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OBJECTIVE: To evaluate the presence of multiple genetic diagnoses in syndromic growth disorders. STUDY DESIGN: We carried out a cross-sectional study to evaluate 115 patients with syndromic tall (n = 24) or short stature (n = 91) of unknown cause from a tertiary referral center for growth disorders. Exome sequencing was performed to assess germline single nucleotide, InDel, and copy number variants. All variants were classified according to ACMG/AMP guidelines. The main outcome measured was the frequency of multiple genetic diagnoses in a cohort of children with syndromic growth disorders. RESULTS: The total diagnostic yield of the cohort was 54.8% (63/115). Six patients had multiple genetic diagnoses (tall stature group = 2; short stature group = 4). The proportion of multiple diagnoses within total cases was 5.2% (6/115), and within solved cases was 9.5% (6/63). No characteristics were significantly more frequent when compared with patients with single or multiple genetic findings. Among patients with multiple diagnoses, 3 had syndromes with overlapping clinical features, and the others had syndromes with distinct phenotypes. CONCLUSION: Recognition of multiple genetic diagnoses as a possibility in complex cases of syndromic growth disorders opens a new perspective on treatment and genetic counseling for affected patients, defying the medical common sense of trying to fit all findings into one diagnosis.
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Nanismo , Transtornos do Crescimento , Criança , Feminino , Humanos , Sequenciamento do Exoma , Estudos Transversais , Transtornos do Crescimento/diagnóstico , Transtornos do Crescimento/genética , Nanismo/genética , FenótipoRESUMO
BACKGROUND: POLE mutated endometrial carcinomas may represent a subspecific type of tumors harboring a more favorable prognosis. Grade 3 (G3 or high-grade) endometrioid endometrial carcinomas remain a clinical dilemma, with some tumors behaving as the low-grade counterparts and others presenting a more aggressive behavior. OBJECTIVES: To determine the association between POLE mutational status and the overall-survival (OS) and progression-free-survival (PFS) of patients with G3 endometrioid endometrial cancer (EC). We also aimed to determine the prevalence of POLE mutations in G3 endometrioid EC. METHODS: We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO No: CRD4202340008). We searched the following electronic databases: PubMed/Medline, EMBASE, Cochrane Library, Scopus, and Web of Science. For time-to-event data, the effect of POLE mutation in G3 EC was described using hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Individual patient data for each study was investigated if available from the study authors. If individual patient data were not available, information regarding time-to-event outcomes was extracted using an appropriate methodology. OS and PFS were analyzed using both one-stage and two-stage approaches, the Kaplan-Meier method, and Cox-proportional hazards models. RESULTS: This systematic review and meta-analysis included 19 studies with 3092 patients who had high-grade endometrioid EC. Patients with POLE mutations had lower risks of death (HR = 0.36, 95% CI 0.26 to 0.50, I2 = 0%, 10 trials) and disease progression (HR = 0.31, 95% CI 0.17 to 0.57, I2 = 33%, 10 trials). The pooled prevalence of POLE mutation was 11% (95% CI 9 to 13, I2 = 68%, 18 studies). CONCLUSION: POLE mutations in high-grade endometrioid EC are associated with a more favorable prognosis with increased OS and PFS.
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Carcinoma Endometrioide , DNA Polimerase II , Neoplasias do Endométrio , Mutação , Gradação de Tumores , Proteínas de Ligação a Poli-ADP-Ribose , Humanos , Feminino , Neoplasias do Endométrio/genética , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/mortalidade , Carcinoma Endometrioide/genética , Carcinoma Endometrioide/patologia , DNA Polimerase II/genética , Proteínas de Ligação a Poli-ADP-Ribose/genética , Prognóstico , Intervalo Livre de ProgressãoRESUMO
BACKGROUND: Syndromic obesity (SO) refers to obesity with additional phenotypes, including intellectual disability (ID)/developmental delay (DD), dysmorphic features, or organ-specific abnormalities. SO is rare, has high phenotypic variability, and frequently follows a monogenic pattern of inheritance. However, the genetic etiology of most cases of SO has not been elucidated. SUBJECTS AND METHODS: In this study, we investigated 20 SO patients by whole-exome sequencing (WES) trios to identify causal genetic variants. RESULTS: 4/20 patients had negative results for array comparative genomic hybridization (aCGH) analyses. In the remaining 15 patients, in addition to SNVs and indels, CNVs were also evaluated. Pathogenic/likely pathogenic (P/LP) SNVs/indels were detected in 6/20 patients (involving MED13L, AHDC1, EHMT1, MYT1L, GRIA3, and SETD1A), while two patients carried an inherited VUS. In addition, P/LP CNVs were observed in 3/15 patients (involving SATG2, KIAA0442, and MEIS2). CONCLUSIONS: All nine detected P/LP variants involved genes already known to lead to syndromic ID/DD; however, for only two genes (EHMT1 and MYT1L) is the link with obesity well established. This is the first study applying a comprehensive genomic investigation of an SO cohort, showing a high diagnostic yield (~47%). Additionally, our findings suggested that several known ID/DD genes may also predispose individuals to SO.
