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1.
Artículo en Inglés | MEDLINE | ID: mdl-39393626

RESUMEN

OBJECTIVE: This study explored the characteristics and prognostic impact of chronic lung allograft dysfunction (CLAD) after deceased-donor lung transplantation and living-donor lobar lung transplantation, wherein the lower lobes from two donors are usually transplanted into one recipient. METHODS: The clinical data of 123 deceased-donor and 67 living-donor lung transplantations performed in adult patients at our institution between June 2008 and September 2019 were retrospectively reviewed. The cumulative incidence of CLAD was evaluated on a per-recipient and per-donor graft basis using the Kaplan-Meier method. RESULTS: The smaller number of human leukocyte antigen mismatches, shorter ischemic time, and lower incidence of grade 3 primary graft dysfunction were observed in living-donor transplantation than in deceased-donor transplantation (p<0.001). Restrictive allograft syndrome (RAS)-type CLAD occurred in 9 (20.9%) of 43 CLAD patients after deceased-donor transplantation and 9 (45.0%) of 20 CLAD patients after living-donor transplantation. CLAD occurred unilaterally in 15 patients (75.0%) after bilateral living-donor transplantation. Despite the higher incidence of RAS-type CLAD after living-donor transplantation, the overall survival rates after the transplantation and survival rates after the onset of CLAD were comparable between the deceased-donor transplant and living-donor transplant patients. The cumulative incidence of CLAD per recipient was similar between the deceased-donor and the living-donor transplant recipients (p=0.32). In the per-donor graft analysis, the cumulative incidence of CLAD was significantly lower in the living-donor grafts than in the deceased-donor grafts (p=0.003). CONCLUSIONS: The manifestation of CLAD after living-donor lobar lung transplantation is unique and differs from that after deceased-donor lung transplantation.

2.
Artículo en Inglés | MEDLINE | ID: mdl-39251208

RESUMEN

The management of oligometastatic renal cell carcinoma with pulmonary metastases is controversial and occasionally requires multimodality management, including salvage pulmonary metastasectomy after immune checkpoint inhibitors (ICIs). However, limited data are available on these patients. We describe a case series of three consecutive patients who underwent salvage pulmonary metastasectomy after ICIs for oligometastatic renal cell carcinoma and discussed the important characteristics of these patients. After salvage pulmonary metastasectomy, none of the patients had recurrent pulmonary metastases, although one of them developed a brain metastasis postoperatively. Our case series suggests that salvage pulmonary metastasectomy after ICIs may control pulmonary metastases in carefully selected patients with oligometastatic renal cell carcinoma, although the management of extrapulmonary metastases may be required after salvage pulmonary metastasectomy.

3.
Toxics ; 12(8)2024 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-39195660

RESUMEN

Hawke's Bay in New Zealand was impacted by Cyclone Gabrielle in 2023, experiencing intense weather conditions and rainfall. Rivers and streams surged beyond their banks, displacing large amounts of sediment. The sewage treatment plant and industries in the Waitangi catchment, south of the city of Napier, were heavily impacted, making them potential sources of contaminants. The aim of this study was to investigate the risk of displaced sediments deposited south of Napier City, using bioassays and chemical analysis methods. Sediment samples were collected across a gradient between the coastline and the Waitangi Stream. The toxicity of chemically extracted or elutriate samples was assessed by Microtox®, mussel embryo-larval development, and aryl hydrocarbon and constitutive androstane receptor yeast two-hybrid assays. Targeted chemical analysis and automated identification and quantification system (AIQS-GC) methods were used to identify contaminants. The elutriates showed low toxicity and the yeast assays showed levels of activity like those previously reported. Chemical methods confirmed historical contamination by DDT and its metabolites DDE and DDD, as well as by plant sterols. Overall, the toxicity and chemicals detected are what would be expected from a typical agricultural soil. The risk posed by the displaced sediment in the Waitangi catchment can be considered low. Combining chemical and bioanalytical methods was an effective approach to investigate the potential risks of post-disaster contamination.

