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BACKGROUND: Neoadjuvant short-course radiotherapy (SCRT) followed by CAPOX and camrelizumab (a programmed cell death protein 1 monoclonal antibody) has shown potential clinical activity for locally advanced rectal cancer (LARC) in a phase II trial. This study aimed to further confirm the efficacy and safety of SCRT followed by CAPOX and camrelizumab compared to long-course chemoradiotherapy (LCRT) followed by CAPOX alone as neoadjuvant treatment for LARC. PATIENTS AND METHODS: In this randomized, phase III trial, patients with T3-4/N+ rectal adenocarcinoma were randomly assigned (1 : 1) to receive SCRT or long-course chemoradiotherapy (LCRT), followed by two cycles of camrelizumab and CAPOX or CAPOX alone, respectively. After surgery, each arm underwent either six cycles of camrelizumab and CAPOX, followed by up to 17 doses of camrelizumab, or six cycles of CAPOX. The primary endpoint was pathological complete response (pCR) rate (ypT0N0) assessed by a blinded independent review committee. Key secondary endpoints tested hierarchically were 3-year event-free survival (EFS) rate and overall survival (OS). RESULTS: Between July 2021 and March 2023, the intention-to-treat population comprised 113 patients in the experimental arm and 118 patients in the control arm, with surgery carried out in 92% and 83.9%, respectively. At data cut-off (11 July 2023), the pCR rates were 39.8% [95% confidence interval (CI) 30.7% to 49.5%] in the experimental arm compared to 15.3% (95% CI 9.3% to 23.0%) in the control arm (difference, 24.6%; odds ratio, 3.7; 95% CI 2.0-6.9; P < 0.001). In each arm, surgical complication rates were 40.0% and 40.8%, and grade ≥3 treatment-related adverse events were 29.2% and 27.2%. Three-year EFS rate and OS continue to mature. CONCLUSIONS: In LARC patients, neoadjuvant SCRT followed by camrelizumab plus CAPOX demonstrated a significantly higher pCR rate than LCRT followed by CAPOX, with a well-tolerated safety profile. SCRT followed by camrelizumab and chemotherapy can be recommended as a neoadjuvant treatment modality for these patients.
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Objective: To evaluate the long-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using Cai tube for treating left-sided colorectal cancer. Methods: This was a randomized controlled trial. Inclusion criteria were as follows: preoperative pathological diagnosis of left-sided colorectal adenocarcinoma (rectal, sigmoid colon, descending colon, or left transverse colon cancer with the caudad margin ≥8 cm from the anal margin); preoperative abdominal and pelvic computed tomography (or magnetic resonance imaging) showing maximum tumor diameter <4.5 cm; and BMI <30 kg/m2. Patients with synchronous multiple primary cancers or recurrent cancers, a history of neoadjuvant chemoradiotherapy, preoperative evidence of significant local infiltration, distant metastasis, or complications such as intestinal obstruction and intestinal perforation, or who were not otherwise considered suitable for laparoscopic surgery were excluded. A random number table was used to randomize sequential patients to NOSES surgery using Cai tube (non-assisted incision anal sleeve: patent number ZL201410168748.2) (NOSES group) or traditional laparoscopic-assisted surgery (CLS group). Relevant clinical data of the two groups of patients were analyzed, the main outcomes being disease-free survival, overall survival, overall recurrence rate, and local recurrence rate 5 years after surgery. Results: Patients in both study groups completed the surgery successfully with no requirement for additional surgery. After mean 70 (7-83) months postoperative follow-up, the 5-year overall postoperative survival in the NOSES and CLS groups was 90.0% and 83.3%, respectively (P=0.455); disease free survival was 90.0% and 83.3%, respectively (P=0.455); overall recurrence rate 6.6% and 10.0%, respectively (P=0.625); and local recurrence rate both were 3.3% (P=0.990), respectively. None of these differences was statistically significant. Conclusions: NOSES and CLS have similar long-term efficacy, and NOSES deserves to be used in clinical practice.
