Progress in understanding the pathogenesis of the anemia of chronic disease [see comments]

Means, Robert T.; Krantz, SB

doi:10.1182/blood.v80.7.1639.bloodjournal8071639

Cited by 271 publications

(134 citation statements)

References 63 publications

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“…In our study, we also found that the platelet engraftment was poorer for patients with HCT‐CI scores of ≥3 ( P = 0.033). We speculate that this might be the result of direct damage of comorbidities on the marrow microenvironment , or that it might result from increases in a negative regulator of hematopoiesis, such as TNF‐α and IL‐6 . Therefore, a high comorbidity burden may well affect the platelet engraftment negatively.…”

Section: Discussionmentioning

confidence: 99%

The hematopoietic cell transplantation‐specific comorbidity index (HCT‐CI) is an outcome predictor for partially matched related donor transplantation

Liu

et al. 2013

American J Hematol

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To validate the predictive ability of the Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI) on the outcome of hematopoietic stem cell transplantation (HSCT) patients who received transplants from partially matched related donors (PMRD), a total of 526 patients who received PMRD HSCT between January 2006 and December 2009 at the Institute of Hematology, Peking University were enrolled. Patients were grouped according to their HCT-CI score; 31.0%, 31.4%, and 37.6% of patients had HCT-CI scores of 0, 1-2, and !3, respectively. Patients with HCT-CI scores of !3 had a significantly poorer 2-year overall survival (OS) than patients with HCT-CI scores of 0-2 (54.55% vs. 78.05%, P < 0.001). In addition, patients with HCT-CI scores of !3 had a significantly higher 2-year cumulative incidence of relapse and nonrelapse mortality (NRM) than patients with scores of 0-2 (relapse: 23.23% vs. 11.59%, P < 0.001; NRM: 34.30% vs. 15.93%, P < 0.001). HCT-CI scores of <3 were associated with better OS, less relapse, and lower NRM in multivariate analysis. Patients who had high comorbidity scores as well as high-risk disease had the poorest outcomes. Therefore, we found that HCT-CI is associated with the outcomes of PMRD HSCT and we should closely monitor patients with a high comorbidity burden. Am. J. Hematol. 88:497-502, 2013. V C 2013 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

The hematopoietic cell transplantation‐specific comorbidity index (HCT‐CI) is an outcome predictor for partially matched related donor transplantation

Liu

et al. 2013

American J Hematol

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“…Serum levels of EPO that are inappropriately low for the degree of anaemia have been demonstrated in patients with acquired immunodeficiency syndrome (AIDS), rheumatoid arthritis and other chronic inflammatory diseases, as well as in cancer 136–138 . The blunted EPO response can be mimicked in animals with acute activation of the immune system, 30 as well as in rat isolated perfused kidneys and the human hepatoma cell lines 139 .…”

Section: Dysregulated Expression Of Epo In Different Clinical Statesmentioning

confidence: 99%

Hypoxia‐induced Erythropoietin Production: A Paradigm for Oxygen‐regulated Gene Expression

Stockmann¹,

Fandrey²

2006

Clin Exp Pharma Physio

139

113

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The mechanisms controlling the expression of the gene encoding for the hormone erythropoietin (EPO) are exemplary for oxygen-regulated gene expression. In humans and other mammals, hypoxia modulates EPO levels by increasing expression of the EPO gene. An association between polycythaemia and people living at high altitudes was first reported more than 100 years ago. Since the identification of EPO as the humoral regulator of red blood cell production and the cloning of the EPO gene, considerable progress has been made in understanding the regulation of EPO gene expression. This has finally led to the identification of a widespread cellular oxygen-sensing mechanism. Central to this mechanism is the transcription factor complex hypoxia-inducible factor (HIF)-1. The abundance and activity of HIF-1, a heterodimer of an alpha- and beta-subunit, is predominantly regulated by oxygen-dependent post-translational hydroxylation of the alpha-subunit. Non-heme ferrous iron containing hydroxylases use dioxygen and 2-oxoglutarate to specifically target proline and an asparagine residue in HIF-1alpha. As such, the three prolyl hydroxylases (prolyl hydroxylase domain-containing protein (PHD) 1, PHD2 and PHD3) and the asparagyl hydroxylase (factor inhibiting HIF (FIH)-1) act as cellular oxygen sensors. In addition to erythropoiesis, HIF-1 regulates a broad range of physiologically relevant genes involved in angiogenesis, apoptosis, vasomotor control and energy metabolism. Therefore, the HIF system is implicated in the pathophysiology of many human diseases. In addition to the tight regulation by oxygen tension, temporal and tissue-specific signals limit expression of the EPO gene primarily to the fetal liver and the adult kidney.

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“…Anemia of chronic disease (ACD) is well‐observed in chronic inflammatory diseases such as rheumatoid arthritis, malignant neoplasm and so on. The mechanisms of ACD are proposed as disturbances of iron metabolism, reduced erythropoiesis in bone marrow and life span‐shortening of red blood cells (16). Biological contaminations of dialysate lead chronic inflammatory responses in hemodialysis patients, and then lead ACD expressed as erythoropoietin resistance.…”

Section: Clinical Usefulness Of Ultrapure Dialysatementioning

confidence: 99%

Review: Clinical Usefulness of Ultrapure Dialysate— Recent Evidence and Perspectives

Masakane¹

2006

Ther Apher Dial

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It has generally been accepted that biological contamination of dialysate deteriorates the biocompatibility of dialysis therapy and accelerates dialysis-related complications such as dialysis-related amyloidosis (DRA) and malnutrition-inflammation-atherosclerosis (MIA) syndrome. During the past decade several studies have clarified that very slight amounts of contamination can lead to inflammatory response, and we could not confirm biological dialysate quality only by measuring endotoxin levels despite of measuring viable cell counts or biofilms. To achieve this, the European Renal Association/European Dialysis Transplantation Association and the American National Standardization Institute/Association for the Advancement of Medical Instrumentation published new standards for dialysate, in which very strict control levels were recommended with regard to viable bacterial cell counts. In 2004 JSDT raised the required standard of the levels of endotoxin, and began to develop a standard for bacterial cell counts. In Japan, many chronic kidney disease patients are treated with centralized dialysate supply systems which have weak spots in disinfecting the system. This causes some difficulties in making a standard for viable bacterial cell counts. In the present paper, we summarize evidences of clinical usefulness of ultrapure dialysate and perspectives of the standard for dialysate in Japan.

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Progress in understanding the pathogenesis of the anemia of chronic disease [see comments]

Cited by 271 publications

References 63 publications

The hematopoietic cell transplantation‐specific comorbidity index (HCT‐CI) is an outcome predictor for partially matched related donor transplantation

The hematopoietic cell transplantation‐specific comorbidity index (HCT‐CI) is an outcome predictor for partially matched related donor transplantation

Hypoxia‐induced Erythropoietin Production: A Paradigm for Oxygen‐regulated Gene Expression

Review: Clinical Usefulness of Ultrapure Dialysate— Recent Evidence and Perspectives

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