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Resistant and refractory cytomegalovirus (CMV) viremia can limit the provision of chemotherapy due to myelosuppression and end-organ dysfunction. Few therapies are available for children with clinically significant CMV viremia. We successfully used maribavir for a 4-year-old patient with lymphoma to complete his chemotherapy course. Resistance to maribavir did result after many months of therapy.
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Infecções por Citomegalovirus , Diclororribofuranosilbenzimidazol , Neoplasias , Ribonucleosídeos , Pré-Escolar , Humanos , Antivirais/uso terapêutico , Benzimidazóis/uso terapêutico , Infecções por Citomegalovirus/tratamento farmacológico , Diclororribofuranosilbenzimidazol/análogos & derivados , Neoplasias/tratamento farmacológico , Ribonucleosídeos/uso terapêutico , Viremia/tratamento farmacológicoRESUMO
PURPOSE: Medulloepithelioma is a rare, malignant tumor that typically arises in the periventricular region of the cerebral hemispheres or the ciliary body of the eye. Even rarer still is the extracranial manifestation of medulloepithelioma with only 12 cases reported to date. Our purpose is to report a case of an intradural, extra-medullary medulloepithelioma and review the limited literature about diagnosis and treatment of this extremely rare pathology. METHODS: PubMed was queried using search terms "peripheral medulloepithelioma" and "pre-sacral medulloepithelioma." Medulloepitheliomas which were intraocular or occurred in reproductive organs were excluded. Patients' age, sex, the symptomatic period prior to diagnosis, primary tumor site, stage, treatment regimen, pathologic description, and survival outcomes were collected. RESULTS: We present a case of extracranial medulloepithelioma in an 8-year-old male. Morphology of the neoplasm was representative of medulloepithelioma but there was no amplification of C19MC. Additionally, the neoplasm stained positive for CD99. Twelve other cases of extracranial medulloepithelioma were found in literature review. CONCLUSIONS: The rarity of extracranial medulloepithelioma makes for a challenging diagnosis. Designing an optimal treatment strategy is difficult because of a scarcity of cases and wide variety in locations and treatments. Our case provides an example of treatment including resection, intense induction chemotherapy, consolidation with high-dose chemotherapy and stem cell rescue, craniospinal proton radiation therapy, and metronomic chemotherapy.
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Tumores Neuroectodérmicos Primitivos , Terapia com Prótons , Criança , Humanos , Masculino , Tumores Neuroectodérmicos Primitivos/diagnóstico por imagem , Tumores Neuroectodérmicos Primitivos/terapiaRESUMO
Pleomorphic xanthoastrocytoma is a malignant brain tumor that has a good prognosis with complete resection but does not respond well to chemotherapy if there is residual tumor. BRAF V600E mutations are common in pleomorphic xanthoastrocytomas and provide an additional means for treatment when excision is not possible. Monotherapy with the BRAF V600E inhibitor vemurafenib has only been reported in a small number of cases and mostly in adults. We present the case of a 16-year-old male who responded to vemurafenib monotherapy initially and had an additional response to vemurafenib following progression after a brief time off the medication.
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Antineoplásicos/uso terapêutico , Astrocitoma/tratamento farmacológico , Neoplasias Encefálicas/tratamento farmacológico , Vemurafenib/uso terapêutico , Adolescente , Astrocitoma/patologia , Neoplasias Encefálicas/secundário , Humanos , Masculino , PrognósticoRESUMO
Cardiac pacemaking is governed by specialized cardiomyocytes located in the sinoatrial node (SAN). SAN cells (SANCs) integrate voltage-gated currents from channels on the membrane surface (membrane clock) with rhythmic Ca(2+) release from internal Ca(2+) stores (Ca(2+) clock) to adjust heart rate to meet hemodynamic demand. Here, we report that stromal interaction molecule 1 (STIM1) and Orai1 channels, key components of store-operated Ca(2+) entry, are selectively expressed in SANCs. Cardiac-specific deletion of STIM1 in mice resulted in depletion of sarcoplasmic reticulum (SR) Ca(2+) stores of SANCs and led to SAN dysfunction, as was evident by a reduction in heart rate, sinus arrest, and an exaggerated autonomic response to cholinergic signaling. Moreover, STIM1 influenced SAN function by regulating ionic fluxes in SANCs, including activation of a store-operated Ca(2+) current, a reduction in L-type Ca(2+) current, and enhancing the activities of Na(+)/Ca(2+) exchanger. In conclusion, these studies reveal that STIM1 is a multifunctional regulator of Ca(2+) dynamics in SANCs that links SR Ca(2+) store content with electrical events occurring in the plasma membrane, thereby contributing to automaticity of the SAN.
