Ośrodek Dawców Szpiku – wyzwania i realizacja zadań w oparciu o doświadczenia Instytutu Hematologii i Transfuzjologii

A network of bone marrow donor centers (BMDC) was established in 2011 and it currently includes 14. The main tasks of the BMDC involve actions related to: recruitment of potential donors of hematopoietic stem cells (HSC), documentation of personal and contact data for potential donors as well as data related to Human Leucocyte Antigen (HLA) compatibility, provision of medical care for donors as well as cooperation with other national and international HSC transplantation centers in securing access to transplantation material. The BMDC at the Institute of Hematology and Transfusion Medicine carries on the activity of the Registry of Bone Marrow Donors PL2 established in 1999. The current number of potential HSC donors registered in the data base of our BMDC is approximately 13,500, most of whom were entered into the Registry in the period 1999–2010.     

Conditional ligands for Asian HLA variants facilitate the definition of CD8+ T‐cell responses in acute and chronic viral diseases

Conditional ligands have enabled the high‐throughput production of human leukocyte antigen (HLA) libraries that present defined peptides. Immunomonitoring platforms typically concentrate on restriction elements associated with European ancestry, and such tools are scarce for Asian HLA variants. We report 30 novel irradiation‐sensitive ligands, specifically targeting South East Asian populations, which provide 93, 63, and 79% coverage for HLA‐A, ‐B, and ‐C, respectively. Unique ligands for all 16 HLA types were constructed to provide the desired soluble HLA product in sufficient yield. Peptide exchange was accomplished for all variants as demonstrated by an ELISA‐based MHC stability assay. HLA tetramers with redirected specificity could detect antigen‐specific CD8⁺ T‐cell responses against human cytomegalovirus, hepatitis B (HBV), dengue virus (DENV), and Epstein‐Barr virus (EBV) infections. The potential of this population‐centric HLA library was demonstrated with the characterization of seven novel T‐cell epitopes from severe acute respiratory syndrome coronavirus, HBV, and DENV. Posthoc analysis revealed that the majority of responses would be more readily identified by our unbiased discovery approach than through the application of state‐of‐the‐art epitope prediction. This flow cytometry‐based technology therefore holds considerable promise for monitoring clinically relevant antigen‐specific T‐cell responses in populations of distinct ethnicity.     

HLA-DRB typing among polyarticular juvenile idiopathic arthritis and progressive pseudorheumatoid dysplasia patients

Juvenile Idiopathic Arthritis (JIA) is a multi-factorial disease influenced both by environmental and genetic factors. Progressive pseudorheumatoid dysplasia (PPD) is a rare autosomal recessive genetic disorder affecting multiple joints, mimicking JIA. Aim of the work: to reveal the frequency of HLA-DR types among the studied patients and to correlate the different allele variations clinically. Patients and methods: Thirty JIA patients, in addition to 15 molecularly diagnosed PPD patients were subjected to full history taking and clinical examination. HLA-DRB1 typing was performed to 24/30 JIA and 12/15 PPD cases and thirty healthy age and sex matched children who were included as a control group. Results: The JIA patients were 22 females and 8 males with mean age of 15.8 ± 1.96 years and disease duration 5.3 ± 4.4 years. PPD patients were 8 males and 7 females with mean age of 8.7 ± 3.06 years and disease duration 3.95 ± 2.68 years. A significant frequency of HLA-DRB 04 (p = 0.049) among JIA patients was present in comparison to the controls (OR = 2.81, CI:1.02–7.75), other risky alleles were HLA-DRB 10, 13 and 15. However, HLA-DRB 01, 03, 07, 11 and 14 were found to be protective. HLA-DRB 01, 04, 10 and 13 were found to be risky alleles in PPD. However, HLA 03, 07, 11 and 15 were found to be protective alleles among PPD patients. Conclusion: HLA-DRB 04 was found in a higher frequency in JIA patients with a significant difference in comparison to the controls, denoting that it may play a role in the genetic pathogenesis of JIA.     

Study of HLA-A, -B, -C, -DRB1 and -DQB1 polymorphisms in COVID-19 patients

BackgroundHuman leukocyte antigen (HLA) plays an important role in immune responses to infections, especially in the development of acquired immunity. Given the high degree of polymorphisms that HLA molecules present, some will be more or less effective in controlling SARS-CoV-2 infection. We wanted to analyze whether certain polymorphisms may be involved in the protection or susceptibility to COVID-19.MethodsWe studied the polymorphisms in HLA class I (HLA-A, -B and -C) and II (HLA-DRB1 and HLA-DQB1) molecules in 450 patients who required hospitalization for COVID-19, creating one of the largest HLA-typed patient cohort to date.ResultsOur results show that there is no relationship between HLA polymorphisms or haplotypes and susceptibility or protection to COVID-19.ConclusionOur results may contribute to resolve the contradictory data on the role of HLA polymorphisms in COVID-19 infection.     