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Deficiências do Desenvolvimento , Deficiência Intelectual , Criança , Hibridização Genômica Comparativa , Variações do Número de Cópias de DNA , Proteínas de Ligação a DNA/genética , Deficiências do Desenvolvimento/genética , Histona-Lisina N-Metiltransferase/genética , Humanos , Deficiência Intelectual/genética , Obesidade/genética , Obesidade/patologiaRESUMO
Most infants born with very low birth weight (VLBW, birth weight < 1500 g) show spontaneous catch-up growth in postnatal life. The reasons for the absence of catch-up growth are not entirely understood. We performed a comprehensive investigation of 52 children born with VLBW. Ten children had a history of an external cause that explained the VLBW and five refused genetic evaluation. Twenty-three cases were initially evaluated by a candidate gene approach. Patients with a negative result in the candidate gene approach (n = 14) or without clinical suspicion (n = 14) were assessed by chromosome microarray analysis (CMA) and/or whole-exome sequencing (WES). A genetic condition was identified in 19 of 37 (51.4%) patients without an external cause, nine by candidate gene approach, and 10 by a genomic approach (CMA/WES). Silver-Russell syndrome was the most frequent diagnosis (n = 5) and the remaining patients were diagnosed with other rare monogenic conditions. Almost all patients with a positive genetic diagnosis exhibited syndromic features (94.4%). However, microcephaly, neurodevelopmental disorders, major malformation, or facial dysmorphism were also frequently observed in children with an external cause. In conclusion, a significant proportion of children born with VLBW with persistent short stature have a genetic/epigenetic condition.
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Nanismo , Peso ao Nascer , Criança , Nanismo/diagnóstico , Nanismo/epidemiologia , Nanismo/genética , Epigênese Genética , Transtornos do Crescimento/genética , Humanos , Lactente , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Sequenciamento do ExomaRESUMO
Ventilation/perfusion (V/Q) imaging and computed tomography pulmonary angiography (CTPA) are common tools for acute pulmonary embolism (PE) diagnosis. Limited contemporary data exist about the utilization of each modality, including the predictors of using V/Q versus CTPA. We used the data from patients diagnosed with PE using V/Q or CTPA from 2007 to 2019 in Registro Informatizado Enfermedad ThromboEmbolica, an international prospective registry of patients with venous thromboembolism. Outcomes was to determine the trends in utilization of V/Q vs. CTPA and, in a contemporary subgroup fitting with current practices, to evaluate predictors of V/Q use with multivariable logistic regression. Among 26,540 patients with PE, 89.2% were diagnosed with CTPA, 7.1% with V/Q and 3.7% with > 1 thoracic imaging modality. Over time, the proportional use of V/Q scanning declined (13.9 to 3.3%, P < 0.001). In multivariable analysis, heart failure history (odds ratio [OR]:1.5; 95% confidence interval [CI] 1.14-1.98), diabetes ([OR 1.71; 95% CI 1.39-2.10]), moderate and severe renal failure (respectively [OR 1.87; 95% CI 1.47-2.38] and [OR 9.36; 95% CI 6.98-12.55]) were the patient-level predictors of V/Q utilization. We also observed an influence of geographical and institutional factors, partly explained by time-limited V/Q availability (less use over weekends) and regional practices. Use of V/Q for the diagnosis of PE decreased over time, but it still has an important role in specific situations with an influence of patient-related, institution-related and logistical factors. Local and regional resources should be evaluated to improve V/Q accessibility than could benefit for this population.