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Canais de Cálcio/metabolismo , Sinalização do Cálcio/fisiologia , Cálcio/metabolismo , Miócitos Cardíacos/metabolismo , Retículo Sarcoplasmático/metabolismo , Nó Sinoatrial/metabolismo , Animais , Canais de Cálcio/genética , Canais de Cálcio Tipo L/genética , Canais de Cálcio Tipo L/metabolismo , Camundongos , Camundongos Knockout , Miócitos Cardíacos/citologia , Proteína ORAI1 , Retículo Sarcoplasmático/genética , Nó Sinoatrial/citologia , Molécula 1 de Interação EstromalRESUMO
RATIONALE: A major goal for the treatment of heart tissue damaged by cardiac injury is to develop strategies for restoring healthy heart muscle through the regeneration and repair of damaged myocardium. We recently demonstrated that administration of a specific combination of microRNAs (miR combo) into the infarcted myocardium leads to direct in vivo reprogramming of noncardiac myocytes to cardiac myocytes. However, the biological and functional consequences of such reprogramming are not yet known. OBJECTIVE: The aim of this study was to determine whether noncardiac myocytes directly reprogrammed using miRNAs in vivo develop into mature functional cardiac myocytes in situ, and whether reprogramming leads to improvement of cardiac function. METHODS AND RESULTS: We subjected fibroblast-specific protein 1-Cre mice/tandem dimer Tomato (tdTomato) mice to cardiac injury by permanent ligation of the left anterior descending coronary artery and injected lentiviruses encoding miR combo or a control nontargeting miRNA. miR combo significantly increased the number of reprogramming events in vivo. Five to 6 weeks after injury, morphological and physiological properties of tdTomato(-) and tdTomato(+) cardiac myocyte-like cells were analyzed ex vivo. tdTomato(+) cells expressed cardiac myocyte markers, sarcomeric organization, excitation-contraction coupling, and action potentials characteristic of mature ventricular cardiac myocytes (tdTomato(-) cells). Reprogramming was associated with improvement of cardiac function, as analyzed by serial echocardiography. There was a time delayed and progressive improvement in fractional shortening and other measures of ventricular function, indicating that miR combo promotes functional recovery of damaged myocardium. CONCLUSIONS: The findings from this study further validate the potential use of miRNA-mediated reprogramming as a therapeutic approach to promote cardiac regeneration after myocardial injury.
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Reprogramação Celular , MicroRNAs/metabolismo , Infarto do Miocárdio/metabolismo , Miócitos Cardíacos/citologia , Animais , Fibroblastos/citologia , Fibroblastos/metabolismo , Regeneração Tecidual Guiada , Masculino , Camundongos , MicroRNAs/genética , Infarto do Miocárdio/terapia , Miócitos Cardíacos/metabolismo , Proteína A4 de Ligação a Cálcio da Família S100 , Proteínas S100/genética , Proteínas S100/metabolismoRESUMO
RATIONALE: Repopulation of the injured heart with new, functional cardiomyocytes remains a daunting challenge for cardiac regenerative medicine. An ideal therapeutic approach would involve an effective method at achieving direct conversion of injured areas to functional tissue in situ. OBJECTIVE: The aim of this study was to develop a strategy that identified and evaluated the potential of specific micro (mi)RNAs capable of inducing reprogramming of cardiac fibroblasts directly to cardiomyocytes in vitro and in vivo. METHODS AND RESULTS: Using a combinatorial strategy, we identified a combination of miRNAs 1, 133, 208, and 499 capable of inducing direct cellular reprogramming of fibroblasts to cardiomyocyte-like cells in vitro. Detailed studies of the reprogrammed cells demonstrated that a single transient transfection of the miRNAs can direct a switch in cell fate as documented by expression of mature cardiomyocyte markers, sarcomeric organization, and exhibition of spontaneous calcium flux characteristic of a cardiomyocyte-like phenotype. Interestingly, we also found that miRNA-mediated reprogramming was enhanced 10-fold on JAK inhibitor I treatment. Importantly, administration of miRNAs into ischemic mouse myocardium resulted in evidence of direct conversion of cardiac fibroblasts to cardiomyocytes in situ. Genetic tracing analysis using Fsp1Cre-traced fibroblasts from both cardiac and noncardiac cell sources strongly suggests that induced cells are most likely of fibroblastic origin. CONCLUSIONS: The findings from this study provide proof-of-concept that miRNAs have the capability of directly converting fibroblasts to a cardiomyocyte-like phenotype in vitro. Also of significance is that this is the first report of direct cardiac reprogramming in vivo. Our approach may have broad and important implications for therapeutic tissue regeneration in general.
