scholarly journals Oral changes in patients before and after transplantation of solid organs and hematopoietic stem cells

2020 ◽  
pp. 106-106
Author(s):  
Olivera Jovicic ◽  
Jelena Mandic ◽  
Zoran Mandinic ◽  
Aleksandra Colovic

Introduction/Objective. The aim of this paper is to point out the prevalence and severity of oral diseases in patients in the period before and after the transplantation of solid organs and hematopoietic stem cells. Methods. MEDLINE literature search was done via PubMed. Results. The development and improvement of transplantation medicine in specialized centers lead to an increasing number of patients, both adults and children, with transplanted solid organs and hematopoietic stem cells. Despite the success of therapy, numerous changes and complications can be observed on other organs in patients undergoing transplantation of solid organs and hematopoietic stem cells in the pre and post-transplant phase. Systemic diseases and conditions related to organ and cell transplantation, which are accompanied by numerous oral manifestations. The most common oral changes are gingival enlargement, desquamation of the oral epithelium, very painful ulcerations, polypoid and granulomatous changes in the oral mucosa, hard dental tissues with frequent complications, developmental anomalies of teeth in younger children, and in the later stage also the occurrence of oral cancer. After transplantation of solid organs and hematopoietic changes in the oral cavity and other organs occur depending on the patient?s post- transplantation period as well as on the applied immunosuppressive therapy. Conclusion. Oral changes development pre and post transplantation of solid organ and hematopoietic stem cells points to the importance of timely and good cooperation between the dentist and the doctor who treats the underlying disease.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1727-1727
Author(s):  
Tao Du ◽  
Camelia Iancu-Rubin ◽  
George F. Atweh ◽  
Rona Singer Weinberg

Abstract Umbilical cord blood (CB) is an important source of hematopoietic stem cells for stem cell transplantation and is being used with increasing frequency. A major concern related to clinical CB transplantation is the long delay in platelet recovery. Megakaryopoiesis is characterized by the acquisition of lineage-specific markers (e.g. CD41) during the early stages that is followed by polyploidization (DNA content > 4N) during the later stages of megakaryopoiesis. Using a newborn blood (NB) model of CB transplantation that was previously developed in our laboratory, we asked whether the delay in platelet recovery is a result of a decrease in the rate of megakaryocyte production or a delay in their maturation. C57BL/6 mice were transplanted with either murine adult bone marrow (BM) cells or murine new-born blood (NB) cells following lethal irradiation. We had previously shown that the concentration of Lin-Sca-1+c-Kit+ stem cells in murine adult BM was approximately 3 times higher than that in NB. To correct for this difference in stem cell concentration, irradiated mice were transplanted with either 0.5 ×106 BM cells or 2×106 NB cells. Platelet counts at 2 and 4 weeks were lower in mice transplanted with NB cells than in mice transplanted with BM cells (Table 1). Interestingly, the platelet counts became comparable in NB and BM recipients at 8 weeks post-transplantation. We compared the ability of BM cells from both NB and BM recipients to form CFU-Meg colonies in methylcellulose. At 2 and 4 weeks post-transplantation, BM cultures derived from NB recipients generated fewer CFU-Meg colonies than cultures from BM recipients (Table 1). Interestingly, after 8 weeks, the numbers of CFU-Meg from both stem cell sources were similar. We also compared the ability of BM cells from NB and BM recipients to differentiate into megakaryocytes in liquid culture, using CD41 expression and polyploidy as markers of megakaryocytic maturation. At 2 weeks post-transplantation, cultures from NB recipients generated 13% CD41+ cells whereas cultures from BM recipients generated 22% CD41+ cells. However, by 4 weeks post-transplantation, the numbers of CD41+ cells were similar in cultures derived from NB recipients and BM recipients (Table 1). Moreover, at 2 and 4 weeks post-transplantation, there were fewer polyploid cells in liquid cultures from NB recipients compared to BM recipients (Table 1). The lower number of polyploid cells was commensurate with the lower number of CD41+ cells. This suggests that the rate of maturation of megakaryocyte is similar in NB and BM. In conclusion, our studies show that CB stem cells generate megakaryocytic progenitors at a slower rate than BM stem cells and that the delay in platelet recovery is not a result of a delay in the maturation of megakaryocytic progenitors. Thus, in order to increase the rate of platelet recovery following CB transplantation, the focus should be on enhancing the rate of production of megakaryocytic progenitors from hematopoietic stem cells. Table 1. Platelet(×103/μl) CFU-Meg(Colonies/1 × 105 Cells) CD41(%) Ploidy(% >4N DNAContent) normal BM(n=5) 1200±120 35.5±5 55±5 27±3 2 weeks NBT-2M(n=5) 190± 38 10±2 13±2 7.5±1 BMT-0.5M(n=5) 400±50 17±4 22±1 11±2 4 weeks NBT-2M(n=5) 550±59 18±2 26±2 14.5±2 BMT-0.5M(n=5) 730±110 23±3 27±1 18±3 8 weeks NBT-2M(n=5) 930±115 39±7 N/A N/A BMT-0.5M(n=5) 970±130 40±4 N/A N/A


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2204-2204
Author(s):  
Mary-Elizabeth A. Muchmore ◽  
Matthew J. Burge ◽  
Judith A. Shizuru

Abstract Transplantation of purified allogeneic hematopoietic stem cells (HSC) has the potential to be a curative treatment for autoimmune diseases. Before it becomes a viable therapy, however, the treatment-related mortality and difficulty of achieving engraftment must be addressed. Our research has focused on developing non-myeloablative regimens that lead to donor-derived engraftment of purified HSC in a murine model. Total lymphoid irradiation (TLI) consists of low-dose fractionated irradiation targeted to the thymus, abdomen, and peripheral nodes, while the skull, lungs, and long bones remain shielded. The non-myeloablative conditioning regimen of TLI and anti-thymocyte globulin (ATG) was followed by HSC transplantation. HSCs were isolated by the composite phenotype of Thy1.1+, c-kit+, Sca-1+, and lineage- (KTLS) or, in strains lacking the Thy1.1 marker, c-kit+, Sca-1+, and lineage- (KSL). We tested HSC transplantations across three major histocompatiblity complex (MHC)-matched strain combinations known through previous studies in our group to have significantly different barriers to engraftment. In all three strain combinations we observed stable mixed chimerism (approximately 50% donor-derived cells) when high doses of HSC (10,000/mouse) were administered. Chimerism was measured at thirty-day intervals, and initially sharply increased and then stabilized around day ninety post-transplantation. In prior studies from our laboratory in a spontaneously arising autoimmune diabetes model, we demonstrated that mixed allogeneic chimerism alone following low dose total body irradiation (TBI) and HSC transplantation was sufficient to block the autoimmune pathogenesis. In order to establish a second clinically relevant conditioning regimen, we attempted here to lower the dose of TBI by using cyclophosphamide and ATG in addition to low dose TBI. However, less robust engraftment was observed as compared to the TLI/ATG approach. To study how TLI/ATG allows engraftment, we have examined the marrow of TLI/ATG conditioned, untransplanted animals. Though TUNEL and Caspase-3 assays did not show a significant increase in apoptosis compared to controls, a 71% decrease in the quantitative number of HSCs isolated from these animals was observed. This depletion of HSCs in the marrow could provide a niche for donor HSCs to inhabit. Further histologic studies on lymphoid organs exposed to radiation through TLI, including the thymus and spleen, are ongoing and may further elucidate the mechanisms by which TLI reconditions the host immune system. The durable mixed chimerism observed following TLI/ATG conditioning and HCT will be applied to mice affected with the rodent form of multiple sclerosis (experimental autoimmune encephalomyelitis) and to tolerance induction of solid-organ grafts. SUMMARY: The combination of TLI/ATG non-myeloablative conditioning and transplantation of allogeneic HSC leads to a durable mixed chimeric state between donor and host and will next be applied to the induction of tolerance to autoantigens and alloantigens.


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1194-1194
Author(s):  
Ulrika Blank ◽  
Sarah Warsi ◽  
Silja Andradottir ◽  
Emma Rörby ◽  
Stefan Karlsson

Abstract Abstract 1194 The Bone Morphogenetic Proteins (BMPs), which belong to the TGF-beta superfamily of ligands, figure prominently during development and are involved in a wide variety of biological processes throughout life. BMP ligands signal via Type I and Type II receptors, both of which are required at the cell surface for propagation of the signal intra-cellularly. Upon receptor activation, both the Smad1/5/8 pathway and the Tak1 MAPK circuitry can be activated, ultimately leading to transcriptional regulation of target genes (Blank et al., Development 2009). Although the BMP pathway plays a role during embryonic development of hematopoiesis, its role in adult hematopoiesis has remained elusive. Previous studies of the Smad1/5/8 pathway have indicated that this pathway is not involved in regulation of adult hematopoietic stem cells (HSCs) in vivo. However, previously published findings demonstrate that the BMP Type II receptor (BmprII) is highly expressed in HSCs, suggesting that BMPs may still play a role in adult HSC regulation via Smad-independent mechanisms. To fully elucidate the role of BMP signaling in hematopoietic cells, we utilized a conditional knockout mouse model targeted to the BmprII gene by Vav-Cre-mediated deletion. Steady state hematopoiesis was essentially normal in BmprII knockouts, but the more primitive LSK population in the bone marrow (BM) was significantly reduced in knockouts compared to littermate controls at 16 weeks of age (0.107% of BM vs. 0.133%, p≤0.05, n=8–10). This reduction in primitive cells translated functionally into a reduced colony forming capacity in vitro (86 colonies/90 000 cells plated vs. 112/90 000 cells plated for controls, p≤0.05, n=8–10). Additionally, when hematopoietic cells were challenged in vivo by transplanting 0.2×10e6 knockout or littermate control whole BM cells in a competitive fashion with 0×10e6 wild type whole BM cells into lethally irradiated recipient mice, the regenerative capacity of BmprII knockout cells was significantly reduced both short term in peripheral blood, at 4 weeks post transplantation (36.5% vs. 48.6% donor-derived cells, p≤0.05, n=7 donors per genotype), and long term in the BM at 16 weeks post transplantation (40.9% vs. 63.4% donor-derived cells, p≤0.05, n=7 donors per genotype). Furthermore, we found a reduction in the myeloid compartment in the BM of BmprII donor recipients at 16 weeks post transplantation (40.3% vs. 64.5% Gr1+/Mac1+ cells of the donor population, p≤0.05, n=7 donors per genotype) coupled with an increase in B-lymphoid cells (46.7% vs. 26.3% B220+ cells of the donor population, p≤0.05, n=7 donors per genotype). To quantify more primitive cells, LSK SLAM FACS analysis was performed, revealing a significant decrease in the numbers of LSK cells (3508 cells vs. 12022 cells per femur, p≤0.05, n=7 donors per genotype), as well as LSK SLAM cells (542 vs. 3023 cells per femur, p≤0.05) derived from BmprII donors. Our studies indicate that the BMP circuitry plays a critical role in HSC regulation and that inactivation of this pathway at the receptor level results in a reduced regenerative capacity in vivo. Disclosures: No relevant conflicts of interest to declare.


2003 ◽  
Vol 31 (12) ◽  
pp. 1338-1347 ◽  
Author(s):  
Naoyuki Uchida ◽  
Brad Dykstra ◽  
Kristin J Lyons ◽  
Frank Y.K Leung ◽  
Connie J Eaves

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 78-78
Author(s):  
Heather A Himburg ◽  
Garrett Muramoto ◽  
Sarah Kristen Meadows ◽  
Alice Bryn Salter ◽  
Nelson J Chao ◽  
...  

Abstract The ability to undergo self-renewal is a defining feature of hematopoietic stem cells (HSCs) but the extrinsic signals which regulate HSC self-renewal remain unclear. We performed a genome-wide expression analysis on primary human brain ECs (HUBECs, n=10) which support the ex vivo expansion of HSCs in non-contact culture (Blood100:4433–4439; Blood105:576–583) and non-brain ECs which do not support HSC expansion (n=8) in order to identify soluble proteins overexpressed by the HSC-supportive HUBECs. We identified pleiotrophin (PTN), an 18 kD heparin binding growth factor, to be 32-fold overexpressed in HUBECs as compared to non-supportive EC lines. PTN has established activity in angiogenesis, embryogenesis, neuronal cell growth and tumorigenesis, but has no known function in hematopoiesis. We first tested whether secreted PTN was responsible for the amplification of HSCs that we have observed in co-cultures of HSCs with HUBECs via “loss of function” studies in which a blocking anti-PTN antibody was added to HUBEC cultures and HSC content was measured. Competitive repopulating unit (CRU) assays were performed in which limiting doses of donor CD45.1+ bone marrow (BM) 34−c-kit+sca-1+lin− (34-KSL) HSCs (10, 30 or 100 cells) or their progeny following 7 day non-contact culture with HUBECs + IgG or HUBECs + a blocking anti-PTN were transplanted into lethally irradiated CD45.2+ C57Bl6 mice. Mice transplanted with the progeny of 34-KSL cells cultured with HUBECs demonstrated 4–6 fold increased levels of donor-derived CD45.1+ multilineage repopulation at 8-, 12- and 24-weeks post-transplantation as compared to mice transplanted with input 34-KSL cells. In contrast, mice transplanted with the progeny of 34-KSL cells following culture with HUBECs + anti-PTN demonstrated significant reduction in donor CD45.1+ cell repopulation compared to mice transplanted with the progeny of HUBEC cultures and no difference in donor CD45.1+ cell engraftment compared to mice transplanted with input 34-KSL cells. CRU frequency within day 0 34-KSL cells was estimated to be 1 in 40 cells (95% Confidence Interval [CI]: 1/22-1/72), whereas the CRU estimate within the progeny of 34-KSL cells following HUBEC culture was 1 in 4 cells (CI: 1/2-1/9). The addition of anti-PTN to the HUBEC co-culture decreased the CRU estimate to 1 in 29 cells (CI: 1/16-1/52), suggesting that PTN signaling was responsible for the expansion of HSCs observed in HUBEC co-cultures. In order to confirm whether PTN is indeed a novel growth and self-renewal factor for HSCs, we next performed “gain of function” studies in which 34-KSL cells were placed in liquid suspension cultures with cytokines (thrombopoietin 50 ng/mL, SCF 120 ng/mL, flt-3 ligand 20 ng/mL) with and without the addition of increasing doses of recombinant murine PTN (10, 50 and 100 ng/mL) and total cell expansion and HSC content were compared. The addition of 100 ng/mL PTN to cytokine cultures caused a 20-fold increase in KSL cell content at day 7 compared to input (P<0.001), whereas a decline in KSL cells was observed with cytokine cultures alone (P<0.001), suggesting that PTN caused an expansion of stem/progenitor cells in vitro. Competitive repopulating assays were performed in which CD45.2+ recipient mice were lethally irradiated and transplanted with limiting doses (10, 30 and 100 cells) of CD45.1+ donor BM 34-KSL cells or their progeny following culture with cytokines alone or cytokines + 100 ng/mL PTN. CRU analysis at 4 weeks post-transplantation revealed that the CRU frequency within input 34-KSL cells was was 1 in 32 cells (CI: 1/18-1/57) and the CRU estimate within the progeny of 34-KSL cells cultured with cytokines alone was 1 in 69 (CI: 1/36-1/130). Conversely, the CRU estimate within the progeny of 34-KSL cells cultured with cytokines + PTN was 1 in 4 cells (CI: 1/2-1/10), indicating a 8-fold increase in short term repopulating cell content in response to PTN treatment. Longer term analysis will be performed in these mice to confirm whether PTN treatment induces the self-renewal and amplification of long-term repopulating HSCs in culture. Taken together, these data demonstrate that secreted PTN is primarily responsible for amplification of HSCs that we have observed in cultures of HSCs with ECs and the addition of PTN alone induces the expansion of phenotypic and functional HSCs in culture. PTN is therefore a novel soluble growth factor for HSCs and appears to play an important role in the extrinsic regulation of HSC self-renewal.


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2325-2325
Author(s):  
Joseph Yusup Shin ◽  
Wenhuo Hu ◽  
Christopher Y. Park

Abstract Abstract 2325 Hematopoietic stem cells (HSC) can be identified on the basis of differential cell surface protein expression, such that 10 out of 13 purified HSC (Lin−c-Kit+Sca-1+CD150+CD34−FLK2−) exhibit long-term reconstitution potential in single-cell transplants. HSCs express c-Kit, and interactions between c-Kit and its ligand, stem cell factor, have been shown to be critical for HSC self-renewal; however, HSCs express a log-fold variation in c-Kit levels. We hypothesized that differing levels of c-Kit expression on HSCs may identify functionally distinct classes of HSCs. Thus, we measured the function and cellular characteristics of c-Kithi HSCs and c-Kitlo HSCs (defined as the top 30% and bottom 30% of c-Kit expressors, respectively), including colony formation, cell cycle status, lineage fates, and serial engraftment potential. In methylcellulose colony assays, c-Kithi HSCs formed 5-fold more colonies than c-Kitlo HSCs (P=0.01), as well as 4-fold more megakaryocyte colonies in vitro. c-Kithi HSC were 2.4-fold enriched for cycling cells (G2-S-M) in comparison to c-Kitlo HSC as assessed by flow cytometry in vivo (15.4% versus 6.4%, P=0.001). Lethally irradiated mice competitively transplanted with 400 c-Kitlo HSCs and 300,000 competitor bone marrow cells exhibited increasing levels of donor chimerism, peaking at a mean of 80% peripheral blood CD45 chimerism by 16 weeks post-transplantation, whereas mice transplanted with c-Kithi HSCs reached a mean of 20% chimerism (p<0.00015). Evaluation of the bone marrow revealed an increase in HSC chimerism from 23% to 44% in mice injected with c-Kitlo HSCs from weeks 7 to 18, while HSC chimerism decreased from 18% to 3.0% in c-Kithi HSC-transplanted mice (P<0.00021). Levels of myeloid chimerism in the bone marrow and peripheral blood were not significantly different during the first 4 weeks following transplantation between mice transplanted with c-Kithi or c-Kitlo HSCs, and evaluation of HSC bone marrow lodging at 24 hours post-transplantation demonstrated no difference in the number of c-Kithi and c-Kitlo HSCs, indicating that differential homing is not the reason for the observed differences in long-term engraftment. Donor HSCs purified from mice transplanted with c-Kithi HSC maintained higher levels of c-Kit expression compared to those from mice injected with c-Kitlo HSC by week 18 post-transplantation (P=0.01). Secondary recipients serially transplanted with c-Kithi HSC exhibited a chimerism level of 40% to 3% from week 4 to 8 post-secondary transplant, whereas chimerism levels remained at 6% in mice injected with c-Kitlo HSC. These results indicate that c-Kithi HSCs exhibit reduced self-renewal capacity compared with c-Kitlo HSCs, and that the differences in c-Kithi and c-Kitlo HSC function are cell-intrinsic. Analysis of transplanted HSC fates revealed that c-Kithi HSCs produced two-fold more pre-megakaryocyte-erythroid progenitors and pluriploid megakaryocytes compared to their c-Kitlo counterparts in vivo, suggesting a megakaryocytic lineage bias in c-Kithi HSC. Consistent with this finding, the transplanted c-Kithi HSC gave rise to 10-fold more platelets and reached a maximum platelet output two days earlier than c-Kitlo HSC. To determine the potential mechanisms underlying the transition from c-Kitlo to c-Kithi HSCs, we assessed the activity of c-Cbl, an E3 ubiquitin ligase known to negatively regulate surface c-Kit expression in a Src-dependent manner. Flow cytometric analysis revealed 6-fold more activated c-Cbl in freshly purified c-Kitlo HSC compared to c-Kithi HSC (P=0.02), suggesting that functional loss of c-Cbl increases c-Kit expression on c-Kitlo HSCs. Mice treated for nine days with Src inhibitors, which inhibit c-Cbl activity, experienced a 1.5-fold and 2-fold increase in the absolute number of c-Kithi HSCs (P=0.067) and megakaryocyte progenitors (P=0.002), respectively. Thus, c-Cbl loss likely promotes the generation of c-Kithi HSCs. In summary, differential expression of c-Kit identifies HSC with distinct functional attributes with c-Kithi HSC exhibiting increased cell cycling, megakaryocyte lineage bias, decreased self-renewal capacity, and decreased c-Cbl activity. Since c-Kitlo HSC represent a population of cells enriched for long-term self-renewal capacity, characterization of this cell population provides an opportunity to better understand the mechanisms that regulate HSC function. Disclosures: No relevant conflicts of interest to declare.