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Embolia Pulmonar , Angiografia/métodos , Humanos , Pulmão , Perfusão , Embolia Pulmonar/diagnóstico por imagem , Cintilografia , Relação Ventilação-PerfusãoRESUMO
Recurrent pregnancy loss (RPL) affects 1-2% of women and is defined as having experienced two or more failed pregnancies. In almost 50% of cases, the causes are idiopathic (IRPL), but increasing evidence has suggested an immunological cause. B cells are known to provide crucial support for a successful pregnancy outcome. However, their involvement in the mechanisms underlying IRPL is still unclear. This systematic review and meta-analysis aimed to comprehensively summarise the existing evidence regarding the levels and profiles of B cells in IRPL. An extensive computerized search in PubMed/Medline, Embase, Scopus, and Web of Science databases was performed with no imposed limits. Two reviewers independently screened all retrieved studies, extracted all the data, and assessed the methodological quality. Disagreements were resolved by a third reviewer. From a total of 1125 retrieved studies, 19 studies were included in the systematic review, and 8 studies were quantitatively analysed. We highlight a potential association between women with IRPL and increased levels of endometrial B cells. In addition, the flow cytometry technique seems to be preferred over immunohistochemistry for identifying those differences, while further studies are necessary to clarify the role of B cells as an immunological risk factor for RPL.
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Aborto Habitual , Gravidez , Feminino , Humanos , Fatores de RiscoRESUMO
Endometriosis is a chronic inflammatory disorder, characterized by the presence of endometrial cells outside the uterine cavity. An increasing number of studies correlate the immune system with endometriosis, particularly NK receptors (NKR), which have been suggested to play an essential role in the pathogenesis of the disease. This systematic review aims to enlighten the role of NKR in endometriosis. A literature search was performed independently by two reviewers, to identify studies assessing the role of NKR in endometriosis. In total, 18 studies were included. Endometriosis pathogenesis seems to be marked by the overexpression of NK inhibitor receptors (KIRS), namely, CD158a+, KIR2DL1, CD94/NKG2A, PD-1, NKB1, and EB6, and inhibiting ligands such as PD-L1, HLA-E, HLA-G, and HLA-I. Concurrently, there is a decrease in NK-activating receptors and natural cytotoxicity receptors (NCRs), such as NKp46, NKp30, and NKG2D. The immune shift from NK surveillance to NK suppression is also apparent in the greater relative number of ITIM domains compared with ITAM domains in NKRs. In conclusion, NK receptor activity seems to dictate the immunocompetency of women to clear endometriotic cells from the peritoneal cavity. Future research could explore NKRs as therapeutic targets, such as that which is now well established in cancer therapy through immunotherapy.
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Endometriose , Células Matadoras Naturais , Humanos , Feminino , Receptores de Células Matadoras Naturais , Endometriose/patologia , Endométrio/patologiaRESUMO
Monitoring measurable residual disease (MRD) is crucial to assess treatment response in Multiple Myeloma (MM). Detection of MRD in peripheral blood (PB) by exploring Extracellular Vesicles (EVs), and their cargo, would allow frequent and minimally invasive monitoring of MM. This work aims to detect biomarkers of MRD in EVs isolated from MM patient samples at diagnosis and remission and compare the MRD-associated content between BM and PB EVs. EVs were isolated by size-exclusion chromatography, concentrated by ultrafiltration, and characterized according to their size and concentration, morphology, protein concentration, and the presence of EV-associated protein markers. EVs from healthy blood donors were used as controls. It was possible to isolate EVs from PB and BM carrying MM markers. Diagnostic samples had different levels of MM markers between PB and BM paired samples, but no differences between PB and BM were found at remission. EVs concentration was lower in the PB of healthy controls than of patients, and MM markers were mostly not detected in EVs from controls. This study pinpoints the potential of PB EVs from MM remission patients as a source of MM biomarkers and as a non-invasive approach for monitoring MRD.
