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2.
Intern Med ; 61(14): 2167-2170, 2022 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-35569982

RESUMO

Coronavirus disease 2019 (COVID-19) has become a pandemic, and vaccines remain the only effective tools available for ending it. However, their side effects, such as syncope, which mimics sudden cardiac death, are serious concerns. We herein report 6 cases of delayed vasovagal syncope and presyncope (VVR) caused by COVID-19 vaccination among 25,530 COVID-19 patients. The prevalence of delayed VVR due to COVID-19 vaccination was 0.026%. In addition, no delayed VVR was found among 17,386 patients who received the influenza vaccine. Delayed VVR is likely to be overlooked if medical staff are not aware of this symptom. This report provides significant information regarding effects of COVID-19 vaccination.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Síncope Vasovagal , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Humanos , Síncope/induzido quimicamente , Síncope Vasovagal/induzido quimicamente , Vacinação/efeitos adversos
3.
Oxf Med Case Reports ; 2022(4): omac040, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35464898

RESUMO

ST-segment elevation myocardial infarction (STEMI) can be caused by coronary artery vasospasm (VSA) due to endothelial dysfunction. However, the clinical role of endothelial function tests in VSA-induced STEMI is not fully understood. We present the case of a 43-year-old woman with atypical chest pain and no coronary risk factors. STEMI caused by VSA was diagnosed. Flow-mediated vasodilatation (FMD) and EndPAT tests were performed; the FMD and reactive hyperaemia index were 3.8% and 1.23, respectively. Endothelial dysfunction is the putative cause of STEMI. FMD and EndPAT tests might be useful for predicting adverse outcomes in young premenopausal women with VSA.

5.
Geriatr Gerontol Int ; 20(11): 1044-1049, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32924229

RESUMO

AIM: We aimed to describe the clinical characteristics, treatment and outcomes of patients with COVID-19 pneumonia, in particular older patients, admitted to tertiary and partner hospitals in Saitama, Japan. METHODS: We retrospectively reviewed the medical records of patients with COVID-19 pneumonia admitted to tertiary and partner hospitals in Saitama, Japan. Twenty-six patients with COVID-19 were categorized into two groups, i.e., older (≥75 years) and younger adults (≤74 years). We evaluated the clinical characteristics, comorbidities, symptoms, laboratory test results, treatments and outcomes of the patients. RESULTS: The majority of the older patients had comorbidities, such as dementia, cardiovascular disease and bone fractures. Comorbidities were significantly more frequent in older patients than younger patients. No association was found between age and body temperature or the incidence of respiratory failure. White blood cell count was significantly lower in older patients (P = 0.018) and the decrease in lymphocytes was greater in younger patients (P = 0.009). Computed tomography (CT) of all patients showed non-segmental, peripherally dominant ground-glass opacities consistent with COVID-19 pneumonia. In older patients, antiviral drugs, anticoagulants and anti-inflammatory drugs were administered on a compassionate use basis. The difference in mortality between the older and the younger patients was not statistically significant. CONCLUSIONS: In older patients, typical clinical symptoms and blood test changes were often absent; however, CT always contained typical findings of COVID-19, suggesting that CT may be a useful diagnostic tool. Our report illustrates that appropriate treatment, taking patient background into consideration, may improve their condition regardless of age. Geriatr Gerontol Int 2020; 20: 1044-1049.


Assuntos
Infecções por Coronavirus , Doenças não Transmissíveis/epidemiologia , Pandemias , Pneumonia Viral , Tomografia Computadorizada por Raios X , Fatores Etários , Idoso , Betacoronavirus , COVID-19 , Comorbidade , Infecções por Coronavirus/sangue , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Japão/epidemiologia , Contagem de Leucócitos/métodos , Contagem de Leucócitos/estatística & dados numéricos , Masculino , Avaliação de Processos e Resultados em Cuidados de Saúde , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Fatores de Risco , SARS-CoV-2 , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Tomografia Computadorizada por Raios X/métodos , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Tratamento Farmacológico da COVID-19
6.
Intern Med ; 56(3): 377-380, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28154287

RESUMO

A 73-year-old man with type 2 diabetes mellitus and end-stage renal disease was diagnosed with acute myocardial infarction. He required continuous dialysis after percutaneous coronary intervention. Subsequently, multiple nodules were discovered in both lungs for the first time, and Cryptococcus neoformans was isolated from the patient's sputum, blood, bilateral pleural fluid, and cerebrospinal fluid cultures, resulting in a diagnosis of disseminated cryptococcosis. This case represents an invaluable example of disseminated cryptococcosis with rapidly growing lung nodules in a dialysis patient, and illustrates that dialysis causes innate immune disorder and the reactivation of cryptococcosis.


