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The experiences of sexual minority men who report self-perceived problematic pornography use is under theorised and not well understood despite controversial and conflicting research into the phenomena in heterosexual male populations. This study aimed to widen the conversation to consider the experience of sexuality in relation to self-perceived problematic pornography use, rather than contribute to literature that debates the definition and aetiology of problematic pornography use. Semi-structured online qualitative interviews were conducted with three sexual minority men who self-reported problematic pornography use. Interpretive phenomenological analysis was used to develop themes. Five themes pertinent to understanding the participants' experiences with problematic pornography use were developed: problematised sexuality, pornography as liberator, pornography as corrupter, reform, and relapse and restore. The themes highlight three men's relationship with their sexuality as a feature of their self-perceived problematic pornography use. The research suggests that idiographic experiences of self-perceived problematic pornography use are influenced and maintained by an incongruent and conflicting relationship between an individual's own experiences of sexuality and self-perceptions of pornography use. Limitations and future research recommendations are discussed.
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Literatura Erótica , Conducta Sexual , Humanos , Masculino , Heterosexualidad , Autoinforme , AutoimagenRESUMEN
The 2',5'- oligoadenylate synthetase (OAS) - ribonuclease L (RNAseL) - phosphodiesterase 12 (PDE12) pathway is an essential interferon-induced effector mechanism against RNA virus infection. Inhibition of PDE12 leads to selective amplification of RNAseL activity in infected cells. We aimed to investigate PDE12 as a potential pan-RNA virus antiviral drug target and develop PDE12 inhibitors that elicit antiviral activity against a range of viruses. A library of 18â000 small molecules was screened for PDE12 inhibitor activity using a fluorescent probe specific for PDE12. The lead compounds (CO-17 or CO-63) were tested in cell-based antiviral assays using encephalomyocarditis virus (EMCV), hepatitis C virus (HCV), dengue virus (DENV), West Nile virus (WNV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in vitro. Cross reactivity of PDE12 inhibitors with other PDEs and in vivo toxicity were measured. In EMCV assays, CO-17 potentiated the effect of IFNα by 3 log10. The compounds were selective for PDE12 when tested against a panel of other PDEs and non-toxic at up to 42 mgâ¯kg-1 in rats in vivo. Thus, we have identified PDE12 inhibitors (CO-17 and CO-63), and established the principle that inhibitors of PDE12 have antiviral properties. Early studies suggest these PDE12 inhibitors are well tolerated at the therapeutic range, and reduce viral load in studies of DENV, HCV, WNV and SARS-CoV-2 in human cells and WNV in a mouse model.
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COVID-19 , Virus ARN , Humanos , Ratones , Animales , Ratas , Antivirales/farmacología , SARS-CoV-2 , Interferón-alfa , Virus de la Encefalomiocarditis , Hidrolasas Diéster FosfóricasRESUMEN
The significance of the paper by Yu et al. (1979) is discussed in the context of the long history of ethylene as a plant growth regulator. By launching the era of molecular analysis and biotechnological exploitation, this research made a vital contribution to crop production and quality.
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Liasas , Aminoácido Oxidorreductasas , Etilenos , Liasas/genéticaRESUMEN
Further and continuing education is not only important for individual employability, but also for regional development. Therefore, improving participation in further and continuing education and removing barriers to participation are key concerns of regional education governance. The present study was conducted in a peripheral region of Rhineland-Palatinate in western Germany, where the annual participation rate in continuing education is relatively low compared to other geographic areas in Germany. This quantitative study was designed to understand: (1) To what extent do adult learners engage in continuing education within their habitual lifelong learning process? (2) Which circumstantial factors influence their participation in continuing education? And (3) What are the barriers hindering their participation? The authors found that for two-thirds of adult learners, a precondition for their enrolment in a continuing education course was the satisfaction of both work-related and private life-related factors. The authors' findings point towards the need for flexible study programmes which learners can fit to the demands of their work and life.
