tbuckley/cabot-search huggingface dataset:
Provide evidence of claims or leave register, Charity Commission tells complementary and alternative medicine organisations
Authors: Zosia Kmietowicz
Journal: BMJ (2018)

Organisations that provide complementary and alternative medicine (CAM) and claim to cure or treat a condition will need to provide their evidence of their claims gain charitable status.

The Charity Commission said in a report that it has revised its guidance to make it clearer who qualifies for charitable status.1

It undertook a two year review …
Abstract 20260: Impact of Glycemic Control on Residual Cardiovascular Risk in Diabetic Patients Treated With Statin Therapy
Authors: Venu Menon, Stephen J Nicholls, A M Lincoff, Paul Cremer, Jeffrey S Riesmeyer, Govinda Weerakkody, Giacomo Ruotolo, Kathy Wolski, Julie S John, Ellen McErlean, Steven E Nissen
Journal: Circulation (2017)

Background: Cardiovascular event rates in patients with diabetes mellitus (DM) are significantly greater than that observed in those without DM. We evaluated the impact of glycemic control on the c...
Abstract 15555: Administration of c-Kit+ Cardiac Stem Cells (CSCs) Results in Increased Proliferation and Cardiac Content of CSCs 1 Year Later
Authors: Qianhong Li, Ning Chen, Li Luo, Qinghui Ou, Wei Xie, Gregory N Hunt, Xian-Liang Tang, Gregg D Rokosh, Roberto Bolli
Journal: Circulation (2014)

Background: We have previously shown in rats that the beneficial effects of c-kit + CSCs on LV function and remodeling post-myocardial infarction persist for at least 1 year after CSC administration. However, in that study the retention of transplanted Y-chromosome + cells in the risk region (RR) of female rat hearts at 1 year was low (&lt;10% of total nuclei) and not sufficient to account for the functional improvement, suggesting that other mechanisms must be at work. Methods and Results: To address this issue, rats received intracoronary vehicle or 1x10 6 syngeneic CSCs 4 h after a 90-min coronary occlusion; 11 months later, BrdU treatment was given for 1 month. CSCs, which are c-kit + /CD45 − , were distinguished from c-kit + hematopoietic stem cells/mast cells, which are CD45 + . At 1 year after CSC administration, the total number of c-kit + or c-kit + /BrdU + cells in the heart (the sum of c-kit + /CD45 − and c-kit + /CD45 + cells) did not differ between CSC and control groups (Figs. H and I). However, CSC transplantation resulted in increased numbers of CSCs (c-kit + /CD45 − cells) in the RR (i.e., the infarct zone plus border zone)(47.6±7.0% of total c-kit + cells vs. 27.9±4.1% in vehicle group; n=5, P &lt;0.05; Fig. J). Among CSCs (c-kit + /CD45 − cells), the fraction that was newly formed (c-kit + /CD45 − /BrdU + ) was dramatically increased in the RR of the CSC group (+ 2.6-fold vs. vehicle group; n=4, P &lt;0.05; Fig. M), indicating increased CSC proliferation and turnover. Conclusions: These data reveal, for the first time, that a single intracoronary infusion of CSCs is followed by an increase in both the proliferation and the total number of c-kit + CSCs in the myocardium that persists, surprisingly, for at least 1 year after cell delivery. Since transplanted cells do not differentiate into adult myocytes, these data suggest that the long-term salubrious effects of CSCs on cardiac function are mediated by sustained activation of the CSC pool in the heart.
Gaming, Upcoding, Fraud, and the Stubborn Persistence of Unstable Angina
Authors: Christian A. McNeely, David L. Brown
Journal: JAMA Internal Medicine (2018)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Endoscopic ultrasound-guided coil embolization and thrombin injection of a bleeding gastroduodenal artery pseudoaneurysm
Authors: Malay Sharma, Piyush Somani, Tagore Sunkara, Ritesh Prajapati, Rahul Talele
Journal: Endoscopy (2018)

