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1.
Ann Oncol ; 33(7): 693-701, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35398288

RESUMO

BACKGROUND: Pancreatic cancer presents as advanced disease in >80% of patients; yet, appropriate ages to consider prevention and early detection strategies are poorly defined. We investigated age-specific associations and attributable risks of pancreatic cancer for established modifiable and non-modifiable risk factors. PATIENTS AND METHODS: We included 167 483 participants from two prospective US cohort studies with 1190 incident cases of pancreatic cancer during >30 years of follow-up; 5107 pancreatic cancer cases and 8845 control participants of European ancestry from a completed multicenter genome-wide association study (GWAS); and 248 893 pancreatic cancer cases documented in the US Surveillance, Epidemiology, and End Results (SEER) Program. Across different age categories, we investigated cigarette smoking, obesity, diabetes, height, and non-O blood group in the prospective cohorts; weighted polygenic risk score of 22 previously identified single nucleotide polymorphisms in the GWAS; and male sex and black race in the SEER Program. RESULTS: In the prospective cohorts, all five risk factors were more strongly associated with pancreatic cancer risk among younger participants, with associations attenuated among those aged >70 years. The hazard ratios comparing participants with three to five risk factors with those with no risk factors were 9.24 [95% confidence interval (CI) 4.11-20.77] among those aged ≤60 years, 3.00 (95% CI 1.85-4.86) among those aged 61-70 years, and 1.46 (95% CI 1.10-1.94) among those aged >70 years (Pheterogeneity = 3×10-5). These factors together were related to 65.6%, 49.7%, and 17.2% of incident pancreatic cancers in these age groups, respectively. In the GWAS and the SEER Program, the associations with the polygenic risk score, male sex, and black race were all stronger among younger individuals (Pheterogeneity ≤0.01). CONCLUSIONS: Established risk factors are more strongly associated with earlier-onset pancreatic cancer, emphasizing the importance of age at initiation for cancer prevention and control programs targeting this highly lethal malignancy.


Assuntos
Estudo de Associação Genômica Ampla , Neoplasias Pancreáticas , Humanos , Masculino , Neoplasias Pancreáticas/etiologia , Neoplasias Pancreáticas/genética , Estudos Prospectivos , Fatores de Risco , Neoplasias Pancreáticas
2.
J Opt Soc Am A Opt Image Sci Vis ; 35(6): 1063-1073, 2018 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29877322

RESUMO

Photonic wire bonds, i.e., freeform waveguides written by 3D direct laser writing, emerge as a technology to connect different optical chips in fully integrated photonic devices. With the long-term vision of scaling up this technology to a large-scale fabrication process, the in situ optimization of the trajectory of photonic wire bonds is at stake. A prerequisite for the real-time optimization is the availability of a fast loss estimator for single-mode waveguides of arbitrary trajectory. Losses occur because of the bending of the waveguides and at transitions among sections of the waveguide with different curvatures. Here, we present an approach that resides on the fundamental mode approximation, i.e., the assumption that the photonic wire bonds predominantly carry their energy in a single mode. It allows us to predict in a quick and reliable way the pertinent losses from pre-computed modal properties of the waveguide, enabling fast design of optimum paths.

3.
Mol Psychiatry ; 20(10): 1232-9, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25469926

RESUMO

Usual sleep duration is a heritable trait correlated with psychiatric morbidity, cardiometabolic disease and mortality, although little is known about the genetic variants influencing this trait. A genome-wide association study (GWAS) of usual sleep duration was conducted using 18 population-based cohorts totaling 47 180 individuals of European ancestry. Genome-wide significant association was identified at two loci. The strongest is located on chromosome 2, in an intergenic region 35- to 80-kb upstream from the thyroid-specific transcription factor PAX8 (lowest P=1.1 × 10(-9)). This finding was replicated in an African-American sample of 4771 individuals (lowest P=9.3 × 10(-4)). The strongest combined association was at rs1823125 (P=1.5 × 10(-10), minor allele frequency 0.26 in the discovery sample, 0.12 in the replication sample), with each copy of the minor allele associated with a sleep duration 3.1 min longer per night. The alleles associated with longer sleep duration were associated in previous GWAS with a more favorable metabolic profile and a lower risk of attention deficit hyperactivity disorder. Understanding the mechanisms underlying these associations may help elucidate biological mechanisms influencing sleep duration and its association with psychiatric, metabolic and cardiovascular disease.