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Neoplasias Colorrectales , Laparoscopía , Neoplasias del Recto , Humanos , Neoplasias del Recto/cirugía , Estudios de Seguimiento , Estudios Retrospectivos , Recurrencia Local de Neoplasia/cirugía , Neoplasias Colorrectales/cirugía , Laparoscopía/métodos , Resultado del TratamientoRESUMEN
Objective: To evaluate the mid-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using the Cai tube in the treatment of left colorectal cancer. Methods: A prospective randomized control trial (China Clinical Trials Registration Number: ChiCTR-OOR-15007060) was performed. Sixty patients with left colorectal cancer at Department of Gastrointestinal Surgery of Zhongshan Hospital from September 2015 to August 2017 were prospectively enrolled. Case inclusion criteria: (1) left colorectal adenocarcinoma (rectal cancer with distance ≥ 8 cm from tumor low margin to anal edge, sigmoid colon cancer, descending colon cancer and left transverse colon cancer) confirmed by preoperative pathology; (2) satisfactory conditions of conventional laparoscopic surgery; (3) maximum diameter of the tumor < 4.5 cm confirmed by preoperative abdominal and pelvic CT or MRI; (4) BMI < 30 kg/m2. Case exclusion criteria: (1) benign lesions, mucinous adenocarcinoma, signet-ring cell carcinoma and other special pathological types of tumors confirmed by preoperative pathological examination; (2) multiple or recurrent cancers; (3) with a history of neoadjuvant chemoradiotherapy; (4) obvious regional infiltration or distant metastasis indicated by preoperative imaging examination; (5) intestinal obstruction, intestinal perforation, etc. Participants were randomly assigned to NOSES group (using the Cai tube) and conventional laparoscopy (CL) group by random number table method. Clinical data between two groups were compared and analyzed, including perioperative conditions, tumor exfoliation cell detection and bacterial culture results of intraperitoneal lavage fluid, postoperative complications (Clavien-Dindo grading), postoperative pain [visual simulation scoring (VAS) assessment], anal function (Kirwan anal function grading assessment), and postoperative 3-year disease-free survival (DFS), overall survival (OS), overall recurrence rate, and local recurrence rate. Results: A total of 60 patients were enrolled, with 30 in the NOSES group and 30 in the CL group. All the patients in the NOSES group successfully completed operation with Cai tube. Baseline data between the two groups were not significantly different (all P>0.05). There were no statistically significant differences between two groups in conversion rate to open surgery, number of lymph node harivested, proximal and distal resection margin of tumor, negative rate of circumferential margin, operation time, blood loss, inflammatory indexes, postoperative anal function, postoperative hospital stay, hospitalization cost, morbidity of postoperative complications (Clavien-Dindo grade II or above) (all P>0.05). Compared to the CL group, the NOSES group had lower maximum postoperative VAS score (2.5±0.3 vs. 5.1±0.4, t=3.187, P<0.01), and fewer use of additional postoperative analgesia [6.7% (2/30) vs. 33.3% (10/30),χ2=6.670, P=0.02]. The postoperative time to gas passage was shorter in the NOSES group [(2.2±1.4) days vs. (3.1±1.2) days,P=0.026]. No tumor cells and bacterial contamination were found in abdominal lavage fluid before and after operation in either group. The anal function at postoperative 3-month of all the patients in the NOSES group was Kirwan grade I to II, while in the CL group, anal function of 2 cases (6.7%) was Kirwan grade III, and of 28 cases was also Kirwan grade I to II, whose difference was not statistically significant (P>0.05). In the NOSES group and the CL group, 3-year DFS was 96.7% and 83.3% (P=0.090), OS was 100% and 90% (P=0.096), overall recurrence rate was 3.3% and 10.0% (P=0.166), and local recurrence rate was 3.3% and 3.3% (P=0.999), respectively, whose differences were not statistically significant (all P>0.05). Conclusions: In the treatment of left colorectal cancer, compared with conventional laparoscopic colectomy, NOSES colectomy using Cai tube exhibits less scar, less postoperative pain, shorter recovery of gastrointestinal function, and similar mid-term outcomes. Given proper surgical indications, the surgical procedure is safe and feasible.
