Intestinal damage determines the inflammatory response and early complications in patients receiving conditioning for a stem cell transplantation
Stem cell transplantation (SCT) is still complicated by the occurrence of fever and inflammatory complications attributed to neutropenia and subsequent infectious complications. The role of mucosal barrier injury (MBI) of the intestinal tract therein has received little attention. We performed a ret...
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| Veröffentlicht in: | PloS one 2010-12, Vol.5 (12), p.e15156-e15156 |
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| creator | van der Velden, Walter J F M Herbers, Alexandra H E Feuth, Ton Schaap, Nicolaas P M Donnelly, J Peter Blijlevens, Nicole M A |
| description | Stem cell transplantation (SCT) is still complicated by the occurrence of fever and inflammatory complications attributed to neutropenia and subsequent infectious complications. The role of mucosal barrier injury (MBI) of the intestinal tract therein has received little attention.
We performed a retrospective analysis in 163 SCT recipients of which data had been collected prospectively on intestinal damage (citrulline), inflammation (C-reactive protein), and neutrophil count. Six different conditioning regimens were studied; 5 myeloablative (MA) and 1 non-myeloablative (NMA). Linear mixed model multivariate and AUC analyses were used to define the role of intestinal damage in post-SCT inflammation. We also studied the relationship between the degree of intestinal damage and the occurrence of early post-SCT complications.
In the 5 MA regimen there was a striking pattern of inflammatory response that coincided with the occurrence of severe intestinal damage. This contrasted with a modest inflammatory response seen in the NMA regimen in which intestinal damage was limited. With linear mixed model analysis the degree of intestinal damage was shown the most important determinant of the inflammatory response, and both neutropenia and bacteremia had only a minor impact. AUC analysis revealed a strong correlation between citrulline and CRP (Pearson correlation r = 0.96). Intestinal damage was associated with the occurrence of bacteremia and acute lung injury, and influenced the kinetics of acute graft-versus-host disease.
The degree of intestinal damage after myeloablative conditioning appeared to be the most important determined the inflammatory response following SCT, and was associated with inflammatory complications. Studies should explore ways to ameliorate cytotoxic therapy-induced intestinal damage in order to reduce complications associated with myeloablative conditioning therapy. |
| doi_str_mv | 10.1371/journal.pone.0015156 |
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We performed a retrospective analysis in 163 SCT recipients of which data had been collected prospectively on intestinal damage (citrulline), inflammation (C-reactive protein), and neutrophil count. Six different conditioning regimens were studied; 5 myeloablative (MA) and 1 non-myeloablative (NMA). Linear mixed model multivariate and AUC analyses were used to define the role of intestinal damage in post-SCT inflammation. We also studied the relationship between the degree of intestinal damage and the occurrence of early post-SCT complications.
In the 5 MA regimen there was a striking pattern of inflammatory response that coincided with the occurrence of severe intestinal damage. This contrasted with a modest inflammatory response seen in the NMA regimen in which intestinal damage was limited. With linear mixed model analysis the degree of intestinal damage was shown the most important determinant of the inflammatory response, and both neutropenia and bacteremia had only a minor impact. AUC analysis revealed a strong correlation between citrulline and CRP (Pearson correlation r = 0.96). Intestinal damage was associated with the occurrence of bacteremia and acute lung injury, and influenced the kinetics of acute graft-versus-host disease.
