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1.
Transl Oncol ; 45: 101988, 2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38733642

RESUMEN

Radiation is one of the standard therapies for pediatric high-grade glioma (pHGG), of which the prognosis remains poor. To gain an in-depth understanding of biological consequences beyond the classic DNA damage, we treated 9 patient-derived orthotopic xenograft (PDOX) models, including one with DNA mismatch repair (MMR) deficiency, with fractionated radiations (2 Gy/day x 5 days). Extension of survival time was noted in 5 PDOX models (P < 0.05) accompanied by γH2AX positivity in >95 % tumor cells in tumor core and >85 % in the invasive foci as well as ∼30 % apoptotic and mitotic catastrophic cell death. The model with DNA MMR (IC-1406HGG) was the most responsive to radiation with a reduction of Ki-67(+) cells. Altered metabolism, including mitochondria number elevation, COX IV activation and reactive oxygen species accumulation, were detected together with the enrichment of CD133+ tumor cells. The latter was caused by the entry of quiescent G0 cells into cell cycle and the activation of self-renewal (SOX2 and BMI1) and epithelial mesenchymal transition (fibronectin) genes. These novel insights about the cellular and molecular mechanisms of fractionated radiation in vivo should support the development of new radio-sensitizing therapies.

2.
Cell Death Differ ; 31(5): 683-696, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38589496

RESUMEN

Protein phosphatase 1 catalytic subunit gamma (PPP1CC) promotes DNA repair and tumor development and progression, however, its underlying mechanisms remain unclear. This study investigated the molecular mechanism of PPP1CC's involvement in DNA repair and the potential clinical implications. High expression of PPP1CC was significantly correlated with radioresistance and poor prognosis in human nasopharyngeal carcinoma (NPC) patients. The mechanistic study revealed that PPP1CC bound to Ku70/Ku80 heterodimers and activated DNA-PKcs by promoting DNA-PK holoenzyme formation, which enhanced nonhomologous end junction (NHEJ) -mediated DNA repair and led to radioresistance. Importantly, BRCA1-BRCA2-containing complex subunit 3 (BRCC3) interacted with PPP1CC to enhance its stability by removing the K48-linked polyubiquitin chain at Lys234 to prevent PPP1CC degradation. Therefore, BRCC3 helped the overexpressed PPP1CC to maintain its high protein level, thereby sustaining the elevation of DNA repair capacity and radioresistance. Our study identified the molecular mechanism by which PPP1CC promotes NHEJ-mediated DNA repair and radioresistance, suggesting that the BRCC3-PPP1CC-Ku70 axis is a potential therapeutic target to improve the efficacy of radiotherapy.


Asunto(s)
Reparación del ADN por Unión de Extremidades , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas , Proteína Fosfatasa 1 , Tolerancia a Radiación , Humanos , Carcinoma Nasofaríngeo/radioterapia , Carcinoma Nasofaríngeo/patología , Carcinoma Nasofaríngeo/genética , Carcinoma Nasofaríngeo/metabolismo , Proteína Fosfatasa 1/metabolismo , Proteína Fosfatasa 1/genética , Neoplasias Nasofaríngeas/radioterapia , Neoplasias Nasofaríngeas/genética , Neoplasias Nasofaríngeas/patología , Neoplasias Nasofaríngeas/metabolismo , Tolerancia a Radiación/genética , Pronóstico , Línea Celular Tumoral , Autoantígeno Ku/metabolismo , Autoantígeno Ku/genética , Animales , Proteína Quinasa Activada por ADN/metabolismo , Proteína Quinasa Activada por ADN/genética , Ratones Desnudos , Femenino , Masculino , Reparación del ADN , Ratones
3.
Plants (Basel) ; 13(7)2024 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-38611512

