儿童急性淋巴细胞白血病的年轻幸存者的葡萄糖皮质激素敏感性:它有什么意义?
Adriana Aparecida Siviero-Miachon1,2, Ana Virgínia Lopes de Sousa3, Bruno Moreira Simião1
1Pediatric Endocrinology, Federal University of Sao Paulo - UNIFESP/EPM, Sao Paulo, Brazil.
概括
儿童急性淋巴细胞白血病的幸存者表现出降低的葡萄糖皮质醇敏感性. 癌症幸存者的这一发现表明,与心血管疾病风险和个性化治疗的需要有潜在的联系.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 遗传学 是一个遗传学.
背景情况:
- 儿童急性淋巴细胞白血病 (ALL) 幸存者可能会经历长期的健康问题.
- 葡萄糖皮质醇敏感性对代谢和免疫功能至关重要.
- 评估所有幸存者的葡萄糖皮质激素敏感性对于了解长期健康风险很重要.
研究的目的:
- 为了评估在儿童时期幸存下来的成年人中葡萄糖皮质激素敏感性的ALL.
- 为了比较体内和体外测量ALL幸存者和对照者之间的葡萄糖皮质激素敏感性.
- 探索潜在的遗传因素,影响该人口的葡萄糖皮质体敏感性.
主要方法:
- 在体内测试包括静脉注射和口服德甲抑制测试,以测量血清和唾液皮质醇.
- 在体外分析包括评估葡萄糖皮质体受体 (GR) 基因多态 (BcI1-NR3C1,A3669G) 和GR-α mRNA拼接变异.
- 在30名ALL幸存者 (≥18年,≥2年治疗后) 和32名年龄匹配的对照者之间比较了数据.
主要成果:
- 所有幸存者在口服德克萨米他后表现出减少的唾液皮质醇抑制,73.3%显示出高灵敏度 (p<0.05).
- 血清皮质醇水平和抑制百分比在静脉注射德甲后ALL幸存者组显着较低 (p<0.05).
- 确定了特定的GR多态 (BcI1-NR3C1,A3669G),幸存者中的GR-αmRNA水平较低 (p<0.05).
结论:
- 童年幸存者ALL表现出葡萄糖皮质激素敏感性降低.
- 降低葡萄糖皮质激素敏感性可能会影响所有幸存者的不良健康结果的风险,包括心血管疾病.
- 这些发现支持对ALL幸存者的个性化治疗策略的需求,以减轻潜在的长期并发症.
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