RESUMEN
OBJECTIVES: We hypothesized that the duration of pulsed radiofrequency (PRF) application may affect the effectiveness of PRF in patients with chronic lumbosacral radicular pain (LRP). MATERIALS AND METHODS: In this prospective, double-blind, randomized study, 68 patients were randomly allocated to two groups: a 6-minute group, in which PRF was applied at 42 °C for 2 minutes followed by a 2-minute pause, repeated three times; and a 12-minute group, with a continuous application at 42 °C for 12 minutes. The total application time in each group was equal. After PRF, 2 to 3 mL of 1% lidocaine with 5 mg of dexamethasone was injected. The primary outcome was the intensity of leg pain measured using a numerical rating scale (NRS) three months after the procedure. The secondary outcomes were intensities of leg and back pain, the Oswestry Disability Index (ODI), the Medication Quantification Scale III (MQS), the Global Perceived Effect of Satisfaction (GPES), and the incidence of adverse events during follow-up. Primary and secondary outcomes were analyzed using a linear mixed-effect model in the modified intention-to-treat population. RESULTS: Each group comprised 34 patients. Three patients in each group did not receive the allocated intervention owing to alleviation of pain. The estimated NRS mean of leg pain at three months was 4.0 (95% CI, 3.2-4.9) and 4.5 (95% CI, 3.6-5.4) in the 6- and 12-minute groups, respectively, with no significant difference between groups (estimated mean difference, -0.5; 95% CI, -1.8 to 0.8; p = 0.436). Regarding the intensities of leg and back pain, ODI, MQS, and GPES, there was no significant difference between the two groups except for GPES at six months. No adverse events were observed in the groups. CONCLUSIONS: Among patients with chronic LRP, a prolonged PRF application of 12 minutes, compared with 6 minutes, caused no significant difference in leg pain intensity. CLINICAL TRIAL REGISTRATION: The Clinicaltrials.gov registration number under the Clinical Trial Registry of Korea for the study is KCT0003850; https://cris.nih.go.kr.
RESUMEN
Background: Increasing evidence supporting the clinical effectiveness of cooled radiofrequency ablation (RFA) therapy for genicular nerves in patients with chronic knee osteoarthritis (OA) exists. However, no study has been conducted to eliminate the potential influence of a placebo effect associated with this procedure. Therefore, we evaluated the efficacy of cooled RFA compared with a sham procedure in patients with painful knees due to OA. Methods: In this double-blind, randomized, controlled study, participants were randomly assigned to receive cooled RFA of the knee (cooled RFA group, n = 20) or a sham procedure (sham group, n = 20). The primary outcome was the proportion of successful responders at the three-month follow-up. The secondary outcomes were successful responders at one and six months; pain intensity of the knee; functional status; medication; and satisfaction at one, three, and six months after the procedures. Results: For the primary outcome, the successful responder rate was significantly higher in the cooled RFA group (76.5%) than in the sham group (33.3%) (p = 0.018). For the secondary outcome, more successful responders were observed in the cooled RFA group than in the sham group at one and six months after the procedure (p = 0.041 and 0.007, respectively). The decreased knee pain intensity was maintained throughout the six-month follow-up period in the cooled RFA group. No differences were observed in functional status, medication change, or satisfaction in both groups. Conclusions: The cooled RFA of genicular nerves offers significant pain relief and surpasses the effects attributable to a placebo.
Asunto(s)
Osteoartritis de la Rodilla , Ablación por Radiofrecuencia , Humanos , Método Doble Ciego , Osteoartritis de la Rodilla/terapia , Osteoartritis de la Rodilla/cirugía , Osteoartritis de la Rodilla/complicaciones , Femenino , Masculino , Ablación por Radiofrecuencia/métodos , Persona de Mediana Edad , Anciano , Resultado del Tratamiento , Dolor Crónico/terapia , Dolor Crónico/etiología , Dimensión del Dolor , Articulación de la Rodilla/inervaciónRESUMEN
BACKGROUND: Although the ultrasound-guided rectus sheath block (RSB) is usually regarded as an easy and safe procedure in clinical settings, there is currently no report on complications incidence. Therefore, the present study investigated complications in a large cohort and described the technical considerations to minimize complications of real-time ultrasound-guided RSBs. METHODS: This was a retrospective cohort study of patients who underwent real-time ultrasound-guided RSBs for perioperative pain control in laparoscopic surgery with an umbilical port between February 1, 2017, and February 28, 2021, at the Asan Medical Center in South Korea. All RSBs were performed bilaterally using a 23-gauge Quincke needle, and a bilateral 2-block placement was regarded as 1 RSB. Patient data, including demographics, preoperative laboratory data, preoperative antiplatelet or anticoagulant medication with the duration of discontinuation, and type of surgery, were collected to show the study population characteristics and explore potential factors associated with adverse events such as hematoma. Ultrasound images of patients and adverse events of RSBs, including extrarectus sheath injections, vascular injuries, bowel injury, or local anesthetic systemic toxicity, were also analyzed accordingly. RESULTS: A total of 4033 procedures were analyzed. The mean body mass index of the patients was 24.1 (21.8-26.5) kg/m2. The preoperative laboratory data were within normal range in 4028 (99.9%) patients. Preoperative antiplatelets or anticoagulants were administered in 17.3% of the patients. Overall, 96 complications (2.4%) were observed. Among them, extrarectus sheath injection occurred in 88 cases (2.2%), which included preperitoneal injection (0.9%) and intraperitoneal injection (1.3%). Vascular injuries constituted 8 cases (0.2%) and all vascular injuries resulted in hematoma: 7 cases of inferior epigastric artery injury with rectus sheath hematoma and 1 of inferior mesenteric artery injury with retroperitoneal hematoma. Bowel injury or local anesthetic systemic toxicity was not reported. CONCLUSIONS: In this study of RSBs performed on 4033 patients using a 23-gauge Quincke needle in patients with low body mass index, there were 8 cases (0.2%) of vascular injury, all of which accompanied hematoma.