Analyse des obstacles à la participation à la formation continue en Allemagne : Pourquoi une perspective régionale est (encore) importante L'éducation complémentaire et continue est importante non seulement pour l'employabilité des individus, mais aussi pour le développement régional. Par conséquent, l'amélioration de la participation à la formation continue et l'élimination des obstacles à la participation sont des préoccupations essentielles de la gouvernance régionale de l'éducation. La présente étude a été menée dans une région périphérique de la Rhénanie-Palatinat, dans l'ouest de l'Allemagne, où le taux de participation annuel à la formation continue est relativement faible par rapport à d'autres zones géographiques en Allemagne. Cette étude quantitative a été conçue pour comprendre : (1) Dans quelle mesure est-ce que les apprenants adultes s'engagent dans la formation continue dans le cadre de leur processus habituel d'apprentissage tout au long de la vie ? (2) Quels sont les facteurs circonstanciels qui influencent leur participation à la formation continue ? et (3) Quels sont les obstacles qui entravent leur participation ? Les auteurs ont constaté que pour deux tiers des apprenants adultes, une condition préalable à leur inscription à un cours de formation continue était la satisfaction de facteurs liés à la fois à leur vie professionnelle et à leur vie privée. Les conclusions des auteurs soulignent la nécessité de programmes d'études flexibles que les apprenants peuvent adapter aux exigences de leur travail et de leur vie personnelle.
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With the finest biochemical and molecular approaches, convincing explorative strategies, and long-term vision, Stefan Hörtensteiner succeeded in elucidating the biochemical pathway responsible for chlorophyll degradation. After having contributed to the identification of key chlorophyll degradation products in the course of the past 25 years, he gradually identified and characterized most of the crucial players in the PAO/phyllobilin degradation pathway of chlorophyll. He was one of the brightest plant biochemists of his generation, and his work opened doors to a better understanding of plant senescence, tetrapyrrole homeostasis, and their complex regulation. He sadly passed away on 5 December 2020, aged 57.
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Clorofila , Hojas de la Planta , Color , TetrapirrolesRESUMEN
Understanding how dynamic molecular networks affect whole-organism physiology, analogous to mapping genotype to phenotype, remains a key challenge in biology. Quantitative models that represent processes at multiple scales and link understanding from several research domains can help to tackle this problem. Such integrated models are more common in crop science and ecophysiology than in the research communities that elucidate molecular networks. Several laboratories have modeled particular aspects of growth in Arabidopsis thaliana, but it was unclear whether these existing models could productively be combined. We test this approach by constructing a multiscale model of Arabidopsis rosette growth. Four existing models were integrated with minimal parameter modification (leaf water content and one flowering parameter used measured data). The resulting framework model links genetic regulation and biochemical dynamics to events at the organ and whole-plant levels, helping to understand the combined effects of endogenous and environmental regulators on Arabidopsis growth. The framework model was validated and tested with metabolic, physiological, and biomass data from two laboratories, for five photoperiods, three accessions, and a transgenic line, highlighting the plasticity of plant growth strategies. The model was extended to include stochastic development. Model simulations gave insight into the developmental control of leaf production and provided a quantitative explanation for the pleiotropic developmental phenotype caused by overexpression of miR156, which was an open question. Modular, multiscale models, assembling knowledge from systems biology to ecophysiology, will help to understand and to engineer plant behavior from the genome to the field.
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Arabidopsis/crecimiento & desarrollo , Modelos Biológicos , Arabidopsis/genética , Arabidopsis/metabolismo , Carbono/metabolismo , Simulación por Computador , Ecosistema , Genes de Plantas , Redes y Vías Metabólicas , Fenotipo , Fotoperiodo , Fotosíntesis , Hojas de la Planta/crecimiento & desarrollo , Plantas Modificadas Genéticamente , Almidón/metabolismo , Procesos Estocásticos , Biología de SistemasRESUMEN
BACKGROUND: Content analysis of replies to closed questions in questionnaires can be undertaken to understand remarks that may explain the responses, provide illustrative examples of issues raised in the questionnaire, define new issues or issues of importance that were not covered in the questionnaire and inform the design of new questions in future surveys. AIM: To discuss the usefulness of summative content analysis to free text in postal questionnaires. DISCUSSION: Content analysis provides useful comparative insights between two respondent groups in the case example provided. Five themes emerged: poor understanding of the concept of 'patient lateral transfer work technique' and the direct instrument nursing observation (DINO) instrument's key directions; outcomes of patient transfer; positive responses; manual handling risk; and poor translation into English of DINO. CONCLUSION: Respondents need an opportunity to clarify their responses to questionnaires using free text, to provide insight into their understanding of the question being asked, understanding of the concept or construct being discussed, and data triangulation through the confirmation of item responses and free-text comments. IMPLICATIONS FOR PRACTICE: Responses to questions in a postal questionnaire and the opportunity for free-text commentary by respondents enable the identification of hidden meanings behind tickbox responses to questions.