Assuntos
Dissonias/genética , Sono/genética , Adulto , Negro ou Afro-Americano/genética , Idoso , Feminino , Estudos de Associação Genética , Estudo de Associação Genômica Ampla , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Autorrelato , População Branca/genética
5.
Nat Rev Cancer ; 5(12): 977-85, 2005 12.
Artigo em Inglês | MEDLINE | ID: mdl-16341085

RESUMO

Most cases of breast and prostate cancer are not associated with mutations in known high-penetrance genes, indicating the involvement of multiple low-penetrance risk alleles. Studies that have attempted to identify these genes have met with limited success. The National Cancer Institute Breast and Prostate Cancer Cohort Consortium--a pooled analysis of multiple large cohort studies with a total of more than 5,000 cases of breast cancer and 8,000 cases of prostate cancer--was therefore initiated. The goal of this consortium is to characterize variations in approximately 50 genes that mediate two pathways that are associated with these cancers--the steroid-hormone metabolism pathway and the insulin-like growth factor signalling pathway--and to associate these variations with cancer risk.


Assuntos
Neoplasias da Mama/genética , Genes Neoplásicos , Penetrância , Neoplasias da Próstata/genética , Neoplasias da Mama/metabolismo , Estudos de Coortes , Feminino , Hormônios Esteroides Gonadais/metabolismo , Humanos , Masculino , Neoplasias da Próstata/metabolismo
7.
Nervenarzt ; 83(4): 435-49, 2012 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-21901539

RESUMO

The only recommended therapy in the acute phase of ischemic stroke is thrombolysis within 4.5-(6) h after symptom onset. For secondary stroke prevention platelet inhibitors or, in cases of cardiac embolism, anticoagulants are used. However, these substances bear significant limitations: either they show only moderate efficacy (platelet inhibitors), or they are associated with a considerable bleeding risk (rt-PA, anticoagulants). Although the majority of strokes are caused by embolic or thrombotic vessel occlusion, strikingly little is known about the pathophysiological role of platelets and their local function in the brain vasculature. The recent development of novel transgenic mouse lines paved the way for the in-depth analysis of the different molecular steps of thrombus formation involving platelets and the plasma coagulation cascade in models of acute ischemic stroke. It was demonstrated that prevention of early platelet adhesion to the damaged vessel wall by blocking the platelet surface receptors GPIbα or GPVI dramatically protects against experimental stroke without increasing the frequency of intracranial hemorrhage. Moreover, the critical involvement of the blood coagulation factor XII (FXII)-driven intrinsic coagulation cascade in thrombus formation during the course of ischemic brain damage could be unraveled thereby disproving established concepts of hemostasis. Based on these findings novel pharmacological blockers of GPIbα and FXIIa were designed that likewise proved to be safe and effective in animal stroke studies. Those compounds now lay the groundwork for a novel and intriguing concept in ischemic stroke and other thromboembolic diseases: antithrombosis devoid of any bleeding complications. Further preclinical testing is currently ongoing.


Assuntos
Anticoagulantes/uso terapêutico , Isquemia Encefálica/complicações , Isquemia Encefálica/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica/métodos , Doença Aguda , Animais , Humanos , Camundongos , Camundongos Transgênicos
8.
Gene Ther ; 18(4): 326-33, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21179173

RESUMO

Usually, small interfering RNAs and most antisense molecules need mechanical or chemical delivery methods to down-modulate the targeted mRNA. However, these delivery approaches complicate the interpretations of biological consequences. We show that locked nucleic acid (LNA)-based antisense oligonucleotides (LNA-ONs) readily down-modulate genes of interest in multiple cell lines without any delivery means. The down-modulation of genes was quick, robust, long-lasting and specific followed by potent down-modulation of protein. The efficiency of the effect varied among the 30 tumor cell lines investigated. The most robust effects were found in those cells where nuclear localization of the LNA-ON was clearly observed. Importantly, without using any delivery agent, we demonstrated that HER3 mRNA and protein could be efficiently down-modulated in cells and a tumor xenograft model. These data provide a simple and efficient approach to identify potential drug targets and animal models. Further elucidation of the mechanism of cellular uptake and trafficking of LNA-ONs may enhance not only the therapeutic values of this platform but also antisense molecules in general.


