1.Paroxetine alleviates dendritic cell and T lymphocyte activation via GRK2-mediated PI3K-AKT signaling in rheumatoid arthritis.
Tingting LIU ; Chao JIN ; Jing SUN ; Lina ZHU ; Chun WANG ; Feng XIAO ; Xiaochang LIU ; Liying LV ; Xiaoke YANG ; Wenjing ZHOU ; Chao TAN ; Xianli WANG ; Wei WEI
Chinese Medical Journal 2025;138(4):441-451
BACKGROUND:
G protein-coupled receptor kinase 2 (GRK2) could participate in the regulation of diverse cells via interacting with non-G-protein-coupled receptors. In the present work, we explored how paroxetine, a GRK2 inhibitor, modulates the differentiation and activation of immune cells in rheumatoid arthritis (RA).
METHODS:
The blood samples of healthy individuals and RA patients were collected between July 2021 and March 2022 from the First Affiliated Hospital of Anhui Medical University. C57BL/6 mice were used to induce the collagen-induced arthritis (CIA) model. Flow cytometry analysis was used to characterize the differentiation and function of dendritic cells (DCs)/T cells. Co-immunoprecipitation was used to explore the specific molecular mechanism.
RESULTS:
In patients with RA, high expression of GRK2 in peripheral blood lymphocytes, accompanied by the increases of phosphatidylinositol 3 kinase (PI3K), protein kinase B (AKT), and mammalian target of rapamycin (mTOR). In animal model, a decrease in regulatory T cells (T regs ), an increase in the cluster of differentiation 8 positive (CD8 + ) T cells, and maturation of DCs were observed. Paroxetine, when used in vitro and in CIA mice, restrained the maturation of DCs and the differentiation of CD8 + T cells, and induced the proportion of T regs . Paroxetine inhibited the secretion of pro-inflammatory cytokines, the expression of C-C motif chemokine receptor 7 in DCs and T cells. Simultaneously, paroxetine upregulated the expression of programmed death ligand 1, and anti-inflammatory cytokines. Additionally, paroxetine inhibited the PI3K-AKT-mTOR metabolic pathway in both DCs and T cells. This was associated with a reduction in mitochondrial membrane potential and changes in the utilization of glucose and lipids, particularly in DCs. Paroxetine reversed PI3K-AKT pathway activation induced by 740 Y-P (a PI3K agonist) through inhibiting the interaction between GRK2 and PI3K in DCs and T cells.
CONCLUSION
Paroxetine exerts an immunosuppressive effect by targeting GRK2, which subsequently inhibits the metabolism-related PI3K-AKT-mTOR pathway of DCs and T cells in RA.
G-Protein-Coupled Receptor Kinase 2/metabolism*
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Arthritis, Rheumatoid/immunology*
;
Animals
;
Dendritic Cells/metabolism*
;
Paroxetine/therapeutic use*
;
Proto-Oncogene Proteins c-akt/metabolism*
;
Mice
;
Humans
;
Mice, Inbred C57BL
;
Signal Transduction/drug effects*
;
Male
;
Phosphatidylinositol 3-Kinases/metabolism*
;
Lymphocyte Activation/drug effects*
;
Female
;
T-Lymphocytes/metabolism*
;
Middle Aged
2.LAG-3 and PD-1 combination therapy in tumor immunotherapy.
Chinese Journal of Cellular and Molecular Immunology 2025;41(4):355-362
Programmed death 1 (PD-1) and its ligand (PD-L1) serve as crucial targets in cancer immunotherapy, and their inhibitors have significantly improved the prognosis of many patients with malignant tumors. However, the issues of drug resistance and limited overall response rate associated with monotherapy remain prevalent. As a new generation of immune checkpoints, lymphocyte activation gene 3 (LAG-3) synergistically enhances the suppression of T cells alongside PD-1 in various cancers. Combining the blockade of both PD-1 and LAG-3 yields stronger anti-tumor immune effects compared to blocking either target alone, thereby reversing the immunosuppressive state of the tumor microenvironment and reducing the occurrence of resistance. This review covers the structural characteristics of LAG-3 and unveils its specific interactions with PD-1 across multiple cancers, providing a novel reference for overcoming the limitations of single-agent therapy.