4.
Vaccine ; 42(23): 126221, 2024 Oct 03.
Artículo en Inglés | MEDLINE | ID: mdl-39180977

RESUMEN

Poor post-vaccination production of antibody against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a concern among solid organ transplant (SOT) recipients. Furthermore, the timing and kinetics of antibody titers after the second vaccine dose are unknown. We conducted a multicenter prospective observational study that included 614 SOT recipients: 460 kidney, 53 heart, 50 liver, 20 lung, and 31 simultaneous pancreas-kidney (SPK). The participants received two doses of the mRNA vaccine (Pfizer BNT162b2 or Moderna mRNA-1273), as indicated. Serum samples were collected before the first and second vaccinations and at 1, 3, and 6 months after the second vaccine dose, which were then assessed for SARS-CoV-2 antibodies. The overall seropositivity rate was 43% at 1 month after administration of the second vaccine dose; it gradually increased to 68% at 3 months after second dose administration and to 70% at 6 months. In addition, recipient of kidney, lung or SPK transplants had lower antibody titers at the 3- and 6-month time points than did the other recipients. SOT recipients acquired SARS-CoV-2 S-IgG antibodies slowly, and the peak titer differed significantly from that of the general population.


Asunto(s)
Anticuerpos Antivirales , Vacuna BNT162 , Vacunas contra la COVID-19 , COVID-19 , Trasplante de Órganos , SARS-CoV-2 , Receptores de Trasplantes , Humanos , Anticuerpos Antivirales/sangre , Estudios Prospectivos , Masculino , Femenino , Persona de Mediana Edad , COVID-19/prevención & control , COVID-19/inmunología , SARS-CoV-2/inmunología , Vacuna BNT162/inmunología , Vacuna BNT162/administración & dosificación , Anciano , Adulto , Vacunas contra la COVID-19/inmunología , Vacunas contra la COVID-19/administración & dosificación , Vacuna nCoV-2019 mRNA-1273/inmunología , Vacuna nCoV-2019 mRNA-1273/administración & dosificación , Inmunoglobulina G/sangre , Vacunación
5.
Ther Drug Monit ; 2024 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-39115832

RESUMEN

BACKGROUND: Tacrolimus is an immunosuppressant administered to patients undergoing lung transplantation. Itraconazole is often concomitantly used with tacrolimus to prevent fungal infections and increase tacrolimus concentration. However, the pharmacokinetics of tacrolimus in Japanese lung transplant recipients and the effect of itraconazole on its pharmacokinetics have not been adequately evaluated. Population pharmacokinetic analysis was conducted to develop an optimal dose adjustment method for use upon itraconazole initiation in Japanese lung transplant recipients. METHODS: This study comprised Japanese lung transplant recipients whose blood tacrolimus and itraconazole concentrations were measured between January 2017 and December 2019. A nonlinear mixed-effects modeling program was used to explore the covariates of tacrolimus pharmacokinetics and effects of concomitant itraconazole use. Using the model, the optimal initial tacrolimus dose was calculated and a dose adjustment method comprising concomitant itraconazole use was developed. RESULTS: A total of 1693 tacrolimus trough blood concentrations and 85 itraconazole trough plasma concentrations were obtained from 43 patients. Postoperative day, albumin level, and administration route were extracted as covariates for tacrolimus pharmacokinetics. The drug-drug interaction between tacrolimus and itraconazole could be predicted more accurately by considering the concentration-dependent inhibition of itraconazole. The optimal initial tacrolimus dose was 2.0 mg twice daily for tube and 1.5 mg twice daily for oral administration. To maintain the target concentration, the tacrolimus dose was reduced by 60% upon itraconazole initiation. CONCLUSIONS: This study is the first to use population pharmacokinetic analysis to assess the interaction between tacrolimus and itraconazole in patients who underwent lung transplantation. These results provide useful insights for optimizing the initial tacrolimus dose for concomitant itraconazole use.

