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We discovered high-titer neutralizing autoantibodies against interleukin-10 in a child with infantile-onset inflammatory bowel disease (IBD), a phenocopy of inborn errors of interleukin-10 signaling. After B-cell-depletion therapy and an associated decrease in the anti-interleukin-10 titer, conventional IBD therapy could be withdrawn. A second child with neutralizing anti-interleukin-10 autoantibodies had a milder course of IBD and has been treated without B-cell depletion. We conclude that neutralizing anti-interleukin-10 autoantibodies may be a causative or modifying factor in IBD, with potential implications for therapy. (Funded by the National Institute for Health and Care Research and others.).
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Anticuerpos Neutralizantes , Autoanticuerpos , Enfermedades Inflamatorias del Intestino , Interleucina-10 , Humanos , Interleucina-10/inmunología , Autoanticuerpos/inmunología , Autoanticuerpos/sangre , Anticuerpos Neutralizantes/inmunología , Anticuerpos Neutralizantes/sangre , Enfermedades Inflamatorias del Intestino/inmunología , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Masculino , Femenino , Linfocitos B/inmunología , Lactante , NiñoRESUMEN
Neural crest cells are a transient embryonic cell population that migrate collectively to various locations throughout the embryo to contribute a number of cell types to several organs. After induction, the neural crest delaminates and undergoes an epithelial-to-mesenchymal transition before migrating through intricate yet characteristic paths. The neural crest exhibits a variety of migratory behaviors ranging from sheet-like mass migration in the cephalic regions to chain migration in the trunk. During their journey, neural crest cells rely on a range of signals both from their environment and within the migrating population for navigating through the embryo as a collective. Here we review these interactions and mechanisms, including chemotactic cues of neural crest cells' migration.
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Movimiento Celular/genética , Quimiotaxis/genética , Desarrollo Embrionario/genética , Cresta Neural/crecimiento & desarrollo , Animales , Linaje de la Célula/genética , Cresta Neural/citologíaRESUMEN
BACKGROUND: German-derived ethnicities are one of the largest ethnic groups in Hungary, dating back to the formation of the Kingdom of Hungary, which took place at the beginning of the 11th century. Germans arrived in Hungary in many waves. The most significant immigration wave took place following the collapse of the Ottoman Empire in East-Central Europe which closed the 150 year long Ottoman occupation. To date, there are no comprehensive genome-wide studies investigating the genetic makeup of the Danube Swabians. Here we analyzed 47 Danube Swabian samples collected from elderly Swabian individuals living in the Dunaszekcso-Bár area, in Danube side villages of Southwest Hungary. These Swabians, according to self-declaration, did not admix with other ethnic groups for 3-6 succeeding generations. Using Illumina Infinium 720 K Beadchip genotype data, we applied allele frequency-based and haplotype-based genome-wide marker data analyses to investigate the ancestry and genetic composition of the collected Danube Swabian samples. RESULTS: Haplotype-based analyses like identity by descent segment analysis show that the investigated Danube Swabians possess significant German and other West European ancestry, but their Hungarian ancestry is also prominent. Our results suggest that their main source of ancestry can be traced back to Western Europe, presumably to the region of Germany. CONCLUSION: This is the first analysis of Danube Swabian population samples based on genome-wide autosomal data. Our results establish the basis for conducting further comprehensive research on Danube Swabians and on other German ethnicities of the Carpathian basin, which can help reconstruct their origin, and identify their major archaic genomic patterns.
