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1.
Cell ; 186(9): 1930-1949.e31, 2023 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-37071993

RESUMO

Cortical circuits are composed predominantly of pyramidal-to-pyramidal neuron connections, yet their assembly during embryonic development is not well understood. We show that mouse embryonic Rbp4-Cre cortical neurons, transcriptomically closest to layer 5 pyramidal neurons, display two phases of circuit assembly in vivo. At E14.5, they form a multi-layered circuit motif, composed of only embryonic near-projecting-type neurons. By E17.5, this transitions to a second motif involving all three embryonic types, analogous to the three adult layer 5 types. In vivo patch clamp recordings and two-photon calcium imaging of embryonic Rbp4-Cre neurons reveal active somas and neurites, tetrodotoxin-sensitive voltage-gated conductances, and functional glutamatergic synapses, from E14.5 onwards. Embryonic Rbp4-Cre neurons strongly express autism-associated genes and perturbing these genes interferes with the switch between the two motifs. Hence, pyramidal neurons form active, transient, multi-layered pyramidal-to-pyramidal circuits at the inception of neocortex, and studying these circuits could yield insights into the etiology of autism.


Assuntos
Transtorno Autístico , Neocórtex , Células Piramidais , Animais , Feminino , Camundongos , Gravidez , Transtorno Autístico/genética , Transtorno Autístico/patologia , Mutação , Neocórtex/fisiologia , Neurônios/fisiologia , Células Piramidais/fisiologia
2.
Nature ; 601(7891): 105-109, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34853473

RESUMO

Local circuit architecture facilitates the emergence of feature selectivity in the cerebral cortex1. In the hippocampus, it remains unknown whether local computations supported by specific connectivity motifs2 regulate the spatial receptive fields of pyramidal cells3. Here we developed an in vivo electroporation method for monosynaptic retrograde tracing4 and optogenetics manipulation at single-cell resolution to interrogate the dynamic interaction of place cells with their microcircuitry during navigation. We found a local circuit mechanism in CA1 whereby the spatial tuning of an individual place cell can propagate to a functionally recurrent subnetwork5 to which it belongs. The emergence of place fields in individual neurons led to the development of inverse selectivity in a subset of their presynaptic interneurons, and recruited functionally coupled place cells at that location. Thus, the spatial selectivity of single CA1 neurons is amplified through local circuit plasticity to enable effective multi-neuronal representations that can flexibly scale environmental features locally without degrading the feedforward input structure.


Assuntos
Hipocampo/citologia , Hipocampo/fisiologia , Vias Neurais , Memória Espacial/fisiologia , Navegação Espacial/fisiologia , Animais , Região CA1 Hipocampal/citologia , Região CA1 Hipocampal/fisiologia , Linhagem da Célula , Eletroporação , Feminino , Interneurônios/fisiologia , Masculino , Camundongos , Inibição Neural , Optogenética , Células de Lugar/fisiologia , Terminações Pré-Sinápticas/metabolismo , Células Piramidais/fisiologia , Análise de Célula Única
3.
Chemistry ; 30(31): e202400009, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38446718

RESUMO

An effective, GFP-inspired fluorescent Zn2+ sensor is developed for two-photon microscopy and related biological application that features an 8-methoxyquinoline moiety. Excellent photophysical characteristics including a 37-fold fluorescence enhancement with excitation and emission maxima at 440 nm and 505 nm, respectively, as well as a high two-photon cross-section of 73 GM at 880 nm are reported. Based on the experimental data, the relationship between the structure and properties was elucidated and explained backed up by DFT calculations, particularly the observed PeT phenomenon for the turn-on process. Biological validation and detailed experimental and theoretical characterization of the free and the zinc-bound compounds are presented.