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Laparoscopía , Neoplasias del Recto , Neoplasias del Colon Sigmoide , Estudios de Seguimiento , Humanos , Dolor Postoperatorio , Complicaciones Posoperatorias/cirugía , Estudios Prospectivos , Neoplasias del Recto/cirugía , Estudios Retrospectivos , Neoplasias del Colon Sigmoide/cirugía , Resultado del TratamientoRESUMEN
OBJECTIVE: To explore short-term outcomes obtained with Laparoscopic-assisted Natural Orifice Specimen Extraction for left colorectal cancer radical resection. METHODS: A total of 123 patients with left colorectal tumor who had undergone laparoscopic surgery between Jan.2014 and Jun.2015 were reviewed. According to surgical approach, transanal specimen extraction using the Cai Tube (study group, n=29) and trans-abdominal incision specimen extraction (control group, n=123) were studied. Propensity score matching was applied at a ratio of 1â¶1 comparing the study (n=23) and control (n=23) groups. RESULTS: The two matched groups had similar baseline characteristics. There was no significant difference in the length of distal or proximal resection margin, the rate of circumferential resection negative margin, the estimated blood loss, the levels of C-reactive protein on 2nd day after surgery, the postoperative time to take liquid, the postoperative hospital day, the hospital fee and the postoperative anal function. The study group presented longer operative time[(237.8±68.1)min vs (168.9±47.5)min, P<0.05], less number of lymph nodes dissected (12.4±5.4 vs 16.4±7.2, P<0.05), higher white cell count on 2nd day after surgery[(11.7±3.4)×10(9)/L vs (9.4±2.6)×10(9)/L, P<0.05], but quicker postoperative recovery of bowel function[(2.6±0.7)d vs (3.4±0.7)d, P<0.05], shorter postoperative ambulation time[(2.3±0.6)d vs (3.6±0.7)d, P<0.05], lower rate of postoperative complications (0/23 vs 6/23, P<0.05) and lower rate of utilization of painkillers in addition to postoperative analgesia pump (1/20 vs 9/23, P<0.05). CONCLUSION: Laparoscopic-assisted left colorectal cancer radical resection using the Cai Tube is in line with oncologic principle, less pain, quicker recovery and better cosmetic results.
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Neoplasias Colorrectales/cirugía , Cirugía Colorrectal/métodos , Laparoscopía/métodos , Cirugía Endoscópica por Orificios Naturales/métodos , Puntaje de Propensión , Canal Anal , Defecación , Femenino , Humanos , Laparoscopía/efectos adversos , Ganglios Linfáticos , Masculino , Cirugía Endoscópica por Orificios Naturales/efectos adversos , Tempo Operativo , Dolor Postoperatorio , Complicaciones Posoperatorias , Resultado del TratamientoRESUMEN
One hundred twelve patients with geriatric acute myeloid leukemia (AML), refractory or relapsed AML, or myelodysplastic syndrome and refractory anemia with excess of blasts in transformation (MDS-RAEBt) were entered into this study to receive CAG (aclarubicin and low-dose cytosine arabinoside [Ara-C]in combination with granulocyte colony-stimulating factor [G-CSF]) with the objective of evaluating the efficacy and tolerance of this regimen. Low-dose Ara-C was given subcutaneously at a dosage of 10 mg/m2 every 12 hours on days 1 to 14. Aclarubicin was administered intravenously at a dosage of 14 mg/m2 per day on days 1 to 4 (CAG regimen A) or 7 mg/m2 on days 1 to 8 (CAG regimen B). Recombinant G-CSF was given subcutaneously at a dosage of 200 3g/m2 per day on days 1 to 14. We demonstrated comparable overall complete remission rates for the 4 groups of patients: 30.8% (8/26) in the elderly patients, 48.4% (30/62) in the refractory AML patients, 44.4% (8/18) in the relapsed AML patients, and 38.5% (5/13) in the MDS-RAEBt patients. Of the 52 patients followed up, the 12-month progression-free survival (PFS) and overall survival (OS) rates estimated by the Kaplan-Meier method were 40.73% 3 8.15% and 42.85% 3 8.23%, respectively. The median PFS and OS times were 9.0 3 2.2 months and 11.0 3 1.6 months, respectively. Toxic effects were very rare and mainly consisted of neutropenia and thrombocytopenia due to myelosuppression; approximately 70% to 80% of patients had neutropenia or thrombocytopenia that exceeded National Cancer Institute grade II. Nonhematologic toxicities were not observed in this study. The CAG regimen seems promising, with acceptable toxicity, for the treatment of various categories of poor-prognosis AML and MDS-RAEBt.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Leucemia Mieloide/tratamiento farmacológico , Síndromes Mielodisplásicos/tratamiento farmacológico , Aclarubicina/administración & dosificación , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Citarabina/administración & dosificación , Relación Dosis-Respuesta a Droga , Femenino , Factor Estimulante de Colonias de Granulocitos/administración & dosificación , Humanos , Inyecciones Subcutáneas , Leucemia Mieloide/patología , Masculino , Persona de Mediana Edad , Síndromes Mielodisplásicos/patología , Neutropenia/inducido químicamente , Análisis de Supervivencia , Trombocitopenia/inducido químicamente , Resultado del TratamientoRESUMEN
To study the role of intron in the expression of hFIX, retroviral vectors with intron containing hFIX were constructed. It is fundamental for the intron study whether the intron constructed in retroviral vector can be steadily transferred into target cell. First, we constructed two forward-orientation retroviral vectors: G1NaC-i-IX contains the exogenous intron from IL-2, and G1NaC-i'-IX contains the truncated intron I from hFIX gene, covering the splicing donor and acceptor sequences. RT-PCR result indicated that intron in the forward-orientation retroviral vector was spliced after packaging in PA317. Then, reverse-orientation retroviral vectors G1NaC-i'-IXR and G1NaPAIXi' BAM were constructed, in which the reverse and complimentary sequences of hFIX gene with intron appeared in retroviral RNA. RT-PCR assay combined with ELISA test indicated that intron was retained after packaging and hFIX gene with intron constructed in the reverse-orientation retroviral vector can be transduced intact and expressed hFIX at a high level in vitro.
