CAG预激方案联合左旋门冬酰胺酶和泼尼松诱导治疗复发难治性前体淋巴细胞白血病/淋巴瘤

目的 寻找复发难治性前体淋巴细胞白血病/淋巴瘤诱导缓解的有效方法.方法 以CAG预激方案联合左旋门冬酰胺酶(L-Asp)和泼尼松(PDN)诱导治疗6例复发难治性前体淋巴细胞白血病/淋巴瘤和1例急性杂合细胞白血病.结果 6例患者完全缓解(CR),1例部分缓解(PR),总有效率100%(7/7),CR率85.7%(6/7).患者不良反应轻,均可耐受.结论 CAG联合L-Asp和PDN是复发难治性前体淋巴细胞白血病/淋巴瘤值得尝试的诱导化疗方案.     

Identification of Recurrent Mutations in the microRNA-Binding Sites of B-Cell Lymphoma-Associated Genes in Follicular Lymphoma

Follicular lymphoma (FL) is a common indolent B-cell lymphoma that can transform into the more aggressive transformed FL (tFL). However, the molecular process driving this transformation is uncertain. In this work, we aimed to identify microRNA (miRNA)-binding sites recurrently mutated in follicular lymphoma patients, as well as in transformed FL patients. Using whole-genome sequencing data from FL tumors, we discovered 544 mutations located in bioinformatically predicted microRNA-binding sites. We then studied these specific regions using targeted sequencing in a cohort of 55 FL patients, found 16 recurrent mutations, and identified a further 69 variants. After filtering for QC, we identified 21 genes with mutated miRNA-binding sites that were also enriched for B-cell-associated genes by Gene Ontology. Over 40% of mutations identified in these genes were present exclusively in tFL patients. We validated the predicted miRNA-binding sites of five of the genes by luciferase assay and demonstrated that the identified mutations in BCL2 and EZH2 genes impaired the binding efficiency of miR-5008 and miR-144 and regulated the endogenous levels of messenger RNA (mRNA).     

布鲁顿氏酪氨酸激酶（BTK）抑制剂与难治性套细胞淋巴瘤

布鲁顿氏酪氨酸激酶（Bruton tyrosine kinase, BTK）是B细胞受体信号转导的关键介体，也是套细胞淋巴瘤（mantle cell lymphoma, MCL）的临床有效治疗靶标。BTK抑制剂（bruton tyrosine kinase inhibitors, BTKI）在MCL治疗中发挥了关键作用，我们介绍了BTKI的作用机制。伊布替尼是第一代BTKI，临床疗效较好，但存在局限性，比如毒性和耐药问题。新型BTKI，如泽布替尼、阿卡替尼及奥布替尼，可以提高第一代BTKI的有效性和安全性。这篇综述比较了这两代BTKI在结构、功能上的异同，为BTKI更好地应用于临床提供依据。2019年11月15日，美国FDA批准泽布替尼上市，用于治疗经治的成年套细胞淋巴瘤患者。与伊布替尼相比，新一代BTKI泽布替尼靶点选择性更高，抑制更持久，不良反应少，患者受益更多。泽布替尼为复发/难治性MCL患者提供可行的治疗选择，同时也在积极开展治疗其他B细胞淋巴瘤的临床研究，是非常有前景的靶向药物。     

Gentamicin Arrests Cancer Cell Growth: The Intriguing Involvement of Nuclear Sphingomyelin Metabolism

The use of gentamicin for the treatment of bacterial infection has always been an interesting and highly speculated issue for the scientific community. Conversely, its effect on cancer cells has been very little investigated. We studied the effect of high doses of gentamicin on non-Hodgkin’s T-cell human lymphoblastic lymphoma (SUP-T1). We showed that gentamicin delayed cell growth and induced cell death in lymphoma cells with a rather mild effect on lymphocytes. In SUP-T1 cells, GAPDH, B2M, CDKN1A and CDKN1B were down-expressed in comparison with lymphocytes. Gentamicin treatment in SUP-T1 cells restored the expression of GAPDH, B2M and CDKN1A to values similar to those of lymphocytes and caused overexpression of CDKN1B. The drug acted via sphingomyelin metabolism; in whole cells, sphingomyelinase activity was stimulated, whereas in purified nuclei, sphingomyelinase activity was inhibited and that of sphingomyelin-synthase was stimulated, with a consequent high level of nuclear sphingomyelin content. We suggest that the increase of nuclear sphingomyelin might enrich the nucleus of lipid microdomains that act as a platform for active chromatin and, thus, might be responsible for gene expression. It is possible that in lymphoblastic lymphoma, high doses of gentamicin induce a beneficial therapeutic outcome.     

Population-Predicted MHC Class II Epitope Presentation of SARS-CoV-2 Structural Proteins Correlates to the Case Fatality Rates of COVID-19 in Different Countries

We observed substantial differences in predicted Major Histocompatibility Complex II (MHCII) epitope presentation of SARS-CoV-2 proteins for different populations but only minor differences in predicted MHCI epitope presentation. A comparison of this predicted epitope MHC-coverage revealed for the early phase of infection spread (till day 15 after reaching 128 observed infection cases) highly significant negative correlations with the case fatality rate. Specifically, this was observed in different populations for MHC class II presentation of the viral spike protein (p-value: 0.0733 for linear regression), the envelope protein (p-value: 0.023), and the membrane protein (p-value: 0.00053), indicating that the high case fatality rates of COVID-19 observed in some countries seem to be related with poor MHC class II presentation and hence weak adaptive immune response against these viral envelope proteins. Our results highlight the general importance of the SARS-CoV-2 structural proteins in immunological control in early infection spread looking at a global census in various countries and taking case fatality rate into account. Other factors such as health system and control measures become more important after the early spread. Our study should encourage further studies on MHCII alleles as potential risk factors in COVID-19 including assessment of local populations and specific allele distributions.     

