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1.
J Biol Chem ; 290(36): 21876-89, 2015 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-26203193

RESUMEN

Aldosterone regulates sodium homeostasis by activating the mineralocorticoid receptor (MR), a member of the nuclear receptor superfamily. Hyperaldosteronism leads todeleterious effects on the kidney, blood vessels, and heart. Although steroidal antagonists such as spironolactone and eplerenone are clinically useful for the treatment of cardiovascular diseases, they are associated with several side effects. Finerenone, a novel nonsteroidal MR antagonist, is presently being evaluated in two clinical phase IIb trials. Here, we characterized the molecular mechanisms of action of finerenone and spironolactone at several key steps of the MR signaling pathway. Molecular modeling and mutagenesis approaches allowed identification of Ser-810 and Ala-773 as key residues for the high MR selectivity of finerenone. Moreover, we showed that, in contrast to spironolactone, which activates the S810L mutant MR responsible for a severe form of early onset hypertension, finerenone displays strict antagonistic properties. Aldosterone-dependent phosphorylation and degradation of MR are inhibited by both finerenone and spironolactone. However, automated quantification of MR subcellular distribution demonstrated that finerenone delays aldosterone-induced nuclear accumulation of MR more efficiently than spironolactone. Finally, chromatin immunoprecipitation assays revealed that, as opposed to spironolactone, finerenone inhibits MR, steroid receptor coactivator-1, and RNA polymerase II binding at the regulatory sequence of the SCNN1A gene and also remarkably reduces basal MR and steroid receptor coactivator-1 recruitment, unraveling a specific and unrecognized inactivating mechanism on MR signaling. Overall, our data demonstrate that the highly potent and selective MR antagonist finerenone specifically impairs several critical steps of the MR signaling pathway and therefore represents a promising new generation MR antagonist.


Asunto(s)
Aldosterona/farmacología , Naftiridinas/farmacología , Coactivador 1 de Receptor Nuclear/metabolismo , Receptores de Mineralocorticoides/metabolismo , Transporte Activo de Núcleo Celular/efectos de los fármacos , Western Blotting , Línea Celular , Núcleo Celular/efectos de los fármacos , Núcleo Celular/metabolismo , Inmunoprecipitación de Cromatina , Relación Dosis-Respuesta a Droga , Regulación hacia Abajo/efectos de los fármacos , Canales Epiteliales de Sodio/genética , Células HEK293 , Humanos , Cinética , Microscopía Fluorescente , Mutación , Regiones Promotoras Genéticas/genética , Unión Proteica/efectos de los fármacos , Receptores de Mineralocorticoides/genética , Transducción de Señal/efectos de los fármacos , Espironolactona/farmacología , Activación Transcripcional/efectos de los fármacos
2.
Ann Surg ; 264(1): 47-53, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-26756766

RESUMEN

OBJECTIVE: The aim of the study was to assess the impact of a preoperative medically supervised exercise program on outcomes after elective abdominal aortic aneurysm (AAA) repair. BACKGROUND: Functional capacity is an important predictor of postoperative outcomes after elective AAA repair. Improving patients' preoperative fitness with exercise has the potential to positively influence recovery. METHODS: A randomized controlled trial was performed at a tertiary vascular unit. Patients scheduled for open or endovascular AAA repair were randomized to either 6 weeks of preoperative supervised exercise or standard treatment using sealed envelopes. The primary outcome measure was a composite endpoint of cardiac, pulmonary, and renal complications. Secondary outcome measures were 30-day mortality, lengths of hospital and critical care stay, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, reoperation, and postoperative bleeding. RESULTS: One hundred twenty-four patients were randomized (111 men, mean [SD] age 73 [7] y). Fourteen patients sustained postoperative complications in the exercise group (22.6%), compared with 26 in the nonexercise group (41.9%; P = 0.021). Four patients (2 in each group) died within the first 30 postoperative days. Duration of hospital stay was significantly shorter in the exercise group (median 7 [interquartile range 5-9] vs 8 [interquartile range 6-12.3] d; P = 0.025). There were no significant differences between the groups in the length of critical care stay (P = 0.845), APACHE II scores (P = 0.256), incidence of reoperations (P = 1.000), or postoperative bleeding (P = 0.343). CONCLUSIONS: A period of preoperative supervised exercise training reduces postoperative cardiac, respiratory, renal complications, and length of hospital stay in patients undergoing elective AAA repair.


Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Procedimientos Quirúrgicos Electivos , Ejercicio Físico , Tiempo de Internación , Cuidados Preoperatorios , Anciano , Anciano de 80 o más Años , Aneurisma de la Aorta Abdominal/mortalidad , Procedimientos Quirúrgicos Electivos/métodos , Femenino , Hemorragia , Hospitales Universitarios , Humanos , Masculino , Cuidados Preoperatorios/métodos , Estudios Prospectivos , Reoperación , Factores de Riesgo , Resultado del Tratamiento
3.
FASEB J ; 29(9): 3977-89, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26054365

