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1.
Int J Mol Sci ; 24(17)2023 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-37685847

RESUMO

Metallic nanoparticles (mNPs) are widely used as food additives and can interact with gliadin triggering an immune response, but evaluation of the effects on crypts, hypertrophic in celiac subjects, is still lacking. This study evaluated the effects of gold and silver mNPs in combination with gliadin on crypt-like cells (HIEC-6). Transmission electron microscopy (TEM) was used to evaluate gliadin-mNP aggregates in cells. Western blot and immunofluorescence analysis assessed autophagy-related molecule levels (p62, LC3, beclin-1, EGFR). Lysosome functionality was tested with acridine orange (AO) and Magic Red assays. TEM identified an increase in autophagic vacuoles after exposure to gliadin + mNPs, as also detected by significant increments in LC3-II and p62 expression. Immunofluorescence confirmed the presence of mature autophagosomes, showing LC3 and p62 colocalization, indicating an altered autophagic flux, further assessed with EGFR degradation, AO and Magic Red assays. The results showed a significant reduction in lysosomal enzyme activity and a modest reduction in acidity. Thus, gliadin + mNPs can block the autophagic flux inducing a lysosomal defect. The alteration of this pathway, essential for cell function, can lead to cell damage and death. The potential effects of this copresence in food should be further characterized to avoid a negative impact on celiac disease subjects.


Assuntos
Ouro , Nanopartículas , Humanos , Glutens , Prata , Gliadina , Autofagia , Laranja de Acridina , Receptores ErbB
2.
Pediatr Res ; 91(1): 129-136, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34465872

RESUMO

BACKGROUND: Necrotizing enterocolitis (NEC) is a major challenge for premature infants in neonatal intensive care units and efforts toward the search for indicators that could be used to predict the development of the disease have given limited results until now. METHODS: In this study, stools from 132 very low birth weight infants were collected daily in the context of a multi-center prospective study aimed at investigating the potential of fecal biomarkers for NEC prediction. Eight infants (~6%) received a stage 3 NEC diagnosis. Their stools collected up to 10 days before diagnosis were included and matched with 14 non-NEC controls and tested by ELISA for the quantitation of eight biomarkers. RESULTS: Biomarkers were evaluated in all available stool samples leading to the identification of lipocalin-2 and calprotectin as the two most reliable predicting markers over the 10-day period prior to NEC development. Pooling the data for each infant confirmed the significance of lipocalin-2 and calprotectin, individually and in combination 1 week in advance of the NEC clinical diagnosis. CONCLUSIONS: The lipocalin-2 and calprotectin tandem represents a significant biomarker signature for predicting NEC development. Although not yet fulfilling the "perfect biomarker" criteria, it represents a first step toward it. IMPACT: Stool biomarkers can be used to predict NEC development in very low birth weight infants more than a week before the diagnosis. LCN2 was identified as a new robust biomarker for predicting NEC development, which used in conjunction with CALPRO, allows the identification of more than half of the cases that will develop NEC in very low birth weight infants. Combining more stool markers with the LCN2/CALPRO tandem such as PGE2 can further improve the algorithm for the prediction of NEC development.


Assuntos
Enterocolite Necrosante/diagnóstico , Fezes/química , Recém-Nascido Prematuro , Complexo Antígeno L1 Leucocitário/metabolismo , Lipocalina-2/metabolismo , Biomarcadores/metabolismo , Enterocolite Necrosante/metabolismo , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino
3.
Ann Intern Med ; 173(6): 417-425, 2020 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-32716707