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Etnicidad , Genética de Población , Humanos , Anciano , Frecuencia de los Genes , Etnicidad/genética , Europa (Continente) , HungríaRESUMEN
PURPOSE: Nonerythrocytic αII-spectrin (SPTAN1) variants have been previously associated with intellectual disability and epilepsy. We conducted this study to delineate the phenotypic spectrum of SPTAN1 variants. METHODS: We carried out SPTAN1 gene enrichment analysis in the rare disease component of the 100,000 Genomes Project and screened 100,000 Genomes Project, DECIPHER database, and GeneMatcher to identify individuals with SPTAN1 variants. Functional studies were performed on fibroblasts from 2 patients. RESULTS: Statistically significant enrichment of rare (minor allele frequency < 1 × 10-5) probably damaging SPTAN1 variants was identified in families with hereditary ataxia (HA) or hereditary spastic paraplegia (HSP) (12/1142 cases vs 52/23,847 controls, p = 2.8 × 10-5). We identified 31 individuals carrying SPTAN1 heterozygous variants or deletions. A total of 10 patients presented with pure or complex HSP/HA. The remaining 21 patients had developmental delay and seizures. Irregular αII-spectrin aggregation was noted in fibroblasts derived from 2 patients with p.(Arg19Trp) and p.(Glu2207del) variants. CONCLUSION: We found that SPTAN1 is a genetic cause of neurodevelopmental disorder, which we classified into 3 distinct subgroups. The first comprises developmental epileptic encephalopathy. The second group exhibits milder phenotypes of developmental delay with or without seizures. The final group accounts for patients with pure or complex HSP/HA.
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Epilepsia , Paraplejía Espástica Hereditaria , Humanos , Espectrina/genética , Mutación , Epilepsia/genética , Fenotipo , Ataxia , Paraplejía Espástica Hereditaria/genética , Convulsiones , Paraplejía , LinajeRESUMEN
Serine protease inhibitor Kazal type 1 (SPINK1) is a trypsin-selective inhibitor protein secreted by the exocrine pancreas. Loss-of-function SPINK1 mutations predispose to chronic pancreatitis through either reduced expression, secretion, or impaired trypsin inhibition. In this study, we aimed to characterize the inhibitory activity of mouse SPINK1 against cationic (T7) and anionic (T8, T9, T20) mouse trypsin isoforms. Kinetic measurements with a peptide substrate, and digestion experiments with ß-casein indicated that the catalytic activity of all mouse trypsins is comparable. Human SPINK1 and its mouse ortholog inhibited mouse trypsins with comparable efficiency (KD range 0.7-2.2 pM), with the sole exception of T7 trypsin, which was inhibited less effectively by the human inhibitor (KD 21.9 pM). Characterization of four chronic pancreatitis-associated human SPINK1 mutations in the context of the mouse inhibitor revealed that the reactive-loop mutations R42N (human K41N) and I43M (human I42M) impaired SPINK1 binding to trypsin (KD 60 nM and 47.5 pM, respectively), whereas mutations D35S (human N34S) and A56S (human P55S) had no impact on trypsin inhibition. Our results confirmed that high-affinity trypsin inhibition by SPINK1 is conserved in the mouse, and the functional consequences of human pancreatitis-associated SPINK1 mutations can be replicated in the mouse inhibitor.
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Pancreatitis Crónica , Inhibidor de Tripsina Pancreática de Kazal , Humanos , Animales , Ratones , Inhibidor de Tripsina Pancreática de Kazal/genética , Tripsina/genética , Enfermedad Crónica , Mutación , Pancreatitis Crónica/genética , Isoformas de Proteínas/genética , Predisposición Genética a la EnfermedadRESUMEN
The mechanistic target of the rapamycin signaling pathway serves as a central regulator of cell metabolism, growth, proliferation, and survival. In its regulation, the GTPase-activating protein activity toward Rags1 complex has an inhibitory effect. Mutations in genes encoding this complex protein are among the most common abnormalities in focal epilepsies. Within these mutations, the mutations affecting the DEPDC5 gene have been associated with different autosomal dominantly inherited epilepsy types. Due to the limited data available on mTOR inhibitor therapy in nontuberous sclerosis complex epileptic patients, here we present the clinical management of a patient with intractable epilepsy, skin hypopigmentation, and a DEPDC5 variant. The patient's phenotype is compatible with a nonlesional DEPDC5-related epileptic encephalopathy. We initiated compassionate, off-label everolimus treatment as the patient's condition continuously deteriorated. Due to bilateral pneumonia occurring at the beginning of the treatment, it was temporarily discontinued, and resumed in half the dose. Follow-up examination after 18 months showed a 90% reduction in seizure frequency with moderate improvement in attention function and nutritional status. Our case report emphasizes the importance of early genetic testing in patients with epileptic encephalopathy. Clinical consequences of mammalian target of rapamycin complex 1 (mTORC1) upregulation may be amenable to tailored treatment with mTOR inhibitors. A clinical trial on an international scale would be needed to draw conclusions.