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Transdiferenciação Celular , Fibroblastos/metabolismo , MicroRNAs/metabolismo , Miócitos Cardíacos/metabolismo , Animais , Transdiferenciação Celular/efeitos dos fármacos , Transdiferenciação Celular/genética , Células Cultivadas , Modelos Animais de Doenças , Fibroblastos/efeitos dos fármacos , Fibroblastos/patologia , Regulação da Expressão Gênica , Terapia Genética/métodos , Janus Quinase 1/antagonistas & inibidores , Janus Quinase 1/metabolismo , Proteínas Luminescentes/genética , Proteínas Luminescentes/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , MicroRNAs/administração & dosagem , Contração Miocárdica , Isquemia Miocárdica/genética , Isquemia Miocárdica/metabolismo , Isquemia Miocárdica/patologia , Isquemia Miocárdica/fisiopatologia , Isquemia Miocárdica/terapia , Miócitos Cardíacos/efeitos dos fármacos , Miócitos Cardíacos/patologia , Inibidores de Proteínas Quinases/farmacologia , Recuperação de Função Fisiológica , Regeneração , Proteínas S100/genética , Proteínas S100/metabolismo , Transfecção , Proteína Vermelha FluorescenteRESUMO
BACKGROUND: The oriental migratory locust is a major crop pest across eastern and south-eastern Asia. Metarhizium anisopliae is an effective biopesticide agent used for locust control, but its performance is temperature dependent, and thus can be more variable than chemical pesticide performance. To predict biopesticide performance for the control of the oriental migratory locust, we adapted a previous temperature-dependent model and validated it using field trial data. To increase the applicability of this model, we explored the use of readily available temperature variables, as well as our own satellite-derived canopy temperature variable, to run the model. RESULTS: Compared to collected in situ temperature data, our canopy temperature variable most accurately represented the ambient temperature experienced by the locust. When the biopesticide performance model was run using this canopy temperature and compared to field trials results, the model predictions were more accurate than when the model was run with the other temperature variables. The accuracy of the biopesticide performance model was impacted by vegetation cover, but across the areas most associated with locust oviposition, growth and migration, the model predictions were satisfactorily accurate to guide biopesticide operational use. CONCLUSION: We validated the model in six provinces in China, representing the three agro-ecological zones largely representative of the oriental migratory locust problem areas in China, Thailand, Cambodia and Vietnam. Whilst further validation work is needed, this model could be used in these countries to assess, at a fine spatial scale, the appropriateness of M. anisopliae for controlling the oriental migratory locust. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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Gafanhotos , Locusta migratoria , Animais , Agentes de Controle Biológico , Controle de Pragas , China , VietnãRESUMO
Emerging technologies are increasingly employed in environmental citizen science projects. This integration offers benefits and opportunities for scientists and participants alike. Citizen science can support large-scale, long-term monitoring of species occurrences, behaviour and interactions. At the same time, technologies can foster participant engagement, regardless of pre-existing taxonomic expertise or experience, and permit new types of data to be collected. Yet, technologies may also create challenges by potentially increasing financial costs, necessitating technological expertise or demanding training of participants. Technology could also reduce people's direct involvement and engagement with nature. In this perspective, we discuss how current technologies have spurred an increase in citizen science projects and how the implementation of emerging technologies in citizen science may enhance scientific impact and public engagement. We show how technology can act as (i) a facilitator of current citizen science and monitoring efforts, (ii) an enabler of new research opportunities, and (iii) a transformer of science, policy and public participation, but could also become (iv) an inhibitor of participation, equity and scientific rigour. Technology is developing fast and promises to provide many exciting opportunities for citizen science and insect monitoring, but while we seize these opportunities, we must remain vigilant against potential risks. This article is part of the theme issue 'Towards a toolkit for global insect biodiversity monitoring'.
