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  • American Society of Hematology  (4)
  • 2005-2009  (4)
  • 1
    Online Resource
    Online Resource
    American Society of Hematology ; 2008
    In:  Blood Vol. 112, No. 11 ( 2008-11-16), p. 392-392
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 392-392
    Abstract: The risk of thrombosis differs between men and women; however, the mechanisms underlying this sex difference are unknown. We recently reported differences in thrombosis that are dependent on sexually-dimorphic patterns of growth hormone (GH) secretion and its subsequent effects on the expression of coagulation-related genes in the liver. Mice that are deficient in STAT5A and STAT5B are largely insensitive to growth hormone and demonstrate loss or reversal of sex-specific patterns of liver gene expression. Thus, genetic manipulation of STAT5 factors provides a means of probing the mechanism of GH-dependent sex differences in thrombosis. We analyzed mice with global (STAT5g) and liver-specific (STAT5c) disruptions of the Stat5a and Stat5b genes, and determined their susceptibility to thrombosis in vivo and coagulation in vitro. In an in vivo model of pulmonary embolism, control female mice were relatively protected from thrombosis compared to control males, demonstrating percent survival of 61.3% and 50.0% and median survival times of 1200 and 972 seconds, respectively. In contrast, STAT5g males and females showed similar susceptibility to pulmonary embolism and had significantly reduced survival compared to matched controls, with percentages of 12.5% and 11.1% and median survival times of 468 and 275 seconds, respectively. As with the global loss of STAT5AB, liver-specific disruption of STAT5AB resulted in reduced survival compared to control mice. In vitro coagulation studies of whole blood triggered with dilute tissue factor (TF 1:1000) revealed significantly longer clot times in control females compared to control males. In contrast, mice with either global or liver-specific disruption of STAT5AB showed similar whole blood clot times between males and females, but had significantly shorter clot times as compared to controls. Similar results were obtained from coagulation studies in platelet poor plasma, indicating that platelets or white blood cells do not play a major role in this phenotype. No significant differences were found between control and STAT5AB-deficient mice in the expression or activity of a panel of pro- or anti-coagulant factors. APC sensitivity ratios were also similar between control and STAT5g males and females. An in vitro clotting model was employed to measure thrombin-antithrombin (TAT) complexes, fibrinogen, and D-dimer levels over time. Clotting was triggered with a 1:10,000 dilution of TF and analyzed at two minute intervals for ten minutes. Levels of TAT and fibrinogen did not differ between genotypes throughout the time course. In contrast, D-dimer was decreased in STAT5AB-deficient mice at each interval with a 52% reduction present at four minutes and a 46% reduction remaining at ten minutes. These studies have shown that global and liver-specific loss of STAT5AB results in reduced survival in a pulmonary embolism model, in vivo and shorter clotting times, in vitro. Furthermore, STAT5AB -deficiency eliminated the relative protection from thrombosis afforded to control female mice. This observed increase in thrombosis was not due to significant changes in coagulation factor activity, APC resistance, fibrinogen levels, or thrombin generation. However, a major decrease in D-dimer levels suggests a defect in the fibrinolytic system. While future studies are aimed at further defining the mechanistic regulation of the fibrinolytic system by growth hormone and downstream mediators, the current findings demonstrate a novel role for STAT5AB as a significant regulator of sexdependent thrombosis.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 2
    In: Blood, American Society of Hematology, Vol. 109, No. 8 ( 2007-04-15), p. 3451-3461