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Epilepsias Parciales , Epilepsia Generalizada , Epilepsia , Humanos , Inhibidores mTOR , Serina-Treonina Quinasas TOR/genética , Serina-Treonina Quinasas TOR/metabolismo , Serina-Treonina Quinasas TOR/uso terapéutico , Epilepsia/genética , Epilepsias Parciales/tratamiento farmacológico , Epilepsias Parciales/genética , Convulsiones/tratamiento farmacológico , Proteínas Activadoras de GTPasa/genéticaRESUMEN
Biological membranes, primarily composed of lipids, envelop each living cell. The intricate composition and organization of membrane lipids, including the variety of fatty acids they encompass, serve a dynamic role in sustaining cellular structural integrity and functionality. Typically, modifications in lipid composition coincide with consequential alterations in universally significant signaling pathways. Exploring the various fatty acids, which serve as the foundational building blocks of membrane lipids, provides crucial insights into the underlying mechanisms governing a myriad of cellular processes, such as membrane fluidity, protein trafficking, signal transduction, intercellular communication, and the etiology of certain metabolic disorders. Furthermore, comprehending how alterations in the lipid composition, especially concerning the fatty acid profile, either contribute to or prevent the onset of pathological conditions stands as a compelling area of research. Hence, this review aims to meticulously introduce the intricacies of membrane lipids and their constituent fatty acids in a healthy organism, thereby illuminating their remarkable diversity and profound influence on cellular function. Furthermore, this review aspires to highlight some potential therapeutic targets for various pathological conditions that may be ameliorated through dietary fatty acid supplements. The initial section of this review expounds on the eukaryotic biomembranes and their complex lipids. Subsequent sections provide insights into the synthesis, membrane incorporation, and distribution of fatty acids across various fractions of membrane lipids. The last section highlights the functional significance of membrane-associated fatty acids and their innate capacity to shape the various cellular physiological responses.
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Ácidos Grasos , Lípidos de la Membrana , Ácidos Grasos/metabolismo , Lípidos de la Membrana/metabolismo , Membrana Celular/metabolismo , Fluidez de la Membrana , Eucariontes/metabolismo , Fosfolípidos/metabolismoRESUMEN
Hemodynamic disturbance, a rise in neutrophil-to-lymphocyte ratio (NLR) and release of inflammatory cytokines into blood, is a bad prognostic indicator in severe COVID-19 and other diseases involving cytokine storm syndrome (CSS). The purpose of this study was to explore if zymosan, a known stimulator of the innate immune system, could reproduce these changes in pigs. Pigs were instrumented for hemodynamic analysis and, after i.v. administration of zymosan, serial blood samples were taken to measure blood cell changes, cytokine gene transcription in PBMC and blood levels of inflammatory cytokines, using qPCR and ELISA. Zymosan bolus (0.1 mg/kg) elicited transient hemodynamic disturbance within minutes without detectable cytokine or blood cell changes. In contrast, infusion of 1 mg/kg zymosan triggered maximal pulmonary hypertension with tachycardia, lasting for 30 min. This was followed by a transient granulopenia and then, up to 6 h, major granulocytosis, resulting in a 3-4-fold increase in NLR. These changes were paralleled by massive transcription and/or rise in IL-6, TNF-alpha, CCL-2, CXCL-10, and IL-1RA in blood. There was significant correlation between lymphopenia and IL-6 gene expression. We conclude that the presented model may enable mechanistic studies on late-stage COVID-19 and CSS, as well as streamlined drug testing against these conditions.
