Rong-Hwa Jan

Impact of maternal and neonatal factors on CD34+ cell count, total nucleated cells, and volume of cord blood.

Abstract:  The engraftment outcome of UCB transplantation is highly dependent on cell number. It would be useful to predict CB cell content using information of donor‐related variables before cell processing. In this study, CBs were obtained from 1312 single‐birth term deliveries in the Buddhist Tzu Chi Stem Cells Center from January 2001 to June 2006. We evaluated whether maternal factors, such as age and race, have an effect on laboratory parameters of hematopoietic content, including CD34+ cell counts, TNCs, and cord blood volume. We also studied the impact of neonatal factors, such as delivery method, gestational age, sex, birth weight, and birth order on the same parameters. In multivariate analysis, babies delivered via Cesarean section had more CD34+ cells and volume, but lower TNCs. Similar results were found for either babies of shorter gestational age or in male infants. Babies with larger birth weight had higher CD34+ cell volume, and TNC, while mothers with fewer previous live births had CB with more TNCs. Maternal age and race had no effect on these laboratory parameters. To conclude, our results suggest that neonatal factors affect CB cell yields. TNCs tend to be more affected by different variables than CD34+ cell counts and volume. These findings may help in collecting CB efficiently and improve the CB transplantation rate.

Effect of probiotics on allergic rhinitis in Df, Dp or dust-sensitive children: a randomized double blind controlled trial.

ObjectiveTo study, we examined the effect of Lactobacillus salivarius on the clinical symptoms and medication use among children with established allergic rhinitis (AR).DesignDouble blind, randomized, controlled trial.SettingHualien Tzu-Chi General Hospital.MethodsAtopic children with current allergic rhinitis received 4 × 109 colony forming units/g of Lactobacillus salivarius (n=99) or placebo (n=100) daily as a powder mixed with food or water for 12 weeks. The SCORing Allergic rhinitis index (specific symptoms scores [SSS] and symptom medication scores [SMS]), which measures the extent and severity of AR, was assessed in each subject at each of the visits — 2 weeks prior to treatment initiation (visit 0), at the beginning of the treatment (visit 1), then at 4 (visit 2), 8 (visit 3) and 12 weeks (visit 4) after starting treatment. The WBC, RBC, platelet and, eosinophil counts as well as the IgE antibody levels of the individuals were evaluated before and after 3 months of treatment.ResultsThe major outcome, indicating the efficacy of Lactobacillus salivarius treatment, was the reduction in rhinitis symptoms and drug scores. No significant statistical differences were found between baseline or 12 weeks in the probiotic and placebo groups for any immunological or blood cell variables.ConclusionsOur study demonstrates that Lactobacillus salivarius treatment reduces rhinitis symptoms and drug usage in children with allergic rhinitis.

Immuno-modulatory activity of Ganoderma lucidum-derived polysacharide on human monocytoid dendritic cells pulsed with Der p 1 allergen

BackgroundGanoderma lucidum-derived polysaccharide (PS-G) can rapidly and effectively promote the activation and maturation of immature dendritic cells (DCs), suggesting that PS-G possesses the capacity to regulate immune responses. This study aimed to clarify the immunologic effect of PS-G on monocyte-derived dendritic cells (MD-DCs) from asthmatic children allergic to house dust mites. The MD-DCs were stimulated for 24 h with the related allergen, Der p 1, in the presence or absence of PS-G. Cell surface markers and phagocytic capacity were assessed by FACS analysis, and key polarizing cytokines (IL-12 p40, IL-12 p70, IL-6, IL-23, and IL-10) were quantified. The subsequent regulatory effect of pulsed MD-DCs on naïve T cells was evaluated by determining the T-cell cytokine profile.ResultsPS-G induced the maturation of MD-DCs and decreased phagocytic capacity, even if pulsed with Der p 1. After incubation with PS-G and Der p 1, MD-DCs produced higher amounts of IL-12 p70, IL-12 p40, IL-6, IL-23, and IL10 than Der p 1-pulsed DCs. Furthermore, type 1 helper T (Th1) cell cytokine (INF-γ) production was highly increased when naïve autologous T cells were co-cultured with Der p 1-pulsed MD-DCs. Naïve T cells stimulated by MD-DCs pulsed with Der p 1 failed to produce proliferation of T-cells, whereas the addition of PS-G to Der p 1 induced a significant proliferation of T-cells similar to that observed with PS-G alone.ConclusionThe presence of PS-G in an allergen pulse promoted allergic MD-DCs to produce IL-12 p70, IL-12 p40, IL-6, IL-23, and IL-10, and exerted an effect on shifting the immune balance towards Th1 in children with allergic asthma.

