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1.
Phys Rev Lett ; 119(24): 248301, 2017 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-29286724

RESUMEN

We report experimental results on the competitive passage of elongated self-propelled vehicles rushing through a constriction. For the chosen experimental conditions, we observe the emergence of intermittencies similar to those reported previously for active matter passing through narrow doors. Noteworthy, we find that, when the number of individuals crowding in front of the bottleneck increases, there is a transition from an unclogged to a clogged state characterized by a lack of convergence of the mean clog duration as the measuring time increases. It is demonstrated that this transition-which was reported previously only for externally vibrated systems such as colloids or granulars-appears also for self-propelled agents. This suggests that the transition should also occur for the flow through constrictions of living agents (e.g., humans and sheep), an issue that has been elusive so far in experiments due to safety risks.


Asunto(s)
Aglomeración , Modelos Teóricos , Movimiento (Física) , Vibración
2.
Am J Transplant ; 15(7): 1933-47, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25649290

RESUMEN

The pathogenesis of chronic rejection, Bronchiolitis Obliterans Syndrome (BOS) following lung transplantation (LT) is poorly understood. We hypothesized that development of antibodies to HLA (DSA) is associated with dysregulation of microRNA (miRNA) that predisposes BOS. Towards this, miRNA profiling of mononuclear cells from 10 stable LT (DSA(-) BOS(-) ), 10 LT with DSA(+) BOS(-) (DSA group) and 10 LT with DSA(+) BOS(+) (BOS group) were performed. Prediction by mirPath indicated that differential miRNAs in DSA(+) BOS(-) compared to stable are significantly up-regulated (relative fold >2, p < 0.05) for TGF-ß and B cell receptor signal pathways. A total of seventy-four miRNAs were up-regulated and six miRNAs were down regulated in LT with DSA(+) BOS(+) when compared to stable (relative fold >2, p < 0.05). There was also significant enrichment of cell cycle and gap junction pathways. An inverse correlation between expression of two key miRNAs and their target genes were observed: miR-369-5p and miR-548d were down regulated in DSA(+) LT while their gene targets in TGF-ß signal pathways were up-regulated. In addition, miR-628-5p and miR-134 were down regulated and their target genes (B cell development) were up-regulated. Therefore, we conclude that alloimmunity induced changes in miRNAs affecting the TGF-ß and B cell receptor signal pathways play important roles in BOS development.


Asunto(s)
Bronquiolitis Obliterante/cirugía , Rechazo de Injerto/etiología , Antígenos HLA/inmunología , Isoanticuerpos/inmunología , Trasplante de Pulmón , MicroARNs/genética , Aloinjertos , Bronquiolitis Obliterante/complicaciones , Femenino , Estudios de Seguimiento , Perfilación de la Expresión Génica , Regulación de la Expresión Génica , Rechazo de Injerto/patología , Supervivencia de Injerto , Antígenos HLA/genética , Humanos , Isoanticuerpos/sangre , Masculino , Persona de Mediana Edad , Pronóstico , Factores de Riesgo , Donantes de Tejidos , Factor de Crecimiento Transformador beta/genética , Receptores de Trasplantes
3.
Phys Rev E ; 109(5-1): 054609, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38907499

RESUMEN

In this paper, we conduct experimental investigations on the behavior of confined self-propelled particles within a circular arena, employing small commercial robots capable of locomotion, communication, and information processing. These robots execute circular trajectories, which can be clockwise or counterclockwise, based on two internal states. Using a majority-based stochastic decision algorithm, each robot can reverse its direction based on the states of two neighboring robots. By manipulating a control parameter governing the interaction, the system exhibits a transition from a state where all robots rotate randomly to one where they rotate uniformly in the same direction. Moreover, this transition significantly impacts the trajectories of the robots. To extend our findings to larger systems, we introduce a mathematical model enabling characterization of the order transition type and the resulting trajectories. Our results reveal a second-order transition from active Brownian to chiral motion.