The degree of intestinal damage after myeloablative conditioning appeared to be the most important determined the inflammatory response following SCT, and was associated with inflammatory complications. Studies should explore ways to ameliorate cytotoxic therapy-induced intestinal damage in order to reduce complications associated with myeloablative conditioning therapy.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0015156</identifier><identifier>PMID: 21188146</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Adult respiratory distress syndrome ; Aged ; Analysis ; Bacteremia ; Bacteremia - complications ; Biology ; Bone marrow ; C-reactive protein ; C-Reactive Protein - biosynthesis ; Cancer therapies ; Chemotherapy ; Citrulline ; Complications ; Conditioning ; Correlation ; Correlation analysis ; Cytotoxicity ; Damage ; Disease ; Epidemiology ; Female ; Fever ; Graft-versus-host reaction ; Hematology ; Humans ; Impact analysis ; Infections ; Inflammation ; Inflammatory response ; Intestine ; Intestines - abnormalities ; Intestines - metabolism ; Kinetics ; Lung Diseases - immunology ; Male ; Medicine ; Middle Aged ; Mortality ; Mucosa ; Mucous Membrane - pathology ; Neutropenia ; Neutrophils - cytology ; Prospective Studies ; Reaction kinetics ; Retrospective Studies ; Stem cell transplantation ; Stem Cell Transplantation - methods ; Stem cells ; Studies ; Therapy ; Transplantation ; Transplantation Conditioning - methods ; Transplants & implants</subject><ispartof>PloS one, 2010-12, Vol.5 (12), p.e15156-e15156</ispartof><rights>COPYRIGHT 2010 Public Library of Science</rights><rights>2010. This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c757t-40a4e39628b396115ce3621b116812af65fe34acdc25dc62c4ec8dbd01dda1e43</citedby><cites>FETCH-LOGICAL-c757t-40a4e39628b396115ce3621b116812af65fe34acdc25dc62c4ec8dbd01dda1e43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004799/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004799/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21188146$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Bereswill, Stefan</contributor><creatorcontrib>van der Velden, Walter J F M</creatorcontrib><creatorcontrib>Herbers, Alexandra H E</creatorcontrib><creatorcontrib>Feuth, Ton</creatorcontrib><creatorcontrib>Schaap, Nicolaas P M</creatorcontrib><creatorcontrib>Donnelly, J Peter</creatorcontrib><creatorcontrib>Blijlevens, Nicole M A</creatorcontrib><title>Intestinal damage determines the inflammatory response and early complications in patients receiving conditioning for a stem cell transplantation</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Stem cell transplantation (SCT) is still complicated by the occurrence of fever and inflammatory complications attributed to neutropenia and subsequent infectious complications. The role of mucosal barrier injury (MBI) of the intestinal tract therein has received little attention.
We performed a retrospective analysis in 163 SCT recipients of which data had been collected prospectively on intestinal damage (citrulline), inflammation (C-reactive protein), and neutrophil count. Six different conditioning regimens were studied; 5 myeloablative (MA) and 1 non-myeloablative (NMA). Linear mixed model multivariate and AUC analyses were used to define the role of intestinal damage in post-SCT inflammation. We also studied the relationship between the degree of intestinal damage and the occurrence of early post-SCT complications.
In the 5 MA regimen there was a striking pattern of inflammatory response that coincided with the occurrence of severe intestinal damage. This contrasted with a modest inflammatory response seen in the NMA regimen in which intestinal damage was limited. With linear mixed model analysis the degree of intestinal damage was shown the most important determinant of the inflammatory response, and both neutropenia and bacteremia had only a minor impact. AUC analysis revealed a strong correlation between citrulline and CRP (Pearson correlation r = 0.96). Intestinal damage was associated with the occurrence of bacteremia and acute lung injury, and influenced the kinetics of acute graft-versus-host disease.
The degree of intestinal damage after myeloablative conditioning appeared to be the most important determined the inflammatory response following SCT, and was associated with inflammatory complications. Studies should explore ways to ameliorate cytotoxic therapy-induced intestinal damage in order to reduce complications associated with myeloablative conditioning therapy.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adult respiratory distress syndrome</subject><subject>Aged</subject><subject>Analysis</subject><subject>Bacteremia</subject><subject>Bacteremia - complications</subject><subject>Biology</subject><subject>Bone marrow</subject><subject>C-reactive protein</subject><subject>C-Reactive Protein - biosynthesis</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Citrulline</subject><subject>Complications</subject><subject>Conditioning</subject><subject>Correlation</subject><subject>Correlation analysis</subject><subject>Cytotoxicity</subject><subject>Damage</subject><subject>Disease</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Fever</subject><subject>Graft-versus-host reaction</subject><subject>Hematology</subject><subject>Humans</subject><subject>Impact analysis</subject><subject>Infections</subject><subject>Inflammation</subject><subject>Inflammatory response</subject><subject>Intestine</subject><subject>Intestines - 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complications</topic><topic>Biology</topic><topic>Bone marrow</topic><topic>C-reactive protein</topic><topic>C-Reactive Protein - biosynthesis</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Citrulline</topic><topic>Complications</topic><topic>Conditioning</topic><topic>Correlation</topic><topic>Correlation analysis</topic><topic>Cytotoxicity</topic><topic>Damage</topic><topic>Disease</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Fever</topic><topic>Graft-versus-host reaction</topic><topic>Hematology</topic><topic>Humans</topic><topic>Impact analysis</topic><topic>Infections</topic><topic>Inflammation</topic><topic>Inflammatory response</topic><topic>Intestine</topic><topic>Intestines - abnormalities</topic><topic>Intestines - metabolism</topic><topic>Kinetics</topic><topic>Lung Diseases - immunology</topic><topic>Male</topic><topic>Medicine</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Mucosa</topic><topic>Mucous Membrane - pathology</topic><topic>Neutropenia</topic><topic>Neutrophils - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van der Velden, Walter J F M</au><au>Herbers, Alexandra H E</au><au>Feuth, Ton</au><au>Schaap, Nicolaas P M</au><au>Donnelly, J Peter</au><au>Blijlevens, Nicole M A</au><au>Bereswill, Stefan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intestinal damage determines the inflammatory response and early complications in patients receiving conditioning for a stem cell transplantation</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2010-12-20</date><risdate>2010</risdate><volume>5</volume><issue>12</issue><spage>e15156</spage><epage>e15156</epage><pages>e15156-e15156</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Stem cell transplantation (SCT) is still complicated by the occurrence of fever and inflammatory complications attributed to neutropenia and subsequent infectious complications. The role of mucosal barrier injury (MBI) of the intestinal tract therein has received little attention.