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Ciência do Cidadão , Insetos , Animais , Ciência do Cidadão/métodos , Participação da Comunidade/métodos , Monitoramento Ambiental/métodosRESUMO
During muscle development, the sarco/endoplasmic reticulum (SR/ER) undergoes remodeling to establish a specialized internal Ca(2+) store for muscle contraction. We hypothesized that store operated Ca(2+) entry (SOCE) is required to fill Ca(2+) stores and is, therefore, critical to creating a mature SR/ER. Stromal interaction molecule 1 (STIM1) functions as a sensor of internal Ca(2+) store content and an activator of SOCE channels. Myocytes lacking STIM1 display reduced SR Ca(2+) content and altered expression of key SR proteins. Sarcolipin (SLN), an inhibitor of the SR calcium pump, was markedly increased in the muscle of mutant STIM1 mice. SLN opposes the actions of STIM1 by limiting SOCE, reducing SR Ca(2+) content and delaying muscle differentiation. During mouse muscle development SLN is highly expressed in embryonic muscle, while the expression of STIM1 is up-regulated postnatally. These results suggest that SOCE regulates SR/ER specialization and that SLN and STIM1 act in opposing fashions to govern SOCE during myogenesis.
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Cálcio/fisiologia , Retículo Endoplasmático/fisiologia , Glicoproteínas de Membrana/fisiologia , Desenvolvimento Muscular , Proteínas Musculares/fisiologia , Proteolipídeos/fisiologia , Animais , Canais de Cálcio , Sinalização do Cálcio , Diferenciação Celular , Células Cultivadas , Regulação da Expressão Gênica no Desenvolvimento , Camundongos , Músculo Esquelético/citologia , Músculo Esquelético/fisiologia , Molécula 1 de Interação EstromalRESUMO
Rugose spiraling whitefly (RSW), Aleurodicus rugioperculatus Martin, a native pest of coconut in Central America, has recently been introduced to South-East Asia. Little is known about the spread of RSW in Bangladesh, the effect this pest has on coconut plants, or the full range of its plant hosts. To fill this knowledge gap, we conducted surveys across the southern coastal coconut producing region of Bangladesh. Coconut plant damage from RSW was high throughout all the areas surveyed, and this was correlated with the population density of RSW. Areas, such as Khulna, which had the highest population density of RSW, had the highest level of RSW leaf damage. Coconut plants with an infestation of RSW had significantly fewer leaves and fruits. The coconut fruits were also smaller, both in terms of size and weight, and contained less water and lighter endosperm compared to non-infested plants. This highlights the need for the management of RSW in coconut growing regions. We also report 39 new host plant species for RSW from 22 plant families, including the economically important mangrove plant Nipa palm, Nypa fruticans Wurmb.
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Hemípteros , Animais , Cocos , Bangladesh , Folhas de PlantaRESUMO
Cerebellar long-term depression (LTD) is a form of long-term synaptic plasticity that is triggered by calcium(Ca2+) signals in the postsynaptic Purkinje cell. This Ca2+comes both from IP3-mediated release from intracellular Ca2+ stores, as well as from Ca2+ influx through voltage-gated Ca2+ channels. The Ca2+ signal that triggers LTD occurs locally within dendritic spines and is due to supralinear summation of signals coming from these two Ca2+ sources. The properties of this postsynaptic Ca2+signal can explain several features of LTD, such as its associativity, synapse specificity, and dependence on thetiming of synaptic activity, and can account for the slow kinetics of LTD expression. Thus, from a Ca2+ signaling perspective, LTD is one of the best understood forms of synaptic plasticity.
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Sinalização do Cálcio/fisiologia , Cálcio/fisiologia , Cerebelo/fisiologia , Plasticidade Neuronal/fisiologia , Sinapses/fisiologia , Animais , Humanos , Cinética , Fibras Nervosas/fisiologia , Transmissão SinápticaRESUMO
Mutations in the canonical transient receptor potential cation channel 6 (TRPC6) are responsible for familial forms of adult onset focal segmental glomerulosclerosis (FSGS). The mechanisms by which TRPC6 mutations cause kidney disease are not well understood. We used TRPC6-deficient mice to examine the function of TRPC6 in the kidney. We found that adult TRPC6-deficient mice had BP and albumin excretion rates similar to wild-type animals. Glomerular histomorphology revealed no abnormalities on both light and electron microscopy. To determine whether the absence of TRPC6 would alter susceptibility to hypertension and renal injury, we infused mice with angiotensin II continuously for 28 days. Although both groups developed similar levels of hypertension, TRPC6-deficient mice had significantly less albuminuria, especially during the early phase of the infusion; this suggested that TRPC6 adversely influences the glomerular filter. We used whole-cell patch-clamp recording to measure cell-membrane currents in primary cultures of podocytes from both wild-type and TRPC6-deficient mice. In podocytes from wild-type mice, angiotensin II and a direct activator of TRPC6 both augmented cell-membrane currents; TRPC6 deficiency abrogated these increases in current magnitude. Our findings suggest that TRPC6 promotes albuminuria, perhaps by promoting angiotensin II-dependent increases in Ca(2+), suggesting that TRPC6 blockade may be therapeutically beneficial in proteinuric kidney disease.