RESUMEN

Aldosterone exerts its effects mainly by activating the mineralocorticoid receptor (MR), a transcription factor that regulates gene expression through complex and dynamic interactions with coregulators and transcriptional machinery, leading to fine-tuned control of vectorial ionic transport in the distal nephron. To identify genome-wide aldosterone-regulated MR targets in human renal cells, we set up a chromatin immunoprecipitation (ChIP) assay by using a specific anti-MR antibody in a differentiated human renal cell line expressing green fluorescent protein (GFP)-MR. This approach, coupled with high-throughput sequencing, allowed identification of 974 genomic MR targets. Computational analysis identified an MR response element (MRE) including single or multiple half-sites and palindromic motifs in which the AGtACAgxatGTtCt sequence was the most prevalent motif. Most genomic MR-binding sites (MBSs) are located >10 kb from the transcriptional start sites of target genes (84%). Specific aldosterone-induced recruitment of MR on the first most relevant genomic sequences was further validated by ChIP-quantitative (q)PCR and correlated with concomitant and positive aldosterone-activated transcriptional regulation of the corresponding gene, as assayed by RT-qPCR. It was notable that most MBSs lacked MREs but harbored DNA recognition motifs for other transcription factors (FOX, EGR1, AP1, PAX5) suggesting functional interaction. This work provides new insights into aldosterone MR-mediated renal signaling and opens relevant perspectives for mineralocorticoid-related pathophysiology.


Asunto(s)
Aldosterona/farmacología , Regulación de la Expresión Génica/efectos de los fármacos , Riñón/metabolismo , Receptores de Mineralocorticoides/biosíntesis , Elementos de Respuesta/fisiología , Transducción de Señal/efectos de los fármacos , Aldosterona/metabolismo , Línea Celular , Regulación de la Expresión Génica/fisiología , Humanos , Riñón/citología , Receptores de Mineralocorticoides/genética , Transducción de Señal/fisiología
4.
J Vasc Surg ; 58(6): 1533-9, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23880550

RESUMEN

OBJECTIVE: The aim of this study was to identify whether revascularization by percutaneous transluminal angioplasty (PTA) for patients with intermittent claudication improved measures of functional performance including balance. METHODS: A prospective observational study was performed at a single tertiary vascular center. Patients with symptomatic intermittent claudication (Rutherford grades 1-3) were recruited to the study. Participants were assessed at baseline (pre-PTA) and then 3, 6, and 12 months post-PTA for markers of (1) lower limb ischemia (treadmill walking distances and ankle-brachial pressure index), (2) physical function (6-minute walk, Timed Up and Go, and chair stand time), (3) balance impairment using computerized dynamic posturography with the Sensory Organization Test, and (4) quality of life (VascuQoL and Short Form Health Survey [SF-36]). RESULTS: Forty-three participants underwent PTA. Over 12 months, a significant improvement was demonstrated in initial (P = .04) and maximum treadmill walking distance (P = .019). Physical functional ability improved across all outcome measures (P < .02), and some domains of both generic (P < .03) and disease-specific quality of life (P < .01). No significant improvement in balance was demonstrated by the Sensory Organization Test (P = .24). CONCLUSIONS: Balance impairment is common in claudicants and does not improve with revascularization. Further research regarding effective treatment of balance impairment is required in this specific group of patients.


Asunto(s)
Angioplastia/métodos , Claudicación Intermitente/terapia , Equilibrio Postural/fisiología , Calidad de Vida , Caminata/fisiología , Anciano , Prueba de Esfuerzo , Tolerancia al Ejercicio/fisiología , Femenino , Estudios de Seguimiento , Humanos , Claudicación Intermitente/fisiopatología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Encuestas y Cuestionarios , Resultado del Tratamiento
5.
World J Surg ; 37(5): 1169-73, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23400591

RESUMEN

OBJECTIVE: To determine whether resting pre-operative left ventricular ejection fraction (LVEF) estimated by multiple gated acquisition scanning (MUGA) predicts long-term survival in patients undergoing elective abdominal aortic aneurysm (AAA) repair. METHODS: A retrospective study of MUGA scans which were performed to estimate pre-operative resting LVEF in 127 patients [106 (83 %) males, mean age 74 ± 7.6 years] who underwent elective AAA repair over a period of 4 years from March 2007. We compared outcomes and long-term survival between patients who had a pre-operative LVEF ≤ 40 % (Group 1, n = 60) and LVEF > 40 % (Group 2, n = 67). RESULTS: Overall 19 (15 %) patients died during the follow-up period (13 patients in group 1 and 6 patients in group 2). 30-day mortality was 8 %. There was no significant difference between group 1 and 2 in terms of patients' mean age or median length of hospital stay (8 days for both groups, p = 0.61). However, group 2 had more females than group 1(18 vs. 3, p = 0.001). Median survival for patients in group 2 was significantly higher than patients in group 1 (1,258 days vs. 1,000 days, p = 0.03). In a Cox regression model which included age, sex, smoking status and LVEF as covariates, only smoking status and LVEF predicted survival [Hazard ratio (HR) = 1.06, p = 0.04 and HR = 0.93, p = 0.00, respectively]. CONCLUSION: This study shows that there is a role for pre-operative MUGA scan assessment of resting LVEF in predicting long-term survival post elective AAA repair and that the lower the pre-operative LVEF the poorer the long-term outcome.


Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Procedimientos Quirúrgicos Electivos , Cuidados Preoperatorios , Radiofármacos , Volumen Sistólico , Tecnecio , Anciano , Anciano de 80 o más Años , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/mortalidad , Aneurisma de la Aorta Abdominal/fisiopatología , Electrocardiografía , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Periodo Preoperatorio , Cintigrafía , Estudios Retrospectivos , Análisis de Supervivencia , Resultado del Tratamiento
6.
Haematologica ; 97(9): 1348-56, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22419581

RESUMEN

BACKGROUND: Patients with gene expression profiling-defined high-risk myeloma in relapse have poor outcomes with current therapies. We tested whether natural killer cells expanded by co-culture with K562 cells transfected with 41BBL and membrane-bound interleukin-15 could kill myeloma cells with a high-risk gene expression profile in vitro and in a unique model which recapitulates human myeloma. DESIGN AND METHODS: OPM2 and high-risk primary myeloma tumors were grown in human fetal bone implanted into non-obese diabetic severe combined immunodeficiency mice with a deficient interleukin-2 receptor gamma chain. These mice are devoid of endogenous natural killer and T-cell activity and were used to determine whether adoptively transferred expanded natural killer cells could inhibit myeloma growth and myeloma-associated bone destruction. RESULTS: Natural killer cells from healthy donors and myeloma patients expanded a median of 804- and 351-fold, respectively, without significant T-cell expansion. Expanded natural killer cells killed both allogeneic and autologous primary myeloma cells avidly via a perforin-mediated mechanism in which the activating receptor NKG2D, natural cytotoxicity receptors, and DNAX-accessory molecule-1 played a central role. Adoptive transfer of expanded natural killer cells inhibited the growth of established OPM2 and high-risk primary myeloma tumors grown in the murine model. The transferred, expanded natural killer cells proliferated in vivo in an interleukin-2 dose-dependent fashion, persisted up to 4 weeks, were readily detectable in the human bone, inhibited myeloma growth and protected bone from myeloma-induced osteolysis. CONCLUSIONS: These studies provide the rationale for testing expanded natural killer cells in humans.


Asunto(s)
Citotoxicidad Inmunológica/inmunología , Inmunoterapia Adoptiva , Células Asesinas Naturales/inmunología , Mieloma Múltiple/terapia , Linfocitos T/inmunología , Animales , Apoptosis , Western Blotting , Proliferación Celular , Técnicas de Cocultivo , Citometría de Flujo , Humanos , Técnicas para Inmunoenzimas , Subunidad gamma Común de Receptores de Interleucina/genética , Interleucina-2/metabolismo , Células Asesinas Naturales/metabolismo , Activación de Linfocitos , Ratones , Ratones Endogámicos NOD , Ratones SCID , Mieloma Múltiple/inmunología , Mieloma Múltiple/metabolismo , Subfamilia K de Receptores Similares a Lectina de Células NK/metabolismo , Osteólisis , Linfocitos T/metabolismo , Células Tumorales Cultivadas
7.
Ann Vasc Surg ; 26(3): 322-9, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22305865

RESUMEN

BACKGROUND: The influence of intraluminal thrombus (ILT) on the proteolytic environment within the wall of an abdominal aortic aneurysm (AAA) is unknown. This is the first study to examine the correlation between ILT thickness and the levels of matrix metalloproteinases (MMPs) and their natural inhibitors (tissue inhibitors of matrix metalloproteinases [TIMPs]) within the adjacent AAA wall. METHODS: Thirty-five patients undergoing elective repair of AAAs were studied. A single full-thickness infrarenal aortic sample was obtained uniformly from the arteriotomy site from each patient. All samples were snap frozen and analyzed for total and active MMP 2, 8, and 9 and TIMP 1 and 2. Thrombus thickness at the specimen site was measured on the preoperative contrast computed tomographic angiograms. RESULTS: There was a statistically significant correlation between ILT thickness, concentration of TIMP 1, and active concentration of MMP 9. MMP 2 (active and total) and TIMP 2 demonstrated a positive correlation with ILT thickness, although not statistically significant. CONCLUSION: In this novel study, we found a significant positive correlation of ILT thickness with active MMP 9 and TIMP 1 concentration in the adjacent AAA wall, and this may have implications for AAA expansion and eventual rupture.


Asunto(s)
Aorta Abdominal/enzimología , Aneurisma de la Aorta Abdominal/enzimología , Metaloproteinasas de la Matriz/análisis , Trombosis/enzimología , Inhibidores Tisulares de Metaloproteinasas/análisis , Anciano , Anciano de 80 o más Años , Aorta Abdominal/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aortografía/métodos , Inglaterra , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Masculino , Metaloproteinasa 2 de la Matriz/análisis , Metaloproteinasa 8 de la Matriz/análisis , Metaloproteinasa 9 de la Matriz/análisis , Persona de Mediana Edad , Análisis de Regresión , Trombosis/diagnóstico por imagen , Inhibidor Tisular de Metaloproteinasa-1/análisis , Inhibidor Tisular de Metaloproteinasa-2/análisis , Tomografía Computarizada por Rayos X
8.
Ann Vasc Surg ; 25(7): 878-86, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21802257