6.
J Surg Res ; 301: 315-323, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39013278

RESUMEN

INTRODUCTION: Carbon monoxide (CO) has been shown to exert protective effects in multiple organs following ischemic injury, including the lung. The purpose of this study was to examine the effects of CO administration during ex vivo lung perfusion (EVLP) on lung grafts exposed to prolonged cold ischemia. METHODS: Ten porcine lungs were subjected to 18 h of cold ischemia followed by 6 h of EVLP. Lungs were randomized to EVLP alone (control, n = 5) or delivery of 500 ppm of CO during the 1st hour of EVLP (treatment, n = 5). Following EVLP, the left lungs were transplanted and reperfused for 4 h. RESULTS: At the end of EVLP, pulmonary vascular resistance (P = 0.007) and wet to dry lung weight ratios (P = 0.027) were significantly reduced in CO treated lungs. Posttransplant, lung graft PaO2/FiO2 (P = 0.032) and compliance (P = 0.024) were significantly higher and peak airway pressure (P = 0.032) and wet to dry ratios (P = 0.003) were significantly lower in CO treated lungs. Interleukin-6 was significantly reduced in plasma during reperfusion in the CO treated group (P = 0.040). CONCLUSIONS: In this preclinical porcine model, CO application during EVLP resulted in better graft performance and outcomes after reperfusion.


Asunto(s)
Monóxido de Carbono , Isquemia Fría , Trasplante de Pulmón , Pulmón , Perfusión , Animales , Trasplante de Pulmón/métodos , Perfusión/métodos , Pulmón/irrigación sanguínea , Porcinos , Preservación de Órganos/métodos , Daño por Reperfusión/prevención & control , Daño por Reperfusión/etiología , Interleucina-6/sangre , Interleucina-6/metabolismo
7.
Chemosphere ; 361: 142495, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38823427

RESUMEN

The cationic surfactant triethanolamine-based esterquat (TEAQ) is a main ingredient in commercial fabric softeners and is produced and used in large quantities. However, little information is available for its occurrence in the environment, particularly in sediments. Here, we developed an analytical method for quantifying TEAQ in sediment and investigated TEAQ contamination in Japanese river and lake sediments. In our analytical method, TEAQ concentrations were measured by liquid chromatography-tandem mass spectrometry using a polymer-based size-exclusion column, which resulted in excellent peak shapes. TEAQ was detected at significant levels in procedural blanks, resulting in a method limit of detection in the sediment of 8.9-97 µg/kg-dry for TEAQ monoesters and 0.6-24 µg/kg-dry for TEAQ diesters. TEAQ was detected in 22 out of 26 sediment samples, with the sum of all homologue concentrations being up to 1340 µg/kg-dry. The concentration of TEAQ in sediments was high at locations where the concentrations of benzalkoniums and the organic carbon content were also high. TEAQ was detected in 8 out of 14 commercial fabric softeners at concentrations of 1.7-7.4 wt%. TEAQ homologues containing only saturated fatty acids accounted for 83 ± 5% of the total TEAQ in the sediments, whereas those with unsaturated fatty acids accounted for 71 ± 14% of the total TEAQ in a commercial technical mixture and the softener products. The results of this study will be useful for the environmental risk assessment of esterquats.


Asunto(s)
Monitoreo del Ambiente , Sedimentos Geológicos , Ríos , Espectrometría de Masas en Tándem , Contaminantes Químicos del Agua , Sedimentos Geológicos/química , Contaminantes Químicos del Agua/análisis , Monitoreo del Ambiente/métodos , Ríos/química , Etanolaminas/análisis , Tensoactivos/análisis , Tensoactivos/química , Cromatografía Liquida , Lagos/química
8.
Front Endocrinol (Lausanne) ; 15: 1380779, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38919481