    Abstract: CCAAT enhancer-binding protein (CEBP) transcription factors play pivotal roles in proliferation and differentiation, including suppression of myeloid leukemogenesis. Mutations of CEBPA are found in a subset of acute myeloid leukemia (AML) and in some cases of familial AML. Here, using cytogenetics, fluorescence in situ hybridization (FISH), and molecular cloning, we show that 5 CEBP gene family members are targeted by recurrent IGH chromosomal translocations in BCP-ALL. Ten patients with t(8;14)(q11;q32) involved CEBPD on chromosome 8, and 9 patients with t(14;19)(q32;q13) involved CEBPA, while a further patient involved CEBPG, located 71 kb telomeric of CEBPA in chromosome band 19q13; 4 patients with inv(14)(q11q32)/t(14;14)(q11;q32) involved CEBPE and 3 patients with t(14;20)(q32;q13) involved CEBPB. In 16 patients the translocation breakpoints were cloned using long-distance inverse–polymerase chain reaction (LDI-PCR). With the exception of CEBPD breakpoints, which were scattered within a 43-kb region centromeric of CEBPD, translocation breakpoints were clustered immediately 5′ or 3′ of the involved CEBP gene. Except in 1 patient with t(14;14)(q11;q32), the involved CEBP genes retained germ-line sequences. Quantitative reverse transcription (RT)–PCR showed overexpression of the translocated CEBP gene. Our findings implicate the CEBP gene family as novel oncogenes in BCP-ALL, and suggest opposing functions of CEBP dysregulation in myeloid and lymphoid leukemogenesis.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2007
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
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  • 3
    Online Resource
    Online Resource
    American Society of Hematology ; 2006
    In:  Blood Vol. 108, No. 11 ( 2006-11-16), p. 2784-2784
    In: Blood, American Society of Hematology, Vol. 108, No. 11 ( 2006-11-16), p. 2784-2784
    Abstract: Purine analogs are potently immunosuppressive and result in profound suppression of normal CD4 and CD8 T lymphocytes. Despite developing pronounced lymphopenia, patients with CLL treated with these agents do not necessarily develop opportunistic infections and it is thought that other factors including neutropenia and response to therapy play an important role in determining the risk of infection. We evaluated 48 patients with CLL treated with purine analogs on 2 different studies in order to determine the degree of T cell suppression and its correlation with clinically important outcomes. In the upfront setting we analyzed 27 patients while in the salvage setting another 21 patients were evaluated (some analyses had fewer patients). Initial treatment was fludarabine (F) 25 mg/m2/d x 5d x 6 cycles, followed by high-dose cyclophosphamide (C) 3000 mg/m2 x 3 doses, and then a second consolidation with rituximab (R) 375 mg/m2 x 4 doses (F→C→R). The salvage regimen was pentostatin 4 mg/m2 and cyclophosphamide 600 mg/m2 with or without rituximab 375 mg/m2 x 6 cycles (PC(R)). CD4, CD8, and total T cell numbers were correlated with response, time to treatment failure (TTF), number of days hospitalized for infection and overall survival (OS). All patients had a prompt reduction in T cells. In untreated patients, 6 cycles of single-agent F results in a median decrease of 93% in the total T cell count from baseline. Subsequent therapy with C and R did not further reduce the total T cell count. In the salvage setting, 6 cycles of PC(R) reduced the T cell count a median of 82% from baseline. The frequency of complete response (CR) in previously untreated CLL patients with a T cell count below the median (282/μl) was 100% vs 22% (p=0.002) in patients whose T cell count remained greater than the median. Among previously treated patients those with a T cell count below the median (368/μl) after PC(R) had a CR frequency of 57% compared to 25% (p=N.S.) of patients with a T cell count 〉 368/μl. Despite profound T cell suppression, patients with T cell counts below the median level required fewer hospital days for infection when compared with patients whose T cell counts were above the median (median 1 vs 10 days (p=0.09) after F→C→R as initial therapy and 21 vs 44 days (p=N.S.) after PC(R)). CLL patients treated with PC(R) who had T cell counts below the median following therapy had improved TTF and OS compared to patients with less pronounced T cell suppression (TTF: 14 mos vs 〉 30 mos and OS: 32 mos vs 〉 38 mos). As expected, CLL patients have profound lymphopenia when treated with purine analogs. Interestingly, F as a single agent in an untreated population results in a similar degree of T cell suppression when compared with the combination of PC(R) given to relapsed/refractory patients. Despite low T cell counts, infections are not more common in patients with the most severe T cell suppression; in fact the converse is true. Patients with the most profound T cell suppression appear to have the greatest clinical benefit. The mechanism behind this clinical benefit is uncertain but we believe that the degree of T cell suppression may represent a surrogate for efficacy of chemotherapy (combining both AUC and an individual’s innate sensitivity to chemotherapy) and that patients with high quality responses and return of normal hematopoiesis have fewer infections than patients with persistent leukemia. In order to confirm these findings we are currently prospectively studying T cell suppression in patients receiving PCR as initial therapy.