Assuntos
Criptococose/complicações , Criptococose/microbiologia , Diabetes Mellitus Tipo 2 , Pneumopatias Fúngicas/microbiologia , Insuficiência Renal Crônica/complicações , Idoso , Cryptococcus neoformans/isolamento & purificação , Humanos , Pneumopatias Fúngicas/complicações , Masculino , Escarro/microbiologia , Traqueia/microbiologia
7.
J Nutr Sci Vitaminol (Tokyo) ; 58(2): 96-104, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22790567

RESUMO

ATP-binding cassette transporters (ABC) A1 and G1 are key molecules in cholesterol efflux from macrophages, which is an initial step of reverse cholesterol transport (RCT), a major anti-atherogenic property of high-density lipoprotein (HDL). Astaxanthin is one of the naturally occurring carotenoids responsible for the pink-red pigmentation in a variety of living organisms. Although astaxanthin is known to be a strong antioxidant, it remains unclear through what mechanism of action it affects cholesterol homeostasis in macrophages. We therefore investigated the effects of astaxanthin on cholesterol efflux and ABCA1/G1 expressions in macrophages. Astaxanthin enhanced both apolipoprotein (apo) A-I- and HDL-mediated cholesterol efflux from RAW264.7 cells. In supporting these enhanced cholesterol efflux mechanisms, astaxanthin promoted ABCA1/G1 expression in various macrophages. In contrast, peroxisome proliferator-activated receptor γ, liver X receptor (LXR) α and LXRß levels remained unchanged by astaxanthin. An experiment using actinomycin D demonstrated that astaxanthin transcriptionally induced ABCA1/G1 expression, and oxysterol depletion caused by overexpression of cholesterol sulfotransferase further revealed that these inductions in ABCA1/G1 were independent of LXR-mediated pathways. Finally, we performed luciferase assays using human ABCA1/G1 promoter-reporter constructs to reveal that astaxanthin activated both promoters irrespective of the presence or absence of LXR-responsive elements, indicating LXR-independence of these activations. In conclusion, astaxanthin increased ABCA1/G1 expression, thereby enhancing apoA-I/HDL-mediated cholesterol efflux from the macrophages in an LXR-independent manner. In addition to the anti-oxidative properties, the potential cardioprotective properties of astaxanthin might therefore be associated with an enhanced anti-atherogenic function of HDL.


Assuntos
Transportadores de Cassetes de Ligação de ATP/genética , Colesterol/metabolismo , Expressão Gênica/efeitos dos fármacos , Lipoproteínas/genética , Macrófagos/metabolismo , Transportador 1 de Cassete de Ligação de ATP , Membro 1 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Transportadores de Cassetes de Ligação de ATP/fisiologia , Animais , Antioxidantes , Apolipoproteína A-I/efeitos dos fármacos , Apolipoproteína A-I/fisiologia , Cardiotônicos , Linhagem Celular , Lipoproteínas/fisiologia , Lipoproteínas HDL/efeitos dos fármacos , Lipoproteínas HDL/fisiologia , Receptores X do Fígado , Macrófagos/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos C57BL , Receptores Nucleares Órfãos/fisiologia , Xantofilas/farmacologia
9.
Cardiovasc Res ; 95(2): 251-9, 2012 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-22396501

