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1.
Life Sci ; 348: 122686, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38710282

RESUMO

Proper and functional immune response requires a complex interaction between innate and adaptive immune cells, which dendritic cells (DCs) are the primary actors in this coordination as professional antigen-presenting cells. DCs are armed with numerous pattern recognition receptors (PRRs) such as nucleotide-binding and oligomerization domain-like receptors (NLRs) like NLRP3, which influence the development of their activation state upon sensation of ligands. NLRP3 is a crucial component of the immune system for protection against tumors and infectious agents, because its activation leads to the assembly of inflammasomes that cause the formation of active caspase-1 and stimulate the maturation and release of proinflammatory cytokines. But, when NLRP3 becomes overactivated, it plays a pathogenic role in the progression of several autoimmune disorders. So, NLRP3 activation is strictly regulated by diverse signaling pathways that are mentioned in detail in this review. Furthermore, the role of NLRP3 in all of the diverse immune cells' subsets is briefly mentioned in this study because NLRP3 plays a pivotal role in modulating other immune cells which are accompanied by DCs' responses and subsequently influence differentiation of T cells to diverse T helper subsets and even impact on cytotoxic CD8+ T cells' responses. This review sheds light on the functional and therapeutic role of NLRP3 in DCs and its contribution to the occurrence and progression of autoimmune disorders, prevention of diverse tumors' development, and recognition and annihilation of various infectious agents. Furthermore, we highlight NLRP3 targeting potential for improving DC-based immunotherapeutic approaches, to be used for the benefit of patients suffering from these disorders.


Assuntos
Doenças Autoimunes , Autoimunidade , Células Dendríticas , Inflamassomos , Proteína 3 que Contém Domínio de Pirina da Família NLR , Neoplasias , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/imunologia , Humanos , Neoplasias/imunologia , Neoplasias/terapia , Inflamassomos/imunologia , Inflamassomos/metabolismo , Animais , Autoimunidade/imunologia , Doenças Autoimunes/imunologia , Doenças Autoimunes/terapia , Doenças Autoimunes/metabolismo , Doenças Transmissíveis/imunologia , Doenças Transmissíveis/metabolismo , Doenças Transmissíveis/terapia
2.
Front Immunol ; 15: 1289303, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38352878

RESUMO

Immunotherapy treatments aim to modulate the host's immune response to either mitigate it in inflammatory/autoimmune disease or enhance it against infection or cancer. Among different immunotherapies reaching clinical application during the last years, chimeric antigen receptor (CAR) immunotherapy has emerged as an effective treatment for cancer where different CAR T cells have already been approved. Yet their use against infectious diseases is an area still relatively poorly explored, albeit with tremendous potential for research and clinical application. Infectious diseases represent a global health challenge, with the escalating threat of antimicrobial resistance underscoring the need for alternative therapeutic approaches. This review aims to systematically evaluate the current applications of CAR immunotherapy in infectious diseases and discuss its potential for future applications. Notably, CAR cell therapies, initially developed for cancer treatment, are gaining recognition as potential remedies for infectious diseases. The review sheds light on significant progress in CAR T cell therapy directed at viral and opportunistic fungal infections.


Assuntos
Doenças Transmissíveis , Neoplasias , Receptores de Antígenos Quiméricos , Humanos , Imunoterapia , Imunoterapia Adotiva , Neoplasias/terapia , Doenças Transmissíveis/terapia
3.
Clin Microbiol Rev ; 36(4): e0001523, 2023 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-37909789

RESUMO

MicroRNAs (miRNAs) are conserved, short, non-coding RNAs that play a crucial role in the post-transcriptional regulation of gene expression. They have been implicated in the pathogenesis of cancer and neurological, cardiovascular, and autoimmune diseases. Several recent studies have suggested that miRNAs are key players in regulating the differentiation, maturation, and activation of immune cells, thereby influencing the host immune response to infection. The resultant upregulation or downregulation of miRNAs from infection influences the protein expression of genes responsible for the immune response and can determine the risk of disease progression. Recently, miRNAs have been explored as diagnostic biomarkers and therapeutic targets in various infectious diseases. This review summarizes our current understanding of the role of miRNAs during viral, fungal, bacterial, and parasitic infections from a clinical perspective, including critical functional mechanisms and implications for their potential use as biomarkers and therapeutic targets.


