1.Abrupt Decline in Estimated Glomerular Filtration Rate after Initiating Sodium-Glucose Cotransporter 2 Inhibitors Predicts Clinical Outcomes: A Systematic Review and Meta-Analysis
Min-Hsiang CHUANG ; Yu-Shuo TANG ; Jui-Yi CHEN ; Heng-Chih PAN ; Hung-Wei LIAO ; Wen-Kai CHU ; Chung-Yi CHENG ; Vin-Cent WU ; Michael HEUNG
Diabetes & Metabolism Journal 2024;48(2):242-252
Background:
The initiation of sodium-glucose cotransporter-2 inhibitors (SGLT2i) typically leads to a reversible initial dip in estimated glomerular filtration rate (eGFR). The implications of this phenomenon on clinical outcomes are not well-defined.
Methods:
We searched MEDLINE, Embase, and Cochrane Library from inception to March 23, 2023 to identify randomized controlled trials and cohort studies comparing kidney and cardiovascular outcomes in patients with and without initial eGFR dip after initiating SGLT2i. Pooled estimates were calculated using random-effect meta-analysis.
Results:
We included seven studies in our analysis, which revealed that an initial eGFR dip following the initiation of SGLT2i was associated with less annual eGFR decline (mean difference, 0.64; 95% confidence interval [CI], 0.437 to 0.843) regardless of baseline eGFR. The risk of major adverse kidney events was similar between the non-dipping and dipping groups but reduced in patients with a ≤10% eGFR dip (hazard ratio [HR], 0.915; 95% CI, 0.865 to 0.967). No significant differences were observed in the composite of hospitalized heart failure and cardiovascular death (HR, 0.824; 95% CI, 0.633 to 1.074), hospitalized heart failure (HR, 1.059; 95% CI, 0.574 to 1.952), or all-cause mortality (HR, 0.83; 95% CI, 0.589 to 1.170). The risk of serious adverse events (AEs), discontinuation of SGLT2i due to AEs, kidney-related AEs, and volume depletion were similar between the two groups. Patients with >10% eGFR dip had increased risk of hyperkalemia compared to the non-dipping group.
Conclusion
Initial eGFR dip after initiating SGLT2i might be associated with less annual eGFR decline. There were no significant disparities in the risks of adverse cardiovascular outcomes between the dipping and non-dipping groups.
2.Long-term follow-up of humanized and murine CD19 CAR-T-cell therapy for B-cell acute lymphoblastic leukemia.
Meng Yi DU ; Yan Qiang ZHANG ; Dan Ying LIAO ; Wei XIE ; Wei XIONG ; Heng MEI ; Yu HU
Chinese Journal of Hematology 2023;44(10):793-799
Objective: Murine CD19 chimeric antigen receptor T-cell (CAR-T) products have been approved for the treatment of refractory/relapsed (R/R) B-cell acute lymphocytic leukemia (B-ALL) ; moreover, humanized products are also undergoing clinical trials. This study aimed to explore the differences in safety and short- and long-term follow-up efficacy between humanized and murine CD19 CAR-T-cells for treating relapsed and refractory B-ALL. Methods: Clinical data of 80 patients with R/R B-ALL treated with CD19-targeted CAR-T-cells at the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology between May 2016 and March 2023 were analyzed, which included 31 patients with murine CAR-T and 49 with humanized products. Results: The proportion of patients with cytokine-release syndrome (CRS) in the murine and humanized groups was 63.1% and 65.3%, respectively. Moreover, a higher proportion of patients suffered from severe CRS in the murine group than in the humanized CAR-T group (19.4% vs 