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Introduction: Acquired Hemophilia A (AHA) is a rare autoimmune disorder characterized by the emergence of inhibitors that specifically target coagulation Factor VIII, frequently resulting in severe bleeding episodes. Methods: We conducted a retrospective analysis of the medical records of a 68-year-old male patient who presented with adalimumab-induced AHA. Results: The patient received adalimumab, a tumor necrosis factor inhibitor antibody, as part of his treatment for rheumatoid arthritis. The patient's clinical journey, characterized by intense bleeding and coagulopathy, was effectively managed with the application of recombinant Factor VIIa (rFVIIa) and the CyDRi protocol. Discussion: The case emphasizes the importance of prompt coagulation assessment in patients with bleeding symptoms receiving disease-modifying therapy for rheumatoid arthritis that includes adalimumab therapy, considering the rare yet life-threatening nature of AHA. Additionally, this report provides an extensive review of the existing literature on drug-induced AHA, with a special emphasis on cases linked to immunomodulatory medications. Through this two-pronged approach, our report aims to enhance understanding and awareness of this severe complication among healthcare providers, promoting timely diagnosis and intervention.
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Adalimumab , Hemofilia A , Humanos , Hemofilia A/tratamento farmacológico , Hemofilia A/induzido quimicamente , Masculino , Idoso , Adalimumab/efeitos adversos , Adalimumab/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Fator VIIa/uso terapêutico , Antirreumáticos/uso terapêutico , Antirreumáticos/efeitos adversos , Rituximab/uso terapêutico , Rituximab/efeitos adversos , Estudos Retrospectivos , Proteínas Recombinantes/uso terapêuticoRESUMO
Poly-ß-hydroxybutyrate (PHB) is a potential source of biodegradable plastics that are environmentally friendly due to their complete degradation to water and carbon dioxide. This study aimed to investigate PHB production in the cyanobacterium Synechocystis sp. PCC6714 MT_a24 in an outdoor bioreactor using urban wastewater as a sole nutrient source. The culture was grown in a thin-layer raceway pond with a working volume of 100 L, reaching a biomass density of up to 3.5 g L-1 of cell dry weight (CDW). The maximum PHB content was found under nutrient-limiting conditions in the late stationary phase, reaching 23.7 ± 2.2% PHB per CDW. These data are one of the highest reported for photosynthetic production of PHB by cyanobacteria, moreover using urban wastewater in pilot-scale cultivation which multiplies the potential of sustainable cultivation approaches. Contamination by grazers (Poterioochromonas malhamensis) was managed by culturing Synechocystis in a highly alkaline environment (pH about 10.5) which did not significantly affect the culture growth. Furthermore, the strain MT_a24 showed significant wastewater nutrient remediation removing about 72% of nitrogen and 67% of phosphorus. These trials demonstrate that the photosynthetic production of PHB by Synechocystis sp. PCC6714 MT_a24 in the outdoor thin-layer bioreactor using urban wastewater and ambient carbon dioxide. It shows a promising approach for the cost-effective and sustainable production of biodegradable carbon-negative plastics. KEY POINTS: ⢠High PHB production by cyanobacteria in outdoor raceway pond ⢠Urban wastewater used as a sole source of nutrients for phototrophic growth ⢠Potential for cost-effective and sustainable production of biodegradable plastics.
