4 research outputs found
KIR+ CD8+ T Lymphocytes in Cancer Immunosurveillance and Patient Survival: Gene Expression Profiling
Killer-cell immunoglobulin-like receptors (KIR) are molecules expressed by the most important cells of the immune system for cancer immune vigilance, natural killer (NK) and effector T cells. In this manuscript we study the role that cytotoxic CD8+ T cells expressing KIR receptors could play in cancer immune surveillance. With this objective, frequencies of different KIR+ CD8+ T cell subsets are correlated with the overall survival of patients with melanoma, ovarian and bladder carcinomas. In addition, the gene expression profile of KIR+ CD8+ T cell subsets related to the survival of patients is studied with the aim of discovering new therapeutic targets, so that the outcome of patients with cancer can be improved.
Killer-cell immunoglobulin-like receptors (KIR) are expressed by natural killer (NK) and effector T cells. Although KIR+ T cells accumulate in oncologic patients, their role in cancer immune response remains elusive. This study explored the role of KIR+CD8+ T cells in cancer immunosurveillance by analyzing their frequency at diagnosis in the blood of 249 patients (80 melanomas, 80 bladder cancers, and 89 ovarian cancers), their relationship with overall survival (OS) of patients, and their gene expression profiles. KIR2DL1+ CD8+ T cells expanded in the presence of HLA-C2-ligands in patients who survived, but it did not in patients who died. In contrast, presence of HLA-C1-ligands was associated with dose-dependent expansions of KIR2DL2/S2+ CD8+ T cells and with shorter OS. KIR interactions with their specific ligands profoundly impacted CD8+ T cell expression profiles, involving multiple signaling pathways, effector functions, the secretome, and consequently, the cellular microenvironment, which could impact their cancer immunosurveillance capacities. KIR2DL1/S1+ CD8+ T cells showed a gene expression signature related to efficient tumor immunosurveillance, whereas KIR2DL2/L3/S2+CD8+ T cells showed transcriptomic profiles related to suppressive anti-tumor responses. These results could be the basis for the discovery of new therapeutic targets so that the outcome of patients with cancer can be improved
Home parenteral nutrition registry in Spain for the year 2010: NADYA-SENPE group
Objetivos: Comunicar los datos del Registro del Grupo
NADYA SENPE de Nutrición Parenteral Domiciliaria
NPD en España del año 2010.
Material y métodos: Estudio descriptivo de la base de
datos del Registro de ámbito nacional de NPD del grupo
NADYA-SENPE (1 de enero de 2010 al 31 de diciembre de
2010). Para el cálculo de prevalencias se utilizó los últimos
datos publicados por el Instituto Nacional de Estadística.
Resultados: Se registraron 148 pacientes procedentes de
23 hospitales, 86 mujeres (58,11%) y 9 niños (6,08%). La
edad media de los 139 pacientes adultos fue de 53,06 ±
15,41 años. La duración media de la NPD fue de 316,97
días/paciente. El diagnóstico más frecuente en los niños
(menores de 14 años) fue intestino corto traumático con 5
casos (55,55%) y en los adultos la neoplasia en tratamiento
paliativo 29 (19,59%). El motivo de la indicación de la NPD
fue el síndrome de intestino corto en 74 ocasiones (47%).
La vía de acceso más frecuentemente registrada fue el catéter
tunelizado en 36 (22,78%) casos seguido del reservorio
en 13 (8,23%) y otras vías en 3 ocasiones (1,90%). Se registraron
23 infecciones relacionadas con el catéter (82,14%),
lo que representa 0,49/1000 días de NP y todas ellas ocurrieron
en los adultos. A lo largo del año finalizaron 24 episodios
de NPD, la causa más frecuente fue el paso a la vía
oral en 12 episodios (50%). Se registró que los pacientes
tenían una actividad normal en 70 episodios de NPD
(44,30%) con una total autonomía en 88 de episodios
(55,69%). Se identificaron 39 (24,68%) posibles candidatos
para trasplante intestinal.
Conclusiones: El número de pacientes registrados es
discretamente inferior al del año anterior, aunque el
número de hospitales participantes es el mismo. La complicación
más frecuente sigue siendo la infección relacionada
con el catéter aunque ha disminuido su incidencia
respecto a años anteriores, presentándose la tasa más
baja desde la creación del registro.
Las diferencias en la participación en el registro observadas
por Comunidades Autónomas lleva a plantear el
desarrollo de estrategias de implementación del registro.
Se observa un aumento progresivo de la duración de los
días de NPD a lo largo de los años que hace pensar en la
cronicidad de algunos pacientes, pero nos obliga a estudiar
la existencia de un posible factor de confusión, en el
caso de que existiera un olvido de cierre de algún episodio
por lo que se hace necesario actualizar el registro con sistemas
de alertas periódicas que faciliten la revisión de los
pacientes incluidos y optimice la validez del registroObjectives: To report the Group Registry NADYASENPE
data about home parenteral nutrition (HPN) in
Spain in 2010.
