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1.
Org Biomol Chem ; 22(13): 2492-2509, 2024 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-38446020

RESUMEN

Direct vicinal difunctionalization of π-systems has emerged as a powerful platform for constructing multiple bonds in a single synthetic operation using simple chemical feedstocks. Over the past decade, there has been exponential growth in the direct construction of successive C-S and C-I bonds using a wide variety of sulfonyl and iodide reactants through 1,2-iodosulfonylation of alkynes in a regio- and stereo-selective manner. In this review, we mainly focus on the recent developments in the preparation of ß-iodovinyl sulfones and their practical applications in organic synthesis. The most promising photoredox and electrochemical transformations for synthesizing ß-iodovinyl sulfones are also reviewed. The multifunctional ß-iodovinyl sulfones have recently been burgeoning as versatile synthetic precursors due to the combination of vinyl iodide and vinyl sulfone moieties, essential building blocks for diverse synthetic manipulations. We hereby present the chemistry of ß-iodovinyl sulfones, which can be classified into numerous sections based on the sulfonyl surrogates, and potential synthetic approaches are systematically outlined.

2.
Medicina (Kaunas) ; 60(2)2024 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-38399536

RESUMEN

Background and Objectives: Anaerobic bacteria like Fusobacterium can lead to severe and life-threatening infections. The inherent complexities in the isolation of these bacteria may result in diagnostic and therapeutic delays, thereby escalating both morbidity and mortality rates. We aimed to examine data from patients with infections due to Fusobacterium to gain insights into the epidemiology and clinical outcomes of patients with these infections. Methods and Results: We conducted a retrospective analysis of clinical data from a cohort of patients with cultures positive for Fusobacterium species at a tertiary care medical center in the United States. Between 2009 and 2015, we identified 96 patients with cultures positive for Fusobacterium. Patients could be categorized into three groups based on the site of primary infection. Patients with head and neck infections constituted 37% (n 36). Patients with infections of other soft tissue sites accounted for 38.5% (n 37). Patients with anaerobic bacteremia due to Fusobacterium formed 24% (n 23) of the cohort. Surgical intervention coupled with antibiotic therapy emerged as cornerstones of management for patients with head and neck or other soft tissue infections, who generally exhibited more favorable outcomes. Patients with bacteremia were older, more likely to have malignancy, and had a high mortality rate. When speciation was available, Fusobacterium necrophorum was the most frequently isolated species. Conclusions: Our retrospective analysis of epidemiology and clinical outcomes of Fusobacterium infections revealed three distinct cohorts. Patients with head, neck, or soft tissue infections had better outcomes than those with bacteremia. Our findings highlight the importance of employing management strategies based on infection site and underlying comorbidities in patients with Fusobacterium infections. Further research is needed to investigate the optimal therapeutic strategies and identify prognostic indicators to improve clinical outcomes for these complex infections.


Asunto(s)
Bacteriemia , Infecciones por Fusobacterium , Infecciones de los Tejidos Blandos , Humanos , Estudios Retrospectivos , Infecciones por Fusobacterium/tratamiento farmacológico , Infecciones por Fusobacterium/epidemiología , Infecciones por Fusobacterium/diagnóstico , Fusobacterium , Bacteriemia/tratamiento farmacológico , Bacteriemia/epidemiología
3.
Medicina (Kaunas) ; 60(6)2024 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-38929621

RESUMEN

Background and Objectives: Gabapentin has shown promise as a potential agent for the treatment of alcohol withdrawal syndrome. We aimed to evaluate the effectiveness of gabapentin as a benzodiazepine-sparing agent in patients undergoing alcohol withdrawal treatment in all the hospitals of a large tertiary healthcare system. Materials and Methods: Medical records of patients admitted to the hospital for alcohol withdrawal management between 1 January 2020 and 31 August 2022 were reviewed. Patients were divided into two cohorts: benzodiazepine-only treatment who received benzodiazepines as the primary pharmacotherapy and gabapentin adjunctive treatment who received gabapentin in addition to benzodiazepines. The outcomes assessed included the total benzodiazepine dosage administered during the treatment and the length of hospital stay. The statistical models were calibrated to account for various factors. Results: A total of 4364 patients were included in the final analysis. Among these, 79 patients (1.8%) received gabapentin in addition to benzodiazepines, and 4285 patients (98.2%) received benzodiazepines only. Patients administered gabapentin required significantly lower average cumulative benzodiazepine dosages, approximately 17.9% less, compared to those not receiving gabapentin (median 2 mg vs. 4 mg of lorazepam equivalent dose (p < 0.01)). However, there were no significant differences in outcomes between the two groups. Conclusions: Our findings demonstrate that using gabapentin with benzodiazepine was associated with a reduction in the cumulative benzodiazepine dosage for alcohol withdrawal. Considering gabapentin as an adjunctive therapy holds promise for patients with comorbidities who could benefit from reducing benzodiazepine dose. This strategy warrants further investigation.