Asunto(s)
Bloqueo Nervioso , Lesiones del Sistema Vascular , Humanos , Anestésicos Locales/efectos adversos , Estudios Retrospectivos , Recto del Abdomen/diagnóstico por imagen , Ultrasonografía Intervencional/efectos adversos , Ultrasonografía Intervencional/métodos , Bloqueo Nervioso/efectos adversos , Bloqueo Nervioso/métodosRESUMEN
Background and Objectives: With the aging population, the incidence of degenerative lumbar spinal stenosis (LSS) is increasing. Sarcopenia is an age-related muscular decrease. Although epidural balloon neuroplasty is effective in patients with LSS refractory to conventional treatments, its effect has not been assessed in patients with sarcopenia. Therefore, this study evaluated the effect of epidural balloon neuroplasty in patients with LSS and sarcopenia. Materials and Methods: This retrospective study reviewed the following details from the electronic medical records: patient characteristics, including sex, age, body mass index, diabetes, hypertension, stenosis grading, pain duration, location, pain intensity, and medications. Back and leg pain intensity was evaluated before and after the procedure at one, three, and six months during the follow-up period. A generalized estimating equations model was used at six months follow-up. Patients were divided into sarcopenia and non-sarcopenia groups using the cross-sectional area of the psoas muscle at the level of L3 on magnetic resonance imaging. Results: A total of 477 patients were included (sarcopenia group: 314 patients, 65.8%; non-sarcopenia group: 163 patients, 34.2%). Age, sex, body mass index, and medication quantification scale III were statistically different between both groups. The generalized estimating equations analyses-with unadjusted and adjusted estimation-revealed a significantly reduced pain intensity after the procedure compared to the baseline in both groups. The difference in pain intensity between both groups was not statistically different. Conclusions: Percutaneous epidural balloon neuroplasty may be considered for patients with chronic lumbar LSS regardless of accompanying sarcopenia.
Asunto(s)
Estenosis Espinal , Humanos , Anciano , Estenosis Espinal/complicaciones , Estenosis Espinal/cirugía , Estudios Retrospectivos , Vértebras Lumbares/cirugía , Vértebras Lumbares/patología , Catéteres , Constricción Patológica , Resultado del TratamientoRESUMEN
BACKGROUND: Pheochromocytoma often carries a risk for perioperative hemodynamic instability (HDI). The aim of this study is to evaluate the risk factors of intraoperative HDI during minimally invasive posterior retroperitoneal adrenalectomy (PRA) for pheochromocytoma. MATERIALS AND METHODS: This retrospective study analyzed the prospectively collected data of 172 patients who underwent laparoscopic PRA or robotic PRA for pheochromocytoma between January 2014 and December 2020 at a single tertiary center. The patients were divided into two groups according to the intraoperative hypertensive event of systolic blood pressure (> 160 mmHg). The clinical manifestations and perioperative hemodynamic conditions were analysed. RESULTS: In the multivariate logistic regression analysis, the tumor size (> 3.4 cm) [OR 3.14, 95% confidence intervals (CI) (1.48-6.64), p = 0.003], type of preoperative alpha-blocker (selective type) [OR 3.9, 95% CI (1.52-10.02), p = 0.005], preoperative use of beta-blockers [OR 3.94, 95% CI (1.07-14.49), p = 0.039] and type of anesthesia [total intravenous anesthesia (TIVA) vs. balanced anesthesia (BA)] [OR 2.57, 95% CI (1.23-5.38), p = 0.012] were determined as independent risk factors of intraoperative hypertensive events during minimally invasive adrenalectomy. CONCLUSIONS: The type of anesthesia was independently associated with intraoperative HDI along with larger tumor size, type of preoperative alpha-blocker and the use of preoperative beta-blockers. TIVA increased the risk of intraoperative hypertensive events compared with BA. Thus, the consideration of the type of anesthesia prior to adrenal surgery for pheochromocytoma along with the use of preoperative non-selective alpha-blockers may be beneficial in minimizing the risk of intraoperative HDI.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales , Hipertensión , Laparoscopía , Feocromocitoma , Neoplasias de las Glándulas Suprarrenales/patología , Adrenalectomía/efectos adversos , Anestesia General , Hemodinámica , Humanos , Laparoscopía/efectos adversos , Feocromocitoma/patología , Estudios RetrospectivosRESUMEN