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Factor IX/genética , Vectores Genéticos , Intrones , Empalme del ARN , Retroviridae/genética , Humanos , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
This paper probes into the feasibility of increasing expression level of hFIX gene with endogenous intron 1 sequence. hFIX minigene was obtained with middle sequence truncated intron 1 inserted into the relative site of hFIX cDNA, and plasmid vector pKG5i'IX, retroviral vector GINaCi'IX were constructed. These vectors were transduced into target cells of PA317, C2C12, primary rabbit skin fibroblasts (RSF) and primary human skin fibroblasts (HSF). The expression level of mixed colonies are PA317/pKGoi'IX, 151 ng/10(6) cells/24h; PA317/G1NaCi'IX, 308 ng/10(6) cells/24 h; C2C12/G1 NaCi'IX, 188 ng/10(5) cells/24 h; RSF/G1NaCi'IX, 1929 ng/10(5) cells/24 h; HSF/G1NaCi'IX, 1646 ng/10(6) cells/24 h. These results indicated that hFIX minigene with intron 1 is able to increase the expression level to about 3 times of that of hFIX cDNA. Meanwhile, in order to study the application of hFIX minigene in the retroviral-mediated gene transfer system and refrain from intron splicing during viral production, a retroviral vector G1NaCi'IXR with reversely inserted hFIX minigene expression cassette was constructed. The expression level of reverse constructor in PA317 cells was 390 ng/10(6) cells/24 h with 79% of bioactivity. PCR detection of HT/G1NaCi'IXR cells infected with PA317/G1NaCi'IXR supernatant confirmed the existence of intron 1 sequence. These results suggested that expression vector with forward-inserted intron1-carrying hFIX expression cassette can be used in directed gene transfer, but when using the retroviral-mediated gene transfer system, reversely-inserted intronl-carrying hFIX expression cassette should be considered.
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Factor IX/genética , Regulación de la Expresión Génica/genética , Intrones/genética , Animales , Células Cultivadas , Fibroblastos , Técnicas de Transferencia de Gen , Vectores Genéticos/genética , Humanos , Ratones , Empalme del ARN/genética , Conejos , Retroviridae/genéticaRESUMEN
AIM: To construct retroviral vector bringing HSV-tk gene under control of human AFP enhancer core sequence and human pgk promoter. METHODS: Internal SV40 promoter was deleted by SalI from retroviral vector pMNSM to construct pMNM. HSV-tk gene driven by pgk promoter was released by BamH I from an eukaryotic expression vector pBPGK-tk, and inserted into polylinker site of pMNM to construct pMNP-tk retroviral vector. Human α-fetoprotein gene enhancer core sequence was released by EcoR I from pGEM. 7Z-AFPe plasmid was inserted into the immediate upstream of pgk promoter of pMNP-tk vector. Construction of hepatoma specific retroviral vector pMNAP-tk was completed. RESULTS: The structure of pMNP-tk and pMNAP-tk vector was confirmed by restriction analysis. CONCLUSION: The vector is of great significance for hepatoma specific prodrug transformation gene therapy.