Asunto(s)
Benzodiazepinas , Gabapentina , Síndrome de Abstinencia a Sustancias , Humanos , Gabapentina/uso terapéutico , Gabapentina/administración & dosificación , Masculino , Benzodiazepinas/uso terapéutico , Benzodiazepinas/administración & dosificación , Femenino , Persona de Mediana Edad , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico , Adulto , Estudios Retrospectivos , Resultado del Tratamiento , Anciano , Tiempo de Internación/estadística & datos numéricos
4.
J Org Chem ; 88(13): 8889-8903, 2023 Jul 07.
Artículo en Inglés | MEDLINE | ID: mdl-37283071

RESUMEN

Benzoheteroles and vinyl sulfones are the most promising pharmaceutical relevance motifs, yet the hybrid analogues of these scaffolds still need to be explored. We report herein a general and highly efficient Pd(OAc)2-catalyzed intramolecular cyclization and vinylation of o-alkynylphenols/o-alkynylanilines with (E)-ß-iodovinyl sulfones under mild reaction conditions. A direct C(sp2)-C(sp2) cross-coupling is enabled for the diversity-oriented synthesis of vinyl sulfone-tethered benzofurans and indoles in good to high yields with excellent stereoselectivity. Notably, this tandem process was consistent at the gram scale, and in situ, generation of 2-(phenylethynyl)phenol has also been utilized in a scalable synthesis. Late-stage synthetic transformations were also further explored, including isomerization and desulfonylative-sulfenylation. Moreover, several control experiments were accomplished, and we proposed a plausible mechanism based on existing experimental results.


Asunto(s)
Compuestos de Anilina , Fenoles , Catálisis , Ciclización , Fenol
5.
J Org Chem ; 88(3): 1635-1648, 2023 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-36650618

RESUMEN

Benzoheteroles are valuable scaffolds in medicinal chemistry, but the direct synthesis of 3-vinyl benzoheterole analogues remains unexplored. A rationally designed new class of 1,6-enyne-containing propargylic alcohols has been prepared for the modular synthesis of 3-alkenyl benzoheteroles. Ag-catalyzed cascade radical sulfonylative-cycloannulation of 1,6-enynols with sodium sulfinates is realized to access a wide variety of 2,3-disubstituted benzoheteroles in good to high yields. Moreover, a three-component coupling of 1,6-enynols, aryldiazonium salts, and Na2S2O5 (as an SO2 surrogate) has been achieved to deliver benzoheterole derivatives in moderate to good yields. Of note, a scalable reaction and late-stage synthetic transformations were successfully demonstrated. A plausible mechanism is also presented based on the existing experimental results and control experiments.

6.
J Org Chem ; 87(6): 3934-3951, 2022 03 18.
Artículo en Inglés | MEDLINE | ID: mdl-35245070

RESUMEN

The nature of solvent is a key factor for stereoselective mono- and bis-thiolation of (E)-ß-iodovinyl sulfones with thiols under basic conditions. A novel and unprecedented vicinal bisthiolation of (E)-ß-iodovinyl sulfones with thiols under the influence of K2CO3/DMSO at room temperature for quick assembly of (E)-1,2-dithio-1-alkenes is presented. Solvent-induced stereoselective monosulfenylation of (E)-ß-iodovinyl sulfones with thiols has also been established for the synthesis of both (E)- and (Z)-1,2-thiosulfonylethenes in MeCN and MeOH, respectively. Moreover, K2CO3-mediated desulfonylative-sulfenylation of (Z)-1,2-thiosulfonylethenes with thiols in DMSO furnished unsymmetrical (Z)-1,2-dithio-1-alkenes for the first time. The solvent-dependent versatile reactivity of (E)-ß-iodovinyl sulfones has been successfully explored to provide a set of (E)-/(Z)-1,2-dithio-1-alkenes and (E)-/(Z)-1,2-thiosulfonyl-1-alkenes in good to high yields with excellent stereoselectivities. Notably, this operationally simple process utilizes a broad substrate scope with good functional group tolerance and compatibility. The efficacy of the process has been proven for gram-scale reactions, and plausible mechanistic models are outlined on the basis of experimental results and control experiments.