宫外孕Ⅱ号方合桂枝茯苓汤加减治疗输卵管妊娠的临床效果

目的 探讨宫外孕Ⅱ号方合桂枝茯苓汤加减治疗输卵管妊娠的临床效果。方法 选取2019年5月至2021年5月安康市中医医院妇科收治的80例输卵管妊娠患者为研究对象,按照随机数字表法将其分为对照组和观察组,各40例。对照组给予米非司酮联合甲氨蝶呤治疗,观察组在对照组基础上给予宫外孕Ⅱ号方合桂枝茯苓汤加减治疗。比较两组的临床疗效、症状积分、血清β-HCG水平、盆腔包块直径、腹痛天数、阴道出血天数、凝血功能、不良反应发生情况及月经复潮情况。结果 观察组的治疗总有效率为97.50%,高于对照组的82.50%,差异具有统计学意义（P<0.05）。治疗前,两组的症状积分比较,差异无统计学意义（P>0.05）;治疗1、2、4周后,两组的症状积分均较治疗前降低,且观察组低于对照组,差异具有统计学意义（P<0.05）。治疗4周后,两组的血清β-HCG水平均较治疗前降低,盆腔包块直径、腹痛天数、阴道出血天数均较治疗前缩短,且观察组优于对照组,差异具有统计学意义（P<0.05）。治疗4周后,两组的APTT、PT均较治疗前缩短,FIB水平均较治疗前降低,且观察组优于对照组,差异具有统计学意...     

妊娠期糖尿病循证临床实践指南的质量评价

目的:对国内外妊娠期糖尿病相关循证指南进行分析及评价,总结各指南特点,为临床制定妊娠期糖尿病的相关护理管理流程及方案提供参考依据。方法:计算机检索PubMed、万方数据库、中国期刊全文数据库及妇产科专业学会网站、国内外临床实践指南网站等指南制定机构,收集国内外发表的妊娠期糖尿病相关循证指南,采用AGREEⅡ评价工具对纳入指南进行质量评价及分析。结果:最终共筛选出5部妊娠期糖尿病相关循证指南,均为英文版本,5部指南的标准化得分均数分别为76.92%、60.57%、83.41%、67.44%、61.96%,指南总体质量评价为3部A级,2部B级。结论:妊娠期糖尿病的相关指南总体质量较高,但是某些指南在参与人员、独立性、制作的严谨性方面还有待完善;而目前我国尚无高质量的妊娠期糖尿病管理循证指南,本研究筛选出的临床实践指南可以为我国妊娠期糖尿病临床管理决策提供循证依据,但建议使用时结合我国国情,并进行本土化修正。     

The Schizophrenia–Rheumatoid Arthritis Connection: Infectious, Immune, or Both?

Schizophrenia and rheumatoid arthritis share an impressive number of similarities. Both are chronic, relapsing diseases of unknown etiology. Both became prominent in the early 19th century and have prevalences of approximately 1% in North America and Europe. Both run in families, have pairwise concordance rates of approximately 30% among monozygotic twins, and are more common among individuals born in urban areas. For both diseases, studies have reported greater exposure to cats in childhood than in controls. Both diseases have been associated with similar class II HLA antigens. Both have also been suspected of having infectious etiology, with similar agents—retroviruses, herpesviruses including EBV, and Toxoplasma gondii—having been associated in some cases. Since there is also a well-documented inverse correlation between these two diseases, it is possible that they share a common infectious and/or immune etiology and that once a person gets one of the diseases then they are relatively immune to the other.     

RFLPs分析技术在分类学研究中的应用

RFLPs技术是随着分子生物学的发展而产生的一种根据基因组DNA上存在着一些限制性内切酶的长度片断多态性的特点来进行基因分型的方法。本文综述了这项技术的基本方法及其在HLA的基因分型、寄生虫的虫种鉴定及病毒分型中的具体应用。RFLPs技术的应用对于分类学的鉴定研究具有突破性意义。     

冠通方及其拆方含药血清对Ang Ⅱ诱导的大鼠血管平滑肌细胞增殖的影响

目的：探讨冠通方及其拆方对含药血清对血管紧张素Ⅱ（AngⅡ）诱导的大鼠血管平滑肌细胞增殖的影响,阐析防治冠心病支架术后再狭窄的作用机理以寻找药物作用的靶点。方法：建立AngⅡ诱导的血管平滑肌细胞（VSMC）增殖模型;采用四甲基偶氮唑蓝（MTT）比色法观察冠通方及其拆方对VSMC增殖的影响;并用免疫组化法观察冠通方及其拆方对大鼠VSMC表达的影响。结果：冠通方组及其拆方含药血清均可抑制大鼠VSMC的增殖（P〈0.05）;其中冠通方组作用结果最好（P〈0.01）;冠通方组、拆方3组与阴性组比较均有显著性差异（P〈0.01）;其中冠通方组的抑制VSMC的增殖最强（P〈0.01）;拆方3组其次（P〈0.05）;拆方1、2组间比较差异无统计学意义（P〉0.05）。结论：冠通方能抑制血管平滑肌细胞（VSMC）的增殖,其机制可能与降低VSMC中含量表达有关。