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Investigación en Enfermería/organización & administración , Servicios Postales , Estadística como Asunto/métodos , Encuestas y Cuestionarios , Humanos , Investigación Cualitativa , Proyectos de InvestigaciónRESUMEN
BACKGROUND & AIMS: Hepatitis C virus (HCV) associates with lipoproteins to form "lipoviral particles" (LVPs) that can facilitate viral entry into hepatocytes. Initial attachment occurs via heparan sulphate proteoglycans and low-density lipoprotein receptor (LDLR); CD81 then mediates a post-attachment event. Proprotein convertase subtilisin kexin type 9 (PCSK9) enhances the degradation of the LDLR and modulates liver CD81 levels. We measured LVP and PCSK9 in patients chronically infected with HCV genotype (G)3. PCSK9 concentrations were also measured in HCV-G1 to indirectly examine the role of LDLR in LVP clearance. METHODS: HCV RNA, LVP (d<1.07g/ml) and non-LVP (d>1.07g/ml) fractions, were quantified in patients with HCV-G3 (n=39) by real time RT-PCR and LVP ratios (LVPr; LVP/(LVP+non-LVP)) were calculated. Insulin resistance (IR) was assessed using the homeostasis model assessment of IR (HOMA-IR). Plasma PCSK9 concentrations were measured by ELISA in HCV-G3 and HCV-G1 (n=51). RESULTS: In HCV-G3 LVP load correlated inversely with HDL-C (r=-0.421; p=0.008), and apoE (r=-0.428; p=0.013). The LVPr varied more than 35-fold (median 0.286; range 0.027 to 0.969); PCSK9 was the strongest negative predictor of LVPr (R(2)=16.2%; p=0.012). HOMA-IR was not associated with LVP load or LVPr. PCSK9 concentrations were significantly lower in HCV-G3 compared to HCV-G1 (p<0.001). PCSK9 did not correlate with LDL-C in HCV-G3 or G1. CONCLUSIONS: The inverse correlation of LVP with apoE in HCV-G3, compared to the reverse in HCV-G1 suggests HCV genotype-specific differences in apoE mediated viral entry. Lower PCSK9 and LDL concentrations imply upregulated LDLR activity in HCV-G3.
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Apolipoproteínas E/metabolismo , LDL-Colesterol/metabolismo , Hepacivirus/genética , Hepatitis C Crónica , Proproteína Convertasas/metabolismo , Serina Endopeptidasas/metabolismo , Virión/metabolismo , Adulto , Femenino , Genotipo , Hepatitis C Crónica/metabolismo , Hepatitis C Crónica/virología , Hepatocitos/metabolismo , Humanos , Lipoproteínas LDL/metabolismo , Masculino , Persona de Mediana Edad , Proproteína Convertasa 9 , ARN Viral/análisis , Receptores de LDL/metabolismo , Estadística como AsuntoRESUMEN
BACKGROUND: Seven drugs are licensed for the treatment of chronic hepatitis B (CHB) in the United Kingdom. Which initial treatment, secondary therapy, and whether antivirals should be given alone or in combination are questions of considerable uncertainty. OBJECTIVE: The aim of this model was to undertake a comprehensive economic evaluation of all antiviral treatments for CHB to recommend the most cost-effective therapeutic sequence. METHODS: We developed a probabilistic Markov model to compare the cost-effectiveness of all clinically relevant antiviral treatment sequences for nucleos(t)ide-naive adults with hepatitis B e-antigen (HBeAg)-positive or HBeAg-negative CHB. Relative rates of HBeAg seroconversion and viral suppression were obtained from a network meta-analysis. Data on mortality, antiviral drug resistance, durability of response, adverse events, and costs were obtained from published literature. Results are reported in terms of lifetime costs, quality-adjusted life-years (QALYs), and expected net benefit. RESULTS: In the base-case analysis, pegylated interferon alpha-2a (peg-IFN α-2a) followed by tenofovir disoproxil fumarate was most effective and cost-effective in HBeAg-positive patients, with a cost of £7488 per QALY gained compared with no treatment. In HBeAg-negative patients, peg-IFN α-2a followed by entecavir was most effective and cost-effective, with a cost of £6981 per QALY gained. The model was robust to a wide range of sensitivity analyses. CONCLUSIONS: Peg-IFN α-2a followed by tenofovir disoproxil fumarate or entecavir is the most effective antiviral treatment strategy for people with both variants of CHB. At a cost of less than £10,000 per QALY gained, these sequences are considered cost-effective in England and Wales. The results of this analysis were used to inform 2013 National Institute for Health and Care Excellence guideline recommendations.