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Vesículas Extracelulares , Mieloma Múltiplo , Humanos , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/metabolismo , Neoplasia Residual/diagnóstico , Biópsia Líquida , Vesículas Extracelulares/metabolismo , Biomarcadores/metabolismoRESUMO
Low-dose acetylsalicylic acid (ASA) is widely used during pregnancy to prevent obstetric complications of placental dysfunction, such as preeclampsia, stillbirth and fetal growth restriction, and obstetric complications in pregnant women with antiphospholipid syndrome. ASA-sensitive pregnant women cannot benefit from the effects of ASA due to the possibility of severe or potentially life-threatening hypersensitivity reactions to ASA. ASA desensitization is a valuable and safe therapeutic option for these women, allowing them to start daily prophylaxis with ASA and prevent pregnancy complications. The authors discuss the recent advances in obstetric conditions preventable by ASA and the management of ASA hypersensitivity in pregnancy, including ASA desensitization. To encourage the implementation of ASA desensitization protocols in ASA-sensitive pregnant women, they also propose a practical approach for use in daily clinical practice.
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Síndrome Antifosfolipídica , Pré-Eclâmpsia , Síndrome Antifosfolipídica/complicações , Síndrome Antifosfolipídica/tratamento farmacológico , Aspirina/efeitos adversos , Dessensibilização Imunológica , Feminino , Humanos , Pré-Eclâmpsia/tratamento farmacológico , Pré-Eclâmpsia/prevenção & controle , Gravidez , GestantesRESUMO
The present study aimed to propose a water quality index (WQI) for the Federal District, Brazil, as a management tool for water resources used in irrigation. Irrigated agriculture is a sector that has been growing in the region, with a consequent demand for quality water. One strategy for assessing water quality in rural areas is to adopt monitoring programs, which generate a large amount of data that often needs to be synthesized. The use of indexes is a way of organizing data in a synthetic and easy to understand format. Although initially formulated to assess the quality of drinking water, it is believed that a similar logic can easily be applied to assess the quality of irrigation water. Studies that evaluate the quality of water for irrigation are very common in arid or semi-arid regions, due to the problems of saline water in the soil and crops. On the other hand, the microbiological approach to water is poorly investigated, since contamination of crops can pose a risk to food security. In this work, three water bodies were selected in rural areas due to their preponderant use: irrigation. The monitoring occurred between May 2012 and April 2013 in 9 sampling points. For each sample collected, 22 physical, chemical, and biological parameters were established. Principal component analysis (PCA) was used in the evaluation and selection of water quality variables to compose the WQI. From PCA, it was possible to reduce the number of parameters from 16 to 6 main ones that reflect the water resources characteristics in the region, which were pH, electrical conductivity, total hardness, sodium absorption ratio, nitrate, and Escherichia coli. Of the five classes proposed for WQI, two points were classified as "very good." The other sample points were classified as "good" and "average" for the irrigation practice. The adapted WQI proved to be a good tool in the management of the water quality of the three rivers, and it can be easily used to assess the quality of water for irrigation in the region.
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Poluentes Químicos da Água/análise , Qualidade da Água , Irrigação Agrícola , Brasil , Monitoramento Ambiental , Abastecimento de ÁguaRESUMO
BACKGROUND: Postexercise heart rate (HR) recovery presents an exponential decay, with two distinct phases: a fast phase, characterized by abrupt decay of HR, and determined by parasympathetic reactivation; and a slow phase, characterized by gradual decay of HR, and predominantly determined by sympathetic withdrawal. Although several methods have been proposed to assess postexercise HR recovery, none of those methods selectively assesses the time of transition from the fast to the slow phase of the HR recovery curve (HRRPT ), and the magnitude of decay prior to (HRRFP ) and after this point (HRRSP ). Therefore, the aim of the present study was to propose a method to identify HRRPT , HRRFP , and HRRSP and to verify the effects of exercise intensity and physical fitness on such parameters. METHODS: Ten healthy young participants (24 ± 3 years; 23.6 ± 1.7 kg/m2 ) randomly underwent two exercise sessions (30 min of cycling), at moderate (MI) and high intensity (HI); followed by 5 min of inactive recovery. HR was continuously recorded during the sessions. The algorithm for HRRPT analysis was written in Python and is freely available online. RESULTS: HRRPT and HRRSP were increased in HI session compared with MI (81 ± 24 vs. 60 ± 20 s; 8 ± 10 vs. 1 ± 5 bpm; p = .04), and there was no difference in HRRFP between sessions (49 ± 15 vs. 46 ± 10 bpm; p = .17). In addition, HRRPT for MI exercise session was significantly and negatively associated with VO2max (r = -0.85, p < .05). CONCLUSION: The method herein presented was sensitive to exercise intensity, and partially responsive to aerobic fitness. Next studies should perform the pharmacological and clinical validations of the method.