RESUMEN

As global food security faces challenges, enhancing crop yield and stress resistance becomes imperative. This study comprehensively explores the impact of nanomaterials (NMs) on Gramineae plants, with a focus on the effects of various types of nanoparticles, such as iron-based, titanium-containing, zinc, and copper nanoparticles, on plant photosynthesis, chlorophyll content, and antioxidant enzyme activity. We found that the effects of nanoparticles largely depend on their chemical properties, particle size, concentration, and the species and developmental stage of the plant. Under appropriate conditions, specific NMs can promote the root development of Gramineae plants, enhance photosynthesis, and increase chlorophyll content. Notably, iron-based and titanium-containing nanoparticles show significant effects in promoting chlorophyll synthesis and plant growth. However, the impact of nanoparticles on oxidative stress is complex. Under certain conditions, nanoparticles can enhance plants' antioxidant enzyme activity, improving their ability to withstand environmental stresses; excessive or inappropriate NMs may cause oxidative stress, affecting plant growth and development. Copper nanoparticles, in particular, exhibit this dual nature, being beneficial at low concentrations but potentially harmful at high concentrations. This study provides a theoretical basis for the future development of nanofertilizers aimed at precisely targeting Gramineae plants to enhance their antioxidant stress capacity and improve photosynthesis efficiency. We emphasize the importance of balancing the agricultural advantages of nanotechnology with environmental safety in practical applications. Future research should focus on a deeper understanding of the interaction mechanisms between more NMs and plants and explore strategies to reduce potential environmental impacts to ensure the health and sustainability of the ecosystem while enhancing the yield and quality of Gramineae crops.

4.
Angew Chem Int Ed Engl ; 63(15): e202400577, 2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-38284909

RESUMEN

Atomically dispersed metal-nitrogen-carbon (M-N-C) catalysts have exhibited encouraging oxygen reduction reaction (ORR) activity. Nevertheless, the insufficient long-term stability remains a widespread concern owing to the inevitable 2-electron byproducts, H2O2. Here, we construct Co-N-Cr cross-interfacial electron bridges (CIEBs) via the interfacial electronic coupling between Cr2O3 and Co-N-C, breaking the activity-stability trade-off. The partially occupied Cr 3d-orbitals of Co-N-Cr CIEBs induce the electron rearrangement of CoN4 sites, lowering the Co-OOH* antibonding orbital occupancy and accelerating the adsorption of intermediates. Consequently, the Co-N-Cr CIEBs suppress the two-electron ORR process and approach the apex of Sabatier volcano plot for four-electron pathway simultaneously. As a proof-of-concept, the Co-N-Cr CIEBs is synthesized by the molten salt template method, exhibiting dominant 4-electron selectively and extremely low H2O2 yield confirmed by Damjanovic kinetic analysis. The Co-N-Cr CIEBs demonstrates impressive bifunctional oxygen catalytic activity (▵E=0.70 V) and breakthrough durability including 100 % current retention after 10 h continuous operation and cycling performance over 1500 h for Zn-air battery. The hybrid interfacial configuration and the understanding of the electronic coupling mechanism reported here could shed new light on the design of superdurable M-N-C catalysts.

5.
Arthritis Rheumatol ; 76(4): 599-613, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37946666

RESUMEN

OBJECTIVE: The peripheral B cell compartment is heavily disturbed in systemic lupus erythematosus (SLE), but whether B cells develop aberrantly in the bone marrow (BM) is largely unknown. METHODS: We performed single-cell RNA/B cell receptor (BCR) sequencing and immune profiling of BM B cells and classified patients with SLE into two groups: early B cell (Pro-B and Pre-B) normal (EBnor) and EB defective/low (EBlo) groups. RESULTS: The SLE-EBlo group exhibited more severe disease activity and proinflammatory status, overaction of type I interferon signaling and metabolic pathways within the B cell compartment, and aberrant BCR repertoires compared with the SLE-EBnor group. Moreover, in one patient with SLE who was initially classified in the SLE-EBlo group, early B cell deficiency and associated abnormalities were largely rectified in a second BM sample at the remission phase. CONCLUSION: In summary, this study suggests that early B cell loss in BM defines a unique pathological state in a subset of patients with SLE that may play an active role in the dysregulated autoimmune responses.


Asunto(s)
Médula Ósea , Lupus Eritematoso Sistémico , Humanos , Niño , Médula Ósea/patología , Discapacidades del Desarrollo/metabolismo , Discapacidades del Desarrollo/patología , Linfocitos B , Transducción de Señal
6.
Cancer Med ; 12(24): 22091-22102, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-38073447