Assuntos
Doenças Transmissíveis , MicroRNAs , Doenças Parasitárias , Humanos , MicroRNAs/genética , MicroRNAs/metabolismo , Regulação da Expressão Gênica , Biomarcadores , Doenças Parasitárias/diagnóstico , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/genética , Doenças Transmissíveis/terapia
4.
PLoS One ; 18(9): e0291421, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37683019

RESUMO

BACKGROUND: Infectious disease (ID) clinicians can provide essential services for febrile patients in tertiary hospitals. The aim of this study was to evaluate the role of ID consultations (IDC) in managing hospitalized patients with infections in an oriental medical hospital (OMH), which serves as a long-term care facility. To our knowledge, this is the first study on the role of IDCs in managing patients in an OMH. METHODS: This retrospective study was conducted in an OMH in Seoul, Korea, from June 2006 to June 2013. RESULTS: Among the 465 cases of hospital-acquired fever, 141 (30.3%) were referred for ID. The most common cause of fever was infection in both groups. The peak body temperature of the patient was higher in IDC group (38.8±0.6°C vs. 38.6±0.5°C, p<0.001). Crude mortality at 30 days (14.6% vs. 7.8%, p = 0.043) and infection-attributable mortality (15.3% vs. 6.7%, p = 0.039) were higher in the No-IDC group. Multivariable analysis showed that infection as the focus of fever (adjusted Odd ratio [aOR] 3.49, 95% confidence interval (CI) 1.64-7.44), underlying cancer (aOR 10.32, 95% CI 4.34-24.51,), and multiorgan dysfunction syndrome (aOR 15.68, 95% CI 2.06-119.08) were associated with increased 30-day mortality. Multivariate analysis showed that in patients with infectious fever, appropriate antibiotic therapy (aOR 0.19, 95% CI 0.05-0.76) was the only factor associated with decreased infection-attributable mortality while underlying cancer (aOR 7.80, 95% CI 2.555-23.807) and severe sepsis or septic shock at the onset of fever (aOR 10.15, 95% CI 1.00-102.85) were associated with increased infection-attributable mortality. CONCLUSION: Infection was the most common cause of fever in patients hospitalized for OMH. Infection as the focus of fever, underlying cancer, and MODS was associated with increased 30-day mortality in patients with nosocomial fever. Appropriate antibiotic therapy was associated with decreased infection-attributable mortality in patients with infectious fever.


Assuntos
Cardiomiopatia Dilatada , Doenças Transmissíveis , Humanos , Assistência de Longa Duração , Estudos Retrospectivos , Casas de Saúde , Febre , Encaminhamento e Consulta , Centros de Atenção Terciária , Doenças Transmissíveis/terapia
5.
Hum Gene Ther ; 34(17-18): 896-904, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37639360

RESUMO

The development of prophylatic or therapeutic medicines for infectious diseases is one of the priorities for health organizations worldwide. Innovative solutions are required to achieve effective, safe, and accessible treatments for most if not all infectious diseases, particularly those that are chronic in nature or that emerge unexpectedly over time. Genetic technologies offer versatile possibilities to design therapies against pathogens. Recent developments such as mRNA vaccines, CRISPR gene editing, and immunotherapies provide unprecedented hope to achieve significant results in the field of infectious diseases. This review will focus on advances in this domain, showcasing the cross-fertilization with other fields (e.g., oncology), and addressing some of the logistical and economic concerns important to consider when making these advances accessible to diverse populations around the world.


Assuntos
Doenças Transmissíveis , Humanos , Doenças Transmissíveis/genética , Doenças Transmissíveis/terapia , Terapia Genética , Vacinação , Clonagem Molecular , Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas
7.
Expert Rev Anti Infect Ther ; 21(4): 365-374, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36815406