RESUMO

AIMS: Endothelin-1 (ET-1) contributes to the pathogenesis of cardiovascular diseases with multiple properties such as vasoconstriction. Human ET-1 gene expression is up-regulated by the transcription factor hypoxia-inducible factor-1 (HIF-1) through hypoxia response element (HRE). Although previous studies suggested that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) alter HIF-1-related gene expression, it remained unclear whether statins modulate HIF-1-mediated ET-1 expression. Therefore, we investigated the effect of fluvastatin on hypoxia-induced human ET-1 expression in vascular smooth muscle cells (VSMC). METHODS AND RESULTS: Hypoxia (1% O(2)), compared with the normoxic condition (21% O(2)), significantly induced the expression of preproET-1 mRNA, ET-1 protein, and ET-1 secretion in VSMC. Hypoxia induced a 2.3-fold increase in HRE-dependent ET-1 reporter gene activation. Under concentrations of 1 µmol/L or greater, fluvastatin attenuated the hypoxia-induced ET-1 gene expression through the accelerated ubiquitin/proteasome-dependent degradation of HIF-1α, thus consequently attenuating HIF-1α binding to the HRE of the ET-1 gene. These inhibitory effects of fluvastatin were cancelled by concomitant treatment with mevalonate, farnesyl pyrophosphate, or geranylgeranyl pyrophosphate, but not squalene. CONCLUSION: The present study suggests that fluvastatin attenuates HIF-1-dependent ET-1 gene expression in conjunction with the stimulation of HIF-1α ubiquitin/proteasome-dependent degradation via isoprenoid-dependent mechanisms.


Assuntos
Endotelina-1/metabolismo , Ácidos Graxos Monoinsaturados/farmacologia , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Indóis/farmacologia , Miócitos de Músculo Liso/metabolismo , Células Cultivadas , Fluvastatina , Humanos , Hipóxia/metabolismo , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Proteólise/efeitos dos fármacos , Fatores de Transcrição
10.
Biochim Biophys Acta ; 1821(4): 561-72, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22353356

RESUMO

ABC transporter G1 (ABCG1) plays a pivotal role in HDL-mediated cholesterol efflux and atherogenesis. We investigated whether, and how, retinoic acid receptors (RARs) regulate ABCG1 expression in macrophages. All-trans retinoic acid (ATRA), an RAR ligand, increased ABCG1 protein levels and apoA-I/HDL-mediated cholesterol efflux from the macrophages. Both ATRA and other RAR agonists, TTNPB and Am580, increased major transcripts driven by promoter B upstream of exon 5, though minor transcripts driven by promoter A upstream of exon 1 were only increased by ATRA. The stimulatory effects of ATRA on ABCG1 expression were completely abolished in the presence of RAR/RXR antagonists but were only partially canceled in the presence of an LXR antagonist. Adenovirus with overexpressed oxysterol sulfotransferase abolished the LXR pathway, as previously reported, and ATRA-responsiveness in ABCA1/ABCG1 expressions were respectively attenuated by 38 and 22% compared to the control virus. Promoter assays revealed that ABCG1 levels were regulated more by promoter B than promoter A, and ATRA activated promoter B in a liver X receptor-responsive element (LXRE)-dependent manner. Further, LXRE-B in intron 7, but not LXRE-A in intron 5, enhanced ATRA responsiveness under overexpression of all RAR isoforms-RARα/ß/γ. In contrast, the activation of promoter B by TTNPB depended on LXRE-B and RARα, but not on RARß/γ. Finally, chromatin immunoprecipitation and gel-shift assays revealed a specific and direct repeat 4-dependent binding of RARα to LXRE-B. In conclusion, RAR ligands increase ABCA1/G1 expression and apoA-I/HDL-mediated cholesterol efflux from macrophages, and modulate ABCG1 promoter activity via LXRE-dependent mechanisms.