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Antivirales/economía , Antivirales/uso terapéutico , Costos de los Medicamentos , Antígenos e de la Hepatitis B/sangre , Hepatitis B Crónica/tratamiento farmacológico , Hepatitis B Crónica/economía , Adulto , Biomarcadores/sangre , Investigación sobre la Eficacia Comparativa , Análisis Costo-Beneficio , Técnicas de Apoyo para la Decisión , Sustitución de Medicamentos/economía , Quimioterapia Combinada/economía , Femenino , Hepatitis B Crónica/sangre , Hepatitis B Crónica/diagnóstico , Humanos , Masculino , Cadenas de Markov , Modelos Económicos , Selección de Paciente , Guías de Práctica Clínica como Asunto , Probabilidad , Calidad de Vida , Años de Vida Ajustados por Calidad de Vida , Medicina Estatal/economía , Factores de Tiempo , Resultado del Tratamiento , Reino Unido , Adulto JovenRESUMEN
Stay-green (sometimes staygreen) refers to the heritable delayed foliar senescence character in model and crop plant species. In a cosmetic stay-green, a lesion interferes with an early step in chlorophyll catabolism. The possible contribution of synthesis to chlorophyll turnover in cosmetic stay-greens is considered. In functional stay-greens, the transition from the carbon capture period to the nitrogen mobilization (senescence) phase of canopy development is delayed, and/or the senescence syndrome proceeds slowly. Yield and composition in high-carbon (C) crops such as cereals, and in high-nitrogen (N) species such as legumes, reflect the source-sink relationship with canopy C capture and N remobilization. Quantitative trait loci studies show that functional stay-green is a valuable trait for improving crop stress tolerance, and is associated with the domestication syndrome in cereals. Stay-green variants reveal how autumnal senescence and dormancy are coordinated in trees. The stay-green phenotype can be the result of alterations in hormone metabolism and signalling, particularly affecting networks involving cytokinins and ethylene. Members of the WRKY and NAC families, and an ever-expanding cast of additional senescence-associated transcription factors, are identifiable by mutations that result in stay-green. Empirical selection for functional stay-green has contributed to increasing crop yields, particularly where it is part of a strategy that also targets other traits such as sink capacity and environmental sensitivity and is associated with appropriate crop management methodology. The onset and progress of senescence are phenological metrics that show climate change sensitivity, indicating that understanding stay-green can contribute to the design of appropriate crop types for future environments.
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Carácter Cuantitativo Heredable , Carbono/metabolismo , Clorofila/metabolismo , Reguladores del Crecimiento de las Plantas/metabolismo , Estrés Fisiológico , Factores de Transcripción/metabolismoRESUMEN
BACKGROUND & AIMS: Hepatitis C virus (HCV) utilises cholesterol and lipoprotein metabolism for replication and infectivity. Statins and omega-3 (n-3) polyunsaturated fatty acids (PUFA) have been shown to have antiviral properties in vitro. This open label pilot study evaluated the efficacy of fluvastatin (Lescol(®) 40-80 mg) and n-3 PUFA (Omacor(®) 1 g and 2-4 g) on HCV-RNA and lipoviral particles (LVP) in difficult to treat prior non-responders. METHODS: Patients (n = 60) were randomly allocated in a factorial design to: no active drug; low-dose n-3 PUFA; high-dose n-3 PUFA; fluvastatin; low-dose n-3 PUFA + fluvastatin; or high-dose n-3 PUFA + fluvastatin. 50/60 completed study drugs for 12 weeks and followed up to week 24. Comparison was made between fluvastatin (n = 24) vs no fluvastatin (n = 26) and n-3 PUFA high-dose (n = 17) vs low-dose (n = 17) vs none (n = 16). The primary outcomes were change in total HCV-RNA, LVP and ALT at week 12 compared with baseline. Secondary outcome was change in interferon-gamma-inducible protein-10 (IP10) as a measure of interferon activation. RESULTS: 35% had compensated cirrhosis and 45% were prior null responders. There was no significant change in total HCV RNA, LVP, non-LVP or LVP ratio in patients receiving fluvastatin or n-3 PUFAs. ALT was not significantly different in those treated with fluvastatin or n-3 PUFAs. 12 weeks of low-dose n-3 PUFA decreased median IP10 concentration by -39 pg/ml (-111, 7.0 pg/ml Q1-Q3). CONCLUSIONS: Fluvastatin and n-3 PUFAs have no effect on plasma HCV-RNA or LVP. The effect of low-dose n-3 PUFA on IP10 warrants further prospective evaluation as a supplemental therapy to enhance interferon sensitivity.