4.
Am J Transplant ; 12(10): 2663-74, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22822907

RESUMEN

The molecular mechanisms leading to the development of chronic lung allograft dysfunction following de novo development of antibodies to mismatched donor MHC remain undefined. We demonstrated that intrabronchial administration of antibodies to MHC class I resulted in induction of both innate and adaptive cellular immune responses characterized by a predominance of Th17 specific to lung associated self-antigens Kα1-tubulin and Collagen-V leading to the development of obliterative airway lesions (OAD), correlate of chronic rejection following human lung transplantation. To determine the role of regulatory T cells (Treg) in the pathogenesis of OAD, we administered anti-MHC class I to mice, in which Treg were depleted by conditional ablation of FoxP3+cells. Under this condition, we observed a threefold increase in pulmonary cellular infiltration, luminal occlusion and fibrous deposition when compared anti-MHC class I Ab administered mice maintaining FoxP3. OAD lesions were accompanied with enhanced accumulation of neutrophils along with self-antigen-specific Th17 and humoral responses. However, IL-17-blockade or adoptive transfer of Treg abrogated OAD. We conclude that Treg exerts a suppressive effect on anti-MHC induced IL-8-mediated neutrophil infiltration and innate immune responses that leads to inhibition of Th17 immune responses to lung associated self-antigens which is critical for development of OAD.


Asunto(s)
Autoanticuerpos/inmunología , Bronquiolitis Obliterante/inmunología , Antígenos de Histocompatibilidad Clase I/inmunología , Linfocitos T Reguladores/inmunología , Traslado Adoptivo , Animales , Inmunidad Celular , Inmunidad Innata , Interleucina-17/inmunología , Ratones
5.
Am J Transplant ; 12(8): 2164-71, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22568593

RESUMEN

Bronchiolitis obliterans syndrome (BOS), the clinical correlate of chronic rejection after lung transplantation, is the leading obstacle to better long-term outcomes. We previously instituted a clinical protocol to screen for donor-specific human leukocyte antigen (HLA) antibodies (DSA) and a preemptive antibody-directed therapy protocol consisting of rituximab and/or intravenous immune globulin. In this study, we retrospectively analyzed serum samples from lung transplant recipients (n = 108) for antibodies to self-antigens (K-α 1 tubulin and collagen V) before and after antibody-directed therapy and correlated the results with the subsequent development of BOS. Seventy-two of the 108 recipients developed antibodies to self-antigens. There was a correlation between the development of antibodies to self-antigens and DSA. Sixteen of the 54 patients who had antibodies to self-antigens and were treated with antibody-directed therapy cleared the antibodies, and they were significantly less likely to develop BOS than those who had persistent antibodies. Furthermore, those who cleared DSA after treatment but had persistent antibodies to self-antigens were significantly more likely to develop BOS than those who cleared these antibodies. We conclude that antibodies to self-antigens are an important risk factor for the development of BOS.


Asunto(s)
Autoanticuerpos/inmunología , Colágeno Tipo V/inmunología , Rechazo de Injerto , Trasplante de Pulmón , Tubulina (Proteína)/inmunología , Adulto , Autoantígenos/inmunología , Bronquiolitis Obliterante/inmunología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
6.
Phys Rev E ; 106(1-1): 014615, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35974547

RESUMEN

In this paper, the dynamics of a self-propelled stochastic particle under the influence of an axisymmetric light field is experimentally studied. The particle under consideration has the main characteristic of carrying a light sensor in an eccentric location. For the chosen experimental conditions, the emerging trajectories are orbital, and, more interestingly, they suggest the existence of bistability. A mathematical model incorporating the key experimental components is introduced. By means of numerical simulations and theoretical analysis, it is found that, in addition to the orbiting behavior, the sensor location could produce trapped or diffusive behaviors. Furthermore, the study reveals that stochastic perturbation and the eccentric location of the sensor are responsible for inducing bistability in the orbital trajectories, supporting experimental observations.

7.
Am J Transplant ; 10(5): 1189-99, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20420631

RESUMEN

Graft rejection remains a formidable problem contributing to poor outcomes after lung transplantation. Blocking chemokine pathways have yielded promising results in some organ transplant systems. Previous clinical studies have demonstrated upregulation of CCR2 ligands following lung transplantation. Moreover, lung injury is attenuated in CCR2-deficient mice in several inflammatory models. In this study, we examined the role of CCR2 in monocyte recruitment and alloimmune responses in a mouse model of vascularized orthotopic lung transplantation. The CCR2 ligand MCP-1 is upregulated in serum and allografts following lung transplantation. CCR2 is critical for the mobilization of monocytes from the bone marrow into the bloodstream and for the accumulation of CD11c(+) cells within lung allografts. A portion of graft-infiltrating recipient CD11c(+) cells expresses both recipient and donor MHC molecules. Two-photon imaging demonstrates that recipient CD11c(+) cells are associated with recipient T cells within the graft. While recipient CCR2 deficiency does not prevent acute lung rejection and is associated with increased graft infiltration by T cells, it significantly reduces CD4(+) T(h)1 indirect and direct allorecognition. Thus, CCR2 may be a potential target to attenuate alloimmune responses after lung transplantation.


