RESUMO
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a complication of deep hypothermic circulatory arrest (DHCA). Various amounts of neurologic dysfunctions have been shown after DHCA, which has often been attributed to systemic inflammatory response syndrome and cerebral ischemia/reperfusion injury. Remimazolam is one of the commonly used anesthetic drugs with protective actions against inflammatory diseases, such as sepsis and cerebral ischemia/reperfusion injury. Here, we determined the protective effect and potential mechanism of action of remimazolam against neuronal damage after DHCA. METHODS: A rat model of DHCA was established, and a gradient dosage of remimazolam was administered during cardiopulmonary bypass (CPB). The cognitive function of rats was evaluated by Morris water maze. Hematoxylin and eosin and TUNEL staining were performed to assess hippocampus tissue injury and neuronal apoptosis. Inflammatory cytokines concentration were analyzed by enzyme-linked immunosorbent assay. The protein expression was analyzed using automated electrophoresis western analysis and immunohistochemical analysis. RESULTS: The appropriate dosage of remimazolam reduced histologic injury, neuronal apoptosis, microglia activation, and secondary inflammatory cascades, as well as the downregulation of the expression of the HMGB1-TLR4-NF-κB pathway after DHCA, improved the memory and learning abilities in DHCA rats. Further, administration of a TLR4 antagonist TAK-242 had a similar effect to remimazolam, while the TLR4 agonist LPS attenuated the effect of remimazolam. CONCLUSIONS: Remimazolam could ameliorate POCD after DHCA through the HMGB1-TLR4-NF-κB signaling pathway.
Assuntos
Parada Circulatória Induzida por Hipotermia Profunda , Proteína HMGB1 , NF-kappa B , Complicações Cognitivas Pós-Operatórias , Ratos Sprague-Dawley , Transdução de Sinais , Receptor 4 Toll-Like , Animais , Receptor 4 Toll-Like/metabolismo , Proteína HMGB1/metabolismo , NF-kappa B/metabolismo , Ratos , Masculino , Complicações Cognitivas Pós-Operatórias/etiologia , Complicações Cognitivas Pós-Operatórias/prevenção & controle , Complicações Cognitivas Pós-Operatórias/metabolismo , Complicações Cognitivas Pós-Operatórias/tratamento farmacológico , Parada Circulatória Induzida por Hipotermia Profunda/efeitos adversos , Transdução de Sinais/efeitos dos fármacos , Benzodiazepinas/farmacologia , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Fármacos Neuroprotetores/farmacologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/tratamento farmacológico , Disfunção Cognitiva/metabolismoRESUMO
Introduction: Experimental data indicate that morphine and fentanyl may have antitumor effects in gastric cancer cells (GC). Hydromorphone, as an analgesic, is used against refractory cancer pain in recent years. However, the data on hydromorphone influencing the biological characteristics of human gastric cancer cells are lacking. The aim of this study was to investigate how hydromorphone affected the growth of human gastric cancer in vitro. Material and Methods: Human GC cell lines (HGC-27, MGC-803, AGS and SGC-7901) and human gastric epithelial cells GSE-1 were exposed to various concentrations of hydromorphone (0-800µM). The cell viability, invasion and migration abilities were measured using cell counting kit-8, Transwell and wound healing assays. Apoptosis and cell cycle were evaluated by flow cytometry. Results: Hydromorphone was toxic in GSE-1 cells at the concentration 800µM. It showed enhanced antitumor effects at a longer incubation time and higher concentrations in HGC-27, MGC-803, AGS and SGC-7901 cells. Hydromorphone inhibited the progression of MGC- 803 cells by cell cycle arrest and apoptosis induction. Conclusion: Hydromorphone suppresses the proliferation of human GC cells in a dose- and time-dependent manner. That may provide a theoretical basis for the clinical application of hydromorphone in the safe and effective treatment of GC.
Assuntos
MicroRNAs , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/patologia , Hidromorfona/farmacologia , Hidromorfona/uso terapêutico , Linhagem Celular Tumoral , Proliferação de Células , MicroRNAs/metabolismoRESUMO
INTRODUCTION: Apolipoprotein A1 (apoA1) is the major apoprotein constituent of high density lipoprotein (HDL) which exerts innate protective effects in systemic inflammation. However, its role in the acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) has not been well studied. The objective of this study was to investigate the potential association between APOA1 -75 G/A polymorphism and the development of ALI after cardiopulmonary bypass (CPB) surgery. MATERIALS AND METHODS: A hospital-based case-control study was conducted in patients with ALI (n = 300), patients without ALI (n = 300) and healthy controls (n = 300). Polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assay was applied to assess the APOA1 -75 G/A genotypes. RESULTS: Patients with ALI had a significantly higher frequency of APOA1 -75 AA genotype [odds ratio (OR) =1.75, 95% confidence interval (CI) = 1.04, 2.92; P = 0.03] than patients without ALI. APOA1 -75 AA genotype (OR =3.47, 95% CI = 1.60, 7.52; P = 0.002) and A allele (OR =1.92, 95% CI = 1.24, 2.96; P = 0.003) were the significant independent prognostic factors for the 30-day survival rate of patients with ALI after CPB surgery. CONCLUSION: Our study suggested that APOA1 -75 AA genotype was associated with a higher ALI risk after CPB surgery. Patients with the APOA1 -75 AA genotype and A allele had higher 30-day mortality of ALI after CPB surgery. Additional studies are needed to confirm this finding.