Plasma Lipidome Acts As Diagnostic Marker and Predictor for Cyclosporin Response in Patients with Aplastic Anemia

Abstract Background：The lipid metabolomic profile has been well defined in the pathogenesis and differential diagnosis in patients with different myeloid diseases. However, the role of plasma lipidome was rarely explored, especially in aplastic anemia (AA), a disease which has close connection with lipid metabolism. Methods: Peripheral fasting serum levels of patients newly diagnosed with AA from March 2019 to December 2019 were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) for the serum lipid profiles. Meanwhile, the lipidomes for patients with hypocellular myelodysplastic syndrome (h-MDS) and age and sex matched healthy volunteers were taken as controls. The lipid profiles were tested again 6 months after standard cyclosporin A（CsA）treatment in patients with AA. For all the patients, those with a history of hyperlipidemia, diabetes, obesity (body mass index > 28 kg/m 2) or complications with other malignant diseases at diagnosis were excluded. Results: The study enrolled 15 patients with AA, 11 patients with h-MDS and 20 healthy controls. All the enrolled AA patients were non-severe and transfusion dependent, and were treated with CsA 3-5mg/kg/d for at least 6 months. For h-MDS patients, five were MDS with single lineage dysplasia, three were MDS with multilineage dysplasia, and three were MDS-Excess Blasts 1 (MDS-RAEB1). Metabolites in arachidonic acid pathway and retinol metabolism were significantly decreased in the AA patients compared with the healthy controls (P<0.05). AA patients had decreased arachidonic acid pathway metabolites and retinol metabolism-related metabolites as compared with h-MDS（P<0.05), whereas h-MDS patients had increased metabolism of proline and threonine and abnormal sphingolipid metabolism compared with AA patients and the normal controls. After 6-month of CsA treatment, leukotriene B4, 15(S)-HETE, all-trans-retinal and protectin D1 decreased significantly. Patients who had response to CsA had higher levels of baseline protectin D1 (p=0.011), leukotriene B4 (p=0.011), 15(S)-HETE (p=0.004) and all-trans-retinal (p=0.000) than those who had no response. Conclusion: The lipid profiles showed significant difference not only between patients with AA and healthy controls, but also between AA and h-MDS. Meanwhile, some of baseline value and the change in lipid molecules may predict the CsA response at 6 months. Disclosures No relevant conflicts of interest to declare.

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Plasma Lipidome Acts as Diagnostic Marker and Predictor for Cyclosporin Response in Patients with Aplastic Anemia

10.21203/rs.3.rs-1042753/v1 ◽

2021 ◽

Author(s):

Jing Ruan ◽

Chen Yang ◽

Yali Du ◽

Miao Chen ◽

Bing Han

Keyword(s):

Arachidonic Acid ◽

Aplastic Anemia ◽

Serum Lipid ◽

Leukotriene B4 ◽

Sphingolipid Metabolism ◽

Before And After ◽

Transfusion Dependency ◽

Retinol Metabolism ◽

Acid Pathway ◽

Prognostic Prediction

Abstract The lipid metabolomic profile has been well defined in the pathogenesis and differential diagnosis in patients with different myeloid diseases. We assumed that the serum lipid metabolites could also help the diagnosis and prognostic prediction of aplastic anemia (AA). In this study, serum lipid profiles were explored in AA patients before and after cyclosporin (CsA) treatment. Meanwhile, hypocellular myelodysplastic syndrome (h-MDS) patients and the healthy volunteers were compared as controls. 15 AA patients, 11 h-MDS patients and 20 age and sex matched health controls were enrolled. All the AA patients were diagnosed to be non-severe aplastic anemia with transfusion dependency and were treated by CsA 3-5mg/kg/d for at least 6 months. AA patients had decreased arachidonic acid pathway metabolites and retinol metabolism-related metabolites as compared with h-MDS and the health (P<0.05), whereas h-MDS patients had increased metabolism of proline and threonine and abnormal sphingolipid metabolism compared with AA patients and the normal controls. After 6-month of CsA treatment, serum arachidonic acid, PGE2, PGJ2, 15(S)-HETE, leukotriene B4 and Protectin D1 decreased significantly. Patients who had response to CsA had higher levels of baseline protectin D1 (p=0.011), leukotriene B4 (p=0.011), 15(S)-HETE (p=0.004) and all-trans-retinal (p=0.000) than those who had no response.

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Chlorobutanol, a Preservative of Desmopressin, Inhibits Human Platelet Aggregation and Release In Vitro

Thrombosis and Haemostasis ◽

10.1055/s-0038-1647339 ◽

1990 ◽

Vol 64 (03) ◽

pp. 473-477 ◽

Cited By ~ 4

Author(s):

Shih-Luen Chen ◽

Wu-Chang Yang ◽

Tung-Po Huang ◽

Shiang Wann ◽

Che-ming Teng

Keyword(s):

Arachidonic Acid ◽

Platelet Aggregation ◽

Atp Release ◽

Free Calcium ◽

Dependent Manner ◽

Antiplatelet Effect ◽

Human Platelet Aggregation ◽

Acid Pathway ◽

Arachidonic Acid Pathway

SummaryTherapeutic preparations of desmopressin for parenteral use contain the preservative chlorobutanol (5 mg/ml). We show here that chlorobutanol is a potent inhibitor of platelet aggregation and release. It exhibited a significant inhibitory activity toward several aggregation inducers in a concentration- and time-dependent manner. Thromboxane B2 formation, ATP release, and elevation of cytosolic free calcium caused by collagen, ADP, epinephrine, arachidonic acid and thrombin respectively were markedly inhibited by chlorobutanol. Chlorobutanol had no effect on elastase- treated platelets and its antiplatelet effect could be reversed. It is concluded that the antiplatelet effect of chlorobutanol is mainly due to its inhibition on the arachidonic acid pathway but it is unlikely to have a nonspecitic toxic effect. This antiplatelet effect of chlorobutanol suggests that desmopressin, when administered for improving hemostasis, should not contain chlorobutanol as a preservative.

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Sex-Associated Differences On The Effect Of Asa Or Flurbiprofen On Platelet Function Ex Vivo

10.1055/s-0038-1652096 ◽

1981 ◽

Author(s):

E E Nishizawa ◽

B A Molony ◽

M M Meinzinger ◽

D J Williams

Keyword(s):

Arachidonic Acid ◽

Platelet Function ◽

Bleeding Time ◽

Ex Vivo ◽

Normal Male ◽

Normal Response ◽

Beneficial Effects ◽

Acid Pathway ◽

Induced Aggregation ◽

Arachidonic Acid Pathway

It has been reported that although ASA may have some beneficial effects in males, no differences from placebo was detected in females in clinical trials on venous thrombosis, TIA and stroke. Since ASA inhibits platelet function and because the end-points measured in the above clinical studies may be related to platelet function, we measured bleeding time and platelet aggregation induced by collagen or arachidonic acid following oral administration of ASA (650 mg) or flurbiprofen (100 mg) in normal male and female volunteers (10 per group, total of 40 subjects) between the age of 50 and 70.No sex-associated differences in response with either drug were observed in bleeding time or platelet function. Thus, we were unable to confirm that the observation of beneficial effect of ASA in males was due to its effect on platelets. However, more interestingly there was a statistically shorter bleeding time in males (p = 0.026) before administration of drug. It was also found that despite the normal response to collagen, PRP prepared from pre-drug blood samples from 6 individuals (15%) did not aggregate when stimulated with arachidonic acid at concentrations as high as 1 mM. These results suggest that, at least in some individuals, collagen-induced aggregation may proceed by a pathway independent of the arachidonic acid pathway.

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