We performed a retrospective analysis in 163 SCT recipients of which data had been collected prospectively on intestinal damage (citrulline), inflammation (C-reactive protein), and neutrophil count. Six different conditioning regimens were studied; 5 myeloablative (MA) and 1 non-myeloablative (NMA). Linear mixed model multivariate and AUC analyses were used to define the role of intestinal damage in post-SCT inflammation. We also studied the relationship between the degree of intestinal damage and the occurrence of early post-SCT complications.
In the 5 MA regimen there was a striking pattern of inflammatory response that coincided with the occurrence of severe intestinal damage. This contrasted with a modest inflammatory response seen in the NMA regimen in which intestinal damage was limited. With linear mixed model analysis the degree of intestinal damage was shown the most important determinant of the inflammatory response, and both neutropenia and bacteremia had only a minor impact. AUC analysis revealed a strong correlation between citrulline and CRP (Pearson correlation r = 0.96). Intestinal damage was associated with the occurrence of bacteremia and acute lung injury, and influenced the kinetics of acute graft-versus-host disease.
The degree of intestinal damage after myeloablative conditioning appeared to be the most important determined the inflammatory response following SCT, and was associated with inflammatory complications. Studies should explore ways to ameliorate cytotoxic therapy-induced intestinal damage in order to reduce complications associated with myeloablative conditioning therapy.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>21188146</pmid><doi>10.1371/journal.pone.0015156</doi><tpages>e15156</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2010-12, Vol.5 (12), p.e15156-e15156 |
| issn | 1932-6203 1932-6203 |
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| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Adult Adult respiratory distress syndrome Aged Analysis Bacteremia Bacteremia - complications Biology Bone marrow C-reactive protein C-Reactive Protein - biosynthesis Cancer therapies Chemotherapy Citrulline Complications Conditioning Correlation Correlation analysis Cytotoxicity Damage Disease Epidemiology Female Fever Graft-versus-host reaction Hematology Humans Impact analysis Infections Inflammation Inflammatory response Intestine Intestines - abnormalities Intestines - metabolism Kinetics Lung Diseases - immunology Male Medicine Middle Aged Mortality Mucosa Mucous Membrane - pathology Neutropenia Neutrophils - cytology Prospective Studies Reaction kinetics Retrospective Studies Stem cell transplantation Stem Cell Transplantation - methods Stem cells Studies Therapy Transplantation Transplantation Conditioning - methods Transplants & implants |
| title | Intestinal damage determines the inflammatory response and early complications in patients receiving conditioning for a stem cell transplantation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T01%3A42%3A12IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Intestinal%20damage%20determines%20the%20inflammatory%20response%20and%20early%20complications%20in%20patients%20receiving%20conditioning%20for%20a%20stem%20cell%20transplantation&rft.jtitle=PloS%20one&rft.au=van%20der%20Velden,%20Walter%20J%20F%20M&rft.date=2010-12-20&rft.volume=5&rft.issue=12&rft.spage=e15156&rft.epage=e15156&rft.pages=e15156-e15156&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0015156&rft_dat=%3Cgale_plos_%3EA473814343%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1296203847&rft_id=info:pmid/21188146&rft_galeid=A473814343&rft_doaj_id=oai_doaj_org_article_ecbcecf37ab643cd9dcce7f438cb04ea&rfr_iscdi=true |