RESUMEN

BACKGROUND AND PURPOSE: To identify anatomic prognostic factors and their potential roles in refining M1 classification for de novo metastatic nasopharyngeal carcinoma (M1-NPC). MATERIALS AND METHODS: All M1-NPC treated with chemotherapy and/or radiotherapy between 2010 and 2019 from two centers (training and validation cohort) were included. The prognostic value of metastatic disease extent and involved organs for overall survival (OS) were assessed by several multivariable analyses (MVA) models. A new M1 classification was proposed and validated in a separate cohort who received immuno-chemotherapy. RESULTS: A total of 197 M1-NPC in the training and 307 in the validation cohorts were included for M1 subdivision study with median follow-up of 46 and 57 months. MVA model with "≤2 organs/≤5 lesions" as the definition of oligometastasis had the highest C-index (0.623) versus others (0.606-0.621). Patients with oligometastasis had better OS versus polymetastasis (hazard ratio [HR] 0.47/0.63) while liver metastases carried worse OS (HR 1.57/1.45) in MVA in the training/validation cohorts, respectively. We proposed to divide M1-NPC into M1a (oligometastasis without liver metastases) and M1b (liver metastases or polymetastasis) with 3-year OS of 66.5%/31.7% and 64.9%/35.0% in the training/validation cohorts, respectively. M1a subset had a better median progress-free survival (not reach vs. 17 months, p < 0.001) in the immuno-chemotherapy cohort (n = 163). CONCLUSION: Oligometastasis (≤2 organs/≤5 lesions) and liver metastasis are prognostic for M1-NPC. Subdivision of M1-NPC into M1a (oligometastasis without liver metastasis) and M1b (liver metastasis or polymetastasis) depicts the prognosis well in M1-NPC patients who received immuno-chemotherapy.


Asunto(s)
Neoplasias Hepáticas , Neoplasias Nasofaríngeas , Humanos , Carcinoma Nasofaríngeo/terapia , Carcinoma Nasofaríngeo/patología , Pronóstico , Estadificación de Neoplasias , Neoplasias Nasofaríngeas/patología , Neoplasias Hepáticas/patología , Estudios Retrospectivos
7.
Int J Mol Sci ; 24(19)2023 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-37834154

RESUMEN

Glioblastoma multiforme (GBM) is a highly aggressive malignancy and represents the most common brain tumor in adults. To better understand its biology for new and effective therapies, we examined the role of GDP-mannose pyrophosphorylase B (GMPPB), a key unit of the GDP-mannose pyrophosphorylase (GDP-MP) that catalyzes the formation of GDP-mannose. Impaired GMPPB function will reduce the amount of GDP-mannose available for O-mannosylation. Abnormal O-mannosylation of alpha dystroglycan (α-DG) has been reported to be involved in cancer metastasis and arenavirus entry. Here, we found that GMPPB is highly expressed in a panel of GBM cell lines and clinical samples and that expression of GMPPB is positively correlated with the WHO grade of gliomas. Additionally, expression of GMPPB was negatively correlated with the prognosis of GBM patients. We demonstrate that silencing GMPPB inhibits the proliferation, migration, and invasion of GBM cells both in vitro and in vivo and that overexpression of GMPPB exhibits the opposite effects. Consequently, targeting GMPPB in GBM cells results in impaired GBM tumor growth and invasion. Finally, we identify that the Hippo/MMP3 axis is essential for GMPPB-promoted GBM aggressiveness. These findings indicate that GMPPB represents a potential novel target for GBM treatment.


Asunto(s)
Neoplasias Encefálicas , Silenciador del Gen , Glioblastoma , Adulto , Humanos , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/metabolismo , Línea Celular Tumoral , Proliferación Celular , Regulación Neoplásica de la Expresión Génica , Glioblastoma/genética , Glioblastoma/metabolismo , Manosa , Metaloproteinasa 3 de la Matriz/metabolismo
8.
Biomed Pharmacother ; 165: 115231, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37516022

RESUMEN

Male infertility is a global concern, with a noticeable increase in the decline of spermatogenesis and sperm quality. However, there are limited clinically effective treatments available. This study aimed to investigate the potential effectiveness of puerarin in treating male infertility, which leads to gonadal changes. The results obtained from various analyses such as CASA, immunofluorescence, DIFF-Quick, hematoxylin and eosin (H&E), and periodic acid-Schiff (PAS) staining demonstrated that puerarin supplementation significantly alleviated the busulfan-induced reduction in spermatogenesis and sperm quality in both young and adult mice. Furthermore, puerarin exhibited a marked improvement in the damage caused by busulfan to the architecture of seminiferous tubules, causal epididymis, blood-testicular barrier (BTB), as well as spermatogonia and Sertoli cells. Similarly, puerarin significantly reduced the levels of total antioxidant capacity (T-AOC), malondialdehyde (MDA), and caspase-3 in the testes of busulfan-induced mice, as determined by microplate reader analysis. Additionally, RNA-seq data, RT-qPCR, and western blotting revealed that puerarin restored the abnormal gene expressions induced by busulfan to nearly healthy levels. Notably, puerarin significantly reversed the impact of busulfan on the expression of marker genes involved in spermatogenesis and oxidative stress. Moreover, puerarin suppressed the phosphorylation of p38, ERK1/2, and JNK in the testes, as observed through testicular analysis. Consequently, this study concludes that puerarin may serve as a potential alternative for treating busulfan-induced damage to male fertility by inactivating the testicular MAPK pathways. These findings may pave the way for the use of puerarin in addressing chemotherapy- or other factors-induced male infertility in humans.