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Plásticos Biodegradáveis , Synechocystis , Dióxido de Carbono , Hidroxibutiratos , Poliésteres , Lagoas , Águas ResiduáriasRESUMO
Low production rates are still one limiting factor for the industrial climate-neutral production of biovaluable compounds in cyanobacteria. Next to optimized cultivation conditions, new production strategies are required. Hence, the use of established molecular tools could lead to increased product yields in the cyanobacterial model organism Synechocystis sp. PCC6803. Its main storage compound glycogen was chosen to be increased by the use of these tools. In this study, the three genes glgC, glgA1 and glgA2, which are part of the glycogen synthesis pathway, were combined with the Pcpc560 promoter and the neutral cloning site NSC1. The complete genome integration, protein formation, biomass production and glycogen accumulation were determined to select the most productive transformants. The overexpression of glgA2 did not increase the biomass or glycogen production in short-term trials compared to the other two genes but caused transformants death in long-term trials. The transformants glgA1_11 and glgC_2 showed significantly increased biomass (1.6-fold - 1.7-fold) and glycogen production (3.5-fold - 4-fold) compared to the wild type after 96 h making them a promising energy source for further applications. Those could include for example a two-stage production process, with first energy production (glycogen) and second increased product formation (e.g. ethanol).
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Synechocystis , Glicogênio , Synechocystis/genéticaRESUMO
Microalgae-based bioenergy production is a promising field with regard to the wide variety of algal species and metabolic potential. The use of liquid wastes as nutrient clearly improves the sustainability of microalgal biofuel production. Microalgae and bacteria have an ecological inter-kingdom relationship. This microenvironment called phycosphere has a major role in the ecosystem productivity and can be utilized both in bioremediation and biomass production. However, knowledge on the effects of indigenous bacteria on microalgal growth and the characteristics of bacterial communities associated with microalgae are limited. In this study municipal, industrial and agricultural liquid waste derivatives were used as cultivation media. Chlorella vulgaris green microalgae and its bacterial partners efficiently metabolized the carbon, nitrogen and phosphorous content available in these wastes. The read-based metagenomics approach revealed a diverse microbial composition at the start point of cultivations in the different types of liquid wastes. The relative abundance of the observed taxa significantly changed over the cultivation period. The genome-centric reconstruction of phycospheric bacteria further explained the observed correlations between the taxonomic composition and biomass yield of the various waste-based biodegradation systems. Functional profile investigation of the reconstructed microbes revealed a variety of relevant biological processes like organic acid oxidation and vitamin B synthesis. Thus, liquid wastes were shown to serve as valuable resources of nutrients as well as of growth promoting bacteria enabling increased microalgal biomass production.
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Microalgae accumulate bioavailable selenium-containing amino acids (Se-AAs), and these are useful as a food supplement. While this accumulation has been studied in phototrophic algal cultures, little data exists for heterotrophic cultures. We have determined the Se-AAs content, selenium/sulfur (Se/S) substitution rates, and overall Se accumulation balance in photo- and heterotrophic Chlorella cultures. Laboratory trials revealed that heterotrophic cultures tolerate Se doses â¼8-fold higher compared to phototrophic cultures, resulting in a â¼2-3-fold higher Se-AAs content. In large-scale experiments, both cultivation regimes provided comparable Se-AAs content. Outdoor phototrophic cultures accumulated up to 400 µg g-1 of total Se-AAs and exhibited a high level of Se/S substitution (5-10%) with 30-60% organic/total Se embedded in the biomass. A slightly higher content of Se-AAs and ratio of Se/S substitution was obtained for a heterotrophic culture in pilot-scale fermentors. The data presented here shows that heterotrophic Chlorella cultures provide an alternative for Se-enriched biomass production and provides information on Se-AAs content and speciation in different cultivation regimes.
