RESUMEN
This study aimed to define the expression patterns of HENMT1 and PIWI proteins in human testis and investigate their association with transposon expression, infertility sub-type or development of testicular germ cell tumours (TGCTs). Testis biopsies showing normal spermatogenesis were used to identify normal localisation patterns of HENMT1 and PIWIL1 by immunolocalisation and RT-PCR after laser microdissection. 222 testis biopsies representing normal spermatogenesis, hypospermatogenesis, spermatogenic arrests, Sertoli cell-only (SCO) tumours and TGCTs were analysed by RT-qPCR for expression of HENMT1/PIWIL1/PIWIL2/PIWIL3/PIWIL4 and LINE-1 Additionally, HENMT1-overexpressing TCam2 seminoma cell lines were analysed for the same parameters by RT-qPCR. We found that HENMT1 and PIWIL1 are coexpressed in pachytene spermatocytes and spermatids. Expression of HENMT1, PIWIL1 and PIWIL2 was mainly dependent on germ cell content but low levels of expression were also detected in some SCO samples. Levels of HENMT1, PIWIL1 and PIWIL2 expression were low in TGCT. Samples with HENMT1, PIWIL2 and PIWIL4 expression showed significantly (P < 0.05) lower transposon expression compared to samples without expression in the same histological group. HENMT1-overexpressing TCam2 cells showed lower LINE-1 expression than empty vector-transfected control lines. Our findings support that the transposon-regulating function of the piRNA pathway found in the mouse is conserved in adult human testis. HENMT1 and PIWI proteins are expressed in a germ-cell-specific manner and required for transposon control.
Asunto(s)
Proteínas Argonautas/genética , Elementos Transponibles de ADN , Metiltransferasas/genética , Neoplasias de Células Germinales y Embrionarias/genética , Seminoma/genética , Tumor de Células de Sertoli/genética , Síndrome de Sólo Células de Sertoli/genética , Neoplasias Testiculares/genética , Testículo/enzimología , Adolescente , Adulto , Anciano , Proteínas Argonautas/metabolismo , Línea Celular Tumoral , Fertilidad/genética , Regulación Enzimológica de la Expresión Génica , Regulación Neoplásica de la Expresión Génica , Humanos , Elementos de Nucleótido Esparcido Largo , Masculino , Metiltransferasas/metabolismo , Persona de Mediana Edad , Neoplasias de Células Germinales y Embrionarias/enzimología , Neoplasias de Células Germinales y Embrionarias/patología , ARN Interferente Pequeño/genética , ARN Interferente Pequeño/metabolismo , Seminoma/enzimología , Seminoma/patología , Tumor de Células de Sertoli/enzimología , Tumor de Células de Sertoli/patología , Síndrome de Sólo Células de Sertoli/enzimología , Síndrome de Sólo Células de Sertoli/fisiopatología , Espermatogénesis/genética , Neoplasias Testiculares/enzimología , Neoplasias Testiculares/patología , Testículo/patología , Testículo/fisiopatología , Adulto JovenRESUMEN
Follistatin, an inhibitor of activin A, has key regulatory roles in the female reproductive tract. Follistatin has two splice variants: FST288, largely associated with cell surfaces, and FST315, the predominant circulating form. The mechanism regulating uterine expression of these variants is unknown. Quantitative RT-PCR was used to measure expression of follistatin splice variants (Fst288, Fst315), the activin bA subunit (Inhba) and the inhibin a subunit (Inha) in uterine tissues during early pregnancy (days 14, preimplantation) and in response to exogenous 17b-oestradiol (single s.c. injection) and progesterone (three daily s.c. injections) in ovariectomized mice. Uterine Fst288, Fst315 and Inhba expression increased during early pregnancy, with greater increases in Fst315 relative to Fst288 suggesting differential regulation of these variants. Fst288, Fst315, Inhba and Inha all increased in response to progesterone treatment. Fst288, but not Fst315, mRNA decreased in response to 17b-oestradiol treatment, whereas Inhba increased. A comparison of the absolute concentrations of uterine follistatin mRNA using crossing thresholds indicated that both variants were more highly expressed in early pregnancy in contrast to the hormone treatment models. It is concluded that progesterone regulates uterine expression of both follistatin variants, as well as activin A, during early pregnancy in the mouse uterus