Humans
;
Neoplasms/immunology*
;
Immunotherapy/methods*
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Programmed Cell Death 1 Receptor/metabolism*
;
Lymphocyte Activation Gene 3 Protein
;
Antigens, CD/metabolism*
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Animals
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Tumor Microenvironment/immunology*
;
Immune Checkpoint Inhibitors/therapeutic use*
3.A novel fully human LAG-3 monoclonal antibody LBL-007 combined with PD-1 antibody inhibits proliferation, migration and invasion of tumor cells via blocking NF-κB pathway.
Huinan ZHOU ; Jianfei LIU ; Chenglin WU ; Kewei QIN ; Lijun ZHOU
Chinese Journal of Cellular and Molecular Immunology 2025;41(5):398-405
Objective To investigate the effects of LBL-007, a novel fully human lymphocyte activation gene 3 (LAG-3) monoclonal antibody, in combination with programmed cell death protein 1 (PD-1) antibody, on the invasion, migration and proliferation of tumor cells, and to elucidate the underlying mechanisms. Methods Human lymphocyte cells Jurkat were co-cultured with A549 and MGC803 tumor cell lines and treated with the isotype control antibody human IgG, LBL-007, anti-PD-1 antibody BE0188, or tumor necrosis factor-alpha (TNF-α, the NF-κB signaling pathway agonist). Tumor cell proliferation was assessed using a colony formation assay; invasion was measured by TranswellTM assay; migration was evaluated using a wound healing assay. Western blotting was employed to determine the expression levels of NF-κB pathway-related proteins: IκB inhibitor kinase alpha (Ikkα), phosphorylated Ikkα (p-IKKα), NF-κB subunit p65, phosphorylated p65 (p-p65), NF-κB Inhibitor Alpha (IκBα), phosphorylated IκBα (p-IκBα), matrix metalloproteinase 9 (MMP9), and MMP2. Results Compared with the control and IgG isotype groups, LBL-007 and BE0188 significantly reduced tumor cell proliferation, invasion, and migration. They also decreased the phosphorylation of p-IKKα, p-p65 and p-IκBα, and the expression of MMP9 and MMP2 of tumor cells in the co-culture system. The combined treatment of LBL-007 and BE0188 enhanced inhibitory effects. Treatment with the NF-κB signaling pathway agonist TNF-α reversed the suppressive effects of LBL-007 and BE0188 on tumor cell proliferation, invasion, migration, and NF-κB signaling. Conclusion LBL-007 and anti-PD-1 antibody synergistically inhibit the invasion, migration, and proliferation of A549 and MGC803 tumor cells by blocking the NF-κB signaling pathway.
Humans
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Cell Proliferation/drug effects*
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Cell Movement/drug effects*
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Signal Transduction/drug effects*
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NF-kappa B/metabolism*
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Neoplasm Invasiveness
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Antibodies, Monoclonal/pharmacology*
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Programmed Cell Death 1 Receptor/antagonists & inhibitors*
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Cell Line, Tumor
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Antigens, CD/immunology*
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Lymphocyte Activation Gene 3 Protein
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A549 Cells
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I-kappa B Kinase/metabolism*
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Jurkat Cells
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Matrix Metalloproteinase 9/metabolism*
4.The characteristics and clinical values of peripheral T lymphocytic subsets and functional changes in primary biliary cholangitis.