RESUMEN

Objective: Aromatherapy is a holistic healing method to promote health and well-being by using natural plant extracts. However, its precise mechanism of action and influence on the endocrine system remains unclear. Since recent studies reported that a neuropeptide, oxytocin, can attenuate anxiety, we hypothesized that if oxytocin secretion is promoted through aromatherapy, it may improve mood and anxiety. The present study is aimed to investigate the relationship between oxytocin and the effects of aromatherapy with lavender oil on anxiety level, by measuring salivary oxytocin levels in healthy men and women. Methods: We conducted a randomized open crossover trial in 15 men and 10 women. Each participant received a placebo intervention (control group) and aromatherapy with lavender oil (aromatherapy group). For the aromatherapy group, each participant spent a 30-min session in a room with diffused lavender essential oil, followed by a 10-min hand massage using a carrier oil containing lavender oil. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI) before the intervention, 30-min after the start of intervention, and after hand massage, in both groups. Saliva samples were collected at the same time points of the STAI. Results: In women, either aromatherapy or hand massage was associated with a reduction in anxiety levels, independently. Moreover, salivary oxytocin levels were increased after aromatherapy. On the other hand, in men, anxiety levels were decreased after aromatherapy, as well as after hand massage, regardless of the use of lavender oil. However, there were no significant differences in changes of salivary oxytocin levels between the control and aromatherapy groups during the intervention period. Interestingly, there was a positive correlation between anxiety levels and salivary oxytocin levels before the intervention, but a negative correlation was observed after hand massage with lavender oil. Conclusion: The results of the present study indicate that in women, aromatherapy with lavender oil attenuated anxiety with increase in oxytocin level in women, whereas in men, there was no clear relationship of aromatherapy with anxiety or oxytocin levels but, there was a change in correlation between anxiety and oxytocin. The results of the present study suggest that the effect of aromatherapy can vary depending on sex.


Asunto(s)
Ansiedad , Aromaterapia , Estudios Cruzados , Lavandula , Aceites Volátiles , Oxitocina , Aceites de Plantas , Saliva , Humanos , Oxitocina/metabolismo , Aromaterapia/métodos , Femenino , Masculino , Saliva/química , Saliva/metabolismo , Ansiedad/terapia , Ansiedad/metabolismo , Adulto , Aceites Volátiles/uso terapéutico , Lavandula/química , Adulto Joven , Caracteres Sexuales
9.
Leukemia ; 38(6): 1256-1265, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38740980

RESUMEN

Recent advances in in-depth data-independent acquisition proteomic analysis have enabled comprehensive quantitative analysis of >10,000 proteins. Herein, an integrated proteogenomic analysis for inherited bone marrow failure syndrome (IBMFS) was performed to reveal their biological features and to develop a proteomic-based diagnostic assay in the discovery cohort; dyskeratosis congenita (n = 12), Fanconi anemia (n = 11), Diamond-Blackfan anemia (DBA, n = 9), Shwachman-Diamond syndrome (SDS, n = 6), ADH5/ALDH2 deficiency (n = 4), and other IBMFS (n = 18). Unsupervised proteomic clustering identified eight independent clusters (C1-C8), with the ribosomal pathway specifically downregulated in C1 and C2, enriched for DBA and SDS, respectively. Six patients with SDS had significantly decreased SBDS protein expression, with two of these not diagnosed by DNA sequencing alone. Four patients with ADH5/ALDH2 deficiency showed significantly reduced ADH5 protein expression. To perform a large-scale rapid IBMFS screening, targeted proteomic analysis was performed on 417 samples from patients with IBMFS-related hematological disorders (n = 390) and healthy controls (n = 27). SBDS and ADH5 protein expressions were significantly reduced in SDS and ADH5/ALDH2 deficiency, respectively. The clinical application of this first integrated proteogenomic analysis would be useful for the diagnosis and screening of IBMFS, where appropriate clinical screening tests are lacking.


Asunto(s)
Enfermedades de la Médula Ósea , Trastornos de Fallo de la Médula Ósea , Proteogenómica , Humanos , Trastornos de Fallo de la Médula Ósea/genética , Trastornos de Fallo de la Médula Ósea/patología , Proteogenómica/métodos , Masculino , Femenino , Enfermedades de la Médula Ósea/genética , Enfermedades de la Médula Ósea/patología , Niño , Adulto , Adolescente , Preescolar , Anemia de Diamond-Blackfan/genética , Anemia de Diamond-Blackfan/diagnóstico , Adulto Joven , Anemia de Fanconi/genética , Anemia de Fanconi/diagnóstico , Proteómica/métodos , Lactante , Síndrome de Shwachman-Diamond/genética , Disqueratosis Congénita/genética , Disqueratosis Congénita/diagnóstico , Disqueratosis Congénita/patología
10.
Cureus ; 16(5): e60029, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38736769

