ABSTRACT
Early and accurate diagnosis of acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation is crucial for the prognosis of patients. This study identified a potential biomarker for the severity of aGVHD after human leukocyte antigen (HLA)-haploidentical peripheral blood hematopoietic stem cell transplantation (haplo-PBSCT). We included 20 healthy subjects and 57 patients who underwent haplo-PBSCT. Of these patients, 22 developed aGVHD after haplo-PBSCT. The results showed that patients with aGVHD had significantly increased levels of Tim-3+/Perforin+/Granzyme B+CD8+ T cells, but significantly decreased Galectin-9. The differences in Galectin-9 and Tim-3+/Granzyme B+CD8+ T cells between grade I-II aGVHD and III-IV aGVHD were also significant. In vitro, the apoptosis of CD8+ T cells from aGVHD patients was significantly increased after Tim-3/Galectin-9 pathway activation, which decreased Granzyme B secretion. As revealed by univariate analysis, the level of Tim-3+CD8+ T cells was a risk factor for severe aGVHD. ROC analysis demonstrated that high levels of Tim-3+CD8+ T cells had a significant diagnostic value for severe aGVHD, with an area under the curve of 0.854 and cut-off value of 14.155%. In conclusion, the binding of Tim-3 with exogenous Galectin-9 can promote apoptosis of CD8+ T cells and affect the secretion of Granzyme B. Tim-3+CD8+ T cells have the potential to serve as immunological markers for assessing the severity of aGVHD after haplo-PBSCT and identifying patients at a higher risk for severe aGVHD.
ABSTRACT
Objective@#To analyze the relationship between sleep and non suicidal self injury (NSSI) behaviors of Tajik middle school students in high altitude areas, and to provide references for physical and mental health promotion in middle school students.@*Methods@#The stratified random cluster sampling method was used to select 1 224 Tajik middle school students in the Taxkorgan area of Xinjiang as participants. Sleep, NSSI, general demographic were investigated, and Logistic regression analysis was used to analyze the relationship between sleep and NSSI.@*Results@#The detection rate of NSSI among Tajik middle school students in high altitude areas was 7.92%. About 18.71% of the students had insomnia problems and 14.62% of students had nightmares at least once in the past week. The detection rates of NSSI differed in gender, grades, physical conditions, father s education, mother s education, family monthly income, smoking status, and drinking status ( χ 2=6.45, 19.12, 13.83, 12.39, 8.32, 11.45, 17.31, 9.72, respectively, all P <0.05). Logistic regression analysis showed that sleep time ≥9 h/d on school days was negatively correlated with NSSI( OR =0.62); weekend sleep time <5 h/d( OR =1.81), weekend sleep time 5-7 h/d( OR =1.45), insomnia( OR =1.33), nightmares( OR =1.64-3.27) were positively correlated with NSSI( P <0.05).@*Conclusion@#Insufficient sleep time, insomnia and nightmares are the influencing factors of non suicidal self injury behavior in Tajik middle school students. Sleep intervention for Tajik middle school students in high altitude areas should be strengthened to promote physical and mental health.