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Antivirales/uso terapéutico , Ácidos Grasos Monoinsaturados/uso terapéutico , Ácidos Grasos Omega-3/uso terapéutico , Hepatitis C Crónica/tratamiento farmacológico , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Indoles/uso terapéutico , Adulto , Alanina Transaminasa/sangre , Quimiocina CXCL10/sangre , Quimioterapia Combinada , Ácidos Grasos Monoinsaturados/farmacología , Ácidos Grasos Omega-3/farmacología , Femenino , Fluvastatina , Hepatitis C Crónica/sangre , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/farmacología , Indoles/farmacología , Masculino , Persona de Mediana Edad , Proyectos Piloto , Carga Viral/efectos de los fármacosRESUMEN
UNLABELLED: 696 I. 697 II. 697 III. 699 IV. 700 V. 703 VI. 704 VII. 707 708 References 708 SUMMARY: This review considers the relationship between the lifespan of an individual plant and the longevity of its component cells, tissues and organs. It begins by defining the terms senescence, growth, development, turnover, ageing, death and program. Genetic and epigenetic mechanisms regulating phase change from juvenility to maturity influence directly the capacity for responding to senescence signals and factors determining reproduction-related patterns of deteriorative ageing and death. Senescence is responsive to communication between sources and sinks in which sugar signalling and hormonal regulation play central roles. Monocarpy and polycarpy represent contrasting outcomes of the balance between the determinacy of apical meristems and source-sink cross-talk. Even extremely long-lived perennials sustain a high degree of meristem integrity. Factors associated with deteriorative ageing in animals, such as somatic mutation, telomere attrition and the costs of repair and maintenance, do not seem to be particularly significant for plant lifespan, but autophagy-related regulatory networks integrated with nutrient signalling may have a part to play. Size is an important influence on physiological function and fitness of old trees. Self-control of modular structure allows trees to sustain viability over prolonged lifespans. Different turnover patterns of structural modules can account for the range of plant life histories and longevities.
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Desarrollo de la Planta , Factores de Tiempo , Senescencia Celular , Regulación del Desarrollo de la Expresión Génica , Regulación de la Expresión Génica de las Plantas , Longevidad , Zea mays/crecimiento & desarrollo , Zea mays/fisiologíaRESUMEN
The British Society of Gastroenterology guidelines on the management of cholangiocarcinoma were originally published in 2002. This is the first update since then and is based on a comprehensive review of the recent literature, including data from randomised controlled trials, systematic reviews, meta-analyses, cohort, prospective and retrospective studies.