Assuntos
Corantes Fluorescentes , Proteínas de Fluorescência Verde , Quinolinas , Zinco , Zinco/química , Corantes Fluorescentes/química , Quinolinas/química , Proteínas de Fluorescência Verde/química , Humanos , Teoria da Densidade Funcional , Microscopia de Fluorescência por Excitação Multifotônica/métodos , Fótons
4.
Cell Mol Biol Lett ; 29(1): 105, 2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39030477

RESUMO

BACKGROUND: The organism-wide effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection are well studied, but little is known about the dynamics of how the infection spreads in time among or within cells due to the scarcity of suitable high-resolution experimental systems. It has been reported that SARS-CoV-2 infection pathways converge at calcium influx and subcellular calcium distribution changes. Imaging combined with a proper staining technique is an effective tool for studying subcellular calcium-related infection and replication mechanisms at such resolutions. METHODS: Using two-photon (2P) fluorescence imaging with our novel Ca-selective dye, automated image analysis and clustering analysis were applied to reveal titer and variant effects on SARS-CoV-2-infected Vero E6 cells. RESULTS: The application of a new calcium sensor molecule is shown, combined with a high-end 2P technique for imaging and identifying the patterns associated with cellular infection damage within cells. Vero E6 cells infected with SARS-CoV-2 variants, D614G or B.1.1.7, exhibit elevated cytosolic calcium levels, allowing infection monitoring by tracking the cellular changes in calcium level by the internalized calcium sensor. The imaging provides valuable information on how the level and intracellular distribution of calcium are perturbed during the infection. Moreover, two-photon calcium sensing allowed the distinction of infections by two studied viral variants via cluster analysis of the image parameters. This approach will facilitate the study of cellular correlates of infection and their quantification depending on viral variants and viral load. CONCLUSIONS: We propose a new two-photon microscopy-based method combined with a cell-internalized sensor to quantify the level of SARS-CoV-2 infection. We optimized the applied dye concentrations to not interfere with viral fusion and viral replication events. The presented method ensured the proper monitoring of viral infection, replication, and cell fate. It also enabled distinguishing intracellular details of cell damage, such as vacuole and apoptotic body formation. Using clustering analysis, 2P microscopy calcium fluorescence images were suitable to distinguish two different viral variants in cell cultures. Cellular harm levels read out by calcium imaging were quantitatively related to the initial viral multiplicity of infection numbers. Thus, 2P quantitative calcium imaging might be used as a correlate of infection or a correlate of activity in cellular antiviral studies.


Assuntos
COVID-19 , Cálcio , Corantes Fluorescentes , SARS-CoV-2 , Chlorocebus aethiops , Células Vero , Cálcio/metabolismo , Cálcio/análise , Animais , COVID-19/virologia , COVID-19/metabolismo , Corantes Fluorescentes/química , Humanos , Fótons
5.
Int J Mol Sci ; 25(6)2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38542479

RESUMO

The few commercially available chemosensors and published probes for in vitro Zn2+ detection in two-photon microscopy are compromised by their flawed spectroscopic properties, causing issues in selectivity or challenging multistep syntheses. Herein, we present the development of an effective small molecular GFP chromophore-based fluorescent chemosensor with a 2,2'-bipyridine chelator moiety (GFZnP BIPY) for Zn2+ detection that has straightforward synthesis and uncompromised properties. Detailed experimental characterizations of the free and the zinc-bound compounds within the physiologically relevant pH range are presented. Excellent photophysical characteristics are reported, including a 53-fold fluorescence enhancement with excitation and emission maxima at 422 nm and 492 nm, respectively. A high two-photon cross section of 3.0 GM at 840 nm as well as excellent metal ion selectivity are reported. In vitro experiments on HEK 293 cell culture were carried out using two-photon microscopy to demonstrate the applicability of the novel sensor for zinc bioimaging.