RESUMEN

Introduction Fan therapy has gained attention as a non-pharmacological treatment for alleviating dyspnea in patients receiving palliative care and in those with chronic progressive diseases. However, the effectiveness of fan therapy for dyspnea in critically ill patients in intensive care units (ICUs) remains unclear. This study aimed to investigate the efficacy and safety of fan therapy for lung transplant patients in the ICU. Methods Fan therapy was performed on lung transplant recipients (age >18 years) who experienced dyspnea during their ICU stay. A tabletop portable fan was used to blow air on the patient's face for five minutes providing fan therapy. The intensity of dyspnea before and after the fan therapy was determined, and a statistical analysis was conducted using a paired t-test to evaluate the changes. Results Between May 2023 and February 2024, 16 patients who were admitted to the ICU following lung transplantation were screened, and eight patients received fan therapy. Fan therapy was performed at a median of postoperative day 12. Seven patients (87.5%) received mechanical ventilation via tracheostomy. The mean (±standard deviation) numerical rating scale (NRS) for dyspnea before and after fan therapy was 5.6±2.3 and 4.4±1.5, respectively (p = 0.08). The mean (±standard deviation) respiratory distress observation scale (RDOS) before and after fan therapy was 4.8 ± 2.0 and 3.8 ± 1.7, respectively (p = 0.03). No serious adverse events were observed, and no significant alterations were observed in the respiratory rate, oxygen saturation levels, pulse rate, or blood pressure. Conclusion The findings suggest that fan therapy can be safely used to relieve dyspnea in lung transplant recipients during their ICU stay. Further evaluations in larger trials are required to confirm the results of this study.

11.
RSC Adv ; 14(17): 12021-12029, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38623302

RESUMEN

Molecular imprinting technology has been widely studied as a technique to obtain molecular recognition by artificial means. Selecting functional monomers or polymerization conditions plays a key role to optimize molecularly imprinted polymer (MIP) synthesis. To date, there have been few reports well exploiting the effect of crosslinkers. Here, in this study, we synthesized the MIPs using poly(ethyleneglycol) dimethacrylate with different units of ethylene oxide (n = 1 to 23) as crosslinkers to observe the molecular recognition abilities. The MIPs were attached to the surface of mono-dispersed polymer beads. The obtained spherical MIPs and non-imprinted polymers were filled in a column for high performance liquid chromatography. Then the retention selectivity toward TR active substances was evaluated. The result revealed that the recognition ability did not improve regardless of the amount of ethylene oxide. With the crosslinker (n = 9), extremely high retention selectivity was observed, which provides at most around ten times as large imprinting factors in comparison with other MIPs. Interestingly, we obtained the highest recognition ability at around polymerization temperature from the evaluation of the recognition ability toward temperature shift using the MIP (n = 9). In general, hydrogen bonding based on MIPs provides high recognition ability at low temperature, whereas, this study indicates that the use of flexible crosslinkers may enable the synthesis of MIPs that precisely memorize the conditions of polymerization. Lastly, we simultaneously analyzed the TR active substances using the column filled with MIPs (n = 9). The result showed relatively linear correlation between the retention strength of each substance and phycological activity toward TR obtained by yeast assay. Therefore, we can conclude that an induced fit like the receptor emerged by constructing the flexible molecular recognition field.

12.
Surg Today ; 54(10): 1220-1226, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38619591

RESUMEN

PURPOSE: To investigate how revision of the organ transplant law in Japan affected lung transplantation in this country. METHODS: Lung transplant candidates registered between January, 2000 and December, 2009 were designated as the pre-revision group (n = 396) and those registered between January, 2011 and December, 2020, as the post-revision group (n = 1326). Both groups were analyzed retrospectively using data collected by the Japanese Society of Lung and Heart-Lung Transplantation. RESULTS: The number of patients who underwent brain-dead donor lung transplantation (BDLT) increased significantly after the law amendment (32.2 vs. 13.8%, p < 0.01). The median waiting time for BDLT was significantly reduced (708 days vs. 1163 days, p < 0.01) and the mortality rate while waiting for BDLT improved significantly after the law amendment (33.1 vs. 42.6%, p < 0.01). In the post-revision group, 18 pediatric patients underwent BDLT. The 5-year survival rates after BDLT were comparable between the groups (73.5% in the pre-revision group vs. 73.2% in the post-revision group, p = 0.32). CONCLUSIONS: The organ transplant law revision shortened the waiting time for BDLT significantly and decreased the mortality rate while waiting for BDLT. The posttransplant outcomes in Japan remained favorable throughout the study period.