RESUMO

INTRODUCTION: Corona Virus Disease of 2019 (COVID-19) pandemic has renewed interest in monoclonal antibodies for treating infectious diseases. During last two decades experimental data has been accumulated showing the potential of radioimmunotherapy (RIT) of infectious diseases. In addition, COVID-19 pandemic has created a novel landscape for opportunistic fungal infections in post-COVID-19 patients resulting from severe immune suppression. AREAS COVERED: We analyze recent results on targeting "pan-antigens" shared by fungal pathogens in mouse models and in healthy dogs; on developing RIT of prosthetic joint infections (PJI); examine RIT as potential human immunodeficiency virus (HIV) cure strategy and analyze its mechanisms and safety. Literature review was performed using PubMed and Google Scholar and includes relevant articles from 2000 to 2022. EXPERT OPINION: Some of the RIT of infection applications can, hopefully, be moved into the clinic earlier than others after preclinical development: (1) RIT of opportunistic fungal infections might contribute to saving lives as current antifungal drugs do not work in severely immunocompromised patients; (2) RIT of patients with PJI. Success of RIT in these patients will allow to expand the application of RIT to other similarly vulnerable patients' populations such as cancer patients with weakened immune system and organ transplant recipients.


Assuntos
COVID-19 , Doenças Transmissíveis , Micoses , Camundongos , Humanos , Animais , Cães , Radioimunoterapia/métodos , Pandemias , Doenças Transmissíveis/terapia
8.
Adv Protein Chem Struct Biol ; 133: 231-269, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36707203

RESUMO

Secretory proteins are playing important role during the host-pathogen interaction to develop the infection or protection into the cell. Pathogens developing infectious disease to human being are taken up by host macrophages or number of immune cells, play an important role in physiological, developmental and immunological function. At the same time, infectious agents are also secreting various proteins to neutralize the resistance caused by host cells and also helping the pathogens to develop the infection. Secretory proteins (secretome) are only developed at the time of host-pathogen interaction, therefore they become very important to develop the targeted and potential therapeutic strategies. Pathogen specific secretory proteins released during interaction with host cell provide opportunity to develop point of care and rapid diagnostic kits. Proteins secreted by pathogens at the time of interaction with host cell have also been found as immunogenic in nature and numbers of vaccines have been developed to control the spread of human infectious diseases. This chapter highlights the importance of secretory proteins in the development of diagnostic and therapeutic strategies to fight against human infectious diseases.


Assuntos
Doenças Transmissíveis , Vacinas , Humanos , Interações Hospedeiro-Patógeno , Macrófagos , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/terapia
9.
Arq. ciências saúde UNIPAR ; 27(3): 1164-1172, 2023.
Artigo em Português | LILACS | ID: biblio-1425449

RESUMO

O Lúpus Eritematoso Sistêmico (LES) é uma patologia crônica, de origem autoimune e inflamatória. As diversas manifestações clínicas existentes em pacientes acometidos pelo LES, sejam elas sistêmicas ou órgãos-alvo, possibilitam variados diagnósticos diferenciais. Dentre as manifestações clínicas que possibilitam estes diagnósticos está o acometimento cutâneo, com vasta variabilidade de apresentação. Da mesma forma, a sífilis também possui apresentação cutânea, tornando possível o diferencial de diagnóstico com outras patologias, inclusive o próprio LES. O presente estudo tem como objetivo relatar um caso de sífilis mimetizando lúpus eritematoso sistêmico, descrever o quadro clínico apresentado pelo paciente, bem como as ferramentas utilizadas para diagnóstico, e a posterior abordagem terapêutica. O caso relatado refere-se a um paciente de 29 anos, do sexo masculino, procedente de Campos Novos (SC), que apresentou um quadro clínico e laboratorial de lúpus-like induzido por uma infecção aguda de sífilis. A resolução completa de critérios inflamatórios de LES ocorreu após tratamento correto da doença infecciosa, com total melhora clínica e sorológica.


Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease. The various clinical manifestations in SLE patients, both systemic and in target organs, allow for various differential diagnoses. Among the clinical manifestations that aid in diagnosis are the cutaneous injuries, which have a wide range of presentations. Syphilis also has cutaneous manifestations, which aid in the differential diagnosis from other pathologies, including SLE. The present study aims to report a case of syphilis mimicking SLE, describe the clinical condition presented by the patient, the tools used for diagnosis, and the therapeutic approach. The case reported refers to a 29- year-old male patient from Campos Novos (SC), who showed a clinical and laboratory lupus-like condition induced by an acute syphilis infection. The full resolution of SLE inflammatory criteria occurred following appropriate treatment for the infectious disease, with complete clinical and serological improvement.


