THE MAIN PARAMETERS OF CELLULAR IMMUNITY IN PATIENTS WITH TRIPLE-NEGATIVE BREAST CANCER: RELATIONSHIP WITH EFFICIENCY OF CHEMOTHERAPY

Chemotherapy is among the primary methods of treating advanced breast cancer. It was shown that clinical efficacy of various chemotherapeutic agents in many cases depends not only on their direct cytostatic and/or cytotoxic effect upon tumor cells, but also on their ability to modulate phenotype of the tumor cells and to influence anti-tumor immune response. Initial state of the immune system and its response to treatment is crucial. Antitumor response involves cells of innate and adaptive immunity (NK, NKT, T cells). These populations are heterogeneous and contain, e.g., cells with antitumor activity and regulatory (suppressor) cells that suppress immune response and promote tumor progression. The aim of this work was to determine the relationship between the initial state of cellular immunity of patients suffering from locally advanced breast cancer with triple negative phenotype, and clinical effect of chemotherapy (cisplatin + doxorubicin/paclitaxel), and studying effects of the therapy upon subpopulation profiles of peripheral blood lymphocytes in the patients. We registered the terms of the disease progression as well as overall survival and progression-free survival. The disease progressed in 25 of 53 cases (47.2%) whereas 28 of 53 patients (52.8%) remained progression-free. The observation period was 35.5 months. Laboratory examination of the patients included immunophenotyping of peripheral blood lymphocytes and determination of NK cell cytotoxic activity before and after chemotherapy. Percentages of effectors and regulatory lymphocyte populations were determined. The results obtained showed that, for some lymphocyte subsets, the pre-treatment differences of cell percentage deviations from control were found between the progression-free groups and patients with progression of the disease. The differences in percentages of NKT cells and lymphocytes expressing CD25 activation marker proved to be most significant. Decreased number of NKT cells and activated CD25+ lymphocytes prior to chemotherapy was associated with increased probability of disease progression. Reduced percentage of NKT cells against control was observed in 56% of patients from the progression group (PD), and only 21.4% in the group free of disease progression (DF). [OR = 4.6 (95% CI 1.4 to 15.4)]. Percentage of CD25+ lymphocytes was decreased from 68.2% in the PD group, and 28.6% for DF patients [OR = 5.4 (95% CI 1.6-18.1)]. We studied relationships between the overall survival (OS) and percentage of perforin-containing NK, NKT, and T cells, and mean perforin fluorescence density (PFD) in these lymphocyte subsets in 26 of the 53 patients before treatment. A statistically significant positive correlation was revealed between OS and perforin PFD in all the three cell populations under study. Normalization of the parameters altered before treatment, and an increase of T cell numbers was observed in the disease-free patients