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COVID-19 , Citocinas , Porcinos , Animales , Citocinas/metabolismo , Zimosan/farmacología , Interleucina-6/metabolismo , Síndrome de Liberación de Citoquinas/etiología , Leucocitos Mononucleares/metabolismo , Inmunidad InnataRESUMEN
A 25-week experiment was undertaken to explore the effect of partial replacement of dietary fishmeal (FM) with black soldier fly meal (Hermetia illucens) (BS), mealworm meal (Tenebrio molitor) (MW), and a 1 : 1 mixture of both insect meals (BSMW) on fillet quality in African catfish (Clarias gariepinus). A total of 96 fish with an average initial body weight of 248 ± 28 g were stocked into a recirculating aquaculture system and fed in four different dietary groups (control, BS, MW, and BSMW). No mortality was recorded in any of the groups. At the end of the feeding period, 24 fish (n = 6 for each treatment, weight between 690 and 822 g) were used for analysis. There was no alteration in filleting yield or other slaughter indices within experimental groups, except the hepatosomatic index. Among quality attributes, pH 24 hr postmortem exhibited a significant difference (p < 0.05). In respect of the fatty acid profile, the n-6/n-3 ratio ranged between 1.17 and 1.40 but was not significantly modified by the partial replacement of FM. Similarly, the proximate composition of the fillets was not significantly different between the control and experimental diet groups. The ratio of polyunsaturated fatty acid to saturated fatty acids ranged between 0.67 and 0.79 in the fillets, without significant differences between groups. The atherogenic index was increased in the BS group, as compared to the others; however, the thrombogenicity index of fillets was not significantly affected. Similarly, the conventional quality traits of the fillet, such as cooking, drip, and thawing losses, did not differ within treatments. This study demonstrates that the dietary inclusion of black soldier fly and/or mealworm meals used for African catfish at the tested inclusion level has negligible impact on fillet properties.
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The serine protease inhibitor Kazal type 1 (SPINK1) protects the pancreas from intrapancreatic trypsin activation that can lead to pancreatitis. Loss-of-function genetic variants of SPINK1 increase the risk for chronic pancreatitis, often by diminishing inhibitor expression or secretion. Variants that are secreted normally have been presumed to be pathogenic because of defective trypsin inhibition, but evidence has been lacking. Here, we report quantitative studies on the inhibition of human trypsins by wildtype SPINK1 and seven secreted missense variants. We found that tyrosine sulfation of human trypsins weakens binding of SPINK1 because of altered interactions with Tyr43 in the SPINK1 reactive loop. Using authentic sulfated human trypsins, we provide conclusive evidence that SPINK1 variants N34S, N37S, R65Q, and Q68R have unimpaired inhibitory activity, whereas variant P55S exhibits a small and clinically insignificant binding defect. In contrast, rare variants K41N and I42M that affect the reactive-site peptide bond of SPINK1 decrease inhibitor binding by 20,000- to 30,000-fold and three- to sevenfold, respectively. Taken together, the observations indicate that defective trypsin inhibition by SPINK1 variants is an uncommon mechanism in chronic pancreatitis. The results also strengthen the notion that a decline in inhibitor levels explains pancreatitis risk associated with the large majority of SPINK1 variants.