Material and methods: A descriptive study of the database
of the national registry of HPN of NADYA-SENPE
(December 10, 2009 to December 10, 2010). For the calculation
of prevalence the latest data published by the Institute
National Statistics Office (01/01/2009) was used.
Results: There were registered 148 patients from 23
hospitals, 86 women (58.11%) and 9 children (6.08%).
The average age of the 139 patients older than 14 years
was 53.06 ± 15.41 years. The average duration of HPN
was 316.97 days/patient. The most common diagnosis in
those younger than 14 years was short bowel traumatic
with 5 cases (55.55%) and in those older than 14 years,
palliative care cancer with 29 cases (19.59%). The reason
for the indication for HPN was short bowel syndrome in
74 cases (47%). The access via most frequently recorded
was tunneled catheter in 36 cases (22.78%) followed by
implanted port-catheters in 13 cases (8.23%) and other
pathways in 3 cases (1.90%). There were 23 catheterrelated
infections (82.14%) which represented 0.49 /1,000
days of PN, all of which occurred in cases older than 14
years. During the year 24 episodes of HPN ended, the
most frequent cause was the transition to oral nutrition in
12 episodes (50%). It was reported that patients had a
normal activity in 70 episodes of HPN (44.30%) with complete
autonomy in 88 episodes (55.69%). Some patients 39
(24.68%) were potential candidates for intestinal transplantation.
Conclusions: The number of registered patients is
slightly lower than the previous year, although the number
of participating hospitals is the same. The most frequent
complication remains catheter-related infection
but its incidence has decreased from previous years, presenting
the lowest rate since the creation of the record.
Differences in participation in the registry observed in
the Autonomous Communities causes the development of
implementation strategies. There is a gradual increase in
day length of HPN over the years, which suggests the
chronic treatments of some patients and obliges to study
the existence of a possible confounding factor, in case
there is an oversight of closing an episode. Therefore, it is
necessary to update the registry with warning systems
that facilitate periodic review of the patients and optimize
the validity of registratio
Quality of life and cost-effectiveness analysis of topical tranexamic acid and fibrin glue in femur fracture surgery
Background: we assessed quality of life (QoL) of patients undergoing surgery for proximal femur fracture and performed a cost-effectiveness analysis of haemostatic drugs for reducing postoperative bleeding. Methods: we analysed data from an open, multicentre, parallel, randomized controlled clinical trial (RCT) that assessed the efficacy and safety of tranexamic acid (TXA group) and fibrin glue (FG group) administered topically prior to surgical closure, compared with usual haemostasis methods (control group). For this study we conducted a cost-effectiveness analysis of these interventions from the Spanish Health System perspective, using a time horizon of 12 months. The cost was reported in USPPP) than the cost of TXA (12.9 USPPP). When comparing the cost-effectiveness of the interventions, FG was ruled out by simple dominance since it was more costly (13,314.7 USPPP) and less effective (utilities of 0.0532 vs. 0.0734, respectively). TXA compared to usual haemostasis had an ICER of 15,289.6 $USPPP per QALY). Conclusions: there were no significant differences between the intervention groups in terms of postoperative changes in QoL. However, topical TXA was more cost-effective than FG or usual haemostasis
KIR+ CD8+ T Lymphocytes in Cancer Immunosurveillance and Patient Survival: Gene Expression Profiling
Killer-cell immunoglobulin-like receptors (KIR) are expressed by natural killer (NK) and effector T cells. Although KIR+ T cells accumulate in oncologic patients, their role in cancer immune response remains elusive. This study explored the role of KIR+CD8+ T cells in cancer immunosurveillance by analyzing their frequency at diagnosis in the blood of 249 patients (80 melanomas, 80 bladder cancers, and 89 ovarian cancers), their relationship with overall survival (OS) of patients, and their gene expression profiles. KIR2DL1+ CD8+ T cells expanded in the presence of HLA-C2-ligands in patients who survived, but it did not in patients who died. In contrast, presence of HLA-C1-ligands was associated with dose-dependent expansions of KIR2DL2/S2+ CD8+ T cells and with shorter OS. KIR interactions with their specific ligands profoundly impacted CD8+ T cell expression profiles, involving multiple signaling pathways, effector functions, the secretome, and consequently, the cellular microenvironment, which could impact their cancer immunosurveillance capacities. KIR2DL1/S1+ CD8+ T cells showed a gene expression signature related to efficient tumor immunosurveillance, whereas KIR2DL2/L3/S2+CD8+ T cells showed transcriptomic profiles related to suppressive anti-tumor responses. These results could be the basis for the discovery of new therapeutic targets so that the outcome of patients with cancer can be improved.This research was funded by the Spanish Ministry of Economy—Institute of Health Carlos III (PI1302297), Fundación Mutua Madrileña (AP74392010), and Fundación Séneca de la Agencia de Ciencia y Tecnología, Región de Murcia, (20812-PI-18). M.V. Martínez-Sánchez was funded by the Asociación Pablo Ugarte (APU).Ye