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自体树突状细胞给药对糖尿病肾病水分子扩散及抗炎生物标志物影响的临床试验

Clinical Trial of Autologous Dendritic Cell Administration Effect on Water Molecule Diffusion and Anti-Inflammatory Biomarkers in Diabetic Kidney Disease.

作者信息

Dimu Paulus Stefanus, Icksan Aziza Ghanie, Hernowo Bhimo Aji, Putranto Terawan Agus

机构信息

Faculty of Medicine, Dentistry, and Health Science, Universitas Prima Indonesia, Medan 20118, Indonesia.

Department of Radiology, Slamet Riyadi Army Hospital, Surakarta 57148, Indonesia.

出版信息

Curr Issues Mol Biol. 2024 Dec 4;46(12):13767-13779. doi: 10.3390/cimb46120822.

Abstract

Diabetic kidney disease (DKD) significantly increases mortality, with patients facing a fourfold risk of death within ten years. Chronic inflammation, marked by transforming growth factor-β (TGF-β) and intracellular adhesion molecule-1 (ICAM-1) activity, contributes to kidney damage and fibrosis. This study investigates the effect of autologous dendritic cells on inflammation and kidney function, focusing on apparent diffusion coefficient (ADC), TGF-β, and ICAM-1 levels. This quasi-experimental clinical trial involved 22 DKD patients at Gatot Soebroto Army Hospital. Patients received autologous dendritic cell injections. Baseline and post-intervention magnetic resonance imaging (MRI) scans measured ADC values, and ICAM-1 and TGF-β levels were analyzed. Post intervention, the median ADC decreased from 1.75 mm/s to 1.64 mm/s ( = 0.223). ICAM-1 levels increased significantly in females ( = 0.04) but not in males ( = 0.35). No significant changes were found in TGF-β levels ( = 0.506). ADC changes were statistically insignificant and did not correlate with CKD severity. ICAM-1 increases in females correlated with improved creatinine levels, suggesting kidney function improvement. Autologous dendritic cell therapy revealed potential gender-specific immune responses but showed limited overall biomarker improvements. Further studies are required to validate its therapeutic value.

摘要

糖尿病肾病(DKD)显著增加死亡率,患者在十年内面临四倍的死亡风险。以转化生长因子-β(TGF-β)和细胞间黏附分子-1(ICAM-1)活性为特征的慢性炎症会导致肾脏损伤和纤维化。本研究调查了自体树突状细胞对炎症和肾功能的影响,重点关注表观扩散系数(ADC)、TGF-β和ICAM-1水平。这项准实验性临床试验纳入了加托·苏布罗托陆军医院的22名DKD患者。患者接受了自体树突状细胞注射。干预前后的磁共振成像(MRI)扫描测量了ADC值,并分析了ICAM-1和TGF-β水平。干预后,ADC中位数从1.75毫米/秒降至1.64毫米/秒( = 0.223)。ICAM-1水平在女性中显著升高( = 0.04),但在男性中未显著升高( = 0.35)。TGF-β水平未发现显著变化( = 0.506)。ADC变化无统计学意义,且与慢性肾脏病严重程度无关。女性ICAM-1升高与肌酐水平改善相关,提示肾功能改善。自体树突状细胞疗法显示出潜在的性别特异性免疫反应,但总体生物标志物改善有限。需要进一步研究来验证其治疗价值。

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