Liming ZHENG ; Jinhan LIU ; Hong LI ; Longgen LIU ; Guojun ZHENG ; Sijia DAI
Chinese Journal of Cellular and Molecular Immunology 2025;41(5):437-443
Objective This study aimed to analyze the characteristics and clinical significance of peripheral lymphocytic subsets and cytokine levels, including interleukin 1β(IL-1β), IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12P70, IL-17A, tumor necrosis factor α(TNF-α), interferon γ(IFN-γ) and IFN-α, in patients with primary biliary cholangitis (PBC), to provide some novel insights into the pathogenesis of PBC. Methods We retrospectively collected clinical features and laboratory data from hospitalized patients who were primarily diagnosed with PBC and from healthy physical examinees at the Third People's Hospital of Changzhou between January 1, 2023, and June 30, 2024. Results A total of 152 PBC patients and 96 healthy controls who met the inclusion and exclusion criteria were enrolled. Significant differences were observed in baseline characteristics and laboratory data between the two groups. After the propensity score matching (PSM) analysis, 61 PBC patients and 61 healthy controls were successfully matched, ensuring that the general characteristics (age and gender) of the two groups were balanced and comparable. Compared to the control group, the proportion of peripheral lymphocytes was significantly higher in the PBC group (31.9% vs. 17.8%), primarily due to an increase in CD4+ T cells (46.77% vs. 41.19%), while CD8+T cells were significantly decreased (19.73% vs. 22.07%). Notably, the proportions of CD4+ programmed cell death 1 (PD-1)+ T and CD8+PD-1+ T cells were elevated, with CD8+PD-1+ T cells showing a significant positive correlation with the severity of liver inflammation (r=0.41). Furthermore, the mitochondrial mass (MM) of CD4+ T cells was significantly increased in PBC patients, whereas no significant changes were observed in the MM of CD8+ T cells or the mitochondrial membrane potential (MMP) of CD3+ T cells. Additionally, the plasma levels of cytokines, such as IL-4, IL-8, IL-10 and IFN-α, were abnormally elevated. The plasma levels of IL-5 and IL-1β were negatively correlated with the stage of liver fibrosis in patients with PBC (r=-0.52). Conclusion The overactivation and proliferation of CD4+ T cells, along with the suppression of CD8+ T cell function and increased PD-1 expression leads to T cell exhaustion, indicating significant immunological alterations in PBC patients. These changes are closely associated with the disease progression. Additionally, cytokines are likely involved in the immune regulation process of PBC and may influence the pathogenic mechanisms of the disease. Regular monitoring of lymphocyte subsets and cytokine levels can help assess the immune status and disease activity in patients with PBC, thereby guiding the individualized treatment strategies.
Humans
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Male
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Female
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Middle Aged
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Liver Cirrhosis, Biliary/blood*
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Retrospective Studies
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T-Lymphocyte Subsets/immunology*
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Aged
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Cytokines/blood*
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Adult
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CD8-Positive T-Lymphocytes/immunology*
5.Construction of NK cell-conditional Cd226 knockout mice and preliminary investigation of their role in ulcerative colitis.
Jianchun LYU ; Zichan GUO ; Yazhen WANG ; Ziyan CHEN ; Zhengxiang ZHANG ; Lihua CHEN
Chinese Journal of Cellular and Molecular Immunology 2025;41(6):488-494
Objective To generate and characterize natural killer cell (NK cell)-conditional Cd226 gene knockout mice using Cre-loxP technology, and to explore the role of CD226 on NK cells in alleviating intestinal inflammation in a murine model of ulcerative colitis (UC). Methods NK cell-conditional Cd226 gene knockout mice were generated by crossing loxP-flanked Cd226 mice with Ncr1-Cre mice via the Cre-loxP system. Polymerase chain reaction (PCR) and agarose gel electrophoresis were used for genotyping. A UC model was established by dextran sulfate sodium (DSS) induction. Flow cytometry was performed to analyze CD226 expression levels on NK cells and the infiltration of related immune cells in colon tissues. Hematoxylin-eosin (HE) staining was performed to assess the degree of colonic inflammation. Results DNA gel electrophoresis and flow cytometry confirmed the successful generation of NK cell-specific Cd226 knockout mice. After conditional knockout of Cd226 in NK cells, inflammation in the UC mouse model was alleviated. Flow cytometry results showed a reduced proportion of NK cells in peripheral blood and the colon lamina propria, while HE staining demonstrated attenuated inflammatory responses. Conclusion Specific knockout of Cd226 in NK cells mitigates intestinal inflammation in UC mice by reducing NK cell numbers and inhibiting their pro-inflammatory functions.
Animals
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Colitis, Ulcerative/pathology*
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Killer Cells, Natural/metabolism*
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Mice, Knockout
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T Lineage-Specific Activation Antigen 1
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Antigens, Differentiation, T-Lymphocyte/genetics*
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Mice
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Disease Models, Animal
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Mice, Inbred C57BL
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Male
6.Research on the inhibitory effects of evodiamine on activated T cell proliferation.
