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FdR – Publicaties niet-programma gebonde

Autologous stem cell transplantation for progressive systemic sclerosis: a prospective non-interventional study from the European Society for Blood and Marrow Transplantation Autoimmune Disease Working Party

Three randomized controlled trials in early severe systemic sclerosis demonstrated that autologous hematopoietic stem cell transplantation was superior to standard cyclophosphamide therapy. This European Society for Blood and Marrow Transplantation multicenter, prospective, non-interventional study was designed to further decipher efficacy and safety of this procedure for severe systemic sclerosis patients in real-life practice and to search for prognostic factors. All consecutive adult patients with systemic sclerosis undergoing a first autologous hematopoietic stem cell transplant between December 2012 and February 2016 were prospectively included in the study. The primary endpoint was progression-free survival. Secondary endpoints were overall survival, non-relapse mortality, response and incidence of progression. Eighty patients with systemic sclerosis were included. The median duration of the follow-up was 24 (range, 6-57) months after stem cell transplantation using cyclophosphamide plus antithymocyte globulin conditioning for all, with CD34(+) selection in 35 patients. At 2 years, the progression-free survival rate was 81.8%, the overall survival rate was 90%, the response rate was 88.7% and the incidence of progression was 11.9%. The 100-day non-relapse mortality rate was 6.25% (n=5) with four deaths from cardiac events, including three due to cyclophosphamide toxicity. Modified Rodnan skin score and forced vital capacity improved with time (P24 and older age at transplantation were associated with lower progression-free survival (hazard ratios 3.32 and 1.77, respectively). CD34(+)-cell selection was associated with better response (hazard ratio 0.46). This study confirms the efficacy of autologous stem cell transplantation, using non-myeloablative conditioning, in real-life practice for severe systemic sclerosis. Careful cardio-pulmonary assessment to identify organ involvement at the time of the patient's referral, reduced cyclophosphamide doses and CD34(+)-cell selection may improve outcomes.Immunobiology of allogeneic stem cell transplantation and immunotherapy of hematological disease

Autologous haematopoietic stem cell transplantation and other cellular therapy in multiple sclerosis and immune-mediated neurological diseases : updated guidelines and recommendations from the EBMT autoimmune diseases working party (ADWP) and the joint accreditation committee of EBMT and ISCT (JACIE)

These updated EBMT guidelines review the clinical evidence, registry activity and mechanisms of action of haematopoietic stem cell transplantation (HSCT) in multiple sclerosis (MS) and other immune-mediated neurological diseases and provide recommendations for patient selection, transplant technique, follow-up and future development. The major focus is on autologous HSCT (aHSCT), used in MS for over two decades and currently the fastest growing indication for this treatment in Europe, with increasing evidence to support its use in highly active relapsing remitting MS failing to respond to disease modifying therapies. aHSCT may have a potential role in the treatment of the progressive forms of MS with a significant inflammatory component and other immune-mediated neurological diseases, including chronic inflammatory demyelinating polyneuropathy, neuromyelitis optica, myasthenia gravis and stiff person syndrome. Allogeneic HSCT should only be considered where potential risks are justified. Compared with other immunomodulatory treatments, HSCT is associated with greater short-term risks and requires close interspeciality collaboration between transplant physicians and neurologists with a special interest in these neurological conditions before, during and after treatment in accredited HSCT centres. Other experimental cell therapies are developmental for these diseases and patients should only be treated on clinical trials

Neospongodes atlantica, a potential case of an early biological introduction in the Southwestern Atlantic

Soft corals (Anthozoa: Octocorallia) are discreet components in the Southwestern Atlantic reef communities. In Brazil, the native octocoral shallow-reef fauna is mostly represented by gorgonians. Consequently, except for the nephtheid Neospongodes atlantica, most of the known soft corals from this region are considered non-indigenous. Hitherto, the monotypic genus Neospongodes, which was proposed in the early 1900s, has been considered to be endemic to the Northeastern Brazilian coast. Herein, based on in situ records, we show that N. atlantica is a substrate generalist that has been probably expanding its distribution by dominating extensive shallow and mesophotic sandy and reef bottoms, generally outcompeting other reef benthic organisms, including Brazilian endemic species. Based on previously unidentified museum specimens, new records, and a broad literature review, we provide the most comprehensive modelling of the potential distribution of this species in the Southwestern Atlantic. Based on molecular inference supported by in-depth morphological analysis, the probable non-indigenous and, therefore, ancient introduction of N. atlantica in Brazilian waters is discussed. Finally, these results support that Neospongodes and the Indo-Pacific Stereonephthya are synonyms, which led us to propose the latter as taxonomically invalid