Assuntos
Regulação da Expressão Gênica , Neoplasias/genética , Oligonucleotídeos Antissenso/farmacologia , Animais , Linhagem Celular Tumoral , Inativação Gênica , Marcação de Genes , Humanos , Receptor ErbB-3/genética , Transfecção
9.
Sci Total Environ ; 777: 146218, 2021 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-33689893

RESUMO

Environmental models aim to reproduce landscape processes with mathematical equations. Observations are used for validation. The performance and uncertainties are quantified either by single or multi-criteria model assessment. In a case-study, we combine both approaches. We use a coupled hydro-biogeochemistry landscape-scale model to simulate 14 target values on discharge, stream nitrate as well as soil moisture, soil temperature and trace gas emissions (N2O, CO2) from different land uses. We reveal typical mistakes that happen during both, single and multi-criteria model assessment. Such as overestimated uncertainty in multi-criteria and ignored wrong model processes in single-criterion calibration. These mistakes can mislead the development of water quality and in general all environmental models. Only the combination of both approaches reveals the five types of posterior probability distributions for model parameters. Each type allocates a specific type of error. We identify and locate mismatched parameter values, obsolete parameters, flawed model structures and wrong process representations. The presented method can guide model users and developers to the so far hidden errors in their models. We emphasize to include observations from physical, chemical, biological and ecological processes in the model assessment, rather than the typical discipline specific assessments.

10.
Science ; 371(6528)2021 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-33303683

RESUMO

Treatments are lacking for sarcopenia, a debilitating age-related skeletal muscle wasting syndrome. We identifed increased amounts of 15-hydroxyprostaglandin dehydrogenase (15-PGDH), the prostaglandin E2 (PGE2)-degrading enzyme, as a hallmark of aged tissues, including skeletal muscle. The consequent reduction in PGE2 signaling contributed to muscle atrophy in aged mice and results from 15-PGDH-expressing myofibers and interstitial cells, such as macrophages, within muscle. Overexpression of 15-PGDH in young muscles induced atrophy. Inhibition of 15-PGDH, by targeted genetic depletion or a small-molecule inhibitor, increased aged muscle mass, strength, and exercise performance. These benefits arise from a physiological increase in PGE2 concentrations, which augmented mitochondrial function and autophagy and decreased transforming growth factor-ß signaling and activity of ubiquitin-proteasome pathways. Thus, PGE2 signaling ameliorates muscle atrophy and rejuvenates muscle function, and 15-PGDH may be a suitable therapeutic target for countering sarcopenia.


Assuntos
Envelhecimento/metabolismo , Dinoprostona/metabolismo , Hidroxiprostaglandina Desidrogenases/fisiologia , Músculo Esquelético/patologia , Rejuvenescimento , Sarcopenia/enzimologia , Animais , Morte Celular Autofágica/genética , Morte Celular Autofágica/fisiologia , Hidroxiprostaglandina Desidrogenases/antagonistas & inibidores , Hidroxiprostaglandina Desidrogenases/genética , Macrófagos/enzimologia , Camundongos , Camundongos Endogâmicos C57BL , Mitocôndrias Musculares/ultraestrutura , Força Muscular/genética , Força Muscular/fisiologia , Músculo Esquelético/enzimologia , Miofibrilas/enzimologia , Sarcopenia/genética
11.
J Synchrotron Radiat ; 17(2): 257-62, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20157280

RESUMO

A synchrotron study is presented in which the concept of one-dimensional tomographic reconstruction of small-angle X-ray scattering patterns is applied to investigate polyamide 6 monofilaments, dip-coated with alumina particles. The filaments are scanned with a focused synchrotron beam and the resulting scattering patterns are recorded with a PILATUS 2M detector. The reconstructed sequence of SAXS images reflects the local nanostructure variation along the filament radius. In particular, the influence of coating process parameters on the polyamide 6 is investigated.