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Using the total human/mouse DNA as the probe, screening has been carried out three times with in situ plaque hybridization to obtain the single-copy DNA sequence from the human X chromosome genomic library. The effective rate of screening is 1.45%. DNAs from clones containing single-copy inserts have been analyzed by a panel of hybrid cells with or without human X chromosome. Three segments, designated by DXFD52,73,75, are mapped to the X chromosome. DXFD52 has been precisely localized on Xq12-q13 with in situ chromosomal hybridization. DXFD52 has been partially sequenced. The results indicate that DXFD52 is a new isolated single-copy segment on the X chromosome. Great progress in the RFLPs study with DXFD52 has been achieved in the population of Chongqing, Sichuan Province. The results show that the DXFD52 can be used to detect the RFLP with Hind III, Bgl II, and Hinf I. DXFD52 will be a potential "landmark" for the construction of the complete linkage map of human genome and the analysis of genomic sequence. And also, the results provide the experience in the development of a useful DNA probe to be applied to diagnosing X-linked disorders.
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ADN/genética , Ligamiento Genético , Cromosoma X , Secuencia de Bases , Mapeo Cromosómico , ADN/aislamiento & purificación , Humanos , Datos de Secuencia Molecular , Polimorfismo de Longitud del Fragmento de Restricción , Análisis de Secuencia de ADN , Cromosoma X/químicaRESUMEN
Pulmonary endocrine cells and immunocompetent cells from the lungs of 35 subjects with bronchiectasis and in 10 normal controls were investigated by using immunohistochemical technique. The morphological and immunohistochemical characteristics of bronchus associated lymphoid tissue (BALT) of the lung were also studied. The number of calcitonin and serotonin immunoreactive pulmonary endocrine cells increased significantly in bronchiectasis as compared with those from control subjects. The number of IgA, IgG and IgM positive cells and UCHL1 positive cells were higher in the bronchial lamina propria in bronchiectasis than those in controls. These changes were most marked in hyperplastic BALT areas, which suggest that neuroendocrine and immune mechanisms may be involved in the pathogenesis of bronchiectasis.
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Bronquios/patología , Bronquiectasia/metabolismo , Calcitonina/análisis , Serotonina/análisis , Adulto , Bronquios/química , Humanos , Inmunoglobulinas/análisis , Inmunohistoquímica , Neuroinmunomodulación , Sistemas Neurosecretores/químicaRESUMEN
Twenty patients with ovarian borderline epithelial tumors were analysed. The tumor in 9 patients were serous and in 11 patients mucinous in nature type. 15 cases were classified as of stage I, 3 cases of stage II and 2 cases of stage III, according to the FIGO staging. All pathologic slides were re-reviewed to confirm the diagnosis and no patients were lost to follow-up. Total hysterectomy and unilateral or bilateral salpingo-oophorectomy were done in 12 patients, among whom, 2 died of tumor recurrences. Unilateral adnexectomy was done in 8 patients, and none died of tumor recurrence. Fourteen patients received post operative chemotherapy 1-8 courses with PAC regimen, 12 patients were alive up to the present. Six patients did not receive chemotherapy and among these 3 with stage Ia were alive and 1 with stage Ib died of tumor recurrences. The survival rate of stage I was 92.3%. Our results indicated that the prognosis was closely related to clinical staging. We suggested that patients of stage I who wish to preserve childbearing function may be treated with unilateral salpingo-oophorectomy, and chemotherapy should be given to the patients with high risk factors. Because of the indolent nature of these tumors, long-term follow-up at least 10 years is necessary.
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Neoplasias Ováricas/terapia , Adolescente , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioterapia Adyuvante , Cisplatino/administración & dosificación , Ciclofosfamida/administración & dosificación , Cistoadenoma Mucinoso/terapia , Cistadenoma Seroso/terapia , Doxorrubicina/administración & dosificación , Femenino , Estudios de Seguimiento , Humanos , Histerectomía , Persona de Mediana Edad , PronósticoRESUMEN
In this study, rabbits were used as a model for gene therapy for hemophilia B. Human factor IX cDNA was transferred to cultured normal rabbit skin fibroblasts (RSF) by a recombinant plasmid (pCMVIX) or retrovirus (XL-IX or N2CMVIX) constructed in our laboratory. Infected fibroblasts capable of synthesizing and secreting high levels of biologically active human factor IX protein were selected and embedded in a collagen matrix. The latter was surgically implanted into rabbits as autografts or allografts. Human factor IX protein was detected in the plasma of all the grafted rabbits, and its expression has been maintained for more than 10 months at the time of writing. In addition, we have improved and simplified the method of implantation from surgically grafting the tissue-like matrix to the injection of the infected cell-collagen mixture subcutaneously. Using the latter method, human factor IX in rabbits injected with RSF-N2CMVIX reached a peak of 480 ng/ml plasma, and its expression has continued for more than 3 months at the time of writing. We suggest that the simplified method of transplantation by subcutaneous injection would offer an effective and acceptable approach to somatic cell gene therapy and may be practical for human trials.