Asunto(s)
Busulfano , Infertilidad Masculina , Humanos , Masculino , Animales , Ratones , Busulfano/toxicidad , Semen , Espermatogénesis , Testículo , Infertilidad Masculina/inducido químicamente , Infertilidad Masculina/tratamiento farmacológico , Infertilidad Masculina/metabolismo
9.
Plants (Basel) ; 12(13)2023 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-37447115

RESUMEN

Persistent luminescence materials (PLMs) are widely used across a multitude of fields due to their distinct optical properties. However, like other micron-sized materials such as microplastics, the production and recycling processes of PLMs can lead to their accumulation in soil and water, potentially posing detrimental effects on plant growth and development. In this study, we investigated the impact of commercially available blue PLM (bPLM), green PLM (gPLM), and red PLM (rPLM) on germination, seedling growth, and oxidative stress responses in rice. Our findings demonstrate that the morphology and size of PLMs do not significantly differ in their effects on rice growth. All three types of PLMs significantly inhibited root length and stem length, disrupted root cell structures, and decreased seedling biomass. Interestingly, gPLM and bPLM were found to stimulate the synthesis of osmolytes and chlorophyll in rice, while rPLM had the opposite effect. Changes in the antioxidant enzyme system in rice clearly indicated that the three types of PLMs induced reactive oxygen species (ROS) damage in rice. This study enhances our understanding of the potential environmental impacts of PLMs, offering valuable insights for the safe and responsible use of these materials in various applications.

10.
iScience ; 26(6): 106932, 2023 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-37378335

RESUMEN

Chemotherapy remains controversial for stage II nasopharyngeal carcinoma because of its considerable prognostic heterogeneity. We aimed to develop an MRI-based deep learning model for predicting distant metastasis and assessing chemotherapy efficacy in stage II nasopharyngeal carcinoma. This multicenter retrospective study enrolled 1072 patients from three Chinese centers for training (Center 1, n = 575) and external validation (Centers 2 and 3, n = 497). The deep learning model significantly predicted the risk of distant metastases for stage II nasopharyngeal carcinoma and was validated in the external validation cohort. In addition, the deep learning model outperformed the clinical and radiomics models in terms of predictive performance. Furthermore, the deep learning model facilitates the identification of high-risk patients who could benefit from chemotherapy, providing useful additional information for individualized treatment decisions.

11.
Molecules ; 28(9)2023 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-37175229

RESUMEN

Luminescent polymer nanomaterials not only have the characteristics of various types of luminescent functional materials and a wide range of applications, but also have the characteristics of good biocompatibility and easy functionalization of polymer nanomaterials. They are widely used in biomedical fields such as bioimaging, biosensing, and drug delivery. Designing and constructing new controllable synthesis methods for multifunctional fluorescent polymer nanomaterials with good water solubility and excellent biocompatibility is of great significance. Exploring efficient functionalization methods for luminescent materials is still one of the core issues in the design and development of new fluorescent materials. With this in mind, this review first introduces the structures, properties, and synthetic methods regarding fluorescent polymeric nanomaterials. Then, the functionalization strategies of fluorescent polymer nanomaterials are summarized. In addition, the research progress of multifunctional fluorescent polymer nanomaterials for bioimaging is also discussed. Finally, the synthesis, development, and application fields of fluorescent polymeric nanomaterials, as well as the challenges and opportunities of structure-property correlations, are comprehensively summarized and the corresponding perspectives are well illustrated.


