS,DFS,或其他移植后结果。
    结论:UCBT的操作系统随着时间的推移有所改善。在成年人中,OS在白人中是可比的,黑人,和亚洲人,拉丁裔患者较低。在儿童中,OS在白人中是可比的,黑人,Latinx,亚洲人,但Black患者的III/IV级急性GVHD较高。成人和儿童按种族和种族匹配UCB单位和患者没有生存益处。
    BACKGROUND: Umbilical cord blood transplant (UCBT) improves access to transplant for patients lacking a fully matched donor. Previous Center for International Blood and Marrow Transplant Research (CIBMTR) showed that Black patients had a lower overall survival (OS) than White patients following single UCBT. The current study draws on a larger modern cohort and compares outcomes among White, Latinx, Black, and Asian patients.
    OBJECTIVE: To compare outcomes by social determinants of health.
    METHODS: We designed a retrospective study using CIBMTR data. US patients were between ages 1 and 80; 983 received single and 1529 double UCBT as reported to CIBMTR, following either a myeloablative (N = 1752) or reduced intensity conditioning (N = 759) for acute myeloid leukemia, acute lymphoid leukemia, or myelodysplasia. The primary outcome was 2-year OS. Secondary outcomes included disease free survival, transplant related mortality (TRM), acute and chronic graft vs host disease (GVHD), and GVHD free, relapse free survival (GRFS).
    RESULTS: For 1705 adults, in univariate analysis, 2-year OS was 41.5% (99% CI, 37.6 to 45.3) for Whites, 36.1% (99% CI, 28.2 to 44.5) for Latinx, 45.8% (99% CI, 36.7 to 55.1) for Blacks, and 44.5% (99% CI, 33.6 to 55.6) for Asians. In multivariate analysis of adults, Latinx patients had inferior OS compared to black patients (p = .0005, HR 1.45, 99% CI 1.18 to 1.79). OS improved over time for all racial/ethnic groups. GVHD rates were comparable among the different racial/ethnic groups. In the 807 children, the 2-year OS in univariate analysis was 66.1% (99% CI, 59.7 to 72.2) for Whites, 57.1% (99%CI, 49 to 64.9) for Latinx, 46.8% (99%CI, 35.3 to 58.4) for Blacks, and 53.8% (99%CI, 32.7 to 74.2) for Asians. In multivariate analysis, no difference in OS was observed among racial/ethnic groups (p = .051). Grade III/IV acute GVHD was higher in Blacks compared with Whites (p = .0016, HR 2.25, 99% CI 1.36 to 3.74) and Latinx (p = .0016, HR 2.17, 99% CI 1.43 to 3.30). There was no survival advantage to receiving a UCB unit from a donor of similar race and ethnicity, for any racial/ethnic groups, for both children and adults. Black and Latinx adult patients were more likely to live in areas defined as high poverty. Patients from high poverty level areas had worse OS (p = .03), due to a higher rate of TRM (p=0.04). Educational level, and type of insurance did not impact overall survival, GVHD, TRM or other transplant outcomes. Children from areas with a higher poverty level had higher TRM, regardless of race and ethnicity (p = .02). Public health insurance, such as Medicaid, was also associated with a higher TRM (p = .02). However, poverty did not impact pediatric OS, DFS, or other post-transplant outcomes.
    CONCLUSIONS: OS for UCBT has improved over time. In adults, OS is comparable among Whites, Blacks, and Asians and lower for Latinx patients. In children, OS is comparable among Whites, Blacks, Latinx, and Asians, but Grade III/IV acute GVHD was higher in Black patients. There was no survival benefit to matching UCB unit and patient by race and ethnicity for adults and children.
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  • 文章类型: Journal Article
    应用造血干细胞(HSC)的治疗方法的主要挑战是细胞数量。本研究的主要目的是使用生物信息学工具预测miRNAs和抗miRNAs,并研究它们对预测增殖改善的关键基因表达水平的影响。和抑制从人脐带血(HUCB)分离的HSC的分化。通过利用KEGG信号通路丰富文本(PubMed)和StemChecker服务器数据,构建了一个包含与HSC分化和增殖阶段相关基因的网络,并使用GEO数据集进行了改进。生物信息学工具预测了含有miR-20a-5p的miRNA的谱,miR-423-5p,和由5'-miR-340/3'-miR-524构建的嵌合抗miRNA,用于网络中的高分基因(RB1,SMAD4,STAT1,CALML4,GNG13和CDKN1A/CDKN1B基因)。使用聚乙烯亚胺(PEI)将miRNA和抗miRNA转移到HSC中。在含有PEI+(miRNA/抗miRNA)的细胞组中使用RT-qPCR技术估计基因表达水平(n=6)。此外,使用流式细胞术评估CD标志物(90、16和45)。发现高分基因之间有很强的关系,miRNA,和嵌合抗miRNA。miR-20a-5p可显著降低RB1、SMAD4和STAT1基因表达水平(P<0.05)。此外,抗miRNA提高了GNG13的基因表达水平(P<0.05),miR-423-5p降低了CDKN1A基因的表达水平(P<0.01)。细胞计数也显着增加(P<0.05),但CD45分化标记在细胞组中没有变化。该研究揭示了预测的miRNA/抗miRNA谱扩增了从HUCB分离的HSC。虽然miR-20a-5p抑制参与细胞分化的RB1,SMAD4和STAT1基因,抗-miRNA促进了GNG13基因的增殖过程。值得注意的是,混合miRNA/抗miRNA组表现出最高的细胞扩增。这种方法有望提高HSC治疗中的细胞数量。