Assuntos
Transportadores de Cassetes de Ligação de ATP/metabolismo , Macrófagos/efeitos dos fármacos , Receptores do Ácido Retinoico/agonistas , Tretinoína/farmacologia , Transportador 1 de Cassete de Ligação de ATP , Membro 1 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Transportadores de Cassetes de Ligação de ATP/genética , Animais , Benzoatos/farmacologia , Transporte Biológico/efeitos dos fármacos , Western Blotting , Células COS , Linhagem Celular , Chlorocebus aethiops , Colesterol/metabolismo , Regulação da Expressão Gênica/efeitos dos fármacos , Células HEK293 , Humanos , Receptores X do Fígado , Macrófagos/citologia , Macrófagos/metabolismo , Modelos Genéticos , Receptores Nucleares Órfãos/agonistas , Receptores Nucleares Órfãos/genética , Receptores Nucleares Órfãos/metabolismo , Regiões Promotoras Genéticas/genética , Ligação Proteica/efeitos dos fármacos , Receptores do Ácido Retinoico/genética , Receptores do Ácido Retinoico/metabolismo , Elementos de Resposta/genética , Receptores X de Retinoides/agonistas , Receptores X de Retinoides/genética , Receptores X de Retinoides/metabolismo , Retinoides/farmacologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transdução de Sinais/efeitos dos fármacos , Tetra-Hidronaftalenos/farmacologia
11.
Aviat Space Environ Med ; 82(9): 904-8, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21888276

RESUMO

INTRODUCTION: Cardiovascular diseases can lead to sudden in-flight incapacitation and long-term disability in aircraft pilots. Electrocardiogram (ECG) has been widely used to screen for these diseases in routine aeromedical examinations. Several ECG changes such as complete left bundle-branch block (CLBBB) and left ventricular hypertrophy (LVH) have been associated with increased likelihood of underlying structural cardiac diseases in addition to the emergence of newly recognized cardiovascular diseases such as Brugada syndrome. Therefore, the purpose of this study was to analyze decadal ECG changes in aircraft pilots between 40 and 50 yr in order to make an appropriate evaluation of these ECG changes. METHODS: We analyzed the ECGs from the annual aeromedical examination of age 50 compared to those 40 yr of age in a total of 176 Japan Air Self-Defense Force pilots. RESULTS: With regard to decadal changes, we detected 34 new ECG changes (1 of sinus tachycardia, 8 sinus bradycardia, 1 atrial fibrillation, 2 premature atrial contraction, 1 premature ventricular contraction, 2 left axis deviation, 6 first-degree atrioventricular block, 1 CLBBB, 3 complete right bundle-branch block, 2 incomplete right bundle-branch block, 1 right ventricular conduction delay, and 6 LVH). Although the majority of them were concluded to be normal variants, the results of echocardiography in two hypertensive pilots without good control demonstrated abnormalities: one had mild hypertrophic nonobstructive cardiomyopathy and another had heart enlargement. CONCLUSION: Thus, this study recommends additional cardiovascular examinations, including echocardiography for hypertensive pilots with ECG changes.


Assuntos
Medicina Aeroespacial , Eletrocardiografia , Cardiopatias/epidemiologia , Militares , Adulto , Idade de Início , Síndrome de Brugada/epidemiologia , Humanos , Hipertensão/epidemiologia , Hipertrofia Ventricular Esquerda , Masculino , Pessoa de Meia-Idade
12.
Arterioscler Thromb Vasc Biol ; 31(9): 1980-7, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21817095

RESUMO

OBJECTIVE: ATP-binding cassette transporter A1 (ABCA1) and ABCG1 are key molecules in an initial step of reverse cholesterol transport (RCT), a major antiatherogenic property of high-density lipoprotein (HDL). The ubiquitin-proteasome system (UPS) mediates nonlysosomal pathways for protein degradation and is known to be involved in atherosclerosis. However, little is known about the effects of the UPS on these molecules and overall RCT. We therefore investigated whether UPS inhibition affects ABCA1/G1 expression in macrophages and RCT in vitro and in vivo. METHODS AND RESULTS: Various proteasome inhibitors increased ABCA1/G1 expression in macrophages, translating into enhanced apolipoprotein A-I- and HDL-mediated cholesterol efflux from macrophages. ABCA1 and ABCG1 were found to undergo polyubiquitination in the macrophages and HEK293 cells overexpressing these proteins, and pulse-chase analysis revealed that proteasome inhibitors inhibited ABCA1/G1 protein degradation. In in vivo experiments, the proteasome inhibitor bortezomib increased ABCA1/G1 protein levels in mouse peritoneal macrophages, and RCT assays showed that it significantly increased the fecal (54% increase compared with saline) and plasma (23%) appearances of the tracer derived from intraperitoneally injected (3)H-cholesterol-labeled macrophages. CONCLUSIONS: The present study provided evidence that the UPS is involved in ABCA1/G1 degradation, thereby affecting RCT in vivo. Therefore, specific inhibition of the UPS pathway might lead to a novel HDL therapy that enhances RCT.


