Improving Inflammation Resolution to Mitigate Acquired Bone Marrow Failure

改善炎症消退减轻获得性骨髓衰竭 骨髓衰竭是血液生产的毁灭性崩溃，目前的治疗方法是 不够充分。一线治疗包括免疫抑制治疗，如果可行，还包括骨髓治疗。 移植。这些疗法在短期内往往是有效的，特别是对年轻患者， 然而，它们在老年患者中的效果要差得多。免疫抑制不是很好的耐受性， 尤其是在老年人中，并增加了感染的易感性。因此，替代方案 治疗是必要的。众所周知，骨髓衰竭与不能解决有关。 发炎。炎症的消退需要在促炎和促炎之间取得平衡 白三烯或前列腺素和w3衍生的专门化促分解介质(SPM)，如 解决剂。使用获得性重型再生障碍性贫血(SAA)小鼠模型，该模型反映了 人类疾病，我们确立了受损的炎症消解计划在疾病中的作用 发病机制。我们的初步工作证明了SPM在改善SAA方面的有效性。这个 拟议工作的基本原理是，与其钝化炎症反应，不如促进 分解和修复过程可能是治疗骨髓衰竭的理想策略。这个 拟议的研究将解决我们对生理上相关的 骨髓中炎症消解的过程。我们提出了三个整合但独立的 目的是：(1)解决分辨率受损的机制，(2)确定SPM在 (3)评价三七总皂甙对造血干细胞功能的影响。 这项拟议的工作将支持一种不使用免疫抑制来治疗BMF的新方法， 这是对目前护理标准的重大背离。我们相信这些研究将是 为BMF患者，特别是IST失败的老年患者提供有效的治疗选择，以及 其中宿主的防御已经被削弱了。同时，拟议的研究可能会提供 与其他疾病相关的新的机械论见解，其特点是旷日持久且未解决 炎症，从而会对人类健康产生广泛的影响。

Improving Inflammation Resolution to Mitigate Acquired Bone Marrow Failure Bone marrow failure is the devastating collapse of blood production, and current treatments are inadequate. First line therapies include immunosuppressive therapies, and when feasible, bone marrow transplantation. These therapies are often efficacious in the short-term, especially for young patients, however they are much less effective in older patients. Immune suppression is not well tolerated, especially in the elderly, and carries increased susceptibility to infection. Therefore, alternative therapies are needed. It is well established that bone marrow failure is associated with non-resolving inflammation. The resolution of inflammation requires the balance between pro-inflammatory leukotrienes or prostaglandins and w3-derived specialized pro-resolving mediators (SPMs), like resolvins. Using a mouse model of acquired severe aplastic anemia (SAA) that mirrors key features of human disease, we established a role for impaired inflammation resolution programs in disease pathogenesis. Our preliminary work demonstrates the effectiveness of SPMs in ameliorating SAA. The rationale for the proposed work is that rather than blunting inflammatory responses, promoting resolution and reparative processes may be an ideal therapeutic strategy for bone marrow failure. The proposed studies will address a fundamental gap in our understanding of the physiologically relevant process of inflammation resolution in the bone marrow. We propose three integrated, but independent, Aims to: (1) address mechanisms of impaired resolution, (2) determine the impact of SPMs in the marrow in SAA, and (3) evaluate the effect of SPMs on function of hematopoietic stem cells. The proposed work will support a novel approach to treat BMF without the use of immune suppression, representing an important departure from the current standard of care. We believe these studies will be impactful therapeutic options for BMF patients, particularly older patients where IST has failed, and wherein host defenses are already weakened. At the same time, the proposed studies may provide new mechanistic insight relevant to other diseases characterized by prolonged and non-resolved inflammation, and thus will have broad impact to human health.