RESUMO

BACKGROUND: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors could increase the risk for diabetic ketoacidosis (DKA). OBJECTIVE: To assess whether SGLT-2 inhibitors, compared with dipeptidyl peptidase-4 (DPP-4) inhibitors, are associated with an increased risk for DKA in patients with type 2 diabetes. DESIGN: Population-based cohort study; prevalent new-user design between 2013 and 2018. (ClinicalTrials.gov: NCT04017221). SETTING: Electronic health care databases from 7 Canadian provinces and the United Kingdom. PATIENTS: 208 757 new users of SGLT-2 inhibitors were matched by using time-conditional propensity scores to 208 757 recipients of DPP-4 inhibitors. MEASUREMENTS: Cox proportional hazards models estimated site-specific hazard ratios (HRs) with 95% CIs of DKA comparing receipt of SGLT-2 inhibitors with receipt of DPP-4 inhibitors, which were pooled by using random-effects models. Secondary analyses were stratified by molecule, age, sex, and prior receipt of insulin. RESULTS: Overall, 521 patients were diagnosed with DKA during 370 454 person-years of follow-up (incidence rate per 1000 person-years, 1.40 [95% CI, 1.29 to 1.53]). Compared with DPP-4 inhibitors, SGLT-2 inhibitors were associated with an increased risk for DKA (incidence rate, 2.03 [CI, 1.83 to 2.25] versus 0.75 [CI, 0.63 to 0.89], respectively; HR, 2.85 [CI, 1.99 to 4.08]). Molecule-specific HRs were 1.86 (CI, 1.11 to 3.10) for dapagliflozin, 2.52 (CI, 1.23 to 5.14) for empagliflozin, and 3.58 (CI, 2.13 to 6.03) for canagliflozin. Age and sex did not modify the association; prior receipt of insulin appeared to decrease the risk. LIMITATIONS: There was unmeasured confounding and no laboratory data were available for the majority of patients, and molecule-specific analyses were conducted at a limited number of sites. CONCLUSION: SGLT-2 inhibitors were associated with an almost 3-fold increased risk for DKA, with molecule-specific analyses suggesting a class effect. PRIMARY FUNDING SOURCE: Canadian Institutes of Health Research.


Assuntos
Cetoacidose Diabética/induzido quimicamente , Hipoglicemiantes/efeitos adversos , Inibidores do Transportador 2 de Sódio-Glicose/efeitos adversos , Adulto , Fatores Etários , Idoso , Diabetes Mellitus Tipo 2/tratamento farmacológico , Inibidores da Dipeptidil Peptidase IV/efeitos adversos , Inibidores da Dipeptidil Peptidase IV/uso terapêutico , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Adulto Jovem
4.
Diabetes Obes Metab ; 22(9): 1648-1658, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32383792

RESUMO

AIM: To compare urosepsis rates in patients with type 2 diabetes treated using sodium-glucose co-transporter-2 inhibitors (SGLT2i) with dipeptidyl peptidase-4 inhibitors (DPP4i) in a real-world setting. METHODS: We conducted a matched cohort study using a prevalent new-user design with time-conditional propensity scores. New users of SGLT2i from seven Canadian provinces and the UK were matched to DPP4i users. The primary outcome was hospitalization with a diagnosis of urosepsis and the secondary outcome was Fournier's gangrene. Site-specific hazard ratios for urosepsis comparing SGLT2i with DPP4i were estimated using Cox proportional hazards models and pooled using a random effects meta-analysis. RESULTS: We included 208 244 users of SGLT2i and 208 244 users of DPP4i. Among SGLT2i users, 42% initiated canagliflozin, 31% dapagliflozin and 27% empagliflozin. During a mean follow-up of 0.9 years, patients initiating SGLT2i had a lower rate of urosepsis compared with those receiving DPP4i. The pooled adjusted hazard ratio was 0.58 (95% confidence interval [CI]: 0.42-0.80). The incidence rates of Fournier's gangrene were numerically similar in SGLT2i (0.08 per 1000 person-years; 95% CI: 0.05-0.13) and DPP4i users (0.14; 95% CI: 0.09-0.21). CONCLUSIONS: In this large, multi-site study, we did not observe an increased risk for urosepsis associated with SGLT2i compared with DPP4i among patients with type 2 diabetes in a real-world setting.


Assuntos
Diabetes Mellitus Tipo 2 , Inibidores da Dipeptidil Peptidase IV , Inibidores do Transportador 2 de Sódio-Glicose , Simportadores , Canadá , Estudos de Coortes , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Glucose , Humanos , Sódio , Inibidores do Transportador 2 de Sódio-Glicose/efeitos adversos , Resultado do Tratamento
5.
J Pediatr Gastroenterol Nutr ; 68(5): 623-629, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31022092

