• MeSH
• Demography MeSH
• Humans MeSH
• Primary Health Care * statistics & numerical data   MeSH
• Health Status Indicators MeSH
• Check Tag
• Humans MeSH
• Publication type
• Chart MeSH
• Tables MeSH
• Geographicals
• Czech Republic MeSH

Cíl: Zaměřili jsme se na stanovení prevalence infekce SARS-CoV-2 se symptomatickým nebo asymptomatickým průběhem a na identifikaci prediktorů symptomatické nebo asymptomatické infekce SARS-CoV-2 u pacientů během sedmi měsíců následujících po transplantaci alogenních hematopoetických kmenových buněk (alo-HSCT) v období cirkulace varianty omikron. Metody: Prevalence proběhlé infekce SARS-CoV-2 byla detekována u pacientů během sedmi měsíců po allo-HSCT v omikronovém období pomocí buněčné a humorální imunitní odpovědi proti nukleoproteinu SARS-CoV-2 (NCP). Výsledky: Pozitivní markery prodělané infekce byly identifikovány u 45,2 % pacientů (n = 42). Infekce byla asymptomatická u 68,4 % pacientů s anti-NCP pozitivitou. Hledání rizikových faktorů pro symptomatickou infekci SARS-CoV-2 u příjemců alo-HSCT odhalilo, že nízká úroveň rekonstituce B buněk byla jediným signifikantně souvisejícím rizikovým faktorem. Závěr: Vysoký podíl příjemců alo-HSCT, kteří byli asymptomaticky infikováni do sedmi měsíců po transplantaci v letech 2022–2023, přestože byli imunokompromitovaní a neočkovaní, ukazuje na oslabení cirkulujícího viru a může signalizovat pro pacienty po transplantaci menší riziko onemocnění SARS-CoV-2 v omikronovém období. Ukázalo se, že očkování těchto pacientů proti SARS- -CoV-2 je spojeno s nízkým, ale významným rizikem exacerbace vyléčené chronické reakce štěpu proti hostiteli (GVHD – Graft Versus Host Disease) a s rizikem de novo GVHD. Nízká úroveň rekonstituce B-buněk byla jediným významným rizikovým faktorem pro symptomatickou infekci SARS-CoV-2 u příjemců alo-HSCT.

Aim: We aimed to determine the prevalence of SARS-CoV-2 infection, including both symptomatic and asymptomatic courses, and to identify predictors of asymptomatic or symptomatic SARS-CoV-2 infection in patients within seven months after allo-HSCT (allogenic hematopoietic stem cell transplantation) in the Omicron period. Methods: Prevalence of the past SARS-CoV-2 infection was determined in patients within seven months after allo-HSCT in the Omicron period using the cellular and humoral immune response against the SARS-CoV-2 nucleoprotein (NCP). Results: Positive markers of past infection were identified in 45.2% of patients (n = 42). The infection was asymptomatic in 68.4% of anti-NCP positive patients. The search for risk factors for symptomatic SARS-CoV-2 infection in allo-HSCT recipients revealed that a low level of B cell reconstitution was the only significantly associated risk factor. Conclusion: A high proportion of allo-HSCT recipients who were asymptomatically infected within up to seven months after transplantation from 2022 to 2023 despite being immunosuppressed and unvaccinated indicates an attenuation of the circulating virus and may signal less risk for transplanted patients from SARS-CoV-2 infection in the Omicron period. Vaccination of these patients against SARS-CoV-2 was shown to be associated with a low but significant risk of exacerbation of cured chronic GVHD (graft versus host disease) and the risk of de novo GVHD. The low level of B-cell reconstitution was the only significant risk factor for symptomatic SARS-CoV-2 infection in HSCT recipients.

• Keywords
• Omikron,
• MeSH
• Asymptomatic Infections * epidemiology   MeSH
• B-Lymphocytes immunology   microbiology   transplantation   MeSH
• COVID-19 * complications   microbiology   MeSH
• Transplantation, Homologous MeSH
• Cohort Studies MeSH
• Humans MeSH
• Graft vs Host Disease etiology   immunology   MeSH
• Risk Factors MeSH
• SARS-CoV-2 pathogenicity   MeSH
• Hematopoietic Stem Cell Transplantation * MeSH
• COVID-19 Vaccines adverse effects   MeSH
• Check Tag
• Humans MeSH

Imúnna cytopénia je zriedkavou komplikáciou transplantácie krvotvorných buniek. Je výsledkom dysregulácie imunitného systému po rekonštitúcii darcovskej krvotvorby. Aktuálne odporúčania a usmernenia pre diagnostiku a liečbu choroby v pediatrickej transplantológii nie sú jednotné, vychádzajú z poznatkov o autoimúnnych cytopéniach bez transplantácie. Imúnna cytopénia spojená s transplantáciou má častejšie refraktérny a prolongovaný priebeh, čo potvrdzuje odlišnú etiopatogenézu choroby. Liečba zahŕňa široké spektrum liečebných modalít od pozorovania až po intenzívny manažment, hlavne v prípade koexistencie iných peritransplantačných komplikácií. Pacienti okrem podpornej liečby môžu vyžadovať modifikáciu imunosupresie, u niektorých je nutná liečba na odstránenie plazmocytov, prípadne auto- alebo aloprotilátok z krvného obehu. Uvádzame komplexný pohľad na patofyiológiu, liečbu a prognózu potransplantačných imúnnych cytopénií u detí, a prezentujeme aj vlastný súbor pacientov.