12.
J Exp Biol ; 213(2): 262-70, 2010 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-20038660

RESUMO

Although landing is a crucial part of insect flight, it has attracted relatively little study. Here, we investigate, for the first time, the final moments of a honeybee's (Apis mellifera) landing manoeuvre. Using high-speed video recordings, we analyse the behaviour of bees as they approach and land on surfaces of various orientations. The bees enter a stable hover phase, immediately prior to touchdown. We have quantified behaviour during this hover phase and examined whether it changes as the tilt of the landing surface is varied from horizontal (floor), through sloped (uphill) and vertical (wall), to inverted (ceiling). The bees hover at a remarkably constant distance from the surface, irrespective of its tilt. Body inclination increases progressively as the tilt of the surface is increased, and is accompanied by an elevation of the antennae. The tight correlation between the tilt of the surface, and the orientation of the body and the antennae, indicates that the bee's visual system is capable of inferring the tilt of the surface, and pointing the antennae toward it. Touchdown is initiated by extending the appendage closest to the surface, namely, the hind legs when landing on horizontal or sloping surfaces, and the front legs or antennae when landing on vertical surfaces. Touchdown on inverted surfaces is most likely triggered by a mechanosensory signal from the antennae. Evidently, bees use a landing strategy that is flexibly tailored to the varying topography of the terrain.


Assuntos
Abelhas/fisiologia , Voo Animal/fisiologia , Atividade Motora/fisiologia , Animais , Desempenho Psicomotor
13.
Nervenarzt ; 81(10): 1218-25, 2010 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-20401600

RESUMO

Symptomatic treatment of amyotrophic lateral sclerosis (ALS) is relevant in preventing complications and improving quality of life as long as curative therapies are still out of sight. About one third of ALS patients show disabling problems associated with dysarthria, dysphagia, sialorrhea, and a pseudobulbar affective disorder already in the early stages of ALS. A multidisciplinary approach is the cornerstone of symptomatic treatment of bulbar and pseudobulbar ALS features. Except for riluzole randomized controlled trials are lacking. Here, we review the current views with regard to epidemiology, pathophysiology, diagnosis, and practical aspects of treating bulbar and pseudobulbar symptoms.


Assuntos
Esclerose Lateral Amiotrófica/terapia , Transtornos de Deglutição/terapia , Disartria/terapia , Cuidados Paliativos/métodos , Equipe de Assistência ao Paciente , Paralisia Pseudobulbar/terapia , Sialorreia/terapia , Sintomas Afetivos/diagnóstico , Sintomas Afetivos/fisiopatologia , Sintomas Afetivos/terapia , Esclerose Lateral Amiotrófica/diagnóstico , Esclerose Lateral Amiotrófica/fisiopatologia , Esclerose Lateral Amiotrófica/psicologia , Antidepressivos/uso terapêutico , Terapia Combinada , Auxiliares de Comunicação para Pessoas com Deficiência , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/fisiopatologia , Disartria/diagnóstico , Disartria/fisiopatologia , Antagonistas de Aminoácidos Excitatórios/uso terapêutico , Humanos , Paralisia Pseudobulbar/diagnóstico , Paralisia Pseudobulbar/fisiopatologia , Qualidade de Vida/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Riluzol/uso terapêutico , Sialorreia/diagnóstico , Sialorreia/fisiopatologia
14.
J Synchrotron Radiat ; 16(Pt 3): 368-75, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19395800

RESUMO

PILATUS is a silicon hybrid pixel detector system, operating in single-photon-counting mode, that has been developed at the Paul Scherrer Institut for the needs of macromolecular crystallography at the Swiss Light Source (SLS). A calibrated PILATUS module has been characterized with monochromatic synchrotron radiation. The influence of charge sharing on the count rate and the overall energy resolution of the detector were investigated. The dead-time of the system was determined using the attenuated direct synchrotron beam. A single module detector was also tested in surface diffraction experiments at the SLS, whereby its performance regarding fluorescence suppression and saturation tolerance were evaluated, and have shown to greatly improve the sensitivity, reliability and speed of surface diffraction data acquisition.


Assuntos
Fotometria/instrumentação , Radiometria/instrumentação , Transdutores , Difração de Raios X/instrumentação , Desenho Assistido por Computador , Desenho de Equipamento , Análise de Falha de Equipamento , Fotometria/métodos , Fótons , Doses de Radiação , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
15.
J Synchrotron Radiat ; 16(Pt 4): 489-93, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19535862

RESUMO

A synchrotron beam has been used to investigate the radiation tolerance of a PILATUS II module. It has been demonstrated that radiation-induced threshold shifts become significant above 30 Mrad. Individual adjustment of pixel thresholds after irradiation enabled retention of standard behaviour in excess of 40 Mrad. This implies that a module can be continuously irradiated for in excess of 40 days at an individual pixel count rate of 10(6) counts s(-1).