Asunto(s)
Compuestos de Sulfhidrilo , Sulfonas , Alquenos , Dimetilsulfóxido , Solventes , Estereoisomerismo
7.
Org Biomol Chem ; 20(21): 4331-4337, 2022 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-35451451

RESUMEN

Pyrazolo[1,5-a]pyridines continue to occupy a special place in medicinal chemistry, but the direct construction of 3-sulfonyl analogues remains unexplored. Under basic conditions, pyridinium-N-amine and the corresponding dipolar aminide played a vibrant role in [3 + 2]-cycloaddition using (E)-ß-iodovinyl sulfones. K2CO3-mediated tandem cycloannulative-desulfonylation of (E)-ß-iodovinyl sulfones with 1-aminopyridinium iodide is realized to access 2-substituted pyrazolo[1,5-a]pyridines in good to high yields. An essential modification of the dipolar N-tosylpyridinium imide allows the first preparative synthesis of 3-sulfonyl-pyrazolo[1,5-a]pyridines in moderate to high yields. Of note, the metal-free protocol features a broad substrate scope with good functional group tolerance and compatibility. The efficacy of the process was proved with gram-scale reactions, and a plausible mechanism is also presented based on concrete results.


Asunto(s)
Piridinas , Sulfonas
8.
J Intensive Care Med ; 37(5): 647-654, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-34041934

RESUMEN

BACKGROUND: Patients with acute respiratory distress syndrome (ARDS) are highly susceptible to developing delirium for a multitude of reasons. Previous studies have linked pre-existing depression with an increased risk of postoperative delirium in patients undergoing cardiac and non-cardiac surgery. However, the evidence regarding the association between pre-existing psychiatric illnesses and delirium in ARDS patients is unknown. In this study, we aim to determine the relationship between pre-existing psychiatric illness and the risk of development of delirium amongst ARDS patients. STUDY DESIGN AND METHODS: We performed a retrospective study of a mixed group of patients admitted to the intensive care unit (ICU) between January 2016 and December 2019 with a diagnosis of ARDS per the Berlin definition. The study group was divided into 2 cohorts: subjects with delirium and subjects without delirium. Comparison between the 2 groups was conducted to examine the impact of pre-existing psychiatric illnesses including major depressive disorder (MDD), generalized anxiety disorder (GAD), bipolar disorder, schizophrenia, or post-traumatic stress disorder. Multivariable logistic regression analysis was performed adjusting for benzodiazepine use, sedatives, analgesics, sequential organ failure assessment score, and corticosteroid use to determine the association between pre-existing psychiatric disorders and delirium. RESULTS: 286 patients with ARDS were identified; 124 (43%) of whom were diagnosed with ICU delirium. In patients diagnosed with ICU delirium, 49.2% were found to have preexisting psychiatric illnesses, compared to 34.0% without any preexisting psychiatric illness (OR = 1.94, P = 0.01). In a subgroup analysis of individual psychiatric illnesses, GAD and MDD were associated with the development of delirium (OR = 1.88, P = 0.04 and OR = 1.76, P = 0.05 respectively). INTERPRETATION: ARDS patients with preexisting psychiatric illnesses, particularly GAD and MDD are associated with an increased risk of developing ICU delirium. Clinicians should be aware of the effect of psychiatric co-morbidities on developing delirium in critically ill patients.


Asunto(s)
Delirio , Trastorno Depresivo Mayor , Síndrome de Dificultad Respiratoria , Enfermedad Crítica , Delirio/epidemiología , Delirio/etiología , Trastorno Depresivo Mayor/complicaciones , Humanos , Unidades de Cuidados Intensivos , Síndrome de Dificultad Respiratoria/etiología , Estudios Retrospectivos , Factores de Riesgo
9.
J Intensive Care Med ; 37(3): 327-336, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33511898