Asunto(s)
Trasplante de Pulmón , Listas de Espera , Trasplante de Pulmón/legislación & jurisprudencia , Trasplante de Pulmón/mortalidad , Humanos , Japón , Estudios Retrospectivos , Masculino , Femenino , Factores de Tiempo , Persona de Mediana Edad , Tasa de Supervivencia , Adulto , Muerte Encefálica/legislación & jurisprudencia , Niño , Obtención de Tejidos y Órganos/legislación & jurisprudencia , Adolescente , Adulto Joven , Preescolar
13.
Mol Cell Proteomics ; 23(4): 100745, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38447790

RESUMEN

In recent years, there has been a growing demand for low-input proteomics, particularly in the context of single-cell proteomics (SCP). In this study, we have developed a lauryl maltose neopentyl glycol (LMNG)-assisted sample preparation (LASP) method. This method effectively reduces protein and peptide loss in samples by incorporating LMNG, a surfactant, into the digestion solution and subsequently removing the LMNG simply via reversed phase solid-phase extraction. The advantage of removing LMNG during sample preparation for general proteomic analysis is the prevention of mass spectrometry (MS) contamination. When we applied the LASP method to the low-input SP3 method and on-bead digestion in coimmunoprecipitation-MS, we observed a significant improvement in the recovery of the digested peptides. Furthermore, we have established a simple and easy sample preparation method for SCP based on the LASP method and identified a median of 1175 proteins from a single HEK239F cell using liquid chromatography (LC)-MS/MS with a throughput of 80 samples per day.


Asunto(s)
Métodos Analíticos de la Preparación de la Muestra , Glicoles , Maltosa , Proteómica , Análisis de la Célula Individual , Maltosa/química , Glicoles/química , Análisis de la Célula Individual/métodos , Proteómica/métodos , Humanos , Células HEK293 , Cromatografía Líquida con Espectrometría de Masas , Inmunoprecipitación
14.
J Thorac Dis ; 16(2): 1473-1479, 2024 Feb 29.
Artículo en Inglés | MEDLINE | ID: mdl-38505082

RESUMEN

Background: Despite the low number of lung transplantations (LTs) in Japan, 10 LT facilities are accredited and good outcomes have been reported. A database review was conducted to clarify the impact of case volume at LT facilities in Japan on short- and long-term outcomes. Methods: All cadaveric LT cases treated between 2000 and 2021 in Japan were analyzed using the database of the Japanese Society of Lung and Heart-Lung Transplantation (JSLHT). The nine institutions represented were categorized into the low-volume (LV; <80 cumulative LT cases, <8 LTs/year, n=5) and high-volume (HV; ≥80 cumulative LT cases, ≥8 LTs/year, n=4) centers. Ninety-day and 1-year mortality, as well as 5- and 10-year survival data were evaluated. Results: A total of 658 cadaveric LTs were performed at the nine institutions. The 90-day rates of mortality at the HV and LV centers were 3.5% and 3.9%, respectively (P=0.801), while the 1-year mortality rates were 9.2% and 11.5%, respectively (P=0.199). Additionally, log-rank analysis of Kaplan-Meier curves showing case volume did not reveal a significant difference in long-term survival between the HV and LV centers (P=0.272), though the LV centers had wide differences for long-term outcomes (P=0.030). Conclusions: Case volume did not have effects on short- or long-term outcomes following LT in Japan, while there were large variations in long-term outcomes among the LV centers compared to those of the HV centers.

15.
Asian Cardiovasc Thorac Ann ; : 2184923241241583, 2024 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-38528734

RESUMEN

The management of malignant melanoma with pulmonary metastases is controversial and occasionally requires multimodality management, including pulmonary metastasectomy after immune checkpoint inhibitors (ICIs). However, limited data are available on these patients. We described a case series of three consecutive patients who underwent pulmonary metastasectomy after ICIs for malignant melanoma and discussed the important characteristics of these patients. After pulmonary metastasectomy, none of the patients had recurrent pulmonary metastases, although extrapulmonary metastases were developed. Our case series suggests that pulmonary metastasectomy after ICIs may control pulmonary metastases in carefully selected patients with malignant melanoma.