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Pancreatitis Crónica/genética , Inhibidor de Tripsina Pancreática de Kazal/genética , Tripsina/metabolismo , Células HEK293 , Humanos , Modelos Moleculares , Mutación Missense , Pancreatitis Crónica/metabolismo , Unión Proteica , Inhibidor de Tripsina Pancreática de Kazal/metabolismoRESUMEN
OBJECTIVES: The authors' aim was to examine the preoperative hormone and nutritional status in patients undergoing elective cardiac surgery. DESIGN AND SETTINGS: The authors' research was a single-center, prospective, observational study (ClinicalTrials.gov: NCT03736499). PARTICIPANTS & INTERVENTIONS: The authors examined 252 patients who underwent elective cardiac surgery. Preoperative thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), prolactin, and testosterone levels were collected and analyzed after the surgery. The Geriatric Nutritional Risk Index (GNRI), Controlling Nutritional Status (CONUT), and Prognostic Nutritional Index (PNI) were all calculated as a sum and groups. Frailty was calculated based on the modified Frailty Index-11. The primary outcome was overall mortality. MEASUREMENTS AND MAIN RESULTS: The mean age of the patients was 64.23 years (standard deviation: 11.07 years). Thirty-three patients (13.01%) died during the median follow-up time of 20.48 months (interquartile range: 18.90-22.98 months). Thyroid hormones were examined as continuous variables and also in 3 groups based on low, normal, and high hormone levels. Continuous TSH (p = 0.230), continuous fT3 (p = 0.492), and continuous fT4 (p = 0.657) were not significantly associated with total mortality. After adjustment for the European System for Cardiac Operative Risk Evaluation II and postoperative complications, the following nutritional scores were associated with total mortality: GNRI < 91 (adjusted hazard ratio [AHR]: 4.384; 95% confidence interval [CI]: 1.866-10.303, p = 0.001), the higher CONUT group (AHR: 1.736; 95% CI: 1.736-2.866, p = 0.031), and a PNI < 48 points (AHR: 3.465; 95% CI: 1.735-6.918, p < 0.001). The modified Frailty Index-11 was not associated with mortality. CONCLUSIONS: Before cardiac surgery, nutritional status should be assessed because the findings may help to decrease mortality. The hormone levels were not associated with mortality.
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Procedimientos Quirúrgicos Cardíacos , Fragilidad , Desnutrición , Anciano , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Humanos , Persona de Mediana Edad , Estado Nutricional , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos , Hormonas Tiroideas , TirotropinaRESUMEN
Mesotrypsin is an unusual human trypsin isoform with inhibitor resistance and the ability to degrade trypsin inhibitors. Degradation of the protective serine protease inhibitor Kazal type 1 (SPINK1) by mesotrypsin in the pancreas may contribute to the pathogenesis of pancreatitis. Here we tested the hypothesis that the regulatory digestive protease chymotrypsin C (CTRC) mitigates the harmful effects of mesotrypsin by cleaving the autolysis loop. As human trypsins are post-translationally sulfated in the autolysis loop, we also assessed the effect of this modification. We found that mesotrypsin cleaved in the autolysis loop by CTRC exhibited catalytic impairment on short peptides due to a 10-fold increase in Km , it digested ß-casein poorly and bound soybean trypsin inhibitor with 10-fold decreased affinity. Importantly, CTRC-cleaved mesotrypsin degraded SPINK1 with markedly reduced efficiency. Sulfation increased mesotrypsin activity but accelerated CTRC-mediated cleavage of the autolysis loop and did not protect against the detrimental effect of CTRC cleavage. The observations indicate that CTRC-mediated cleavage of the autolysis loop in mesotrypsin decreases protease activity and thereby protects the pancreas against unwanted SPINK1 degradation. The findings expand the role of CTRC as a key defense mechanism against pancreatitis through regulation of intrapancreatic trypsin activity.