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Aminoácidos/metabolismo , Chlorella/metabolismo , Chlorella/efeitos da radiação , Selênio/metabolismo , Aminoácidos/análise , Biomassa , Chlorella/classificação , Chlorella/crescimento & desenvolvimento , Processos Heterotróficos , Microalgas/química , Microalgas/crescimento & desenvolvimento , Microalgas/metabolismo , Microalgas/efeitos da radiação , Processos Fototróficos , Selênio/análiseRESUMO
We have worked out a rapid 1-day test based on photosynthesis measurements to estimate suitable growth temperature of microalgae cultures. To verify the proposed procedure, several microalgae-Chlorella, Nostoc, Synechocystis, Scenedesmus, and Cylindrospermum-were cultured under controlled laboratory conditions (irradiance, temperature, mixing, CO2, and nutrient supply) to find the optima of photosynthetic activity using the range between 15 and 35 °C. These activities were recorded at each temperature step after 2 h of acclimation which should be sufficient as oxygen production and the PQ cycle are regulated by fast processes. Photosynthetic activity was measured using three techniques-oxygen production/respiration, saturating pulse analysis of fluorescence quenching, and fast fluorescence induction kinetics-to estimate the temperature optima which should correspond to high growth rate. We measured all variables that might have been directly related to growth-photosynthetic oxygen evolution, maximum photochemical yield of PSII, Fv/Fm, relative electron transport rate rETRmax, and the transients Vj and Vi determined by fast fluorescence induction curves. When the temperature optima for photosynthetic activity were verified in growth tests, we found good correlation. For most of tested microalgae strains, temperature around 30 °C was found to be the most suitable at this setting. We concluded that the developed test can be used as a rapid 1-day pre-screening to estimate a suitable growth temperature of microalgae strains before they are cultured in a pilot scale.
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Técnicas de Cultura/métodos , Microalgas/crescimento & desenvolvimento , Chlorella/crescimento & desenvolvimento , Chlorella/metabolismo , Chlorella/efeitos da radiação , Cianobactérias/crescimento & desenvolvimento , Cianobactérias/metabolismo , Cianobactérias/efeitos da radiação , Cinética , Luz , Microalgas/metabolismo , Microalgas/efeitos da radiação , Oxigênio/metabolismo , Fotossíntese , Scenedesmus/crescimento & desenvolvimento , Scenedesmus/metabolismo , Scenedesmus/efeitos da radiação , TemperaturaRESUMO
In this work, the key moments of the development of the so-called thin-layer cascades (TLC) for microalgae production are described. Development started at the end of the 1950s when the first generation of TLCs was set-up in former Czechoslovakia. Since, similar units for microalgae culturing, which are relatively simple, low-cost and highly productive, have been installed in a number of other countries worldwide. The TLCs are characterized by microalgae growth at a low depth (< 50 mm) and fast flow (0.4-0.5 m/s) of culture compared to mixed ponds or raceways. It guarantees a high ratio of exposed surface to total culture volume (> 100 1/m) and rapid light/dark cycling frequencies of cells which result in high biomass productivity (> 30 g/m2/day) and operating at high biomass density, > 10 g/L of dry mass (DW). In TLCs, microalgae culture is grown in the system of inclined platforms that combine the advantages of open systems-direct sun irradiance, easy heat derivation, simple cleaning and maintenance, and efficient degassing-with positive features of closed systems-operation at high biomass densities achieving high volumetric productivity. Among significant advantages of thin layer cascades compared to raceway ponds are the operation at much higher cell densities, very high daylight productivities, and the possibility to store the culture in retention tanks at night, or in unfavourable weather conditions. Concerning the limitations of TLCs, one has to consider contaminations by other microalgae that limit cultivation to robust, fast-growing strains, or those cultured in selective environments.
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Microalgas/crescimento & desenvolvimento , Reatores Biológicos/história , Biotecnologia/história , Biotecnologia/instrumentação , Biotecnologia/métodos , História do Século XX , Luz , Microalgas/metabolismo , Microalgas/efeitos da radiaçãoRESUMO
The worldwide growing demand for energy permanently increases the pressure on industrial and scientific community to introduce new alternative biofuels on the global energy market. Besides the leading role of biodiesel and biogas, bioethanol receives more and more attention as first- and second-generation biofuel in the sustainable energy industry. Lately, microalgae (green algae and cyanobacteria) biomass has also remarkable potential as a feedstock for the third-generation biofuel production due to their high lipid and carbohydrate content. The third-generation bioethanol production technology can be divided into three major processing ways: (i) fermentation of pre-treated microalgae biomass, (ii) dark fermentation of reserved carbohydrates and (iii) direct "photo-fermentation" from carbon dioxide to bioethanol using light energy. All three technologies provide possible solutions, but from a practical point of view, traditional fermentation technology from microalgae biomass receives currently the most attention. This study mainly focusses on the latest advances in traditional fermentation processes including the steps of enhanced carbohydrate accumulation, biomass pre-treatment, starch and glycogen downstream processing and various fermentation approaches.