Jianan TANG ; Xingyan LUO ; Jingjing HE ; Xiaoxin ZENG ; Yang LIU ; Yi LAI
Chinese Journal of Cellular and Molecular Immunology 2025;41(6):524-530
Objective To explore the characteristics of the inhibitory effect of Evodiamine on the proliferation of activated T cells. Methods Mononuclear cells from peripheral blood (PBMCs) were obtained from healthy donors through density gradient centrifugation, and T cells were subsequently purified by using immunomagnetic bead separation. T cell activation was induced by employing anti-human CD3 and anti-human CD28 antibodies. T cells were treated with different concentrations of EVO (0.37, 1.11, 3.33, and 10)μmol/L. Flow cytometry was applied to evaluate the proliferation index, apoptosis rate, viability, CD25 expression levels, and cell cycle distribution of T cells. The expression levels of cytokines IL-2, IL-17A, IL-4, and IL-10 were quantified by using ELISA. Results 1.11, 3.33 and 10 μmol/L EVO effectively inhibited the proliferation of activated T cells, with an IC50 of (1.5±0.3)μmol/L. EVO did not induce apoptosis in activated T cells and affect the survival rate of resting T cells. EVO did not affect the expression of CD25 and the secretion of IL-2 in activated T cells. EVO arrested the T cell cycle at the G2/M phase, resulting in an increase in G2/M phase cells, and exhibited a concentration-dependent effect. EVO did not affect the secretion of IL-4, IL-10 by activated T cells, but significantly inhibited the secretion of IL-17A. Conclusion EVO did not significantly affect the activation process of T cells but inhibited T cell proliferation by arresting the cell cycle at the G2/M phase and significantly suppressed the secretion of the pro-inflammatory cytokine IL-17A, which suggests that EVO has the potential to serve as a lead compound for the development of low-toxicity and high-efficiency immunosuppressants and elucidates the mechanisms underlying the anti-inflammatory and immunomodulatory effects of the traditional Chinese medicine Evodia rutaecarpa.
Humans
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Cell Proliferation/drug effects*
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Quinazolines/pharmacology*
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T-Lymphocytes/metabolism*
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Lymphocyte Activation/drug effects*
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Apoptosis/drug effects*
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Interleukin-4/metabolism*
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Interleukin-10/metabolism*
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Interleukin-2 Receptor alpha Subunit/metabolism*
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Interleukin-17/metabolism*
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Interleukin-2/metabolism*
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Cell Cycle/drug effects*
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Cells, Cultured
7.The important role and interaction of platelet-activating factor and T cell immune function in the pathogenesis of vitiligo.
Yi LIU ; Xiaoping LI ; Yao CHEN
Chinese Journal of Cellular and Molecular Immunology 2025;41(8):717-723
Objective To investigate the relationship between serum platelet-activating factor (PAF) level, T cell immune function and disease activity in vitiligo patients. Methods A total of 102 patients with vitiligo treated in our hospital from July 18th, 2022 to July 26th, 2023 were enrolled as study subjects. According to VIDA score, the patients were divided into an advanced-stage group (n=54) and a stable stage group (n=49). PAF and T lymphocyte levels were compared between the two groups. Logistic regression analysis was performed to examine the relationship between PAF levels and disease activity, as well as their correlation with T cell subsets. Unconditional logistic regression modeling was employed to analyze the interaction between PAF levels and T cell subsets in disease activity. Results No significant difference was observed in CD3+ levels between advanced and stable stage vitiligo patients. PAF and CD8+ levels in advanced group were significantly higher than those in stable group, while CD4+ levles and CD4+/CD8+ ratios were significantly lower than those in stable group. When PAF level was 18.24 ng/L, the maximum Youden index reached 0.670, with corresponding sensitivity of 84.22% and specificity of 82.77%. The area under ROC curve AUC was 0.858. The intensity of association between PAF level and disease activity was nonlinear dose-response relationship. Among patients with VIDA score ≥1, significant differences were observed in both CD4+ and CD8+ levels across different PAF levels, and the CD4+/CD8+ ratios in vitiligo patients with different VIDA scores was significantly different. Interaction analysis revealed that after adjusting for confounding factors, the effect of PAF levels and T cell subsets on disease activity in vitiligo patients showed significant interaction in both additive model (RERI=4.674, 95%CI: 1.032~11.942; AP=0.763, 95%CI: 0.336~1.201; S=6.854, 95%CI: 1.904~16.520) and multiplicative model (OR=3.461, 95%CI: 1.365~8.713). Conclusion Serum PAF, CD4+, CD8+ and CD4+/CD8+ of vitiligo patients are closely related to disease activity, and PAF level interacts with T cell subsets (CD4+, CD8+, CD4+/CD8+) in the disease activity of vitiligo patients. PAF and T cell immune function may contribute to the occurrence and development of vitiligo, which could serve as clinical indicators of disease activity to guide timely management.