Background: The ganglion impar (ganglion of Walther) block has been used to manage coccygeal and perineal (perianal and genital) pain due to both benign and malignant causes. However, the factors associated with successful responses to ganglion impar block are unknown. Therefore, in the present study, we aimed to identify the independent factors associated with successful responses to ganglion impar block in patients with chronic pain in coccygeal and perineal regions. Methods: From January 2008 to December 2017, we performed a retrospective review of 106 patients who underwent ganglion impar block. Patients were considered successful responders if they reported a decrease of more than 50% or 4 points on the 11-point (0 = no pain and 10 = worst possible pain) numerical rating scale 1 month after the procedure, while others were considered non-responders. Logistic regression analysis was performed to identify factors independently associated with successful responses at 1 month after the procedure. Results: Multivariable logistic regression analysis showed that cancer-related causes were significantly associated with successful responses at 1 month after ganglion impar block (odds ratio = 2.60, 95% confidence interval = 1.05 to 6.43, P = 0.038). Conclusion: Ganglion impar block may be more effective in cancer-related pain than pain due to benign causes.
Asunto(s)
Dolor en Cáncer/terapia , Dolor Crónico/terapia , Ganglios Simpáticos/efectos de los fármacos , Bloqueo Nervioso/estadística & datos numéricos , Neuralgia/terapia , Adulto , Anciano , Anestésicos Locales/administración & dosificación , Dolor en Cáncer/diagnóstico , Dolor Crónico/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Bloqueo Nervioso/métodos , Neuralgia/diagnóstico , Dimensión del Dolor/estadística & datos numéricos , Perineo/inervación , Pronóstico , Estudios Retrospectivos , Región Sacrococcígea/inervación , Resultado del TratamientoRESUMEN
BACKGROUND: Catheter-related bladder discomfort occurs because of involuntary contractions of the bladder smooth muscle after urinary catheterization. Magnesium is associated with smooth muscle relaxation. This study hypothesized that among patients having transurethral resection of bladder tumor, magnesium will reduce the incidence of postoperative moderate-to-severe catheter-related bladder discomfort. METHODS: In this double-blind, randomized study, patients were randomly allocated to the magnesium group (n = 60) or the control group (n = 60). In magnesium group, a 50 mg/kg loading dose of intravenous magnesium sulfate was administered for 15 min, followed by an intravenous infusion of 15 mg · kg · h during the intraoperative period. Patients in the control group similarly received normal saline. The primary outcome was the incidence of catheter-related bladder discomfort above a moderate grade at 0 h postoperatively. None, mild, moderate, and severe catheter-related bladder discomfort at 1, 2, and 6 h postoperatively, patient satisfaction, and magnesium-related adverse effects were also assessed. RESULTS: The incidence of catheter-related bladder discomfort above a moderate grade at 0 h postoperatively was significantly lower in the magnesium group than in the control group (13 [22%] vs. 46 [77%]; P < 0.001; relative risk = 0.283; 95% CI, 0.171 to 0.467; absolute risk reduction = 0.55; number needed to treat = 2); similar results were observed for catheter-related bladder discomfort above a moderate grade at 1 and 2 h postoperatively (5 [8%] vs. 17 [28%]; P = 0.005; relative risk = 0.294; 95% CI, 0.116 to 0.746; and 1 [2%] vs. 14 [23%]; P < 0.001; relative risk = 0.071; 95% CI, 0.010 to 0.526, respectively). Patient satisfaction on a scale from 1 to 7 was significantly higher in the magnesium group than in the control group (5.1 ± 0.8 vs. 3.5 ± 1.0; P < 0.001; 95% CI, 1.281 to 1.919). Magnesium-related adverse effects were not significantly different between groups. CONCLUSIONS: Magnesium reduced the incidence of catheter-related bladder discomfort above a moderate grade and increased patient satisfaction among patients having transurethral resection of bladder tumor.