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Quimotripsina/metabolismo , Proteolisis , Inhibidores de Tripsina/metabolismo , Tripsina/metabolismo , Biocatálisis , Caseínas/metabolismo , Células HEK293 , Humanos , Cinética , Mutación/genética , Inhibidor de Tripsina Pancreática de Kazal/metabolismoRESUMEN
BACKGROUND/OBJECTIVE: Mutation-induced misfolding of digestive enzymes has been shown to cause chronic pancreatitis. Recently, heterozygous pancreatic lipase (PNLIP) mutations leading to reduced secretion were identified. The aim of the present study was to investigate whether PNLIP mutants with a secretion defect result in endoplasmic reticulum (ER) stress in cell culture models. METHODS: We introduced the coding DNA for wild-type and A174P, G233E, C254R and V454F mutant PNLIP into two mammalian cell lines and carried out functional assays to assess PNLIP expression, secretion and ER stress. RESULTS: We found that wild-type PNLIP was readily secreted from the investigated cell lines. In contrast, none of the lipase mutants were detectable in the conditioned media. PNLIP variants accumulated in the cells as intracellular protein aggregates probably due to misfolding in the ER. Consistent with this notion, PNLIP mutants induced ER stress, as indicated by increased mRNA levels of spliced X-box Binding Protein 1 (XBP1) and the ER chaperone Immunoglobulin Binding Protein (BiP). CONCLUSION: The results indicate that PNLIP mutations associated with a lipase secretion defect cause ER stress and thereby may increase the risk for chronic pancreatitis.
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Estrés del Retículo Endoplásmico , Lipasa/genética , Animales , Estrés del Retículo Endoplásmico/genética , Mutación , Jugo Pancreático , Pancreatitis Crónica/genéticaRESUMEN
BACKGROUND: Pericardial tamponade is a serious condition which may eventually lead to severe haemodynamic disturbances and cardiac arrest. It is most often caused by the accumulation of fluid inside the pericardium, as a result of different aetiological factors such as pericarditis, neoplastic diseases, lymphatic dysfunctions, or idiopathic pericardial disease. Pericardial tamponade can develop after cardiac surgical procedures or as a complication of myocardial infarction. Collection of blood inside the pericardial sack can be the result of pericardial or cardiac trauma. It is exceedingly rare for the injury to be caused by a migrating foreign body. Although a typical picture of pericardial tamponade has been previously described, the disorder may clinically resemble an acute myocardial infarction. CASE PRESENTATION: We report the case of a 58-year-old female patient complaining of new onset thoracic pain and shortness of breath. Electrocardiographic examination results were suggestive of an acute inferior myocardial infarction. However, echocardiography revealed significant pericardial tamponade. The cause was found to be a needle which remained inside the pelvis following a previous cesarean delivery, which the patient had undergone 18 years prior. In emergency setting, the needle was removed and the pericardial tamponade was resolved. Due to the prompt and efficient management, the patient had an uneventful postoperative recovery and presented no recurrence at the follow-up examinations. CONCLUSIONS: The migration of foreign bodies through tissues is exceedingly rare. If present, it may cause life-threatening complications. Since the aetiology of pericardial tamponade is vast, a thorough assessment is highly important. Therefore, echocardiography is the imaging modality of choice. We wish to highlight the possibility of migrating foreign bodies as probable cause for pericardial tamponade, as well as the importance of echocardiographic methods in the fast-track evaluation of such critical conditions.