16.
Nat Mater ; 7(2): 134-7, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18204454

RESUMO

Imaging with visible light today uses numerous contrast mechanisms, including bright- and dark-field contrast, phase-contrast schemes and confocal and fluorescence-based methods. X-ray imaging, on the other hand, has only recently seen the development of an analogous variety of contrast modalities. Although X-ray phase-contrast imaging could successfully be implemented at a relatively early stage with several techniques, dark-field imaging, or more generally scattering-based imaging, with hard X-rays and good signal-to-noise ratio, in practice still remains a challenging task even at highly brilliant synchrotron sources. In this letter, we report a new approach on the basis of a grating interferometer that can efficiently yield dark-field scatter images of high quality, even with conventional X-ray tube sources. Because the image contrast is formed through the mechanism of small-angle scattering, it provides complementary and otherwise inaccessible structural information about the specimen at the micrometre and submicrometre length scale. Our approach is fully compatible with conventional transmission radiography and a recently developed hard-X-ray phase-contrast imaging scheme. Applications to X-ray medical imaging, industrial non-destructive testing and security screening are discussed.

17.
J Fish Biol ; 74(1): 77-89, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20735525

RESUMO

Muscle morphology was investigated in newly hatched barramundi Lates calcarifer larvae incubated at set temperatures (26, 29 and 31 degrees C) prior to hatching. Three days after hatching (the start of exogenous feeding), larvae from the 26 and 31 degrees C treatments were each divided into two groups and reared at that temperature or transferred over the period of several hours to 29 degrees C (control temperature). Incubation temperature significantly affected muscle cellularity in the developing embryo, with larvae incubated at 26 degrees C (mean +/-s.e. 223.3 +/- 7.9) having on average 14.4% more inner muscle fibres than those incubated at 31 degrees C (195.2 +/- 8.8) and 4.8% more than those incubated at 29 degrees C (213.5 +/- 4.7). Conversely, inner muscle fibre cross-sectional area significantly increased at the warm incubation temperature in L. calcarifer, so that the total cross-sectional muscle area was not different between treatment groups. The total cross-sectional area of superficial muscle fibres and the proportion of superficial to total fibre cross-sectional area in just hatched L. calcarifer were also affected by incubation temperature, with incubation at the cool temperature (26 degrees C) increasing both the total cross-sectional area and proportion of superficial muscle fibres. By 9 days post-hatch, the aforementioned differences were no longer significant. Similarly, there was no difference in total superficial fibre cross-sectional area between any treatment groups of L. calcarifer, whereas incubation temperature still significantly affected the proportion of superficial to total muscle fibre cross-sectional area. Larvae hatched and grown at 31 degrees C had a significantly reduced percentage of superficial muscle cross-sectional area (mean +/-s.e. 5.11 +/- 0.66%) compared with those incubated and grown at 29 degrees C (8.04 +/- 0.77%) and 26 degrees C (9.32 +/- 0.56%) and those incubated at 26 degrees C and transferred to 29 degrees C (7.52 +/- 0.53%), and incubated at 31 degrees C and transferred to 29 degrees C (6.28 +/- 0.69%). These results indicate that changes in muscle cellularity induced by raising or lowering the incubation temperature of L. calcarifer display varying degrees of persistence over developmental time. The significance of these findings to the culture of L. calcarifer is discussed.


Assuntos
Desenvolvimento Muscular , Músculos/fisiologia , Perciformes/crescimento & desenvolvimento , Animais , Tamanho Corporal , Larva/crescimento & desenvolvimento , Larva/fisiologia , Perciformes/fisiologia , Temperatura
18.
Br J Health Psychol ; 13(Pt 2): 291-310, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-17535498

RESUMO

OBJECTIVES: The present study examined the ability of the TPB to predict the intention to quit smoking and quitting behaviour. In addition, the predictive power of future orientation, number of cigarettes smoked, planning, past behaviour and the interactions between intention and other predictors was examined. MATERIAL AND METHODS: The data were derived from a longitudinal survey among 103 daily smoking students at the University of Oslo (mean age 24.6 years, mean number of years of smoking = 8 years). These data were collected by means of self-administered questionnaires at T1 (October 2003) and at T2 (February 2004) in terms of recording actual quitting. RESULTS: The TPB components accounted for 30% of the variance in quitting intentions, and affective attitude and descriptive norm emerged as the strongest predictors of quitting intention. Ordinal regression analysis showed that intention was a borderline significant predictor of subsequent quitting behaviour, while the impact of PBC was non-significant (model 1). The inclusion of the additional variables improved the fit of the model, with number of cigarettes and planning appearing as significant predictors of behaviour (model 2). As predicted, there was a significant interaction between perceived control and intentions on quitting (model 3). Nagelkerke R(2) increased from .07 in model 1 to .54 in model 2, and finally to .58 in model 3. CONCLUSIONS: The results indicate that affective attitude and descriptive norm play a more crucial role than the other TPB predictors in motivating smokers to quit. The results also indicate that self-regulatory strategies are important in relation to addictive behaviours.