El lupus eritematoso sistémico (LES) es una enfermedad inflamatoria autoinmune crónica. Las diversas manifestaciones clínicas de los pacientes con LES, tanto sistémicas como en órganos diana, permiten realizar varios diagnósticos diferenciales. Entre las manifestaciones clínicas que ayudan al diagnóstico se encuentran las lesiones cutáneas, que tienen una amplia gama de presentaciones. La sífilis también tiene manifestaciones cutáneas, que ayudan al diagnóstico diferencial con otras patologías, incluido el LES. El presente estudio tiene como objetivo comunicar un caso de sífilis que simula un LES, describir el cuadro clínico presentado por la paciente, las herramientas utilizadas para el diagnóstico y el abordaje terapéutico. El caso relatado se refiere a un paciente masculino de 29 años, natural de Campos Novos (SC), que presentó un cuadro clínico y de laboratorio semejante al lupus, inducido por una infección aguda por sífilis. La resolución completa de los criterios inflamatorios del LES ocurrió tras el tratamiento adecuado de la enfermedad infecciosa, con mejoría clínica y serológica completa.


Assuntos
Humanos , Masculino , Adulto , Sífilis/diagnóstico , Sífilis/patologia , Sífilis/terapia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/patologia , Lúpus Eritematoso Sistêmico/terapia , Manifestações Cutâneas , Adaptação Biológica , Doenças Transmissíveis/patologia , Doenças Transmissíveis/terapia , Técnicas de Laboratório Clínico/métodos , Relatos de Casos como Assunto , Infecções/diagnóstico
11.
Curr Opin Biotechnol ; 78: 102818, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36242952

RESUMO

The COVID-19 pandemic demonstrated that monoclonal antibodies can be deployed faster than antimicrobials and vaccines. However, the majority of mAbs treat cancer and autoimmune diseases, whereas a minority treat infection. This is in part because targeting a single antigen by the antibody Fab domain is insufficient to stop the dynamic microbial life cycle. Thus, finding the 'right' antigens remains the focus of intense investigations. Equally important is the antibody-Fc domain that has the capacity to induce immune responses that enhance neutralization, and limit pathology and transmission. While Fc-effector functions have been less deeply studied, conceptual and technical advances reveal previously underappreciated antibody potential to combat diseases from microbes difficult to address with current diagnostics, therapeutics, and vaccines, including S. aureus, P. aeruginosa, P. falciparum, and M. tuberculosis. What is learned about engineering antibodies for these challenging organisms will enhance our approach to new and emerging infectious diseases.


Assuntos
COVID-19 , Doenças Transmissíveis , Humanos , Anticorpos Monoclonais/uso terapêutico , Staphylococcus aureus , Pandemias , Antígenos , Doenças Transmissíveis/terapia , Anticorpos Neutralizantes
12.
Przegl Epidemiol ; 76(1): 19-28, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35860922

RESUMO

Occurrence of infectious disease in a woman is an interdisciplinary area of medicine. The common problem of lower recruitment of women to clinical trials leads to the necessity to rely in clinical practice on the exchange of practical experiences, specialist consultations and individualization of treatment. As the COVID-19 pandemic shows, there is a close relationship between infectious diseases and civilization diseases. People suffering from chronic diseases are both more susceptible to infection and the more severe course of an infectious disease. On the other hand, infection may accelerate or initiate the onset of a noncommunicable disease. Women, especially those living with HIV, are a group with an underestimated risk of high blood pressure or some cancers. Therefore, one of the main goals of the conference is to break the stereotypes of thinking about health, in which gender is the main determinant of some screening tests. Late presentation of women to medical care is a significant problem that is of great importance in the diagnosis and treatment of both communicable and non-communicable diseases. Women put family and professional responsibilities in the first place, and they are known to downplay their own health problems. It leads to the diagnosis of cardiovascular diseases or cancer at the stage of advanced changes, limiting the possibilities of effective therapy. Understanding gender attributed differences in the etiology and epidemiology of diseases allows for the improvement of patient care, as well as determines the right direction of reforms in the area of healthcare. It is essential to build models of care based on an interdisciplinary and patient-centered approach, with broad support from both stakeholders and NGOs. Each contact of the patient with the health care system should be seen as an opportunity for screening both in the area of civilization diseases, women's health, and infectious diseases corresponding to her lifestyle.