RESUMEN

BACKGROUND: There is a conflicting body of evidence regarding the benefit of vitamin C, thiamine, and hydrocortisone in combination as an adjunctive therapy for sepsis with or without septic shock. We aimed to assess the efficacy of this treatment among predefined populations. METHODS: A literature review of major electronic databases was performed to include randomized controlled trials (RCTs) evaluating vitamin C, thiamine, and hydrocortisone in the treatment of patients with sepsis with or without septic shock in comparison to the control group. RESULTS: Seven studies met our inclusion criteria, and 6 studies were included in the final analysis totaling 839 patients (mean age 64.2 ± 18; SOFA score 8.7 ± 3.3; 46.6% female). There was no significant difference between both groups in long term mortality (Risk Ratio (RR) 1.05; 95% CI 0.85-1.30; P = 0.64), ICU mortality (RR 1.03; 95% CI 0.73-1.44; P = 0.87), or incidence of acute kidney injury (RR 1.05; 95% CI 0.80-1.37; P = 0.75). Furthermore, there was no significant difference in hospital length of stay, ICU length of stay, and ICU free days on day 28 between the intervention and control groups. There was, however, a significant difference in the reduction of SOFA score on day 3 from baseline (MD -0.92; 95% CI -1.43 to -.41; P < 0.05). In a trial sequential analysis for mortality outcomes, our results are inconclusive for excluding lack of benefit of this therapy. CONCLUSION: Among patients with sepsis with or without septic shock, treatment with vitamin C, thiamine, and hydrocortisone was not associated with a significant reduction in mortality, incidence of AKI, hospital and ICU length of stay, or ICU free days on day 28. There was a significant reduction of SOFA score on day 3 post-randomization. Further studies with a larger number of patients are needed to provide further evidence on the efficacy or lack of efficacy of this treatment.


Asunto(s)
Sepsis , Choque Séptico , Anciano , Anciano de 80 o más Años , Ácido Ascórbico/uso terapéutico , Femenino , Humanos , Hidrocortisona , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Sepsis/tratamiento farmacológico , Choque Séptico/tratamiento farmacológico , Tiamina/uso terapéutico
10.
Lung ; 200(6): 763-771, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36255519

RESUMEN

BACKGROUND: Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) caused by an immunological reaction to repeated inhalational exposure to antigens. The etiology and exact immunopathology are poorly understood. Autoimmunity overlapping with HP has been described but the role of concomitant autoimmunity in the clinical course and outcome of the HP is not clearly established. In this study, we examined patients diagnosed with HP and compare them to patients with concomitant HP and autoimmunity. METHODS: Patients were retrospectively screened from a single-center ILD registry. Patients > 18 years with an established multidisciplinary diagnosis of HP were included in the study. Patients with HP without autoimmune features and patients with HP with autoimmune features (HPAF) were assessed. We compared the demographics, clinical characteristics, treatment, and outcomes between the two groups. We used a Cox proportional hazards model to compare lung transplant-free survival outcomes of patients with HPAF to those with non-HPAF HP patients. RESULTS: Of 73 patients with HP, 43 were diagnosed with HPAF. Patients with HPAF had a higher echocardiographic probability of pulmonary hypertension as compared to non-HPAF HP patients [48.8 vs 23.3%, p = 0.028, Crude odds ratio (cOR) = 3.14]. Symptomatically, those with HPAF reported a higher prevalence of arthritis as compared to non-HPAF HP (20.9 vs 3.3%, p = 0.040, cOR = 7.68). No significant differences between pulmonary function tests, oxygen requirements, mortality, and lung transplantation rates were found between the two groups. There was no statistically significant difference in transplant-free survival (p = 0.836). CONCLUSION: Patients with HPAF had a higher echocardiographic probability of pulmonary hypertension as compared to patients with non-HPAF HP. The clinical characteristics and outcomes did not differ between the two groups and concomitant autoimmunity among the HP group did not portend a poorer prognosis.


Asunto(s)
Alveolitis Alérgica Extrínseca , Hipertensión Pulmonar , Enfermedades Pulmonares Intersticiales , Humanos , Hipertensión Pulmonar/complicaciones , Estudios Retrospectivos , Alveolitis Alérgica Extrínseca/diagnóstico , Alveolitis Alérgica Extrínseca/epidemiología , Enfermedades Pulmonares Intersticiales/diagnóstico , Enfermedades Pulmonares Intersticiales/epidemiología , Enfermedades Pulmonares Intersticiales/etiología , Pulmón
11.
Org Biomol Chem ; 19(14): 3087-3118, 2021 04 14.
Artículo en Inglés | MEDLINE | ID: mdl-33885563