Does Ex Vivo CD34+Cell Selection Change the Outcome of Systemic Sclerosis Patients Treated with Autologous Hematopoietic Stem Cell Transplantation (AHSCT), an Adwp EBMT Study?

Pathophysiology and treatment of rheumatic disease

Purificação e caracterização de alfa-galactosidases de sementes de Platymiscium pubescens Micheli Purification and characterization of alpha-galactosidases from Platymiscium pubescens Micheli seeds

Este trabalho objetivou foi determinar a composição bioquímica de sementes de espécies florestais e caracterizar a enzima alfa-galactosidase de sementes germinadas de Platymiscium pubescens. Os maiores teores de lipídios foram determinados em sementes de Chorisia speciosa, Caesalpinia peltophoroides, Tabebuia serratifolia e Tabebuia velanedae, enquanto sementes de Enterolobium contortisiliquum, Schizolobium parahyba e Cassia grandis apresentaram os maiores teores protéicos. A alfa-galactosidase catalisa a hidrólise dos oligossacarídeos de rafinose, em sementes de leguminosas, durante a germinação. A maior atividade da alfa-galactosidase foi detectada em sementes de Platymiscium pubescens após 72 h de embebição. Duas formas de alfa-galactosidases, C1 e C2, foram purificadas de sementes germinadas de P. pubescens, usando-se fracionamento com sulfato de amônio e cromatografias de filtração em gel e de afinidade. Essas enzimas apresentaram atividade máxima em pH 5,5 e a 50-55 ºC. Os valores de Km ap das formas C1 e C2, para o substrato ro-nitrofenil-alfa-D-galactopiranosídeo, foram de 0,54 mM e 0,78 mM, e para a rafinose, de 4,64 mM e 5,09 mM, respectivamente. Essas enzimas exibiram estabilidade térmica moderada, mantendo 70% da atividade original após 3 h de incubação a 45 ºC. A atividade enzimática da C1 e C2 foi totalmente perdida na presença de CuSO4 e dodecil sulfato de sódio (SDS). Tais enzimas também hidrolisaram melibiose, rafinose e estaquiose, indicando potencial para aplicações biotecnológicas.<br>The objective of this work was to determine seed biochemical composition of forest species and to characterize alpha-galactosidase enzyme of germinated seeds of Platymiscium pubescens. The highest lipid levels were found in seeds of Chorisia speciosa, Caesalpinia peltophoroides, Tabebuia serratifolia and Tabebuia velanedae, whereas seeds of Enterolobium contortisiliquum, Schizolobium parahyba and Cassia grandis showed the highest protein levels. alpha-galactosidase catalyzes the hydrolyzis of raffinose oligossacarides in legume seeds during germination. The highest activity of alpha-galactosidase was found in seeds of Platymiscium pubescens after 72 h of soaking in the water. Two forms of alpha-galactosidases, C1 and C2, were purified from germinated seeds of P. pubescens, using partition with ammonium sulfate, and gel filtration and affinity chromatographies. These enzymes presented maximum activity at pH 5.5, 50-55ºC. Km ap values in the C1 and C2 forms forrho-nitrophenyl-alpha-D-galactopyranoside substrate were 0.54 mM and 0.78 mM, and 4.64 mM and 5.09 mM for raffinose, respectively. These enzymes showed moderate thermal stability, maintaining 70% of the original activity after 3 h incubation at 45ºC. The C1 and C2 enzymatic activity was totally lost in the presence of CuSO4 and sodium dodecyl sulfate (SDS). These enzymes also hydrolyzed melibiose, raffinose and stachyose, indicating a potential for biotechnological applications