Asunto(s)
Folistatina/metabolismo , Regulación de la Expresión Génica/efectos de los fármacos , Progesterona/farmacología , Útero/efectos de los fármacos , Animales , Estradiol/farmacología , Femenino , Folistatina/química , Folistatina/genética , Subunidades beta de Inhibinas/genética , Subunidades beta de Inhibinas/metabolismo , Inhibinas/genética , Inhibinas/metabolismo , Ratones , Embarazo , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , ARN Mensajero/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa , Útero/metabolismoRESUMEN
BACKGROUND: Photodynamic therapy (PDT) is a treatment modality for a range of diseases including cancer. The BF(2)-chelated tetraaryl-azadipyrromethenes (ADPMs) are an emerging class of non-porphyrin PDT agent, which have previously shown excellent photochemical and photophysical properties for therapeutic application. Herein, in vivo efficacy and mechanism of action studies have been completed for the lead agent, ADMP06. METHODS: A multi-modality imaging approach was employed to assess efficacy of treatment, as well as probe the mechanism of action of ADPM06-mediated PDT. RESULTS: Tumour ablation in 71% of animals bearing mammary tumours was achieved after delivery of 2 mg kg(-1) of ADPM06 followed immediately by light irradiation with 150 J cm(-2). The inherent fluorescence of ADPM06 was utilised to monitor organ biodistribution patterns, with fluorescence reaching baseline levels in all organs within 24 h. Mechanism of action studies were carried out using dynamic positron emission tomography and magnetic resonance imaging techniques, which, when taken together, indicated a decrease in tumour vascular perfusion and concomitant reduction in tumour metabolism over time after treatment. CONCLUSION: The encouraging treatment responses in vivo and vascular-targeting mechanism of action continue to indicate therapeutic benefit for this new class of photosensitiser.
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Neoplasias Mamarias Experimentales/tratamiento farmacológico , Fotoquimioterapia , Fármacos Fotosensibilizantes/uso terapéutico , Pirroles/uso terapéutico , Animales , Línea Celular Tumoral , Células Cultivadas , Células Endoteliales/citología , Células Endoteliales/efectos de los fármacos , Femenino , Humanos , Imagen por Resonancia Magnética , Neoplasias Mamarias Experimentales/irrigación sanguínea , Ratones , Ratones Endogámicos C57BL , Tomografía de Emisión de Positrones , Pirroles/farmacocinética , Distribución TisularRESUMEN
Production and regulation of activin A and inhibin B during the cycle of the seminiferous epithelium were investigated in adult rats. Immunohistochemistry localised the activin beta(A)-subunit to the Sertoli cell cytoplasm, with much weaker expression in spermatocytes and spermatids. Both activin A and inhibin B, measured by ELISA were secreted by, seminiferous tubule fragments over 72 h in culture. Activin A was secreted in a cyclic manner with peak secretion from tubules isolated at stage VIII. Tubules collected during stage VI produced the least activin A. Inhibin B secretion was highest from stage IX-I tubules and lowest from stage VII tubules. Addition of interleukin-1beta (IL-1beta) had relatively little effect on activin A or inhibin B secretion in culture. In contrast, the peak secretion of activin A by stage VIII tubules was blocked by co-incubation with an excess of human recombinant IL-1 receptor antagonist, whereas inhibin B secretion increased slightly. Dibutyryl cAMP stimulated activin A secretion by late stage VII and VIII tubules and stimulated inhibin B across all stages. These data indicate that activin A and inhibin B are cyclically regulated within the seminiferous epithelium, with endogenous IL-1 (presumably IL-1alpha produced by the Sertoli cells), responsible for a peak of activin A production subsequent to sperm release at stage VIII. These data provide direct evidence that production of activin A and inhibin B by the Sertoli cell is locally modulated by IL-1alpha , in addition to FSH/cAMP, under the influence of the developing spermatogenic cells.