RESUMEN

This review mainly focuses on recent developments in the preparation of ß-keto sulfones and their extensive synthetic applications. New prospects for the synthesis of ß-keto thiosulfones have also been highlighted. Over the last decade, there has been exponential growth in the direct construction of ß-keto sulfones using a wide variety of keto and sulfonyl precursors. Of note, the most promising photoredox transformations and electrochemical synthesis methods of ß-keto sulfones are also presented. Moreover, ß-keto sulfones are versatile building blocks in organic synthesis due to their three essential functional groups: sulfonyl, carbonyl, and active methylene moieties. The convenient preparation of ß-keto sulfones allows the synthesis of many valuable carbocyclic and heterocyclic compounds, and the effortless removal of the sulfonyl moiety via transformations is supported. The chemistry of ß-keto sulfones (2013 to present) can be divided into several sections based on the sulfonyl surrogates, and ubiquitous synthetic strategies were systematically outlined.

12.
Am J Pathol ; 189(3): 482-491, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30414411

RESUMEN

The transcription factor Nur77 belongs to the NR4A subfamily of nuclear hormone receptors. It features an atypical ligand-binding site that precludes canonical ligand binding, leading to the designation orphan nuclear receptor. However, recent studies show that small molecules can interact with the receptor and modulate its activity by inducing a conformational change in the Nur77 ligand-binding site. Nur77 expression and activation are rapidly induced by various physiological and pathologic stimuli. Once expressed, Nur77 initiates transcriptional activity and modulates expression of its target genes. Both in vitro and in vivo evidence shows that Nur77 dampens the immune response to proinflammatory stimuli, such as tumor necrosis factor-α, Toll-like receptor ligands, and oxidized lipids, primarily by suppressing NF-κB signaling. Although studies focusing on Nur77's role in lung pathophysiology are currently incomplete, available data support its involvement in the pathogenesis of lung diseases, including asthma, acute lung injury, and pulmonary fibrosis, and thus suggest a therapeutic potential for Nur77 activation in these diseases. This review addresses the mechanisms that control Nur77 as well as its known roles in inflammation-related lung diseases. Evidence regarding the therapeutic potential of Nur77-targeting molecules will also be presented. Although current knowledge is limited, additional research followed by clinical studies may firmly identify Nur77 as a pharmacologic target for inflammation-related lung diseases.


Asunto(s)
Enfermedades Pulmonares/metabolismo , Pulmón/metabolismo , Miembro 1 del Grupo A de la Subfamilia 4 de Receptores Nucleares/metabolismo , Transducción de Señal , Transcripción Genética , Animales , Humanos , Inflamación/metabolismo , Inflamación/patología , Pulmón/patología , Enfermedades Pulmonares/patología , Enfermedades Pulmonares/terapia , FN-kappa B/biosíntesis , Receptores Toll-Like/biosíntesis , Factor de Necrosis Tumoral alfa/biosíntesis
13.
Clin Sci (Lond) ; 134(9): 1063-1079, 2020 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-32369100

RESUMEN

Asthma is a chronic disease of the airways that has long been viewed predominately as an inflammatory condition. Accordingly, current therapeutic interventions focus primarily on resolving inflammation. However, the mainstay of asthma therapy neither fully improves lung function nor prevents disease exacerbations, suggesting involvement of other factors. An emerging concept now holds that airway remodeling, another major pathological feature of asthma, is as important as inflammation in asthma pathogenesis. Structural changes associated with asthma include disrupted epithelial integrity, subepithelial fibrosis, goblet cell hyperplasia/metaplasia, smooth muscle hypertrophy/hyperplasia, and enhanced vascularity. These alterations are hypothesized to contribute to airway hyperresponsiveness, airway obstruction, airflow limitation, and progressive decline of lung function in asthmatic individuals. Consequently, targeting inflammation alone does not suffice to provide optimal clinical benefits. Here we review asthmatic airway remodeling, focusing on airway epithelium, which is critical to maintaining a healthy respiratory system, and is the primary defense against inhaled irritants. In asthma, airway epithelium is both a mediator and target of inflammation, manifesting remodeling and resulting obstruction among its downstream effects. We also highlight the potential benefits of therapeutically targeting airway structural alterations. Since pathological tissue remodeling is likewise observed in other injury- and inflammation-prone tissues and organs, our discussion may have implications beyond asthma and lung disease.