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Etanol/metabolismo , Microalgas/metabolismo , Polissacarídeos/metabolismo , Biocombustíveis/análise , Biotecnologia , FermentaçãoRESUMO
Most photosynthetic organisms store and convert solar energy in an aerobic process and produce biomass for various uses. Utilization of biomass for the production of renewable energy carriers employs anaerobic conditions. This review focuses on microalgal biomass and its use for biological hydrogen and methane production. Microalgae offer several advantages compared to terrestrial plants. Strategies to maintain anaerobic environment for biohydrogen production are summarized. Efficient biogas production via anaerobic digestion is significantly affected by the biomass composition, pretreatment strategies and the parameters of the digestion process. Coupled biohydrogen and biogas production increases the efficiency and sustainability of renewable energy production.
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Biocombustíveis/análise , Hidrogênio/metabolismo , Metano/biossíntese , Microalgas/metabolismo , Anaerobiose , Biomassa , Microalgas/crescimento & desenvolvimentoRESUMO
Tyrosine kinase inhibitors are widely used for treatment of certain oncohematological diseases. Several clinical studies have confirmed that specific BCR-ABL tyrosine kinase inhibitors alter the physiological process of bone tissue in a complex and unclearly identified manner. Since these treatments are being given to more and more patients, and the therapy takes decades or lasts even lifelong, it is justifiable to obtain more detailed knowledge of the molecular background of these mechanisms. In this article the authors summarize preliminary research results and human clinical observations on imatinib and nilotinib which are related to bone metabolism, and present the results of their own experiments in in vitro osteoblast cultures. Based on the presented results, the effects of imatinib and nilotinib on bone cells depend on the concentration of imatinib and nilotinib, the maturation stage of the cells and the distribution ratio of receptor tyrosine kinase signaling pathways. In this study the authors firstly prepared a stop-gap, comprehensive review in the Hungarian literature, regarding the effects of tyrosine kinase inhibitors on bone metabolism. In addition they firstly performed whole transcriptome analysis on osteoblasts in order to obtain a better understanding of the cellular molecular mechanisms. Orv. Hetil., 2016, 157(36), 1429-1437.
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Antineoplásicos/uso terapêutico , Mesilato de Imatinib/uso terapêutico , Leucemia/tratamento farmacológico , Pirimidinas/uso terapêutico , Osso e Ossos/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Osteoclastos/efeitos dos fármacosRESUMO
Numerous clinical observations have confirmed that breakpoint cluster region-abelson fusion oncoprotein tyrosine kinase inhibitors used in leukemia treatment alter bone physiology in a complex manner. The aim of the present study was to analyze the whole transcriptome of cultured murine osteoblasts and determine the changes following treatment with imatinib and nilotinib using Sequencing by Oligonucleotide Ligation and Detection next generation RNA sequencing. This study also aimed to identify candidate signaling pathways and network regulators by multivariate Ingenuity Pathway Analysis. Based on the right-tailed Fisher's exact test, significantly altered pathways including upstream regulators were defined for each drug. The correlation between these pathways and bone metabolism was also examined. The preliminary results suggest the two drugs have different mechanisms of action on osteoblasts, and imatinib was shown to have a greater effect on gene expression. Data also indicated the potential role of a number of genes and signaling cascades that may contribute to identifying novel targets for the treatment of metabolic bone diseases.