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Eletrocardiografia/métodos , Frequência Cardíaca/fisiologia , Aptidão Física/fisiologia , Adulto , Humanos , Masculino , Valores de Referência , Adulto JovemRESUMO
Mitochondria are central organelles for cellular metabolism. In cancer cells, mitochondrial oxidative phosphorylation (OXPHOS) dysfunction has been shown to promote migration, invasion, metastization and apoptosis resistance. With the purpose of analysing the effects of OXPHOS dysfunction in cancer cells and the molecular players involved, we generated cybrid cell lines harbouring either wild-type (WT) or mutant mitochondrial DNA (mtDNA) [tRNAmut cybrids, which harbour the pathogenic A3243T mutation in the leucine transfer RNA gene (tRNAleu)]. tRNAmut cybrids exhibited lower oxygen consumption and higher glucose consumption and lactate production than WT cybrids. tRNAmut cybrids displayed increased motility and migration capacities, which were associated with altered integrin-ß1 N-glycosylation, in particular with higher levels of ß-1,6-N-acetylglucosamine (GlcNAc) branched N-glycans. This integrin-ß1 N-glycosylation pattern was correlated with higher levels of membrane-bound integrin-ß1 and also with increased binding to fibronectin. When cultured in vitro, tRNAmut cybrids presented lower growth rate than WT cybrids, however, when injected in nude mice, tRNAmut cybrids produced larger tumours and showed higher metastatic potential than WT cybrids. We conclude that mtDNA-driven OXPHOS dysfunction correlates with increased motility and migration capacities, through a mechanism that may involve the cross talk between cancer cell mitochondria and the extracellular matrix.
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Movimento Celular , Integrina beta1/metabolismo , Mitocôndrias/metabolismo , Neoplasias/metabolismo , Fosforilação Oxidativa , Animais , Linhagem Celular Tumoral , Glicosilação , Humanos , Integrina beta1/química , Integrina beta1/genética , Camundongos , Camundongos Nus , Neoplasias/genética , Consumo de Oxigênio , RNA de Transferência de Leucina/genética , RNA de Transferência de Leucina/metabolismoRESUMO
Atmospheric aerosols exert an important influence on climate through their effects on stratiform cloud albedo and lifetime and the invigoration of convective storms. Model calculations suggest that almost half of the global cloud condensation nuclei in the atmospheric boundary layer may originate from the nucleation of aerosols from trace condensable vapours, although the sensitivity of the number of cloud condensation nuclei to changes of nucleation rate may be small. Despite extensive research, fundamental questions remain about the nucleation rate of sulphuric acid particles and the mechanisms responsible, including the roles of galactic cosmic rays and other chemical species such as ammonia. Here we present the first results from the CLOUD experiment at CERN. We find that atmospherically relevant ammonia mixing ratios of 100 parts per trillion by volume, or less, increase the nucleation rate of sulphuric acid particles more than 100-1,000-fold. Time-resolved molecular measurements reveal that nucleation proceeds by a base-stabilization mechanism involving the stepwise accretion of ammonia molecules. Ions increase the nucleation rate by an additional factor of between two and more than ten at ground-level galactic-cosmic-ray intensities, provided that the nucleation rate lies below the limiting ion-pair production rate. We find that ion-induced binary nucleation of H(2)SO(4)-H(2)O can occur in the mid-troposphere but is negligible in the boundary layer. However, even with the large enhancements in rate due to ammonia and ions, atmospheric concentrations of ammonia and sulphuric acid are insufficient to account for observed boundary-layer nucleation.
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This study aimed to assess the relationship between an uphill time-trial (TT) performance and both aerobic and anaerobic parameters obtained from laboratory tests. Fifteen cyclists performed a Wingate anaerobic test, a graded exercise test (GXT) and a field-based 20-min TT with 2.7% mean gradient. After a 5-week non-supervised training period, 10 of them performed a second TT for analysis of pacing reproducibility. Stepwise multiple regressions demonstrated that 91% of TT mean power output variation (W kg-1) could be explained by peak oxygen uptake (ml kg-1.min-1) and the respiratory compensation point (W kg-1), with standardised beta coefficients of 0.64 and 0.39, respectively. The agreement between mean power output and power at respiratory compensation point showed a bias ± random error of 16.2 ± 51.8 W or 5.7 ± 19.7%. One-way repeated-measures analysis of variance revealed a significant effect of the time interval (123.1 ± 8.7; 97.8 ± 1.2 and 94.0 ± 7.2% of mean power output, for epochs 0-2, 2-18 and 18-20 min, respectively; P < 0.001), characterising a positive pacing profile. This study indicates that an uphill, 20-min TT-type performance is correlated to aerobic physiological GXT variables and that cyclists adopt reproducible pacing strategies when they are tested 5 weeks apart (coefficients of variation of 6.3; 1 and 4%, for 0-2, 2-18 and 18-20 min, respectively).
