Controlled trials in hepatitis B virus-related decompensate liver cirrhosis: peripheral blood monocyte transplant versus granulocyte-colony-stimulating factor mobilization therapy

BACKGROUND

Liver cirrhosis represents the end stage of chronic liver injury. Currently, liver transplantation provides the only definite cure but it is beset with many problems, including lack of donors and risk of rejection. Stem cell therapy is very attractive in this setting because it has the potential to help tissue regeneration. In this study, we aimed to investigate the therapeutic effect of peripheral blood monocyte cell (PBMC) transplantation in decompensated liver cirrhosis.

METHODS

A total of 40 subjects (31 men and nine females, age range 21-71 years) was recruited to two groups. Group 1 received granulocyte-colony-stimulating factor (G-CSF) mobilization, PBMC collection by leukapheresis and PBMC transplant therapy. Group 2 received G-CSF mobilization for 4 days. At baseline and 6 months after treatment, liver function of the two groups was monitored by blood examination and ultrasonagraphy.

RESULTS

Both groups gained significant improvement in liver synthetic function, such as serum albumin and prothrombin time, from baseline to 6 months after treatment (P<0.01). However, there was no significant difference in alanine aminotransferase, aspartate aminotransferase and total bilirubin in both groups (P>0.05). Compared with group 2, a significantly improved liver function was observed in group 1, including elevated serum albumin level and a decreased CTP score (P<0.05). No major adverse effects were noted.

DISCUSSION

Autologous PBMC transplantation could be considered as a novel and alternative treatment for patients with decompensated liver cirrhosis.

Detection and differentiation of Theileria luwenshuni and T. uilenbergi infection in small ruminants by PCR

Theileria luwenshuni and T. uilenbergi are newly identified Theileria species highly pathogenic for sheep and goats in China. As they are morphologically indistinguishable and poorly characterized, there is no easily applicable method available to differentiate between these species. In the present study, PCR assays are described for the differentiation and detection of T. luwenshuni and T. uilenbergi using species-specific primers, which were designed based on the hypervariable region of the small subunit ribosomal RNA gene sequences. By testing 100 field blood samples of sheep collected from five geographically different regions where the Theileria species were described to be prevalent, the PCR assays not only detected infected samples but also identified mixed infection. This suggests that these PCR assays are useful tools for the detection of and differentiation between T. luwenshuni and T. uilenbergi.

Development and evaluation of a loop-mediated isothermal amplification method for diagnosis of tropical theileriosis

A loop-mediated isothermal amplification (LAMP) assay was developed and evaluated for diagnosis of tropical theileriosis. A set of six primers was designed based on the unique gene of Theileria annulata (Theileria annulata strain Ankara hypothetical protein (GeneDB TA04795). The protocol for the reaction was setup and the specificity and sensitivity of the assay were established. The specificity experiment showed that LAMP primers amplified T. annulata DNA successfully, while no amplification was seen for Theileria parva, Theileria mutans, Theileria sergenti, Theileria sinensis, Babesia bovis as well as bovine genomic DNA and water control. When the sensitivity of LAMP assay was compared with that of conventional PCR a 10-fold higher sensitivity was found, with a detection limit of 10 pg/microl of genomic DNA isolated from a T. annulata-infected cell line. The LAMP product was confirmed by restriction digestion and staining with SYBR Green I. Furthermore, the LAMP assay was applied for the diagnosis of T. annulata in field samples and compared with reverse line blot (RLB), demonstrating that results of the LAMP assay corresponded to those of RLB. These results indicate that the LAMP assay is rapid and simple to run, cost-effective, sensitive and specific and has potential usefulness for application in epidemiological studies on T. annulata infection of cattle.

Observation of efficacy and safety of converting the calcineurin inhibitor to sirolimus in renal transplant recipients with chronic allograft nephropathy

OBJECTIVE

The objective of this study was to evaluate the efficacy and safety of converting from a calcineurin inhibitor (CNI) to sirolimus among renal transplant recipients with chronic allograft nephropathy (CAN).

METHODS

In 16 patients with CAN, substituted sirolimus for CsA or FK506 and observed the incidence of acute rejection and changes in serum creatinine, triglycerides, cholesterol, blood uric acid, and peripheral blood leukocyte/platelet counts within 12 months. All recipients underwent an allograft biopsy before conversion. The targeted sirolimus level was 4-8 ug/L.