A 50-year-old man had an episode of alcohol-induced acute pancreatitis 1 month before presenting with melena, which required six units of transfused blood for hemodynamic stabilization. After hemodynamic resuscitation, the patient underwent upper gastrointestinal endoscopy. Upper endoscopy showed a bulge with overlying ulceration in the second part of the duodenum. Side-viewing endoscopy showed a pulsatile bulge with a large overlying ulcer ([Fig. 1]). Abdominal ultrasound showed a pseudoaneurysm of size 3.8 × 5.6 cm arising from the gastroduodenal artery (GDA). Abdominal computed tomography with angiography showed a saccular pseudo-aneurysm of size 4 × 6 cm in relation to the GDA ([Fig. 2]). Endoscopic ultrasound (EUS) from the duodenal bulb showed a pseudoaneurysm of size 4.1 × 5.8 cm arising from the GDA ([Fig. 3 a]). Radiological or EUS-guided interventions were considered. The patient selected the option of EUS-guided coil embolization ([Video 1]).
Abstract 18646: Low Metabolic Demand of Induced Pacemaker Cells Enhances Their Survival and Automaticity
Authors: Jin-mo Gu, Elizabeth H Kim, Jun Li, Darren B Foster, Hee Cheol Cho
Journal: Circulation (2017)

The automaticity of cardiac pacemaker cells is central to sinus rhythm generation. As such, metabolism of the pacemaker cells may be optimized to support their survival. However, the scarcity of na...
Assessment of a Targeted Electronic Health Record Intervention to Reduce Telemetry Duration
Authors: Nader Najafi, Russ Cucina, Bruce Pierre, Raman Khanna
Journal: JAMA Internal Medicine (2018)

Physicians frequently use cardiac monitoring, or telemetry, beyond the duration recommended by published practice standards, resulting in "alarm fatigue" and excess cost. Prior studies have demonstrated an association between multicomponent quality improvement interventions and safe reduction of telemetry duration.To determine if a single-component intervention, a targeted electronic health record (EHR) alert, could achieve similar gains to multicomponent interventions and safely reduce unnecessary monitoring.This cluster-randomized clinical trial was conducted between November 2016 and May 2017 on the general medicine service of the Division of Hospital Medicine at the University of California, San Francisco Medical Center and included physicians of 12 inpatient medical teams (6 intervention, 6 control).The EHR alert was randomized to half of the teams on the general medicine service. The alert displayed during daytime hours when physicians attempted to place an order for patients not in the intensive care unit whose telemetry order duration exceeded the recommended duration for a given indication.The primary outcome was telemetry monitoring hours per hospitalization, which was measured using time-stamped orders data from the EHR database. Physician responses to the alert were collected using EHR reporting tools. The potential adverse outcomes of rapid-response calls and medical emergency events were measured by counting the notes documenting these events in the EHR.Of the 1021 patients included in this study, in the intervention arm, there was a mean (SD) age of 64.5 (18.9) and 215 (45%) were women; in the control arm, there was a mean (SD) age of 63.8 (19.1) and 249 (46%) were women. The 12 teams were stratified to 8 house-staff teams and 4 hospitalist teams, with 499 hospitalizations analyzed in the intervention arm and 567 hospitalizations analyzed in the control arm. The alert prompted a significant reduction in telemetry monitoring duration (-8.7 hours per hospitalization; 95% CI, -14.1 to -3.5 hours; P = .001) with no significant change in rapid-response calls or medical emergency events. The most common physician response to the alert was to discontinue telemetry monitoring (62% of 200 alerts).A targeted EHR alert can safely and successfully reduce cardiac monitoring by prompting discontinuation when appropriate. This single-component electronic intervention is less resource intensive than typical multicomponent interventions that include human resources.ClinicalTrials.gov identifier: NCT02529176.
Improving professionalism will increase job satisfaction, says RCP
Authors: Abi Rimmer
Journal: BMJ (2018)

Helping doctors bridge the gap between their training and the reality of modern practice by improving professionalism could increase job satisfaction, improve patient care, and raise productivity, the Royal College of Physicians has said.