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Taponamiento Cardíaco/diagnóstico por imagen , Cesárea/efectos adversos , Ecocardiografía , Migración de Cuerpo Extraño/diagnóstico por imagen , Agujas/efectos adversos , Derrame Pericárdico/diagnóstico por imagen , Infarto del Miocardio con Elevación del ST/diagnóstico , Taponamiento Cardíaco/etiología , Taponamiento Cardíaco/cirugía , Cesárea/instrumentación , Remoción de Dispositivos , Diagnóstico Diferencial , Electrocardiografía , Femenino , Migración de Cuerpo Extraño/etiología , Migración de Cuerpo Extraño/cirugía , Humanos , Persona de Mediana Edad , Derrame Pericárdico/etiología , Derrame Pericárdico/cirugía , Valor Predictivo de las Pruebas , Embarazo , Resultado del TratamientoRESUMEN
BACKGROUND: In recent decades, previous studies have noted the importance of frailty, which is a frequently used term in perioperative risk evaluations. Psychological and socioeconomical domains were investigated as part of frailty syndrome. The aim of this study was to assess the importance of these factors in mortality after vascular surgery. METHODS: In our prospective, observational study (ClinicalTrials.gov Identifier: NCT02224222), we examined 164 patients who underwent elective vascular surgery between 2014 and 2017. At the outpatient anaesthesiology clinic, patients completed a questionnaire about cognitive functions, depression and anxiety, social support and self-reported quality of life were assessed using a comprehensive frailty index, in addition to medical variables. Propensity score matching was performed to analyse the difference between patients and controls in a nationwide population cohort. The primary outcome was 4 year mortality. The Kaplan-Meier method and Cox regression analysis were used for statistical analyses. RESULTS: The patients' mean age was 67.05 years (SD: 9.49 years). Mini-Mental State Examination scores of less than 27 points were recorded for 41 patients. Overall mortality rates were 22.4 and 47.6% in the control and cognitive impairment groups, respectively (p = 0.013). In the univariate Cox regression analysis, cognitive impairment measured using age- and education-adjusted MMSE scores increased the risk of mortality (AHR: 2.842, 95% CI: 1.389-5.815, p = 0.004). CONCLUSION: Even mild cognitive dysfunction measured preoperatively using the MMSE represents a potentially important risk factor for mortality after vascular surgery.
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Disfunción Cognitiva , Anciano Frágil , Anciano , Humanos , Pruebas de Estado Mental y Demencia , Estudios Prospectivos , Calidad de Vida , Factores de RiesgoRESUMEN
Intravenous administration of lipid-based nanodrugs can cause hypersensitivity, also known as infusion reactions (IRs), that can be attenuated by slow infusion in adult patients. We studied the role of infusion rate and complement (C) activation in IRs in pediatric patients treated with Abelcet, and also in anesthetized rats. IRs were observed in 6 out of 10 (60%) patients who received Abelcet infusion in 4â¯h or less, while no patients who received the infusion in 6 h showed C activation or IRs. The rat model indicated an inverse relationship between infusion speed and Abelcet-induced hypotension, taken as an experimental endpoint of IRs, while the rise of C3a in blood, an index of C activation, directly correlated with hypotension. The results suggest that pediatric patients are more prone to produce IRs, and that the optimal infusion time of Abelcet may be much longer than the presently recommended 2â¯h.
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Anfotericina B/efectos adversos , Antifúngicos/efectos adversos , Complemento C3a/metabolismo , Hipersensibilidad a las Drogas , Anfotericina B/administración & dosificación , Animales , Antifúngicos/administración & dosificación , Niño , Activación de Complemento , Humanos , Infusiones Intravenosas , Masculino , Ratas , Ratas Wistar , Factores de TiempoRESUMEN
A fundamental question in embryo morphogenesis is how a complex pattern is established in seemingly uniform tissues. During vertebrate development, neural crest cells differentiate as a continuous mass of tissue along the neural tube and subsequently split into spatially distinct migratory streams to invade the rest of the embryo. How these streams are established is not well understood. Inhibitory signals surrounding the migratory streams led to the idea that position and size of streams are determined by a pre-pattern of such signals. While clear evidence for a pre-pattern in the cranial region is still lacking, all computational models of neural crest migration published so far have assumed a pre-pattern of negative signals that channel the neural crest into streams. Here we test the hypothesis that instead of following a pre-existing pattern, the cranial neural crest creates their own migratory pathway by interacting with the surrounding tissue. By combining theoretical modeling with experimentation, we show that streams emerge from the interaction of the hindbrain neural crest and the neighboring epibranchial placodal tissues, without the need for a pre-existing guidance cue. Our model suggests that the initial collective neural crest invasion is based on short-range repulsion and asymmetric attraction between neighboring tissues. The model provides a coherent explanation for the formation of cranial neural crest streams in concert with previously reported findings and our new in vivo observations. Our results point to a general mechanism of inducing collective invasion patterns.