Assuntos
2,2'-Dipiridil , Compostos Heterocíclicos , Humanos , Células HEK293 , Microscopia de Fluorescência , Quelantes , Zinco , Corantes Fluorescentes/química , Espectrometria de Fluorescência
6.
Org Biomol Chem ; 21(44): 8829-8836, 2023 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-37917021

RESUMO

An asymmetric cyanine-type fluorescent dye was designed and synthesized via a versatile, multi-step process, aiming to conjugate with an Her2+ receptor specific antibody by an azide-alkyne click reaction. The aromaticity and the excitation and relaxation energetics of the fluorophore were characterized by computational methods. The synthesized dye exhibited excellent fluorescence properties for confocal microscopy, offering efficient applicability in in vitro imaging due to its merits such as a high molar absorption coefficient (36 816 M-1 cm-1), excellent brightness, optimal wavelength (627 nm), larger Stokes shift (26 nm) and appropriate photostability compared to cyanines. The conjugated cyanine-trastuzumab was constructed via an effective, metal-free, strain-promoted azide-alkyne click reaction leading to a regulated number of dyes being conjugated. This novel cyanine-labelled antibody was successfully applied for in vitro confocal imaging and flow cytometry of Her2+ tumor cells.


Assuntos
Azidas , Corantes Fluorescentes , Carbocianinas , Anticorpos , Alcinos , Microscopia Confocal
7.
Int J Mol Sci ; 23(8)2022 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-35457056

RESUMO

Psoriasis is a chronic inflammatory disease with unmet medical needs. To clarify potential therapeutic targets, different animal models have been developed. In the current study, imiquimod-induced psoriasiform dermatitis was used for monitoring the changes in skin thickness, transepidermal water loss, body weight, blood perfusion and drug permeability for a topical cream formulation of caffeine, both in wild type and in knock out mice. Morphological characterization of control and diseased tissues was performed by scanning electron microscopy and two-photon microscopy. The chemically induced psoriatic group showed increased skin permeability for the model drug during disease progression. In wild type and TRPA1 KO mice, however, enhanced skin thickness and hyperkeratosis blocked further increase of drug penetration at the late phase (96 h). These results indicate that topical drug therapy can be more effective in early phases of plaque development, when skin thickness is lower. Although paracellular connections (tight junctions) are looser in the advanced phase, hyperkeratosis blocks drug delivery through the transappendageal routes. Novel drug formulations may have the potency for effective drug delivery across the epidermal barrier even in the advanced phase. For development of more effective topical drugs, further research is proposed to explore drug penetration both in healthy and diseased conditions.


Assuntos
Dispositivos Lab-On-A-Chip , Psoríase , Animais , Modelos Animais de Doenças , Epiderme , Camundongos , Imagem Óptica , Permeabilidade , Psoríase/induzido quimicamente , Psoríase/tratamento farmacológico , Pele
8.
Proc Natl Acad Sci U S A ; 114(36): E7612-E7621, 2017 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-28827326

RESUMO

Striatal spiny projection neurons (SPNs) receive convergent excitatory synaptic inputs from the cortex and thalamus. Activation of spatially clustered and temporally synchronized excitatory inputs at the distal dendrites could trigger plateau potentials in SPNs. Such supralinear synaptic integration is crucial for dendritic computation. However, how plateau potentials interact with subsequent excitatory and inhibitory synaptic inputs remains unknown. By combining computational simulation, two-photon imaging, optogenetics, and dual-color uncaging of glutamate and GABA, we demonstrate that plateau potentials can broaden the spatiotemporal window for integrating excitatory inputs and promote spiking. The temporal window of spiking can be delicately controlled by GABAergic inhibition in a cell-type-specific manner. This subtle inhibitory control of plateau potential depends on the location and kinetics of the GABAergic inputs and is achieved by the balance between relief and reestablishment of NMDA receptor Mg2+ block. These findings represent a mechanism for controlling spatiotemporal synaptic integration in SPNs.