The college’s Advancing Medical Professionalism report, says the case of Hadiza Bawa-Garba “sent shock waves through the medical profession and prompted many questions about professionalism.”1

The environment that …
Abstract P371: Race Disparities in the Contribution of Lipid Profiles to Ankle-Brachial Index: Lifecourse Evidence from the Bogalusa Heart Study
Authors: Camilo Fernandez, Liqiang Zheng, Yajun Guo, Rupert Barshop, Emily Harville, Wei Chen, Lydia Bazzano
Journal: Circulation (2017)

Background: Ankle-brachial index (ABI) is a practical non-invasive estimation of the burden of atherosclerosis on the vascular system. Although cholesterol is known to affect ABI as part of the disease process, information is limited on the contribution of longitudinal measures of cholesterol on the decline of ABI over time. Hypothesis: Race (black-white)—specific differences exist in cumulative burden effects of cholesterol, measured from childhood to adulthood, on ABI decline in young adults. Methods: We examined 497 adult participants of the Bogalusa Heart Study (72.8% white, 43.1% men, age 32-51 years), who had at least 3 measurements of cardiovascular (CV) risk factors since childhood (average follow-up 33.5 years). ABI was obtained in two separate instances: baseline (2001-2002) and follow-up (2007-2010), and its change was computed as the mean difference, divided by the time (years), between the two instances. The long-term cumulative burden of each risk factor was calculated as the total area under the curve (AUCt). Measurements of cholesterol and other CV risk factors in childhood, adulthood and AUCt were standardized to z-scores prior to regression analyses. Results: ABI significantly decreased (1.09±0.09 vs 1.03±0.09, p&lt;0.01) after a mean follow-up of 6.8 years. There were no significant differences in annual ABI decline between male and female (p=0.56) / black and white (p=0.18) participants. In multivariable linear regression analyses, after adjustment for sex, lipid-lowering medications, smoking status, body mass index, systolic blood pressure and baseline ABI, significant predictors of annual ABI decline in white participants were: childhood total cholesterol (TC) (β= -0.11, p&lt;0.01), low-density lipoprotein cholesterol (LDL-C; β= -0.10; p&lt;0.01), and non-high-density lipoprotein cholesterol (non-HDL-C; β= -0.10, p&lt;0.01), as well as the AUCt of TC (β= -0.09; p=0.02) and non-HDL-C (β= -0.08, p=0.04). The AUCt of HDL-C was the only significant predictor in black participants (β= 0.16, p=0.04). Conclusions: These findings suggest that the impact of cholesterol levels on future adult ABI decline starts in childhood, and follows a cumulative detrimental pattern throughout the lifespan in a race-dependent fashion. Further, this information may aid in the development of strategies to improve prevention, diagnosis and treatment of vascular disease by race group
A network meta-analysis of the frontline immune-checkpoint inhibitor-based regimens in advanced non-small cell lung cancer
Authors: J.G. Kattan, E.E. Rassy, Z. Bakouny, T. Assi, N. Pavlidis
Journal: Annals of Oncology (2018)