Immune cytopenia is a rare complication of haematopoietic stem cell transplantation. It is the result of immune system dysregulation after the reconstitution of donor haematopoiesis. Current recommendations and guidelines for the diagnosis and treatment of the disease in paediatric transplantation are unclear, based on knowledge about autoimmune cytopenia not associated with transplantation. Immune cytopenia associated with transplantation is usually more refractory and runs a prolonged course, conforming the different etiopathogenesis of the disease. Treatment includes a wide spectrum of approaches from observation to intensive management, especially in the case of coexistent other peri-transplantation complications. In addition to supportive treatment, patients may require modification of immunosuppression. Some cases may need treatment focused on removing plasma cells, auto- or alloantibodies from the bloodstream. We provide a comprehensive review of the pathophysiology, treatment and prognosis of post-transplant immune cytopenia in children, and we present our cohort of such patients.

• MeSH
• Anemia, Hemolytic, Autoimmune diagnosis   etiology   pathology   MeSH
• Autoimmune Diseases etiology   classification   physiopathology   therapy   MeSH
• Cytopenia * diagnosis   etiology   physiopathology   therapy   MeSH
• Diagnosis, Differential MeSH
• Child MeSH
• Epidemiologic Studies MeSH
• Immune System pathology   MeSH
• Humans MeSH
• Risk Factors MeSH
• Bone Marrow Transplantation * adverse effects   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

Human cytoplasmic tRNAs contain dihydrouridine modifications at positions 16 and 17 (D16/D17). The enzyme responsible for D16/D17 formation and its cellular roles remain elusive. Here, we identify DUS1L as the human tRNA D16/D17 writer. DUS1L knockout in the glioblastoma cell lines LNZ308 and U87 causes loss of D16/D17. D formation is reconstituted in vitro using recombinant DUS1L in the presence of NADPH or NADH. DUS1L knockout/overexpression in LNZ308 cells shows that DUS1L supports cell growth. Moreover, higher DUS1L expression in glioma patients is associated with poorer prognosis. Upon vector-mediated DUS1L overexpression in LNZ308 cells, 5' and 3' processing of precursor tRNATyr(GUA) is inhibited, resulting in a reduced mature tRNATyr(GUA) level, reduced translation of the tyrosine codons UAC and UAU, and reduced translational readthrough of the near-cognate stop codons UAA and UAG. Moreover, DUS1L overexpression increases the amounts of several D16/D17-containing tRNAs and total cellular translation. Our study identifies a human dihydrouridine writer, providing the foundation to study its roles in health and disease.

• MeSH
• Humans MeSH
• Cell Line, Tumor MeSH
• Protein Biosynthesis * MeSH
• RNA, Transfer * metabolism   genetics   MeSH
• Uridine metabolism   analogs & derivatives   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

Changes in the protonation state of lyophilized proteins can impact structural integrity, chemical stability, and propensity to aggregate upon reconstitution. When a buffer is chosen, the freezing/drying process may result in dramatic changes in the protonation state of the protein due to ionization shift of the buffer. In order to determine whether protonation shifts are occurring, ionizable probes can be added to the formulation. Optical probes (dyes) have shown dramatic ionization changes in lyophilized products, but it is unclear whether the pH indicator is uniform throughout the matrix and whether the change in the pH indicator actually mirrors drug ionization changes. In solid-state NMR (SSNMR) spectroscopy, the chemical shift of the carbonyl carbon in carboxylic acids is very sensitive to the ionization state of the acid. Therefore, SSNMR can be used to measure ionization changes in a lyophilized matrix by employing a small quantity of an isotopically-labeled carboxylic acid species in the formulation. This paper compares the apparent pH of six trehalose-containing lyophilized buffer systems using SSNMR and UV-Vis diffuse reflectance spectroscopy (UVDRS). Both SSNMR and UVDRS results using two different ionization probes (butyric acid and bromocresol purple, respectively) showed little change in apparent acidity compared to the pre-lyophilized solution in a sodium citrate buffer, but a greater change was observed in potassium phosphate, sodium phosphate, and histidine buffers. While the trends between the two methods were similar, there were differences in the numerical values of equivalent pH (pHeq) observed between the two methods. The potential causes contributing to the differences are discussed.