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Regulação da Expressão Gênica/efeitos dos fármacos , Mesilato de Imatinib/farmacologia , Osteoblastos/efeitos dos fármacos , Osteoblastos/metabolismo , Inibidores de Proteínas Quinases/farmacologia , Pirimidinas/farmacologia , Transcriptoma , Animais , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Biologia Computacional/métodos , Perfilação da Expressão Gênica , Camundongos , Transdução de SinaisRESUMO
The steadily increase of global energy requirements has brought about a general agreement on the need for novel renewable and environmentally friendly energy sources and carriers. Among the alternatives to a fossil fuel-based economy, hydrogen gas is considered a game-changer. Certain methods of hydrogen production can utilize various low-priced industrial and agricultural wastes as substrate, thus coupling organic waste treatment with renewable energy generation. Among these approaches, different biological strategies have been investigated and successfully implemented in laboratory-scale systems. Although promising, several key aspects need further investigation in order to push these technologies towards large-scale industrial implementation. Some of the major scientific and technical bottlenecks will be discussed, along with possible solutions, including a thorough exploration of novel research combining microbial dark fermentation and algal photoheterotrophic degradation systems, integrated with wastewater treatment and metabolic by-products usage.
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Biocombustíveis , Hidrogênio/metabolismo , Clorófitas/metabolismo , Conservação de Recursos Energéticos/economia , Conservação de Recursos Energéticos/tendências , Fermentação , Hidrogênio/química , Modelos Teóricos , Gerenciamento de Resíduos/métodos , Águas Residuárias/químicaRESUMO
A microalgal biomass offers a potential alternative to the maize silage commonly used in biogas technology. In this study, photoautotrophically grown Scenedesmus obliquus was used as biogas substrate. This microalga has a low C/N ratio of 8.5 relative to the optimum 20-30. A significant increase in the ammonium ion content was not observed. The methane content of the biogas generated from Sc. obliquus proved to be higher than that from maize silage, but the specific biogas yield was lower. Semi-continuous steady biogas production lasted for 2 months. Because of the thick cell wall of Sc. obliquus, the biomass-degrading microorganisms require additional time to digest its biomass. The methane concentration in the biogas was also high, in co-digestion (i.e., 52-56%) as in alga-fed anaerobic digestion (i.e., 55-62%). These results may be related to the relative predominance of the order Clostridiales in co-digestion and to the more balanced C/N ratio of the mixed algal-maize biomass. Predominance of the order Methanosarcinales was observed in the domain Archaea, which supported the diversity of metabolic pathways in the process.
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Biocombustíveis , Fermentação , Metagenoma , Scenedesmus/metabolismo , Compostos de Amônio/metabolismo , Archaea/metabolismo , Biomassa , Reatores Biológicos , Metano/metabolismo , Methanosarcinales/metabolismo , Microalgas/metabolismo , Scenedesmus/crescimento & desenvolvimento , Silagem , Zea mays/metabolismoRESUMO
BACKGROUND: The growing concern regarding the use of agricultural land for the production of biomass for food/feed or energy is dictating the search for alternative biomass sources. Photosynthetic microorganisms grown on marginal or deserted land present a promising alternative to the cultivation of energy plants and thereby may dampen the 'food or fuel' dispute. Microalgae offer diverse utilization routes. RESULTS: A two-stage energetic utilization, using a natural mixed population of algae (Chlamydomonas sp. and Scenedesmus sp.) and mutualistic bacteria (primarily Rhizobium sp.), was tested for coupled biohydrogen and biogas production. The microalgal-bacterial biomass generated hydrogen without sulfur deprivation. Algal hydrogen production in the mixed population started earlier but lasted for a shorter period relative to the benchmark approach. The residual biomass after hydrogen production was used for biogas generation and was compared with the biogas production from maize silage. The gas evolved from the microbial biomass was enriched in methane, but the specific gas production was lower than that of maize silage. Sustainable biogas production from the microbial biomass proceeded without noticeable difficulties in continuously stirred fed-batch laboratory-size reactors for an extended period of time. Co-fermentation of the microbial biomass and maize silage improved the biogas production: The metagenomic results indicated that pronounced changes took place in the domain Bacteria, primarily due to the introduction of a considerable bacterial biomass into the system with the substrate; this effect was partially compensated in the case of co-fermentation. The bacteria living in syntrophy with the algae apparently persisted in the anaerobic reactor and predominated in the bacterial population. The Archaea community remained virtually unaffected by the changes in the substrate biomass composition. CONCLUSION: Through elimination of cost- and labor-demanding sulfur deprivation, sustainable biohydrogen production can be carried out by using microalgae and their mutualistic bacterial partners. The beneficial effect of the mutualistic mixed bacteria in O2 quenching is that the spent algal-bacterial biomass can be further exploited for biogas production. Anaerobic fermentation of the microbial biomass depends on the composition of the biogas-producing microbial community. Co-fermentation of the mixed microbial biomass with maize silage improved the biogas productivity.