RESUMO

BACKGROUND AND OBJECTIVE: The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with a broad spectrum of life-threatening adverse effects on the immature gastrointestinal tract. NSAID derivatives exploiting the beneficial effects of biologically active gases, such as hydrogen sulfide (H2S), have been developed. Herein, we determined the effects of ketoprofen and ATB-352, a H2S-releasing ketoprofen derivative, on selected metabolic pathways previously identified to be significantly altered by indomethacin in the human immature intestine. METHODS: Ketoprofen and ATB-352 were tested on human mid-gestation small intestinal explants maintained in a serum-free organ culture system for 48 hours. The expression levels of the representative genes involved in selected metabolic pathways were measured by real-time PCR after a treatment of 48 hours. RESULTS: Tested at a concentration that allows more than 80% inhibition of PGE2 production, ketoprofen was found to be less damaging than indomethacin at an equivalent dosage. However, based on the inducibility of cyclooxygenase-2 transcript expression, we were able to discriminate between responder individuals in which the deleterious effects observed with indomethacin were attenuated, and non-responder specimens in which the effects were similar to those observed with indomethacin. ATB-352 did not induce significant changes compared to ketoprofen on these metabolic pathways. CONCLUSIONS: These results show less damaging effects of ketoprofen compared to indomethacin on the immature intestine and indicate that the intestinal response to this NSAID significantly varies between individuals. However, the results did not allow us to demonstrate a specific beneficial effect of H2S release in organ culture.


Assuntos
Anti-Inflamatórios não Esteroides/farmacologia , Indometacina/farmacologia , Intestino Delgado/efeitos dos fármacos , Cetoprofeno/farmacologia , Transdução de Sinais/efeitos dos fármacos , Ciclo-Oxigenase 2/efeitos dos fármacos , Humanos , Intestino Delgado/embriologia , Cetoprofeno/análogos & derivados
6.
Biochem Biophys Res Commun ; 495(1): 1510-1515, 2018 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-29198708

RESUMO

Interactions between cells and the extracellular matrix regulate a wide range of cell processes such as proliferation and differentiation. Laminins are major components of the basement membrane that actively participate in most biological functions via their interactions with a variety of specific cell receptors. The α5-containing laminins (LAMA5) are one of the three main types of laminins identified at the epithelial basal lamina in the adult intestine. The aim of the present study was to investigate the role of α5-containing laminins on intestinal cell proliferation and differentiation. Using an shRNA targeting approach, the effects of knocking down the expression of LAMA5 were investigated in the enterocytic-like Caco-2/15 cell line, a well-characterized model for intestinal cell differentiation. Surprisingly, the abolition of the laminin α5 chain resulted in a drastic increase in the differentiation marker sucrase-isomaltase which was correctly expressed at the apical pole of the cells as observed by indirect immunofluorescence. Transient increases of dipeptidylpeptidase IV, villin, CDX2, HNF-1α, HNF-4α and transepithelial resistance as well as an apparent redistribution of the junctional components ZO-1 and E-cadherin were also observed at early stages of differentiation but no specific effect was observed on cell proliferation as evaluated by BrdU incorporation. Taken together, these data suggest that α5-containing laminins repress intestinal differentiation in its early stages.


Assuntos
Diferenciação Celular/fisiologia , Enterócitos/citologia , Enterócitos/fisiologia , Proteínas da Matriz Extracelular/metabolismo , Intestinos/citologia , Laminina/metabolismo , Animais , Células CACO-2 , Proliferação de Células/fisiologia , Técnicas de Silenciamento de Genes , Humanos , Intestinos/fisiologia
7.
Pediatr Res ; 84(6): 813-820, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30341414

RESUMO

BACKGROUND: The use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin (INDO) and ibuprofen (IBU) has been shown to be an effective therapy for the closure of patent ductus arteriosus (PDA). However, this treatment has been associated with an increased risk of developing enteropathies in neonates. Whether the use of IBU is safer than INDO for the immature intestine remains to be elucidated. METHODS: The direct impact of IBU on the human immature intestinal transcriptome was investigated using serum-free organ culture. Differentially expressed genes were analyzed with Ingenuity Pathway Analysis software and compared with those previously reported with INDO. Validation of differentially expressed genes was confirmed by qPCR. RESULTS: We identified several biological processes that were significantly modulated by IBU at similar levels to what had previously been observed with INDO, while the expression of genes involved in "antimicrobial response" and "mucus production" was significantly decreased exclusively by IBU in the immature intestine. CONCLUSIONS: Our findings indicate that IBU has a harmful influence on the immature intestine. In addition to exerting many of the INDO observed deleterious effects, IBU alters pathways regulating microbial colonization and intestinal epithelial defense.


Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Ibuprofeno/efeitos adversos , Mucosa Intestinal/efeitos dos fármacos , Intestinos/efeitos dos fármacos , Intestinos/embriologia , Anti-Inflamatórios não Esteroides/farmacologia , Meios de Cultura Livres de Soro , Dinoprostona/metabolismo , Relação Dose-Resposta a Droga , Permeabilidade do Canal Arterial/tratamento farmacológico , Feto , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Glicólise , Humanos , Ibuprofeno/farmacologia , Mucosa Intestinal/crescimento & desenvolvimento , Intestino Delgado/embriologia , Metabolismo dos Lipídeos , Análise de Sequência com Séries de Oligonucleotídeos , Técnicas de Cultura de Órgãos , Oxirredutases/metabolismo , Risco , Transcriptoma
8.
Nitric Oxide ; 66: 53-61, 2017 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-28315470

RESUMO

BACKGROUND AND AIM: NO synthase 2 (NOS2) was recently identified as one the most overexpressed genes in intestinal samples of premature infants with necrotizing enterocolitis (NEC). NOS2 is widely implicated in the processes of epithelial cell injury/apoptosis and host immune defense but its specific role in inflammation of the immature human intestinal mucosa remains unclear. Interestingly, factors that prevent NEC such as epidermal growth factor (EGF) attenuate the inflammatory response in the mid-gestation human small intestine using serum-free organ culture while drugs that are associated with NEC occurrence such as the non-steroidal anti-inflammatory drug, indomethacin (INDO), exert multiple detrimental effects on the immature human intestine. In this study we investigate the potential role of NOS2 in modulating the gut inflammatory response under protective and stressful conditions by determining the expression profile of NOS2 and its downstream pathways in the immature intestine. METHODS: Gene expression profiles of cultured mid-gestation human intestinal explants were investigated in the absence or presence of a physiological concentration of EGF (50 ng/ml) or 1 µM INDO for 48 h using Illumina whole genome microarrays, Ingenuity Pathway Analysis software and quantitative PCR to investigate the expression of NOS2 and NOS2-pathway related genes. RESULTS: In the immature intestine, NOS2 expression was found to be increased by EGF and repressed by INDO. Bioinformatic analysis identified differentially regulated pathways where NOS2 is known to play an important role including citrulline/arginine metabolism, epithelial cell junctions and oxidative stress. At the individual gene level, we identified many differentially expressed genes of the citrulline/arginine metabolism pathway such as ARG1, ARG2, GLS, OAT and OTC in response to EGF and INDO. Gene expression of tight junction components such as CLDN1, CLDN2, CLDN7 and OCN and of antioxidant markers such as DUOX2, GPX2, SOD2 were also found to be differentially modulated by EGF and INDO. CONCLUSION: These results suggest that the protective effect of EGF and the deleterious influence of INDO on the immature intestine could be mediated via regulation of NOS2. Pathways downstream of NOS2 involved with these effects include metabolism linked to NO production, epithelial barrier permeability and antioxidant expression. These results suggest that NOS2 is a likely regulator of the inflammatory response in the immature human gut and may provide a mechanistic basis for the protective effect of EGF and the deleterious effects of INDO.


Assuntos
Anti-Inflamatórios/farmacologia , Íleo/metabolismo , Óxido Nítrico Sintase Tipo II/metabolismo , Transdução de Sinais/efeitos dos fármacos , Arginina/metabolismo , Citrulina/metabolismo , Fator de Crescimento Epidérmico/farmacologia , Pesquisa Fetal , Fármacos Gastrointestinais/farmacologia , Humanos , Íleo/efeitos dos fármacos , Íleo/enzimologia , Indometacina/farmacologia , Óxido Nítrico Sintase Tipo II/análise , Técnicas de Cultura de Órgãos
9.
Clin Sci (Lond) ; 130(23): 2217-2237, 2016 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-27630205

RESUMO

Diets rich in fruits and vegetables may reduce oxidative stress (OxS) and inflammation via several mechanisms. These beneficial effects may be due to their high polyphenol content. The aims of the present study are to evaluate the preventive and therapeutic aspects of polyphenols in dried apple peel powder (DAPP) on intestinal inflammation while elucidating the underlying mechanisms and clinical benefits. Induction of intestinal inflammation in mice was performed by oral administration of the inflammatory agent dextran sulfate sodium (DSS) at 2.5% for 10 days. Physiological and supraphysiological doses of DAPP (200 and 400 mg/kg/day respectively) were administered by gavage for 10 days pre- and post-DSS treatment. DSS-mediated inflammation caused weight loss, shortening of the colon, dystrophic detachment of the epithelium, and infiltration of mono- and poly-morphonuclear cells in the colon. DSS induced an increase in lipid peroxidation, a down-regulation of antioxidant enzymes, an augmented expression of myeloperoxidase (MPO) and cyclooxygenase-2 (COX-2), an elevated production of prostaglandin E2 (PGE2) and a shift in mucosa-associated microbial composition. However, DAPP normalized most of these abnormalities in preventive or therapeutic situations in addition to lowering inflammatory cytokines while stimulating antioxidant transcription factors and modulating other potential healing pathways. The supraphysiological dose of DAPP in therapeutic situations also improved mitochondrial dysfunction. Relative abundance of Peptostreptococcaceae and Enterobacteriaceae bacteria was slightly decreased in DAPP-treated mice. In conclusion, DAPP exhibits powerful antioxidant and anti-inflammatory action in the intestine and is associated with the regulation of cellular signalling pathways and changes in microbiota composition. Evaluation of preventive and therapeutic effects of DAPP may be clinically feasible in individuals with intestinal inflammatory bowel diseases.