Asunto(s)
Trasplante de Pulmón/métodos , Monocitos , Animales , Quimiocinas , Rechazo de Injerto/inmunología , Inflamación , Recuento de Linfocitos , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Ratones Noqueados , Monocitos/inmunología , Monocitos/metabolismo , Monocitos/fisiología , Neumonía/metabolismo , Linfocitos T/metabolismo , Trasplante Homólogo
8.
Phys Rev E ; 101(4-1): 042302, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32422803

RESUMEN

We study experimentally the properties of the flow of mechanical vibration-driven vehicles confined in two chambers connected through a narrow opening. We report that the density of particles around the opening presents critical behavior and scaling properties. By mapping this density to the financial market price, we document that the main stylized facts observed in financial systems have their counterparts in the mechanical system. The experimental model accurately reproduces financial properties such as scaling of the price fluctuation, volatility clustering, and multiscaling.

9.
Transplant Proc ; 41(1): 388-90, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19249563

RESUMEN

In lung grafts, ischemia-reperfusion signals rapidly induce the recruitment and differentiation of host monocytes into macrophages and dendritic cells. The nature of ischemia-reperfusion signals are antigen independent, but have been hypothesized to initiate Toll-like receptor (TLR) and interleukin (IL)-1R-mediated signaling pathways that are thought to potentiate alloimmune responses. We wondered whether MyD88, an adaptor molecule critical for both TLR and IL-1R-mediated inflammatory responses, regulated monocyte differentiation in a mouse model of vascularized orthotopic lung transplantation. Orthotopic left lung transplants were performed in the following syngeneic combinations: CD45.1(+) B6 --> CD45.2(+) MyD88(-/-) and CD45.1(+) B6 --> CD45.2(+) B6. One day later, recipient-derived dendritic cells and macrophage numbers were assessed in the bronchiolar lavage by FACS analysis. Compared with the bronchiolar lavage of wildtype recipients, MyD88(-/-) recipients had lower numbers of dendritic cells in lung graft airways that were of recipient origin. Lower numbers of newly differentiated lung graft dendritic cells was coincident with the appearance of higher numbers of undifferentiated monocytes in the lung airways of MyD88(-/-) recipients as compared with wild-type recipients. Moreover, adoptive transfer experiments demonstrated that MyD88(-/-) monocytes were poorer at differentiating into lung dendritic cells as compared with wild-type monocytes. Taken together, these data show that MyD88 regulates graft-infiltrating monocyte differentiation and suggests a mechanism by which TLR/IL-1R-signaling pathways control adaptive responses in lung allografts through controlling monocyte fate.


Asunto(s)
Trasplante de Pulmón/fisiología , Monocitos/fisiología , Factor 88 de Diferenciación Mieloide/fisiología , Animales , Diferenciación Celular , Células Dendríticas/inmunología , Antígenos Comunes de Leucocito/inmunología , Trasplante de Pulmón/inmunología , Macrófagos/citología , Macrófagos/fisiología , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Monocitos/citología , Transducción de Señal/inmunología , Trasplante Homólogo/inmunología , Trasplante Homólogo/fisiología
10.
Transplant Proc ; 41(1): 385-7, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19249562

RESUMEN

Lung allografts are considered to be more immunogenic than other solid organs. Little is known about the effectiveness of immunosuppressive regimens after lung transplantation. Herein, we describe a novel model of murine vascularized orthotopic lung transplantation we used to study the effects of costimulatory blockade on lung rejection. Transplants were performed in the Balb --> B6 strain combination. Recipients were either not immunosuppressed or received perioperative CD40/CD40L and CD28/B7 costimulatory blockade. Nonimmunosupressed Balb/c --> B6 lung transplants had severe acute rejection 7 days after transplantation and CD8(+) T cells outnumbered CD4(+) T cells within the allografts. Alternatively, B6 recipients that received perioperative costimulatory blockade had minimal inflammation and there were nearly equal numbers of CD8(+) and CD4(+) T cells in these grafts. Approximately one third of graft-infiltrating CD4(+) T cells expressed Foxp3. CD4(+) T cells isolated from these grafts induced apoptosis of alloreactive CD8(+) T cells that were stimulated with donor splenocytes in vitro. In contrast with wild-type B6 recipient mice, we observed severe rejection of Balb/c lungs 7 days after transplantation into Bcl-2 transgenic B6 recipients that had received costimulatory blockade. CD8(+) T cells outnumbered CD4(+) T cells in these immunosuppressed Bcl-2 transgenic recipients and, compared with immunosuppressed wild-type B6 recipients, a lower percentage of graft-infiltrating CD4(+) T cells expressed Foxp3, and a higher percentage of graft-infiltrating CD8(+) T cells expressed intereferon-gamma. Thus, our results show that perioperative blockade of the CD40/CD40L and CD28/B7 costimulatory pathways markedly ameliorates acute rejection of lung allografts in wild type but not Bcl-2 transgenic recipients.


