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1.
Lancet ; 403(10425): 493-502, 2024 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-38244561

RESUMO

The COVID-19 pandemic profoundly affected all mass gatherings for sporting and religious events, causing cancellation, postponement, or downsizing. On March 24, 2020, the Japanese Government, the Tokyo Organising Committee of the Olympic and Paralympic Games, and the International Olympic Committee decided to postpone the Tokyo 2020 Olympic and Paralympic Games until the summer of 2021. With the emergence of SARS-CoV-2, the potential creation of a superspreading event that would overwhelm the Tokyo health system was perceived as a risk. Even with a delayed start date, an extensive scale of resources, planning, risk assessment, communication, and SARS-CoV-2 testing were required for the Games to be held during the COVID-19 pandemic. The effectiveness of various mitigation and control measures, including the availability of vaccines and the expansion of effective testing options, allowed event organisers and the Japanese Government to successfully host the rescheduled 2020 Tokyo Olympic Games from July 23 to Aug 8, 2021 with robust safety plans in place. In February and March, 2022, Beijing hosted the 2022 Winter Olympic Games as scheduled, built on the lessons learnt from the Tokyo Games, and developed specific COVID-19 countermeasure plans in the context of China's national framework for the plan called Zero COVID. Results from the testing programmes at both the Tokyo and Beijing Games show that the measures put in place were effective at preventing the spread of COVID-19 within the Games, and ensured that neither event became a COVID-19-spreading event. The extensive experience from the Tokyo and Beijing Olympic Games highlights that it is possible to organise mass gatherings during a pandemic, provided that appropriate risk assessment, risk mitigation, and risk communication arrangements are in place, leaving legacies for future mass gatherings, public health, epidemic preparedness, and wider pandemic response.


Assuntos
COVID-19 , Pandemias , Humanos , Pandemias/prevenção & controle , Pequim , Tóquio/epidemiologia , Teste para COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , SARS-CoV-2
2.
Am J Physiol Renal Physiol ; 327(3): F435-F449, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-38779754

RESUMO

We have previously observed that prolonged administration of rapamycin, an inhibitor targeting the mammalian target of rapamycin complex (mTORC)1, partially reduced hypertension and alleviated kidney inflammation in Dahl salt-sensitive (SS) rats. In contrast, treatment with PP242, an inhibitor affecting both mTORC1/mTORC2, not only completely prevented hypertension but also provided substantial protection against kidney injury. Notably, PP242 exhibited potent natriuretic effects that were not evident with rapamycin. The primary objective of this study was to pinpoint the specific tubular sites responsible for the natriuretic effect of PP242 in SS rats subjected to either 0.4% NaCl (normal salt) or 4.0% NaCl (high salt) diet. Acute effects of PP242 on natriuretic, diuretic, and kaliuretic responses were determined in unanesthetized SS rats utilizing benzamil, furosemide, or hydrochlorothiazide [inhibitors of epithelial Na+ channel (ENaC), Na-K-2Cl cotransporter (NKCC2), or Na-Cl cotransporter (NCC), respectively] either administered alone or in combination. The findings indicate that the natriuretic effects of PP242 in SS rats stem predominantly from the inhibition of NCC and a reduction of ENaC open probability. Molecular analysis revealed that mTORC2 regulates NCC activity through protein phosphorylation and ENaC activity through proteolytic cleavage in vivo. Evidence also indicated that PP242 also prevents the loss of K+ associated with the inhibition of NCC. These findings suggest that PP242 may represent an improved therapeutic approach for antihypertensive intervention, potentially controlling blood pressure and mitigating kidney injury in salt-sensitive human subjects.NEW & NOTEWORTHY This study explored mechanisms underlying the natriuretic effects of mammalian target of rapamycin protein complex 2 inhibition using PP242 and revealed both epithelial Na+ channel and Na-Cl cotransporter in the distal tubular segments were potentially inhibited. These observations, with prior lab evidence, indicate that PP242 prevents hypertension via its potent inhibitory effects on these specific sodium transporters and by reducing renal immune responses. This dual action, coupled with potassium sparing effects, suggests an improved approach for managing hypertension and associated kidney damage.