Asunto(s)
Nanoestructuras , Polímeros , Polímeros/química , Nanoestructuras/química , Colorantes , Sistemas de Liberación de Medicamentos
12.
Biomedicines ; 11(2)2023 Feb 07.
Artículo en Inglés | MEDLINE | ID: mdl-36831011

RESUMEN

Mitochondrial isocitrate dehydrogenase 2 (IDH2) is an important metabolic enzyme in the tricarboxylic acid cycle (TCA) cycle. Our previous study showed that high expression of wild-type IDH2 promotes the proliferation of lung cancer cells. This study aims to test the potential of targeting IDH2 as a therapeutic strategy to inhibit lung cancer in vitro and in vivo. First, we analyzed the available data from the databases gene expression omnibus (GEO) database to evaluate the clinical relevance of IDH2 expression in affecting lung cancer patient survival. We then generated a stable IDH2-knockdown lung cancer cell line using a lentivirus-based method for in vitro and in vivo study. Cell growth, apoptosis, cell viability, and colony formation assays were conducted to test the sensitivity of lung cancer cells with different IDH2 expression status to cisplatin or radiation treatment in vitro. For mechanistic study, Cellular oxygen consumption and extracellular acidification rates were measured using a Seahorse metabolic analyzer, and reactive oxygen species (ROS) generation was analyzed using flow cytometry. An animal study using a xenograft tumor model was performed to further evaluate the in vivo therapeutic effect on tumor growth. We found that high IDH2 expression was associated with poor survival in lung cancer patients undergoing chemotherapy. Inhibition of IDH2 significantly enhanced the anticancer activity of cisplatin and also increased the effect of radiation against lung cancer cells. IDH2 was upregulated in cisplatin-resistant lung cancer cells, which could be sensitized by targeted inhibition of IDH2. Mechanistic study showed that abrogation of IDH2 caused only minimal changes in oxygen consumption rate (OCR) and extracellular acidification rate (ECAR) in lung cancer cells, but induced a significant increase in ROS, which rendered the cancer cells more sensitive to cisplatin. Pretreatment of lung cancer cells with the ROS scavenger N-acetyl-cysteine could partially rescue cells from the cytotoxic effect of cisplatin and IDH2 inhibition. Importantly, abrogation of IDH2 significantly increased the sensitivity of lung cancer cells to cisplatin in vivo.

13.
Tissue Cell ; 81: 102005, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36608640

RESUMEN

Idiopathic pulmonary fibrosis (IPF) is a common chronic and progressive lung disease. Fibulin-2 (FBLN2) is upregulated in patients with IPF; however, its exact role in IPF remains unclear. The present study aimed to investigate the role and the regulatory mechanism of FBLN2 in TGF-ß1-induced fibrogenesis using human lung fibroblast-derived MRC-5 cells. Cell transfection was performed to regulate FBLN2 expression. Reverse transcription-quantitative PCR and western blot analyses were performed to detect the expression levels of FBLN2 and vitronectin (VTN). Cell viability and migration were determined via the Cell Counting Kit-8 and wound healing assays, respectively. Immunofluorescence was performed to detect α-smooth muscle actin (α-SMA)-positive cells. The STRING database was used to predict the interaction between FBLN2 and VTN, which was verified via the protein immunoprecipitation assay. The results demonstrated that inhibition of FBLN2 notably inhibited TGF-ß1-induced proliferation and migration, as well as downregulating the protein expression levels of MMP2 and MMP9 in MRC-5 cells. In addition, inhibition of FBLN2 suppressed the expression levels of α-SMA, collagen type 1 α1 and fibronectin. FBLN2 was demonstrated to bind to VTN and negatively regulate its expression. Furthermore, overexpression of VTN partly abolished the inhibitory effects of FBLN2 knockdown on TGF-ß1-induced proliferation, migration and fibrosis, as well as the activity of focal adhesion kinase (FAK) signaling. Taken together, the results of the present study suggest that FBLN2 knockdown can attenuate TGF-ß1-induced fibrosis in MRC-5 cells by downregulating VTN expression via FAK signaling. Thus, FBLN2 may be a potential therapeutic target for IPF treatment.