Asunto(s)
Trasplante de Pulmón/fisiología , Proteínas Proto-Oncogénicas c-bcl-2/genética , Trasplante Homólogo/fisiología , Abatacept , Animales , Linfocitos T CD4-Positivos/inmunología , Regulación de la Expresión Génica , Rechazo de Injerto/inmunología , Inmunoconjugados/inmunología , Trasplante de Pulmón/inmunología , Trasplante de Pulmón/patología , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL
11.
Am J Transplant ; 8(11): 2454-62, 2008 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-18785961

RESUMEN

Primary graft dysfunction (PGD) is a common early complication after lung transplantation. We conducted a retrospective cohort study of 334 recipients to evaluate the impact of PGD graded at 24, 48 and 72 h on the risk of bronchiolitis obliterans syndrome (BOS) development (stage 1) and progression (stages 2 and 3). We constructed multivariable Cox proportional hazards models to determine the risk of BOS attributable to PGD in the context of other potential risk factors including acute rejection, lymphocytic bronchitis and respiratory viral infections. All grades of PGD at all time points were significant risk factors for BOS development and progression independent of acute rejection, lymphocytic bronchitis and respiratory viral infections. Specifically, PGD grade 1 at T24 was associated with a relative risk of BOS stage 1 of 1.93, grade 2 with a relative risk of 2.29 and grade 3 with a relative risk of 3.31. Furthermore, this direct relationship between the severity of PGD and the risk of BOS persisted at all time points. We conclude that all grades of PGD at all time points are independent risk factors for BOS development and progression. Future strategies that might attenuate the severity of PGD may mitigate the risk of BOS.


Asunto(s)
Bronquiolitis Obliterante/terapia , Trasplante de Pulmón/efectos adversos , Trasplante de Pulmón/métodos , Disfunción Primaria del Injerto/terapia , Estudios de Cohortes , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estudios Retrospectivos , Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
12.
J Clin Invest ; 98(2): 434-42, 1996 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-8755654

RESUMEN

Vascular remodeling in adult human elastic pulmonary arteries is characterized by diffuse neointimal lesions containing smooth muscle cells expressing extracellular matrix genes. Recent studies suggest vascular injury is needed to initiate remodeling and that growth factor mediators participate in the repair response. However, because neointimal formation is only observed in patients with pulmonary artery blood pressures approaching systemic levels, it has been hypothesized that systemic-like hemodynamic conditions are also necessary. To test that hypothesis, subclavian-pulmonary artery anastomoses were created in Sprague-Dawley rats under three different experimental conditions: no accompanying injury, or after monocrotaline or balloon endarterectomy injury. Pulmonary vascular remodeling was not induced by the subclavian-pulmonary artery anastomosis alone. A non-neointimal pattern of remodeling after mild monocrotaline-induced injury was converted into a neointimal pattern in the presence of the anastomosis. Neointima was also observed after severe, balloon endarterectomy-induced injury even in the absence of anastomosis. Tropoelastin, type I procollagen and TGF-beta gene expression, and angiotensin converting enzyme immunoreactivity, was confined to the neointima resembling the pattern of gene expression and immunoreactivity in human hypertensive elastic pulmonary artery neointimal lesions. These observations introduce the concepts that the type of injury and the associated hemodynamic conditions can modify the elastic pulmonary artery response to injury.