Asunto(s)
Sulfato de Magnesio/uso terapéutico , Complicaciones Posoperatorias/tratamiento farmacológico , Enfermedades de la Vejiga Urinaria/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/cirugía , Procedimientos Quirúrgicos Urológicos , Administración Intravenosa , Anciano , Método Doble Ciego , Femenino , Humanos , Sulfato de Magnesio/administración & dosificación , Masculino , Persona de Mediana Edad , Relajación Muscular/efectos de los fármacos , Dolor Postoperatorio , Satisfacción del Paciente , Conducta de Reducción del Riesgo , Resultado del Tratamiento , Enfermedades de la Vejiga Urinaria/etiología , Neoplasias de la Vejiga Urinaria/complicaciones , Cateterismo Urinario/efectos adversosRESUMEN
BACKGROUND: Contrast dispersion pattern on epidurography may be associated with clinical improvement after epidural neuroplasty. However, insufficient evidence supports this theory. The current study aims to evaluate the relevance of contrast dispersion and clinical improvement after percutaneous epidural neuroplasty using an inflatable balloon catheter. METHODS: One hundred patients with lumbar spinal stenosis who underwent combined balloon decompression and epidural adhesiolysis between March 2015 to December 2015 participated in the present study. Participants were divided into two groups by contrast dispersion pattern on postprocedural epidurography: the complete contrast dispersion (CCD) and incomplete contrast dispersion (ICCD) groups. The numeric rating scale (NRS), Oswestry Disability Index (ODI), and global perceived effects (GPE) were each assessed before and one, three, six, nine, and 12 months after the intervention. RESULTS: After combined balloon decompression and adhesiolysis, significant pain reduction and functional improvement were maintained up to 12 months in patients with lumbar spinal stenosis. NRS and GPE in the CCD group were significantly lower than in the ICCD group from six to 12 months after the intervention. The ODI in the CCD group was also significantly lower compared with that in the ICCD group from one to 12 months after the intervention. CONCLUSIONS: Combined balloon decompression and adhesiolysis with the inflatable balloon catheter can provide noteworthy pain reduction and improvement of physical function for a long-term period in patients with lumbar spinal stenosis. Because CCD showed better clinical improvement compared with ICCD, a contrast dispersion pattern may be associated with an improved clinical outcome.
Asunto(s)
Descompresión Quirúrgica/métodos , Dilatación/métodos , Espacio Epidural/diagnóstico por imagen , Vértebras Lumbares , Estenosis Espinal/cirugía , Adherencias Tisulares/cirugía , Actividades Cotidianas , Anciano , Medios de Contraste , Femenino , Fluoroscopía , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos , Dimensión del Dolor , Estudios Prospectivos , Estenosis Espinal/diagnóstico por imagen , Estenosis Espinal/fisiopatología , Adherencias Tisulares/diagnóstico por imagen , Adherencias Tisulares/fisiopatología , Resultado del TratamientoRESUMEN
BACKGROUND: Male patients undergoing transurethral resection of bladder tumors (TURBT) are prone to suffer from catheter-related bladder discomfort (CRBD). Lidocaine administration has been widely performed to reduce postoperative pain. Here, the effect of intravenous lidocaine administration on moderate-to-severe CRBD was evaluated in male patients undergoing TURBT. METHODS: Patients were randomly allocated to receive intravenous lidocaine (1.5 mg/kg bolus dose followed by a 2 mg/kg/h continuous infusion during the intraoperative period, which was continued for 1 hour postsurgery; group L) or placebo (normal saline; group C). The primary outcome was moderate-to-severe CRBD at 0 hour postsurgery (on admission to the postanesthetic care unit), analyzed using the χ test. The secondary outcome was opioid requirement during the 24-hour postoperative period. None, mild, and moderate-to-severe CRBD at 1, 2, and 6 hours postsurgery, postoperative pain, patient satisfaction, side effects of lidocaine and rescue medications (tramadol and fentanyl), and surgical complications were also assessed. RESULTS: A total of 132 patients were included in the study (66 patients in each group). The incidence of moderate-to-severe CRBD at 0 hour postsurgery was significantly lower in group L than in group C (25.8% vs 66.7%, P < .001, relative risk: 0.386, 95% confidence interval: 0.248-0.602). Opioid requirements during the 24-hour postoperative period were significantly lower in group L than in group C (10.0 mg [interquartile range (IQR), 5.0-15.0 mg] vs 13.8 mg [IQR, 10.0-20.0 mg], P = .005). At 1 and 2 hours postsurgery (but not at 6 hours), the incidence of moderate-to-severe CRBD was significantly lower in group L than in group C (1 hour: 10.6% vs 27.3%, P = .026; 2 hours: 0.0% vs 15.2%, P = .003). Patient satisfaction was significantly greater in group L than in group C (5.0 [IQR, 4.8-6.0] vs 4.0 [IQR, 4.0-5.0], P < .001). No lidocaine-related side effects were reported. Rescue medication-related side effects and surgical complications did not differ significantly between the 2 groups. CONCLUSIONS: Intravenous lidocaine administration resulted in lower incidence of moderate-to-severe CRBD, lower opioid requirement, and higher patient satisfaction in male patients undergoing TURBT without evidence of significant side effects.
