ABO incompatible living donor liver transplantation has the potential to expand the donor pool for patients with end stage liver diseases on the expense of challenges to overcome immunological barriers across blood ty...ABO incompatible living donor liver transplantation has the potential to expand the donor pool for patients with end stage liver diseases on the expense of challenges to overcome immunological barriers across blood type.There is a profound impact of age on incidence and severity of antibody mediated rejection(AMR).Even children older than 1 year have chances of AMR;children aged 8 years or older have risks of hepatic necrosis similar to adult liver recipients.The mechanism of AMR is based on circulatory disturbances secondary to inflammation and injury of the vascular endothelium caused by an antibody-antigen-complement reaction.The strategy to overcome ABO blood type barrier is based on both pre-transplant desensitization and adequate treatment of this phenomenon.Nowadays,rituximab is the standard means of desensitization but unfortunately an insufficient aid to treat AMR.Because of low incidence(less than 5%in the rituximab era),in practice of AMR only some case reports about the treatment of clinical AMR are available in the literature.Initial experiences revealed that the proteasome inhibitor,bortezomib might be a promising treatment based on its capacity to deplete plasma cell agents.Although ABO blood type barrier has been counteracted in 95%of patients by applying“rituximab-desensitization”,many issues,such as prediction of high-risk patients of infection and AMR and secure treatment strategies for evoked AMR,remain to be resolved.展开更多
Objective: To assess the effect of different ABO blood group gene locus on severity and prognosis of acute myocardial infarction (AMI). Methods: 100 patients with AMI diagnosed in our hospital from June 2018 to June 2...Objective: To assess the effect of different ABO blood group gene locus on severity and prognosis of acute myocardial infarction (AMI). Methods: 100 patients with AMI diagnosed in our hospital from June 2018 to June 2019 were selected as the myocardial infarction group. At the same time, 100 healthy patients with physical examination results in our hospital were selected as the control group. Single-nucleotide polymorphisms of peripheral blood ABO gene loci rs505922, rs579459, rs643434, rs651007, and rs8176743 were detected. The differences of ABO blood group gene loci in different groups were compared. The correlation between the distribution of ABO blood group gene loci and the incidence and prognosis of patients with AMI was analyzed. Results: 98 cases were included in the myocardial infarction group and 99 cases were included in the control group. Compared with the control group, the genotypes of rs643434 and rs651007 locus in the myocardial infarction group were statistically significant (P<0.05). Analysis under different genetic models , compared with the control group, the myocardial infarction group had a significant difference in the rs643434 gene dominant mode, rs651007 dominant mode and recessive mode (P<0.05). The dominant mode of rs643434 was correlated with Gensini score and TIMI grade. The dominant mode of rs651007 was correlated with Gensini score, TIMI grade and troponin.The recessive mode of rs651007 was correlated with Gensini score, and the differences were statistically significant (P < 0.05). The dominant mode of rs643434 was related to the occurrence of MACE, and the difference was statistically significant (P < 0.05).Conclusion: Different genetic models of ABO blood group genes rs643434 and rs651007 may be related to the condition and prognosis of AMI.展开更多
基金a grant from Japan Agency for Medical Research and Developement(20317617).
文摘ABO incompatible living donor liver transplantation has the potential to expand the donor pool for patients with end stage liver diseases on the expense of challenges to overcome immunological barriers across blood type.There is a profound impact of age on incidence and severity of antibody mediated rejection(AMR).Even children older than 1 year have chances of AMR;children aged 8 years or older have risks of hepatic necrosis similar to adult liver recipients.The mechanism of AMR is based on circulatory disturbances secondary to inflammation and injury of the vascular endothelium caused by an antibody-antigen-complement reaction.The strategy to overcome ABO blood type barrier is based on both pre-transplant desensitization and adequate treatment of this phenomenon.Nowadays,rituximab is the standard means of desensitization but unfortunately an insufficient aid to treat AMR.Because of low incidence(less than 5%in the rituximab era),in practice of AMR only some case reports about the treatment of clinical AMR are available in the literature.Initial experiences revealed that the proteasome inhibitor,bortezomib might be a promising treatment based on its capacity to deplete plasma cell agents.Although ABO blood type barrier has been counteracted in 95%of patients by applying“rituximab-desensitization”,many issues,such as prediction of high-risk patients of infection and AMR and secure treatment strategies for evoked AMR,remain to be resolved.
基金Subject construction plan project of Shanghai Pudong New Area Health and Family Planning Commission in 2017(No.PWZxk2017-20)
文摘Objective: To assess the effect of different ABO blood group gene locus on severity and prognosis of acute myocardial infarction (AMI). Methods: 100 patients with AMI diagnosed in our hospital from June 2018 to June 2019 were selected as the myocardial infarction group. At the same time, 100 healthy patients with physical examination results in our hospital were selected as the control group. Single-nucleotide polymorphisms of peripheral blood ABO gene loci rs505922, rs579459, rs643434, rs651007, and rs8176743 were detected. The differences of ABO blood group gene loci in different groups were compared. The correlation between the distribution of ABO blood group gene loci and the incidence and prognosis of patients with AMI was analyzed. Results: 98 cases were included in the myocardial infarction group and 99 cases were included in the control group. Compared with the control group, the genotypes of rs643434 and rs651007 locus in the myocardial infarction group were statistically significant (P<0.05). Analysis under different genetic models , compared with the control group, the myocardial infarction group had a significant difference in the rs643434 gene dominant mode, rs651007 dominant mode and recessive mode (P<0.05). The dominant mode of rs643434 was correlated with Gensini score and TIMI grade. The dominant mode of rs651007 was correlated with Gensini score, TIMI grade and troponin.The recessive mode of rs651007 was correlated with Gensini score, and the differences were statistically significant (P < 0.05). The dominant mode of rs643434 was related to the occurrence of MACE, and the difference was statistically significant (P < 0.05).Conclusion: Different genetic models of ABO blood group genes rs643434 and rs651007 may be related to the condition and prognosis of AMI.