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Neosartorya fischeri NRRL 181 isolate secretes a defensin-like antifungal protein (NFAP) which has a remarkable antifungal effect against ascomycetous filamentous fungi. This protein is a promising antifungal agent of biotechnological value; however in spite of the available knowledge of the nature of its 5'-upstream transcriptional regulation elements, the bulk production of NFAP has not been resolved yet. In this study we carried out its heterologous expression in the yeast Pichia pastoris and investigated the growth inhibition effect exerted by the heterologous NFAP (hNFAP) on filamentous fungal isolates from human infections compared with what was caused by the native NFAP. P. pastoris KM71H transformant strain harboring the pPICZαA plasmid with the mature NFAP encoding gene produced the protein. The final yield of the hNFAP was sixfold compared to the NFAP produced by N. fischeri NRRL 181. Based on the signal dispersion of the amide region, it was proven that the hNFAP exists in folded state. The purified hNFAP effectively inhibited the growth of fungal isolates belonging to the Aspergillus and to the Fusarium genus, but all investigated zygomycetous strain proved to be insusceptible. There was no significant difference between the growth inhibition effect exerted by the native and the heterologous NFAP. These data indicated that P. pastoris KM71H can produce the NFAP in an antifungally active folded state. Our results provide a base for further research, e.g., investigation the connection between the protein structure and the antifungal activity using site directed mutagenesis.
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Antifúngicos/farmacologia , Defensinas/biossíntese , Proteínas Fúngicas/biossíntese , Fungos/efeitos dos fármacos , Sequência de Aminoácidos , Defensinas/genética , Defensinas/isolamento & purificação , Defensinas/farmacologia , Dermatomicoses/microbiologia , Proteínas Fúngicas/genética , Proteínas Fúngicas/isolamento & purificação , Proteínas Fúngicas/farmacologia , Fungos/patogenicidade , Humanos , Neosartorya/química , Neosartorya/genética , Neosartorya/metabolismo , Pichia/genéticaRESUMO
The authors present the case of a 63-year-old man who was evaluated for symptoms of lung fibrosis, blue face and epithelopathy affecting both eyes. All these symptoms could be attributed to the adverse effects of amiodarone. Thyroid disorders, which are the most common side-effects of amiodarone treatment were absent. The authors want to draw attention to the potential side effects of amiodarone.