Asunto(s)
Movimiento Celular , Proteínas de la Matriz Extracelular , Factor de Crecimiento Transformador beta1 , Vitronectina , Humanos , Proteínas de Unión al Calcio/genética , Proteínas de Unión al Calcio/metabolismo , Movimiento Celular/genética , Proteínas de la Matriz Extracelular/genética , Proteínas de la Matriz Extracelular/metabolismo , Fibroblastos/metabolismo , Fibrosis/genética , Fibrosis/metabolismo , Factor de Crecimiento Transformador beta1/metabolismo , Factor de Crecimiento Transformador beta1/farmacología , Vitronectina/metabolismo
14.
Radiother Oncol ; 178: 109436, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36464180

RESUMEN

BACKGROUND AND PURPOSE: This multicenter retrospective study aimed to investigated the prognostic value of unequivocal radiologic extranodal extension (rENE) and the efficacy of chemotherapy for stage T1-2 N1 nasopharyngeal carcinoma (NPC) in the IMRT era. MATERIALS AND METHODS: We included 1,082 patients treated in 2005-2017 from three centers. rENE was recorded as G1 (coalescent nodal mass comprising ≥ 2 inseparable nodes) or G2 (invading beyond perinodal fat to frankly infiltrate adjacent structures). Multivariable analysis (MVA) evaluated the prognostic value of rENE. The value of chemotherapy was assessed in rENE-positive (rENE + ) and rENE-negative (rENE - ) subset separately. RESULTS: Centers 1, 2, and 3 had 139/515 (27.0 %), 100/365 (27.4 %), and 43/202 (21.3 %) cN + patients with rENE, respectively. Compared to rENE-, rENE + patients had a worse distant metastasis-free survival (DMFS) and overall survival (OS) (all p < 0.001). MVA confirmed the prognostic of both G1-rENE and G2-rENE for distant metastasis [G1: hazard ratio (HR): 2.933, G2: HR: 6.942, all p < 0.001] and death (G1: HR: 1.587, p = 0.040; G2: HR: 6.162, p < 0.001). There was no significant difference for DMFS and OS between chemo-radiotherapy and radiotherapy alone in rENE + and rENE - groups (all p > 0.1). However, rENE + patients with a cumulative cisplatin/nedaplatin dose (CCND) of > 160 mg/m2 had an improved DMFS (p = 0.033) but no OS (p = 0.197). CONCLUSION: Unequivocal rENE is prognostic in patients with T1-2 N1 NPC. Addition of chemotherapy to radiotherapy did not affect DMFS and OS in rENE - patients. Chemotherapy with a CCND of > 160 mg/m2 improved DMFS in rENE + patients.


Asunto(s)
Neoplasias Nasofaríngeas , Radioterapia de Intensidad Modulada , Humanos , Carcinoma Nasofaríngeo/patología , Estudios Retrospectivos , Extensión Extranodal/patología , Neoplasias Nasofaríngeas/tratamiento farmacológico , Neoplasias Nasofaríngeas/patología , Estadificación de Neoplasias , Pronóstico , Cisplatino/uso terapéutico
15.
Med Decis Making ; 43(2): 175-182, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36062810

RESUMEN

BACKGROUND: Clinicians' decision thresholds for initiating antibiotics in patients with suspected sepsis have not been quantified. We aimed to define an average threshold of infection likelihood at which clinicians initiate antibiotics when treating a patient with suspected infection and to evaluate the influence of severity of illness and clinician-related factors on the threshold. DESIGN: This was a prospective survey of 153 clinicians responding to 8 clinical vignettes constructed from real-world data from 3 health care systems in the United States. We treated each hour in the vignette as a decision to treat or not treat with antibiotics and assigned an infection probability to each hour using a previously developed infection prediction model. We then estimated decision thresholds using regression models based on the timing of antibiotic initiation. We compared thresholds across categories of severity of illness and clinician-related factors. RESULTS: Overall, the treatment threshold occurred at a 69% probability of infection, but the threshold varied significantly across severity of illness categories-when patients had high severity of illness, the treatment threshold occurred at a 55% probability of infection; when patients had intermediate severity, the threshold for antibiotic initiation occurred at an infection probability of 69%, and the threshold was 84% when patients had low severity of illness (P < 0.001 for group differences). Thresholds differed significantly across specialty, highest among infectious disease and lowest among emergency medicine clinicians and across years of experience, decreasing with increasing years of experience. CONCLUSIONS: The threshold infection probability above which physicians choose to initiate antibiotics in suspected sepsis depends on illness severity as well as clinician factors. IMPLICATIONS: Incorporating these context-dependent thresholds into discriminating and well-calibrated models will inform the development of future sepsis clinical decision support systems. Clinician-related differences in treatment thresholds suggests potential unwarranted variation and opportunities for performance improvement. HIGHLIGHTS: Decision making about antibiotic initiation in suspected sepsis occurs under uncertainty, and little is known about clinicians' thresholds for treatment.In this prospective study, 153 clinicians from 3 health care systems reviewed 8 real-world clinical vignettes representing patients with sepsis and indicated the time that they would initiate antibiotics.Using a model-based approach, we estimated decision thresholds and found that thresholds differed significantly across illness severity categories and by clinician specialty and years of experience.


