MicroRNAs may solve the mystery of chronic hepatitis B virus infection

Hepatitis B virus(HBV)infection is a global public health problem that causes persistent liver diseases such as chronic hepatitis,cirrhosis,and hepatocellular carcinoma.A large amount of people die annually from HBV infection.However,the pathogenesises of the HBV-related diseases are ill defined and the therapeutic strategies for the diseases are less than optimum.The recently discovered microRNAs(miRNAs)are tiny noncoding RNAs that regulate gene expression primarily at the post-transcriptional level by binding to mRNAs.miRNAs contribute to a variety of physiological and pathological processes.A number of miRNAs have been found to play a pivotal role in the host-virus interaction including host-HBV interaction.Numerous studies have indicated that HBV infection could change the cellular miRNA expression patterns and different stages of HBV associated disease have displayed distinctive miRNA profiles.Furthermore,the differential expressed miRNAs have been found involved in the progression of HBV-related diseases,for instance some miRNAs are involved in liver tumorigenesis and tumor metastasis.Studies have also shown that the circulating miRNA in serum or plasma might be a very useful biomarker for the diagnosis and prognosis of HBV-related diseases.In addition,miRNA-based therapy strategies have attracted increasing attention,indicating a promising future in the treatment of HBV-related diseases.

Hemophagocytic lymphohistiocytosis secondary to composite lymphoma:Two case reports

BACKGROUND Hemophagocytic lymphohistiocytosis(HLH)is a rare and life-threatening disease caused by inherited pathogenic mutations and acquired dysregulations of the immune system.Composite lymphoma is defined as two or more morphologically and immunophenotypically distinct lymphomas that occur in a single patient.Here,we report two cases of HLH secondary to composite lymphoma with mixed lineage features of T-and B-cell marker expression both in the bone marrow and lymph nodes in adult patients.CASE SUMMARY Two patients were diagnosed with HLH based on the occurrence of fever,pancytopenia,lymphadenopathy,splenomegaly,hemophagocytosis and hyperferritinemia.Immunohistochemical staining of the axillary lymph node and bone marrow in case 1 showed typical features of combined B-cell and T-cell lymphoma.In addition,a lymph node gene study revealed rearrangement of the T-cell receptor chain and the immunoglobulin gene.Morphology and immunohistochemistry studies of a lymph node biopsy in case 2 showed typical features of T cell lymphoma,but immunophenotyping by flow cytometry analysis of bone marrow aspirate showed B cell lymphoma involvement.The patients were treated with high-dose methylprednisolone combined with etoposide to control aggressive HLH progression.The patients also received immunochemotherapy with the R-CHOP(rituximab,cyclophosphamide,doxorubicin,vincristine,and prednisone)regimen immediately after diagnosis.Both patients presented with highly aggressive lymphoma,and died of severe infection or uncontrolled HLH.CONCLUSION We present two rare cases with overwhelming hemophagocytosis along with composite T-and B-cell lymphoma,which posed a diagnostic dilemma.HLH caused by composite lymphoma was characterized by poor clinical outcomes.