Assuntos
Dendritos/fisiologia , Potenciais Pós-Sinápticos Excitadores/fisiologia , Neurônios/fisiologia , Animais , Córtex Cerebral/metabolismo , Córtex Cerebral/fisiologia , Dendritos/metabolismo , Feminino , Ácido Glutâmico/metabolismo , Masculino , Camundongos , Vias Neurais/metabolismo , Vias Neurais/fisiologia , Neurônios/metabolismo , Receptores de N-Metil-D-Aspartato/metabolismo , Sinapses/metabolismo , Sinapses/fisiologia , Transmissão Sináptica/fisiologia , Tálamo/metabolismo , Tálamo/fisiologia , Ácido gama-Aminobutírico/metabolismo
9.
Acta Neuropathol ; 136(3): 461-482, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30027450

RESUMO

Neurotropic herpesviruses can establish lifelong infection in humans and contribute to severe diseases including encephalitis and neurodegeneration. However, the mechanisms through which the brain's immune system recognizes and controls viral infections propagating across synaptically linked neuronal circuits have remained unclear. Using a well-established model of alphaherpesvirus infection that reaches the brain exclusively via retrograde transsynaptic spread from the periphery, and in vivo two-photon imaging combined with high resolution microscopy, we show that microglia are recruited to and isolate infected neurons within hours. Selective elimination of microglia results in a marked increase in the spread of infection and egress of viral particles into the brain parenchyma, which are associated with diverse neurological symptoms. Microglia recruitment and clearance of infected cells require cell-autonomous P2Y12 signalling in microglia, triggered by nucleotides released from affected neurons. In turn, we identify microglia as key contributors to monocyte recruitment into the inflamed brain, which process is largely independent of P2Y12. P2Y12-positive microglia are also recruited to infected neurons in the human brain during viral encephalitis and both microglial responses and leukocyte numbers correlate with the severity of infection. Thus, our data identify a key role for microglial P2Y12 in defence against neurotropic viruses, whilst P2Y12-independent actions of microglia may contribute to neuroinflammation by facilitating monocyte recruitment to the sites of infection.


Assuntos
Encéfalo/metabolismo , Infecções por Herpesviridae/metabolismo , Microglia/metabolismo , Monócitos/metabolismo , Receptores Purinérgicos P2Y12/metabolismo , Transdução de Sinais/fisiologia , Animais , Encéfalo/virologia , Camundongos , Microglia/virologia , Neurônios/metabolismo , Neurônios/virologia
10.
Org Biomol Chem ; 16(11): 1958-1970, 2018 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-29497727

RESUMO

Two-photon (TP) uncaging of neurotransmitter molecules is the method of choice to mimic and study the subtleties of neuronal communication either in the intact brain or in slice preparations. However, the currently available caged materials are just at the limit of their usability and have several drawbacks. The local and focal nature of their use may for example be jeopardized by a high spontaneous hydrolysis rate of the commercially available compounds with increased photochemical release rate. Here, using quantum chemical modelling we show the mechanisms of hydrolysis and two-photon activation, and synthesized more effective caged compounds. Furthermore, we have developed a new enzymatic elimination method removing neurotransmitters inadvertently escaping from their compound during experiment. This method, usable both in one and two-photon experiments, allows for the use of materials with an increased rate of photochemical release. The efficiency of the new compound and the enzymatic method and of the new compound are demonstrated in neurophysiological experiments.

11.
Molecules ; 23(11)2018 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-30400217

RESUMO

Not all amide bonds are created equally. The purpose of the present paper is the reinterpretation of the amide group by means of two concepts: amidicity and carbonylicity. These concepts are meant to provide a new viewpoint in defining the stability and reactivity of amides. With the help of simple quantum-chemical calculations, practicing chemists can easily predict the outcome of a desired process. The main benefit of the concepts is their simplicity. They provide intuitive, but quasi-thermodynamic data, making them a practical rule of thumb for routine use. In the current paper we demonstrate the performance of our methods to describe the chemical character of an amide bond strength and the way of its activation methods. Examples include transamidation, acyl transfer and amide reductions. Also, the method is highly capable for simple interpretation of mechanisms for biological processes, such as protein splicing and drug mechanisms. Finally, we demonstrate how these methods can provide information about photo-activation of amides, through the examples of two caged neurotransmitter derivatives.