RESUMEN

BACKGROUND: To evaluate patients' awareness, functional outcome, and satisfaction after abdominal aortic aneurysm (AAA) repair. METHODS: A study-specific questionnaire was developed with collaboration of a multidisciplinary team. Lists of patients who underwent elective open AAA repair and endovascular aneurysm repair (EVAR) between January 2006 and December 2008 were obtained from the departmental database and cross-checked against hospital database for survival status. Emergency AAA repairs were excluded. Study questionnaires were posted to 138 patients (113 open, 25 EVAR) with self-addressed stamped return envelopes. Statistical analysis was performed using SPSS v16.0. RESULTS: Response rate was 89% (n = 123; 102 open, 21 EVAR). Seventy-one percent (n = 88) were unaware of this condition before diagnosis. Ninety-seven percent (n = 120) indicated their understanding of the need for surgery. Ninety-two percent (n = 113) stated that the operation was adequately explained to them. Ninety percent (n = 111) reported full recovery after surgery, with 60% (n = 74) recovering within 6 months. Eighty-seven percent (n = 108) were satisfied with the overall experience, and 85% (n = 105) stated that they would recommend the operation to family and/or friends if required. CONCLUSIONS: There is a lack of awareness regarding AAA in elderly population. However, after being diagnosed, patients understand the implications and are satisfied with the overall results and would recommend AAA repair to family and/or friends if required.


Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Implantación de Prótesis Vascular/psicología , Procedimientos Endovasculares/psicología , Conocimientos, Actitudes y Práctica en Salud , Pacientes/psicología , Anciano , Anciano de 80 o más Años , Aneurisma de la Aorta Abdominal/fisiopatología , Aneurisma de la Aorta Abdominal/psicología , Concienciación , Comprensión , Procedimientos Quirúrgicos Electivos , Femenino , Encuestas de Atención de la Salud , Humanos , Masculino , Educación del Paciente como Asunto , Satisfacción del Paciente , Estudios Prospectivos , Recuperación de la Función , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento , Reino Unido
9.
Physiol Genomics ; 42(1): 42-54, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20332185

RESUMEN

We studied the gene expression profile during cardiac hypertrophy induced by angiotensin (ANG) II in wild-type mice and the influence of LOX-1 deletion on the gene expression profile. Wild-type and LOX-1 knockout mice were given saline or ANG II infusion for 4 wk. The saline-treated LOX-1 knockout mice showed upregulation of several genes including Ddx3y and Eif2s3y. ANG II infusion enhanced expression of genes known to be associated with cardiac remodeling, such as Agt, Ace, Timp4, Fstl, and Tnfrst12a, as well as oxidant stress-related genes Gnaq, Sos1, and Rac1. Some other strongly upregulated genes identified in this study have not been previously associated with LOX-1 deletion and/or hypertension. To confirm these observations with ANG II infusion and LOX-1 deletion, cultured HL-1 mouse cardiomyocytes were exposed to ANG II or transfected with pCI-neo/LOX-1, which resulted in severalfold increase in reactive oxygen species generation, upregulation of ANG II type 1 (AT(1)) receptor, and cardiomyocyte growth. Quantitative PCR analysis of these treated cardiomyocytes confirmed upregulation of many of the genes identified in the in vivo study. This study provides the first set of data on the gene expression profiling of cardiac tissue treated with ANG II and expands on the important role of LOX-1 in cardiac response to ANG II.


Asunto(s)
Angiotensina II/farmacología , Genómica , Corazón/efectos de los fármacos , Miocardio/metabolismo , Receptores Depuradores de Clase E/deficiencia , Animales , Presión Sanguínea/efectos de los fármacos , Línea Celular , Proliferación Celular/efectos de los fármacos , Tamaño de la Célula/efectos de los fármacos , Perfilación de la Expresión Génica , Corazón/fisiología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Miocitos Cardíacos/citología , Miocitos Cardíacos/efectos de los fármacos , Miocitos Cardíacos/metabolismo , Análisis de Secuencia por Matrices de Oligonucleótidos , Especies Reactivas de Oxígeno/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Receptores Depuradores de Clase E/genética , Vasoconstrictores/farmacología
10.
J Vasc Surg ; 52(6): 1564-71, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20855178

RESUMEN

PURPOSE: To compare articulated and nonarticulated early walking aids (EWAs) for clinical and quality-of-life outcomes in transtibial amputees. METHODS: Patients undergoing lower limb amputation in a tertiary-care vascular surgical unit were screened over a 4-year period. Recruited patients were randomized to receive articulated amputee mobility aid (AMA) or nonarticulated pneumatic postamputation mobility aid (PPAMA) during early rehabilitation. Primary (10-meter walking velocity) and secondary clinical (number and duration of physiotherapy treatments during EWA/prosthesis use) and quality-of-life (SF-36) outcome measures were recorded at five standardized assessment visits. Inter-group and intra-group analyses were performed. RESULTS: Two hundred seventy-two patients were screened and 29 transtibial amputees (median age, 56 years) were recruited (14/treatment arm). No significant difference was seen in demographics and comorbidities at baseline. Inter-group analysis: Median 10-meter walking velocity was significantly (Mann-Whitney, P = .020) faster in the PPAMA group (0.245 m/s, interquartile range [IQR] 0.218-0.402 m/s) compared with the AMA group (0.165 m/s; IQR, 0.118-0.265 m/s) at visit 1. However, there was no difference between the groups at any other visit. Similarly, the number of treatments using EWA was significantly (P = .045) lower in the PPAMA group (5.0; IQR, 3.5-8.0) compared with the AMA group (6.0; IQR, 6.0-10.5). No difference was observed between the groups in duration of physiotherapy or SF-36 domain and summary scores. Intra-group analysis: Both treatment groups showed significant improvement in 10-meter walking velocity (Friedman test; AMA P = .001; PPAMA P = .007); however, other clinical outcomes did not show any statistically significant improvement. Only physical function domain of SF-36 demonstrated significant improvement (Friedman test; AMA P = .037; PPAMA P = .029). CONCLUSIONS: There is no difference in clinical and QOL outcomes between articulated and nonarticulated EWAs in rehabilitation of transtibial amputees.