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Morfogénesis/fisiología , Cresta Neural/embriología , Animales , Anuros/embriología , Adhesión Celular/fisiología , Biología Computacional , Embrión de Mamíferos/embriología , Embrión no Mamífero/embriología , Ratones , Modelos Biológicos , Rombencéfalo/embriologíaRESUMEN
Objective: Our aims were to compare the vitamin D status of children with and without cancer and to examine the possible correlation between vitamin D levels in children with cancer before initiating treatment and prognosis.Method: We compared the data of 173 children with cancer with those of 569 children without cancer.Results: We measured a significant difference (p = 1.34E-08) between the vitamin D levels of children with cancer before treatment and children without cancer. There was a significant correlation between the initial vitamin D levels of children with cancer and the prognosis (p = 0.016, odds ratio = 51.33) at 5% significance.Conclusions: The average vitamin D level was 19.76% lower in the population with cancer compared with the average of the control group, and we found a correlation between the lower vitamin D levels in children with cancer and the adverse prognosis. We suggest that supplying vitamin D is reasonable and a prospective study of vitamin D in pediatric patients with cancer is recommended.
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Neoplasias/sangre , Estado Nutricional , Vitamina D/sangre , Adolescente , Niño , Preescolar , Suplementos Dietéticos , Femenino , Humanos , Hungría , Lactante , Recién Nacido , Masculino , Neoplasias/epidemiología , Neoplasias/terapia , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Vitamina D/administración & dosificación , Deficiencia de Vitamina D/epidemiologíaRESUMEN
OBJECTIVES: Thyroid dysfunction has been shown to be associated with increased all-cause mortality and severity of chronic heart failure in critical illness and severe cardiac diseases. The present study was conducted to ascertain the relationship between perioperative free triiodothyronine and free tetraiodothyronine (fT4) levels and postoperative adverse outcomes after heart transplantation (HTX). DESIGN: Retrospective, observational study. SETTING: Single-center study in a quaternary care university clinical center. PARTICIPANTS: The study comprised adult patients who underwent HTX between 2015 and 2019 and had at least 1 perioperative thyroid hormone laboratory test on the day of surgery or in the 24 hours before/after the procedure (free triiodothyronine, fT4, and thyroid-stimulating hormone). INTERVENTIONS: No interventions were applied. MEASUREMENTS AND MAIN RESULTS: The primary outcome was primary graft dysfunction (PGD), defined by the consensus conference of the International Society for Heart and Lung Transplantation. A total of 151 patients were included in the final analyses. Twenty-nine (19.2%) patients had PGD. Fourteen (9.3%) patients had low fT4 levels. An independent association was found between fT4 and PGD (odds ratio 6.49; 95% confidence interval 2.26-18.61; pâ¯=â¯0.001), with adjusted multivariate Cox regression models. CONCLUSION: The perioperative fT4 level could be a prognostic marker of adverse outcomes in HTX. The authors suggest appropriate perioperative monitoring of fT4 levels. Additional research is warranted to examine the optimal timing, dosage, and method of replacement.
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Insuficiencia Cardíaca , Trasplante de Corazón , Trasplante de Pulmón , Disfunción Primaria del Injerto , Adulto , Insuficiencia Cardíaca/diagnóstico , Trasplante de Corazón/efectos adversos , Humanos , Estudios RetrospectivosRESUMEN
This paper is concerned with the interaction of a two-dimensional plane jet with transverse plane acoustic waves, which occur, for example, in flue instruments in the vicinity of the nozzle exit. The acoustic excitation is modeled with fluctuating boundary conditions within the framework of an incompressible simulation. This method can be easily implemented in commercial CFD software. The simulations are compared with well-documented measurement data from other authors. It is shown that the model can predict not only the growth rate but also the amplitude of the perturbation, thus it captures the key features of the jet behavior in the receptive and in the linear growth region.