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Amiodarona/efeitos adversos , Antiarrítmicos/efeitos adversos , Transtornos da Pigmentação/induzido quimicamente , Fibrose Pulmonar/induzido quimicamente , Amiodarona/administração & dosagem , Antiarrítmicos/administração & dosagem , Olho/efeitos dos fármacos , Humanos , Hipertireoidismo/induzido quimicamente , Hipotireoidismo/induzido quimicamente , Pulmão/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Pele/efeitos dos fármacos , Glândula Tireoide/efeitos dos fármacosRESUMO
The authors report a case of an ectopic ACTH-syndrome that resulted in severe hypercortisolism, hypokalemia, diabetes mellitus and osteoporosis. The ACTH-secreting tumor tissue was localized in the lung. The tumor was removed by segmentectomy and histological evaluation revealed an ACTH-secreting neuroendocrine tumor. After surgery, however, plasma cortisol and ACTH levels failed to decrease significantly due to subtotal tumor removal. Long-acting somatostatin analogue therapy resulted in a normalization of both plasma cortisol and ACTH levels and the clinical symptoms improved significantly. Residual tumor was removed by repeat surgery and the patient was permanently cured.
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Síndrome de ACTH Ectópico/complicações , Síndrome de ACTH Ectópico/diagnóstico , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/diagnóstico , Hormônio Adrenocorticotrópico/metabolismo , Síndrome de Cushing/etiologia , Diabetes Mellitus/etiologia , Humanos , Hipopotassemia/etiologia , Masculino , Pessoa de Meia-Idade , Osteoporose/etiologia , Pneumonectomia/métodos , Reoperação , Somatostatina/análogos & derivados , Somatostatina/uso terapêutico , Resultado do TratamentoRESUMO
According to current concept, macroprolactin is biologically inactive and, therefore, its accumulation in serum has little, if any, pathological significance. Authors present the history of a 80-year-old man who proved to have, among other associated disorders, an intra- and parasellar pituitary tumor measuring 21x12x12 mm in size which was revealed by pituitary MRI. His hormonal evaluation indicated a marked hyperprolactinemia mainly due to macroprolactinemia (total prolactin, 514 ng/ml; reference range, 1.6-10.7 ng/ml; macroprolactin 436 ng/ml, monomer prolactin 78.2 ng/ml). Tests for function of the pituitary-thyroid axis showed a mild subclinical primary hypothyroidism. The function of the pituitary-adrenal axis was normal, and other hormonal tests revealed low-normal serum gonadotropins and decreased testosterone level, whereas serum insulin-like growth factor I was normal. Although the majority of current guidelines state that dopamine-agonist treatment which is successfully used in prolactin-producing pituitary tumors and in other hyperprolactinemic disorders is unnecessary in patients with macroprolactinemia, the authors introduced a dopamine-agonist, quinagolide. During prolonged treatment, plasma prolactin returned close to the upper limit of normal (12.3 ng/ml) and 9 months after the beginning of treatment pituitary MRI showed a remarkable shrinkage of the pituitary tumor. Authors propose that in this patient the pituitary tumor secreted macroprolactin, and they recommend a treatment trial with dopamine-agonist in pituitary macroadenomas associated with macroprolactinemia.
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Aminoquinolinas/uso terapêutico , Agonistas de Dopamina/uso terapêutico , Hiperprolactinemia/etiologia , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/tratamento farmacológico , Prolactina/sangue , Idoso de 80 Anos ou mais , Humanos , Hiperprolactinemia/sangue , Imageamento por Ressonância Magnética , Masculino , Neoplasias Hipofisárias/sangue , Prolactina/efeitos dos fármacos , Fatores de Tempo , Resultado do TratamentoRESUMO
NADPH oxidase of the phagocytic cells (Nox2) transfers electrons from cytosolic NADPH to molecular oxygen in the extracellular or intraphagosomal space. The produced superoxide anion (O*2) provides the source for formation of all toxic oxygen derivatives, but continuous O*2 generation depends on adequate charge compensation. The vital role of Nox2 in efficient elimination of microorganisms is clearly indicated by human pathology as insufficient activity of the enzyme results in severe, recurrent bacterial infections, the typical symptoms of chronic granulomatous disease. The goals of this contribution are to provide critical review of the Nox2-dependent cellular processes that potentially contribute to bacterial killing and degradation and to indicate possible targets of pharmacological interventions.