Asunto(s)
Médicos , Sepsis , Humanos , Estados Unidos , Estudios Prospectivos , Antibacterianos/uso terapéutico , Sepsis/tratamiento farmacológico , Gravedad del Paciente
17.
ACS Appl Mater Interfaces ; 14(48): 53819-53827, 2022 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-36414243

RESUMEN

Developing low-loading Pt-based catalysts possessing glorious catalytic performance can accelerate oxygen reduction reaction (ORR) and hence significantly advance the commercialization of proton exchange membrane fuel cells. In this report, we propose a hybrid catalyst that consists of low-loading sub-3 nm PtCo intermetallic nanoparticles carried on Co-N-C (PtCo/Co-N-C) via the microwave-assisted polyol procedure and subsequent heat treatment. Atomically dispersed Co atoms embedded in the Co-N-C carriers diffuse into the lattice of Pt, thus forming ultrasmall PtCo intermetallic nanoparticles. Owing to the dual effect of the enhanced metal-support interaction and alloy effect, as-fabricated PtCo/Co-N-C catalysts deliver an extraordinary performance, achieving a half-wave potential of 0.921 V, a mass activity of 0.700 A mgPt-1@0.9 V, and brilliant durability in the acidic medium. The fuel cell employing PtCo/Co-N-C as the cathode catalyst with an ultralow Pt loading of 0.05 mg cm-2 exhibits an impressive peak power density of 0.700 W cm-2, higher than that of commercial Pt/C under the same condition. Furthermore, the enhanced intrinsic ORR activity and stability are imputed to the downshifted d-band center and the strengthened metal-support interaction, as revealed by density functional theory calculations. This report affords a facile tactic to fabricate Pt-based alloy composite catalysts, which is also applicable to other alloy catalysts.

18.
Nat Commun ; 13(1): 6689, 2022 11 05.
Artículo en Inglés | MEDLINE | ID: mdl-36335125

RESUMEN

Recurrence is frequent in pediatric ependymoma (EPN). Our longitudinal integrated analysis of 30 patient-matched repeated relapses (3.67 ± 1.76 times) over 13 years (5.8 ± 3.8) reveals stable molecular subtypes (RELA and PFA) and convergent DNA methylation reprogramming during serial relapses accompanied by increased orthotopic patient derived xenograft (PDX) (13/27) formation in the late recurrences. A set of differentially methylated CpGs (DMCs) and DNA methylation regions (DMRs) are found to persist in primary and relapse tumors (potential driver DMCs) and are acquired exclusively in the relapses (potential booster DMCs). Integrating with RNAseq reveals differentially expressed genes regulated by potential driver DMRs (CACNA1H, SLC12A7, RARA in RELA and HSPB8, GMPR, ITGB4 in PFA) and potential booster DMRs (PLEKHG1 in RELA and NOTCH, EPHA2, SUFU, FOXJ1 in PFA tumors). DMCs predicators of relapse are also identified in the primary tumors. This study provides a high-resolution epigenetic roadmap of serial EPN relapses and 13 orthotopic PDX models to facilitate biological and preclinical studies.


Asunto(s)
Ependimoma , Simportadores , Humanos , Niño , Ependimoma/genética , Ependimoma/patología , Metilación de ADN/genética , Recurrencia , Epigénesis Genética , Simportadores/genética
19.
J Natl Cancer Inst ; 114(12): 1689-1697, 2022 12 08.
Artículo en Inglés | MEDLINE | ID: mdl-36066420