    A major challenge in therapeutic approaches applying hematopoietic stem cells (HSCs) is the cell quantity. The primary objective of this study was to predict the miRNAs and anti-miRNAs using bioinformatics tools and investigate their effects on the expression levels of key genes predicted in the improvement of proliferation, and the inhibition of differentiation in HSCs isolated from Human umbilical cord blood (HUCB). A network including genes related to the differentiation and proliferation stages of HSCs was constructed by enriching data of text (PubMed) and StemChecker server with KEGG signaling pathways, and was improved using GEO datasets. Bioinformatics tools predicted a profile from miRNAs containing miR-20a-5p, miR-423-5p, and chimeric anti-miRNA constructed from 5\'-miR-340/3\'-miR-524 for the high-score genes (RB1, SMAD4, STAT1, CALML4, GNG13, and CDKN1A/CDKN1B genes) in the network. The miRNAs and anti-miRNA were transferred into HSCs using polyethylenimine (PEI). The gene expression levels were estimated using the RT-qPCR technique in the PEI + (miRNA/anti-miRNA)-contained cell groups (n = 6). Furthermore, CD markers (90, 16, and 45) were evaluated using flow cytometry. Strong relationships were found between the high-score genes, miRNAs, and chimeric anti-miRNA. The RB1, SMAD4, and STAT1 gene expression levels were decreased by miR-20a-5p (P < 0.05). Additionally, the anti-miRNA increased the gene expression level of GNG13 (P < 0.05), whereas the miR-423-5p decreased the CDKN1A gene expression level (P < 0.01). The cellular count also increased significantly (P < 0.05) but the CD45 differentiation marker did not change in the cell groups. The study revealed the predicted miRNA/anti-miRNA profile expands HSCs isolated from HUCB. While miR-20a-5p suppressed the RB1, SMAD4, and STAT1 genes involved in cellular differentiation, the anti-miRNA promoted the GNG13 gene related to the proliferation process. Notably, the mixed miRNA/anti-miRNA group exhibited the highest cellular expansion. This approach could hold promise for enhancing the cell quantity in HSC therapy.
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  • 文章类型: Journal Article
    背景:证据表明,产前全氟烷基物质和多氟烷基物质(PFAS)和金属,在人群中普遍存在的两类化学物质,影响免疫系统的发育和反应。
    目的:我们评估了孕早期血PFAS和金属是否与抗原或丝裂原刺激的脐带血淋巴细胞增殖和细胞因子分泌有关。
    方法:我们测量了六个PFAS,以及六种非必需金属和四种必需金属,在纵向早产项目万岁队列参与者的早期妊娠血液中,1999-2000年在马萨诸塞州东部招募。我们测量了抗原或丝裂原刺激的脐带血单核细胞增殖反应(n=269-314)和细胞因子分泌(n=217-302)。我们使用协变量调整的最小绝对收缩和选择算子(LASSO)进行变量选择和多变量回归,以估计与免疫标记的关联。
    结果:每ng/mL的MeFOSAA与卵抗原刺激后的3.6%(1.4,5.8)的淋巴细胞增殖反应有关,以及0.8(0.7,1.0)降低了对尘螨的反应中检测到IFN-γ的几率。铯的每ng/g增加与对尘螨的反应中IL-10水平降低27.8%(-45.1,-4.9)相关。汞的每ng/g增加与响应丝裂原PHA的12.0%(1.3,23.8)更高的IL-13水平相关。硒和锌的每ng/g增加与响应有丝分裂原PHA的TNF-α升高0.2%(0.01,0.4)和0.01%(0.002,0.02)相关,分别。
    结论:产前金属和PFAS影响脐带血淋巴细胞增殖和细胞因子分泌,可能会增加儿童特应性疾病的风险。
    BACKGROUND: Evidence suggests that prenatal per- and polyfluoroalkyl substances (PFAS) and metals, two classes of chemicals found ubiquitously in human populations, influence immune system development and response.
    OBJECTIVE: We evaluated whether first trimester blood PFAS and metals were associated with antigen- or mitogen-stimulated cord blood lymphocyte proliferation and cytokine secretion.
    METHODS: We measured six PFAS, as well as six nonessential and four essential metals, in first trimester blood from participants in the longitudinal pre-birth Project Viva cohort, recruited between 1999 and 2000 in eastern Massachusetts. We measured antigen- or mitogen-stimulated cord blood mononuclear cell proliferation responses (n = 269-314) and cytokine secretion (n = 217-302). We used covariate-adjusted least absolute shrinkage and selection operator (LASSO) for variable selection and multivariable regression to estimate associations with the immune markers.
    RESULTS: Each ng/mL of MeFOSAA was associated with a 3.6% (1.4, 5.8) higher lymphocyte proliferation response after stimulation with egg antigen, as well as 0.8 (0.7, 1.0) reduced odds of having IFN-γ detected in response to dust mite. Each ng/g increment of cesium was associated with 27.8% (-45.1, -4.9) lower IL-10 levels in response to dust mite. Each ng/g increment of mercury was associated with 12.0% (1.3, 23.8) higher IL-13 levels in response to mitogen PHA. Each ng/g increment of selenium and zinc was associated with 0.2% (0.01, 0.4) and 0.01% (0.002, 0.02) higher TNF-α in response to mitogen PHA, respectively.
    CONCLUSIONS: Prenatal metals and PFAS influence cord blood lymphocyte proliferation and cytokine secretion in ways that may increase risk for atopic disease in childhood.
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