Assuntos
Canais Epiteliais de Sódio , Alvo Mecanístico do Complexo 2 de Rapamicina , Natriurese , Ratos Endogâmicos Dahl , Cloreto de Sódio na Dieta , Membro 3 da Família 12 de Carreador de Soluto , Animais , Canais Epiteliais de Sódio/metabolismo , Natriurese/efeitos dos fármacos , Alvo Mecanístico do Complexo 2 de Rapamicina/metabolismo , Masculino , Membro 3 da Família 12 de Carreador de Soluto/metabolismo , Hipertensão/metabolismo , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Rim/efeitos dos fármacos , Rim/metabolismo , Modelos Animais de Doenças , Ratos , Amilorida/farmacologia , Amilorida/análogos & derivados , Pressão Sanguínea/efeitos dos fármacos , Fosforilação , Transdução de Sinais/efeitos dos fármacos , Indóis , Purinas
3.
Am J Physiol Renal Physiol ; 322(5): F473-F485, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-35224992

RESUMO

Although the molecular and functional responses related to renal compensatory hypertrophy after unilateral nephrectomy (UNX) has been well described, many aspects of these events remain unclear. One question is how the remaining kidney senses the absence of the contralateral organ, and another is what the role of the renin-angiotensin system is in these responses. Both acute anesthetized and chronic unanesthetized experiments were performed using the angiotensin II type 1 receptor blocker losartan and the renin inhibitor aliskiren to determine the contribution of the renin-angiotensin system to immediate changes and losartan for chronic changes of renal blood flow (RBF) and the associated hypertrophic events in male Sprague-Dawley rats. Chronic experiments used implanted RBF probes and arterial catheters for continuous data collection, and the glomerular filtration rate was determined by noninvasive transcutaneous FITC-sinistrin measurements. The results of the acute experiments found that RBF increased nearly 25% (4.6 ± 0.5 to 5.6 ± 0.6 mL/min/g kidney wt) during the first 15 min following UNX and that this response was abolished by losartan (6.7 ± 0.7 to 7.0 ± 0.7 mL/min/g kidney wt) or aliskiren (5.8 ± 0.4 to 6.0 ± 0.4 mL/min/g kidney wt) treatment. Thereafter, RBF increased progressively over 7 days, and kidney weight increased by 19% of pre-UNX values. When normalized to kidney weight determined at day 7 after UNX, RBF was not significantly different from pre-UNX levels. Semiquantification of CD31-positive capillaries revealed increases of the glomeruli and peritubular capillaries that paralleled the kidney hypertrophy. None of these chronic changes was inhibited by losartan treatment, indicating that neither the compensatory structural nor the RBF changes were angiotensin II type 1 receptor dependent.NEW & NOTEWORTHY This study found that the immediate increases of renal blood flow (RBF) following unilateral nephrectomy (UNX) are a consequence of reduced angiotensin II type 1 (AT1) receptor stimulation. The continuous monitoring of RBF and intermittent measurement of glomerular filtration rate (GFR) in conscious rats during the 1-wk period of rapid hypertrophy following UNX provided unique insights into the regulation of RBF and GFR when faced with increased metabolic loads. It was found that neither kidney hypertrophy nor the associated increase of capillaries was an AT1-dependent phenomenon.


Assuntos
Angiotensina II , Nefrectomia , Angiotensina II/farmacologia , Animais , Rim , Losartan/farmacologia , Masculino , Ratos , Ratos Sprague-Dawley , Circulação Renal , Sistema Renina-Angiotensina
4.
J Phycol ; 58(2): 318-329, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35000198

RESUMO

Analyses of phylogeographic patterns and genetic diversity provide fundamental information for the management and conservation of species. However, little is published about these patterns in Japanese kelp species. In this study, we conducted phylogeographic analyses of a canopy-forming kelp, Eisenia bicyclis, based on genome-wide SNPs identified by ddRAD-seq. We obtained 1,299 SNPs for 76 samples from nine localities across the distribution. STRUCTURE, NeighborNet, and discriminant analysis of principal components consistently showed high genetic differentiation among the Eastern Pacific, Central Pacific, and Sea of Japan coastal regions. Relatively strong gene flow was detected only within populations in the Eastern Pacific and in the Sea of Japan. Genetic diversity and genetic uniqueness were high in the Central Pacific and low in the Sea of Japan. These results suggest that there were at least three independent refugia corresponding to the three regions during the Last Glacial Maximum (LGM). Furthermore, relatively larger populations in the Central Pacific and smaller populations in the Sea of Japan have been maintained in the demographic history from before the LGM to the present. These phylogeographic histories were supported by an Approximate Bayesian Computation analysis. From a conservation genetics perspective, the loss of southern populations in the Central Pacific would greatly reduce the total genetic diversity of the species. Southern populations in the Sea of Japan, which have relatively low genetic diversity, may be highly vulnerable to environmental change, such as heat waves and increased feeding. Therefore, careful monitoring and conservation are needed in the two regions.