16.
Eur J Cardiothorac Surg ; 65(4)2024 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-38539035

RESUMEN

OBJECTIVES: Preoperative intravenous epoprostenol therapy can cause thrombocytopaenia, which may increase the risk of perioperative bleeding during lung transplantation. This study aimed to determine whether lung transplantation can be safely performed in patients with epoprostenol-induced thrombocytopaenia. METHODS: From June 2008 to July 2022, we performed 37 lung transplants in patients with pulmonary arterial hypertension (PAH), including idiopathic PAH (n = 26), congenital heart disease-associated PAH (n = 7), pulmonary veno-occlusive disease (n = 3) and peripheral pulmonary artery stenosis (n = 1) at our institution. Of these, 26 patients received intravenous epoprostenol therapy (EPO group), whereas 11 patients were treated with no epoprostenol (no-EPO group). We retrospectively analysed the preoperative and postoperative platelet counts and post-transplant outcomes in each group. RESULTS: Preoperative platelet counts were relatively lower in the EPO group than in the no-EPO group (median EPO: 127 000 vs no-EPO: 176 000/µl). However, blood loss during surgery was similar between the 2 groups (EPO: 2473 ml vs no-EPO: 2615 ml). The platelet counts significantly increased over 1 month after surgery, and both groups showed similar platelet counts (EPO: 298 000 vs no-EPO: 284 000/µl). In-hospital mortality (EPO: 3.9% vs no-EPO: 18.2%) and the 3-year survival rate (EPO: 91.4% vs no-EPO: 80.8%) were similar between the 2 groups. CONCLUSIONS: Patients with PAH treated with intravenous epoprostenol showed relatively lower platelet counts, which improved after lung transplantation with good post-transplant outcomes.


Asunto(s)
Hipertensión Pulmonar , Trasplante de Pulmón , Hipertensión Arterial Pulmonar , Trombocitopenia , Humanos , Epoprostenol/uso terapéutico , Epoprostenol/efectos adversos , Antihipertensivos/efectos adversos , Hipertensión Pulmonar/tratamiento farmacológico , Hipertensión Pulmonar/cirugía , Estudios Retrospectivos , Hipertensión Pulmonar Primaria Familiar , Trombocitopenia/inducido químicamente , Trombocitopenia/tratamiento farmacológico
17.
J Infect Chemother ; 30(8): 741-745, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38354908

RESUMEN

INTRODUCTION: Fungal infection after lung transplantation can lead to poor clinical outcome, for which lung transplant recipients require prophylaxis. One of the antifungal agents used after lung transplantation is nebulized amphotericin B (AMB). Nebulized AMB causes adverse events such as dyspnea and airway irritation, and long-term use leads to high economic costs. So far, prophylactic regimens employing AMB deoxycholate (AMB-d) and liposomal AMB (L-AMB) have been developed. This study compared the efficacy, safety, and cost of AMB-d and L-AMB. PATIENTS AND METHODS: Patients who underwent lung transplantation at Kyoto University Hospital from January 2021 to May 2023 were included in this study. Thirty-three patients received nebulized AMB-d, whereas 29 received nebulized L-AMB. RESULTS: Both regimens maintained comparable prophylactic efficacy regarding the development of fungal infection in the AMB-d and L-AMB groups (3.0% vs. 3.4%, P = 0.877). Patients treated with nebulized L-AMB experienced fewer respiratory-related adverse reactions than those treated with nebulized AMB-d (6.9% vs. 30.3%, P < 0.05), leading to a longer treatment duration with L-AMB than with AMB-d. Additionally, the daily cost of administering L-AMB was lower than that of administering AMB-d (3609 Japanese yen vs. 1792.3 Japanese yen, P < 0.05). DISCUSSION: These results suggest that nebulized L-AMB is safer and more cost-effective than nebulized AMB-d, with comparable efficacy.