Asunto(s)
Activinas/biosíntesis , Epitelio Seminífero/metabolismo , Espermatogénesis/fisiología , Activinas/análisis , Animales , Bucladesina/farmacología , Citoplasma/química , Ensayo de Inmunoadsorción Enzimática/métodos , Inmunohistoquímica/métodos , Inhibinas/análisis , Inhibinas/biosíntesis , Proteína Antagonista del Receptor de Interleucina 1 , Interleucina-1/metabolismo , Masculino , Ratas , Ratas Sprague-Dawley , Epitelio Seminífero/química , Células de Sertoli/química , Sialoglicoproteínas/farmacología , Espermatozoides/química , Estimulación Química , Técnicas de Cultivo de TejidosRESUMEN
BACKGROUND: Activin A is a member of the transforming growth factor-beta superfamily which is directly implicated in airway structural change and inflammation in asthma. In vitro, the biological effects of activin A are neutralized by the soluble binding protein follistatin. OBJECTIVE: To determine the potential of endogenous follistatin to suppress activin A in vivo by analysing their relative tissue and kinetic compartmentalization during the effector phase of subchronic Th2-driven mucosal inflammation in a murine model of allergic asthma. METHODS: Eosinophilic mucosal inflammation was elicited by triggering Th2 recall responses by antigen challenge in ovalbumin-sensitized BALB/c mice. The kinetics and distribution of activin A and follistatin protein were assessed in lung tissue and bronchoalveolar lavage fluid and measured in relation to airway eosinophilia, goblet cell metaplasia and Th2 cytokine production in mediastinal lymph nodes. RESULTS: Follistatin was released concurrently with activin A suggesting it acts as an endogenous regulator: peak BAL concentrations coincided with maximal airway eosinophilia, and frequency of IL-4, IL-5 and IL-13 producing cells in mediastinal lymph nodes but induction lagged behind the onset of inflammation. Follistatin and activin A immunoreactivity were lost in airway epithelial cells in parallel with goblet cell metaplasia. Exogenous follistatin inhibited the allergen-specific Th2 immune response in mediastinal lymph nodes and mucus production in the lung. CONCLUSION: Follistatin is preformed in the normal lung and released in concert with activin A suggesting it serves as an endogenous regulator. Disturbance of the fine balance between activin A and its endogenous inhibitor follistatin may be a determinant of the severity of allergic inflammation or tissue phenotypic shift in asthma.
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Activinas/metabolismo , Asma/metabolismo , Folistatina/fisiología , Animales , Asma/inmunología , Líquido del Lavado Bronquioalveolar/química , Modelos Animales de Enfermedad , Femenino , Folistatina/metabolismo , Folistatina/farmacología , Inmunización , Interleucinas/biosíntesis , Pulmón/metabolismo , Ganglios Linfáticos/inmunología , Ratones , Ratones Endogámicos BALB C , Moco/metabolismo , Ovalbúmina/inmunología , Proteínas Recombinantes/farmacología , Células Th2/inmunologíaAsunto(s)
Obstrucción de las Vías Aéreas/etiología , Ciclismo/lesiones , Esófago/lesiones , Traumatismos del Cuello/etiología , Tráquea/lesiones , Niño , Esófago/cirugía , Humanos , Masculino , Traumatismos del Cuello/cirugía , Respiración Artificial , Tráquea/cirugía , Heridas no Penetrantes/etiología , Heridas no Penetrantes/cirugíaRESUMEN
The regulation of Sertoli cell activin A and inhibin B secretion during inflammation was investigated in vitro. Adult rat Sertoli cells were incubated with the inflammatory mediators, lipopolysaccharide (LPS), interleukin-1beta (IL-1beta), IL-6 and the IL-1 receptor antagonist (IL-1ra) over 48 h in culture. Activin A, inhibin B and IL-1alpha were measured in the culture medium by specific two-site ELISAs. Both IL-1beta- and LPS-stimulated activin A and inhibited inhibin B secretion. LPS also stimulated the production of IL-1alpha in the cultures. In contrast to IL-1beta, IL-6 had no effect on activin A, although it did have a significant inhibitory effect on inhibin B secretion. Ovine follicle-stimulating hormone (FSH) and the cAMP analogue dibutyryl cAMP opposed the actions of IL-1 and LPS by suppressing activin A and IL-1alpha secretion and by stimulating inhibin B. Blocking IL-1 activity in the cultures by addition of an excess of IL-1ra completely prevented the response of activin A to exogenous IL-1beta, and reduced the response to LPS by 50%. In the presence of IL-1ra, basal secretion of inhibin B was increased, but IL-1ra was unable to reverse the suppression of inhibin B by LPS. These data indicate the importance of both IL-1 isoforms in regulating secretion of activin A and inhibin B by mature Sertoli cells during inflammation. The data also establish that inflammation exerts its effects on activin A and inhibin B secretion via other pathways in addition to those mediated by IL-1, and that hormonal stimulation by FSH and cAMP moderates the Sertoli cell response to inflammation. Interference with the complex interactions between these cytokines and hormones may contribute to the disruption of reproductive function that can accompany infection and illness in men.