Assuntos
Kelp , Phaeophyceae , Teorema de Bayes , Variação Genética , Haplótipos , Kelp/genética , Filogenia , Filogeografia
5.
BMC Infect Dis ; 20(1): 281, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32295538

RESUMO

BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that commonly has a lethal course caused by the tick-borne Huaiyangshan banyang virus [former SFTS virus (SFTSV)]. The viral load in various body fluids in SFTS patients and the best infection control measure for SFTS patients have not been fully established. CASE PRESENTATION: A 79-year-old man was bitten by a tick while working in the bamboo grove in Nagasaki Prefecture in the southwest part of Japan. Due to the occurrence of impaired consciousness, he was referred to Nagasaki University Hospital for treatment. The serum sample tested positive for SFTSV-RNA in the genome amplification assay, and he was diagnosed with SFTS. Furthermore, SFTSV-RNA was detected from the tick that had bitten the patient. He was treated with multimodal therapy, including platelet transfusion, antimicrobials, antifungals, steroids, and continuous hemodiafiltration. His respiration was assisted with mechanical ventilation. On day 5, taking the day on which he was hospitalized as day 0, serum SFTSV-RNA levels reached a peak and then decreased. However, the cerebrospinal fluid collected on day 13 was positive for SFTSV-RNA. In addition, although serum SFTSV-RNA levels decreased below the detectable level on day 16, he was diagnosed with pneumonia with computed tomography. SFTSV-RNA was detected in the bronchoalveolar lavage fluid on day 21. By day 31, he recovered consciousness completely. The pneumonia improved by day 51, but SFTSV-RNA in the sputum remained positive for approximately 4 months after disease onset. Strict countermeasures against droplet/contact infection were continuously conducted. CONCLUSIONS: Even when SFTSV genome levels become undetectable in the serum of SFTS patients in the convalescent phase, the virus genome remains in body fluids and tissues. It may be possible that body fluids such as respiratory excretions become a source of infection to others; thus, careful infection control management is needed.


Assuntos
Líquidos Corporais/virologia , Encefalopatias/virologia , Infecções por Bunyaviridae/epidemiologia , Hemorragia Gastrointestinal/virologia , Phlebovirus/genética , Pneumonia/virologia , RNA Viral/sangue , Idoso , Animais , Encefalopatias/tratamento farmacológico , Líquido da Lavagem Broncoalveolar/virologia , Infecções por Bunyaviridae/tratamento farmacológico , Infecções por Bunyaviridae/virologia , Terapia Combinada , Hemorragia Gastrointestinal/tratamento farmacológico , Hospitais Universitários , Humanos , Japão/epidemiologia , Masculino , Técnicas de Amplificação de Ácido Nucleico , Phlebovirus/isolamento & purificação , Pneumonia/tratamento farmacológico , Escarro/virologia , Carrapatos/virologia , Resultado do Tratamento , Carga Viral
6.
Mol Phylogenet Evol ; 130: 397-405, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30227214

RESUMO

The Bryopsidales is a morphologically diverse group of mainly marine green macroalgae characterized by a siphonous structure. The order is composed of three suborders - Ostreobineae, Bryopsidineae, and Halimedineae. While previous studies improved the higher-level classification of the order, the taxonomic placement of some genera in Bryopsidineae (Pseudobryopsis and Lambia) as well as the relationships between the families of Halimedineae remains uncertain. In this study, we re-assess the phylogeny of the order with datasets derived from chloroplast genomes, drastically increasing the taxon sampling by sequencing 32 new chloroplast genomes. The phylogenies presented here provided good support for the major lineages (suborders and most families) in Bryopsidales. In Bryopsidineae, Pseudobryopsis hainanensis was inferred as a distinct lineage from the three established families allowing us to establish the family Pseudobryopsidaceae. The Antarctic species Lambia antarctica was shown to be an early-branching lineage in the family Bryopsidaceae. In Halimedineae, we revealed several inconsistent phylogenetic positions of macroscopic taxa, and several entirely new lineages of microscopic species. A new classification scheme is proposed, which includes the merger of the families Pseudocodiaceae, Rhipiliaceae and Udoteaceae into a more broadly circumscribed Halimedaceae, and the establishment of tribes for the different lineages found therein. In addition, the deep-water genus Johnson-sea-linkia, currently placed in Rhipiliopsis, was reinstated based on our phylogeny.