• MeSH
• Phosphates * chemistry   MeSH
• Histidine * chemistry   MeSH
• Hydrogen-Ion Concentration MeSH
• Citric Acid chemistry   MeSH
• Freeze Drying * methods   MeSH
• Magnetic Resonance Spectroscopy * methods   MeSH
• Buffers MeSH
• Spectrophotometry, Ultraviolet methods   MeSH
• Trehalose * chemistry   MeSH
• Publication type
• Journal Article MeSH

Anti-T-lymphocyte globulin (ATLG) is used in hematopoietic stem cell transplantation (HSCT) to prevent graft-versus-host disease (GVHD) and graft failure. To date, insight in ATLG pharmacokinetics and -dynamics (PK/PD) is limited, and population PK (POPPK) models are lacking. In this prospective study, we describe ATLG POPPK using NONMEM® and the impact of ATLG exposure on clinical outcome and immune reconstitution in a homogeneous cohort of pediatric acute lymphoblastic leukemia (ALL) patients transplanted with a matched unrelated donor and receiving uniform ATLG dosing. Based on 121 patients and 812 samples for POPPK analysis, a two-compartmental model with parallel linear and non-linear clearance and bodyweight as covariate, best described the ATLG concentration-time data. The level of ATLG exposure (day active ATLG <1 AU/mL, median 16 days post-HSCT) was strongly associated with aGVHD grade II-IV, with a lower incidence in patients with prolonged active ATLG exposure (≤day 16 50% vs. >day 16 8.2%; P<0.001). When stratified for remission state, patients transplanted in complete remission (CR) 2 or 3 with prolonged ATLG exposure had a higher relapse risk, while this effect was not seen in CR1 patients (P=0.010). High level ATLG exposure was associated with delayed CD4 T-cell recovery at 4 and 8 weeks post-HSCT, but not at 12 weeks, and overall and relapse-free survival were not influenced by CD4 recovery at 12 weeks post-HSCT. This study underlines the importance of individualized ATLG exposure with the use of model-informed precision dosing in order to optimize the HSCT outcome in pediatric ALL.

• MeSH
• Precursor Cell Lymphoblastic Leukemia-Lymphoma * therapy   mortality   diagnosis   MeSH
• Antilymphocyte Serum * administration & dosage   MeSH
• Child MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Graft vs Host Disease * etiology   prevention & control   MeSH
• Child, Preschool MeSH
• Prospective Studies MeSH
• Recurrence MeSH
• Hematopoietic Stem Cell Transplantation * adverse effects   methods   MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH

BACKGROUND: A novel supported liquid extraction approach using small polymeric nanofibrous discs was demonstrated and applied to the analysis of real river water. Nanofibrous discs were tested to extract model mixture of 9 common water contaminants 4-nitrophenol, various chlorophenols, bisphenol A, permethrin, and fenoxycarb featuring a wide range of log P values (1.9-6.5). Polyacrylonitrile, polyhydroxybutyrate, and polylactic acid nanofibers were selected as adsorptive materials. One-step desorption was performed directly in HPLC vials, to avoid time-consuming evaporation and reconstitution steps. The discs were allowed to sediment to the bottom of the vial before injection into the chromatographic system. RESULTS: Various parameters affecting the extraction efficiency including 1-octanol volume, extraction time, ionic strength, and sample volume were investigated and optimized. Wetting the nanofiber discs with 1-octanol resulted in up to 20-fold increase in enrichment factor when compared to non-wetted polymer counterparts. The highest enrichment factors were observed for analytes with a log P range of 3.3-4.5. Our developed method showed good linearity in the range 20-200 μg/L for all analytes tested. Satisfactory repeatability with RSD <13 % were achieved covering all steps including disc preparation, wetting, extraction/elution, and chromatography analysis, and recoveries ranged from 58.93 to 121.43 %. SIGNIFICANCE: This work represents novel simple supported liquid extraction approach using impregnated polymer nanofiber discs. Using only 50 μL 1-octanol, we reduced the organic solvent compared to other extraction methods. There was no need for any plastic cartridge to hold the sorbent and direct in-vial desorption reduced the unnecessary, time-consuming steps and simplified the sample preparation protocol.