Assuntos
Transportadores de Cassetes de Ligação de ATP/fisiologia , Colesterol/metabolismo , Lipoproteínas/fisiologia , Macrófagos/metabolismo , Complexo de Endopeptidases do Proteassoma/fisiologia , Transportador 1 de Cassete de Ligação de ATP , Membro 1 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Transportadores de Cassetes de Ligação de ATP/análise , Animais , Apolipoproteína A-I/fisiologia , Ácidos Borônicos/farmacologia , Bortezomib , Células Cultivadas , Células Hep G2 , Humanos , Lipoproteínas/análise , Lipoproteínas HDL/fisiologia , Camundongos , Fosforilação , Inibidores de Proteassoma , Pirazinas/farmacologia , Ubiquitina-Proteína Ligases/fisiologia , Ubiquitinação
13.
Atherosclerosis ; 219(1): 141-50, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21862012

RESUMO

OBJECTIVE: Pioglitazone, a peroxisome proliferator-activated receptor γ (PPARγ) agonist, reportedly reduces cardiovascular events in diabetic patients. ATP cassette binding transporters (ABC) A1 and G1 are pivotal molecules for cholesterol efflux (ChE) from macrophages and high density-lipoprotein biogenesis, and the A1 transporter is regulated by a PPARγ-liver receptor X (LXR) pathway. Also, pioglitazone induces ABCG1 expression, though the exact mechanism remains unclear. We therefore investigated the effects of pioglitazone on ABCA1/G1 expression in vitro and ex vivo. METHODS: The effects of pioglitazone on ChE and ABCA1/G1 expressions in macrophages were assessed. Then, mRNA was quantified in macrophages when PPARγ/LXR inhibition by siRNA or overexpression of oxysterol sulfotransferase was performed. ABCA1/G1 promoter activity with mutated LXR-responsive elements was also measured. As an ex vivo study, 15 type 2 diabetic patients were administered pioglitazone or placebo, and ChE assays and protein expressions were determined using macrophages cultured with the corresponding sera. RESULTS: Pioglitazone increased LXRα/ABCA1/G1 expressions, which enhanced ChE from macrophages. Inhibition of PPARγ/LXR pathways revealed that LXR was primarily involved in pioglitazone's transactivation of ABCA1 but only partially involved for ABCG1. Promoter assays showed that ABCG1 was regulated more by the promoter in intron 4 than that upstream of exon 1 but both promoters were responsive to LXR activation. Sera obtained after pioglitazone treatment promoted ChE and ABCA1/G1 expressions in macrophages. CONCLUSION: Pioglitazone enhanced ChE from macrophages by increasing ABCA1/G1 in LXR-dependent and -independent manners. Our comparable in vitro and ex vivo results shed new light on pioglitazone's novel anti-atherogenic property.


Assuntos
Transportadores de Cassetes de Ligação de ATP/biossíntese , Colesterol/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Hipoglicemiantes/farmacologia , Macrófagos/fisiologia , Receptores Nucleares Órfãos/biossíntese , PPAR gama/metabolismo , Tiazolidinedionas/farmacologia , Transportador 1 de Cassete de Ligação de ATP , Membro 1 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Células Cultivadas , Células HEK293 , Humanos , Receptores X do Fígado , Macrófagos/efeitos dos fármacos , Pioglitazona , Interferência de RNA
14.
J Atheroscler Thromb ; 18(6): 513-30, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21636950