Asunto(s)
Activinas/metabolismo , Mediadores de Inflamación/farmacología , Subunidades beta de Inhibinas/metabolismo , Inhibinas/metabolismo , Células de Sertoli/metabolismo , Animales , Células Cultivadas , Relación Dosis-Respuesta a Droga , Ensayo de Inmunoadsorción Enzimática/métodos , Proteína Antagonista del Receptor de Interleucina 1 , Interleucina-1/farmacología , Interleucina-6/farmacología , Lipopolisacáridos/farmacología , Masculino , Ratas , Ratas Sprague-Dawley , Células de Sertoli/efectos de los fármacos , Células de Sertoli/inmunología , Sialoglicoproteínas/farmacología , Estimulación QuímicaRESUMEN
In several biological systems, the inhibin beta(A) homodimer activin A is stimulated by, and in turn, inhibits the action of interleukin (IL)-1 (both IL-1alpha and IL-1beta) and IL-6. The possibility that a similar regulatory relationship operates within the testis was investigated. Sertoli cells from immature (20-day-old) rats were cultured with human IL-1alpha or IL-1beta, human IL-6 and/or ovine FSH or dibutyryl cAMP. Activin A and the inhibin dimers, inhibin A and inhibin B, were measured by specific ELISA. Immunoreactive inhibin (ir-inhibin) was measured by RIA. Activin/inhibin subunit mRNA expression was measured by quantitative real-time PCR. Both IL-1 isoforms, but not IL-6, stimulated activin A secretion through increased synthesis of beta(A)-subunit mRNA. IL-1 also stimulated activin A secretion by testicular peritubular cells. In contrast to the effect on activin A, IL-1 suppressed inhibin beta(B)-subunit and, to a lesser extent, alpha-subunit mRNA expression, thereby reducing basal and FSH-stimulated inhibin B secretion by the Sertoli cells. Conversely, FSH inhibited basal activin A secretion and antagonised the stimulatory effects of IL-1. Dibutyryl cAMP partially inhibited the action of IL-1 on activin A secretion, but had no significant effect on basal activin A secretion. Secretion of inhibin A was low in all treatment groups. These data demonstrate that IL-1 and FSH/cAMP exert a reciprocal regulation of activin A and inhibin B synthesis and release by the Sertoli cell, and suggest a role for activin A as a potential feedback regulator of IL-1 and IL-6 activity in the testis during normal spermatogenesis and in inflammation.