НОВЫЕ ВОЗМОЖНОСТИ РЕГУЛЯЦИИ ПРОТИВООПУХОЛЕВОГО ИММУННОГО ОТВЕТА

The tumor has different mechanisms capable of destroying the immunological protection. Population of regulatory cells, along with other factors provide “escape” of the tumor from immune surveillance. In our laboratory, we studied the features of quantitative changes of some subpopulations of peripheral blood lymphocytes in primary operable breast cancer (BC) and melanoma at different stages of tumor growth and in the process of tumor therapy. In 94.5% of patients with breast cancer were found to increase compared to the control amount of NKT-cells with the phenotype CD45+CD3+ CD16+CD56+, 78% increase in number of CD8+CD28– T-cells, and 20.5% increase in the number of patients Regulatory CD4+CD25+FOXP3+ T cells. Was found to depend on changes in the number of these cells from the stage of the disease. Patients with stage I and II disease there was a statistically significant increase in the percentage of CD8+CD28– T–cells and CD45+CD3+ CD16+CD56+ NKT-cells compared to the donor. At the same time in patients with stage III the number of cells of both populations declined and did not differ from the norm. Such dynamics of quantitative changes were typical for the main populations of effector cells antitumor immunity. In the evaluation of patients with disseminated melanoma was found that no increase in the number of cytotoxic CD45+CD8+CD11b+ T cells in the treatment dendritic cell vaccine (DCV) appears to be an indication to stop vaccine therapy, initially increased amount of CD3+CD8+CD16+. NKT-cells may serve as grounds for refusal of DCV. A brief description of the major co-receptor inhibitor of T-cells, and monoclonal antibodies that block the inhibitory molecule on immune and tumor cells in order to increase the efficiency of anti-tumor immune response. Encouraging clinical results have been obtained by using anti-CTLA-4 (ipilimumab), and anti-PD-1 (nivolumab) monoclonal antibodies.Опухоль обладает различными механизмами, способными разрушать иммунологическую защиту. Популяции регуляторных клеток наряду с другими факторами обеспечивают «ускользание» опухоли от иммунологического надзора. В нашей лаборатории было проведено изучение особенностей количественных изменений некоторых субпопуляций лимфоцитов периферической крови у первично-операбельных больных раком молочной железы (РМЖ) и диссеминированной меланомой на разных этапах опухолевого роста и в процессе противоопухолевой терапии. У 94,5% больных РМЖ было обнаружено повышение по сравнению с контролем количества NKT-клеток с фенотипом CD45+CD3+CD16+CD56+, у 78% повышение количества CD8+CD28- Т-клеток, и у 20,5% больных повышение количества регуляторных CD4+CD25+FOXP3+ Т-клеток. Выявлена зависимость изменений количества этих клеток от стадии заболевания: у пациенток с I и II стадиями заболевания отмечалось статистически значимое повышение процента CD8+CD28- Т-клеток и CD45+CD3+CD16+CD56+ NKT-клеток по сравнению с донорами. В то же время у пациенток с III стадией количество клеток обеих популяций снижалось и практически не отличалось от нормы. Подобная динамика количественных изменений была характерна и для основных популяций клеток-эффекторов противоопухолевого иммунитета. При обследовании больных диссеминированной меланомой было обнаружено, что отсутствие повышения количества цитотоксических CD45+CD8+CD11b+ Т-клеток в процессе лечения дендритноклеточной вакциной (ДКВ), по-видимому, является показанием к прекращению вакцинотерапии, а исходно повышенное количество CD3+CD8+CD16+ NKT-клеток может служить основанием для отказа от ДКВ. Приводится краткое описание основных ко-ингибиторных рецепторов Т-клеток и моноклональных антител, блокирующих ингибиторные молекулы на иммунокомпетентных и опухолевых клетках, с целью повышения эффективности противоопухолевого иммунного ответа. Обнадеживающие клинические результаты были получены при применении анти-CTLA-4 (ипилимумаб) и анти-PD-1 (ниволумаб) моноклональных антител

Genome-wide analysis in over 1 million individuals of European ancestry yields improved polygenic risk scores for blood pressure traits

Hypertension affects more than one billion people worldwide. Here we identify 113 novel loci, reporting a total of 2,103 independent genetic signals (P < 5 × 10−8) from the largest single-stage blood pressure (BP) genome-wide association study to date (n = 1,028,980 European individuals). These associations explain more than 60% of single nucleotide polymorphism-based BP heritability. Comparing top versus bottom deciles of polygenic risk scores (PRSs) reveals clinically meaningful differences in BP (16.9 mmHg systolic BP, 95% CI, 15.5–18.2 mmHg, P = 2.22 × 10−126) and more than a sevenfold higher odds of hypertension risk (odds ratio, 7.33; 95% CI, 5.54–9.70; P = 4.13 × 10−44) in an independent dataset. Adding PRS into hypertension-prediction models increased the area under the receiver operating characteristic curve (AUROC) from 0.791 (95% CI, 0.781–0.801) to 0.826 (95% CI, 0.817–0.836, ∆AUROC, 0.035, P = 1.98 × 10−34). We compare the 2,103 loci results in non-European ancestries and show significant PRS associations in a large African-American sample. Secondary analyses implicate 500 genes previously unreported for BP. Our study highlights the role of increasingly large genomic studies for precision health research

Уровень рождаемости городского населения на территории Красноярска в контексте всероссийских демографических тенденций (1990-2000)

In the article the main trends of the birth rate development in post-soviet period in Russia are considered on example of the town population Krasnoyarsk territory, we also try to give characteristics of the changes in the fertility behavior of the townsfolk and to find out the answer to the question - how much the reproductive standards of the western countries get implanted in Russian society. In the article all territorial processes is shown in all-Russian context. The search is based on the census data and current demographic and social statistics.На примере городского населения территории Красноярска рассматрены основные тенденции коэффициента рождаемости в постсоветский период в России. Так же мы сделали попытку охарактеризовать перемены в уровне рождаемости горожан и найти ответ на вопрос – насколько репродуктивные стандарты западных стран были переняты Российским обществом. Все территориальные процессы показаны во всероссийском контексте. Исследование основано на данных переписи и на текущей демографической и социальной статистике

Demographic potential of the Krasnoyarsk region in 1990–2000s

В статье анализируется в динамике система показателей, характеризующих демографический потенциал края. Все процессы рассмотрены в сравнении с аналогичными по России в целом, трактуются на основе теории демографической модернизации и конкретизирующей ее концепции второго демографического перехода.The article analyzes in dynamics the system of indicators characterizing the demographic potential of the region. All processes are considered in comparison with similar ones in Russia as a whole, are interpreted on the basis of the theory of demographic modernization and concretising the concept of the second demographic transition