RESUMO

AIM: Reverse cholesterol transport (RCT) is a critical mechanism for the anti-atherogenic property of HDL. The inhibitory effect of the sulfonylurea agent (SUA) glibenclamide on ATP binding-cassette transporter (ABC) A1 may decrease HDL function but it remains unclear whether it attenuates RCT in vivo. We therefore investigated how the SUAs glibenclamide and glimepiride affected the functionality of ABCA1/ABCG1 and scavenger receptor class B type I (SR-BI) expression in macrophages in vitro and overall RCT in vivo. METHODS: RAW264.7, HEK293 and BHK-21 cells were used for in vitro studies. To investigate RCT in vivo, 3H-cholesterol-labeled and acetyl LDL-loaded RAW264.7 cells were injected into mice. RESULTS: High dose (500µM) of glibenclamide inhibited ABCA1 function and apolipoprotein A-I (apoA-I)-mediated cholesterol efflux, and attenuated ABCA1 expression. Although glimepiride maintained apoA-I-mediated cholesterol efflux from RAW264.7 cells, like glibenclamide, it inhibited ABCA1-mediated cholesterol efflux from transfected HEK293 cells. Similarly, the SUAs inhibited SR-BI-mediated cholesterol efflux from transfected BHK-21 cells. High doses of SUAs increased ABCG1 expression in RAW264.7 cells, promoting HDL-mediated cholesterol efflux in an ABCG1-independent manner. Low doses (0.1-100 µM) of SUAs did not affect cholesterol efflux from macrophages despite dose-dependent increases in ABCA1/G1 expression. Furthermore, they did not change RCT or plasma lipid levels in mice. CONCLUSION: High doses of SUAs inhibited the functionality of ABCA1/SR-BI, but not ABCG1. At lower doses, they had no unfavorable effects on cholesterol efflux or overall RCT in vivo. These results indicate that SUAs do not have adverse effects on atherosclerosis contrary to previous findings for glibenclamide.


Assuntos
Transportadores de Cassetes de Ligação de ATP/metabolismo , Colesterol/metabolismo , Glibureto/farmacologia , Hipoglicemiantes/farmacologia , Receptores Depuradores Classe B/metabolismo , Transportadores de Cassetes de Ligação de ATP/antagonistas & inibidores , Transportadores de Cassetes de Ligação de ATP/genética , Animais , Transporte Biológico , Western Blotting , Células Cultivadas , Cricetinae , Células HEK293 , Humanos , Técnicas In Vitro , Fígado/citologia , Fígado/efeitos dos fármacos , Fígado/metabolismo , Macrófagos/citologia , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Macrófagos Peritoneais/citologia , Macrófagos Peritoneais/efeitos dos fármacos , Macrófagos Peritoneais/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , RNA Mensageiro/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Receptores Depuradores Classe B/antagonistas & inibidores , Receptores Depuradores Classe B/genética
15.
Atherosclerosis ; 213(1): 135-41, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20723893

RESUMO

OBJECTIVE: Recent failure of an HDL-cholesterol raising strategy using a cholesteryl ester transfer protein inhibitor highlights the importance of the anti-atherogenic function rather than plasma concentration of HDL. Cilostazol, a selective inhibitor of phosphodiesterase 3, has been widely used in patients with atherosclerotic diseases and is known to increase HDL-cholesterol. However, it remains unclear whether cilostazol enhances anti-atherogenic properties by promoting reverse cholesterol transport (RCT), a major anti-atherogenic function of HDL. METHODS AND RESULTS: We observed that treatment of THP-1 macrophages, human monocyte-derived macrophages, and RAW264.7 cells with cilostazol increased ABCA1 and ABCG1 expression in a concentration-dependent manner, translating into enhanced apoA-I- and HDL-mediated cholesterol efflux from the macrophages. However, other cyclic AMP (cAMP)-elevating agents did not increase ABCA1 gene expression in THP-1 macrophages. Cilostazol did not change intracellular cAMP levels in THP-1 macrophages and RAW264.7 cells, and a protein kinase A (PKA) inhibitor did not affect cilostazol-induced ABCA1 and ABCG1 expression. To further investigate RCT in vivo, (3)H-cholesterol-labeled and acetyl LDL-loaded RAW264.7 cells were intraperitoneally injected into mice and the appearance of the (3)H-tracer was monitored in plasma, liver, and feces. Supporting the in vitro data, cilostazol was found to significantly increase (3)H-tracer levels in both plasma and feces. CONCLUSIONS: These findings indicate that cilostazol might provide anti-atherosclerotic effects by promoting RCT through increased ABCA1/G1 expression in macrophages.