Asunto(s)
Remodelación de las Vías Aéreas (Respiratorias)/efectos de los fármacos , Antiasmáticos/farmacología , Asma/fisiopatología , Inflamación/tratamiento farmacológico , Animales , Asma/tratamiento farmacológico , Epitelio/efectos de los fármacos , Humanos , Inflamación/fisiopatología , Pulmón/efectos de los fármacos , Pulmón/fisiopatología
14.
Org Biomol Chem ; 18(17): 3243-3248, 2020 05 06.
Artículo en Inglés | MEDLINE | ID: mdl-32285079

RESUMEN

A unique phenylboronic acid-catalyzed dimerization-sulfonylation of S-benzyl thiosulfonates has been disclosed. A metal-free tandem construction of S-S and C-S bonds is an operationally simple method to access a wide range of benzyl disulfanylsulfone derivatives in high to excellent yields. Moreover, the robustness of this tandem transformation has been demonstrated by gram-scale reactions, and a plausible mechanism is also proposed.

15.
J Immunol ; 201(6): 1775-1783, 2018 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-30061200

RESUMEN

Airway epithelial cells (AECs) orchestrate inflammatory responses to airborne irritants that enter the respiratory system. A viscous mucus layer produced by goblet cells in the airway epithelium also contributes to a physiological defense mechanism through the physical and chemical barriers it provides. Dysregulation or impairment in these functions has been implicated as a cause of the chronic inflammation and tissue remodeling that constitute major pathological features of asthma. In particular, mucus hypersecretion leading to airway obstruction and impaired pulmonary function is associated with morbidity and mortality in asthma patients. Peroxisome proliferator-activated receptor γ (PPARγ) is a ligand-activated transcription factor involved in a variety of cellular processes. Accumulating evidence indicates that PPARγ agonists antagonize exaggerated inflammatory responses, yet PPARγ's precise role in airway remodeling/mucus hypersecretion has yet to be defined. In this study, we created an AEC-specific PPARγ (AEC-PPARγ) deletion to investigate PPARγ's functions in a murine model of allergic airway disease. AEC-PPARγ deficiency exaggerated airway hyperresponsiveness, inflammation, cytokine expression, and tissue remodeling. We also found that PPARγ directly bound to a PPAR response element found in MUC5AC and repressed gene expression. Likewise, PPARγ regulated mucin and inflammatory factors in primary human bronchial epithelial cells. In light of the current standard therapies' limited and inadequate direct effect on airway mucus hypersecretion, our study showing AEC-PPARγ's role as a transcriptional repressor of MUC5AC highlights this receptor's potential as a pharmacological target for asthma.


Asunto(s)
Asma/inmunología , Células Epiteliales/inmunología , Regulación de la Expresión Génica/inmunología , Mucina 5AC/inmunología , PPAR gamma/inmunología , Mucosa Respiratoria/inmunología , Animales , Asma/genética , Asma/patología , Células Cultivadas , Células Epiteliales/patología , Femenino , Humanos , Inflamación/genética , Inflamación/inmunología , Inflamación/patología , Masculino , Ratones , Ratones Noqueados , Mucina 5AC/genética , PPAR gamma/genética , Mucosa Respiratoria/patología , Elementos de Respuesta/inmunología
16.
Lung ; 198(4): 661-669, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32424799

RESUMEN

PURPOSE: Little is known about the characteristics and impact of acute pulmonary embolism (PE) during episodes of asthma exacerbation. We aimed to characterize patients diagnosed with acute PE in the setting of asthma exacerbation, develop a prediction model to help identify future patients and assess the impact of acute PE on hospital outcomes. METHODS: We included 758 patients who were treated for asthma exacerbation and underwent a computed tomographic pulmonary angiography (CTA) during the same encounter at a university-based hospital between June 2011 and October 2018. We compared clinical characteristics of patients with and without acute PE and developed a machine learning prediction model to classify the PE status based on the clinical variables. We used multivariable regression analysis to evaluate the impact of acute PE on hospital outcomes. RESULTS: Twenty percent of the asthma exacerbation patients who underwent CTA had an acute PE. Factors associated with acute PE included previous history of PE, high CHA2DS2-VASc score, hyperlipidemia, history of deep vein thrombosis, malignancy, chronic systemic corticosteroids use, high body mass index and atrial fibrillation. Using these factors, we developed a random forest machine learning prediction model which had an 88% accuracy in classifying the acute PE status of the patients (area under the receiver operating characteristic curve = 0.899; 95% confidence interval: 0.885-0.913). Acute PE in asthma exacerbation was associated with longer hospital stay and intensive care unit stay. CONCLUSION: It is important to consider acute PE, a potentially life-threatening event, in the setting of asthma exacerbation especially when other risk factors are present.