Assuntos
Clorófitas/classificação , Clorófitas/genética , Cloroplastos/genética , Genoma de Cloroplastos , Filogenia , Regiões Antárticas , DNA Ribossômico/genética , Funções Verossimilhança
7.
J Infect Chemother ; 25(6): 480-484, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30824300

RESUMO

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease caused by a novel bunyavirus. The mechanism underlying disease progression remains unknown, and effective treatment strategy for SFTS is yet to be completely established, making its increasing incidence and subsequent mortality a great concern. Here, we present the autopsy case of a patient with rapidly progressed, fatal SFTS infection. Her viral titer and serum cytokines levels were measured daily and compared with the values of a survivor of the infection. Our findings elucidate the clinical features and pathophysiology of SFTS.


Assuntos
Infecções por Bunyaviridae/diagnóstico , Citocinas/sangue , Phlebovirus/isolamento & purificação , Doenças Transmitidas por Carrapatos/diagnóstico , Carga Viral , Idoso , Infecções por Bunyaviridae/sangue , Infecções por Bunyaviridae/imunologia , Cadáver , Citocinas/imunologia , Evolução Fatal , Feminino , Humanos , Phlebovirus/imunologia , Prognóstico , Doenças Transmitidas por Carrapatos/sangue , Doenças Transmitidas por Carrapatos/imunologia
10.
Adv Perit Dial ; 32: 46-50, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28988589

RESUMO

Neutral icodextrin peritoneal dialysis (PD) fluid (n-ICO) has become available for use in Japan. However, removal of water and solutes remains to be elucidated in detail. The present study was designed to determine removal of water, electrolytes, and small, middle, and large molecules in a period of 16 hours. In addition, biocompatibility with respect to peritoneal mesothelial cells was determined.Three stable patients undergoing PD at Tohoku University Hospital were administered n-ICO. Water removal was monitored every 2 hours. Sodium, urea nitrogen [molecular weight (MW): 28 Da], uric acid (MW: 168 Da), ß2-microglobulin [ß2M (MW: 11,800 Da)], α1-microglobulin [α1M (MW: 33,000 Da)], albumin (MW: 66,000 Da), and immunoglobulin G (MW: 160,000 Da) were measured in plasma and dialysate.Primary human peritoneal mesothelial cells were collected from 6 patients. Equal numbers of cells were seeded into 96-well culture plates and cultured for 12 hours. Culture medium was then replaced with dialysate, and 24-hour cell proliferation was determined by WST-1 assay.Water removal was sustained for 16 hours with n-ICO. The Na concentration in effluent did not change over that time. Small molecules such as urea nitrogen and uric acid were rapidly removed. Thus, their dialysate-to-plasma concentration ratio (D/P) approached 1.0 (equilibrium) in 2 - 4 hours. The D/P values for the larger molecules ß2M and α1M were 0.4 and less than 0.1 respectively at 16 hours. However, larger molecules were removed in a time-dependent manner.Cell proliferation with n-ICO PD fluid was not different from that with lactate-buffered glucose PD fluid, but was increased from that with acidic icodextrin PD fluid (a-ICO).Water and solute removal with the new n-ICO is not much different from that with a-ICO. However, biocompatibility as reflected by cell proliferation was superior under n-ICO than under a-ICO and equal to proliferation under glucose PD fluid.


Assuntos
Soluções para Diálise/uso terapêutico , Glucanos/uso terapêutico , Glucose/uso terapêutico , Falência Renal Crônica/terapia , Diálise Peritoneal/métodos , Adulto , alfa-Globulinas/análise , alfa-Globulinas/metabolismo , Nitrogênio da Ureia Sanguínea , Proliferação de Células/efeitos dos fármacos , Soluções para Diálise/química , Soluções para Diálise/farmacologia , Feminino , Glucanos/química , Glucanos/farmacologia , Glucose/química , Glucose/farmacologia , Humanos , Icodextrina , Imunoglobulina G/análise , Imunoglobulina G/sangue , Falência Renal Crônica/sangue , Falência Renal Crônica/metabolismo , Masculino , Pessoa de Meia-Idade , Peritônio/citologia , Peritônio/efeitos dos fármacos , Albumina Sérica/análise , Albumina Sérica/metabolismo , Sódio/análise , Sódio/sangue , Ácido Úrico/análise , Ácido Úrico/sangue
11.
Adv Perit Dial ; 32: 39-45, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28988588