Asunto(s)
Activinas/farmacología , Hormona Folículo Estimulante/farmacología , Subunidades beta de Inhibinas/farmacología , Inhibinas/farmacología , Interleucina-1/farmacología , Células de Sertoli/metabolismo , Animales , Bucladesina/farmacología , Técnicas de Cultivo de Célula , Ensayo de Inmunoadsorción Enzimática/métodos , Retroalimentación Fisiológica , Interleucina-6/farmacología , Masculino , ARN Mensajero/análisis , Ratas , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Células de Sertoli/efectos de los fármacos , Estimulación QuímicaRESUMEN
The release of activin A in response to intravenous injection of the bacterial cell-wall component lipopolysaccharide (LPS) was investigated in an ovine model of acute inflammatory challenge in newborn and adult sheep, and in non-pregnant and pregnant ewes. Neonatal lambs (<20 days of age) showed a quantitatively similar response in terms of circulating concentrations of activin A, its binding protein follistatin and the cytokine interleukin-6 compared with adult ewes challenged with an equivalent dose (300 ng/kg bodyweight) of LPS. The fever response and plasma tumour necrosis factor-alpha release in response to LPS, however, were significantly (P < 0.01) less in lambs than in the adult group. Pregnant ewes in the last trimester of gestation had similar responses to LPS, in all aspects measured, compared with their non-pregnant counterparts, apart from an ablated fever response. Although the adult and neonatal sheep responded to LPS, a similar response was not apparent in the fetal circulation, possibly due to a protective effect of the placenta. A 10-fold increase in the dose of LPS (from 300 ng to 3 microg/kg bodyweight) given to neonatal lambs elicited an increase in several cytokine responses measured, with a significant (P< 0.05) increase in follistatin release. In contrast, the amount of activin released by the increased dose of LPS was similar to that invoked by the lower dose. The effect of tolerance to LPS was investigated by giving a second challenge of LPS 5 days after the initial injection. In all animals studied, there was an ablated (P < 0.05) response to the subsequent LPS injection, apart from a similar temperature-response profile. These data provide further evidence that activin A concentrations in the bloodstream are acutely responsive to inflammatory challenge in post-natal life and suggest that the response forms a significant component of the innate immune system.
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Activinas/sangre , Envejecimiento/inmunología , Subunidades beta de Inhibinas/sangre , Lipopolisacáridos/farmacología , Preñez/inmunología , Animales , Animales Recién Nacidos , Relación Dosis-Respuesta a Droga , Femenino , Feto/efectos de los fármacos , Exposición Materna , Intercambio Materno-Fetal , Embarazo , Preñez/sangre , OvinosRESUMEN
Many of the proteins and their encoding genes involved in spermatogenesis are unknown, making the specific diagnosis and treatment of infertility in males difficult and highlighting the importance of identifying new genes that are involved in spermatogenesis. Through genome-wide chemical mutagenesis using N-ethyl-N-nitrosourea (ENU) and a three-generation breeding scheme to isolate recessive mutations, we have identified mouse lines with a range of abnormalities relevant to human male fertility. Abnormal phenotypes included hypospermatogenesis, Sertoli cell-only (SCO) seminiferous tubules, germ-cell arrest and abnormal spermiogenesis and were accompanied, in some, with abnormal serum levels of reproductive hormones. In total, from 65 mouse lines, 14 showed a reproductive phenotype consistent with a recessive mutation. This study shows that it is feasible to use ENU mutagenesis as an effective and rapid means of generating mouse models relevant to furthering our understanding of human male infertility. Spermatozoa and genomic DNA from all mouse lines, including those with abnormal reproductive tract parameters, have been cryopreserved for the regeneration of lines as required. This repository will form a valuable resource for the identification and analysis of key regulators of multiple aspects of male fertility.
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Etilnitrosourea/toxicidad , Fertilidad/fisiología , Activinas , Animales , Apoptosis , Cruzamientos Genéticos , Femenino , Fertilidad/efectos de los fármacos , Fertilidad/genética , Hormona Folículo Estimulante/sangre , Masculino , Ratones , Ratones Mutantes , Mutagénesis , Mutágenos , Tamaño de los Órganos , Preservación de Semen , Testículo/anatomía & histología , Testículo/efectos de los fármacosRESUMEN
The role of the inhibins, activins and follistatins in testicular function are being more clearly defined following studies describing the cellular localisation of these proteins to the testis and the availability of specific assay systems enabling measurement of these proteins. Taken together with the results of targetted gene inactivation experiments, several concepts emerge. Inhibin B is predominantly produced by the Sertoli cell in many adult male mammals whereas there is a perinatal peak of inhibin A in the rat. In contrast, activin A has its highest concentrations in the immediate post-natal period during which it is involved in the developmental regulation of both germ cells and Sertoli cells being modulated by follistatin. Activin A levels are considerably lower in the adult testis but Sertoli cell production is stimulated by interleukin-1 and inhibited by FSH. Little is known about the production of activin B due to the absence of a suitable assay but the beta(B) subunit mRNA is expressed in germ cells and Sertoli cells and is stage-dependent. This pattern of expression suggest that it may be involved in autocrine or paracrine actions within the seminiferous epithelium.