Assuntos
COVID-19 , Doenças Transmissíveis , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/terapia , Feminino , Humanos , Masculino , Pandemias , Polônia , Saúde da Mulher
13.
Biomed Pharmacother ; 148: 112751, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35240524

RESUMO

Infectious diseases and cancer are among the key medical challenges that humankind is facing today. A growing amount of evidence suggests that ion channels in the endolysosomal system play a crucial role in the pathology of both groups of diseases. The development of advanced patch-clamp technologies has allowed us to directly characterize ion fluxes through endolysosomal ion channels in their native environments. Endolysosomes are essential organelles for intracellular transport, digestion and metabolism, and maintenance of homeostasis. The endolysosomal ion channels regulate the function of the endolysosomal system through four basic mechanisms: calcium release, control of membrane potential, pH change, and osmolarity regulation. In this review, we put particular emphasis on the endolysosomal cation channels, including TPC2 and TRPML2, which are particularly important in monocyte function. We discuss existing endogenous and synthetic ligands of these channels and summarize current knowledge of their impact on channel activity and function in different cell types. Moreover, we summarize recent findings on the importance of TPC2 and TRPML2 channels as potential drug targets for the prevention and treatment of the emerging infectious diseases and cancer.


Assuntos
Doenças Transmissíveis/terapia , Endossomos/metabolismo , Canais Iônicos/metabolismo , Lisossomos/metabolismo , Neoplasias/terapia , Animais , Transporte Biológico , Cálcio/metabolismo , Canais de Cálcio/metabolismo , Cátions/metabolismo , Doenças Transmissíveis/metabolismo , Homeostase , Humanos , Concentração de Íons de Hidrogênio , Camundongos , Monócitos/metabolismo , Neoplasias/metabolismo , Medicina de Precisão/métodos , Canais de Potencial de Receptor Transitório/metabolismo
14.
Rev Med Virol ; 32(4): e2325, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35037732

RESUMO

Cancer immunotherapy has made improvements due to the advances in chimaeric antigen receptor (CAR) T cell development, offering a promising treatment option for patients who have failed to respond to traditional treatments. In light of the successful use of adoptive CAR T cell therapy for cancer, researchers have been inspired to develop CARs for the treatment of other diseases beyond cancers such as viral infectious diseases. Nonetheless, various obstacles limit the efficacy of CAR T cell therapies and prevent their widespread usage. Severe toxicities, poor in vivo persistence, antigen escape, and heterogeneity, as well as off-target effect, are key challenges that must all be addressed to broaden the application of CAR T cells to a wider spectrum of diseases. The key advances in CAR T cell treatment for cancer and viral infections are reviewed in this article. We will also discuss revolutionary CAR T cell products developed to improve and enhance the therapeutic advantages of these treatments.


Assuntos
Doenças Transmissíveis , Imunoterapia Adotiva , Neoplasias , Receptores de Antígenos Quiméricos , Doenças Transmissíveis/terapia , Humanos , Neoplasias/etiologia , Neoplasias/terapia , Receptores de Antígenos Quiméricos/genética , Linfócitos T
15.
BMJ Mil Health ; 168(6): 457-461, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32123000

RESUMO

Military organisations have battled communicable disease for millennia. They have pioneered disease prevention from the Crusades to the World Wars and continue to do so today. Predeployment vaccinations and chemoprophylaxis are effective in preventing communicable disease, as is reliable vector destruction and bite prevention, especially in the era of multidrug resistant organisms. These measures are unlikely to be fully possible in disasters, but reactive vaccination and efforts to reduce exposure to communicable disease should be a priority. Communicable diseases can be challenging to diagnose-the UK Defence Medical Services have become familiar with tools such as multiplex PCR and mass spectrometry. These have the potential to accurately identify organisms and sensitivity patterns in austere environments. Management of communicable diseases depends on accurate diagnosis and has a largely well-established evidence base but can be limited by a lack of resources and skills in an austere setting, therefore telemedicine can assist diagnosis and treatment of infections by projecting specialist skill. Systems such as EpiNATO2 are useful in monitoring diseases and identifying trends in order to establish control measures. Many of these tools and techniques are effective in austere environments and offer learning opportunities for those providing care in similar settings. Further research is ongoing into diagnostic tools as well as remote management.