Ciltacabtagene autoleucel——治疗复发难治性多发性骨髓瘤的靶向BCMA CAR-T细胞新型疗法

2022年2月28日，美国食品和药物管理局（FDA）批准Ciltacabtagene autoleucel（Cilta-cel）上市，用于治疗成人复发难治性多发性骨髓瘤（relapsed or refractory multiple myeloma, RRMM）。Cilta-cel是中国首个获FDA批准的细胞治疗产品，亦是全球第二款获批靶向B细胞成熟抗原（B-cell maturation antigen, BCMA）的嵌合抗原受体（chimeric antigen receptor, CAR）-T细胞免疫疗法。最新研究发现，RRMM患者接受Cilta-cel治疗后，总缓解率（overall remission rate, ORR）高达97%，12个月无进展生存率为77%；常见毒性作用包括中性粒细胞减少、血小板减少、贫血、细胞因子释放综合征（cytokine release syndrome, CRS）及神经毒性等。本文将对Cilta-cel的作用机制、适应症、药代动力学、临床研究及不良反应等作一综述。     

Finding an Effective Distance Between T-Cell and B-Cell Using S/W ARQ in an Immune System Communication

In this paper,we present the effective distance between T-cell and B-cell in an immune system using Stop and Wait(S/W)Automatic Repeat Request(ARQ).The concentration of the molecules can be increased by increasing the transmitting number of molecules but it may reduce the performance of communication due to higher collision or interference with other molecules.It is also reported in the literature that the concentration of the emitted molecules reduces if the distance from Transmitter(Tx)to Receiver(Rx)increases.Thus,this paper mainly focuses on enhancing the receiver’s capture probability and higher successful complete transmission of the desired molecules by obtaining the effective distance from T-cell to B-cell.In order to find the effective distance,T-cell transmits the molecules 1(Interleukins-2)to B-cell,upon successful reception of molecules 1,antibodies(molecules 2)transmit back to T-cell.Then,the effective distance of an immune system can be obtained after T-cell detects the concentration of the molecules 2 with respect to time.Different schemes of S/W ARQ protocols have implemented in Molecular Communication(MC)but it requires retransmission of duplicate copies due to the lack of addressing an effective distance.Thus,the simulations are performed in MATLAB and the results obtain higher capture probability and also successful complete transmission of the desired molecules.     

The Bone Marrow Niche in B-Cell Acute Lymphoblastic Leukemia: The Role of Microenvironment from Pre-Leukemia to Overt Leukemia

Genetic lesions predisposing to pediatric B-cell acute lymphoblastic leukemia (B-ALL) arise in utero, generating a clinically silent pre-leukemic phase. We here reviewed the role of the surrounding bone marrow (BM) microenvironment in the persistence and transformation of pre-leukemic clones into fully leukemic cells. In this context, inflammation has been highlighted as a crucial microenvironmental stimulus able to promote genetic instability, leading to the disease manifestation. Moreover, we focused on the cross-talk between the bulk of leukemic cells with the surrounding microenvironment, which creates a “corrupted” BM malignant niche, unfavorable for healthy hematopoietic precursors. In detail, several cell subsets, including stromal, endothelial cells, osteoblasts and immune cells, composing the peculiar leukemic niche, can actively interact with B-ALL blasts. Through deregulated molecular pathways they are able to influence leukemia development, survival, chemoresistance, migratory and invasive properties. The concept that the pre-leukemic and leukemic cell survival and evolution are strictly dependent both on genetic lesions and on the external signals coming from the microenvironment paves the way to a new idea of dual targeting therapeutic strategy.     

鸡蛋卵转铁蛋白过敏原B细胞线性表位的预测研究

为预测鸡蛋过敏原卵转铁蛋白的B细胞线性表位,以GenBank中提供的鸡蛋卵转铁蛋白氨基酸序列为基础,分别用Jameson-Wolf法、Kyte-Doolittle法、Emini法和Karplus-Schulz法对鸡蛋卵转铁蛋白的抗原指数、亲水性、蛋白表面可及性及柔韧性进行预测,并用Chou-Fasman法和Deleage-Roux法预测其二级结构,综合分析以上预测结果,得出鸡蛋卵转铁蛋白可能的B细胞线性表位区。结果表明鸡蛋卵转铁蛋白存在7个潜在表位区,包括蛋白第174～181、215～222、231～240、288～294、332～344、415～429、547～555位可能为B细胞线性表位优势区域。该结果将有助于鸡蛋卵转铁蛋白B细胞表位的进一步精确定位。     

间变性淋巴瘤激酶抑制剂的研究进展

研究发现非小细胞肺癌的形成与多种致癌突变密切相关,其中间变性淋巴瘤激酶重排备受关注,针对棘皮动物微管相关蛋白质4-间变性淋巴瘤激酶融合基因的抑制剂克唑替尼对于治疗晚期ALK阳性非小细胞肺癌患者是有效的,2011年获得美国食品药品监督管理局批准上市,但出现了耐药性,第二代间变性淋巴瘤激酶抑制剂的出现,克服了耐药机制,并显示出治疗非小细胞肺癌患者的活性。本论文按化学结构的不同介绍了克唑替尼、Ceritinib、Alectinib、Brigatinib、RXDX-101、PF-06463922、ASP3026、X-396、CEP-37440等间变性淋巴瘤激酶抑制剂及临床研究等,为非小细胞肺癌的靶向治疗药物的开发提供了参考。