Assuntos
Anti-Inflamatórios/administração & dosagem , Frutas/química , Doenças Inflamatórias Intestinais/tratamento farmacológico , Malus/química , Extratos Vegetais/administração & dosagem , Polifenóis/administração & dosagem , Animais , Antioxidantes/administração & dosagem , Ciclo-Oxigenase 2/metabolismo , Humanos , Doenças Inflamatórias Intestinais/metabolismo , Doenças Inflamatórias Intestinais/microbiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Estresse Oxidativo
10.
BMC Gastroenterol ; 15: 119, 2015 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-26376914

RESUMO

BACKGROUND: Metabolic alterations relevant to postprandial dyslipidemia were previously identified in the intestine of obese insulin-resistant subjects. The aim of the study was to identify the genes deregulated by systemic insulin resistance in the intestine of severely obese subjects. METHODS: Transcripts from duodenal samples of insulin-sensitive (HOMA-IR < 3, n = 9) and insulin-resistant (HOMA-IR > 7, n = 9) obese subjects were assayed by microarray (Illumina HumanHT-12). RESULTS: A total of 195 annotated genes were identified as differentially expressed between these two groups (Fold change > 1.2). Of these genes, 36 were found to be directly involved in known intestinal functions, including digestion, extracellular matrix, endocrine system, immunity and cholesterol metabolism. Interestingly, all differentially expressed genes (n = 8) implicated in inflammation and oxidative stress were found to be upregulated in the intestine of insulin-resistant compared to insulin-sensitive subjects. Metabolic pathway analysis revealed that several signaling pathways involved in immunity and inflammation were significantly enriched in differently expressed genes and were predicted to be activated in the intestine of insulin-resistant subjects. Using stringent criteria (Fold change > 1.5; FDR < 0.05), three genes were found to be significantly and differently expressed in the intestine of insulin-resistant compared to insulin-sensitive subjects: the transcripts of the insulinotropic glucose-dependant peptide (GIP) and of the ß-microseminoprotein (MSMB) were significantly reduced, but that of the humanin like-1 (MTRNR2L1) was significantly increased. CONCLUSION: These results underline that systemic insulin resistance is associated with remodeling of key intestinal functions. Moreover, these data indicate that small intestine metabolic dysfunction is accompanied with a local amplification of low-grade inflammatory process implicating several pathways. Genes identified in this study are potentially triggered throughout the development of intestinal metabolic abnormalities, which could contribute to dyslipidemia, a component of metabolic syndrome and diabetes.


Assuntos
Expressão Gênica , Inflamação/genética , Resistência à Insulina/genética , Obesidade/genética , Obesidade/fisiopatologia , RNA Mensageiro/metabolismo , Adulto , Células CACO-2 , Duodeno , Feminino , Polipeptídeo Inibidor Gástrico/genética , Perfilação da Expressão Gênica , Humanos , Peptídeos e Proteínas de Sinalização Intercelular , Masculino , Análise em Microsséries , Obesidade/patologia , Estresse Oxidativo/genética , Proteínas Secretadas pela Próstata/genética , Proteínas/genética , Transdução de Sinais/genética
11.
Appl Opt ; 54(24): 7195-204, 2015 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-26368753

RESUMO

We describe the design, fabrication, and testing of a 1.6 mm thick scleral contact lens providing both 1× and 2.8× magnified vision paths, intended for use as a switchable eye-borne telescopic low-vision aid. The F/9.7 telescopic vision path uses an 8.2 mm diameter annular entrance pupil and 4 internal reflections in a polymethyl methacrylate precision optic. This gas-impermeable insert is contained inside a smooth outer casing of rigid gas-permeable polymer, which also provides achromatic correction for refraction at the curved lens face. The unmagnified F/4.1 vision path is through the central aperture of the lens, with additional transmission between the annular telescope rings to enable peripheral vision. We discuss potential solutions for providing oxygenation for an extended wear version of the lens. The prototype lenses were characterized using a scale-model human eye, and telescope functionality was confirmed in a small-scale clinical (nondispensed) demonstration.