RESUMO

In the present study, we assessed the effect of chronic tolvaptan treatment and compared it with the effect of conventional treatment without tolvaptan. In addition, changes in cardiac load and body fluid composition were compared.The study enrolled 22 patients undergoing peritoneal dialysis who had been receiving tolvaptan for more than 1 year and 10 patients undergoing peritoneal dialysis who had been treated with conventional diuretics. Left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), and E/e' index were measured by echocardiography at baseline and after 12 months of tolvaptan treatment (or an equivalent period). Body composition was analyzed by bioimpedance monitoring (BIM).In the tolvaptan group, LVMI was significantly reduced after 12 months of treatment; in the conventional-treatment group, it was significantly increased. The measured LVEF did not change in the tolvaptan group, but it increased significantly in the conventional-treatment group. The E/e' index was not altered in either group; however, it was reduced in patients receiving tolvaptan whose initial E/e' was greater than 15. Although urine volume was not significantly increased in either group, renal creatinine clearance increased significantly in tolvaptan group; no change was observed in the conventional-treatment group. Renal and peritoneal Kt/V did not significantly change during the study. In both groups, ß2-microglobulin was significantly and similarly increased. Extracellular water (ECW) and intracellular water (ICW) as determined by BIM were both reduced after 12 months of tolvaptan treatment. We observed a significant correlation between the ratio of ECW to total body water at the initiation of tolvaptan and the reduction in ECW after 12 months.Our results indicate that chronic tolvaptan treatment has a beneficial role in body fluid control without a reduction in cardiac and renal function. Volume control depends on an equal reduction in ECW and ICW, which can also have a benefit in avoiding hyponatremia.


Assuntos
Antagonistas dos Receptores de Hormônios Antidiuréticos/uso terapêutico , Benzazepinas/uso terapêutico , Composição Corporal , Diuréticos/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Falência Renal Crônica/terapia , Diálise Peritoneal , Volume Sistólico , Adulto , Idoso , Idoso de 80 Anos ou mais , Líquidos Corporais , Estudos de Casos e Controles , Ecocardiografia , Impedância Elétrica , Feminino , Insuficiência Cardíaca/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tolvaptan
12.
J Nat Prod ; 78(4): 901-8, 2015 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-25768725

RESUMO

Mebamamides A and B, new lipopeptides with four d-amino acid residues and a 3,8-dihydroxy-9-methyldecanoic acid residue, were isolated from the green alga Derbesia marina. Their gross structures were elucidated by spectroscopic and ESI-ITMS analyses. The absolute configurations except for the two leucines were revealed based on chiral-phase HPLC analyses of the acid hydrolysate and a modified Mosher's method. A distinction between D-Leu and L-Leu in the sequence was established by the application of a dansyl-Edman method to the partial acid hydrolysate. Mebamamide A did not exhibit any growth inhibitory activity against HeLa and HL60 cells at 10 µM, and mebamamide B did not exhibit any growth inhibitory activity against those cells at 100 µM. Additionally, it was suggested that mebamamide B induced the differentiation of HL60 cells into macrophage-like cells at 100 µM.


Assuntos
Clorófitas/química , Lipopeptídeos/isolamento & purificação , Peptídeos Cíclicos/isolamento & purificação , Aminoácidos/química , Cromatografia Líquida de Alta Pressão , Ensaios de Seleção de Medicamentos Antitumorais , Células HL-60 , Células HeLa , Humanos , Lipopeptídeos/química , Lipopeptídeos/farmacologia , Macrófagos/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Estrutura Molecular , Ressonância Magnética Nuclear Biomolecular , Peptídeos Cíclicos/química , Peptídeos Cíclicos/farmacologia
13.
Virol J ; 11: 105, 2014 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-24903089

RESUMO

BACKGROUND: The laboratory mouse model is commonly employed to study the pathogenesis of encephalitic flaviviruses such as Japanese encephalitis virus (JEV). However, it is known that some strains of these viruses do not elicit a typical mortality dose response curve from this organism after peripheral infection and the reason for it has not yet been fully understood. It is suggested that induction of more vigorous Type-I IFN (IFN-I) response might control early virus dissemination following increasing infectious challenge doses of the virus. Thus, the objective of this study was to examine this suggested role of IFN-I in the mortality of mice infected with various doses of JEV. METHODS: Inbred 129 mice and their IFNAR KO (A129) mice were subcutaneously inoculated with 100, 102, 104 or 106 pfu of JaOArS982 strain of JEV. Mice were weighed daily and observed for clinical signs. Virus titers in the brains and spleens of JEV-infected mice were determined by plaque forming assays. The upregulated mRNA levels of genes related to IFN-I response of mice were examined by real-time PCR. RESULTS: The mortality rates of 129 mice infected with JaOArS982 did not significantly increase despite the increase in inoculation dose and no significant difference of viral loads was observed between their brains. However, there was clear elevation of the mRNA levels of interferon regulatory factor (IRF)3, IRF7, IRF9, MDA5 and RIG-I at 24 hours post-infection depending on the inoculation dose. In A129 mice, length of survival days and the viral loads of spleen and brain were observed to be inoculation dose-dependent. CONCLUSIONS: From these results, it is suggested that early IFN-I response elicited by high inoculation doses of JEV provides an anti-viral effect during the early phase of infection. Accordingly, virus replication is counteracted by IFN-I response at each increasing inoculation dose resulting in the interference of impending severe disease course or fatal outcome; hence, this might explain the inoculation dose-independent mortality in mice caused by Japanese encephalitis virus.