8.2%, P=0.174). Furthermore, one patient per group died of grade 5 CRS. The incidence of grade 1-2 immune effector cell-associated neurotoxicity syndrome (ICANS) was 12.9% and 6.1%, respectively; severe ICANS were not observed. Among patients receiving murine CAR-T-cells, an overall response (OR) was observed in 74.2%. Conversely, the OR rate of patients receiving humanized CAR-T-cells was 87.8%. During the median follow-up time of 10.5 months, the median recurrence-free survival (RFS) of patients with murine CAR-T-cells was 12 months, which was as long as that of patients with humanized CAR-T-cells. The median overall survival (OS) were not reached in both groups. Of the 45 patients with a bone marrow burden over 20% at baseline, humanized CAR-T therapy was associated with a significantly improved RFS (43.25% vs 33.33%, P=0.027). Bridging transplantation was an independent factor in prolonging OS (χ(2)=8.017, P=0.005) and PFS (χ(2)=6.584, P=0.010). Common risk factors, such as age, high proportion of bone marrow blasts, and BCR-ABL fusion gene expression, had no significant effect on patients' long-term follow-up outcomes. Three patients reached complete remission after reinfusion of humanized CAR-T-cells. However, one patient relapsed one month after his second infusion of murine CAR-T-cells. Conclusions: The results indicate that humanized CAR-T therapy showed durable efficacy in patients with a higher tumor burden in the bone marrow without any influence on safety. Moreover, it could overcome immunogenicity-induced CAR-T resistance, providing treatment options for patients who were not treated successfully with CAR-T therapies.
Animals
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Humans
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Mice
;
Antigens, CD19
;
Burkitt Lymphoma/drug therapy*
;
Cell- and Tissue-Based Therapy
;
Follow-Up Studies
;
Immunotherapy, Adoptive
;
Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy*
;
Precursor B-Cell Lymphoblastic Leukemia-Lymphoma
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Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy*
;
Receptors, Chimeric Antigen
3.A new cinnamic acid ester derivative from Liquidambaris Resina.
Shao-Ying XU ; Qin-Wen XIAO ; Su-Min ZHAO ; Yi-Jian GUAN ; Liao-Heng YUAN ; Yao ZHU ; Chao-Jie WANG ; Peng-Cheng YAN ; Jian-Yong DONG
China Journal of Chinese Materia Medica 2023;48(15):4130-4136
Twelve compounds were isolated from Liquidambaris Resina by silica gel column chromatography and thin layer chromatography. Their structures were identified on the basis of spectral data, electron capture detector data, and physicochemical properties as(2'R, 3'R)-2',3'-dihydroxy-hydrocinnamyl-(E)-cinnamate(1),(E)-cinnamyl-(E)-cinnamate(2), cinnamic acid(3), 28-norlup-20(29)-en-3-one-17β-hydroperoxide(4), erythrodiol(5), 13β,28-epoxy-30-hydroxyolean-1-en-3-one(6),(3β)-olean-12-ene-3,23-diol(7), 2α,3α-dihydroxy-olean-12-en-28-oic acid(8), 28-hydroxyolean-12-en-3-one(9), 3-epi-oleanolic acid(10), 3-oxo-oleanolic acid(11), and hederagenin(12). Compound 1 was a new cinnamic acid ester derivative and compounds 2-4,6-8, and 12 were isolated from Liquidambaris Resina for the first time. Compounds 4, 5, 10, and 12 exerted inhibitory effects on the proliferation of human umbilical vein endothelial cells(HUVEC) with the IC_(50) values of(17.43±2.17),(35.32±0.61),(27.50±0.80), and(46.30±0.30) μmol·L~(-1), respectively.