Asunto(s)
Anestésicos Locales/administración & dosificación , Lidocaína/administración & dosificación , Dolor Postoperatorio/prevención & control , Neoplasias de la Vejiga Urinaria/cirugía , Cateterismo Urinario/efectos adversos , Administración Intravenosa , Anciano , Método Doble Ciego , Humanos , Masculino , Persona de Mediana Edad , Dolor Postoperatorio/etiología , Estudios Prospectivos , Neoplasias de la Vejiga Urinaria/diagnóstico , Catéteres Urinarios/efectos adversosRESUMEN
Seaweeds have been exploited as both food products and therapeutics to manage human ailments for centuries. This study investigated the metabolite profile of five seaweeds (Halimeda spp., Spyridia hypnoides (Bory de Saint-Vincent) Papenfuss, Valoniopsis pachynema (G. Martens) Børgesen, Gracilaria fergusonii J. Agardh and Amphiroa anceps (Lamarck) Decaisne using ultra-high-performance liquid chromatography coupled with electrospray ionization mass spectrometry (UHPLC-ESI-MS/MS). Furthermore, these seaweeds were assessed for antioxidant and inhibitory effects against α-amylase, α-glucosidase, acetyl-cholinesterase (AChE), butyryl-cholinesterase (BChE) and tyrosinase. Valoniopsis pachynema and A. anceps yielded the highest flavonoid (4.30 ± 0.29 mg RE/g) and phenolic content (7.83 ± 0.08 mg RE/g), respectively. Additionally, A. anceps exhibited significant antioxidant properties with all assays and significantly depressed BChE (IC50 = 6.68 ± 0.83 mg/mL) and α-amylase activities (IC50 = 5.34 ± 0.14 mg/mL). Interestingly, the five seaweeds revealed potent inhibitory effects against tyrosinase activity. In conclusion, A. anceps might be considered as a key source of phytoantioxidants and a potential candidate to develop nutritional supplements. Besides, the five tested seaweeds warrant further study and may be exploited as promising natural sources for managing hyperpigmentation.
Asunto(s)
Antioxidantes/análisis , Inhibidores Enzimáticos/análisis , Fitoquímicos/análisis , Algas Marinas/química , Cromatografía Líquida de Alta Presión , Pruebas de Enzimas , Humanos , Análisis MultivarianteRESUMEN
Elderly patients undergoing urological surgery in the lithotomy position may be vulnerable to perioperative hypoxemia. Positive end-expiratory pressure (PEEP) can improve arterial oxygenation. Although laryngeal mask airway (LMA) is widely utilized in urological surgery, it is not known how PEEP affects arterial oxygenation in these patients. We, therefore, evaluated the effect of PEEP on arterial oxygen partial pressure (PaO2) in elderly patients using LMA during urological surgery in the lithotomy position. Patients randomly received zero end-expiratory pressure (group Z, n = 34) or PEEP of 7 cmH2O (group P, n = 33). Ventilatory, respiratory, and haemodynamic variables were measured at 5 min (T0), 30 min (T1), and 60 min (T2) after LMA Supreme™ (sLMA) insertion. The primary outcome was the difference of PaO2 at T2 between the two groups. Atelectasis score, the incidence of a significant leak, and complications associated with sLMA insertion were also evaluated. PaO2 at T2 was significantly higher in group P than in group Z (20.0 ± 4.9 vs. 14.7 ± 3.7 kPa, P < 0.001). Atelectasis score at T2 was lower in group P than in group Z (5.3 ± 1.7 vs. 8.4 ± 2.3, P < 0.001). However, the incidence of a significant leak and complications associated with LMA insertion did not significantly differ between the two groups. PEEP can improve arterial oxygenation and reduce atelectasis in elderly patients using sLMA during urological surgery in the lithotomy position, suggesting that PEEP may be useful for elderly patients with an increased risk of perioperative hypoxemia when using sLMA.