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Hormonas Gonadales/fisiología , Testículo/fisiología , Activinas/genética , Activinas/metabolismo , Activinas/fisiología , Animales , Folistatina/genética , Folistatina/metabolismo , Folistatina/fisiología , Regulación de la Expresión Génica/fisiología , Hormonas Gonadales/genética , Humanos , Inhibinas/fisiología , MasculinoRESUMEN
The aim of the present study was to determine whether activin A concentrations are dependent on feto-placental oxygen availability and to investigate the temporal relationship of activin A with prostaglandin (PG) E(2) and cortisol. Nine fetal sheep (six hypoxic and three control) were instrumented and catheterised at 0.8 gestation. Reduced uterine blood flow was used to achieve three levels of hypoxia (mild = fetal SaO(2) 40-50%; moderate = fetal SaO(2) 30-40%; severe = fetal SaO(2) 20-30%), for 4 h on 3 consecutive days. Activin A, PGE(2) and cortisol levels were determined in maternal and fetal blood and amniotic fluid. Moderate and severe hypoxia produced a significant (P < 0.05) increase in fetal plasma activin A concentrations. The amniotic fluid activin A concentrations were 15-fold higher than those in the fetal circulation, but were unchanged by hypoxia. The fetal PGE(2) response reflected the degree of hypoxia over the 3 days, with moderate and severe hypoxia producing a significant (P < 0.05) increase in PGE(2) concentrations. Fetal plasma cortisol concentrations were increased ( P < 0.05) during all levels of hypoxia. Fetal arterial activin A was increased in response to moderate and severe hypoxia, but levels were not maintained over the hypoxic period. The increases in activin A and cortisol concentrations preceded the increase in PGE(2).
Asunto(s)
Activinas/análisis , Dinoprostona/análisis , Hipoxia Fetal/metabolismo , Hidrocortisona/análisis , Intercambio Materno-Fetal , Oxígeno/metabolismo , Activinas/sangre , Líquido Amniótico/química , Animales , Presión Sanguínea , Dinoprostona/sangre , Femenino , Sangre Fetal/química , Frecuencia Cardíaca Fetal , Hidrocortisona/sangre , Oxígeno/sangre , Presión Parcial , Placenta/irrigación sanguínea , Placenta/metabolismo , Embarazo , OvinosRESUMEN
The aim of this study was to investigate the changes in follistatin, an activin binding protein, during the oestrous cycle, gestation and parturition in ewes using a radioimmunoassay for total follistatin, which uses dissociating reagents to remove the interference of activin. Follistatin concentrations remained unchanged (2.7 +/- 0.2 ng ml(-1)) during the oestrous cycle and decreased as pregnancy progressed. Follistatin concentrations in allantoic fluid also decreased during gestation, whereas in amniotic fluid follistatin concentrations reached a peak at day 75 of gestation (9.8 ng ml(-1)) and had decreased to 4.4 ng ml(-1) at day 140. Follistatin concentrations in fetal blood (7.0 +/- 0.5 ng ml(-1)) did not change from day 50 to day 140 of gestation but were significantly higher than in matched maternal samples (3.1 +/- 0.3 ng ml(-1)). Circulating follistatin in ewes was significantly increased on the day of parturition (5.6 +/- 0.6 ng ml(-1)) compared with the days before parturition (2.7 +/- 0.4 ng ml(-1)), but had decreased by day 2 after birth. Blood samples from newborn lambs showed that plasma follistatin concentration (13.4 +/- 2.3 ng ml(-1)) was significantly higher than that of the mothers and remained high for at least 7 days after birth. These data support previous studies of the human menstrual cycle indicating that follistatin is not an endocrine signal from the ovary; however, in contrast to human pregnancies, follistatin concentrations in sheep decreased and become high only after or during parturition. This difference observed between species may reflect different physiological effects of follistatin or may be the result of measurement of different isoforms.