Assuntos
Vírus da Encefalite Japonesa (Espécie)/imunologia , Encefalite Japonesa/imunologia , Encefalite Japonesa/patologia , Interferon Tipo I/imunologia , Animais , Encéfalo/virologia , Modelos Animais de Doenças , Encefalite Japonesa/mortalidade , Perfilação da Expressão Gênica , Camundongos da Linhagem 129 , Camundongos Knockout , Reação em Cadeia da Polimerase em Tempo Real , Baço/virologia , Análise de Sobrevida , Carga Viral , Ensaio de Placa Viral
14.
Auris Nasus Larynx ; 51(2): 379-390, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38065757

RESUMO

OBJECTIVE: To assess the efficacy, safety, and tissue penetration of solithromycin for the treatment of otorhinolaryngological infections, we conducted three studies: a tissue penetration study with patients scheduled to undergo otorhinolaryngological tissue removal, an open-label study comprising patients with otitis media, pharyngitis, laryngitis, and tonsillitis, and a non-inferiority study compared with high-dose cefcapene-pivoxil (CFPN-PI). METHODS: Tissue penetration study; 17 patients with chronic rhinosinusitis, chronic otitis media, chronic tonsillitis, or palatine tonsillar hypertrophy, who required resection or removal of their tissue, were enrolled. Solithromycin was administered orally, and otorhinolaryngological tissues were collected 3.5-6 h after drug administration; blood was collected within 15 min before and after drug administration. The collected tissues and blood concentrations were measured at a central laboratory. Open-label study; 55 patients who were diagnosed with acute otitis media, laryngopharyngitis, or tonsillitis were enrolled. Solithromycin was administered orally 800 mg on Day 1, while on days 2-7, 400 mg of the drug was administered once daily. The primary endpoint is the clinical response at Test-of-Cure (TOC: 5-10 days after completion) Non-inferiority study; 283 patients with acute rhinosinusitis or acute exacerbation of chronic rhinosinusitis were randomized into either the solithromycin group or CFPN-PI group. Solithromycin was administered 800 mg once daily on Day 1 and 400 mg once daily while on Days 2-7 in solithromycin group, and CFPN-PI was administered 150 mg three times a day while on Days 1-7 in CFPN-PI group. The primary endpoint is the clinical response at TOC. RESULTS: In the tissue penetration study, the tissue concentration ratios (tissue concentration/plasma concentration) of solithromycin were 4.19 in the sinonasal mucosa, 1.33 in the middle ear mucosa, and 6.12 in the palatine tonsil tissue. In the open-label study, the efficacy rates at the TOC were 97.0 % for acute otitis media, 100 % for laryngopharyngitis, and 81.8 % for tonsillitis. In the non-inferiority study comprising patients with rhinosinusitis, the efficacy rate at the TOC was 87.7 % for solithromycin and 89.7 % for CFPN-PI. The difference in the efficacy rate (95 % confidence interval) was -2.0 % (-9.4 % to 5.4 %), verifying the non-inferiority of solithromycin to CFPN-PI. The most common adverse events in patients administered solithromycin were diarrhea (20.7 %), nausea and nasopharyngitis (3.6 %,), pharyngitis and elevated hepatic function test results (3.1 %), and abnormal hepatic function (2.1 %). CONCLUSION: Based on the findings, it is suggested that solithromycin is useful for the treatment of otorhinolaryngological infections.


Assuntos
Laringite , Macrolídeos , Otite Média , Faringite , Tonsilite , Triazóis , Humanos , Antibacterianos/uso terapêutico , Japão , Cefalosporinas/uso terapêutico , Faringite/tratamento farmacológico , Tonsilite/tratamento farmacológico , Otite Média/tratamento farmacológico , Laringite/tratamento farmacológico
15.
PLoS One ; 19(9): e0304747, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39325692