• Publication type
• Journal Article MeSH

BACKGROUND: Cladribine, a selective immune reconstitution therapy, is approved for the treatment of adult patients with highly active multiple sclerosis (MS). OBJECTIVES: Provide experience with cladribine therapy in a real-world setting. METHODS: This is a registry-based retrospective observational cohort study. First, using data from the Czech nationwide registry ReMuS, we analysed patients who initiated cladribine from September 1, 2018 to December 31, 2021. Second, we analysed a subgroup of patients who initiated cladribine between September 1, 2018 to June 30, 2020, thus possessing a follow-up period of at least 2 years. We evaluated demographic and MS characteristics including disease-modifying therapies (DMTs) before and after cladribine administration, relapses, Expanded Disability Status Scale (EDSS), and adherence. RESULTS: In total, 617 patients (335 with follow-up of at least 2 years) started cladribine therapy in the study period (mean age 37.0, mean disease duration 8.4 years, 74.1% females). In most cases, cladribine was administered as a second-line drug, a total of 80.7% had been escalated from a platform DMT. During 2 years before cladribine initiation, the average annualised relapse rate (ARR) was .67. Following cladribine initiation, the ARR decreased to .28 in the first year and .22 in the second year. Overall, across the entire two-year treatment period, 69.0% of patients were relapse-free and the average ARR was .25. As for EDSS development, the median baseline EDSS was 2.5 and remained stable even after 24 months. The adherence to treatment ranged of around 90%. CONCLUSION: This nationwide study confirms the efficacy of cladribine in real-world settings, especially in patients who are not treatment-naïve. In addition, the study shows an exceptionally high adherence rate, a finding that underscores the invaluable role of cladribine, but also the value of registry-based studies in capturing real-world clinical practice.

• Publication type
• Journal Article MeSH

In bone marrow transplantation (BMT), hematopoiesis-reconstituting cells are introduced following myeloablative treatment, which eradicates existing hematopoietic cells and disrupts stroma within the hematopoietic tissue. Both hematopoietic cells and stroma then undergo regeneration. Our study compares the outcomes of a second BMT administered to mice shortly after myeloablative treatment and the first BMT, with those of a second BMT administered to mice experiencing robust hematopoietic regeneration after the initial transplant. We evaluated the efficacy of the second BMT in terms of engraftment efficiency, types of generated blood cells, and longevity of function. Our findings show that regenerating hematopoiesis readily accommodates newly transplanted stem cells, including those endowed with a robust capacity for generating B and T cells. Importantly, our investigation uncovered a window for preferential engraftment of transplanted stem cells coinciding with the resumption of blood cell production. Repeated BMT could intensify hematopoiesis reconstitution and enable therapeutic administration of genetically modified autologous stem cells.

• MeSH
• Hematopoietic Stem Cells immunology   MeSH
• Hematopoiesis * MeSH
• Mice, Inbred C57BL MeSH
• Mice MeSH
• Regeneration MeSH
• Immune Reconstitution MeSH
• Bone Marrow Transplantation * methods   MeSH
• Animals MeSH
• Check Tag
• Mice MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

INTRODUCTION: For many infectious diseases, women are at higher risk and have a more severe disease course than men for many reasons, including biological differences, social inequalities, and restrictive cultural norms. The study focuses on infections with human papillomaviruses (HPV) in the form of cervical cancer as a gender-specific disease. The main goal is to evaluate cervical tumour incidence trends in the Czech female population in the HPV vaccination period 2012-2020 in relation to selected demographic, socioeconomic, and geographic indicators. METHODS: This is a retrospective ecological study. Data from publicly available databases about the incidence and mortality of cervical tumours (C53 Malignant neoplasm of cervix uteri, D06 Carcinoma in situ of cervix uteri according to ICD 10) and HPV vaccination rate were analysed and compared with demographic, socioeconomic and territorial data. Associations were searched using correlation analysis. RESULTS: There was a decreasing trend in the incidence of cervical cancer in the observed period. Regarding cervical tumours (C53, D06) and malignant neoplasm of cervix uteri incidence (C53), the decrease was approximately 11 and 20%, respectively. Differences between regions were observed in incidences and vaccination rates. Based on correlation analysis, indicators connected with urban/rural aspects, such as a share of urban population and population density, were statistically significant. The indicators related to higher cervical cancer incidence are the high unemployment rate of women, the high number of divorces, the high number of abortions, the high share of the urban population, the high number of students, and the high number of women with only primary education. On the other hand, the indicators related to lower cervical cancer incidence are the high gross domestic product (GDP), the high average gross monthly wage per employee, the high employment rate of women, the higher average age of mothers at birth, and the high number of women with tertiary education. CONCLUSION: Results underline the problem of economically disadvantaged regions and families. Increasing vaccination rates, promoting regular screening for cervical cancer, and supporting awareness in the population, especially in regions with higher incidence rates, should be priorities for public health efforts.

• MeSH
• Demography MeSH
• Adult MeSH
• Incidence MeSH
• Papillomavirus Infections epidemiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Uterine Cervical Neoplasms * epidemiology   MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Socioeconomic Factors * MeSH
• Vaccination statistics & numerical data   MeSH
• Papillomavirus Vaccines administration & dosage   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH