Selected Articles March 2014
New prognostic marker in stem cell transplantation
Pretransplant C-reactive protein as a prognostic marker in allogeneic stem cell transplantation
K. K. I. Jordan, I. J. Christensen, C. Heilmann, H. Sengeløv and K. G. Müller
In a study performed by the group of K. G. Müller, it was found that measurements of C-reactive protein (CRP) in patients that undergo allogeneic stem cell transplantation can help predict the survival after the transplant. Before the transplant, patients undergo chemotherapy and total body irradiation. This is called pretransplant conditioning and prevents graft rejection and reduces the number of remaining leukemia cells.
Karina Jordan, MD and PhD student is the first author of the paper.
– I find it important to evaluate the level of CRP before the initiation of the conditioning as the prognosis on survival is largely impaired with elevated CRP levels, even at baseline before the start of the conditioning. Prospective studies will show whether it is possible to improve survival by including CRP in the pre-transplant risk stratification profiling of these patients
The present study was a population-based retrospective study of 349 patients undergoing allogeneic stem cell transplantation at the National Danish SCT centre between January 2000 and January 2009. This is one of the first study that address the prognostic value of baseline CRP levels before start of transplantation and it was found that elevated pretransplant CRP levels predict a poorer survival.
Karina Jordan, who wrote this paper as a part of her PhD was responsible for all the data-management and did the analysis together with a statistician. She enjoys the thrill of science:
– It is always interesting to explore new areas in science, and although it is a small contribution in the big sea I hope the findings will add up to improve the morbidity and mortality of this treatment.
New insights into the pathogenesis of multiple sclerosis
IL-17 and glutamate excitotoxicity in the pathogenesis of multiple sclerosis
M. Kostic, T. Dzopalic, S. Zivanovic, N. Zivkovic, A. Cvetanovic, I. Stojanovic, S. Vojinovic, G. Marjanovic, V. Savic and M. Colic
The relationship between Th17-mediated inflammatory and excitotoxic events was investigated during an active phase of multiple sclerosis (MS). The main pathological feature of MS is immunoinflammatory-mediated demyelination. This demyelination is often accompanied by neurodegeneration, mainly in the form of axonal degeneration, which could be initiated by glutamate excitotoxicity.
– The starting idea for this paper originated from PhD thesis, and in cooperation with my senior mentors and clinicians, we made the study design, says Milos Kostic.
Dr Milos Kostic is assistant at the Department of Immunology at Medical Faculty, University of Nis, Serbia, were this work was mainly carried out. The work was done under the ongoing project ''Preventive, therapeutic, and ethical approach in preclinical and clinical studies of genes and redox cell signalling modulators in immune, inflammatory and proliferative cell response.'' supported by The Ministry of Education and Science of the Republic of Serbia.
– I would highlight, as our main finding that we have reported direct positive correlation between IL-17A and glutamate levels in cerebrospinal fluid of MS patients. This potentially suggests that Th-17 cells besides involvement in immunoinflammatory-mediated demyelinization might use glutamate excitotoxicity as effector mechanism, and thus also mediate neurodegenerative processes during MS development.
An unexpected finding in the study was that CSF IL-17A level tends to fall with disease duration indicating that Th-17 cells are possibly more important for disease initiation rather than progression which may be mediated by some other, inflammation-independent mechanisms.