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Desempenho Atlético/fisiologia , Ciclismo/fisiologia , Adulto , Índice de Massa Corporal , Feminino , Humanos , Masculino , Consumo de Oxigênio/fisiologia , Ventilação Pulmonar , Reprodutibilidade dos Testes , Análise e Desempenho de Tarefas , Fatores de TempoRESUMO
Human hotspot TERT promoter (TERTp) mutations have been reported in a wide range of tumours. Several studies have shown that TERTp mutations are associated with clinicopathological features; in some instances, TERTp mutations were considered as biomarkers of poor prognosis. The rs2853669 SNP, located in the TERT promoter region, was reported to modulate the increased TERT expression levels induced by the recurrent somatic mutations. In this study we aimed to determine the frequency and prognostic value of TERTp mutations and TERT rs2853669 SNP in 504 gliomas from Portuguese and Brazilian patients. TERTp mutations were detected in 47.8% of gliomas (216/452). Glioblastomas (GBM) exhibited the highest frequency of TERTp mutations (66.9%); in this glioma subtype, we found a significant association between TERTp mutations and poor prognosis, regardless of the population. Moreover, in a multivariate analysis, TERTp mutations were the only independent prognostic factor. Our data also showed that the poor prognosis conferred by TERTp mutations was restricted to GBM patients carrying the rs2853669 A allele and not in those carrying the G allele. In conclusion, the presence of TERTp mutations was associated with worse prognosis in GBM patients, although such association depended on the status of the rs2853669 SNP. The status of the rs2853669 SNP should be taken in consideration when assessing the prognostic value of TERTp mutations in GBM patients. TERTp mutations and the rs2853669 SNP can be used in the future as biomarkers of glioma prognosis.
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Neoplasias Encefálicas/genética , Neoplasias Encefálicas/mortalidade , Glioblastoma/genética , Glioblastoma/mortalidade , Mutação , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas , Telomerase/genética , Adolescente , Adulto , Idoso , Alelos , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/terapia , Criança , Pré-Escolar , Feminino , Genótipo , Glioblastoma/patologia , Glioblastoma/terapia , Humanos , Lactente , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prognóstico , Adulto JovemRESUMO
Pheochromocytomas (PCC) and sympathetic paragangliomas (PGL) are rare neuroendocrine tumors, which derive from chromaffin cells occurring in the adrenal medulla and extra-adrenal sympathetic paraganglia. PCC and PGL are often benign, catecholamine-producing tumors, responsible for a myriad of symptoms that may be potentially hazardous to the patient. In contrast, nonsecreting parasympathetic PGL, derived from chief cells, develop mainly in the head and neck region. Although PCC/PGL are more commonly sporadic tumors, germline mutations are present in up to 40% of the patients, ranking these tumors among those with the highest degree of heritability. PCC/PGL are associated with a variety of hereditary syndromes, comprising genetic alterations in RET, NF1, VHL, and SDHx genes, the last 2 being involved in regulating the hypoxia pathway. Additional hypoxia pathway-related genes have been recently associated with PCC/PGL development, namely EGLN1 and EPAS1. Thus, dysregulation of the hypoxia pathway seems to play a major role in PCC/PGL development, in particular through the stabilization of hypoxia-inducible factors and the appearance of a pseudohypoxia signature. This article is focused on reviewing the tumorigenic mechanisms resultant from VHL, SDHx, EGLN1, and EPAS1 mutations, as well as the associated tumors, namely PCC/PGL, and extra manifestations such as polycythemia. In the light of the recent discoveries, hypoxia pathway molecules appear as key players in PCC/PGL development.