Assuntos
Lentes de Contato , Desenho de Equipamento , Adulto , Estudos de Coortes , Simulação por Computador , Gases , Humanos , Interferometria/métodos , Degeneração Macular/terapia , Óptica e Fotônica , Oxigênio/química , Permeabilidade , Polímeros/química , Visão Ocular
12.
Sante Publique ; 27(1 Suppl): S67-75, 2015.
Artigo em Francês | MEDLINE | ID: mdl-26168619

RESUMO

INTRODUCTION: This article presents the results of a project conducted by the Institut national d'excellence en santé et en services sociaux of Québec to develop quality of care indicators for the management of six chronic illnesses. METHODS: Indicators were identified through literature searches and analysis of clinical practice guidelines (CPGs). Interdisciplinary expert panels assessed their validity and the strength of the evidence on which they were based. Representatives of patients (N = 19) and professionals (N = 29) were consulted on their relevance and acceptability. Indicators were categorized according to the Chronic Care Model (CCM). RESULTS: A total of 164 indicators were developed, 126 specific to the illnesses under study and 38 on processes and outcomes generic to the CCM. There was convergence between patients and professionals on the relevance of a majority of indicators. Professionals expressed concerns on the indicators measured by means of patient surveys that they considered to be too subjective. DISCUSSION: The importance given to CPGs as the main source of indicators resulted in a great number of indicators of the technical quality ofcare. Using the CCM contributed to a broader perspective of quality. The consultation process identified some of the concerns of professionals about indicator measurement, thusguidingfuture implementation initiatives.


Assuntos
Doença Crônica/terapia , Guias de Prática Clínica como Assunto , Indicadores de Qualidade em Assistência à Saúde , Qualidade da Assistência à Saúde , Coleta de Dados , Humanos , Modelos Biológicos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde/organização & administração , Indicadores de Qualidade em Assistência à Saúde/normas , Qualidade da Assistência à Saúde/organização & administração , Qualidade da Assistência à Saúde/normas , Quebeque , Encaminhamento e Consulta
13.
J Cell Sci ; 125(Pt 14): 3454-63, 2012 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-22467857

RESUMO

The crypt-villus axis constitutes the functional unit of the small intestine, where mature absorptive cells are confined to the villi, and stem cells and transit amplifying and differentiating cells are restricted to the crypts. The polycomb group (PcG) proteins repress differentiation and promote self-renewal in embryonic stem cells. PcGs prevent transcriptional activity by catalysing epigenetic modifications, such as the covalent addition of methyl groups on histone tails, through the action of the polycomb repressive complex 2 (PRC2). Although a role for PcGs in the preservation of stemness characteristics is now well established, recent evidence suggests that they may also be involved in the regulation of differentiation. Using intestinal epithelial cell models that recapitulate the enterocytic differentiation programme, we generated a RNAi-mediated stable knockdown of SUZ12, which constitutes a cornerstone for PRC2 assembly and functionality, in order to analyse intestinal cell proliferation and differentiation. Expression of SUZ12 was also investigated in human intestinal tissues, revealing the presence of SUZ12 in most proliferative epithelial cells of the crypt and an increase in its expression in colorectal cancers. Moreover, PRC2 disruption led to a significant precocious expression of a number of terminal differentiation markers in intestinal cell models. Taken together, our data identified a mechanism whereby PcG proteins participate in the repression of the enterocytic differentiation program, and suggest that a similar mechanism exists in situ to slow down terminal differentiation in the transit amplifying cell population.


Assuntos
Trato Gastrointestinal/citologia , Complexo Repressor Polycomb 2/fisiologia , Células CACO-2 , Diferenciação Celular/fisiologia , Processos de Crescimento Celular/fisiologia , Células Cultivadas , Trato Gastrointestinal/metabolismo , Regulação da Expressão Gênica no Desenvolvimento , Histonas/genética , Histonas/metabolismo , Humanos , Complexo Repressor Polycomb 2/genética , Complexo Repressor Polycomb 2/metabolismo , Regiões Promotoras Genéticas , Transcrição Gênica
14.
Opt Express ; 22 Suppl 2: A498-510, 2014 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-24922259

RESUMO

We present to the best of our knowledge the first successful demonstration of a planar, self-tracking solar concentrator system capable of a 2-dimensional angular acceptance of over 40°. The light responsive mechanism allows for efficient waveguide coupling and light concentration independently of the angle of incidence within the angular range. A coupling feature is created at the focal spot of the optical system by locally melting a phase change material which acts as an actuator due to the large thermal expansion. A dichroic prism membrane reflects the visible light so that it is efficiently coupled into a waveguide at the point of the created coupling feature. We show simulation results for concentration and efficiency, validated by an experimental proof of concept demonstration of a self-tracking concentrator array element. Simulations show that a system based on this approach can achieve 150X effective concentration by scaling the system collecting area to reasonable dimensions (40 x 10 cm²).