Humans
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Oleanolic Acid
;
Endothelial Cells
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Esters
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Cinnamates
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Triterpenes/chemistry*
;
Molecular Structure
4. ROPs: Molecular Switches of Multiple Signal Pathways in Plant Cells
Heng-Yi LIAO ; Ruo-Lin WANG ; Jin HUANG
Chinese Journal of Biochemistry and Molecular Biology 2022;38(3):271-283
RHO-related GTPases of plants (ROPs) are a class of signal transduction G proteins (alsoknown as GTP binding proteins) widely existing in plants. ROP proteins act as " molecular switches" toregulate the signal transduction process during cellular activities such as plant cell polarity regulation, plant morphological development, hormone level regulation, stress responses and many other life activitiesby shifting between inactive GDP-binding and active GTP-binding forms in the cells. In this review, thedomain structure, classification, the mechanism of activity regulation and biological functions of ROPproteins were summarize. Furthermore, ROP proteins from Arabidopsis, maize, rice and barley werephylogenetically analyzed. The results show that ROP proteins were classified into two types based on thedomain structure of the proteins. However, these ROP proteins were divided into 4 clades based on thesimilarity of protein sequences. Furthermore, the mechanism of ROP proteins as a molecular switchregulating various signaling pathways in cells, and the specific functions and mechanisms of ROPs in thepolarized growth of pollen tubes, root hairs and plant pavement cells and other stress responses werecharacterized. In addition, the research progress of the function of ROPs in plant hormones such as ABA, IAA and BR mediated signal transduction were described as well. At last, the unanswered questions suchas why different ROP proteins play distinct roles in the same signaling pathway and how ROPs coordinatedifferent signal pathways to jointly regulate a plant’ s development or physiological process werediscussed, which may shed light on future research.
5.Pharmacologically targeting molecular motor promotes mitochondrial fission for anti-cancer.
Yi QIAN ; Meimei ZHAO ; Qinghua HAN ; Jingkang WANG ; Lixi LIAO ; Heng YANG ; Dan LIU ; Pengfei TU ; Hong LIANG ; Kewu ZENG
Acta Pharmaceutica Sinica B 2021;11(7):1853-1866
Mitochondrial shape rapidly changes by dynamic balance of fusion and fission to adjust to constantly changing energy demands of cancer cells. Mitochondrial dynamics balance is exactly regulated by molecular motor consisted of myosin and actin cytoskeleton proteins. Thus, targeting myosin-actin molecular motor is considered as a promising strategy for anti-cancer. In this study, we performed a proof-of-concept study with a natural-derived small-molecule J13 to test the feasibility of anti-cancer therapeutics
6.Influence of SCN1A intronic mutations in mRNA splicing and relation of mRNA splicing changes with phenotype in febrile seizures related epilepsy
Lu YU ; Heng MENG ; Bin TANG ; Haiqing XU ; Xiuqu CAI ; Na HE ; Xiaorong LIU ; Bingmei LI ; Meimei GAO ; Yiwu SHI ; Yonghong YI ; Weiping LIAO
Chinese Journal of Neuromedicine 2018;17(8):757-764
Objective To study the influence of SCNIA intronic mutations in mRNA splicing in febrile seizures related epilepsy,and investigate the association between splicing changes and genotype-phenotype-inheritance pattern.Methods Molecular cloning of 5 SCN1A intronic mutations was performed in patients with partial epilepsy with antecedent febrile seizures plus (PEFS+) and Dravet syndrome (DS) through constructing mutant and wild-type plasmids of pTragetE2-3-4-5 and E24-25-26 by using Minigene splicing assay,and the in vitro expressions in HENK293 cells were detected.The mRNA splicing changes were analyzed qualitatively and quantitatively by reverse transcription (RT)-PCR and real time quantitative (q)-PCR.Results (1) Using RT-PCR,DS mutants presented a whole exon skipping without significant remain of normal mRNA transcripts,while PEFS+ mutants showed partial exon skipping or intronic insertion with coexistence of normal and aberrant mRNA transcripts.(2) Statistical differences were found between relative quantity (RQ) of aberrant and normal mRNA in PEFS+ mutant (c.473+5G>A:4.92%±1.05% and 6.10%±0.21%;c.473+5G>C:7.97%±1.12% and 3.94% ±1.25%) and that in DS mutant (c.602+1G>A:60.51%±1.81% and 0.060%±0.022%,P<0.05);similarly,there were statistical differences between relative RQ of normal and aberrant mRNA in PEFS+ mutant c.4853-25T>A (71.22%±11.92% and 7.38%±1.61%) and that in DS mutant c.4853-1G>C (0.08%±0.01% and 22.11%±2.83%,P<0.05).Conclusion The position and difference of splicing patterns of SCNIA intronic mutations are potential molecular pathogenesis for phenotypic difference of febrile seizures related epilepsy.