RESUMEN

BACKGROUND: Nasopharyngeal carcinoma (NPC) is closely associated with genetic factors and Epstein-Barr virus infection, showing strong familial aggregation. Individuals with a family history suffer elevated NPC risk, requiring effective genetic counseling for risk stratification and individualized prevention. METHODS: We performed whole-exome sequencing on 502 familial NPC patients and 404 unaffected relatives and controls. We systematically evaluated the established cancer predisposition genes and investigated novel NPC susceptibility genes, making comparisons with 21 other familial cancers in the UK biobank (N = 5218). RESULTS: Rare pathogenic mutations in the established cancer predisposition genes were observed in familial NPC patients, including ERCC2 (1.39%), TP63 (1.00%), MUTYH (0.80%), and BRCA1 (0.80%). Additionally, 6 novel susceptibility genes were identified. RAD54L, involved in the DNA repair pathway together with ERCC2, MUTYH, and BRCA1, showed the highest frequency (4.18%) in familial NPC. Enrichment analysis found mutations in TP63 were enriched in familial NPC, and RAD54L and EML2 were enriched in both NPC and other Epstein-Barr virus-associated cancers. Besides rare variants, common variants reported in the studies of sporadic NPC were also associated with familial NPC risk. Individuals in the top quantile of common variant-derived genetic risk score while carrying rare variants exhibited increased NPC risk (odds ratio = 13.47, 95% confidence interval = 6.33 to 28.68, P = 1.48 × 10-11); men in this risk group showed a cumulative lifetime risk of 24.19%, much higher than those in the bottom common variant-derived genetic risk score quantile and without rare variants (2.04%). CONCLUSIONS: This study expands the catalog of NPC susceptibility genes and provides the potential for risk stratification of individuals with an NPC family history.


Asunto(s)
Infecciones por Virus de Epstein-Barr , Neoplasias Nasofaríngeas , Masculino , Humanos , Carcinoma Nasofaríngeo/genética , Secuenciación del Exoma , Neoplasias Nasofaríngeas/epidemiología , Neoplasias Nasofaríngeas/genética , Predisposición Genética a la Enfermedad , Herpesvirus Humano 4/genética , Estudios de Casos y Controles , Proteína de la Xerodermia Pigmentosa del Grupo D/genética
20.
EBioMedicine ; 84: 104267, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36116213

RESUMEN

BACKGROUND: Nasopharyngeal carcinoma (NPC) exhibits significant familial aggregation; however, its susceptibility genes are largely unknown. Thus, this study aimed to identify germline mutations that might contribute to the risk of familial NPC, and explore their biological functions. METHODS: Whole-exome sequencing was performed in 13 NPC pedigrees with multiple cases. Mutations co-segregated with disease status were further validated in a cohort composed of 563 probands from independent families, 2,953 sporadic cases, and 3,175 healthy controls. Experimental studies were used to explore the functions of susceptibility genes and their disease-related mutations. FINDINGS: The three rare missense mutations in POLN (DNA polymerase nu) gene, P577L, R303Q, and F545C, were associated with familial NPC risk (5/576 [0·87%] in cases vs. 2/3374 [0·059%] in healthy controls with an adjusted OR of 44·84 [95% CI:3·91-514·34, p = 2·25 × 10-3]). POLN was involved in Epstein-Barr virus (EBV) lytic replication in NPC cells in vitro. POLN promoted viral DNA replication, immediate-early and late lytic gene expression, and progeny viral particle production, ultimately affecting the proliferation of host cells. The three mutations were located in two pivotal functional domains and were predicted to alter the protein stability of POLN in silico. Further assays demonstrated that POLN carrying any of the three mutations displayed reduced protein stability and decreased expression levels, thereby impairing its ability to promote complete EBV lytic replication and facilitate cell survival. INTERPRETATION: We identified a susceptibility gene POLN for familial NPC and elucidated its function. FUNDING: This study was funded by the National Key Research and Development Program of China (2021YFC2500400); the National Key Research and Development Program of China (2020YFC1316902); the Basic and Applied Basic Research Foundation of Guangdong Province, China (2021B1515420007); the National Natural Science Foundation of China (81973131); the National Natural Science Foundation of China (82003520); the National Natural Science Foundation of China (81903395).


Asunto(s)
ADN Polimerasa Dirigida por ADN , Infecciones por Virus de Epstein-Barr , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas , Replicación del ADN , ADN Viral/genética , ADN Viral/metabolismo , ADN Polimerasa Dirigida por ADN/genética , Infecciones por Virus de Epstein-Barr/complicaciones , Infecciones por Virus de Epstein-Barr/genética , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/metabolismo , Humanos , Mutación , Carcinoma Nasofaríngeo/genética , Neoplasias Nasofaríngeas/genética , Neoplasias Nasofaríngeas/patología , Replicación Viral
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