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Neoplasias de los Conductos Biliares , Conductos Biliares Intrahepáticos , Colangiocarcinoma , Neoplasias de los Conductos Biliares/diagnóstico , Neoplasias de los Conductos Biliares/epidemiología , Neoplasias de los Conductos Biliares/etiología , Neoplasias de los Conductos Biliares/terapia , Colangiocarcinoma/diagnóstico , Colangiocarcinoma/epidemiología , Colangiocarcinoma/etiología , Colangiocarcinoma/terapia , Terapia Combinada , Diagnóstico Diferencial , Drenaje/instrumentación , Drenaje/métodos , Hepatectomía , Humanos , Trasplante de Hígado , Clasificación del Tumor , Estadificación de Neoplasias , Cuidados Paliativos , Pancreaticoduodenectomía , Factores de Riesgo , Stents , Reino Unido/epidemiologíaRESUMEN
BACKGROUND & AIMS: Cholangiocarcinomas (CC) can be sub-divided into intrahepatic (IHCC) or extrahepatic (EHCC). Hilar or 'Klatskin' tumours are anatomically extrahepatic. Most international studies, also from the UK, report increasing IHCC and decreasing EHCC incidence. The second edition of the International Classification of Diseases for Oncology (ICD-O-2) assigned 'Klatskin' tumours a unique histology code (8162/3), but this was cross-referenced to the topography code for intrahepatic (IHBD) rather than extrahepatic bile duct tumours (EHBD). Under the third ICD-O edition, 'Klatskin' tumours are cross-referenced to either IHBD or EHBD. New editions of the ICD-O classification are adopted at different time points by different countries. We investigated the impact of changing ICD-O classifications and the potential misclassification of hilar/'Klatskin' tumours on bile duct tumour and CC incidence rates in England and Wales and the US. We also examined whether coding practices by cancer registries in England and Wales could be influencing these rates. METHODS: We analysed age-standardised incidence rates (ASIR) in England and Wales for IHBD and EHBD tumours between 1990 and 2008, then transferred all 'Klatskin' tumours from IHBD to EHBD and reanalysed rates from 1995, when ICD-O-2 was introduced in the UK. We also compared trends in IHBD, EHBD, and 'Klatskin' tumours in England and Wales with those in the USSEER (Surveillance, Epidemiology and End Results) database. Coding practice at Cancer registry level in England and Wales was investigated via a questionnaire completed by all national cancer registries. RESULTS: In England and Wales, 1990-2008, ASIR of IHBD cancers rose (0.43-1.84/100,000 population in males; 0.27-1.51 in females) but fell for EHBD (0.78-0.51/100,000 population in males; 0.62-0.39 in females). After transferring all 'Klatskin' tumours from IHBD to EHBD, there remained a marked increase in ASIR of IHBD cancers and a decrease in ASIR for EHBD, as only 1% of CC were reportedly 'Klatskin'. The US SEER data showed that ASIR for IHBD gradually rose from 0.59/100,000 population in 1990 to 0.91 in 2001, then sharply fell before plateauing at 0.60 by 2007. ASIR for EHBD remained relatively stable at around 0.80/100,000 population until 2001, then began increasing, to 0.97 by 2007. Annually, between 1995 and 2008, the vast majority of 'Klatskin' tumours in England and Wales were coded as IHBD. This was also the case in the SEER data until 2001, when the situation was reversed and subsequently most 'Klatskin' tumours were coded as EHBD. US trends coincide with a switch from ICD-O2 to ICD-O-3 in 2001. In the UK, the switch to ICD-O-3 only occurred in 2008. On questioning, cancer registries in England and Wales stated they would not code a CC described as 'hilar' with the designated 'Klatskin' histology code. If the tumour site is unspecified, most registries classify CC as intrahepatic. CONCLUSIONS: Changes in ICD-classification may be influencing observed changes in IHBD and EHBD incidence rates. Coding misclassification is likely to have been skewing CC registration to an intrahepatic site, thereby contributing to the previously reported rise in intrahepatic tumours.