Asunto(s)
Asma/epidemiología , Reglas de Decisión Clínica , Unidades de Cuidados Intensivos/estadística & datos numéricos , Tiempo de Internación/estadística & datos numéricos , Aprendizaje Automático , Embolia Pulmonar/epidemiología , Adulto , Anciano , Asma/metabolismo , Asma/fisiopatología , Índice de Masa Corporal , Estudios de Casos y Controles , Comorbilidad , Angiografía por Tomografía Computarizada , Creatinina/metabolismo , Progresión de la Enfermedad , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Frecuencia Cardíaca , Hospitales Universitarios , Humanos , Relación Normalizada Internacional , Masculino , Persona de Mediana Edad , Péptido Natriurético Encefálico/metabolismo , Oxígeno/sangre , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/metabolismo , Embolia Pulmonar/fisiopatología
17.
Biochem J ; 476(19): 2757-2767, 2019 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-31492735

RESUMEN

Nur77 is a transcription factor belonging to the NR4A subfamily of nuclear hormone receptors. Upon induction, Nur77 modulates the expression of its target genes and controls a variety of biological and pathophysiological processes. Prior research that revealed a structurally atypical ligand-binding domain (LBD) and failed to locate an endogenous ligand had led to a classification of Nur77 as an orphan receptor. However, several more recent studies indicate that small synthetic molecules and unsaturated fatty acids can bind to Nur77. Discovery of additional endogenous ligands will facilitate our understanding of the receptor's functions and regulatory mechanisms. Our data have identified prostaglandin A2 (PGA2), a cyclopentenone prostaglandin (PG), as such a ligand. Cyclopentenone PGs exert their biological effects primarily by forming protein adducts via the characteristic electrophilic ß-carbon(s) located in their cyclopentenone rings. Our data show that PGA2 induces Nur77 transcriptional activity by forming a covalent adduct between its endocyclic ß-carbon, C9, and Cys566 in the receptor's LBD. The importance of this endocyclic ß-carbon was substantiated by the failure of PGs without such electrophilic properties to react with Nur77. Calculated chemical properties and data from reactive molecular dynamic simulations, intrinsic reaction co-ordinate modeling, and covalent molecular docking also corroborate the selectivity of PGA2's C9 ß-carbon towards Nur77's Cys. In summary, our molecular, chemical, and structural characterization of the PGA2-Nur77 interaction provides the first evidence that PGA2 is an endogenous Nur77 agonist.


Asunto(s)
Miembro 1 del Grupo A de la Subfamilia 4 de Receptores Nucleares/agonistas , Prostaglandinas A/química , Prostaglandinas A/fisiología , Línea Celular , Humanos , Miembro 1 del Grupo A de la Subfamilia 4 de Receptores Nucleares/metabolismo , Prostaglandinas A/metabolismo , Unión Proteica , Dominios Proteicos
18.
Biochem J ; 474(9): 1531-1546, 2017 04 24.
Artículo en Inglés | MEDLINE | ID: mdl-28100650

RESUMEN

Transforming growth factor ß (TGF-ß) contributes to wound healing and, when dysregulated, to pathological fibrosis. TGF-ß and the anti-fibrotic nuclear hormone receptor peroxisome proliferator-activated receptor γ (PPARγ) repress each other's expression, and such PPARγ down-regulation is prominent in fibrosis and mediated, via previously unknown SMAD-signaling mechanisms. Here, we show that TGF-ß induces the association of SMAD3 with both SMAD4, needed for translocation of the complex into the nucleus, and the essential context-sensitive co-repressors E2F4 and p107. The complex mediates TGF-ß-induced repression by binding to regulatory elements in the target promoter. In the PPARG promoter, we found that the SMAD3-SMAD4 complex binds both to a previously unknown consensus TGF-ß inhibitory element (TIE) and also to canonical SMAD-binding elements (SBEs). Furthermore, the TIE and SBEs independently mediated the partial repression of PPARG transcription, the first demonstration of a TIE and SBEs functioning within the same promoter. Also, TGF-ß-treated fibroblasts contained SMAD complexes that activated a SMAD target gene in addition to those repressing PPARG transcription, the first finding of such dual activity within the same cell. These findings describe in detail novel mechanisms by which TGF-ß represses PPARG transcription, thereby facilitating its own pro-fibrotic activity.