7.Establishment of mouse stably knockout of MYSM1 in MSC cell line C3H10T1/2 and its effect on the immune regulation in vitro.
Yu LIU ; ; Heng ZHU ; Xiao-Xia JIANG ; Bin ZHANG ; Li LIAO ; Yuan-Lin LIU ; Yi ZHANG ; Hu CHEN ; Ning MAO
Journal of Experimental Hematology 2017;25(2):549-554
OBJECTIVETo aimed at the establishment of mouse stably knockout of MYSM1 mesenchymal stem cell(MSC) line C3H10T1/2, and to investigate its immunological capacity of MSC in vitro.
METHODSTo establish the stably transfected MSC cell line by using CRISPR-Cas9 technology. Then the Flow cytometry, quantitative PCR and Western blot were employed to detect whether the MYSM1 have been knockout yet. Furthermore, the immune modulatory effect of MYSM1MSC was tested by addition of MYSM1MSC supernatant into spleen lymphocyte and Foxp3 culture. The mRNA expression of inflammatory cytokines such as interleukin-4, interferon-γ and interleukin-17 were detected by quatitatine PCR.
RESULTSThe expression of MYSM1 was steadily knock out in MSC. In addition, MYSM1MSC showed a stronger inhibitory effect on the expression of inflammatory cytokines. Therefore, the MYSM1 has been stably knocked out in C3H10T1/2.
CONCLUSIONThe mouse stably knockout of MYSM1 mesenchymal stem cells has been successfully established, the knock-out of MYSM1 in MSC can induce more potent immunosuppressive effects on cellular immune reaction in vitro. Our data laid a foundation for the further MSC-based applications in immune related diseases.
8.Effects of Shock Wave on the Proliferation and Osteogenic Differentiation of Human Bone Marrow Mesenchymal Stem Cells.
Yi-Meng YANG ; Hao ZHANG ; Wei-Xiong LIAO ; Xiang-Zheng SU ; Ji LI ; Ke-Tao WANG ; Yuan-Lin LIU ; Ning MAO ; Yi ZHANG ; Ning ZHANG ; Gong-Qian ZHANG ; Heng ZHU ; Zhong-Li LI
Journal of Experimental Hematology 2017;25(1):209-213
OBJECTIVETo explore the effects of the shock wave on the capacity of mesenchymal stem cells(MSCs) to proliferate and differentiate into osteoblasts.
METHODSMSCs were isolated from the bone marrow of healthy donors. The human bone marrow MSCs(BM-MSCs) were divided into 3 groups including blank control group,osteoinduced group and shock wave group. The MSCs in blank control group were cultured with common mediam; the MSCs in osteoinduced group were treated with osteogenic agents and cultured; the MSCs in shock wave group were cultured with common medium and stimulated by shock wave. The morphology of MSCs in each groups were observed by micoscopy; the CCK-8 was used to detect the proliferation ability of MSCs; the alkaline phosphatase staining and von Kossa staining were used to evaluale the differentiation potential of MSCs in each groups.
RESULTSThe results of CCK-8 revealed the shock wave could promote cell proliferation as compared with blank control group. The results of alkaline phosphatase and Von Kossa staining showed that the shock wave displayed a stronger ability to promote the human BMMSC differentiation into osteoblasts cells in comparison with the osteoinduced group. The blank control group was weakly positively stainined.
CONCLUSIONThe shock wave treatment can promote proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells.
