白血病患儿从诊断到缓解期RANKL、OPG和25(OH)D水平的变化
Changes in RANKL, OPG, and 25(OH)D Levels in Children with Leukemia from Diagnosis to Remission.
作者信息
Atilano-Miguel Salvador, Barbosa-Cortés Lourdes, Ortiz-Muñiz Rocío, Maldonado-Hernández Jorge, Martin-Trejo Jorge A, Rodríguez-Cruz Maricela, Balcázar-Hernández Lourdes, Solís-Labastida Karina A, Bautista-Martínez Benito A, Juárez-Moya Azalia, Hernández-Piñón Zayra, Galindo-Rodríguez Raeline A, Chávez-Anaya Adriana, Valdez-Avilez Rosa E, Domínguez-Salgado Juan M, Villa-Morales Judith, Rodríguez-Palacios María E
机构信息
Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Ciudad de México 14387, Mexico.
Unidad de Investigación Médica en Nutrición, Unidad Médica de Alta Especialidad (UMAE), Instituto Mexicano del Seguro Social (IMSS), Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Ciudad de México 06720, Mexico.
出版信息
Cancers (Basel). 2024 Aug 10;16(16):2811. doi: 10.3390/cancers16162811.
BACKGROUND
The receptor activator of the nuclear factor-kB (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) pathway is a determining pathway in the balance between bone formation and resorption, and disruptions in this complex can affect bone metabolism.
METHODS
This study analyzes the changes in RANKL, OPG, and 25(OH)D levels; the RANKL/OPG ratio; and other bone turnover markers (BTMs) from diagnosis to complete remission in children with acute lymphoblastic leukemia (ALL). This is a prospective observational cohort study, carried out at the Instituto Mexicano del Seguro Social, Mexico City, including 33 patients (4-17 years) with newly diagnosed B-cell ALL. The patients were treated with the HP09 chemotherapy protocol. Children who had previously been treated with corticosteroids were excluded. A peripheral blood sample at diagnosis and remission was collected to determine the 25(OH)D and BTM concentrations.
RESULTS
Increased RANKL ( = 0.001) and osteocalcin ( < 0.001) levels and RANKL/OPG ratio (<0.001) and a decreased OPG level ( = 0.005) were observed at remission, predominantly in the high-risk (HR) relapse and vitamin D deficiency groups. A negative association between RANKL and OPG (r = -0.454, = 0.008) was observed.
CONCLUSIONS
we suggest that the RANKL/OPG ratio could serve as a bone remodeling marker in ALL patients.
背景
核因子-κB受体激活剂（RANK）/RANK配体（RANKL）/骨保护素（OPG）通路是骨形成与骨吸收平衡的决定性通路，该复合体的破坏会影响骨代谢。
方法
本研究分析了急性淋巴细胞白血病（ALL）患儿从诊断到完全缓解期间RANKL、OPG和25（OH）D水平的变化；RANKL/OPG比值；以及其他骨转换标志物（BTMs）。这是一项前瞻性观察队列研究，在墨西哥城的墨西哥社会保障局进行，纳入33例（4 - 17岁）新诊断的B细胞ALL患者。患者接受HP09化疗方案治疗。排除既往接受过皮质类固醇治疗的儿童。采集诊断和缓解期的外周血样本，以测定25（OH）D和BTM浓度。
结果
缓解期观察到RANKL（ = 0.001）和骨钙素（ < 0.001）水平升高、RANKL/OPG比值（<0.001）升高以及OPG水平降低（ = 0.005），主要见于高危（HR）复发组和维生素D缺乏组。观察到RANKL与OPG之间呈负相关（r = -0.454， = 0.008）。
结论
我们认为RANKL/OPG比值可作为ALL患者骨重塑的标志物。
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