Asunto(s)
Amputación Quirúrgica/rehabilitación , Miembros Artificiales , Pierna/cirugía , Adulto , Anciano , Ambulación Precoz , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modalidades de Fisioterapia , Diseño de Prótesis , Calidad de Vida , Tibia , Caminata
11.
J Vasc Surg ; 52(1): 77-84, 2010 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-20471779

RESUMEN

OBJECTIVES: To establish the relationship between quality of life (QOL) index scores and clinical indicators of lower limb ischemia. METHODS: One hundred seventy-eight patients (108 men, median age 70 years) with femoropopliteal lesions suitable for angioplasty were recruited. Assessments were performed prior to and at 1, 3, 6, and 12 months following intervention (angioplasty and/or supervised exercise program). Clinical indicators of lower limb ischemia (treadmill walking distances, ankle pressures), generic (SF36, EuroQol), and disease-specific (Kings College VascuQol) quality of life questionnaires were analyzed. Correlation analysis was performed for index scores (SF-6D, EQ-5D, VascuQol) and individual domain scores using nonparametric tests. RESULTS: All clinical indicators of lower limb ischemia and quality of life index scores showed a statistically significant improvement as result of intervention (Friedman test, P < .001). Both generic QOL index scores (SF-6D, EQ-5D) showed moderate but statistically significant correlation (Spearman's rank correlation, P < .001) with treadmill walking distances (SF-6D r = 0.533, EQ-5D r = 0.500) and weak but significant correlation to resting and postexercise ankle-brachial pressure index (SF-6D r = 0.253, EuroQol r = 0.214). Disease-specific index scores (VascuQol) showed similar moderate correlation to treadmill walking distances (r = 0.584, P < .001) and weak but statistically significant correlation with resting and postexercise ABPI (r = 0.377, P < .001). All index scores showed strong and statistically significant (P< .001) correlation with patient-reported walking distance (SF-6D r = 0.604, EQ-5D r = 0.511, VascuQol r = 0.769). All domains of SF36 showed similar correlation with clinical indicators except general health. The strongest correlation was seen with treadmill walking distances in the domains of physical function (r = 0.538) and bodily pain (r = 0.524). CONCLUSION: All generic and disease-specific QOL scores show statistically significant improvement with angioplasty and/or supervised exercise in patients with claudication due to femoropopliteal atherosclerosis. However, the degree of improvement seen in clinical indicators of lower limb ischemia is not reflected in these scores. These findings support the use of composite outcome measures with mandatory, independent assessment of QOL as an independent outcome measure in intervention studies in these patients.


Asunto(s)
Angioplastia , Arteriopatías Oclusivas/terapia , Terapia por Ejercicio , Arteria Femoral , Claudicación Intermitente/terapia , Arteria Poplítea , Calidad de Vida , Anciano , Índice Tobillo Braquial , Arteriopatías Oclusivas/complicaciones , Arteriopatías Oclusivas/fisiopatología , Arteriopatías Oclusivas/psicología , Inglaterra , Prueba de Esfuerzo , Tolerancia al Ejercicio , Femenino , Hospitales Universitarios , Humanos , Claudicación Intermitente/etiología , Claudicación Intermitente/fisiopatología , Claudicación Intermitente/psicología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento
12.
J Cardiovasc Pharmacol ; 55(2): 176-83, 2010 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19935077

RESUMEN

BACKGROUND: Curcumin, a natural polyphenolic compound, has been shown to reduce cardiomyocyte growth. Angiotensin II type 1 receptor (AT1R) and lectin-like oxidized low density lipoprotein (ox-LDL) receptor-1 (LOX-1) are major stimuli for cardiomyocyte growth via activation of oxidant signals. We postulated that curcumin may reduce Ang II-mediated cardiomyocyte growth via AT1R and LOX-1 inhibition. METHODS: Adult mouse cardiomyocytes (HL-1) were incubated overnight in serum-free medium, and then treated with solvents or curcumin, the AT1R inhibitor losartan or anti-LOX-1 antibody for 3 hours, and the cells were then stimulated with Ang II. We measured cardiomyocyte growth, and associated intracellular redox signals using reverse transcriptase-polymerase chain reaction and quantitative real-time RT-PCR. We also examined the effect of curcumin on cardiomyocyte biology with forced overexpression of LOX-1 gene. RESULTS: Curcumin (5-10 microM), losartan, and anti-LOX-1 antibody markedly attenuated Ang II-mediated oxidant stress, and the expression of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and nuclear factor-kappaB (NF-kappaB). Attenuation of redox state by curcumin resulted in abrogation of Ang II-mediated cardiomyocyte growth and atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) genes. Curcumin also reduced Ang II-mediated upregulation of AT1R and LOX-1. The forced upregulation of LOX-1 enhanced the expression of genes for AT1R, ANP, and BNP, and curcumin pretreatment reduced LOX-1 and AT1R expression and LOX-1-mediated increase in hypertrophy markers. CONCLUSIONS: Curcumin attenuates Ang II-mediated cardiomyocyte growth by inhibiting LOX-1 and AT1R expression and suppressing the heightened intracellular redox state.