Asunto(s)
PPAR gamma/metabolismo , Proteína smad3/metabolismo , Proteína Smad4/metabolismo , Factor de Crecimiento Transformador beta/fisiología , Secuencia de Bases , Línea Celular , Regulación hacia Abajo , Regulación de la Expresión Génica , Humanos , PPAR gamma/genética , Regiones Promotoras Genéticas , Unión Proteica , ARN Mensajero/genética , Transducción de Señal , Transcripción Genética
19.
Angew Chem Int Ed Engl ; 56(43): 13310-13313, 2017 10 16.
Artículo en Inglés | MEDLINE | ID: mdl-28841255

RESUMEN

Non-oxidative, regioselective, and convergent access to densely functionalized oxazoles is realized in a functional-group tolerant manner using alkynyl thioethers. Sulfur-terminated alkynes provide access to reactivity previously requiring strong donor-substituted alkynes such as ynamides. Sulfur does not act in an analogous donor fashion in this gold-catalyzed reaction, thus leading to complementary regioselective outcomes and addressing the limitations of using ynamides.

20.
J Biol Chem ; 289(10): 6383-6393, 2014 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-24368768

RESUMEN

Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory condition and a leading cause of death, with no available cure. We assessed the actions in pulmonary epithelial cells of peroxisome proliferator-activated receptor γ (PPARγ), a nuclear hormone receptor with anti-inflammatory effects, whose role in COPD is largely unknown. We found that PPARγ was down-regulated in lung tissue and epithelial cells of COPD patients, via both reduced expression and phosphorylation-mediated inhibition, whereas pro-inflammatory nuclear factor-κB (NF-κB) activity was increased. Cigarette smoking is the main risk factor for COPD, and exposing airway epithelial cells to cigarette smoke extract (CSE) likewise down-regulated PPARγ and activated NF-κB. CSE also down-regulated and post-translationally inhibited the glucocorticoid receptor (GR-α) and histone deacetylase 2 (HDAC2), a corepressor important for glucocorticoid action and whose down-regulation is thought to cause glucocorticoid insensitivity in COPD. Treating epithelial cells with synthetic (rosiglitazone) or endogenous (10-nitro-oleic acid) PPARγ agonists strongly up-regulated PPARγ expression and activity, suppressed CSE-induced production and secretion of inflammatory cytokines, and reversed its activation of NF-κB by inhibiting the IκB kinase pathway and by promoting direct inhibitory binding of PPARγ to NF-κB. In contrast, PPARγ knockdown via siRNA augmented CSE-induced chemokine release and decreases in HDAC activity, suggesting a potential anti-inflammatory role of endogenous PPARγ. The results imply that down-regulation of pulmonary epithelial PPARγ by cigarette smoke promotes inflammatory pathways and diminishes glucocorticoid responsiveness, thereby contributing to COPD pathogenesis, and further suggest that PPARγ agonists may be useful for COPD treatment.


Asunto(s)
Antiinflamatorios no Esteroideos/farmacología , Pulmón/efectos de los fármacos , Ácidos Oléicos/farmacología , PPAR gamma/agonistas , Enfermedad Pulmonar Obstructiva Crónica/metabolismo , Mucosa Respiratoria/efectos de los fármacos , Tiazolidinedionas/farmacología , Bronquios/efectos de los fármacos , Bronquios/metabolismo , Bronquios/patología , Células Cultivadas , Regulación hacia Abajo , Resistencia a Medicamentos , Técnicas de Silenciamiento del Gen , Histona Desacetilasa 2/antagonistas & inhibidores , Humanos , Pulmón/metabolismo , Pulmón/patología , FN-kappa B/metabolismo , Estrés Oxidativo/efectos de los fármacos , PPAR gamma/antagonistas & inhibidores , PPAR gamma/genética , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Enfermedad Pulmonar Obstructiva Crónica/patología , Mucosa Respiratoria/metabolismo , Mucosa Respiratoria/patología , Rosiglitazona , Fumar/efectos adversos , Fumar/metabolismo , Fumar/patología
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