Assuntos
Doenças Transmissíveis , Desastres , Medicina Militar , Telemedicina , Humanos , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/terapia , Quimioprevenção , Medicina Militar/métodos
16.
Pediatr Clin North Am ; 69(1): 153-170, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34794672

RESUMO

Immigrant children are a diverse group and include refugees, asylees, and internationally adopted children. They have various infectious disease risk factors, depending on conditions within their country of origin, journey, and current living conditions. Infectious disease screening should take place within the framework of a comprehensive medical evaluation in the medical home. Some screening is recommended for all immigrant children including hepatitis B, syphilis, HIV, tuberculosis, and intestinal parasites; other diseases can be tested for based on individual risks. Although guidelines and resources are available, there is limited evidence supporting much of the care of immigrant children and youth.


Assuntos
Criança Adotada , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/terapia , Emigrantes e Imigrantes , Refugiados , Adolescente , COVID-19/diagnóstico , Criança , Pré-Escolar , Controle de Doenças Transmissíveis/métodos , Feminino , Infecções por HIV/diagnóstico , Hepatite Viral Humana/diagnóstico , Humanos , Imunização/métodos , Lactente , Masculino , Programas de Rastreamento/métodos , Doenças Parasitárias/diagnóstico , Pediatria/métodos , Guias de Prática Clínica como Assunto , Sífilis/diagnóstico , Tuberculose/diagnóstico
17.
Artigo em Português | LILACS, CONASS, ColecionaSUS, SES-GO | ID: biblio-1379114

RESUMO

A terapia nutricional é uma das intervenções terapêuticas mais utilizadas em cuidados intensivos, quando aplicada de forma correta auxilia na diminuição de complicações metabólicas, no equilíbrio imunológico, além de amenizar a perda de massa corporal do paciente gravemente enfermo. Objetivo: avaliar a associação dos indicadores antropométricos e o consumo proteico com o desfecho clínico de pacientes críticos em uso de terapia nutricional enteral (TNE) exclusiva. Materiais e Métodos: Trata-se de um estudo prospectivo de caráter observacional analítico, com a utilização de dados de pacientes adultos e idosos em uso exclusivo de TNE desenvolvido em uma Unidade de Terapia Intensiva (UTI). Realizado por meio da coleta de dados secundários registrados nos prontuários de pacientes ≥ 18 anos, que receberam terapia nutricional enteral exclusiva por pelo menos 72 horas. Utilizou-se os indicadores antropométricos índice de massa corporal (IMC) e circunferência do braço. Para a estimativa das necessidades proteicas, considerou-se a recomendação da American Society for Parenteral and Enteral Nutrition. A adequação nutricional foi realizada por meio da coleta diária do volume da formula enteral prescrita e administrada. Nas análises utilizaram-se testes paramétricos e não paramétricos e foi considerado significante p < 0,05. Resultado: Participaram do estudo 52 pacientes que estiveram em uso de nutrição enteral exclusiva internados na UTI no hospital por pelo menos de 72 horas durante a etapa de coleta de dados. Desses pacientes a maioria era do sexo masculino (76,9%), com idade média de 45,7 anos (DP=15,0, mínimo 20 e máximo 71). O tempo de internação médio foi de 12 dias. Os diagnósticos de AIDS (síndrome da imunodeficiência adquirida) (46,1%) e COVID-19 (13,4%) foram os mais prevalentes. Foram identificados que quase 60% da amostra não tinham comorbidades e o desfecho clínico mais frequente foi a alta hospitalar. Conclusão: Neste estudo não foi verificado associações entre os desfechos clínicos avaliados (alta ou óbito) com o aporte proteico ofertado e os indicadores antropométricos, assim também como não tiveram entre as variáveis demográficas e clínicas investigadas