Asunto(s)
Angiotensina II/fisiología , Aumento de la Célula/efectos de los fármacos , Curcumina/farmacología , Inhibidores de Crecimiento/farmacología , Miocitos Cardíacos/efectos de los fármacos , Miocitos Cardíacos/enzimología , Receptores Depuradores de Clase E/antagonistas & inhibidores , Animales , Cardiomiopatías/inducido químicamente , Cardiomiopatías/metabolismo , Cardiomiopatías/patología , Células Cultivadas , Ratones , Miocitos Cardíacos/citología , Receptor de Angiotensina Tipo 1/fisiología , Receptores Depuradores de Clase E/biosíntesis
13.
J Cardiovasc Pharmacol ; 55(4): 417-24, 2010 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-20422739

RESUMEN

BACKGROUND: Curcumin, a natural polyphenolic compound, has been shown to reduce cardiomyocyte growth. Angiotensin II type 1 receptor (AT1R) and lectin-like oxidized low density lipoprotein (ox-LDL) receptor-1 (LOX-1) are major stimuli for cardiomyocyte growth via activation of oxidant signals. We postulated that curcumin may reduce Ang II-mediated cardiomyocyte growth via AT1R and LOX-1 inhibition. METHODS: Adult mouse cardiomyocytes (HL-1) were incubated overnight in serum-free medium, and then treated with solvents or curcumin, the AT1R inhibitor losartan or anti-LOX-1 antibody for 3 hours, and the cells were then stimulated with Ang II. We measured cardiomyocyte growth, and associated intracellular redox signals using reverse transcriptase-polymerase chain reaction and quantitative real-time RT-PCR. We also examined the effect of curcumin on cardiomyocyte biology with forced overexpression of LOX-1 gene. RESULTS: Curcumin (5-10 microM), losartan, and anti-LOX-1 antibody markedly attenuated Ang II-mediated oxidant stress, and the expression of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and nuclear factor-kappaB (NF-kappaB). Attenuation of redox state by curcumin resulted in abrogation of Ang II-mediated cardiomyocyte growth and atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) genes. Curcumin also reduced Ang II-mediated upregulation of AT1R and LOX-1. The forced upregulation of LOX-1 enhanced the expression of genes for AT1R, ANP, and BNP, and curcumin pretreatment reduced LOX-1 and AT1R expression and LOX-1-mediated increase in hypertrophy markers. CONCLUSIONS: Curcumin attenuates Ang II-mediated cardiomyocyte growth by inhibiting LOX-1 and AT1R expression and suppressing the heightened intracellular redox state.


Asunto(s)
Angiotensina II/farmacología , Aumento de la Célula/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Curcumina/farmacología , Miocitos Cardíacos/citología , Receptores Depuradores de Clase E/genética , Angiotensina II/administración & dosificación , Animales , Anticuerpos/inmunología , Anticuerpos/farmacología , Factor Natriurético Atrial/genética , Línea Celular Transformada , Supervivencia Celular/efectos de los fármacos , Curcumina/administración & dosificación , Expresión Génica/efectos de los fármacos , Expresión Génica/genética , Losartán/farmacología , Glicoproteínas de Membrana/genética , Ratones , Miocitos Cardíacos/efectos de los fármacos , Miocitos Cardíacos/metabolismo , NADPH Oxidasa 2 , NADPH Oxidasas/genética , FN-kappa B/genética , Péptido Natriurético Encefálico/genética , Estrés Oxidativo/efectos de los fármacos , Subunidades de Proteína/genética , Especies Reactivas de Oxígeno/metabolismo , Receptor de Angiotensina Tipo 1/genética , Receptores Depuradores de Clase E/inmunología , Transducción de Señal/genética , Transfección
14.
Biochem Biophys Res Commun ; 387(3): 543-7, 2009 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-19615978

RESUMEN

Statins, inhibitors of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, have been shown to induce both angiogenic and angiostatic responses. We attempted to resolve this controversy by studying the effects of two different statins, rosuvastatin and simvastatin, in two different assay systems. In the matrigel angiogenesis assay, both statins enhanced tube formation by human umbilical vein endothelial cells (HUVECs, p<0.01 vs. control). In the ex vivo mouse aortic ring sprouting assay, both statins virtually abolished new vessel formation (p<0.01). As a basic difference between the two models of angiogenesis is dispersed state of endothelial cells vs. compact monolayer, we analyzed influence of statins on endothelial junction proteins. RT-PCR analysis and cytoimmunostaining of HUVECs treated with simvastatin revealed increased expression of VE-cadherin (p<0.05). The blockade of VE-cadherin with a specific antibody reversed simvastatin-induced tube formation (p<0.002). These data suggest that statins through VE-cadherin stimulation modulate cell-cell adhesion and diminish the ability of cells to proliferate and migrate. The observations of reduced angiogenesis in the intact vessel may relate to anti-atherosclerotic and anti-cancer effects of statins, and provide a feasible explanation for conflicting data under different experimental conditions.


