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<p><b>OBJECTIVE</b>To review the characteristics of regulatory T cells (Tregs) and ex vivo expansion of Tregs for treatment of graft-versus-host disease (GVHD).</p><p><b>DATA SOURCES</b>The data used in this review were retrieved from PubMed (1970-2013). The terms "ex vivo expansion", "regulatory T cell", and "graft-versus-host disease" were used for literature search.</p><p><b>STUDY SELECTION</b>The publications about the characteristics of Tregs, ex vivo expansion of Tregs and clinical applications of Tregs against GVHD were identified, retrieved and reviewed.</p><p><b>RESULTS</b>Tregs can be classified as natural Tregs (nTregs) and induced Tregs (iTregs). Both subsets share most Treg features. Given their immunosuppressive property, Tregs have been tested for their capability of preventing GVHD. The bottleneck of Treg therapy is the limited numbers of naturally existing Tregs. To solve this problem, ex vivo expansion of nTregs or iTregs has been executed. The initial data indicate Treg therapy is effective in reducing GVHD without compromising graft-versus-leukemia (GVL).</p><p><b>CONCLUSION</b>Ex vivo expansion of Tregs is a reliable way to prepare sufficient number of Tregs for management of GVHD.</p>
Subject(s)
Humans , Graft vs Host Disease , Allergy and Immunology , Therapeutics , Hematopoietic Stem Cell Transplantation , T-Lymphocytes, Regulatory , Cell BiologyABSTRACT
Objective To study the expression of nicotinic acetylcholine receptor α7 in CD4 + CD25 + T lymphocytes of peripheral blood in children with sepsis,and to analyze the role of α7nAChR in the development of sepsis.Methods Forty-nine hospitalized patients with sepsis from Nov.2011 to Dec.2012 in PICU of Nanjing Children's Hospital Affiliated to Nanjing Medical University were enrolled,and they were divided into the survival group (n =33)and the dead group (n =16) in accordance with the outcome.At the same time,the total of 40 cases including the children receiving inguinal hernia repair and the children receiving health examination were enrolled as control group.Peripheral venous blood was collected to detect the expression of CD4 +/CD25 +/α7nAChR by indirect flow cytometry.Simultaneously,the CD3 +,CD4 +,CD8 +,CD4 +/CD8 + ratio were detected,and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores were calculated.Results The expressions of CD4 +/CD25 +/α7nAChR in sepsis group were much lower than those in the control group [(25.8 ± 3.1) ％ vs (34.9 ± 2.9) ％,P ＜ 0.05] ; and the expression of CD4 + CD25 +/α7nAChR in the dead group was also significantly lower than that in the survival group [(22.4 ± 2.5) ％ vs (28.1 ± 2.9) ％,P ＜ 0.05].The expressions of α7nAChR on CD4 +/CD25 + T lymphocytes of peripheral blood in children with sepsis was negatively correlated with the APACHE Ⅱ score (r =-0.512,P ＜ 0.05).The CD3 +,CD4 +,CD4 +/CD8 + ratios in the dead group were significantly lower than those in the control group (all P ＜ 0.05) ; in the survival group and the control group,the values of CD3 +,CD4 +,CD8 + were not significantly different,while the ratios of CD4 +/CD8 + between these 2 groups had a significant difference(P ＜ 0.05).Conclusions The expressions of α7nAChR on the CD4 + CD25 +T lymphocytes in the children with sepsis were reduced,and the expressions were lower,the outcome were worse;the children with sepsis have cell immune dysfunction.
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To determine the effect of sevoflurane combination with epidural anesthesia on myocardial injury in patients with coronary artery disease [CAD] undergoing non-cardiac surgery. The investigation was performed in TianJin NanKai Hospital, TianJin, China from November 2009 to March 2010. Eighty patients with CAD undergoing elective abdominal surgery were randomized into 4 groups: group S1- combined sevoflurane general and epidural anesthesia; group S2 - standard sevoflurane general anesthesia; group P1 - combined propofol general and epidural anesthesia; and group P2 - standard propofol general anesthesia. Mean arterial pressure, central venous pressure, electrocardiogram, and bispectral index was monitored throughout the surgery. The serum levels of interleukin-6 [IL-6], interleukin-8 [IL-8], tumor necrosis factor-alpha TNF-alpha, cardiac troponin I [cTnI], and glycogen phosphorylase BB [GP-BB] was measured at different time points during surgery. The ST depression in group P1 and S2 was significantly higher than that in group S1 [p=0.000] and lower than that in group P2 [p=0.00]. The serum levels of IL-6, IL-8, TNF-alpha, cTnI, and GP-BB in group P1 and S2 were dramatically greater than that in group S1 [p=0.00], and lower than that in group P2 [p=0.00]. Sevoflurane in combination with continuous epidural anesthesia could protect against myocardial damage in patients with CAD, downregulation of IL-6, IL-8, and TNF-alpha might contribute to this protection
Subject(s)
Humans , Male , Female , Anesthesia, Epidural , Coronary Artery Disease , Myocardial Reperfusion Injury , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>Kawasaki disease (KD) is an acute and self-limited systemic vasculitis syndrome of unknown origin that mainly affects small and medium-sized arteries, particularly the coronary arteries, which is followed by aneurysm formation. Increased levels of matrix metalloproteinase-1 (MMP-1) have been detected in aortic aneurysms in adults, suggesting an important role of MMP-1 in arterial wall destruction and resultant aneurysm formation. The aim of this study was to investigate the potential role of MMP-1 in the pathogenesis of coronary artery lesions in patients with KD.</p><p><b>METHODS</b>Forty patients with KD, including 23 patients without coronary artery lesions (CAL) and 17 patients with CAL, as well as age-matched 10 febrile and 10 healthy afebrile controls were studied. The duration of KD was divided into three phases: the acute phase, the subacute phase and the convalescent phase. Enzyme-linked immunosorbent assay was used to detect the protein levels of MMP-1 in the sera. MMP-1 mRNA expression in the circulating leucocytes was studied using reverse transcription-polymerase chain reaction.</p><p><b>RESULTS</b>Levels of MMP-1 protein in serum and MMP-1 mRNA expression in the leucocytes were significantly elevated at the acute phase in the two groups of KD patients (CAL group: 14.91 +/- 3.88 ng/ml and 0.89 +/- 0.15 ng/ml; NO-CAL group: 11.27 +/- 3.28 ng/ml and 0.77 +/- 0.14, respectively), compared with febrile (7.05 +/- 1.98 ng/ml and 0.45 +/- 0.12 ng/ml, respectively) and afebrile (5.13 +/- 1.20 ng/ml and 0.29 +/- 0.12 ng/ml, respectively) controls (P < 0.01). Furthermore, MMP-1 protein and MMP-1 mRNA levels were significantly higher in KD patients with CAL than in KD patients without CAL (P < 0.05). There was a significantly positive correlation between the serum protein level of MMP-1 at the acute phase of KD and the circulating leucocytes counts (r = 0.750, P < 0.01). The MMP-1 serum protein level and mRNA expression in the leucocytes at the acute phase of the two KD groups decreased obviously from the subacute through the convalescent phases (P < 0.05 or P < 0.01).</p><p><b>CONCLUSION</b>The expression of MMP-1 at the acute phase of KD was significantly elevated, especially in KD patients with CAL. MMP-1 might be involved in the formation of coronary artery lesions and pathogenesis of KD.</p>