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Factor IX/genética , Hemofilia B/genética , Animales , Células Cultivadas , ADN Complementario/genética , Factor IX/biosíntesis , Fibroblastos/metabolismo , Fibroblastos/trasplante , Expresión Génica , Terapia Genética , Vectores Genéticos , Hemofilia B/terapia , Conejos , Retroviridae/genética , Transducción Genética , TransfecciónRESUMEN
This paper describes the first human gene therapy trial for hemophilia B. Retroviruses were used to introduce human factor IX into autologous, primary human skin fibroblasts from the patients. Recombinant retroviral vector containing human FIX cDNA driven by viral LTR promoter (XL-IX) and double-copy retroviral vector driven by human cytomegalovirus enhancer-promoter (N2CMV-IX) were constructed. After the safety assessment, including soft-agar test, cell morphology observation, analysis of endotoxin, chromosome karyotype, allergic reaction test, nude mice test, routine pathological test, electromicroscopic analysis, and virus detection by PCR, etc., the engineered cells were pooled and embedded in collagen mixture, autologously injected into the patients respectively. The concentration of human FIX protein of Patient 1 increased from 71 ng/ml to 220 ng/ml, with a maximum level of 245 ng/ml. The expression of FIX has lasted for 6 months at the time of writing. The clotting activity also increased from 2.9% to 6.3%, his clinical symptoms have been alleviated obviously. The secretion rate of FIX for Patient 2 increased from 130 to 250 ng/ml, maintained at the level of 220 ng/ml for 5.5 months at the time of writing, but the clotting activity has not been increased steadily. There is no deleterious effect to be found in the two patients since the ex-vivo cells were implanted. The two patients are now under follow-up investigation. We suggested that retrovirus-mediated transfer of genes into skin fibroblasts, to be embedded in collagen and subcutaneously injected into patients, is a simple and effective approach for the gene therapy for hemophilia B.
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Factor IX/genética , Terapia Genética , Hemofilia B/terapia , Adolescente , Niño , ADN Complementario/genética , Factor IX/biosíntesis , Fibroblastos/metabolismo , Fibroblastos/trasplante , Expresión Génica , Vectores Genéticos , Hemofilia B/genética , Humanos , Masculino , Retroviridae/genética , Transducción GenéticaRESUMEN
Double-copy retroviral vector containing human factor IX cDNA driven by human cytomegalovirus enhancer-promoter was constructed. The vector was introduced into the amphotropic packaging cell line PA317. The recombinant virus produced in PA317 was used to transduce skin fibroblasts from a hemophilia B patient. The infected cells produced high levels of biologically active human factor IX at a rate of 3420 ng/10(6) cells/24 h. These cells were embedded in a collagen matrix and implanted into the peritoneal cavity or subcutaneous space of mice. It was demonstrated that human factor IX was produced by the implants for at least 12 days in vivo, reaching a peak of 105 ng/ml plasma. Over 90% of the protein was functionally active. This technique has the potential to be developed into a new approach for gene therapy for hemophilia B.