Asunto(s)
Inhibidores de la Angiogénesis/farmacología , Endotelio Vascular/efectos de los fármacos , Fluorobencenos/farmacología , Inhibidores de Hidroximetilglutaril-CoA Reductasas/farmacología , Neovascularización Fisiológica/efectos de los fármacos , Pirimidinas/farmacología , Simvastatina/farmacología , Sulfonamidas/farmacología , Animales , Antígenos CD/biosíntesis , Aorta/citología , Aorta/efectos de los fármacos , Cadherinas/antagonistas & inhibidores , Cadherinas/biosíntesis , Adhesión Celular/efectos de los fármacos , Movimiento Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Células Cultivadas , Humanos , Ratones , Ratones Endogámicos C57BL , Neovascularización Patológica/metabolismo , Rosuvastatina Cálcica , Venas Umbilicales/citología , Venas Umbilicales/efectos de los fármacos
15.
Appl Environ Microbiol ; 75(4): 1192-6, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19074612

RESUMEN

A total of 210 Salmonella isolates, representing 64 different serovars, were isolated from imported seafood samples, and 55/210 isolates were found to be resistant to at least one antibiotic. Class 1 integrons from three multidrug-resistant Salmonella enterica strains (Salmonella enterica serovars Newport [strain 62], Typhimurium var. Copenhagen [strain 629], and Lansing [strain 803], originating from Hong Kong, the Philippines, and Taiwan, respectively) were characterized. Southern hybridization of plasmids isolated from these strains, using a class 1 integron probe, showed that trimethoprim-sulfamethoxazole and streptomycin resistance genes were located on a megaplasmid in strain 629. Our study indicates that imported seafood could be a reservoir for Salmonella isolates resistant to multiple antibiotics.


Asunto(s)
Farmacorresistencia Bacteriana Múltiple , Integrones , Salmonella enterica/efectos de los fármacos , Salmonella enterica/aislamiento & purificación , Alimentos Marinos/microbiología , Antibacterianos/farmacología , Southern Blotting , ADN Bacteriano/química , ADN Bacteriano/genética , Hong Kong , Datos de Secuencia Molecular , Filipinas , Plásmidos , Salmonella enterica/genética , Análisis de Secuencia de ADN , Taiwán
16.
Microsc Res Tech ; 82(9): 1542-1556, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31209970

RESUMEN

Plant diseases are accountable for economic losses in an agricultural country. The manual process of plant diseases diagnosis is a key challenge from last one decade; therefore, researchers in this area introduced automated systems. In this research work, automated system is proposed for citrus fruit diseases recognition using computer vision technique. The proposed method incorporates five fundamental steps such as preprocessing, disease segmentation, feature extraction and reduction, fusion, and classification. The noise is being removed followed by a contrast stretching procedure in the very first phase. Later, watershed method is applied to excerpt the infectious regions. The shape, texture, and color features are subsequently computed from these infection regions. In the fourth step, reduced features are fused using serial-based approach followed by a final step of classification using multiclass support vector machine. For dimensionality reduction, principal component analysis is utilized, which is a statistical procedure that enforces an orthogonal transformation on a set of observations. Three different image data sets (Citrus Image Gallery, Plant Village, and self-collected) are combined in this research to achieving a classification accuracy of 95.5%. From the stats, it is quite clear that our proposed method outperforms several existing methods with greater precision and accuracy.


Asunto(s)
Citrus/anatomía & histología , Procesamiento de Imagen Asistido por Computador/métodos , Microscopía/métodos , Enfermedades de las Plantas , Automatización de Laboratorios/métodos
17.
Biochem Biophys Res Commun ; 366(4): 871-7, 2008 Feb 22.
Artículo en Inglés | MEDLINE | ID: mdl-18037370

RESUMEN

Angiotensin (Ang) II, via type 1 receptor activation, exerts a significant role in atherogenesis and collagen synthesis. To test the hypothesis that Ang II type 2 receptor (AT2R) upregulation delivered with adeno-associated virus type 2 (AAV/AT2R) would inhibit collagen synthesis in atherosclerotic arteries, LDLR knockout mice were injected with AAV/AT2R and fed 4% cholesterol diet for 18 weeks. LDLR knockout mice treated with saline or AAV/Neo exhibited extensive vessel wall collagen accumulation, which was reduced by about 50% with AT2R over-expression. AT2R upregulation completely blocked the alterations in the expression of procollagen-I, osteopontin, fibronectin, CD68, and matrix metalloproteinases (MMP-2 and MMP-9), as well as phosphorylation of p38 and p44/42 MAPKs. Activity of superoxide dismutase was reduced in the LDLR KO mice and it increased with AT2R upregulation. This study demonstrates that AT2R over-expression reduces enhanced collagen accumulation, MMP expression and activity in atherosclerotic regions via inhibition of pro-oxidant signals.