Asunto(s)
Activinas/metabolismo , Ciclo Estral/metabolismo , Preñez/metabolismo , Ovinos/metabolismo , Activinas/sangre , Líquido Amniótico/metabolismo , Animales , Animales Recién Nacidos , Femenino , Sangre Fetal/metabolismo , Folistatina , Trabajo de Parto/metabolismo , Periodo Posparto/sangre , EmbarazoRESUMEN
AIM: To determine if the introduction of preformatted patient record charts improved documentation by doctors in a rural emergency department. METHODS: All medical records of patients who were discharged from the emergency department were collected and analysed for a period of two weeks (control). The preformatted patient charts were then introduced for a further two weeks, and analysed for the presence or absence of key content items RESULTS: After exclusions, 137 control charts and 96 preformatted charts were collected and analysed. It was found that, overall, there was a significant improvement in the number of the key items documented (p<0.005). There was a trend towards improvement in four parameters, but for three other key content items, there was a nonsignificant decline in documentation standards. CONCLUSION: A structured proforma does improve documentation. However, the improvement is small and further studies are required before use of preformatted patient records for the undifferentiated emergency department patients can be recommended.
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Documentación/normas , Servicio de Urgencia en Hospital/organización & administración , Registros Médicos/normas , Cuerpo Médico de Hospitales , Femenino , Control de Formularios y Registros , Hospitales Rurales , Humanos , Masculino , Nueva Zelanda , Probabilidad , Estudios Prospectivos , Calidad de la Atención de Salud , Valores de Referencia , Sensibilidad y EspecificidadAsunto(s)
Macropodidae , Traumatismo Múltiple/etiología , Adulto , Animales , Humanos , Masculino , Persona de Mediana EdadRESUMEN
To compare maternal serum inhibin A concentrations in early pregnancy with pregnancy outcomes and treatment protocols, serum samples were collected from 237 women undergoing in-vitro fertilization (IVF) and embryo transfer cycles. Samples were collected on day 16 after oocyte retrieval for beta human chorionic gonadotrophin (HCG) pregnancy testing and inhibin A measurement. The samples were divided into non-pregnant (n = 128) and pregnant (n = 109) groups, the pregnancies were followed and outcomes determined. Inhibin A concentrations were significantly lower in non-pregnant women than in women with ongoing pregnancies (P: < 0.001) and those resulting in spontaneous abortions (P: < 0.001). In ongoing pregnancies, inhibin A concentrations were significantly lower in the absence of functioning ovaries (donor oocyte/embryo) (P: < 0.01) and in natural cycles (frozen-thawed embryo transfer) (P: < 0.01) compared with concentrations after ovarian stimulation. Further, since inhibin A concentrations were not significantly different between singleton and multiple pregnancies in the ovarian stimulation protocol, the size of the early trophoblast does not appear to influence the secretion of inhibin A. These data strongly support the concept that the corpus luteum is a major source of circulating inhibin A in early pregnancy. Additionally, low concentrations of serum inhibin A may be useful in predicting betaHCG-positive preclinical 'biochemical' pregnancies.
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Cuerpo Lúteo/fisiología , Transferencia de Embrión , Fertilización In Vitro , Inhibinas/sangre , Resultado del Embarazo , Aborto Espontáneo/sangre , Gonadotropina Coriónica Humana de Subunidad beta/sangre , Terapia de Reemplazo de Estrógeno , Femenino , Humanos , Embarazo , Embarazo Ectópico/sangre , Estudios RetrospectivosRESUMEN
Activins are pluripotent growth factors that have recently been shown to be present in placental and fetal membrane preparations. Our previous studies have identified and purified activin A from ovine amniotic and allantoic fluids. In this study, ligand blots of side fractions from the isolation of activin A from allantoic fluid suggested the presence of activin-binding proteins other than follistatin. Further purification of one of these fractions involved two sequential reverse phase HPLC steps and a Superose 12HR fractionation. SDS-PAGE revealed a single protein band of 55 kDa, which was identified by NH2-terminal sequencing as ovine uterine milk protein (UTMP), a member of the serine protease inhibitor (serpin) superfamily of proteins. Further binding studies, using ligand blot techniques and Superose 12HR fractionation in the presence of [125I]activin, demonstrated UTMP to be an activin-binding protein with a lower affinity for activin than that of follistatin. A study of the specific binding behavior of UTMP to activin, using surface plasmon resonance, revealed an apparent equilibrium dissociation constant (Kd) of 49 +/- 25 nM, compared with the follistatin-activin Kd of 379 +/- 51 pM. Similar to another activin-binding protein, alpha2-macroglobulin, UTMP was unable to neutralize the bioactivity of activin in a bioassay based on the capacity of activin to inhibit the proliferation of an MPC-11 plasmacytoma cell line. The high concentrations of this protein in uterine fluid during pregnancy and its ability to bind activin suggest that UTMP may act as a low affinity, high capacity binding protein to sequester activin in the local uterine environment.