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Albuminúria/metabolismo , Angiotensina II/efeitos adversos , Rim/metabolismo , Canais de Cátion TRPC/metabolismo , Albuminúria/etiologia , Albuminúria/fisiopatologia , Angiotensina II/administração & dosagem , Angiotensina II/farmacologia , Animais , Cálcio/metabolismo , Modelos Animais de Doenças , Hipertensão/fisiopatologia , Injeções Subcutâneas , Rim/efeitos dos fármacos , Rim/fisiopatologia , Masculino , Camundongos , Camundongos Knockout , Técnicas de Patch-Clamp , Podócitos/efeitos dos fármacos , Podócitos/metabolismo , Podócitos/patologia , Canais de Cátion TRPC/genética , Canal de Cátion TRPC6RESUMO
BACKGROUND: The papaya mealybug, Paracoccus marginatus, is a highly polyphagous invasive pest that affects more than 200 plants, many of which are of economic importance. We modelled the potential distribution of P. marginatus using CLIMEX, a process-oriented, climate-based niche model. We combined this model with spatial data on irrigation and cropping patterns to increase the real-world applicability of the model. RESULTS: The resulting model agreed with known distribution points for this pest and with broad areas where P. marginatus has been reported, but for which no GPS data were available. Our model highlights the potential expansion of P. marginatus into novel areas in Central and East Africa, as well as further expansion in Central America and Asia, as these areas are highly climatically suitable, and have large expanses of suitable crop hosts. It also highlights areas, such as the central and eastern states of the USA as well as the western provinces of China, that are suitable for seasonal invasions of P. marginatus. CONCLUSION: Our results offer refined resolution on areas with high potential for invasion by P. marginatus. © 2020 Society of Chemical Industry.
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Carica , Paracoccus , África Oriental , Ásia , China , Mudança ClimáticaRESUMO
Treatment for brain tumors has recently shifted to using the power of the immune system to destroy cancer cells with promising results. Many immunotherapeutic approaches that have been used in adults, including checkpoint inhibitors, vaccine therapy, adoptive immunotherapy, such as chimeric antigen receptor T cell therapy, and viral therapy, are now being evaluated in children. Although these treatments work through different mechanisms, they all activate the immune system and can result in inflammation at the site of disease. This can be especially problematic in the confined area of the brain causing potentially severe neurological side effects, which are of special concern in children with central nervous system malignancies. Steroids can be helpful in the management of neurological complications but carry the risk of making immunotherapeutic approaches less effective. Alternative therapeutic interventions to mitigate side effects are being evaluated. This review describes the most common immunotherapeutic modalities that are now under study for the treatment of pediatric brain tumors, their rationale, associated neurotoxicities, and current management.
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Neoplasias do Sistema Nervoso Central/terapia , Inibidores de Checkpoint Imunológico/uso terapêutico , Imunoterapia , Síndromes Neurotóxicas/terapia , Vacinas/uso terapêutico , Criança , Humanos , Imunoterapia/efeitos adversos , Síndromes Neurotóxicas/etiologiaRESUMO
Histone mutations occur in approximately 4% of different cancer types. In 2012, mutations were found in the gene encoding histone variant H3.3 (H3F3A gene) in pediatric diffuse intrinsic pontine gliomas and pediatric hemispheric gliomas. Tumors with mutations in the H3F3A gene are generally characterized as histone mutated gliomas (HMGs) or diffuse midline gliomas. HMGs are a rare subtype of glial tumor that is malignant and fast growing, carrying a poor prognosis. In 2017, the Beau Biden Cancer Moonshot Program appropriated $1.7 billion toward cancer care in 10 select areas. The National Cancer Institute (NCI) was granted support to focus specifically on rare central nervous system (CNS) tumors through NCI-CONNECT. Its mission is to address the challenges and unmet needs in CNS cancer research and treatment by connecting patients, providers, researchers, and advocacy organizations to work in partnership. On September 27, 2018, NCI-CONNECT convened a workshop on histone mutated midline glioma, one of the 12 CNS cancers included in its initial portfolio. Three leaders in the field provided an overview of advances in histone mutated midline glioma research. These experts shared observations and experiences related to common scientific and clinical challenges in studying these tumors. Although the clinical focus of this workshop was on adult patients, one important objective was to start a collaborative dialogue between pediatric and adult clinicians and researchers. Meeting participants identified needs for diagnostic and treatment standards, disease biology and biological targets for this cancer, disease-specific trial designs, and developed a list of action items and future direction.