15.
Opt Express ; 22 Suppl 7: A1880-94, 2014 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-25607502

RESUMO

Solar concentration has the potential to decrease the cost associated with solar cells by replacing the receiving surface aperture with cheaper optics that concentrate light onto a smaller cell aperture. However a mechanical tracker has to be added to the system to keep the concentrated light on the size reduced solar cell at all times. The tracking device itself uses energy to follow the sun's position during the day. We have previously shown a mechanism for self-tracking that works by making use of the infrared energy of the solar spectrum, to activate a phase change material. In this paper, we show an implementation of a working 53 x 53 mm(2) self-tracking system with an acceptance angle of 32° ( ± 16°). This paper describes the design optimizations and upscaling process to extend the proof-of-principle self-tracking mechanism to a working demonstration device including the incorporation of custom photodiodes for system characterization. The current version demonstrates an effective concentration of 3.5x (compared to 8x theoretical) over 80% of the desired acceptance angle. Further improvements are expected to increase the efficiency of the system and open the possibility to expand the device to concentrations as high as 200x (C(geo) = 400x, η = 50%, for a solar cell matched spectrum).

16.
Genomics ; 101(3): 171-7, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23261704

RESUMO

The use of the anti-inflammatory drug indomethacin (INDO) in preterm infants has been associated with an increased risk of developing enteropathies. In this study, we have investigated the direct impact of INDO on the human mid-gestation intestinal transcriptome using serum-free organ culture. After determining the optimal dose of 1 µM of INDO (90% inhibition of intestinal prostaglandin E2 production and range of circulating levels in treated preterm babies), global gene expression profiles were determined using Illumina bead chip microarrays in both small and large intestines after 48 h of INDO treatment. Using Ingenuity Pathway Analysis software, we identified critical metabolic pathways that were significantly altered by INDO in both intestinal segments including inflammation and also glycolysis, oxidative phosphorylation and free radical scavenging/oxidoreductase activity, which were confirmed by qPCR at the level of individual genes. Taken together, these data revealed that INDO directly exerts multiple detrimental effects on the immature human intestine.


Assuntos
Indometacina/administração & dosagem , Redes e Vias Metabólicas/genética , Nascimento Prematuro/metabolismo , Transcriptoma/efeitos dos fármacos , Feto Abortado/metabolismo , Feto Abortado/patologia , Anti-Inflamatórios/administração & dosagem , Feminino , Humanos , Mucosa Intestinal/metabolismo , Intestinos/fisiopatologia , Técnicas de Cultura de Órgãos , Gravidez , Nascimento Prematuro/tratamento farmacológico , Nascimento Prematuro/fisiopatologia , Transcriptoma/genética
17.
J Extracell Biol ; 3(1): e128, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38938674

RESUMO

Human milk extracellular vesicles (HM EVs) are proposed to protect against disease development in infants. This protection could in part be facilitated by the bioactive EV cargo of proteins and RNA. Notably, mothers birth infants of different gestational ages with unique needs, wherein the EV cargo of HM may diverge. We collected HM from lactating mothers within two weeks of a term or preterm birth. Following purification of EVs, proteins and mRNA were extracted for proteomics and sequencing analyses, respectively. Over 2000 protein groups were identified, and over 8000 genes were quantified. The total number of proteins and mRNA did not differ significantly between the two conditions, while functional bioinformatics of differentially expressed cargo indicated enrichment in immunoregulatory cargo for preterm HM EVs. In term HM EVs, significantly upregulated cargo was enriched in metabolism-related functions. Based on gene expression signatures from HM-contained single cell sequencing data, we proposed that a larger portion of preterm HM EVs are secreted by immune cells, whereas term HM EVs contain more signatures of lactocyte epithelial cells. Proposed differences in EV cargo could indicate variation in mother's milk based on infants' gestational age and provide basis for further functional characterisation.