Asunto(s)
Hemodinámica , Pulmón/irrigación sanguínea , Músculo Liso Vascular/fisiología , Arteria Pulmonar/lesiones , Arteria Pulmonar/fisiología , Adulto , Anastomosis Quirúrgica , Animales , Presión Sanguínea/efectos de los fármacos , Endarterectomía/efectos adversos , Expresión Génica , Humanos , Hibridación in Situ , Masculino , Microscopía Electrónica , Monocrotalina/farmacología , Músculo Liso Vascular/efectos de los fármacos , Músculo Liso Vascular/lesiones , Procolágeno/biosíntesis , Arteria Pulmonar/efectos de los fármacos , Ratas , Ratas Sprague-Dawley , Flujo Sanguíneo Regional , Arteria Subclavia/efectos de los fármacos , Arteria Subclavia/fisiología , Factor de Crecimiento Transformador beta/biosíntesis , Tropoelastina/análisis
13.
Cancer Res ; 56(19): 4499-502, 1996 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-8813147

RESUMEN

The incidence of esophageal adenocarcinoma has increased dramatically over the past 20 years. The causes for this change in incidence and the genetic defects that underlie tumorigenesis are unknown. We performed loss of heterozygosity (LOH) studies in esophageal adenocarcinomas in an effort to map the location of tumor suppressor genes involved in the initiation or progression of this cancer. A genome-wide search for LOH was undertaken using microsatellite repeat polymorphisms and a panel of 27 tumor and matched normal DNAs. This is the first report of an allelotype analysis of esophageal adenocarcinomas. We observed frequent loss of sequences on the short arm of chromosome 17 in the region of the TP53 gene. We also identified a region on 4q lost in more than half of the tumors investigated. The high rate of LOH for 4q sequences speaks to the involvement of an as yet unidentified tumor suppressor gene in esophageal adenocarcinoma tumorigenesis.


Asunto(s)
Adenocarcinoma/genética , Alelos , Cromosomas Humanos Par 4/genética , Neoplasias Esofágicas/genética , Repeticiones de Microsatélite , Eliminación de Secuencia , Cromosomas Humanos Par 4/ultraestructura , ADN de Neoplasias/genética , Genes Supresores de Tumor , Humanos
14.
J Clin Oncol ; 6(5): 832-8, 1988 May.
Artículo en Inglés | MEDLINE | ID: mdl-2835443

RESUMEN

Surgery alone is inadequate therapy for limited small-cell lung cancer (SCLC), resulting in less than 5% long-term survival. Since 1976, we treated patients undergoing surgery for SCLC with adjuvant chemotherapy in an attempt to prolong survival and increase cure. Seventy-seven patients who underwent surgery as their primary treatment were identified, and of these 63 (46 male and 17 female) received chemotherapy. Fifteen patients had a pneumonectomy, 46 a lobectomy, and two had wedge resections. Six patients had positive microscopic resection margins. Pathologic staging showed tumor, node, metastasis (TNM) involvement as follows: T1N0, eight; T2N0, ten; T1N1, six; T2N1, 18; T1N2, five; T2N2, nine; T3N0, three; T3N1, one; and T3N2, three. All patients received cyclophosphamide, Adriamycin (doxorubicion; Adria Laboratories, Mississauga, Ontario), and vincristine; four also received etoposide (VP-16) and cisplatin, one VP-16, and four methotrexate, procarbazine, and lomustine (CCNU). Forty-nine patients received prophylactic cranial irradiation, and 35 received radiotherapy to the mediastinum and primary site. The overall median survival of the 63 patients is 83 weeks, and the projected 5-year survival is 31%. Patients with T1 or T2 tumors without nodal involvement had a median survival of 191 weeks, and projected 5-year survival of 48%. Stage II (T1N1, T2N1) and stage III (any T3 or T1-2N2) patients had median survivals of 72 weeks and 65 weeks, and projected 5-year survivals of 24.5% and 24%, respectively. Thirty-three patients have relapsed and died of disease. Only two patients had an isolated relapse at the primary site. Seven other patients have died without recurrent disease. Adjuvant chemotherapy after surgery results in prolonged survival and cure for a significant number of patients with stage I SCLC, although nodal involvement at any level is associated with shorter survival.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Pequeñas/tratamiento farmacológico , Neoplasias Pulmonares/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Pequeñas/mortalidad , Carcinoma de Células Pequeñas/cirugía , Terapia Combinada , Femenino , Humanos , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/cirugía , Masculino , Mediastinoscopía , Persona de Mediana Edad , Estadificación de Neoplasias
15.
J Clin Oncol ; 10(4): 580-6, 1992 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-1312587

