Visfatin concentrations in children with leukemia before and after stem cell transplantation
Szymon Skoczen1, Przemyslaw J Tomasik2, Jolanta Gozdzik1
1Department of Immunology, Chair of Clinical Immunology and Transplantation, Jagiellonian University Medical College, Krakow, Poland; Transplantation Centre, University Children's Hospital, Krakow, Poland.
Insights
Visfatin (VF) levels are lower in children with leukemia before stem cell transplantation (HSCT) but increase after HSCT. This suggests VF may indicate leukemia remission and its changes reflect treatment effects.
Area of Science:
- Biochemistry
- Immunology
- Pediatric Oncology
Background:
- Visfatin (VF) is an adipocytokine involved in cell proliferation and glucose metabolism.
- Altered VF levels are implicated in metabolic disturbances.
Purpose of the Study:
- To determine visfatin concentrations in children with leukemia undergoing hematopoietic stem cell transplantation (HSCT).
- To assess changes in VF levels before and after HSCT in relation to glucose metabolism.
Main Methods:
- Plasma VF concentrations were measured in 22 children with leukemia (pre- and post-HSCT) and 24 healthy controls.
- Measurements were taken before and during an oral glucose tolerance test (OGTT).
- Glucose, insulin, lipids, and hsCRP were also analyzed.
Main Results:
- Pre-HSCT leukemia patients showed significantly lower VF levels compared to controls at all OGTT time points.
- VF concentrations were significantly higher post-HSCT compared to pre-HSCT levels.
- Lower pre-HSCT VF may relate to chemotherapy-induced immunosuppression.
Conclusions:
- Decreased VF in leukemia patients before HSCT might be linked to myelosuppression and immunosuppression.
- Visfatin may serve as a biochemical marker for leukemia remission.
- Post-HSCT VF normalization could be due to immune reconstitution and inflammation.
Abstract:
Visfatin (VF) is an adipocytokine that performs many functions, including enhancing cell proliferation and biosynthesis of nicotinamide mononucleotides and dinucleotides. It also seems to be involved in the development of glucose metabolism disturbances. The goal of the study was the determination of VF concentrations in children with leukemia who are treated with stem cell transplantation. VF concentrations were measured in plasma before and after oral glucose tolerance test (OGTT; 60 and 120 minutes) in 22 children with leukemia treated with hematopoietic stem cell transplantation (HSCT) and healthy control subjects (n = 24). The HSCT group was studied twice: before HSCT (22 children) and approximately 6 months after HSCT (12 of 22 children). After fasting, concentrations of glucose, insulin, triglycerides, total cholesterol, high-density lipoprotein, and high-sensitivity C-reactive protein (hsCRP) were determined. Significantly lower (p < 0.05) median values of VF concentrations at all time points in the OGTT were found in pre- HSCT children compared with control subjects. The median VF concentration was significantly higher after HSCT compared with before HSCT. The decrease in VF in leukemic children in complete remission may be caused by myelosuppression and immunosuppression after prolong chemotherapy and is beneficial because of the decrease in its antiapoptotic activity. VF can serve as an additional biochemical marker for remission in patients with leukemia. Normalization of plasma VF concentration after HSCT might be caused by a process of immune reconstitution and prolonged inflammation (e.g., infections, graft-versus-host disease), injury to organs (e.g., lungs, gut, liver), and endocrinology deficiencies.
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