Humans
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Vitiligo/blood*
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Platelet Activating Factor/immunology*
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Male
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Female
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Adult
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Middle Aged
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Young Adult
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T-Lymphocytes/immunology*
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Adolescent
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T-Lymphocyte Subsets/immunology*
8.Significance of HALP Score as a Prognostic Indicator for Newly Diagnosed Multiple Myeloma.
Kuan-Shun ZHANG ; Dian-Liang LYU ; Lin SHI
Journal of Experimental Hematology 2025;33(2):442-446
OBJECTIVE:
To investigate the significance of HALP score as a prognostic indicator for newly diagnosed multiple myeloma (MM).
METHODS:
Clinical data of 62 newly diagnosed MM patients in our hospital from January 2020 to December 2022 were collected and retrospectively analyzed. The difference in age, sex, DS stage, R-ISS stage, M protein type, serum creatinine (Scr), β2-microglobulin (β2-MG), blood calcium, lactate dehydrogenase (LDH), hemoglobin (Hb), albumin (ALB), platelet count (PLT), and absolute lymphocyte count (ALC) between patients with low and high HALP scores were analyzed. The prognostic value of the above indexes in newly diagnosed MM patients was analyzed by univariate and multivariate analysis.
RESULTS:
The optimal cut-off value of HALP score was 41 determined by X-tile software. Based on this, 62 patients were divided into a high HALP group (HALP>41, n=25) and a low HALP group (HALP≤41, n=37). The proportion of patients with Hb≥100 g/L in the high HALP group was significantly higher than that in the low HALP group (P <0.05). The median overall survival (OS) time of patients in the high HALP group and low HALP group were 29 (9-39) months and 20 (4-29) months, respectively, with statistically significant difference between the two groups (P <0.01). Univariate analysis showed that R-ISS stage, ALB, Hb, ALC and HALP were closely related to the prognosis of patients (P <0.05). COX regression multivariate analysis showed that R-ISS stage Ⅲ (HR=4.443, 95%CI : 1.480-13.343,P =0.008) and HALP≤41(HR=8.823, 95%CI : 1.858-41.910,P =0.006) were independent risk factors for shortened OS in newly diagnosed MM patients. The median OS of patients with high HALP at R-ISS stage Ⅲ was significantly higher than that of patients with low HALP at the same stage, and the difference was statistically significant (P <0.05).
CONCLUSION
HALP score can be used as a prognostic indicator for newly diagnosed MM patients.
Humans
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Multiple Myeloma/diagnosis*
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Prognosis
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Retrospective Studies
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Male
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Female
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Middle Aged
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Aged
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beta 2-Microglobulin
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Lymphocyte Count
9.Correlation Analysis between Immune Cells in Graft and Early Immune Reconstitution after Allogeneic Hematopoietic Stem Cell Transplantation.
Shan WANG ; Fan LIU ; Qiu-Juan ZHU ; Tao WANG ; Rong GONG ; Wei-Wei TIAN ; Zhi-Lin GAO
Journal of Experimental Hematology 2025;33(4):1173-1180
OBJECTIVE:
To investigate the correlation between the types and quantities of immune cells in the graft and early immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and their influence on clinical prognosis.
METHODS:
The clinical data of 83 patients with hematological diseases who received allo-HSCT in Shanxi Bethune Hospital from September 2020 to June 2023 were retrospectively analyzed. The number of mononuclear cells (MNC), CD34+ cells and lymphocyte subsets (including CD3+T, CD3+CD4+T(Th), CD3+CD8+T(Ts), NK cells and B cells) infused into the recipients was counted, and the peripheral blood lymphocytes were detected before conditioning and on days 14, 30, 60 and 100 post-HSCT.
RESULTS:
Multivariate analysis showed that the number of MNC in the graft affected the recovery of CD4+T lymphocytes after HSCT, and the number of CD4+T lymphocytes in the graft affected the recovery of NK cells and B cells after HSCT. The patient age, donor sex, stem cell source, degree of HLA matching, use of ATG before HSCT, the occurrence of acute graft-versus-host disease (aGVHD) after HSCT, and viral infection all affect the early cellular immune reconstitution post-HSCT. The number of infused cells had no significant impact on the median engraftment time for neutrophils and platelets after HSCT. Patients with lower numbers of CD3+T, CD4+T and B cells in the graft were more prone to viral infection after HSCT. However, the cells in the graft had no significant effect on disease recurrence or mortality.
