The Effect of Mesenchymal Stem Cells Derived Microvesicles on the Treatment of Experimental CCL4 Induced Liver Fibrosis in Rats.

BACKGROUND AND OBJECTIVES: The release of microvesicles (MVs) from mesenchymal stem cells (MSCs) has been implicated in intercellular communication, and may contribute to beneficial paracrine effects of stem cell-based therapies. We investigated the effect of administration of MSC-MVs on the therapeutic potential of carbon tetrachloride (CCL4) induced liver fibrosis in rats. METHODS: Our work included: isolation and further identification of bone marrow MSC-MVs by transmission electron microscopy (TEM). Liver fibrosis was induced in rats by CCl4 followed by injection of prepared MSC-MVs in injured rats. The effects of MSC-MVs were evaluated by biochemical analysis of liver functions, RNA gene expression quantitation for collagen-1α, transforming growth factor ß (TGF-ß), interleukin-1ß (IL-1ß), vascular endothelial growth factor (VEGF) by real time reverse transcription PCR (RT-PCR) techniques. Finally histopathological examination of the liver tissues was assessed for all studied groups. RESULTS: BM-MSC-MVs treated group showed significant increase in serum albumin levels, VEGF quantitative gene expression (p<0.05), while it showed a significant decrease in serum alanine transaminase (ALT) enzyme levels, quantitative gene expression of TGF-ß, collagen-1α, IL-1ß compared to CCL4 fibrotic group (p<0.05). Additionally, the histopathological assessment of the liver tissues of BM-MSC-MVs treated group showed marked decrease in the collagen deposition & improvement of histopathological picture in comparison with CCL4 fibrotic group. CONCLUSIONS: Our study demonstrates that BM-MSC-MVs possess anti-fibrotic, anti-inflammatory, and pro-angiogenic properties which can promote the resolution of CCL4 induced liver fibrosis in rats.

Treatment outcomes of female germ cell tumors: the Egyptian National Cancer Institute experience.

INTRODUCTION: Female germ cell tumors (GCTS) are rare tumors that carry a good prognosis. AIM: To report the experience of the Egyptian National Cancer Institute (ENCI) in managing female GCTs. METHODS: This retrospective study included 19 females with ovarian GCTs presenting to the ENCI between 2006 and 2010. RESULTS: The median age was 23years. Ovaries were the primary site in all patients. Dysgerminoma and teratoma were the predominant pathologies followed by mixed GCT in females. Unilateral ovariectomy or ovarian tumorectomy were the classic surgical procedures with R0 resection being feasible in most cases. Surveillance was adopted in six patients with stage I disease. Chemotherapy was administered in 63% of ovarian GCTs with BEP being the commonest regimen with reasonable tolerability and good response rates. The median OS and EFS were not reached. The projected 5-year OS rate was 93.8%. Both OS and EFS were better in patients responding to chemotherapy than non-responders (p<0.002). Stage of disease did not significantly affect OS or EFS. CONCLUSIONS: Female GCTs rarely affect Egyptian females. They have good prognosis.

Clinico-pathological features and outcome of management of pediatric gastrointestinal lymphoma.

PURPOSE: The purpose of this study is to evaluate pediatric GIT lymphomas as regards clinico-pathological features, controversies in surgical treatment, role of chemotherapy and the prognostic features. PATIENTS AND METHODS: This study included forty three patients with pediatric GIT Non-Hodgkin's lymphoma collected over 7 years at the NCI Cairo University between January 1997 and December 2003. The data of every patient included: Age, sex, presenting symptoms and signs, preoperative investigations, extent of the disease at diagnosis and the type of resection performed, histopathological examination, details of chemotherapy and state at follow up. Overall and disease free survival were calculated and correlated with all parameters. RESULTS: The study included 30 boys and 13 girls with median age 5.00 years (range: 0.4:17). The lesions were located in the small intestine (n=15), the large intestine (n=14), the ileocecal region (n=10), stomach (n=2), and multifocally (n=2). Burkitt's lymphoma was the commonest histological type (n=24). The majority were stage IIE and IIIE (22 and 17 respectively). Exploration was done in thirty nine patients (complete resections were done in 23 cases, incomplete resections (debulking) were done in 14 cases and in 2 cases only lymph node biopsies were done). All patients received a sort of systemic chemotherapy. The median follow up duration was 44 months (range 4- 116 months). The only parameters that had significantly affected the overall survival were localized disease, complete resection, earlier stage and response to chemotherapy with p values, (0.005, 0.001, 0.005 and <0.001 respectively). As regards the disease free survival the only significant factor was localized disease (p=0.035). CONCLUSION: The extent of disease at presentation is the most important prognostic factor in pediatric GIT lymphoma. Surgery still plays an important role such as complete resection in localized disease, management of complicated disease and diagnostic biopsy. There is no value of debulking and surgery is not advised for gastric lesions. Chemotherapy represents a cornerstone in the treatment and offers an excellent chance for long term, disease free survival.