Assuntos
Amidas/química , Modelos Químicos , Algoritmos , Amidas/síntese química , Técnicas de Química Sintética , Termodinâmica
12.
Orv Hetil ; 159(46): 1882-1890, 2018 11.
Artigo em Húngaro | MEDLINE | ID: mdl-30450928

RESUMO

Machine perfusion of marginal grafts might be a possible solution to organ shortage and a promising tool for reducing waiting list morbidity and mortality. In recent years, optimizing the circumstances of organ preservation prior to implantation via machine perfusion has become a hot topic of research. Machine perfusion offers a platform for organ reconditioning, assessment of cell viability and function, pharmacological preconditioning, prolongation of preservation time (ischemia time) and finally reducing graft injury. The objective of the new technology is to increase the pool of transplantable organs safely. Multicentric prospective studies have been evaluating the short and long term outcomes of different methods, however, several questions still remain unanswered. This review summarizes the recent advances in the field of machine perfusion, focusing on preclinical and clinical results. Machine perfusion seems to be a new milestone in the modern era of solid organ transplantation. Orv Hetil. 2018; 159(46): 1882-1890.


Assuntos
Transplante de Órgãos/métodos , Transplante de Órgãos/tendências , Perfusão/métodos , Perfusão/tendências , Transplante de Coração/métodos , Transplante de Coração/tendências , Humanos , Transplante de Rim/métodos , Transplante de Rim/tendências , Transplante de Fígado/métodos , Transplante de Fígado/tendências , Transplante de Pulmão/métodos , Transplante de Pulmão/tendências , Preservação de Órgãos , Transplante de Pâncreas/métodos , Transplante de Pâncreas/tendências
13.
Nat Methods ; 9(2): 201-8, 2012 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-22231641

RESUMO

The understanding of brain computations requires methods that read out neural activity on different spatial and temporal scales. Following signal propagation and integration across a neuron and recording the concerted activity of hundreds of neurons pose distinct challenges, and the design of imaging systems has been mostly focused on tackling one of the two operations. We developed a high-resolution, acousto-optic two-photon microscope with continuous three-dimensional (3D) trajectory and random-access scanning modes that reaches near-cubic-millimeter scan range and can be adapted to imaging different spatial scales. We performed 3D calcium imaging of action potential backpropagation and dendritic spike forward propagation at sub-millisecond temporal resolution in mouse brain slices. We also performed volumetric random-access scanning calcium imaging of spontaneous and visual stimulation-evoked activity in hundreds of neurons of the mouse visual cortex in vivo. These experiments demonstrate the subcellular and network-scale imaging capabilities of our system.


Assuntos
Encéfalo/fisiologia , Fótons , Potenciais de Ação , Animais , Camundongos , Neurônios/fisiologia , Córtex Visual/citologia , Córtex Visual/fisiologia
14.
Opt Express ; 23(18): 23436-49, 2015 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-26368444

RESUMO

Our aim is to establish a novel combined acousto-optical method for in vivo imaging of the human retina with the two-photon microscope. In this paper we present modeling results based on eye model samples constructed with parameters measured on patients. We used effectively the potential of the electronic compensation offered by the acousto-optic lenses to avoid the use of adaptive optical correction. Simulation predicted lateral resolution between 1.6 µm and 3 µm on the retina. This technology allows the visualization of single cells and promises real time measuring of neural activity in individual neurons, neural segments and cell assemblies with 30-100 µs temporal and subcellular spatial resolution.