CONCLUSION
The recovery rate of lymphocyte count after allo-HSCT varies. The numbers of MNC and CD4+T cells in the graft may be related to the cellular immune reconstitution after HSCT, while the numbers of CD34+,CD3+T,CD8+T,NK and B cells have no significant effect on the cellular immune reconstruction. The numbers of CD3+T,CD4+T and B cells in the graft were negatively correlated with viral infection after HSCT, but the cellular components of the graft have no obvious influence on hematopoietic reconstitution, disease recurrence, death, recurrence-free survival(RFS) and overall survival(OS) after HSCT.
Humans
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Hematopoietic Stem Cell Transplantation
;
Immune Reconstitution
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Transplantation, Homologous
;
Retrospective Studies
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Graft vs Host Disease/immunology*
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Male
;
Female
;
Killer Cells, Natural/immunology*
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Adult
;
Middle Aged
;
B-Lymphocytes/immunology*
;
Prognosis
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Lymphocyte Subsets/immunology*
;
Adolescent
10.Correlation between Expression Levels of Tim-3, C-myc and Proportion of T Lymphocyte Subsets and Prognosis in Patients with Acute Lymphoblastic Leukemia.
Yu-Chai ZHONG ; Ke-Ding HU ; Yi-Rong JIANG ; Xiao-Wen HUANG
Journal of Experimental Hematology 2025;33(5):1299-1304
OBJECTIVE:
To analyze the correlation between the expression levels of Tim-3, C-myc and the proportion of T lymphocyte subsets and prognosis in patients with acute lymphoblastic leukemia (ALL).
METHODS:
The research group selected 60 ALL patients admitted to our hospital from December 2019 to December 2021, while the control group selected 55 healthy volunteers who underwent physical examination in our hospital. The expression levels of Tim-3, C-myc mRNA and the proportion of T lymphocyte subsets in the two groups were detected. The mortality rate of ALL patients was calculated, and the correlation between the expression levels of Tim-3, C-myc, and the proportion of T lymphocyte subsets and pathological features and prognosis was analyzed.
RESULTS:
Compared with the control group, the levels of Tim-3, C-myc and CD8+ in the research group were increased, while the levels of CD3+ , CD4+ and CD4+ /CD8+ were decreased (all P < 0.001). The levels of Tim-3, C-myc mRNA, CD3+ , CD4+ , CD8+ , CD4+ /CD8+ were correlated with risk classification and extramedullary infiltration (all P < 0.05). The survival rate of patients with low expression of Tim-3, C-myc, and CD8+ was higher than that of patients with high expression, while the survival rate of patients with high expression of CD3+ , CD4+ , and CD4+ /CD8+ was higher than that of patients with low expression (all P < 0.05). Univariate analysis showed that the deceased patients had higher proportions of extramedullary infiltration and high-risk classification, as well as higher levels of Tim-3, C-myc, and CD8+ , while lower levels of CD3+ , CD4+ , and CD4+ /CD8+ compared with surviving patients (all P < 0.01). Multivariate logistic regression analysis showed that extramedullary invasion, risk classification, Tim-3, C-myc, CD3+ , CD4+ , CD8+ , CD4+ /CD8+ were the main factors affecting the prognosis of ALL patients (all P < 0.05). ROC curve analysis showed that the combination of Tim-3, C-myc, and T lymphocyte subsets had higher sensitivity and accuracy in predicting prognosis of ALL patients compared with the single diagnosis of Tim-3, C-myc, CD3+ , CD4+ , CD8+ , and CD4+ /CD8+ (P < 0.05).
CONCLUSION
ALL patients show higher levels of Tim-3, C-myc mRNA and CD8+ but lower levels of CD3+ , CD4+ and CD4+/CD8+. Moreover, the expression levels of Tim-3, C-myc, CD3+ , CD4+ , CD8+ and CD4+/CD8+ are correlated with extramedullary invasion, high-risk classification and prognosis.
Humans
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Hepatitis A Virus Cellular Receptor 2/metabolism*
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Prognosis
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Proto-Oncogene Proteins c-myc/metabolism*
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Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis*
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T-Lymphocyte Subsets
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Male
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Female
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Adult
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Middle Aged
;
Adolescent
;
RNA, Messenger

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