Background: For frontline NSCLC patients, multiple immune checkpoint inhibitor (ICI) based regimens have shown promising effects on survival outcomes. However, there are currently no studies with direct comparison between the various regimens. The aim of this study was to establish the most effective treatment using a network meta-analysis (NMA) based on all the available randomized controlled trials. Methods: We conducted an independent review for the RCTs evaluating ICIs in frontline advanced NSCLC. A meta-analysis was performed on the primary outcome of OS using the inverse variance heterogeneity method. The Cochrane Q test for heterogeneity was computed and the I2 coefficient was used to quantify the extent of between-study heterogeneity. A threshold for statistical significance of 0.10 was used for the Cochrane Q test and heterogeneity was considered to be substantial if I2> 60%. Since the heterogeneity was found to be both statistically significant and substantial for the primary outcome, it was judged that a pooled analysis would not be representative of the true treatment effect hence a NMA was computed instead. The NMA was computed by utilizing a frequentist approach with generalized pairwise modeling. Results: Network estimates of effects on OS showed the superiority of pembro+platinum doublet compared to all the other regimens: pembro (HR = 1.39, 95%CI 1.02-1.89); atezo+platinum doublet (HR = 1.72, 95%CI 1.31-2.26); ipi+platinum doublet (HR = 1.62, 95%CI 1.28-2.04), nivo (HR = 1.82, 95%CI 1.35-2.47) and platinum doublet (HR = 1.79, 95%CI 1.49-2.14). The superiority of pembro+platinum doublet was also consistent on PFS except when compared to pembro (HR = 1.78, 95%CI 0.72-4.42) and ORR except when compared to ipi+platinum doublet (HR = 0.33, 95%CI 0.07-1.44), where the comparisons did not reach the threshold of statistical significance. Conclusions: Our results support the superiority of pembrolizumab + platinum doublet in the frontline treatment of NSCLC. However, the main limitation of this study is that, due to the limited available data, differences in patient and tumor (pathology and PDL-1 status) characteristics could not be accounted for. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
OP0120 Influence of epidemiology and ethnicity on systemic expression of primary sjÖgren syndrome in 9974 patients
Authors: S Retamozo, N. Acar-Denizli, W. Fai Ng, M. Zeher, A. Rasmussen, R. Seror, X. Li, C. Baldini, J.-E. Gottenberg, D. Danda, L. Quartuccio, R. Priori, G. Hernandez-Molina, B. Armagan, A.A. Kruize, S.-K. Kwok, M. Wahren-Herlenius, S. Praprotnik, D. Sene, E. Bartoloni, R. Solans, M. Rischmueller, T. Mandl, Y. Suzuki, D. Isenberg, V. Valim, P. Wiland, G. Nordmark, G. Fraile, H. Bootsma, T. Nakamura, R. Giacomelli, V. Devauchelle-Pensec, B. Hofauer, M. Bombardieri, V. Fernandes Moça Trevisani, D. Hammenfors, S.G. Pasoto, T.A. Gheita, F. Atzeni, J. Morel, C. Vollenveider, P. Brito-Zerón, M. Ramos-Casals
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Objectives</h3> To analyse the influence of epidemiology and ethnicity on the clinical systemic presentation at diagnosis of primary Sjögren syndrome (SjS). <h3>Methods</h3> The Big Data Sjögren Database included 10 475 worldwide patients from 22 countries fulfilling the 2002 criteria. Age at diagnosis, gender and ethnicity (77% White, 14% Asian, 6% Hispanic, 1% Black/African American, 2% others) were correlated with systemic involvement at diagnosis (retrospectively scored in 9974 patients using ESSDAI/clinESSDAI) <h3>Results</h3> Men had higher mean ESSDAI (8.0 vs 5.9, p&lt;0.001) and clinESSDAI (8.4 vs 6.1, p&lt;0.001) in comparison with women; the domains more active in men included lymphadenopathy (p&lt;0.001), glandular (p&lt;0.001), pulmonary (p=0.001), PNS (p&lt;0.001) and CNS (p&lt;0.001). Highest scores were also reported in patients with young-onset disease (&lt;35 years) with respect to older onset (&gt;65 years) for ESSDAI (6.5 vs 5.6, p=0.002) and clinESSDAI (6.4 vs 5.8, p=0.034). Highest ESSDAI scores were reported in Black/African American, followed by White, Asian and Hispanic patients (6.7 vs 6.3 vs 5.4 vs 4.9, respectively, p&lt;0.001). BAA patients showed the highest frequency of activity in lymphadenopathy, articular, PNS, CNS and biological domains, Whites in glandular, cutaneous and muscular, Asians in pulmonary, renal and haematological and Hispanics in the constitutional domain. <h3>Conclusions</h3> This study provides the first evidence for a strong influence of epidemiology and ethnicity on the systemic phenotype at diagnosis of primary SjS <h3>Disclosure of Interest</h3> None declared
Early extubation followed by immediate noninvasive ventilation vs. standard extubation in hypoxemic patients: a randomized clinical trial
Authors: Rosanna Vaschetto, Federico Longhini, Paolo Persona, Carlo Ori, Giulia Stefani, Songqiao Liu, Yang Yi, Weihua Lu, Tao Yu, Xiaoming Luo, Rui Tang, Maoqin Li, Jiaqiong Li, Gianmaria Cammarota, Andrea Bruni, Eugenio Garofalo, Zhaochen Jin, Jun Yan, Ruiqiang Zheng, Jingjing Yin, Stefania Guido, Francesco Della Corte, Tiziano Fontana, Cesare Gregoretti, Andrea Cortegiani, Antonino Giarratano, Claudia Montagnini, Silvio Cavuto, Haibo Qiu, Paolo Navalesi
Journal: Intensive Care Medicine (2018)
Adoptive T-Cell Therapy for Acute Lymphoblastic Leukemia Targeting Multiple Tumor Associated Antigens
Authors: Swati Naik, Premal Lulla, Ifigeneia Tzannou, Robert A. Krance, George Carrum, Rammurti Kamble, Carlos A. Ramos, Catherine Robertson, Manik Kuvalekar, Ayumi Watanabe, Bambi J. Grilley, Juan F. Vera, Helen E. Heslop, Ann M. Leen
Journal: Blood (2018)
Minimal residual disease quantification by flow cytometry provides reliable risk stratification in T-cell acute lymphoblastic leukemia
Authors: S. Modvig, H. O. Madsen, S. M. Siitonen, S. Rosthøj, A. Tierens, V. Juvonen, L.T.N. Osnes, H. Vålerhaugen, M. Hultdin, I. Thörn, R. Matuzeviciene, M. Stoskus, M. Marincevic, L. Fogelstrand, A. Lilleorg, N. Toft, O. G. Jónsson, K. Pruunsild, G. Vaitkeviciene, K. Vettenranta, B. Lund, J. Abrahamsson, K. Schmiegelow, H. V. Marquart
Journal: Leukemia (2018)
Targeting PKCδ as a Therapeutic Strategy against Heterogeneous Mechanisms of EGFR Inhibitor Resistance in EGFR-Mutant Lung Cancer
Authors: Pei-Chih Lee, Yueh-Fu Fang, Hirohito Yamaguchi, Wei-Jan Wang, Tse-Ching Chen, Xuan Hong, Baozhen Ke, Weiya Xia, Yongkun Wei, Zhengyu Zha, Yan Wang, Han-Pin Kuo, Chih-Wei Wang, Chih-Yen Tu, Chia-Hung Chen, Wei-Chien Huang, Shu-Fen Chiang, Lei Nie, Junwei Hou, Chun-Te Chen, Longfei Huo, Wen-Hao Yang, Rong Deng, Katsuya Nakai, Yi-Hsin Hsu, Shih-Shin Chang, Tai-Jan Chiu, Jun Tang, Ran Zhang, Li Wang, Bingliang Fang, Ting Chen, Kwok-Kin Wong, Jennifer L. Hsu, Mien-Chie Hung
Journal: Cancer Cell (2018)
Subchondral bone osteoclasts induce sensory innervation and osteoarthritis pain
Authors: Shouan Zhu, Jianxi Zhu, Gehua Zhen, Yihe Hu, Senbo An, Yusheng Li, Qin Zheng, Zhiyong Chen, Ya Yang, Mei Wan, Richard Leroy Skolasky, Yong Cao, Tianding Wu, Bo Gao, Mi Yang, Manman Gao, Julia Kuliwaba, Shuangfei Ni, Lei Wang, Chuanlong Wu, David Findlay, Holger K. Eltzschig, Hong Wei Ouyang, Janet Crane, Feng-Quan Zhou, Yun Guan, Xinzhong Dong, Xu Cao
Journal: Journal of Clinical Investigation (2018)