15.
Proc Natl Acad Sci U S A ; 108(5): 2148-53, 2011 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-21224413

RESUMO

Inhibitory interneurons are considered to be the controlling units of neural networks, despite their sparse number and unique morphological characteristics compared with excitatory pyramidal cells. Although pyramidal cell dendrites have been shown to display local regenerative events--dendritic spikes (dSpikes)--evoked by artificially patterned stimulation of synaptic inputs, no such studies exist for interneurons or for spontaneous events. In addition, imaging techniques have yet to attain the required spatial and temporal resolution for the detection of spontaneously occurring events that trigger dSpikes. Here we describe a high-resolution 3D two-photon laser scanning method (Roller Coaster Scanning) capable of imaging long dendritic segments resolving individual spines and inputs with a temporal resolution of a few milliseconds. By using this technique, we found that local, NMDA receptor-dependent dSpikes can be observed in hippocampal CA1 stratum radiatum interneurons during spontaneous network activities in vitro. These NMDA spikes appear when approximately 10 spatially clustered inputs arrive synchronously and trigger supralinear integration in dynamic interaction zones. In contrast to the one-to-one relationship between computational subunits and dendritic branches described in pyramidal cells, here we show that interneurons have relatively small (∼14 µm) sliding interaction zones. Our data suggest a unique principle as to how interneurons integrate synaptic information by local dSpikes.


Assuntos
Potenciais de Ação , Dendritos/fisiologia , Interneurônios/fisiologia
16.
Front Neurosci ; 17: 1209913, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37746144

RESUMO

Transparent epidural devices that facilitate the concurrent use of electrophysiology and neuroimaging are arising tools for neuroscience. Testing the biocompatibility and evoked immune response of novel implantable devices is essential to lay down the fundamentals of their extensive application. Here we present an immunohistochemical evaluation of a Parylene HT/indium-tin oxide (ITO) based electrocorticography (ECoG) device, and provide long-term biocompatibility data at three chronic implantation lengths. We implanted Parylene HT/ITO ECoG devices epidurally in 5 mice and evaluated the evoked astroglial response, neuronal density and cortical thickness. We found increased astroglial response in the superficial cortical layers of all mice compared to contralateral unimplanted controls. This difference was largest at the first time point and decreased over time. Neuronal density was lower on the implanted side only at the last time point, while cortical thickness was smaller in the first and second time points, but not at the last. In this study, we present data that confirms the feasibility and chronic use of Parylene HT/ITO ECoG devices.

17.
ACS Omega ; 8(25): 22836-22843, 2023 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-37396252

RESUMO

A novel family of julolidine-containing fluorescent rhodols equipped with a wide variety of substituents was synthesized in a versatile two-step process. The prepared compounds were fully characterized and exhibited excellent fluorescence properties for microscopy imaging. The best candidate was conjugated to the therapeutic antibody trastuzumab through a copper-free strain-promoted azide-alkyne click reaction. The rhodol-labeled antibody was successfully applied for in vitro confocal and two-photon microscopy imaging of Her2+ cells.

18.
Elife ; 112022 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-36416886

RESUMO

Neocortex is classically divided into distinct areas, each specializing in different function, but all could benefit from reinforcement feedback to inform and update local processing. Yet it remains elusive how global signals like reward and punishment are represented in local cortical computations. Previously, we identified a cortical neuron type, vasoactive intestinal polypeptide (VIP)-expressing interneurons, in auditory cortex that is recruited by behavioral reinforcers and mediates disinhibitory control by inhibiting other inhibitory neurons. As the same disinhibitory cortical circuit is present virtually throughout cortex, we wondered whether VIP neurons are likewise recruited by reinforcers throughout cortex. We monitored VIP neural activity in dozens of cortical regions using three-dimensional random access two-photon microscopy and fiber photometry while mice learned an auditory discrimination task. We found that reward and punishment during initial learning produce rapid, cortex-wide activation of most VIP interneurons. This global recruitment mode showed variations in temporal dynamics in individual neurons and across areas. Neither the weak sensory tuning of VIP interneurons in visual cortex nor their arousal state modulation was fully predictive of reinforcer responses. We suggest that the global response mode of cortical VIP interneurons supports a cell-type-specific circuit mechanism by which organism-level information about reinforcers regulates local circuit processing and plasticity.