Assuntos
Planejamento em Saúde , Intenção , Teoria Psicológica , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/estatística & dados numéricos , Prevenção do Hábito de Fumar , Fumar/epidemiologia , Adulto , Feminino , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Inquéritos e Questionários
19.
Appl Radiat Isot ; 66(4): 474-8, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18035547

RESUMO

We report on the application of the PILATUS 100K pixel detector for medical imaging. Experimental results are presented in the form of X-ray radiographs using standard X-ray absorption contrast and a recently developed phase contrast imaging method. The results obtained with the PILATUS detector are compared to results obtained with a conventional X-ray imaging system consisting of an X-ray scintillation screen, lens optics, and a charge coupled device. Finally, the results for both systems are discussed more quantitatively based on an image power spectrum analysis.


Assuntos
Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Radiografia/métodos , Animais , Galinhas , Humanos , Interpretação de Imagem Radiográfica Assistida por Computador/instrumentação , Radiografia/instrumentação , Asas de Animais/diagnóstico por imagem
20.
J Thromb Haemost ; 16(3): 500-507, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29285876

RESUMO

Essentials Risk-stratification often fails to predict clinical deterioration in pulmonary embolism (PE). First-ever high-throughput metabolomics analysis of risk-stratified PE patients. Changes in circulating metabolites reflect a compromised energy metabolism in PE. Metabolites play a key role in the pathophysiology and risk stratification of PE. SUMMARY: Background Patients with acute pulmonary embolism (PE) exhibit wide variation in clinical presentation and outcomes. Our understanding of the pathophysiologic mechanisms differentiating low-risk and high-risk PE is limited, so current risk-stratification efforts often fail to predict clinical deterioration and are insufficient to guide management. Objectives To improve our understanding of the physiology differentiating low-risk from high-risk PE, we conducted the first-ever high-throughput metabolomics analysis (843 named metabolites) comparing PE patients across risk strata within a nested case-control study. Patients/methods We enrolled 92 patients diagnosed with acute PE and collected plasma within 24 h of PE diagnosis. We used linear regression and pathway analysis to identify metabolites and pathways associated with PE risk-strata. Results When we compared 46 low-risk with 46 intermediate/high-risk PEs, 50 metabolites were significantly different after multiple testing correction. These metabolites were enriched in the following pathways: tricarboxylic acid (TCA) cycle, fatty acid metabolism (acyl carnitine) and purine metabolism, (hypo)xanthine/inosine containing. Additionally, energy, nucleotide and amino acid pathways were downregulated in intermediate/high-risk PE patients. When we compared 28 intermediate-risk with 18 high-risk PE patients, 41 metabolites differed at a nominal P-value level. These metabolites were enriched in fatty acid metabolism (acyl cholines), and hemoglobin and porphyrin metabolism. Conclusion Our results suggest that high-throughput metabolomics can provide insight into the pathophysiology of PE. Specifically, changes in circulating metabolites reflect compromised energy metabolism in intermediate/high-risk PE patients. These findings demonstrate the important role metabolites play in the pathophysiology of PE and highlight metabolomics as a potential tool for risk stratification of PE.


Assuntos
Metaboloma , Embolia Pulmonar/sangue , Embolia Pulmonar/terapia , Resultado do Tratamento , Adolescente , Adulto , Idoso , Carnitina/análogos & derivados , Carnitina/metabolismo , Estudos de Casos e Controles , Ácidos Graxos/metabolismo , Feminino , Hemoglobinas/metabolismo , Humanos , Hipoxantina/metabolismo , Inosina/metabolismo , Masculino , Pessoa de Meia-Idade , Porfirinas/metabolismo , Estudos Prospectivos , Purinas/metabolismo , Medição de Risco , Ácidos Tricarboxílicos/metabolismo , Adulto Jovem
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