Assuntos
Colesterol/metabolismo , Macrófagos/metabolismo , Tetrazóis/farmacologia , Bile/metabolismo , Transporte Biológico , HDL-Colesterol/metabolismo , Cilostazol , AMP Cíclico/metabolismo , Nucleotídeo Cíclico Fosfodiesterase do Tipo 3/metabolismo , Humanos , Técnicas In Vitro , Fígado/metabolismo , Modelos Biológicos , Inibidores da Fosfodiesterase 3/farmacologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa
16.
Aviat Space Environ Med ; 81(6): 593-6, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20540453

RESUMO

Ventricular fibrillation diagnoses such as Brugada syndrome pose a risk of sudden incapacitation or death in aircrew. This case report presents a 44-yr-old male fighter pilot who unexpectedly developed ventricular fibrillation (VF) during an electrophysiological study (EPS) prior to therapy for non-sustained ventricular tachycardia (nsVT). The initial aeromedical disposition for this case was "qualified for flying duties". with the restriction that he must fly with another pilot due to repeatedly observed nsVT. This pilot wanted to return to flight duty in single-seat aircraft without any restrictions. Therefore, this patient decided to undergo catheter therapy for nsVT. Unexpectedly, not VT but VF was induced by catheter manipulation during EPS. Pilsicainide-induced coved-type ST wave elevation consistent with Brugada syndrome was noted in this patient's electrocardiogram. He was ultimately disqualified due to the diagnosis of VF. This report suggests EPS on rare occasions may uncover another severe disease similar to this case report.


Assuntos
Síndrome de Brugada/diagnóstico , Saúde Ocupacional , Taquicardia Ventricular/diagnóstico , Fibrilação Ventricular/diagnóstico , Adulto , Antiarrítmicos/uso terapêutico , Eletrocardiografia , Humanos , Japão , Lidocaína/análogos & derivados , Lidocaína/uso terapêutico , Masculino , Taquicardia Ventricular/fisiopatologia , Fatores de Tempo , Fibrilação Ventricular/fisiopatologia
17.
Intern Med ; 49(10): 925-9, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20467178

RESUMO

A 68-year-old man, who had worked for processing quartz-containing stones for more than 50 years, complained of low-grade fever and arthralgia. Mediastinal lymph nodes were markedly swollen on chest computed tomography. Pathological findings of the lymph node were compatible with silicosis, with a high titer of myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA). During follow-up with prednisolone treatment, pleuritis and uveitis developed as manifestations of vasculitis. Thus, he was diagnosed with MPO-ANCA-associated vasculitis with occupational silica exposure, possibly microscopic polyangiitis (MPA). This case is rare, because pleuritis was the only pulmonary manifestation, without interstitial pneumonia, alveolar hemorrhage or glomerulonephritis.


Assuntos
Poliangiite Microscópica/etiologia , Pleurisia/etiologia , Dióxido de Silício/efeitos adversos , Silicose/complicações , Silicose/diagnóstico , Idoso , Anticorpos Anticitoplasma de Neutrófilos/sangue , Glucocorticoides/uso terapêutico , Humanos , Doenças Linfáticas/etiologia , Doenças Linfáticas/patologia , Masculino , Exposição Ocupacional , Peroxidase/imunologia , Pleurisia/diagnóstico por imagem , Prednisolona/uso terapêutico , Silicose/tratamento farmacológico , Silicose/imunologia , Tomografia Computadorizada por Raios X , Uveíte/etiologia
18.
Circ Res ; 106(4): 779-87, 2010 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-20075335