Nutritional therapy is one of the most used therapeutic interventions in intensive care, when correctly applied, it helps to reduce metabolic complications, immune balance, in addition to mitigating the loss of body mass in seriously ill patients. Objective: to evaluate the association of anthropometric indicators and protein consumption with the clinical outcome of critically ill patients using exclusive enteral nutritional therapy (EN). Materials and Methods: This is a prospective, observational, analytical study, using data from adult and elderly patients exclusively using EN developed in an Intensive Care Unit (ICU). Performed by collecting secondary data recorded in the medical records of patients ≥ 18 years old, who received exclusive enteral nutritional therapy for at least 72 hours. Anthropometric indicators body mass index (BMI) and arm circumference were used. For the estimation of protein requirements, the recommendation of the American Society for Parenteral and Enteral Nutrition was considered. Nutritional adequacy was performed through the daily collection of the volume of the prescribed and administered enteral formula. Parametric and non-parametric tests were used in the analyses, and p < 0.05 was considered significant. Result: The study included 52 patients who had been using exclusive enteral nutrition and were hospitalized in the ICU for at least 72 hours during the data collection stage. Of these patients, the majority were male (76.9%), with a mean age of 45.7 years (SD=15.0, minimum 20 and maximum 71). The mean hospital stay was 12 days. The diagnoses of AIDS (acquired immunodeficiency syndrome) (46.1%) and COVID-19 (13.4%) were the most prevalent. It was identified that almost 60% of the sample had no comorbidities and the most frequent clinical outcome was hospital discharge. Conclusion: In this study, there were no associations between the evaluated clinical outcomes (discharge or death) with the protein intake offered and the anthropometric indicators, as well as they did not have between the demographic and clinical variables investigated


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Nutrição Enteral , Cuidados Críticos/métodos , Índice de Massa Corporal , Doenças Transmissíveis/terapia , Estudos Prospectivos , Unidades de Terapia Intensiva
18.
Front Immunol ; 12: 781815, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34956210

RESUMO

MicroRNAs (miRNAs) are diminutive noncoding RNAs that can influence disease development and progression by post-transcriptionally regulating gene expression. The anti-inflammatory miRNA, miR-223, was first identified as a regulator of myelopoietic differentiation in 2003. This miR-223 exhibits multiple regulatory functions in the immune response, and abnormal expression of miR-223 is shown to be associated with multiple infectious diseases, including viral hepatitis, human immunodeficiency virus type 1 (HIV-1), and tuberculosis (TB) by influencing neutrophil infiltration, macrophage function, dendritic cell (DC) maturation and inflammasome activation. This review summarizes the current understanding of miR-223 physiopathology and highlights the molecular mechanism by which miR-223 regulates immune responses to infectious diseases and how it may be targeted for diagnosis and treatment.


Assuntos
Doenças Transmissíveis/etiologia , Regulação da Expressão Gênica , Interações Hospedeiro-Patógeno/genética , Interações Hospedeiro-Patógeno/imunologia , Imunomodulação/genética , MicroRNAs/genética , Animais , Biomarcadores , Mapeamento Cromossômico , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/terapia , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Suscetibilidade a Doenças , Hematopoese/genética , Humanos , Macrófagos/imunologia , Macrófagos/metabolismo , Especificidade de Órgãos/genética , Interferência de RNA , Transcrição Gênica
19.
Acc Chem Res ; 54(23): 4283-4293, 2021 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-34793124

