Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Vythoulkas Dionysios
Dissertation committee:
Τσιριγώτης Παναγιώτης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Παππά Βασιλική, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Αγγελοπούλου Μαρία, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Κοντοπίδου Φλώρα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Κρούπης Χρήστος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Βαλσάμη Σερένα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Διαμαντόπουλος Παναγιώτης, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Μελέτη της επίδρασης της μεταμόσχευσης αιμοποιητικών κυττάρων στο αγγειακό ενδοθήλιο
Translated title:
The effect of stem cell transplantation on vascular endothelium
Summary:
Introduction: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only treatment option for a variety of malignant and non-malignant hematological diseases. However, during allo-HSCT, the endothelial cells (ECs) of the body's vessels face multiple challenges, resulting in endothelial dysfunction syndromes. Early diagnosis of endothelial dysfunction syndromes is of paramount importance for the development of effective prophylactic and therapeutic strategies.
Purpose: To investigate the association of serum angiopoietin-2 (Ang2) levels and the presence of antibodies against angiotensin II type 1 (AT1R) and endothelin A receptor (ETAR) with the outcome of patients with TA-MA and/or graft-versus-host disease (GVHD) following allo-HSCT.
Methodology: The study involved a total of 52 patients who underwent allo-HSCT from 2016 to 2019 in two different Bone Marrow Transplant Centers in Greece, and who were diagnosed with GVHD and/or TA-TMA.
Results: Εlevated serum Ang2 levels at the time of TMA diagnosis are significantly associated with increased non-relapse mortality and decreased overall survival. To our knowledge, this is the first study demonstrating an association between raised Ang2 levels and poor outcomes in patients with TMA. Antibodies against AT1R (AT1R-Abs) and ETAR (ETAR-Abs) were detected in 27% and 23% of the patients, respectively, but there was no association between the presence of autoantibodies and the outcome of patients with TMA.
Conclusion: Τhis is the first study demonstrating an association between raised Ang2 levels and poor outcomes (shorter OS and higher NRM) in patients with TMA. More interestingly, raised AT1R-Abs levels were found to be positively correlated with the occurrence of fibrotic chronic GvHD after allo-HSCT, suggesting that testing for these antibodies may have clinical utility and especially in the era of multiple angiotensin and endothelin A receptor blockade agents. However, larger, prospective studies are required to validate these results prior to their clinical translation.
Main subject category:
Health Sciences
Keywords:
Allo-HSCT, Allogeneic hematopoietic stem cell transplantation, Hematological diseases, Ang2, Angiopoietin-2, AT1R, Endothelial dysfunction syndromes, ETAR, GvHD, TA-TMA, AT1R-Abs, ETAR-Abs, Malignant, Non-malignant
Number of references:
220