Joint pain is the defining symptom of osteoarthritis (OA) but its origin and mechanisms remain unclear. Here, we investigated an unprecedented role of osteoclast-initiated subchondral bone remodeling in sensory innervation for OA pain. We show that osteoclasts secrete netrin-1 to induce sensory nerve axonal growth in subchondral bone. Reduction of osteoclast formation by knockout of receptor activator of nuclear factor kappa-B ligand (Rankl) in osteocytes inhibited the growth of sensory nerves into subchondral bone, dorsal root ganglion neuron hyperexcitability, and behavioral measures of pain hypersensitivity in OA mice. Moreover, we demonstrated a possible role for netrin-1 secreted by osteoclasts during aberrant subchondral bone remodeling in inducing sensory innervation and OA pain through its receptor DCC (deleted in colorectal cancer). Importantly, knockout of Netrin1 in tartrate-resistant acid phosphatase–positive (TRAP-positive) osteoclasts or knockdown of Dcc reduces OA pain behavior. In particular, inhibition of osteoclast activity by alendronate modifies aberrant subchondral bone remodeling and reduces innervation and pain behavior at the early stage of OA. These results suggest that intervention of the axonal guidance molecules (e.g., netrin-1) derived from aberrant subchondral bone remodeling may have therapeutic potential for OA pain.
P051 A Novel Model for Estimating Survival in Lung Cancer Patients with Leptomeningeal Metastasis
Authors: K. Yin, Y. Li, M. Zheng, B. Jiang, W. Li, J. Yang, H. Tu, Q. Zhou, W. Zhong, X. Yang, H. Yan, L. Li, Y. Wu, X. Zhang
Journal: Journal of Thoracic Oncology (2018)
A potent immunomodulatory role of exosomes derived from mesenchymal stromal cells in preventing cGVHD
Authors: Peilong Lai, Xiaomei Chen, Liyan Guo, Yulian Wang, Xialin Liu, Yan Liu, Tian Zhou, Tian Huang, Suxia Geng, Chengwei Luo, Xin Huang, Suijing Wu, Wei Ling, Xin Du, Chang He, Jianyu Weng
Journal: Journal of Hematology & Oncology (2018)