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Neoplasias de los Conductos Biliares/clasificación , Neoplasias de los Conductos Biliares/epidemiología , Conductos Biliares Intrahepáticos , Colangiocarcinoma/clasificación , Colangiocarcinoma/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Inglaterra/epidemiología , Femenino , Humanos , Incidencia , Tumor de Klatskin/clasificación , Tumor de Klatskin/epidemiología , Masculino , Persona de Mediana Edad , Sistema de Registros , Estudios Retrospectivos , Programa de VERF/estadística & datos numéricos , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Gales/epidemiologíaRESUMEN
BACKGROUND & AIMS: Hepatitis C virus (HCV) interacts with apolipoproteins B (apoB) and E (apoE) to form infectious lipoviral particles (LVP). Response to peginterferon is influenced by interferon-stimulated genes (ISGs) and IL28B genotype. LDL cholesterol (LDL-C) also predicts interferon response, therefore we hypothesised that LVP may also be associated with interferon sensitivity. METHODS: LVP (HCV RNA density ≤1.07 g/ml) and 'non-LVP' (d >1.07 g/ml) were measured in 72 fasted HCV-G1 patients by iodixanol density gradient ultracentrifugation and the LVP ratio (LVP/LVP+non-LVP) was calculated. Fasting lipid profiles and apolipoproteins B and E were measured. Interferon-gamma-inducible protein 10 kDa (IP10), a marker of ISGs, was measured by ELISA. RESULTS: Complete early virological response (EVR) was associated with lower apoE (23.9±7.7 vs. 36.1±15.3 mg/L, p=0.013), higher LDL-C (p=0.039) and lower LVP ratios (p=0.022) compared to null responders. In multivariate linear regression analysis, apoE was independently associated with LVP (R(2) 19.5%, p=0.003) and LVP ratio (p=0.042), and negatively with LDL-C (p<0.001). IP10 was significantly associated with ApoB (p=0.001) and liver stiffness (p=0.032). IL28B rs12979860 CC was associated with complete EVR (p=0.044), low apoE (CC 28±11 vs. CT/TT 35±13 mg/L, p=0.048) and higher non-LVP (p=0.008). Logistic regression analysis indicated that patients with high LVP ratios were less likely to have EVR (odds ratio 0.01, p=0.018). CONCLUSIONS: In HCV-G1, interferon sensitivity is characterised by low LVP ratios and low apoE levels in addition to higher LDL-C and IL28B rs12979860 CC. Null-response is associated with increased LVP ratio. The association of apoE and LVP with peginterferon treatment response suggests that lipid modulation is a potential target to modify interferon sensitivity.
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Antivirales/farmacología , Apolipoproteínas E/sangre , Hepacivirus/metabolismo , Hepatitis C , Virión/metabolismo , Adulto , Apolipoproteínas B/sangre , Biomarcadores/sangre , Quimiocina CXCL10/genética , Quimiocina CXCL10/metabolismo , Farmacorresistencia Viral/fisiología , Femenino , Genotipo , Hepacivirus/genética , Hepatitis C/tratamiento farmacológico , Hepatitis C/metabolismo , Hepatitis C/virología , Humanos , Interferón-alfa/genética , Interferón-alfa/metabolismo , Interferón gamma/genética , Interferón gamma/metabolismo , Interferones , Interleucinas/genética , Interleucinas/metabolismo , Lípidos/sangre , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Carga Viral/fisiología , Virión/genéticaRESUMEN
BACKGROUND: The density of hepatitis C virus (HCV) in plasma is heterogeneous but the factors which influence this are poorly understood. Evidence from animal models and cell culture suggest that low-density apolipoprotein B (apoB)-associated HCV lipoviral particles (LVP) are more infectious than high-density HCV. Objective To measure LVP in patients with chronic hepatitis C genotype 1 (CHC-G1) and examine metabolic determinants of LVP load. Patients 51 patients with CHC-G1 infection. METHODS: Fasting lipid profiles and homeostasis model assessment of insulin resistance (HOMA-IR) were determined in 51 patients with CHC-G1. LVP and non-LVP viral load were measured by real-time PCR of plasma at density <1.07 g/ml and >1.07 g/ml, respectively, following iodixanol density gradient ultracentrifugation. The LVP ratio was calculated using the formula: LVP/(LVP + non-LVP). RESULTS: The mean LVP ratio was 0.241 but varied 25-fold (from 0.029 to 0.74). Univariate analysis showed that the LVP ratio correlated with HOMA-IR (p=0.004) and the triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio (p = 0.004), but not with apoB. In multivariate analysis, HOMA-IR was the main determinant of LVP load (log10IU/ml) (R²=16.6%; p = 0.037) but the TG/HDL-C ratio was the strongest predictor of the LVP ratio (R² = 24.4%; p = 0.019). Higher LVP ratios were associated with non-response to antiviral therapy (p = 0.037) and with greater liver stiffness (p = 0.001). CONCLUSION: IR and associated dyslipidaemia are the major determinants of low-density apoB-associated LVP in fasting plasma. This provides a possible mechanism to explain why IR is associated with more rapidly progressive liver disease and poorer treatment outcomes.
