RESUMO
BACKGROUND: Particulate matter directly emitted into the air by sources such as combustion processes and windblown dust, or formed in the atmosphere by transformation of emitted gases are the major contributors to air pollution that triggers a diverse array of human pathologies including lung cancer. The mortality in lung cancer is usually high as the disease is not symptomatic at its early treatable stage. Moreover, available methods for screening are costly and mainly rely on imaging techniques which lack sufficient sensitivity and specificity. Despite progress in the identification of biomarkers, gene mutation based approaches still face formidable challenges as the disease evolves from a complex interplay between environment and host. Therefore, identification of an epigenomic signature might be useful for early diagnosis with the potential to reduce the environmental-associated disease burden. OBJECTIVE: The review discusses the utility of epigenomic signature in identification and management of the environmental-associated lung cancers. CONCLUSION: Non-invasive 'liquid biopsy' based epigenomic screening has recently emerged as a methodology which has potential to characterize tumor heterogeneity at initial stages. Epigenetic signatures (methylated DNA, miRNA, and post transcriptionally modified histones) known to reflect the vital cellular changes, circulate at higher levels in the individuals with lung cancer. These circulating biological entities are reported to be closely associated with the clinical outcome of lung cancer patients and thus strongly stand as the probable candidate to identify disease at an early stage and monitor treatment response, thereby, benefiting patients and improving their lives. However, for effective implementation of the strategy as "point-of-care" test for screening population-at-risk will require exhaustive clinical validation.
Assuntos
Biomarcadores Tumorais/genética , Epigênese Genética , Exposição por Inalação/efeitos adversos , Neoplasias Pulmonares/genética , Material Particulado/efeitos adversos , Animais , Biomarcadores Tumorais/sangue , MicroRNA Circulante/sangue , MicroRNA Circulante/genética , Metilação de DNA , Detecção Precoce de Câncer/métodos , Perfilação da Expressão Gênica , Predisposição Genética para Doença , Histonas/metabolismo , Humanos , Biópsia Líquida , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Fenótipo , Prognóstico , Processamento de Proteína Pós-Traducional , Medição de Risco , Fatores de Risco , TranscriptomaRESUMO
AIM: To evaluate differences in uteroplacental blood flow and pregnancy outcome in women with idiopathic recurrent spontaneous miscarriage (IRSM) following administration of micronized vaginal progesterone and oral dydrogesterone. METHODS: One hundred and thirty-three women (aged 23-40 years) who had had early miscarriages and spontaneous conception participated. Oral dydrogesterone (group A, n = 51) and micronized vaginal progesterone (group B, n = 50) were administrated for luteal support and compared. Pregnant women without history of recurrent miscarriage served as controls (group C, n = 32). The outcome measures consisted of endometrial blood flow parameters by Doppler indices and ongoing pregnancy rate. RESULTS: Before progesterone supplementation, resistivity index (RI) and pulsatility index (PI) were found to be significantly higher in groups A and B as compared to controls. Although statistically not significant, end diastolic velocity (EDV) and systolic/diastolic (S/D) ratio was found to be superior in controls than IRSM women. Peak systolic velocity (PSV) was comparable between IRSM and non-IRSM groups. Following progesterone supplementation, groups A and B showed a highly significant reduction in RI, PI and an increase in EDV. A relative increase in the value of PSV was observed in group A as compared to group B. There was remarkable difference in S/D in both groups. Although not statistically significant, group C showed reduction in RI, PI, PSV, EDV and S/D ratio. Pregnancy salvage rates were higher in group A (92.0%) as compared to group B (82.3%). CONCLUSION: Progesterone supplementation appears to lower vascular resistance in women with IRSM. Oral dydrogesterone appears to be equally effective in improving endometrial blood flow as compared with micronized progesterone.