Mesenchymal stromal cells (MSCs) are a promising therapy for preventing chronic Graft-Versus-Host Disease (cGVHD) due to their potent immunomodulatory properties. However, the safety concerns regarding the use of MSCs remain unsolved, and conflicting effects are observed due to the heterogeneity of MSCs. Recently, exosomes were shown to mediate the paracrine effects of MSCs, making it a potential candidate for cell-free therapies. The aim of this study is to investigate the efficacy and safety of MSCs-derived exosomes (MSCs-exo) in an established cGVHD mouse model. Bone marrow (BM)-derived MSCs were cultured, and the supernatants of these cultures were collected to prepare exosomes using ultracentrifugation. Exosomes from human dermal fibroblasts (Fib-exo) were used as a negative control. The cGVHD model was established, and tail vein injections of MSCs-exo or Fib-exo were administered once per week for 6 weeks. The symptoms and signs of cGVHD were monitored, and histopathological changes were detected by hematoxylin and eosin and Masson staining. The effects of MSCs-exo on Th17, Th1, and Treg were evaluated by flow cytometry, qPCR, and Luminex. In addition, human peripheral blood mononuclear cells (PBMCs) were stimulated and treated with MSCs-exo in vitro. IL-17-expressing Th17 and IL-10-expressing Treg were evaluated by flow cytometry, qPCR, and ELISA. We found that MSCs-exo effectively prolonged the survival of cGVHD mice and diminished the clinical and pathological scores of cGVHD. Fibrosis in the skin, lung, and liver was significantly ameliorated by MSCs-exo application. In MSCs-exo treated mice, activation of CD4+ T cells and their infiltration into the lung were reduced. Of note, MSCs-exo exhibited potent immunomodulatory effects via the inhibition of IL-17-expressing pathogenic T cells and induction of IL-10-expressing regulatory cells during cGVHD. The expressions of Th17 cell-relevant transcription factors and pro-inflammatory cytokines was markedly reduced after MSCs-exo treatment. In vitro, MSCs-exo blocked Th17 differentiation and improved the Treg phenotype in PBMCs obtained from healthy donors and patients with active cGVHD, further indicating the regulatory effect of MSCs-exo on GVHD effector T cells. Our data suggested that MSCs-exo could improve the survival and ameliorate the pathologic damage of cGVHD by suppressing Th17 cells and inducing Treg. This finding provides a novel alternative approach for the treatment of cGVHD.