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Hipóxia Celular/genética , Mutação , Paraganglioma/genética , Feocromocitoma/genética , Humanos , Neovascularização Patológica , Paraganglioma/irrigação sanguínea , Paraganglioma/patologia , Feocromocitoma/irrigação sanguínea , Feocromocitoma/patologiaRESUMO
BACKGROUND: B cells play a role in pregnancy due to their humoral and regulatory activities. To our knowledge, different maturational stages (from transitional to memory) of circulating B cell subsets have not yet been characterized (cell quantification and phenotype identification) in healthy pregnant women. Thus, the objective of our study was to characterize these subsets (as well as regulatory B cells) from late pregnancy to post-partum and to compare them with the circulating B cells of non-pregnant women. METHODS: In all of the enrolled women, flow cytometry was used to characterize the circulating B cell subsets according to the expression of IgD and CD38 (Bm1-Bm5 classification system). Regulatory B cells were characterized based on the expression of surface antigens (CD24, CD27, and CD38) and the production of IL-10 after lipopolysaccharide stimulation. RESULTS: Compared to the absolute counts of B cells in the non-pregnant women (n = 35), those in the pregnant women (n = 43) were significantly lower (p < 0.05) during the 3rd trimester of pregnancy and on delivery day (immediately after delivery). The percentages of these cells on delivery day and at post-partum were significantly lower than those in the non-pregnant women. In general, the absolute counts and percentages of the majority of the B cell subsets were significantly lower in the 3rd trimester of pregnancy and on delivery day than in the non-pregnant women. However, these counts and percentages did not differ significantly between the post-partum and the non-pregnant women. The most notable exceptions to the above were the percentages of naïve B cells (which were significantly higher in the 3rd trimester and on delivery day than in the non-pregnant women) and of CD24(hi)CD38(hi) regulatory B cells (which were significantly higher in the post-partum than in the non-pregnant women). CONCLUSION: According to our study, the peripheral B cell compartment undergoes quantitative changes during normal late pregnancy and post-partum. Such findings may allow us to better understand immunomodulation during human pregnancy and provide evidence that could aid in the development of new strategies to diagnose and treat pregnancy-associated disturbances. Our findings could also be useful for studies of the mechanisms of maternal responses to vaccination and infection.
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Linfócitos B Reguladores/metabolismo , Parto/sangue , Período Pós-Parto/sangue , Terceiro Trimestre da Gravidez/sangue , ADP-Ribosil Ciclase 1/sangue , Adulto , Antígeno CD24/sangue , Feminino , Citometria de Fluxo , Voluntários Saudáveis , Humanos , Interleucina-10/sangue , Glicoproteínas de Membrana/sangue , Gravidez , Estudos Prospectivos , Membro 7 da Superfamília de Receptores de Fatores de Necrose Tumoral/sangueRESUMO
The cardiovascular system plays a direct role in the maintenance of body temperature. Whether passive heating alters cardiovascular autonomic modulation in conscious rats is still unknown. This study investigated the effects of passive heating on systolic blood pressure variability (SBPV) and heart rate variability (HRV) in conscious rats and the involvement of the renin-angiotensin system in the passive heating effects on SBPV and HRV. Fourteen male Wistar rats were randomly assigned to the control group or the losartan treatment group. A catheter was implanted in the left carotid artery to record pulsatile arterial pressure (PAP), and a telemetry sensor was implanted in the abdominal cavity to measure body temperature (Tbody). After recovering from surgery, the animals were subjected to a passive heating protocol (35°C; 30min) in resting conditions, during which Tbody, tail skin temperature and PAP were measured. The mean arterial pressure, systolic and diastolic blood pressure, heart rate, double product (i.e., the product of systolic blood pressure by heart rate), SBPV and HRV were calculated from the PAP. SBPV and HRV were analyzed in terms of both time and frequency domains. Increases in the thermoregulatory and cardiovascular parameters were observed during passive heating in both groups, and those increases were reflected in the higher time and frequency domains of the SBPV. However, passive heating was not effective in altering HRV. Passive heating altered SBPV but not HRV in conscious rats when they were treated with losartan.