Hepatitis B virus surface antigen can activate human monocyte‐derived dendritic cells by nuclear factor kappa B and p38 mitogen‐activated protein kinase mediated signaling

Hepatitis B virus Ag (HBsAg), a major antigen of hepatitis B virus (HBV), is also a vaccine component for prevention of HBV infection. Dendritic cells (DCs) of HBV carriers reportedly exhibit functional impairment. In this study, the aim was to investigate the effect of HBsAg on activation of human monocyte‐derived dendritic cells (MD‐DCs), and the subsequent signal transduction pathway. Treatment of MD‐DCs with HBsAg resulted in enhanced cell surface expression of cluster of differentiation 80, CD83, CD86 and major histocompatibility complex class II, and increased interleukin (IL)‐12 p40, IL‐12p70, and IL‐10 production. Furthermore, HBsAg treatment of MD‐DCs with HBsAg resulted in enhanced T cell‐stimulatory capacity and increased T cell secretion of interferon and IL‐10. The pathway of MD‐DCs activation by HBsAg was further investigated in the present study. Inhibition of nuclear factor (NF)‐kappa B (κB) by helenalin and p38 mitogen‐activated protein kinase (MAPK) by SB203580 prevented production of IL‐12 p40, IL‐12 p70, and IL‐10. HBsAg also augmented MAPK phosphorylation. Thus, cytokine secretion of human MD‐DCs by HBsAg is blocked by inhibition of the NF‐κB and p38 MAPK pathways. Likewise, decreased inhibition of kappa B alpha concentrations and MAPK phosphorylation are critical for MD‐DC maturation by HBsAg. These findings may provide a strategy for improving the prophylactic and therapeutic efficacy of vaccines and tumor therapies that utilize these pathways.

Hepatitis B virus surface antigen can activate dendritic cells and modulate T helper type immune response

Hepatitis B virus surface antigen (HBsAg) is a major antigen of hepatitis B virus (HBV). Dendritic cells (DC) of HBV carriers have been reported to exhibit functional impairment. In this study, the role of HBsAg on mice bone marrow‐derived dendritic cells and immune responses in vivo was studied. The immune modulatory function of HBsAg was explored by using mice bone marrow‐derived dendritic cells in vitro and also by examining an ovalbumin (OVA) specific immune response in vivo. Treatment of dendritic cells with HBsAg resulted in enhanced cell surface expression of cluster of differentiation (CD) 80, CD83, CD86, and major histocompatibility complex (MHC) class II, and enhanced production of interleukin (IL)‐12 p40 and IL‐12 p70. Treatment of dendritic cells with HBsAg resulted in decreased T cell secretion of IL‐5 by OVA stimulation. In addition, the results showed stronger OVA‐specific immunoglobulin (Ig) M and weaker IgG responses in mice sera when they had been immunized with OVA and co‐injected with HBsAg. It was also found that the mice exhibited significant enhancement of anti‐OVA IgG2a antibody (Ab), as well as marked inhibition of IgG1 Ab production. In cellular immune responses, IL‐5 production was significantly decreased and interferon (IFN)‐γ increased in the group co‐injected with HBsAg. On the other hand, the induction of lymphoproliferative response to OVA stimulation in spleen cells was decreased in the HBsAg co‐injected group. These results demonstrate that HBsAg can affect the differentiation of T helper (Th) cells, which might provide a strategy for improving its prophylactic and therapeutic efficacy.

Familial Cases of Henoch-Schonlein Purpura in Taiwanese Aborigines

Henoch-Schönlein purpura (HSP) is a disorder whose cause and pathogenesis is unknown; some familial cases of this disease have been reported. The clinical heterogeneity in HSP may be conferred by a number of genetic loci, including the major histocompatibility complex. The racial and genetic factors responsible for the occurrence of the familial cases of HSP in Taiwan are unclear. The purpose of this study was to examine the racial and genetic factors in familial HSP cases in Taiwan. We retrospectively collected the HSP cases in our hospital during 2006 through 2010 and observed that familial HSP cases were only in Taroko Aborigines. Six cases of HSP in 3 Taroko families were found, and their human leukocyte antigens (HLA) were studied in the tissue typing laboratory of our hospital, to determine the possible association with familial HSP cases in Taiwanese Aborigines. Our results suggest an increased frequency of familial HSP cases with HLA-A24 in Taiwanese Taroko Aborigines. We concluded that racial and genetic predisposition was the possible cause for the familial occurrence of and renal involvement in HSP in Taiwanese Aborigines.

Incidence of Alloantibodies in Transfused Patients in Eastern Taiwan

Abstract Objective The study was conducted to determine the prevalence of red blood cell alloantibodies for transfused patients in the East Taiwanese population. Materials and Methods We analyzed the clinical and transfusion records of 15,794 individuals who received transfusions in Hualien Tzu Chi Hospital from 2004 to 2006. Blood samples were subjected to standard blood bank procedures for screening for antibodies. Results Of the 15,794 transfused patients, 538 patients (3.39%) were found to have alloantibodies. Among these 538 patients, 333 patients were found to carry alloantibodies at the initial transfusion (2.0%) and 205 (1.3%) patients developed alloantibodies during the transfusion period. Conclusion Our data demonstrate that anti-Mia was the most frequently detected alloantibody in the Eastern Taiwanese population, with an incidence (1.5%) that was higher than reported in other Taiwanese populations.

Autonomic Dysfunction Because of Severe Tetanus in an Unvaccinated Child

Tetanus is rare in a country with a national vaccination program. When it does occur, the associated autonomic dysfunction is a challenge for physicians. We report here a case of an unvaccinated 5-year-old boy who suffered from tetanus complicated by autonomic dysfunction, which was successfully controlled by the infusion of magnesium sulfate. This is the first case that demonstrated the therapeutic effect of magnesium sulfate in a child with tetanus. This case highlights the importance of implementing a vaccination program.