Asunto(s)
Anestesia General/métodos , Análisis de los Gases de la Sangre/métodos , Máscaras Laríngeas , Respiración con Presión Positiva/métodos , Anciano , Anestesia/métodos , Método Doble Ciego , Femenino , Hemodinámica , Humanos , Hipoxia , Incidencia , Masculino , Oxígeno/metabolismo , Posicionamiento del Paciente , Presión , Atelectasia Pulmonar , Riesgo , Posición SupinaRESUMEN
This study aimed to investigate the impact of plant growth regulators, sucrose concentration, and the number of subcultures on axillary shoot multiplication, in vitro flowering, and somaclonal variation and to assess the phytochemical composition, antioxidant capacity, and enzyme inhibitory potential of in vitro-established callus, somaclonal variant, and normal green shoots of Catharanthus roseus. The highest shoot induction rate (95.8%) and highest number of shoots (23.6), with a mean length of 4.5 cm, were attained when the C. roseus nodal explants (0.6-1 cm in length) were cultivated in Murashige and Skoog (MS) medium with 2 µM thidiazuron, 1 µM 2-(1-naphthyl) acetic acid (NAA), and 4% sucrose. The in vitro flowering of C. roseus was affected by sucrose, and the number of subcultures had a significant effect on shoot multiplication and somaclonal variation. The highest levels of phenolics and flavonoids were found in normal green shoots, followed by those in somaclonal variant shoots and callus. The phytochemicals in C. roseus extracts were qualified using liquid chromatography-tandem mass spectrometry. A total of 39, 55, and 59 compounds were identified in the callus, somaclonal variant shoot, and normal green shoot tissues, respectively. The normal green shoot extracts exhibited the best free radical scavenging ability and reducing power activity. The strongest acetylcholinesterase inhibitory effects were found in the callus, with an IC50 of 0.65 mg/mL.
Asunto(s)
Antioxidantes/química , Antioxidantes/farmacología , Catharanthus/química , Inhibidores Enzimáticos/química , Inhibidores Enzimáticos/farmacología , Fitoquímicos/química , Fitoquímicos/farmacologíaRESUMEN
A growing number of evidences from clinical and preclinical studies have shown that dysregulation of microRNA (miRNA) function contributes to the progression of cancer and thus miRNA can be an effective target in therapy. Dietary phytochemicals, such as quercetin, are natural products that have potential anti-cancer properties due to their proven antioxidant, anti-inflammatory, and anti-proliferative effects. Available experimental studies indicate that quercetin could modulate multiple cancer-relevant miRNAs including let-7, miR-21, miR-146a and miR-155, thereby inhibiting cancer initiation and development. This paper reviews the data supporting the use of quercetin for miRNA-mediated chemopreventive and therapeutic strategies in various cancers, with the aim to comprehensively understand its health-promoting benefits and pharmacological potential. Integration of technology platforms for miRNAs biomarker and drug discovery is also presented.
Asunto(s)
Antineoplásicos/uso terapéutico , Antioxidantes/uso terapéutico , MicroARNs , Neoplasias , Quercetina/uso terapéutico , Animales , Antineoplásicos/farmacología , Antioxidantes/farmacología , Biomarcadores , Quimioprevención , Descubrimiento de Drogas , Humanos , Neoplasias/tratamiento farmacológico , Neoplasias/genética , Neoplasias/prevención & control , Quercetina/farmacologíaRESUMEN
The goal of this study was to establish an efficient protocol for the large-scale propagation of Mertensia maritima (L.) Gray, and evaluate the carotenoid, fatty acid, and tocopherol contents in the leaves of in vitro regenerated shoots. Surface-disinfected node and shoot tip explants were placed on semisolid Murashige and Skoog (MS) medium with 0-16 µM N6-benzyladenine (BA), kinetin, (KN), and thidiazuron (TDZ) alone, or in combination with, 1 or 2 µM α-naphthaleneacetic acid (NAA). Of the three different cytokinins employed, TDZ elicited the best results for axillary shoot proliferation. A maximum frequency of shoot initiation above 84%, with a mean of 8.9 and 4.8 shoots per node and shoot tip, respectively, was achieved on the culture medium supplemented with 4 µM TDZ. A combination of TDZ + NAA significantly increased the percentage of multiple shoot formation and number of shoots per explant. The best shoot induction response occurred on MS medium with 4 µM TDZ and 1 µM NAA. On this medium, the node (93.8%) and shoot tip (95.9%) explants produced an average of 17.7 and 8.6 shoots, respectively. The highest root induction frequency (97.4%) and number of roots per shoot (25.4), as well as the greatest root length (4.2 cm), were obtained on half-strength MS medium supplemented with 4 µM indole-3-butyric acid (IBA). The presence of six carotenoids and α-tocopherol in the leaf tissues of M. maritima was confirmed by HPLC. Gas chromatography-mass spectrometry analysis confirmed the presence of 10 fatty acids, including γ-linolenic acid and stearidonic acid in the leaf tissues of M. maritima. All-E-lutein (18.49 µg g-1 fresh weight, FW), α-tocopherol (3.82 µg g-1 FW) and α-linolenic acid (30.37%) were found to be the significant compounds in M. maritima. For the first time, a successful protocol has been established for the mass propagation of M. maritima with promising prospects for harnessing its bioactive reserves.