RESUMO

RATIONALE: Association of habitual coffee consumption with coronary heart disease morbidity and mortality has not been established. We hypothesized that coffee may enhance reverse cholesterol transport (RCT) as the antiatherogenic properties of high-density lipoprotein (HDL). OBJECTIVE: This study was to investigate whether the phenolic acids of coffee and coffee regulates RCT from macrophages in vitro, ex vivo and in vivo. METHODS AND RESULTS: Caffeic acid and ferulic acid, the major phenolic acids of coffee, enhanced cholesterol efflux from THP-1 macrophages mediated by HDL, but not apoA-I. Furthermore, these phenolic acids increased both the mRNA and protein levels of ATP-binding cassette transporter (ABC)G1 and scavenger receptor class B type I (SR-BI), but not ABCA1. Eight healthy volunteers were recruited for the ex vivo study, and blood samples were taken before and 30 minutes after consumption of coffee or water in a crossover study. The mRNA as well as protein levels of ABCG1, SR-BI, and cholesterol efflux by HDL were increased in the macrophages differentiated under autologous sera obtained after coffee consumption compared to baseline sera. Finally, effects of coffee and phenolic acid on in vivo RCT were assessed by intraperitoneally injecting [(3)H]cholesterol-labeled acetyl low-density lipoprotein-loaded RAW264.7 cells into mice, then monitoring appearance of (3)H tracer in plasma, liver, and feces. Supporting in vitro and ex vivo data, ferulic acid was found to significantly increase the levels of (3)H tracer in feces. CONCLUSIONS: Coffee intake might have an antiatherogenic property by increasing ABCG1 and SR-BI expression and enhancing HDL-mediated cholesterol efflux from the macrophages via its plasma phenolic acids.


Assuntos
Bebidas , Ácidos Cafeicos/farmacologia , Colesterol/metabolismo , Café , Ácidos Cumáricos/farmacologia , Lipoproteínas HDL/metabolismo , Macrófagos/efeitos dos fármacos , Transportador 1 de Cassete de Ligação de ATP , Membro 1 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Transportadores de Cassetes de Ligação de ATP/genética , Transportadores de Cassetes de Ligação de ATP/metabolismo , Adulto , Animais , Apolipoproteína A-I/metabolismo , Bile/metabolismo , Transporte Biológico , Ácidos Cafeicos/sangue , Linhagem Celular , Colesterol/sangue , Doença das Coronárias/metabolismo , Doença das Coronárias/prevenção & controle , Ácidos Cumáricos/sangue , Estudos Cross-Over , Relação Dose-Resposta a Droga , Fezes/química , Feminino , Genes Reporter , Humanos , Lipoproteínas HDL/sangue , Lipoproteínas LDL/metabolismo , Fígado/metabolismo , Macrófagos/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , RNA Mensageiro/metabolismo , Receptores Depuradores Classe B/genética , Receptores Depuradores Classe B/metabolismo , Fatores de Tempo , Transfecção , Regulação para Cima
19.
Intern Med ; 48(23): 2025-32, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19952486

RESUMO

Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) of the thymus is rare and little is known about its karyotype abnormality. MALT lymphoma in general shows a good prognosis, but some reports suggest that the presence of trisomy 18 predicts recurrence. Here, we report a patient with MALT lymphoma of the thymus and the left parotid gland accompanied by Sjogren's syndrome. The karyotype analysis revealed that this is the first case of thymic MALT lymphoma with trisomy 18, which we believe is worth reporting. We also review cases with thymic MALT lymphoma previously reported in the literature.


Assuntos
Cromossomos Humanos Par 18 , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Neoplasias do Timo/diagnóstico , Trissomia/diagnóstico , Adulto , Cromossomos Humanos Par 18/genética , Feminino , Humanos , Linfoma de Zona Marginal Tipo Células B/genética , Neoplasias do Timo/genética , Trissomia/genética
20.
Mil Med ; 174(6): 626-30, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19585777

RESUMO

Spatial disorientation (SD) is one of the most severe causative factors in aviation accidents. We analyzed the reported SD episodes to evaluate the characteristics of severe SD in fighter pilots. Three hundred seventeen cases (95.5%) of 332 total valid cases experienced SD, and the ratio of night and day SD experiences (52.7% vs. 47.3%) (p < 0.05) shows a clear prevalence of night SD events. The severity of SD episodes at night (2.23 +/- 1.09) was higher than at day (1.89 +/- 1.04) (p < 0.01). In addition, the severity of visual illusions was significantly higher at night. A significant difference was found for meteorological conditions, such as visual meteorological conditions (VMC), instrument meteorological conditions (IMC) and VMC-IMC (VI) transition, among times of days. In conclusion, the severity of the SD episodes was higher at night. This may be due to an increase in visual severe SD episodes at night.


Assuntos
Adaptação Fisiológica , Aeronaves , Militares , Visão Noturna , Percepção Espacial , Adulto , Inquéritos Epidemiológicos , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Inquéritos e Questionários
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