RESUMO

After decades of extensive fundamental studies and clinical trials, lipid nanoparticles (LNPs) have demonstrated effective mRNA delivery such as the Moderna and Pfizer-BioNTech vaccines fighting against COVID-19. Moreover, researchers and clinicians have been investigating mRNA therapeutics for a variety of therapeutic indications including protein replacement therapy, genome editing, and cancer immunotherapy. To realize these therapeutics in the clinic, there are many formidable challenges. First, novel delivery systems such as LNPs with high delivery efficiency and low toxicity need to be developed for different cell types. Second, mRNA molecules need to be engineered for improved pharmaceutical properties. Lastly, the LNP-mRNA nanoparticle formulations need to match their therapeutic applications.In this Account, we summarize our recent advances in the design and development of various classes of lipids and lipid derivatives, which can be formulated with multiple types of mRNA molecules to treat diverse diseases. For example, we conceived a series of ionizable lipid-like molecules based on the structures of a benzene core, an amide linker, and hydrophobic tails. We identified N1,N3,N5-tris(3-(didodecylamino)propyl)benzene-1,3,5-tricarboxamide (TT3) as a lead compound for mRNA delivery both in vitro and in vivo. Moreover, we tuned the biodegradability of these lipid-like molecules by introducing branched ester or linear ester chains. Meanwhile, inspired by biomimetic compounds, we synthesized vitamin-derived lipids, chemotherapeutic conjugated lipids, phospholipids, and glycolipids. These scaffolds greatly broaden the chemical space of ionizable lipids for mRNA delivery. In another section, we highlight our efforts on the research direction of mRNA engineering. We previously optimized mRNA chemistry using chemically-modified nucleotides to increase the protein expression, such as pseudouridine (ψ), 5-methoxyuridine (5moU), and N1-methylpseudouridine (me1ψ). Also, we engineered the sequences of mRNA 5' untranslated regions (5'-UTRs) and 3' untranslated regions (3'-UTRs), which dramatically enhanced protein expression. With the progress of LNP development and mRNA engineering, we consolidate these technologies and apply them to treat diseases such as genetic disorders, infectious diseases, and cancers. For instance, TT3 and its analog-derived lipid-like nanoparticles can effectively deliver factor IX or VIII mRNA and recover the clotting activity in hemophilia mouse models. Engineered mRNAs encoding SARS-CoV-2 antigens serve well as vaccine candidates against COVID-19. Vitamin-derived lipid nanoparticles loaded with antimicrobial peptide-cathepsin B mRNA enable adoptive macrophage transfer to treat multidrug resistant bacterial sepsis. Biomimetic lipids such as phospholipids formulated with mRNAs encoding costimulatory receptors lead to enhanced cancer immunotherapy.Overall, lipid-mRNA nanoparticle formulations have considerably benefited public health in the COVID-19 pandemic. To expand their applications in clinical use, research work from many disciplines such as chemistry, engineering, materials, pharmaceutical sciences, and medicine need to be integrated. With these collaborative efforts, we believe that more and more lipid-mRNA nanoparticle formulations will enter the clinic in the near future and benefit human health.


Assuntos
Portadores de Fármacos/química , Lipossomos/química , Nanopartículas/química , RNA Mensageiro/química , Animais , Benzamidas/química , Materiais Biomiméticos/química , Doenças Transmissíveis/imunologia , Doenças Transmissíveis/terapia , Modelos Animais de Doenças , Doenças Genéticas Inatas/imunologia , Doenças Genéticas Inatas/terapia , Humanos , Camundongos , Neoplasias/imunologia , Neoplasias/terapia , Fosfolipídeos/química , RNA Mensageiro/metabolismo , RNA Mensageiro/uso terapêutico , Regiões não Traduzidas , Vitaminas/química
20.
Front Cell Infect Microbiol ; 11: 697876, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34307196

RESUMO

Antibodies are essential molecules for diagnosis and treatment of diseases caused by pathogens and their toxins. Antibodies were integrated in our medical repertoire against infectious diseases more than hundred years ago by using animal sera to treat tetanus and diphtheria. In these days, most developed therapeutic antibodies target cancer or autoimmune diseases. The COVID-19 pandemic was a reminder about the importance of antibodies for therapy against infectious diseases. While monoclonal antibodies could be generated by hybridoma technology since the 70ies of the former century, nowadays antibody phage display, among other display technologies, is robustly established to discover new human monoclonal antibodies. Phage display is an in vitro technology which confers the potential for generating antibodies from universal libraries against any conceivable molecule of sufficient size and omits the limitations of the immune systems. If convalescent patients or immunized/infected animals are available, it is possible to construct immune phage display libraries to select in vivo affinity-matured antibodies. A further advantage is the availability of the DNA sequence encoding the phage displayed antibody fragment, which is packaged in the phage particles. Therefore, the selected antibody fragments can be rapidly further engineered in any needed antibody format according to the requirements of the final application. In this review, we present an overview of phage display derived recombinant antibodies against bacterial, viral and eukaryotic pathogens, as well as microbial toxins, intended for diagnostic and therapeutic applications.


Assuntos
Bacteriófagos , COVID-19 , Doenças Transmissíveis , Animais , Anticorpos Monoclonais , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/terapia , Humanos , Pandemias , SARS-CoV-2
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