Asunto(s)
Magnoliopsida/crecimiento & desarrollo , Fitoquímicos/metabolismo , Técnicas de Embriogénesis Somática de Plantas/métodos , Carotenoides/análisis , Carotenoides/metabolismo , Magnoliopsida/química , Magnoliopsida/metabolismo , Fitoquímicos/análisis , Tocoferoles/análisis , Tocoferoles/metabolismoRESUMEN
Xanthine oxidase (XO) found in all mammals and excess activity leads to urolithiasis. The cow milk XO was purified to 305-fold with a specific activity of 8.76 EU/mg and overall yield of 87% by using DEAE-Sepharose chromatography. The phenolics showed potent XO inhibitory effect with Ki , P1 (0.412), P2 (0.632), P3 (0.585), P4 (0.886), P5 (1.633), P6 (0.503), P7 (2.882), P8 (3.761), P9 (4.487), and P10 (5.841) µM. The phenolics P9 and P10 exhibited uncompetitive inhibition; the phenolics P1, P2, P3, P4, and P6 showed competitive inhibition, and other phenolic acids showed noncompetitive inhibition. The studied phenolic compounds showed potent antioxidant activity and expressed as EC50 , ranged from, DPPH (4.2-25.8 µg mL-1 ), ABTS (10.2-42.5 mmol TE 100 g-1 ), and FRAP (6.3-36.8 mol Fe (II) 100 g-1 ). The results obtained from this study might be utilized for design of XO inhibitors and as antigout agent.
Asunto(s)
Antioxidantes/farmacología , Cinamatos/farmacología , Inhibidores Enzimáticos/farmacología , Ácido Gálico/análogos & derivados , Proteínas de la Leche/antagonistas & inhibidores , Xantina Oxidasa/antagonistas & inhibidores , Alquilación , Animales , Antioxidantes/química , Unión Competitiva , Bovinos , Cinamatos/química , Suplementos Dietéticos , Diseño de Fármacos , Inhibidores Enzimáticos/química , Ácido Gálico/química , Ácido Gálico/farmacología , Supresores de la Gota/química , Supresores de la Gota/farmacología , Hidroxibenzoatos/química , Hidroxibenzoatos/farmacología , Cinética , Proteínas de la Leche/aislamiento & purificación , Proteínas de la Leche/metabolismo , Estructura Molecular , Fenoles/química , Fenoles/farmacología , Xantina Oxidasa/aislamiento & purificación , Xantina Oxidasa/metabolismoRESUMEN
The influence of 2,4-dichlorophenoxyacetic acid (2,4-D), benzyladenine (BA), and thidiazuron (TDZ) on direct rhizome induction and shoot formation from rhizome explants of Cymbidium goeringii was explored. Rhizome segments obtained from in vitro seed cultures of C. goeringii were placed on Murashige and Skoog (MS) medium incorporated with 5, 10, 20, or 40 µM 2,4-D and 1, 2, 4, or 8 µM BA or TDZ alone or in combination with 20 µM 2,4-D. The explants developed only rhizomes on MS medium with or without 2,4-D. The highest percent of rhizome formation (100%) was obtained on MS medium incorporated with 20 µM of 2,4-D. The morphology and number of rhizomes varied with the level of 2,4-D in the medium. Direct adventitious shoot formation was achieved on medium incorporated with BA or TDZ. The adventitious shoots produced per explant significantly increased with the supplementation of 2,4-D to cytokinin-containing medium. The highest mean of 21.8 ± 1.8 shoot buds per rhizome segment was obtained in medium fortified with 20 µM 2,4-D and 2 µM TDZ. The greatest percent of root induction (100%) and the mean of 5.3 ± 1.1 roots per shoot were achieved on ½ MS medium incorporated with 2 µM of α-naphthaleneacetic acid. About 97% of the in vitro-produced plantlets acclimatized in the greenhouse. An efficient in vitro propagation protocol was thus developed for C. goeringii using rhizome explants.