Assuntos
Pressão Sanguínea , Regulação da Temperatura Corporal , Frequência Cardíaca , Animais , Pressão Arterial , Sistema Nervoso Autônomo/fisiologia , Temperatura Corporal , Temperatura Alta , Masculino , Ratos , Ratos Wistar , Sistema Renina-Angiotensina , Processamento de Sinais Assistido por Computador , Termografia/métodosRESUMO
Although tyrosine-phosphorylated or activated STAT3 (pY-STAT3) is a well-described mediator of tumorigenesis, its role in thyroid cancer has not been investigated. We observed that 63 of 110 (57%) human primary papillary thyroid carcinoma (PTC) cases expressed nuclear pY-STAT3 in tumor cells, preferentially in association with the tumor stroma. An inverse relationship between pY-STAT3 expression with tumor size and the presence of distant metastases was observed. Using human thyroid cancer-derived cell lines [harboring rearranged during transfection (RET)/PTC, v-RAF murine sarcoma viral oncogene homolog B (BRAF), or rat sarcoma virus oncogene (RAS) alterations], we determined that IL-6/gp130/JAK signaling is responsible for STAT3 activation. STAT3 knockdown by shRNA in representative thyroid cancer cell lines that express high levels of pY-STAT3 had no effect on in vitro growth. However, xenografted short hairpin STAT3 cells generated larger tumors than control cells. Similarly, STAT3 deficiency in a murine model of BRAFV600E-induced PTC led to thyroid tumors that were more proliferative and larger than those tumors expressing STAT3wt. Genome expression analysis revealed that STAT3 knockdown resulted in the down-regulation of multiple transcripts, including the tumor suppressor insulin-like growth factor binding protein 7. Furthermore, STAT3 knockdown led to an increase in glucose consumption, lactate production, and expression of Hypoxia-inducible factor 1 (HIF1α) target genes, suggesting that STAT3 is a negative regulator of aerobic glycolysis. Our studies show that, in the context of thyroid cancer, STAT3 is paradoxically a negative regulator of tumor growth. These findings suggest that targeting STAT3 in these cancers could enhance tumor size and highlight the complexities of the role of STAT3 in tumorigenesis.
Assuntos
Carcinoma Papilar/metabolismo , Fator de Transcrição STAT3/metabolismo , Transdução de Sinais/fisiologia , Neoplasias da Glândula Tireoide/metabolismo , Animais , Carcinoma Papilar/secundário , Divisão Celular/fisiologia , Linhagem Celular Tumoral , Receptor gp130 de Citocina/metabolismo , Modelos Animais de Doenças , Técnicas de Silenciamento de Genes , Humanos , Proteínas de Ligação a Fator de Crescimento Semelhante a Insulina/metabolismo , Interleucina-6/metabolismo , Janus Quinases/metabolismo , Camundongos , Camundongos Transgênicos , Transplante de Neoplasias , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas B-raf/metabolismo , Fator de Transcrição STAT3/genética , Neoplasias da Glândula Tireoide/patologia , Transplante Heterólogo , Microambiente Tumoral/fisiologiaRESUMO
UNLABELLED: It has been shown that water intake (WI) improves postexercise parasympathetic recovery after moderate-intensity exercise session. However, the potential cardiovascular benefit promoted by WI has not been investigated after high-intensity exercise. PURPOSE: To assess the effects of WI on post high-intensity parasympathetic recovery. METHODS: Twelve recreationally active young men participated in the study (22 ± 1.4 years, 24.1 ± 1.6 kg.m(-2)). The experimental protocol consisted of two visits to the laboratory. Each visit consisted in the completion of a 30-min high-intensity [~80% of maximal heart rate (HR)] cycle ergometer aerobic session performing randomly the WI or control (CON, no water consumption) intervention at the end of the exercise. HR and RR intervals (RRi) were continuously recorded by a heart rate monitor before, during and after the exercise. Differences in HR recovery [e.g., absolute heart rate decrement after 1 min of recovery (HRR60s) and time-constant of the first order exponential fitting curve of the HRR (HRRτ)] and in postexercise vagal-related heart rate variability (HRV) indexes (rMSSD30s, rMSSD, pNN50, SD1 and HF) were calculated and compared for WI and CON. RESULTS: A similar HR recovery and an increased postexercise HRV [SD1 = 9.4 ± 5.9 vs. 6.0 ± 3.9 millisecond, HF(ln) = 3.6 ± 1.4 vs. 2.4 ± 1.3 millisecond(2), for WI and CON, respectively; p < .05] was observed in WI compared with CON. CONCLUSION: The results suggest that WI accelerates the postexercise parasympathetic reactivation after high-intensity exercise. Such outcome reveals an important cardioprotective effect of WI.