RESULTS

After conversion to sirolimus, the creatinine level of 7 cases decreased and the efficacy rate was (43.8%). No acute rejection occurred during the follow-up. The cases with hypercholesteremia increased from 3 to 7 after conversion; hypertriglyceridemia increased from 3 to 5; leukopenia occurred in 2; subnormal platelet counts increased from 2 to 3; and hyperuricemia increased from 6 to 7. Meanwhile, the average level of peripheral blood leukocytes obviously decreased in the first month, the average peripheral blood cholesterol increased over 12 months, but the average content of peripheral blood platelets, triglyceride and blood uric acid failed to display as statistic difference. Eight patients showed C4d deposition in peritubular capillary in graft tissue before conversion, 7 cases of whom showed no improvement in renal function. In 6 cases there was no C4d deposition in peritubular capillary in graft tissue. Only 2 of 6 cases showed no improvement in renal function. There were 6 patients whose creatinine level was <2.48 mg/dL before conversion, and renal function in 5 of them improved in a year after conversion. In contrast, among 10 patients whose blood creatinine level was >2.48 mg/dL, only 2 cases improved.

CONCLUSION

It is safe for patients with CAN to use substitute sirolimus for CNI; the incidence of acute rejection did not increase. In this study, 43.8% of patients showed improved renal function. The main adverse reactions after conversion to sirolimus were hypercholesteremia and decreased peripheral blood leukocytes. The serum creatinine level and the deposition of C4d in peritubular capillary were important factors influencing therapeutic efficacy.

Tailored regimen of interferon alpha for HBeAg-positive chronic hepatitis B: a prospective controlled study

The response to interferon-alpha treatment of patients with chronic hepatitis B under the current protocol is not satisfactory. The aim of this study was to try an alternative approach to improve treatment outcome. Of 374 HBeAg-positive patients, 127 of them received 5 million units of interferon-alpha thrice weekly for 6 months and constituted the control group, while 247 in the study group received the same dosage but the duration of treatment was tailored. The study protocol provided for continuation of treatment if HBV DNA levels were continuously decreasing. The treatment ended when viral, antigenic and biochemical endpoints were reached or when HBV DNA levels were no longer decreasing. The median length of tailored treatment was 10 (range 6-24) months. The end-of-treatment response rates were 39.3% and 23.6% (P = 0.002), and after 12-month, follow-up, the sustained response rates were 40.5% and 28.3% (P = 0.013) in the study and control groups, respectively. Excluding the patients who dropped out, 228 and 115 completed a median of 40- and 44-month-long follow-up; the long-term response was thus 45.3% and 33.1% (P = 0.014) in the respective groups. Interferon-alpha treatment tailored in length demonstrated significantly increased efficacy in patients with chronic hepatitis B.

Noninvasive Raman spectroscopy in living mice for evaluation of tumor targeting with carbon nanotubes

An optimized noninvasive Raman microscope was used to evaluate tumor targeting and localization of single walled carbon nanotubes (SWNTs) in mice. Raman images were acquired in two groups of tumor-bearing mice. The control group received plain-SWNTs, whereas the experimental group received tumor targeting RGD-SWNTs intravenously. Raman imaging commenced over the next 72 h and revealed increased accumulation of RGD-SWNTs in tumor ( p < 0.05) as opposed to plain-SWNTs. These results support the development of a new preclinical Raman imager.

Search for pair production of doubly charged Higgs bosons in the H++H- - -->mu+ mu+ mu- mu- final state

We report the results of a search for pair production of doubly charged Higgs bosons via pp over-->H++H - - X-->mu+ mu+ mu- mu- X at sqrt s=1.96 TeV. We use a data set corresponding to an integrated luminosity of 1.1 fb(-1) collected from 2002 to 2006 by the D0 detector at the Fermilab Tevatron Collider. In the absence of an excess above the standard model background, lower mass limits of M(H L +/- +/-) >150 GeV/c2 and M(H R+/- +/-) >127 GeV/c2 at 95% C.L. are set, respectively, for left-handed and right-handed doubly charged Higgs bosons assuming a 100% branching ratio into muons.

Search for Higgs bosons decaying to tau pairs in pp over collisions with the D0 detector

We present a search for the production of neutral Higgs bosons varphi decaying into tau+tau - final states in pp over collisions at a center-of-mass energy of 1.96 TeV. The data, corresponding to an integrated luminosity of approximately 1 fb(-1), were collected by the D0 experiment at the Fermilab Tevatron Collider. Limits on the production cross section times branching ratio are set. The results are interpreted in the minimal supersymmetric standard model yielding limits that are the most stringent to date at hadron colliders.