Asunto(s)
Aterosclerosis/metabolismo , Aterosclerosis/patología , Colágeno/metabolismo , Expresión Génica , Oxidantes/metabolismo , Receptor de Angiotensina Tipo 2/genética , Animales , Aorta/enzimología , Aorta/patología , Aterosclerosis/enzimología , Fibronectinas/metabolismo , Metaloproteinasas de la Matriz/metabolismo , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Osteopontina/metabolismo , Receptor de Angiotensina Tipo 2/metabolismo , Transducción de Señal , Regulación hacia Arriba
18.
Photodiagnosis Photodyn Ther ; 12(3): 459-65, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26073913

RESUMEN

Increase in local temperature during light exposure of biological tissues plays an important role in determining the fate of most therapeutic modalities. Variations in the optical properties (absorption coefficient, scattering coefficient, anisotropy factor, optical depth etc.) of two cancer cell lines "Rhobdomyosarcoma and Cervical carcinoma" due to gradual increase in temperature were determine quantitatively with a double integrating sphere system. It was observed that all three coefficients showed decreasing tendency as the temperature increases for both the cell lines except for scattering coefficient of HeLa which remain constant within error limit. Anisotropy factor for both cell lines increased indicating temperature dependent subcellular density variations. Temperature dependent optical properties information may lead to precise dosimetry and could help clinicians for predicting the therapeutic modality outcome.


Asunto(s)
Calor , Neoplasias/fisiopatología , Fenómenos Ópticos , Anisotropía , Línea Celular Tumoral , Humanos
19.
Photodiagnosis Photodyn Ther ; 12(1): 146-9, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25562442

RESUMEN

Photodynamic therapy (PDT) in combination with other treatment modality expects to overcome the drug resistance experienced in monotherapy. In this present work combination of chemo cum PDT is studied over the range of doses. It is found that treating cells/exposing cells to chemo drug (cisplatin, CDDP) and PDT individually results in minimal cell killing (∼7% and ∼16%) compared to the administration of chemo followed by PDT (∼50% cells were viable). These results showed that cell viability synergistically decreases in case of combination treatment as compared with individual treatment. Photodynamic therapy (PDT) in combination with CDDP chemotherapy expects to overcome the drug resistance experienced in monotherapy.


Asunto(s)
Cisplatino/administración & dosificación , Indoles/administración & dosificación , Compuestos Organometálicos/administración & dosificación , Fotoquimioterapia/métodos , Rabdomiosarcoma/tratamiento farmacológico , Rabdomiosarcoma/patología , Antineoplásicos/administración & dosificación , Apoptosis/efectos de los fármacos , Apoptosis/efectos de la radiación , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Supervivencia Celular/efectos de la radiación , Relación Dosis-Respuesta a Droga , Sinergismo Farmacológico , Humanos , Fármacos Fotosensibilizantes/administración & dosificación , Resultado del Tratamiento
20.
Mol Biol Cell ; 24(9): 1363-74, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23485561

RESUMEN

Progesterone receptor (PR) and progestins affect mammary tumorigenesis; however, the relative contributions of PR isoforms A and B (PRA and PRB, respectively) in cancer cell migration remains elusive. By using a bi-inducible MDA-MB-231 breast cancer cell line expressing PRA and/or PRB, we analyzed the effect of conditional PR isoform expression. Surprisingly, unliganded PRB but not PRA strongly enhanced cell migration as compared with PR(-) cells. 17,21-Dimethyl-19-norpregna-4,9-dien-3,20-dione (R5020) progestin limited this effect and was counteracted by the antagonist 11ß-(4-dimethyl-amino)-phenyl-17ß-hydroxy-17-(1-propynyl)-estra-4,9-dien-3-one (RU486). Of importance, PRA coexpression potentiated PRB-mediated migration, whereas PRA alone was ineffective. PR isoforms differentially regulated expressions of major players of cell migration, such as urokinase plasminogen activator (uPA), its inhibitor plasminogen activator inhibitor type 1, uPA receptor (uPAR), and ß1-integrin, which affect focal adhesion kinase (FAK) signaling. Moreover, unliganded PRB but not PRA enhanced FAK Tyr397 phosphorylation and colocalized with activated FAK in cell protrusions. Because PRB, as well as PRA, coimmunoprecipitated with FAK, both isoforms can interact with FAK complexes, depending on their respective nucleocytoplasmic trafficking. In addition, FAK degradation was coupled to R5020-dependent turnovers of PRA and PRB. Such an effect of PRB/PRA expression on FAK signaling might thus affect adhesion/motility, underscoring the implication of PR isoforms in breast cancer invasiveness and metastatic evolution with underlying therapeutic outcomes.


Asunto(s)
Movimiento Celular , Quinasa 1 de Adhesión Focal/metabolismo , Receptores de Progesterona/metabolismo , Neoplasias de la Mama , Línea Celular Tumoral , Femenino , Adhesiones Focales/metabolismo , Regulación Neoplásica de la Expresión Génica , Humanos , Inhibidor 1 de Activador Plasminogénico/genética , Inhibidor 1 de Activador Plasminogénico/metabolismo , Isoformas de Proteínas/metabolismo , Receptores del Activador de Plasminógeno Tipo Uroquinasa/genética , Receptores del Activador de Plasminógeno Tipo Uroquinasa/metabolismo , Transcripción Genética , Activador de Plasminógeno de Tipo Uroquinasa/genética , Activador de Plasminógeno de Tipo Uroquinasa/metabolismo
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