2016 ◽  
Vol 30 (4) ◽  
pp. 227-234 ◽  
Author(s):  
Reza Elahimehr ◽  
Andrew T. Scheinok ◽  
Dianne B. McKay

Author(s):  
Isabelle Campos de Azevedo ◽  
Jéssica Naiara de Medeiros Araújo ◽  
Isabelle Katherinne Fernandes Costa ◽  
Alexsandra Rodrigues Feijão ◽  
Rita de Cássia Lira da Silva ◽  
...  

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5821-5821 ◽  
Author(s):  
Hicham Bouhlal ◽  
Veronique Harrivel ◽  
Christèle Ossart ◽  
Marie Noelle Lacassagne ◽  
Aline Reignier ◽  
...  

Abstract BACKGROUD: Cryopreservation, before storage, is an essential step for autologous hematopoietic stem cells transplantation. Currently, the quality of the graft is estimated: by the quantification of CD34 cells after thawing, the percentage of viability of CD34+ cells evaluated by an Annexin V/7AAD staining and a functional CFU-GM assay. The cryopreservation protocols can affect the viability of HSC CD34+ after thawing which could affect the quality of the graft after injection. The cell death could be induced by cells necrosis or apoptosis. Apoptosis, or programmed cell death, involves complex pathways in part Fas ligand (FasL), mitochondrial components, caspases, cathepsins, and calpain. The involvement of apoptosis dependent on caspases activation pathway in the CD34+ quality has not been evaluated. We have conducted a study to assess the extent of apoptosis before and after cryopreservation of PBSC CD34+ cells using a Fluorescent Labelled Inhibitor of Caspases FLICA. We determined the percentage of FLICA positive cells in viable cells (7AAD negative cells) before and after thawing and confronted results to colony forming units potential and to the number of days of clinical aplasia. METHODS: we tested the induction of caspases-dependent apoptosis before and after cryoconservation in HSC CD34 cells from patients with different hematological malignances: multiple myeloma (n=11), Hodgkin’s (n=2) and non- Hodgkin’s lymphoma NHL (n=5), and amylose (n=1). We evaluated the caspases activation by flow cytometry using the Fluorescent Labelled Inhibitor of Caspases FLICA staining test. Caspases activation status was evaluated in lymphocytes CD3+, monocytes CD14+ and natural killer NK CD56+ cells. Cells were stained in parallel with 7AAD to visualize late dead cells. The correlation with colony forming units CFU-GM and the number of days of aplasia were evaluated. RESULTS: Caspases-dependent pathway is activated in 22% in CD34 cryoconseved after thawing while this percent was less than 5% in fresh CD34 (p<0.0001). Caspases activation was observed at significantly amounts in other thawing blood cells. Percent of FLICA thawing CD3+, CD56+ and CD14+ cells was 12, 25 and 5% compared to 2, 8 and less than 1% in fresh cells.Induction of caspase-dependent apoptosis in CD34+ after thawing affects clonogenicity. FLICA +CD34 reduced the clonogenicity. Only Flica negative cells are able to differentiate in CFU-GM. Length of aplasia was not affected by the percentage of CD34+ cells engage in a caspases-dependent apoptosis after thawing. CONCLUSION: Our results suggest that cryopreservation induced apoptosis by a caspases-dependent pathway in all the subset of apheresis product and mainly CD34 cells. These results modify the quality control of the product but do not affect the clinical outcome. The percent of CD3 and CD56 FLICA positive cells could modify the effect of DLI. More data will be presented Disclosures No relevant conflicts of interest to declare.


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