RESUMO

The Tokyo 2020 Olympic and Paralympic Games (Games) were held during the height of the coronavirus disease 2019 (COVID-19) pandemic. To detect people infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) early enough to contain the spread and to facilitate the timely arrival of athletes at their game venues, all participating athletes staying in the Olympic Village (up to 14,000) were screened daily for the infection. Toward this aim, a two-step strategy was adopted comprising screening of self-collected saliva samples using a chemiluminescence enzyme immunoassay, followed by confirmatory testing using polymerase chain reaction. The testing system was integrated with an information management system covering all steps. To ensure the accuracy of the test results, rigorous quality assurance measures and monitoring of performance/specimen quality were implemented. A chronological chart analysis was implemented to monitor the holistic process and to give feedback to improve the sampling. Nearly all test results for 418,506 saliva samples were reported within 12 hours of sample collection, achieving the target mean turnaround time of 150 minutes for confirmatory testing. As a result, athlete activity and performance for the Games were ensured. The chronological chart confirmed that no athletes were withdrawn due to a false-positive result, and no infection clusters were identified among the athletes in the Olympic Village. In conclusion, continuous quality improvement as part of the two-step strategy for mass screening for COVID-19 contributed to the success of the Games during the pandemic. The quality practice, systems, and workflows described here may offer a model for future mass-gathering sporting events during similar major infectious disease epidemics.


Assuntos
COVID-19 , Programas de Rastreamento , Melhoria de Qualidade , SARS-CoV-2 , Saliva , Humanos , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Tóquio/epidemiologia , SARS-CoV-2/isolamento & purificação , Saliva/virologia , Programas de Rastreamento/métodos , Esportes , Atletas , Pandemias , Teste para COVID-19/métodos
16.
Hypertension ; 2024 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-39344517

RESUMO

Studies have found that blood flow to the renal medulla is an important determinant of pressure-natriuresis and the long-term regulation of arterial pressure. First, a brief review of methods developed enabling the study of the medullary circulation is presented. Second, studies performed in rats are presented showing medullary blood flow plays a vital role in the pressure-natriuresis relationship and thereby in hypertension. Third, it is shown that chronic reduction of medullary blood flow results in hypertension and that enhancement of medullary blood flow reduces hypertension hereditary models of both salt-sensitive rats and salt-resistant forms of hypertension. The key role that medullary nitric oxide production plays in protecting this region from ischemic injury associated with circulating vasoconstrictor agents and reactive oxygen species is presented. The studies cited are largely the work of my students, research fellows, and colleagues with whom I have performed these studies dating from the late 1980s to more recent years.

17.
Br J Ophthalmol ; 107(7): 946-952, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35232725

RESUMO

AIMS: To compare the visual field (VF) test results measured with the Swedish Interactive Threshold Algorithm Fast (SITA-Fast) and newly developed variational Bayes linear regression visual field (VBLR-VF) Fast or VBLR-VF Fast+. METHOD: Of 65 patients with glaucoma, 31 eyes of 31 patients performed VBLR-VF Fast and SITA-Fast, and 34 eyes of 34 patients performed VBLR-VF Fast+ and SITA-Fast on the same day and iterated the same procedures within 6 months using the 24-2 test grid in the current prospective study. Global index (mean deviation and pattern SD), pointwise retinal sensitivity, test duration and reliability index (fixation loss, false positive and false negative) were compared between SITA-Fast and VBLR-VF Fast or VBLR-VF Fast+. RESULTS: Global indices were not significantly different between SITA-Fast and VBLR-VF Fast or VBLR-VF Fast+. There was no significant difference in the pointwise retinal sensitivity between the SITA-Fast and VBLR-VF Fast algorithms at the first visit, while the VBLR-VF Fast algorithm was approximately 1 dB higher compared to the SITA-Fast algorithm at the second visit. Test duration was reduced by approximately 30 s (10%) with VBLR-VF Fast and by approximately 80 s (30%) with VBLR-VF Fast+ compared with to SITA-Fast (p<0.05). Most cases showed good reliability index values; however, a marginal but significant difference was observed between the VBLR-VF and SITA-Fast algorithms. CONCLUSION: Both VBLR-VF Fast and VBLR-VF Fast+ considerably reduced the test durations. Although there was a marginal difference in the pointwise retinal sensitivities, global indices were almost interchangeable between the VBLR-VF Fast and SITA-Fast.