Asunto(s)
Alantoides/metabolismo , Líquidos Corporales/metabolismo , Glicoproteínas/metabolismo , Serpinas , Ovinos/metabolismo , Activinas , Animales , Femenino , Folistatina , Inhibinas/metabolismo , EmbarazoRESUMEN
Activin A, a dimer of the betaA-subunit of inhibin, has been shown to have multiple biological activities and sites of production. Follistatin is a high-affinity binding protein for activin, which neutralizes its activity. This study provides the first data, using a cross-sectional design, on the measurement of both these proteins in the maternal circulation of a large cohort of women (6-39 weeks of gestation, n = 2-20 women/time point) during normal pregnancies, and confirms that similar patterns are seen in nine women studied longitudinally during pregnancy. The concentrations of total activin A were measured using a specific two-site enzyme-linked immunosorbent assay (ELISA), and a new radioimmunoassay for measuring total follistatin in serum utilizing dissociating reagents to eliminate the interference of activin is described. At 38-39 weeks gestation, both activin A and follistatin concentrations rose to a peak (4.59 +/- 0.54 ng/ml and 72.7 +/- 3.31 ng/ml, respectively). The activin A and follistatin concentrations were highly correlated both in the cross-sectional study (P <0.0001) and in individual women in the longitudinal study (P <0.05-0.0001). Concentrations of follistatin showed a greater increase in the second trimester of pregnancy relative to activin A concentrations. The parallel increase in the secretion of these two proteins throughout pregnancy probably reflects feto-placental secretion.
Asunto(s)
Glicoproteínas/sangre , Sustancias de Crecimiento/sangre , Inhibinas/sangre , Embarazo/sangre , Activinas , Estudios de Cohortes , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática , Femenino , Folistatina , Edad Gestacional , Humanos , Estudios Longitudinales , Masculino , Radioinmunoensayo , Valores de ReferenciaRESUMEN
We have examined the age-dependent effects of human recombinant inhibin A (hrI) on gonadotropin levels in intact male rats. A single s.c. injection of hrI in the dose range 6.25-100 ng/g BW resulted in a significant and consistent decrease (20-40%) in serum FSH measured 6 h later, at the higher (50 and 100 ng/g) doses, in animals 25-91 days of age. Administration of the same doses in animals < or = 20 days old had no significant effect on serum FSH levels. Similarly, no effect of hrI (100 ng/g) on serum FSH levels was observed in 15-day-old rats when FSH levels were monitored from 1 to 8 h. No effect of hrI was observed on serum LH levels except in 40-day-old rats, which exhibited a consistent and significant reduction at the higher (25-100 ng/g) doses of inhibin. Serum inhibin levels 6 h after the injection were not significantly altered at any dose in young animals (< or = 30 days); however, in older animals (40, 50, and 91 days) there was a significant elevation in circulating inhibin levels at the higher doses, strongly suggesting an age-related change in clearance. Testicular inhibin levels were not affected by administration of the exogenous material except at the highest dose (100 ng/g) in the oldest animals (91 days), when an approximately 30% reduction in both the concentration and the total content of inhibin was observed. The data clearly demonstrate that the effect of hrI on serum gonadotropins is age dependent and that changes in clearance may contribute to the period during which circulating inhibin levels are elevated postinjection.