18.
Opt Express ; 21(13): 15980-6, 2013 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-23842384

RESUMO

We present design and first demonstration of optics for a telescopic contact lens with independent optical paths for switching between normal and magnified vision. The magnified optical path incorporates a telescopic arrangement of positive and negative annular concentric reflectors to achieve 2.8 x magnification on the eye, while light passing through a central clear aperture provides unmagnified vision. We present an experimental demonstration of the contact lens mounted on a life-sized optomechanical model eye and, using a pair of modified commercial 3D television glasses, demonstrate electrically operated polarization switching between normal and magnified vision.

19.
J Refract Surg ; 29(2): 126-32, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23380414

RESUMO

PURPOSE: To create an accurate, low-cost optomechanical model eye for investigation of refractive errors in clinical and basic research studies. METHODS: An optomechanical fluid-filled eye model with dimensions consistent with the human eye was designed and fabricated. Optical simulations were performed on the optomechanical eye model, and the quantified resolution and refractive errors were compared with the widely used Navarro eye model using the ray-tracing software ZEMAX (Radiant Zemax, Redmond, WA). The resolution of the physical optomechanical eye model was then quantified with a complementary metal-oxide semiconductor imager using the image resolution software SFR Plus (Imatest, Boulder, CO). Refractive, manufacturing, and assembling errors were also assessed. A refractive intraocular lens (IOL) and a diffractive IOL were added to the optomechanical eye model for tests and analyses of a 1951 U.S. Air Force target chart. RESULTS: Resolution and aberrations of the optomechanical eye model and the Navarro eye model were qualitatively similar in ZEMAX simulations. Experimental testing found that the optomechanical eye model reproduced properties pertinent to human eyes, including resolution better than 20/20 visual acuity and a decrease in resolution as the field of view increased in size. The IOLs were also integrated into the optomechanical eye model to image objects at distances of 15, 10, and 3 feet, and they indicated a resolution of 22.8 cycles per degree at 15 feet. CONCLUSIONS: A life-sized optomechanical eye model with the flexibility to be patient-specific was designed and constructed. The model had the resolution of a healthy human eye and recreated normal refractive errors. This model may be useful in the evaluation of IOLs for cataract surgery.


Assuntos
Extração de Catarata , Olho , Lentes Intraoculares , Modelos Biológicos , Erros de Refração/diagnóstico , Análise Custo-Benefício , Humanos , Implante de Lente Intraocular , Modelos Anatômicos , Óptica e Fotônica
20.
Physiol Genomics ; 44(4): 268-80, 2012 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-22214601

RESUMO

The inflammatory response of the preterm infants' intestine underlines its inability to respond to hemodynamic stress, microbes, and nutrients. Recent evidence suggests that exogenous epidermal growth factor (EGF) exerts a therapeutic influence on neonatal enteropathies. However, the molecular mechanisms underlying the beneficial effects of EGF remain to be clarified. The purpose of this study was to evaluate the impact of EGF on the gene expression profiles of the developing human small and large intestine at midgestation in serum-free organ cultures using microarrays. The gene expression profiles of cultured human fetal ileal and colonic explants were investigated in the absence or presence of a physiological concentration of 50 ng/ml EGF for 48 h. Data were analyzed with the Ingenuity Pathway Analysis (IPA) software and confirmed by qPCR. We found a total of 6,474 differentially expressed genes in the two segments in response to EGF. IPA functional analysis revealed that in addition to differentially modulating distinct cellular, molecular, and physiological functions in the small and large intestine, EGF regulated the inflammatory response in both intestinal segments in a distinct manner. For instance, several intestinal-derived chemokines such as CCL2, CCL25, CXCL5, and CXCL10 were found to be differentially regulated by EGF in the immature ileum and colon. The findings showing the anti-inflammatory influence of exogenous EGF suggests a mechanistic basis for the beneficial effects of EGF on neonatal enteropathies. These results reinforce growing evidence that by midgestation, the human small intestine and colon rely on specific and distinct regulatory pathways.


Assuntos
Fator de Crescimento Epidérmico/metabolismo , Mucosa Intestinal/metabolismo , Intestinos/efeitos dos fármacos , Quimiocina CCL2/metabolismo , Quimiocina CXCL10/metabolismo , Quimiocina CXCL5/metabolismo , Quimiocinas CC/metabolismo , Colo/efeitos dos fármacos , Colo/metabolismo , Fator de Crescimento Epidérmico/farmacologia , Humanos , Íleo/efeitos dos fármacos , Íleo/metabolismo , Intestinos/embriologia , Técnicas de Cultura de Órgãos
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