Assuntos
Glaucoma , Campos Visuais , Humanos , Estudos Prospectivos , Suécia , Modelos Lineares , Reprodutibilidade dos Testes , Teorema de Bayes , Transtornos da Visão/diagnóstico , Glaucoma/diagnóstico , Testes de Campo Visual/métodos , Algoritmos
18.
Brain Res ; 1799: 148166, 2023 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-36402177

RESUMO

In the remodeling of axonal arbor, the growth and retraction of branches are differentially regulated within a single axon. Although cell-autonomously generated differences in microtubule (MT) turnover are thought to be involved in selective branch regulation, the cellular system whereby neurons generate differences of MTs between axonal branches has not been clarified. Because MT turnover tends to be slower in longer branches compared with neighboring shorter branches, feedback regulation depending on branch length is thought to be involved. In the present study, we generated a model of MT lifetime in axonal terminal branches by adapting a length-dependent model in which parameters for MT dynamics were constant in the arbor. The model predicted that differences in MT lifetime between neighboring branches could be generated depending on the distance from terminals. In addition, the following points were predicted. Firstly, destabilization of MTs throughout the arbor decreased the differences in MT lifetime between branches. Secondly, differences of MT lifetime existed even before MTs entered the branch point. In axonal MTs in primary neurons, treatment with a low concentration of nocodazole significantly decreased the differences of detyrosination (deTyr) and tyrosination (Tyr) of tubulins, indicators of MT turnover. Expansion microscopy of the axonal shaft before the branch point revealed differences in deTyr/Tyr modification on MTs. Our model recapitulates the differences in MT turnover between branches and provides a feedback mechanism for MT regulation that depends on the axonal arbor geometry.


Assuntos
Axônios , Microtúbulos , Células Cultivadas , Axônios/fisiologia , Microtúbulos/fisiologia , Neurônios/fisiologia , Tubulina (Proteína)
19.
bioRxiv ; 2023 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-36711564

RESUMO

In the present study, novel methods were developed which allowed continuous (24/7) measurement of blood pressure (BP) and renal blood flow (RBF) in freely moving rats and the intermittent collection of arterial and renal venous blood to estimate kidney metabolic fluxes of O 2 and metabolites. The study determined the effects of a high salt (HS) diet upon whole kidney O 2 consumption and the metabolomic profiles of normal Sprague Dawley (SD) rats. A separate group of rats was studied to determine changes in the cortex (Cx) and outer medulla (OM) tissue metabolomic and mRNAseq profiles before and following the switch from a 0.4% to a 4.0% NaCl diet. Significant changes in the metabolomic and transcriptomic profiles occurred with feeding of the HS diet. A progressive increase of kidney O 2 consumption was found despite a reduction in expression of most of the mRNA encoding enzymes of TCA cycle. Increased glycolysis was evident with the elevation of mRNA expression encoding key glycolytic enzymes and release of pyruvate and lactate from the kidney in the renal venous blood. Glycolytic production of NADH is used in either the production of lactate or oxidized via the malate aspartate shuttle. Aerobic glycolysis (e.g., Warburg-effect) may account for the needed increase in cellular energy. The study provides evidence that kidney metabolism responds to a HS diet enabling enhanced energy production while protecting from oxidate stress and injury.

20.
Function (Oxf) ; 4(5): zqad031, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37575482

RESUMO

In this study, novel methods were developed, which allowed continuous (24/7) measurement of arterial blood pressure and renal blood flow in freely moving rats and the intermittent collection of arterial and renal venous blood to estimate kidney metabolic fluxes of O2 and metabolites. Specifically, the study determined the effects of a high salt (HS; 4.0% NaCl) diet upon whole kidney O2 consumption and arterial and renal venous plasma metabolomic profiles of normal Sprague-Dawley rats. A separate group of rats was studied to determine changes in the cortex and outer medulla tissue metabolomic and mRNAseq profiles before and following the switch from a 0.4% to 4.0% NaCl diet. In addition, targeted mRNA expression analysis of cortical segments was performed. Significant changes in the metabolomic and transcriptomic profiles occurred with feeding of the HS diet. A progressive increase of kidney O2 consumption was found despite a reduction in expression of most of the mRNA encoding enzymes of TCA cycle. A novel finding was the increased expression of glycolysis-related genes in Cx and isolated proximal tubular segments in response to an HS diet, consistent with increased release of pyruvate and lactate from the kidney to the renal venous blood. Data suggests that aerobic glycolysis (eg, Warburg effect) may contribute to energy production under these circumstances. The study provides evidence that kidney metabolism responds to an HS diet enabling enhanced energy production while protecting from oxidative stress and injury. Metabolomic and transcriptomic analysis of kidneys of Sprague-Dawley rats fed a high salt diet.


Assuntos
Cloreto de Sódio na Dieta , Cloreto de Sódio , Ratos , Animais , Ratos Sprague-Dawley , Cloreto de Sódio na Dieta/metabolismo , Cloreto de Sódio/metabolismo , Pressão Sanguínea , Rim , RNA Mensageiro
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