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PURPOSE: Children with pediatric gliomas harboring a BRAF V600E mutation have poor outcomes with current chemoradiotherapy strategies. Our aim was to study the role of targeted BRAF inhibition in these tumors. PATIENTS AND METHODS: We collected clinical, imaging, molecular, and outcome information from patients with BRAF V600E-mutated glioma treated with BRAF inhibition across 29 centers from multiple countries. RESULTS: Sixty-seven patients were treated with BRAF inhibition (pediatric low-grade gliomas [PLGGs], n = 56; pediatric high-grade gliomas [PHGGs], n = 11) for up to 5.6 years. Objective responses were observed in 80% of PLGGs, compared with 28% observed with conventional chemotherapy (P < .001). These responses were rapid (median, 4 months) and sustained in 86% of tumors up to 5 years while receiving therapy. After discontinuation of BRAF inhibition, 76.5% (13 of 17) of patients with PLGG experienced rapid progression (median, 2.3 months). However, upon rechallenge with BRAF inhibition, 90% achieved an objective response. Poor prognostic factors in conventional therapies, such as concomitant homozygous deletion of CDKN2A, were not associated with lack of response to BRAF inhibition. In contrast, only 36% of those with PHGG responded to BRAF inhibition, with all but one tumor progressing within 18 months. In PLGG, responses translated to 3-year progression-free survival of 49.6% (95% CI, 35.3% to 69.5%) versus 29.8% (95% CI, 20% to 44.4%) for BRAF inhibition versus chemotherapy, respectively (P = .02). CONCLUSION: Use of BRAF inhibition results in robust and durable responses in BRAF V600E-mutated PLGG. Prospective studies are required to determine long-term survival and functional outcomes with BRAF inhibitor therapy in childhood gliomas.
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Ineffective communication can contribute to perioperative adverse events even when a safety checklist is used. The purpose of this project was to improve the overall debriefing process of the surgical safety checklist. We included coaches and used the International Classification for Patient Safety for categorizing any opportunities for improvement that were identified during the debriefing process. The results of our project showed an increase in both the total number of debriefings completed and the number of items discussed when completing the debriefing checklist in comparison with the preintervention compliance audits. We concluded that by using a coaching strategy and method to categorize perioperative opportunities for improvement during the debriefing process, there was improved compliance with completing the debriefing process in our facility.
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Lista de Checagem/métodos , Relações Interprofissionais , Equipe de Assistência ao Paciente , Qualidade da Assistência à Saúde/normas , Humanos , Salas Cirúrgicas/organização & administração , Salas Cirúrgicas/tendências , Segurança do Paciente/normas , Desenvolvimento de Programas/métodos , Melhoria de QualidadeRESUMO
Purpose BRAF V600E is a potentially highly targetable mutation detected in a subset of pediatric low-grade gliomas (PLGGs). Its biologic and clinical effect within this diverse group of tumors remains unknown. Patients and Methods A combined clinical and genetic institutional study of patients with PLGGs with long-term follow-up was performed (N = 510). Clinical and treatment data of patients with BRAF V600E mutated PLGG (n = 99) were compared with a large international independent cohort of patients with BRAF V600E mutated-PLGG (n = 180). Results BRAF V600E mutation was detected in 69 of 405 patients (17%) with PLGG across a broad spectrum of histologies and sites, including midline locations, which are not often routinely biopsied in clinical practice. Patients with BRAF V600E PLGG exhibited poor outcomes after chemotherapy and radiation therapies that resulted in a 10-year progression-free survival of 27% (95% CI, 12.1% to 41.9%) and 60.2% (95% CI, 53.3% to 67.1%) for BRAF V600E and wild-type PLGG, respectively ( P < .001). Additional multivariable clinical and molecular stratification revealed that the extent of resection and CDKN2A deletion contributed independently to poor outcome in BRAF V600E PLGG. A similar independent role for CDKN2A and resection on outcome were observed in the independent cohort. Quantitative imaging analysis revealed progressive disease and a lack of response to conventional chemotherapy in most patients with BRAF V600E PLGG. Conclusion BRAF V600E PLGG constitutes a distinct entity with poor prognosis when treated with current adjuvant therapy.