Assuntos
Punição , Peptídeo Intestinal Vasoativo , Camundongos , Animais , Recompensa , Neurônios , Interneurônios
19.
Transplant Proc ; 54(9): 2603-2607, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36400588

RESUMO

BACKGROUND: Fibromuscular dysplasia (FMD), a relatively frequent arterial deformity with an estimated prevalence of 2% to 6% has been sporadically reported during deceased donor kidney donations. Only 8 case reports are available in the previous literature. CASE PRESENTATION: In our work, implantation of 2 kidneys from the same deceased donor with macroscopically evident and later histologically confirmed FMD are presented, one of which ended up as acute arterial complication. Renal arteries were cut short to allow safe implantation, but arterial dissection and thrombosis led to graft loss in the early perioperative period in the latter case. CONCLUSIONS: Although resection of the arterial segments affected by FMD as a routine may allow implantation, macroscopically healthy-looking arteries might still be affected and thus carry elevated postoperative risk. The aim of our case report is to make proposal for an onsite diagnosis of FMD in case of clinical suspicion.


Assuntos
Dissecção Aórtica , Dissecção de Vasos Sanguíneos , Displasia Fibromuscular , Transplante de Rim , Trombose , Humanos , Dissecção Aórtica/diagnóstico , Dissecção Aórtica/etiologia , Displasia Fibromuscular/complicações , Displasia Fibromuscular/diagnóstico , Transplante de Rim/efeitos adversos , Artéria Renal/patologia , Trombose/etiologia , Trombose/complicações
20.
Transplant Proc ; 54(9): 2593-2597, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36414513

RESUMO

BACKGROUND: Hepatocellular carcinoma (HCC) is the leading primary liver tumor and a main indication for transplant. Transplant criteria are based on clinicopathologic features, meanwhile adequate downstaging and molecular mechanisms are getting more attention in evolving therapeutic algorithm of HCC. The aim of our study was to overview the results of the Hungarian Liver Transplant Program in the field of HCC and introduce new aspects of personalized treatment options. METHODS: We performed retrospective analysis of survival and tumor recurrence of HCC-associated liver transplant recipients between October 2013 and December 2020. Patients were categorized in Milan criteria (MC), beyond MC but within University of California, San Francisco (UCSF), and beyond UCSF criteria groups after pathologic examination of the explanted liver. Demographic data and preoperative locoregional treatments were assessed. RESULTS: A total of 529 primer liver transplants were performed, 88 because of HCC. A total of 87 patients had underlying cirrhosis because of hepatitis C (54%), alcohol-related liver disease (33.7%), hepatitis B (4.5%), or unknown etiology. A total of 55.6% of the patients had at least one locoregional treatment. A total of 67.4% of the patients were within MC, 5.6% were within UCSF criteria, and 27% were beyond UCSF criteria. The 1-, 3-, and 5-year survival rates were 80%, 79%, and 75%. The outcome was better in early-stage tumors, but the difference was not significant (P = .745) CONCLUSIONS: The favorable survival in our department legitimates the strict transplant criteria of HCC. Adequate locoregional therapy as downstaging can expand recipient pool. Molecular tumor profiling may lead to personalized treatment of HCC.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Transplante de Fígado , Humanos , Carcinoma Hepatocelular/cirurgia , Transplante de Fígado/efeitos adversos , Neoplasias Hepáticas/cirurgia , Estudos Retrospectivos , Recidiva Local de Neoplasia/etiologia , Resultado do Tratamento , Seleção de Pacientes , Taxa de Sobrevida
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