Measurement of the inclusive jet cross section in pp[over] collisions at square root [s]=1.96 TeV

We report on a measurement of the inclusive jet cross section in pp[over ] collisions at a center-of-mass energy sqrt[s]=1.96 TeV using data collected by the D0 experiment at the Fermilab Tevatron Collider corresponding to an integrated luminosity of 0.70 fb;{-1}. The data cover jet transverse momenta from 50 to 600 GeV and jet rapidities in the range -2.4 to 2.4. Detailed studies of correlations between systematic uncertainties in transverse momentum and rapidity are presented, and the cross section measurements are found to be in good agreement with next-to-leading order QCD calculations.

Search for decay of a fermiophobic Higgs boson hf-->gammagamma with the D0 detector at sqrt s=1.96 TeV

We report the results of a search for a narrow resonance decaying into two photons in 1.1 fb;{-1} of data collected by the D0 experiment at the Fermilab Tevatron Collider during the period 2002-2006. We find no evidence for such a resonance and set a lower limit on the mass of a fermiophobic Higgs boson of m_{h_{f}}>100 GeV at the 95% C.L. This exclusion limit exceeds those obtained in previous searches at the Fermilab Tevatron and covers a significant region of the parameter space B(h_{f}-->gammagamma) vs m_{h_{f}} which was not accessible at the CERN Large Electron-Positron Collider.

Bone marrow-derived mesenchymal stem cells are capable of mediating hepatitis B virus infection in injured tissues

We have previously showed that endothelial progenitor cells (EPCs) through uptake of hepatitis B virus (HBV) may play a critical role in mediating extrahepatic HBV diseases. However, it remains to be elucidated whether mesenchymal stem cells (MSCs) are capable of mediating HBV trans-infection into extrahepatic tissues.

METHODS AND RESULTS

In this study, we showed that HBV antigens, HBV DNA and the viral particles were detected in MSCs after 3 days virus challenge. Neither HBV covalently closed circular DNA nor pregenomic RNA were detected in MSCs. Intravenously transplantation of HBV-exposed MSCs into myocardial infarction mouse model resulted in incorporation of HBV into injured heart and other damaged tissues.

CONCLUSION

These results indicate that MSCs could serve as an additional extrahepatic virus reservoir, which may play a role at least in part in mediating HBV trans-infection into the injured tissues through the process of MSCs recruitment.

Search for large extra dimensions via single photon plus missing energy final states at sqrt s = 1.96 TeV

We report on a search for large extra dimensions in a data sample of approximately 1 fb(-1) of pp[over] collisions at sqrt s=1.96 TeV. We investigate Kaluza-Klein graviton production with a photon and missing transverse energy in the final state. At the 95% C.L. we set limits on the fundamental mass scale M(D) from 884 to 778 GeV for two to eight extra dimensions.

Observation of the Bc meson in the exclusive decay Bc-->J/psipi

A fully reconstructed Bc-->J/psipi signal is observed with the D0 detector at the Fermilab Tevatron pp[over] collider using 1.3 fb(-1) of integrated luminosity. The signal consists of 54+/-12 candidates with a significance that exceeds 5 standard deviations, and confirms earlier observations of this decay. The measured mass of the Bc meson is 6300+/-14(stat)+/-5(syst) MeV/c2.

Poster - Thurs Eve-36: Use of multileaf collimator as a replacement of physical missing tissue compensator

Missing tissue compensators are used to improve dose uniformity for some patients undergoing radiation therapy. Currently, our practice is to machine compensators out of lead alloy plate. Replacing this physical filter with a segmented multileaf collimator (MLC) delivery sequence is beneficial in terms of work flow and delivery efficiency. The purpose of this work is to compare the dose uniformity achieved by fields that are either (A) conventionally compensated, compensated by segmenting the physical compensator thickness map into either (B) step-and-shoot or (C) dynamic MLC delivery sequences using an in-house sequencer, (D) compensated using Pinnacle sequencer, or (E) compensated using IMRT optimization. A computer program was developed to construct both step-and-shoot and dynamic MLC sequence files from mechanical thickness maps of our current compensators. In addition, the Pinnacle sequencer and IMRT optimization were used to generate step-and-shoot MLC sequences. Planar doses were measured for each at the isocenter depth with an ion chamber array to compare the five methods. A comparison of the relative dose distribution shows that the compensation achieved by method (E) is in close agreement with that achieved using method (A), that is, dose uniformity within 4%. Method (D) resulted in the shortest delivery time and achieved dose uniformity to within 5%. Methods (B) and (C) need additional refinement to be of practical use. The results support the feasibility of replacing physical compensators with MLC delivery sequences. Compensation by MLC segments provides more flexibility and efficiency in design and delivery than by physical compensators while maintaining or improving the uniformity of dose to the plane of compensation.