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Neoplasias Encefálicas/enzimologia , Glioma/enzimologia , Proteínas Proto-Oncogênicas B-raf/genética , Adolescente , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/terapia , Neoplasias do Tronco Encefálico/enzimologia , Neoplasias do Tronco Encefálico/genética , Neoplasias do Tronco Encefálico/patologia , Neoplasias do Tronco Encefálico/terapia , Criança , Pré-Escolar , Estudos de Coortes , Diencéfalo/enzimologia , Diencéfalo/patologia , Feminino , Glioma/genética , Glioma/patologia , Glioma/terapia , Humanos , Lactente , Masculino , Mutação , Gradação de Tumores , PrognósticoRESUMO
Immediately after birth, skeletal muscle must undergo an enormous period of growth and differentiation that is coordinated by several intertwined growth signaling pathways. How these pathways are integrated remains unclear but is likely to involve skeletal muscle contractile activity and calcium (Ca(2+)) signaling. Here, we show that Ca(2+) signaling governed by stromal interaction molecule 1 (STIM1) plays a central role in the integration of signaling and, therefore, muscle growth and differentiation. Conditional deletion of STIM1 from the skeletal muscle of mice (mSTIM1(-/-) mice) leads to profound growth delay, reduced myonuclear proliferation, and perinatal lethality. We show that muscle fibers of neonatal mSTIM1(-/-) mice cannot support the activity-dependent Ca(2+) transients evoked by tonic neurostimulation, even though excitation contraction coupling (ECC) remains unperturbed. In addition, disruption of tonic Ca(2+) signaling in muscle fibers attenuates downstream muscle growth signaling, such as that of calcineurin, mitogen-activated protein (MAP) kinases, extracellular signal-regulated kinase 1 and 2 (ERK1/2), and AKT. Based on our findings, we propose a model wherein STIM1-mediated store-operated calcium entry (SOCE) governs the Ca(2+) signaling required for cellular processes that are necessary for neonatal muscle growth and differentiation.
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Canais de Cálcio/metabolismo , Sinalização do Cálcio/genética , Glicoproteínas de Membrana/metabolismo , Desenvolvimento Muscular , Músculo Esquelético/metabolismo , Animais , Transporte Biológico Ativo/genética , Transporte Biológico Ativo/fisiologia , Cálcio/metabolismo , Diferenciação Celular , Proliferação de Células , Células Cultivadas , Sistema de Sinalização das MAP Quinases , Glicoproteínas de Membrana/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Músculo Esquelético/crescimento & desenvolvimento , Técnicas de Patch-Clamp , Proteínas Proto-Oncogênicas c-akt/biossíntese , Proteínas Proto-Oncogênicas c-akt/metabolismo , Molécula 1 de Interação Estromal , Proteínas Quinases p38 Ativadas por Mitógeno/biossíntese , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismoRESUMO
This experiment assessed the effects of training history on resurgence in three college students. Four-choice arbitrary-matching-to-sample trials occurred in two components of a multiple schedule. An A1 or A2 sample stimulus and four (B) comparison stimuli occurred on AB trials, and a C1 or C2 sample stimulus and four (D) comparison stimuli occurred on CD trials. By the end of training, accuracy and latency measures were comparable across separate discriminations, selecting B2 in the presence of A2 and selecting D2 in the presence of C2, despite a lengthier training correlated with the former discrimination. Next, in the presence of A2 and C2, respectively, responses to B2 and D2 were extinguished and responses to B3 and D3 were reinforced. These responses to B3 and D3 then were extinguished in a final condition. In this final condition, resurgence to B2 occurred for each participant, whereas resurgence to D2 occurred for only one participant. Thus, there was greater resurgence of the discrimination with the lengthier training history, despite the discriminations being similar in terms of accuracy and latency before extinction. This result, therefore, can be classified as a latent, or remote, behavioral history effect.