9.Clinical Research on Dachaihu Granule in Treating Chronic Cholecystitis Due to Stagnant Heat in Liver and Gallbladder
Jing CHEN ; Hong SHEN ; Yue-Han LIN ; Heng-Xiang LIAO ; Yi-Ping JIANG ; Chui-Jie WANG ; Xiao-Jing JIN ; Juan-Ping SU ; Feng-Zhen SHAO ; Jian-Dong ZOU ; Fang LIU
Journal of Nanjing University of Traditional Chinese Medicine 2017;33(4):354-358
OBJECTIVE To evaluate the validity and safety of Dachaihu Granule in treating chronic cholecystitis due to Stagnant Heat in Liver and Gallbladder.METHODS A stratified-block randomized,double-blind,double-dummy,parallel,placebo-controlled trial was designed,with 600 cases with chronic cholecystitis from 8 centers being selected and the ratio of treatment group,placebo group and cholagogic tablet group being 360:120:120.Patients in different groups were separately given Dachaihu Granule and cholagogic tablet simulator,Dachaihu Granule simulator and cholagogic tablet simulator,Dachaihu Granule simulator and cholagogic tablet.Then the validity and safety were assessed after 7 days' treatment.RESULTS ①In terms of the comprehensive curative effect of TCM syndromes,it was noticed that there existed no difference between the treatment group and positive medicine group in the integral reduction and disappearance of upper quadrant pain and tenderness,quadrant pain relief evaluated by patients,total symptom scores,integral reduction and disappearance of bitter taste,thirst,constipation and yellow urine,disappearance of vomit,change of gallbladder wall thickness and ultrasonic Murphy's character before and after the treatment,while both the treatment group and positive medicine group were superior to the placebo group(P<0.05~0.01).②The treatment group and positive medicine group has no difference from the placebo group in integral reduction and disappearance o ffever and nausea integral reduction of vomit,change of gallbladder size and inside diameter of common bile duct.③Good safety was noticed.CONCLUSION Chronic cholecystitis due to stagnant heat in liver and gallbladder treated by Dachaihu Granule is safe and effective.
10.Design and verification of Luo-Ye pump-based stress formation for cultivation of tissue-engineered blood vessel.
Wen-Jun LIAO ; Wan-Wen CHEN ; Zhang WEN ; Yue-Heng WU ; Dong-Feng LI ; Jia-Hui ZHOU ; Jian-Yi ZHENG ; Zhan-Yi LIN
Journal of Southern Medical University 2016;36(7):1008-1013
OBJECTIVETo improve Luo-Ye pump-based stress-forming system and optimize the stimulating effect on smooth muscle cells during cultivation of tissue-engineered blood vessels (TEBV).
METHODSA new Luo-Ye pump-based TEBV 3D culture system was developed by adding an air pump to the output of the bioreactor. A pressure guide wire was used to measure the stress at different points of the silicone tube inside the TEBV bio-reactor, and fitting curves of the stress changes over time was created using Origin 8.0 software. The TEBVs were constructed by seeding vascular smooth muscle cells (VSMCs) isolated from human umbilical artery on polyglycolic acid (PGA) and cultured under dynamic conditions with 40 mmHg resistance (improved group), dynamic conditions without resistance (control group) or static condition (static group) for 4 weeks. The harvested TEBVs were then examined with HE staining, masson staining, α-SMA immunohistochemical staining, and scanning and transmission electron microscopy with semi-quantitative analysis of collagen content and α-SMA expression.
RESULTSThe measured stress values and the fitting curves showed that the stress stimuli from the Luo-Ye pump were enhanced by adding an air pump to the output of the bioreactor. Histological analysis revealed improved VSMC density, collagen content and α-SMA expression in the TEBVs constructed with the improved method as compared with those in the control and static groups.
CONCLUSIONAdding an air pump to the Luo-Ye pump significantly enhances the stress stimulation in the TEBV 3-D culture system to promote the secretion function of VSMCs.
Bioreactors ; Blood Vessel Prosthesis ; Cells, Cultured ; Collagen ; metabolism ; Humans ; Myocytes, Smooth Muscle ; cytology ; Polyglycolic Acid ; Tissue Engineering ; methods

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