Asunto(s)
Hepacivirus/aislamiento & purificación , Hepatitis C Crónica/genética , Resistencia a la Insulina/fisiología , Virión/aislamiento & purificación , Adulto , Antivirales/uso terapéutico , Apolipoproteínas B/sangre , Centrifugación por Gradiente de Densidad/métodos , HDL-Colesterol/sangre , Estudios de Cohortes , Femenino , Genotipo , Hepacivirus/genética , Hepatitis C Crónica/tratamiento farmacológico , Hepatitis C Crónica/fisiopatología , Hepatitis C Crónica/virología , Humanos , Lípidos/sangre , Masculino , Persona de Mediana Edad , ARN Viral/sangre , Resultado del Tratamiento , Triglicéridos/sangre , Carga Viral , Virión/genéticaRESUMEN
BACKGROUND AND METHODS: In advanced liver damage, hepatic regeneration can occur through proliferation of a resident hepatic progenitor cell (HPC) population. HPCs are located within a designated niche in close association with myofibroblasts and bone marrow (BM) derived macrophages. Extra-cellular matrix (ECM) laminin invariably surrounds HPCs, but the functional requirement of this matrix-cell association is untested in vivo. Using the collagen Iα1((r/r)) mouse (r/r), which produces mutated collagen I resistant to matrix metalloproteinase degradation and has an exaggerated fibrotic response to liver injury, we test the relationship between collagen degradation, laminin deposition, and the HPC response. RESULTS: Chronic fibrotic carbon tetrachloride (CCl4) injury can induce a florid HPC response associated with dense laminin deposition. In the recovery phase after chronic CCl4 injury, r/r mice have a markedly attenuated HPC response compared to wild-types, together with persistence of collagen I and failure to deposit ECM laminin. Similar results were found in r/r mice given the choline-deficient ethionine supplemented diet, another model of the HPC response. In cross-over sex-mismatched BM transplantation (BMT) experiments between r/r mice and wild-types, the blunted HPC response of r/r mice was not rescued by wild-type BMT and likewise not conferred on to wild-type recipients by r/r BMT, demonstrating that the attenuated HPC response in r/r mice is a property intrinsic to the liver. CONCLUSION: Failure of ECM remodelling after chronic fibrotic liver injury hinders the ability of the liver to activate HPCs. Laminin-progenitor cell interactions within the HPC niche are a critical for HPC mediated regeneration.
Asunto(s)
Matriz Extracelular/fisiología , Cirrosis Hepática Experimental/patología , Regeneración Hepática/fisiología , Células Madre/patología , Animales , Células de la Médula Ósea/patología , Trasplante de Médula Ósea , Tetracloruro de Carbono , Deficiencia de Colina/complicaciones , Colágeno/metabolismo , Etionina/administración & dosificación , Femenino , Laminina/deficiencia , Cirrosis Hepática Experimental/inducido químicamente , Cirrosis Hepática Experimental/fisiopatología , Macrófagos/patología , Masculino , Ratones , Ratones Endogámicos C57BLRESUMEN
The advent of metabonomics has seen a proliferation of biofluid profiling studies of patients with hepatocellular carcinoma. The majority of these studies have been conducted in single indigenous populations making the widespread applicability of candidate metabolite biomarkers difficult. Presented here is a urinary proton nuclear magnetic resonance spectroscopy study of mainly hepatitis C virus infected Egyptian patients with hepatocellular carcinoma, which corroborates findings of a previous study from our group of mainly hepatitis B-infected Nigerian patients with hepatocellular carcinoma. Using multivariate statistical analysis, in the form of orthogonal signal-corrected partial least squared discriminant analysis, the sensitivity and specificity of the technique for distinguishing patients with tumors from healthy controls and patients with cirrhosis was 100%/94% and 81%/71%, respectively. Discriminatory metabolites included glycine, trimethylamine-N-oxide, hippurate, citrate, creatinine, creatine, and carnitine. This metabolic profile bears similarity to profiles identified in the Nigerian cohort of subjects indicative of tumor effects on physiology, energy production, and aberrant chromosomal methylation. This is the first study to identify similarly altered urine metabolic profiles of hepatocellular carcinoma in two etiologically and ethnically distinct populations, suggesting that altered metabolism as a result of tumorogenesis is independent of these two factors.