Východiská: Alogénna transplantácia krvotvorných buniek (allogeneic hematopoietic stem cell transplantation – alloHSCT) predstavuje významný terapeutický výkon pre liečbu celého spektra závažných chorôb. Pokroky v liečbe a podpornej starostlivosti zlepšili celkové prežívanie, avšak napriek tomu sa alloHSCT naďalej vyznačuje značnou úmrtnosťou, najčastejšie zapríčinenou chorobou z reakcie štepu proti hostiteľovi (graft-versus-host disease – GvHD). Cieľom našej retrospektívnej analýzy bolo zistiť, ktoré z vybraných faktorov mali vplyv na celkové prežívanie a vývoj GvHD po alloHSCT od HLA-identických súrodencov. Analyzovali sme vek pacienta a darcu, kompatibilitu v AB0 systéme, zhodu pohlavia príjemcu a darcu, zdroj krvotvorných buniek, čas od diagnózy po alloHSCT, typ prípravného režimu, typ profylaxie GvHD a relaps. Pacienti a metódy: Sledovali sme 96 pacientov (54 mužov, 42 žien), ktorí podstúpili alloHSCT od HLA-identického súrodenca. Medián sledovania bol 64,5 mesiaca (rozsah 1–218 mesiacov), medián veku príjemcov aj darcov bol 34 rokov. Najčastejšou indikáciou alloHSCT bolo malígne hematologické ochorenie. Výsledky: Najvyšší počet úmrtí zapríčinila GvHD a jej komplikácie (n = 24; 46,2 %) a na druhom mieste bol relaps (n = 18; 34,6 %). Akútnu GvHD vyvinulo 30 (31,3%) a chronickú GvHD 25 (26,0%) z celkového počtu 96 pacientov. Celkovo GvHD vyvinulo 45 pacientov (46,9%). Pozorovali sme horšie celkové prežívanie pacientov mužského pohlavia, ktorí mali darkyne ženy v porovnaní s ostatnými pacientami (p = 0,01; HR = 2,33). Celkové prežívanie bolo lepšie u pacientov transplantovaných do 1 roka od stanovenia diagnózy, v porovnaní s pacientami transplantovanými po 1 roku (p = 0,03; HR = 1,93). Žiadny z faktorov nemal štatisticky významný vplyv na akutnú GvHD, chronickú GvHD a celkovo na GvHD. Záver: Potvrdili sme, že nezhoda pohlaví, ak darcom je žena a príjemcom muž, signifikantne negatívne ovplyvňuje celkové prežívanie po alloHSCT. Rovnako, celkové prežívanie mali signifikantne kratšie pacienti, ktorí podstúpili alloHSCT neskôr ako 1 rok od potvrdenia diagnózy.
Backgrounds: Allogeneic hematopoietic stem cell transplantation (alloHSCT) is a substantial therapeutic procedure for the treatment of a wide spectrum of severe diseases. Despite advancements in treatment and supportive care, alloHSCT still carries a considerable mortality risk, primarily caused by graft-versus-host disease (GvHD). Our retrospective analysis aimed to identify the factors influencing overall survival and GvHD development in HLA-identical sibling alloHSCT. We have analyzed patients’ and donors’ age, AB0 compatibility, recipient-donor gender match, stem cell source, time from the diagnosis to alloHSCT, conditioning regimen type, GvHD prophylaxis, and relapse. Patients and methods: Our study included 96 patients (54 male, 42 female) who underwent HLA-identical sibling alloHSCT. The median follow-up was 64.5 months (range 1–218 months), and the median age of both recipients and donors was 34 years. Malignant hematological diseases were the most common indications for alloHSCT. Results: GvHD and its complications accounted for the highest number of deaths (N = 24; 46.2%), followed by relapse (N = 18; 34.6%). Acute GvHD developed in 30 patients (31.3%), while chronic GvHD occurred in 25 patients (26.0%), resulting in a total of 45 patients (46.9%) experiencing GvHD. Male recipients with female donors had significantly worse overall survival compared to other patients (P = 0.01; HR = 2.33). Overall survival was better in patients transplanted within 1 year from the diagnosis compared to those transplanted after 1 year (P = 0.03; HR = 1.93). No factor reached statistical significance regarding the impact on acute GvHD, chronic GvHD, or overall GvHD. Conclusion: We confirmed that sex mismatch, specifically in the case of a female donor and a male recipient, significantly negatively affects overall survival after alloHSCT. Additionally, overall survival is significantly shorter when the interval between the diagnosis and alloHSCT exceeds one year.