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2006
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 4
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 393-393
    Abstract: Thrombosis of arteries and veins is fundamentally important in human diseases such as myocardial infarction, stroke, and venous thrombotic events. Thrombus formation in response to tissue factor (TF) is highly regulated and results from the complex interactions of pro-, anti-coagulant and fibrinolytic effectors. We have taken a mouse genetic approach to identify novel molecules and pathways that regulate the response to a thrombotic trigger. Previously, we observed that the wild-derived inbred mouse strain Cast/EiJ (Cast) was completely resistant to an otherwise lethal dose of TF in an in vivo model of pulmonary embolism (PE). TF-resistance was 100% in the F1 offspring of an intercross to a susceptible strain, C57Bl6/J (B6). To identify the gene(s) mediating TF-resistance, we performed genome-wide linkage analysis on 200 N2 generation animals from a Cast-B6 backcross and found several TF-resistance loci. One such locus was on the proximal end of chromosome 11 (chr11, rs3088940). At the chr11 marker, animals heterozygous for B6 and Cast alleles were significantly protected in the PE model (median survival times of 770 vs. 210 seconds, p & lt;0.05). To confirm linkage, we measured TF-resistance in a congenic strain carrying the Cast chr11 on a B6 background (11C). We found that mice homozygous for Cast chr11 showed significant protection in the PE model; B6, 11C, and Cast strains demonstrated survival fractions of 0, 0.5, and 1 and median survival times of 225, 772 and & gt;1200 seconds, respectively (p & lt;0.0001). To explore the mechanism of TF-resistance and to identify potential candidate genes within the chr11 locus, we performed in vitro analyses of coagulation. Whole blood clotting times triggered with dilute TF were significantly prolonged in 11C mice as compared to B6 (53.7±0.4 vs. 48.9±0.4 sec, p & lt;0.0001). To determine the contribution of platelets, we repeated dilute TF-triggered clotting in platelet poor plasma and found that clotting times remained prolonged in plasma from 11C animals as compared to B6 (52.2±0.5 vs. 46.7±0.9 sec, p & lt;0.05). Next, we measured the aPTT and PT and found that while the PT was similar, the aPTT was prolonged in 11C versus B6 plasma (mean time 50.8±5.3 vs.44.8±6.4, p & lt;0.05). Thus, 11C mice exhibited prolonged clotting times in whole blood and in plasma in response to dilute TF, and had prolonged aPTT. These findings suggested that the principal mechanism of protection was within the intrinsic pathway or in the thrombin feedback pathway. To further investigate, we measured the activity of factors II, V, VII, VIII, IX, X and XI using human factor deficient plasma. There were no significant differences in factor activity between 11C and B6 mice, with the exception of factor XI. Factor XI activity in 11C animals was reduced to 59.1% of B6 activity. These results were confirmed using a chromogenic substrate for factor XI. Activity was decreased in 11C mice as compared to B6 (EC50 values of 74.4±0.3 vs. 70.9±0.6, p & lt;0.0001). The 40% absolute reduction in plasma factor XI activity suggests a potential mechanism for the observed resistance to thrombosis, and supports our theory that the defect lies in the intrinsic or feedback pathway. Since there are no obvious coagulation related genes on mouse chr11, we speculate that the Cast chr11 locus contains a gene(s) that increases the expression and/or activity of a novel inhibitor of factor XI activity, thereby mediating resistance to thrombus formation in vivo.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
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