Asunto(s)
Anfotericina B , Antifúngicos , Análisis Costo-Beneficio , Ácido Desoxicólico , Combinación de Medicamentos , Trasplante de Pulmón , Micosis , Nebulizadores y Vaporizadores , Humanos , Anfotericina B/administración & dosificación , Anfotericina B/economía , Anfotericina B/efectos adversos , Anfotericina B/uso terapéutico , Antifúngicos/economía , Antifúngicos/administración & dosificación , Antifúngicos/uso terapéutico , Antifúngicos/efectos adversos , Masculino , Femenino , Trasplante de Pulmón/efectos adversos , Trasplante de Pulmón/economía , Persona de Mediana Edad , Ácido Desoxicólico/administración & dosificación , Ácido Desoxicólico/efectos adversos , Ácido Desoxicólico/economía , Ácido Desoxicólico/uso terapéutico , Micosis/prevención & control , Micosis/economía , Anciano , Adulto , Administración por Inhalación , Estudios Retrospectivos , Japón
18.
Am J Transplant ; 24(6): 944-953, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38403187

RESUMEN

Chronic lung allograft dysfunction (CLAD) remains one of the major limitations to long-term survival after lung transplantation. We modified a murine model of CLAD and transplanted left lungs from BALB/c donors into B6 recipients that were treated with intermittent cyclosporine and methylprednisolone postoperatively. In this model, the lung allograft developed acute cellular rejection on day 15 which, by day 30 after transplantation, progressed to severe pleural and peribronchovascular fibrosis, reminiscent of changes observed in restrictive allograft syndrome. Lung transplantation into splenectomized B6 alymphoplastic (aly/aly) or splenectomized B6 lymphotoxin-ß receptor-deficient mice demonstrated that recipient secondary lymphoid organs, such as spleen and lymph nodes, are necessary for progression from acute cellular rejection to allograft fibrosis in this model. Our work uncovered a critical role for recipient secondary lymphoid organs in the development of CLAD after pulmonary transplantation and may provide mechanistic insights into the pathogenesis of this complication.


Asunto(s)
Modelos Animales de Enfermedad , Rechazo de Injerto , Trasplante de Pulmón , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Animales , Ratones , Rechazo de Injerto/etiología , Rechazo de Injerto/patología , Trasplante de Pulmón/efectos adversos , Aloinjertos , Progresión de la Enfermedad , Fibrosis , Enfermedad Crónica , Supervivencia de Injerto , Masculino , Tejido Linfoide/patología
20.
Int J Mol Sci ; 25(2)2024 Jan 21.
Artículo en Inglés | MEDLINE | ID: mdl-38279312

RESUMEN

Serum and plasma exhibit a broad dynamic range of protein concentrations, posing challenges for proteome analysis. Various technologies have been developed to reduce this complexity, including high-abundance depletion methods utilizing antibody columns, extracellular vesicle enrichment techniques, and trace protein enrichment using nanobead cocktails. Here, we employed lectins to address this, thereby extending the scope of biomarker discovery in serum or plasma using a novel approach. We enriched serum proteins using 37 different lectins and subjected them to LC-MS/MS analysis with data-independent acquisition. Solanum tuberosum lectin (STL) and Lycopersicon esculentum lectin (LEL) enabled the detection of more serum proteins than the other lectins. STL and LEL bind to N-acetylglucosamine oligomers, emphasizing the significance of capturing these oligomer-binding proteins when analyzing serum trace proteins. Combining STL and LEL proved more effective than using them separately, allowing us to identify over 3000 proteins from serum through single-shot proteome analysis. We applied the STL/LEL trace-protein enrichment method to the sera of systemic lupus erythematosus model mice. This revealed differences in >1300 proteins between the systemic lupus erythematosus model and control mouse sera, underscoring the utility of this method for biomarker discovery.


Asunto(s)
Lupus Eritematoso Sistémico , Solanum lycopersicum , Solanum tuberosum , Animales , Ratones , Proteoma , Solanum tuberosum/metabolismo , Cromatografía Liquida , Espectrometría de Masas en Tándem , Lectinas de Plantas/metabolismo , Lectinas/metabolismo , Proteínas Sanguíneas , Biomarcadores
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