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Factor IX/genética , Expresión Génica , Vectores Genéticos , Hemofilia B/genética , Transfección , Animales , Factor IX/biosíntesis , Femenino , Fibroblastos , Humanos , Ratones , Retroviridae/genética , Transducción GenéticaRESUMEN
To study the possibility of somatic gene therapy for hemophilia B via gene transfer to primary factor IX-deficient skin fibroblasts, we constructed four retroviral vectors containing factor IX cDNA driven by retroviral LTR promoter, SV40 early promoter and mouse MT-I promoter, respectively. These retroviral vectors were transfected into an amphotropic packaging cell line, PA317 cells, by electroporation, and a human fibrosarcoma cell line, HT1080 cells, was used to assay the factor IX-virus titers of these four virus-producing PA317 cells, which ranged from 2 x 10(4) to 5 x 10(5) cfu/ml. The factor IX proteins produced by bulk population of four virus-producing PA317 cells were determined by ELISA. Results showed that LTR promoter directed the highest production of factor IX at the rate of 584 ng/10(6) cells/24 h, while SV40 early promoter and MT promoter directed about 10 and 20 times less production of factor IX than LTR promoter. The highest expressed retroviral vector XL-IX was used to infect a line of factor IX-deficient human primary skin fibroblasts, FDIX cells. The factor IX secretion rate of the infected FDIX cells was about 549 ng/10(6) cells/24 h and over 75% of secreted factor IX was biologically active. We are convinced that this factor IX-deficient human primary skin fibroblast had been cured, or genetically corrected, by retroviral-mediated gene therapy in vitro.
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Factor IX/metabolismo , Hemofilia B/patología , Piel/patología , Transfección , Adulto , Células Cultivadas , ADN/genética , ADN Recombinante , Electricidad , Factor IX/genética , Fibroblastos/patología , Vectores Genéticos , Humanos , Retroviridae/genéticaRESUMEN
Animal experiment and clinical observation were carried out to study the nephrotoxicity of cisplatin in order to give protective measures. In animal experiment it had been demonstrated that the nephrotoxicity induced by cisplatin was mainly related to the intraperitoneal concentration of cisplatin. The nephrotoxicity was permanent in rats treated with cumulative cisplatin. The main pathologic lesions were characterized by interstitial hyperemia, degeneration of the tubular cells and formation of tubular casts. In a Clinical study to compare two preventive methods (sodium thiosulfate and hydration) from cisplatin induced nephrotoxicity, the BUN and serum Cr were measured in 28 patients. The results revealed that there was no significant difference between the two groups (P greater than 0.05). The two protective measures had similar effect in reducing the nephrotoxicity of cisplatin. Five of 6 patients treated with cisplatin developed hypo-magnesemia but only one had symptoms.
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Cisplatino/efectos adversos , Riñón/efectos de los fármacos , Adolescente , Adulto , Anciano , Animales , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma/tratamiento farmacológico , Cisplatino/toxicidad , Femenino , Humanos , Riñón/fisiopatología , Pruebas de Función Renal , Magnesio/sangre , Deficiencia de Magnesio/inducido químicamente , Persona de Mediana Edad , Neoplasias Ováricas/tratamiento farmacológico , Ratas , Ratas EndogámicasRESUMEN
Myotonic dystrophy (DM) is inherited as an autosomal dominant trait and is characterized by variable expressivity and late age-of-onset. In the present paper, the DNA from 61 normal individuals and a DM family with 15 members of 4 generations were collected and digested with PstI, then hybridized with the LDR152 (D19S19). The results showed that the alleles for the PstI polymorphism were 19 and 11kb in size (gene frequencies were 0.4344 and 0.5656 respectively, which are obviously different from the previous data reported). In this DM family, the carriers who had lived most of their life without knowing that they had been infected with the disease were detected by the LDR152 and the estimation of DM risk on at-risk-individuals was also calculated.
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Cromosomas Humanos Par 19 , Ligamiento Genético , Distrofia Miotónica/genética , Humanos , Polimorfismo de Longitud del Fragmento de RestricciónRESUMEN
A 23-mer oligonucleotide based on the core sequence was chemically synthesized and used to screen the human genomic library. Fifteen positive recombinants containing the minisatellite sequences were identified, and one of them, C35.9, was used to perform Southern hybridization with the DNAs from unrelated Chinese individuals. Each sample has 3-11 hybridizing bands, and some of which are polymorphic. The band patterns detected under controlled condition are individual-specific in a limited population. This indicates that the minisatellites obtained by screening the library can be used to detect the polymorphisms of the minisatellites.
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Sondas de ADN , ADN Satélite , Humanos , Polimorfismo GenéticoRESUMEN
A simple method for the identification of mutational sites in human mitochondrial DNA (mtDNA) was described. It was based on the human Cambridge sequence as a relative standard sequence and a single base pair substitution in mtDNA as a unique mutational form. The partial mutational sites can be determined using this method which was characterized by combining the restriction mapping with the analysis for the table of human mtDNA potential mutational sites with rapidity and simplicity. In the meanwhile, six mtDNA mutational sites found in Chinese population were identified by means of this method.