- MeSH
- analýza přežití * MeSH
- dospělí MeSH
- hematologické nádory mortalita terapie MeSH
- histokompatibilita MeSH
- homologní transplantace mortalita statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- nemoc štěpu proti hostiteli epidemiologie mortalita MeSH
- sourozenci MeSH
- statistika jako téma MeSH
- transplantace kostní dřeně * mortalita statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- klinická studie MeSH
HLA-G is an immune checkpoint molecule with immunosuppressive and anti-inflammatory activities, and its expression and level of its soluble form (sHLA-G) may play an important role in tumor prognosis. The HLA-G 14bp ins/del polymorphism and the plasma level of soluble HLA-G (sHLA-G) were investigated by a polymerase chain reaction and ELISA, respectively, in 59 glioma patients. A significantly higher proportion of glioma patients had the 14 nt insert in both homozygous and heterozygous states compared to the control group. Glioma patients also had higher plasma levels of sHLA-G. Patients with methylated MGMT promoters had lower levels of sHLA-G than those with unmethylated MGMT promoters. The level of sHLA-G negatively correlated with the overall survival of patients. Glioblastoma patients who survived more than one year after diagnosis had lower levels of sHLA-G than those surviving less than one year. Patients with sHLA-G levels below the cut-off value of 40 U/mL survived significantly longer than patients with sHLA-G levels above 40 U/mL. The levels of sHLA-G were also negatively correlated with the level of IL-6 (p = 0.0004) and positively with IL-10/IL-6 (p = 0.046). Conclusion: The presence of the 14 nt insert in both homozygous and heterozygous states of the HLA-G 14bp ins/del polymorphism is more frequent in glioma patients and the elevated plasma levels of sHLA-G are negatively associated with their survival.
- Publikační typ
- časopisecké články MeSH
Zápal stredného ucha predstavuje jedno z najbežnejších ochorení na svete a vo všeobecnosti patrí k najčastejším príčinám poruchy sluchu. V niektorých prípadoch môžu epizódy akútnej otitídy progredovať do chronického zápalu stredného ucha aj napriek adekvátnej liečbe. Kvôli komplexnej patogenéze a narastajúcej rezistencii patogénov na antibiotickú liečbu je nevyhnutné hľadanie iných terapeutických postupov, ktorými by bolo možné toto ochorenie modulovať a liečiť. Preto je zásadné porozumieť úlohe vrodenej imunity v strednom uchu pri obrane proti mikroorganizmom. V tejto prehľadovej práci sa zaoberáme úlohou prirodzenej imunity pri otitíde a poukazujeme na úlohy vrodenej celulárnej imunity pri ochrane stredného ucha vo svetle najnovších poznatkov. Vrodený imunitný systém v strednom uchu je zodpovedný za rýchlu identifikáciu a následné odstránenie patogénov. Bunky imunitného systému exprimujú obrovské množstvo receptorov s rozmanitými funkciami s cieľom eliminovať mnohé infekcie skôr, ako sa rozvinie antigénom slabo aktivovaná adaptívna imunita.
Otitis media is one of the most common diseases in the world and generally it also belongs to the most frequent causes of hearing loss. In some cases, it may progress to chronic otitis media despite adequate initial treatment. Due to its complex pathogenesis and growing resistance of pathogens to antibiotic treatment, it is necessary to look for other therapeutic procedures that could be used to modulate and treat this disease. Therefore, it is essential to understand the role of innate immunity of the middle ear in defence against microorganisms. In this article, we discuss the role of innate immunity in otitis media and point to the role of innate immune cells in protecting the middle ear in the light of current knowledge. The innate immune system in the middle ear is responsible for rapid identification and subsequent elimination of pathogens. Cells of the immune system express a multitude of receptors with diverse functions to eliminate many infections before a weakly antigen-sensitized adaptive immunity develops.
- MeSH
- imunogenetika MeSH
- lidé MeSH
- otitis media * imunologie MeSH
- střední ucho imunologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
INTRODUCTION: Anti-inflammatory effect of vitamin D (VD) could be beneficial in improving the survival of glioma patients. The aim of our study was to analyse the serum levels of vitamin D in glioma patients and to find an association with the prognosis of glioma patients and other investigated parameters. MATERIAL AND METHODS: The study included 63 patients with gliomas. Percentage of CD14+ monocytes, TREM-1+ and TREM-2+ monocytes were determined by flow cytometry, serum levels of 25(OH)D were evaluated by electrochemiluminescent binding test. RESULTS: Six patients out of 63 had normal levels of VD. A significant difference in the overall survival (OS) in the patients with severe VD deficiency, VD deficiency and insufficiency in grade IV was found. In grade II and III, the levels of vitamin D positively correlated with the percentage of TREM-2+ monocytes, and in grade II also a negative correlation of VD with TREM-1/TREM-2 ratio was observed. CONCLUSION: Levels of VD could influence the prognosis of patients with high-grade gliomas. Serum level of 25(OH)D in low-grade gliomas positively correlated with the percentage of anti-inflammatory acting TREM-2+ monocytes and negatively with TREM-1/TREM-2 ratio. This could be protective against the progression to high-grade glioma, because TREM-2 is associated with protective functions such as: tissue repair, control of local inflammation, or phagocytosis (Tab. 4, Fig. 4, Ref. 79).
- Klíčová slova
- TREM2,
- MeSH
- analýza přežití MeSH
- dospělí MeSH
- gliom * farmakoterapie krev MeSH
- Kaplanův-Meierův odhad MeSH
- lidé středního věku MeSH
- lidé MeSH
- monocyty MeSH
- prognóza MeSH
- senioři MeSH
- vitamin D * krev MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- klinická studie MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