RESUMEN
Influenza virus has had a high rate of antigenic shift and drift that causes significant morbidity and mortality in humans and animals. The lack of excellent pharmacological treatment underlines the importance of the development of the novel antiviral drugs. We investigated the anti-influenza A and B viruses of 2,4-dichlorophenoxyacetic acid (2,4-D), which is the synthetic analog to auxin and is used as a popular herbicide in the agricultural practices. 2,4-D was evaluated using a cytopathic effect reduction method; assay results showed that 2,4-D possessed strong anti-influenza A and B viruses inhibiting the formation of a visible cytopathic effect. Influenza viral RNA expression was performed by quantitative real-time polymerase chain reaction. 2,4-D also inhibited virus replication in the early stage of influenza virus infection without direct interaction with virus particles. Additionally, 2,4-D significantly inhibited various factors occur during influenza virus infection as the acidic vesicular formation and reactive oxygen species production. Moreover, 2,4-D represented no cytotoxicity in normal kidney cell. Therefore, these findings provide an understanding of the mechanism and efficient use of 2,4-D in pharmacological applications against influenza virus infection.
Asunto(s)
Ácido 2,4-Diclorofenoxiacético/farmacología , Antivirales/farmacología , Autofagia/efectos de los fármacos , Regulación Viral de la Expresión Génica , Subtipo H1N1 del Virus de la Influenza A/efectos de los fármacos , Subtipo H3N2 del Virus de la Influenza A/efectos de los fármacos , Replicación Viral/efectos de los fármacos , Animales , Perros , Interacciones Huésped-Patógeno , Humanos , Subtipo H1N1 del Virus de la Influenza A/genética , Subtipo H1N1 del Virus de la Influenza A/metabolismo , Subtipo H3N2 del Virus de la Influenza A/genética , Subtipo H3N2 del Virus de la Influenza A/metabolismo , Células de Riñón Canino Madin Darby , Neuraminidasa/antagonistas & inhibidores , Neuraminidasa/genética , Neuraminidasa/metabolismo , Oseltamivir/farmacología , ARN Mensajero/antagonistas & inhibidores , ARN Mensajero/genética , ARN Mensajero/metabolismo , ARN Viral/antagonistas & inhibidores , ARN Viral/genética , ARN Viral/metabolismo , Especies Reactivas de Oxígeno/agonistas , Especies Reactivas de Oxígeno/metabolismo , Proteínas Virales/antagonistas & inhibidores , Proteínas Virales/genética , Proteínas Virales/metabolismoRESUMEN
ß-Alanine is a non-essential amino acid and presents as a major component of various sports supplements. It is a non-proteogenic amino acid, formed in vivo by degradation of carnosine, anserine, balenine, and dihydrouracil. The present study was aimed at investigating the anti-tumor effects of ß-alanine in renal and cervical tumor cells. Sulforhodamine-B assay and flow cytometric analysis were used to measure cell viability. Lactate dehydrogenase (LDH) expression was analyzed using FITC-conjugated fluorescent antibody. The cellular adenosine triphosphate (ATP) content was measured using bioluminescence method. Cell migration was determined by the simple standard-scratch method. ß-Alanine reduced renal and cervical cell growth significantly. Percentage of inhibition of renal and cervical tumor cells was increased at higher concentration of ß-alanine. LDH expression and ATP content were significantly reduced in renal and cervical tumor cells in a dose-dependent manner. Renal and cervical tumor cell migration were significantly reduced following 10 and 100 mM of ß-alanine treatment. In our study, ß-alanine exerts no significant effect on normal MDCK cells except a marginal effect at the highest concentration (100 mM). In summary, our experimental data suggest that ß-alanine may be a potential anti-tumor agent exhibiting several anti-cancer effects in renal and cervical tumor cells.
Asunto(s)
Movimiento Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Neoplasias Renales/metabolismo , Neoplasias del Cuello Uterino/metabolismo , beta-Alanina/farmacología , Femenino , Humanos , Neoplasias Renales/tratamiento farmacológico , Neoplasias Renales/patología , L-Lactato Deshidrogenasa/metabolismo , Células Tumorales Cultivadas , Neoplasias del Cuello Uterino/tratamiento farmacológico , Neoplasias del Cuello Uterino/patologíaRESUMEN
In this study, we investigated the antiviral activity of newly synthesized berberine derivatives (BD) against influenza virus infection using several strains in in vitro and in silico. The CPE reduction, pre-incubation, NA activity inhibition and molecular docking assays were used for antiviral evaluation. The anti-influenza activities of BDs were stronger than plant-derived pure commercial berberine, and some of the BDs were more potent than control drug Oseltamivir. The cytotoxicity level was observed in the range 63.16-1639µg/mL for synthesized BDs. Additionally, BDs were detected as able to block influenza viral particles. We targeted neuraminidase one of the influenza surface protein for further probing. Moreover, BDs registered competitive NA inhibition activity comparing with Oseltamivir. The active site of viral NA subunit was fully blocked by BD as the same location as Oseltamivir. The binding energies between influenza NA subunit and BD-5 were higher than Oseltamivir. More H-bonds and NA residues were occupied by BD for stronger binding ability than Oseltamivir. These results indicated that BD inhibits various strains of influenza virus by blocking of viral NA subunit.