RESUMEN

PURPOSE: The 5-year survival rates with surgical resection for preoperatively identified stage IIIA N2 non-small-cell lung cancer (NSCLC) are less than 10%. A pilot study of mitomycin, vindesine, and cisplatin (MVP) induction chemotherapy was undertaken in an attempt to improve the curative potential of surgery in this group of patients. PATIENTS AND METHODS: Thirty-nine patients with mediastinoscopy stage IIIA N2 NSCLC received two cycles of MVP. Responding patients underwent thoracotomy for resection and two further courses of MVP. RESULTS: The overall response rate was 64% (25 of 39) with three complete and 22 partial responses. Twenty-two patients were resected, which included a radical mediastinal node dissection. Eighteen resections were complete and four were incomplete. Pathologically, three patients (7.7%) had no tumor remaining. Toxicity included two postoperative deaths secondary to a bronchopleural (BP) fistula, mitomycin pulmonary toxicity in two patients, and septic deaths in four patients. Twenty-eight patients have died; 20 have recurrent or progressive disease. Eight of the 18 patients completely resected have recurred, with a median time to recurrence of 20.6 months. Sites of recurrence include two locoregional, five distant (two in brain), and one in both. Median survival of all 39 patients is 18.6 months, with a 3-year survival of 26%. The median survival for those patients completely resected was 29.7 months with a 3-year survival of 40%. CONCLUSIONS: We conclude (1) that MVP is an effective but toxic chemotherapeutic regimen for limited NSCLC; (2) the median survival seems to be prolonged; and (3) the role of induction chemotherapy followed by surgery in stage IIIA N2 NSCLC requires a phase III randomized trial to compare it with other treatment modalities.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Neoplasias Pulmonares/tratamiento farmacológico , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Carcinoma de Pulmón de Células no Pequeñas/patología , Cisplatino/administración & dosificación , Evaluación de Medicamentos , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Mitomicinas/administración & dosificación , Estadificación de Neoplasias , Proyectos Piloto , Inducción de Remisión , Análisis de Supervivencia , Vindesina/administración & dosificación
16.
J Thorac Cardiovasc Surg ; 129(2): 423-8, 2005 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-15678055

RESUMEN

OBJECTIVE: Complement activation has been shown to play a significant role in ischemia-reperfusion injury after lung transplantation. TP-10 (soluble complement receptor 1 inhibitor) inhibits the activation of complement by inactivating C3a and C5a convertases. This was a clinical trial of TP-10 to reduce ischemia-reperfusion injury in lung transplantation. METHODS: In a randomized, double-blinded, multicenter, placebo-controlled trial, 59 patients from four lung transplant programs received TP-10 (10 mg/kg, n = 28) or placebo (n = 31) before reperfusion. This dose achieved 90% complement inhibition for 24 hours, and activity had returned toward normal by 72 hours. RESULTS: At 24 hours, 14 of 28 patients in the TP-10 group (50%) were extubated, whereas only 6 of 31 patients in the placebo group (19%) were (P = .01). The total times on the ventilator and in the intensive care unit both tended to be shorter in the TP-10 group, but these differences did not achieve statistical significance. Among patients requiring cardiopulmonary bypass (n = 5 in placebo group and n = 7 in TP-10 group), the mean duration of mechanical ventilation was reduced by 11 days in the TP-10 group (10.6 +/- 5.0 days vs 21.5 +/- 5.9 days in placebo group, P = .2). Operative deaths, incidences of infection and rejection, and length of hospital stay were not significantly different between the two groups. CONCLUSIONS: Short-term complement inhibition with TP-10 led to early extubation in a significantly higher proportion of lung transplant recipients. The effect of TP-10 was greater among patients undergoing cardiopulmonary bypass, with a large reduction in ventilator days. Complement inhibition thus significantly decreases the duration of mechanical ventilation and could be useful in improving the outcome of lung transplant recipients.


Asunto(s)
Trasplante de Pulmón , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Daño por Reperfusión/etiología , Daño por Reperfusión/prevención & control , Adolescente , Adulto , Anciano , Biomarcadores/sangre , Puente Cardiopulmonar , Proteínas Inactivadoras de Complemento/antagonistas & inhibidores , Proteínas Inactivadoras de Complemento/uso terapéutico , Proteínas del Sistema Complemento/efectos de los fármacos , Proteínas del Sistema Complemento/metabolismo , Método Doble Ciego , Femenino , Rechazo de Injerto/etiología , Rechazo de Injerto/mortalidad , Rechazo de Injerto/prevención & control , Humanos , Tiempo de Internación , Enfermedades Pulmonares/mortalidad , Enfermedades Pulmonares/cirugía , Masculino , Persona de Mediana Edad , América del Norte , Consumo de Oxígeno/efectos de los fármacos , Complicaciones Posoperatorias/mortalidad , Receptores de Complemento/antagonistas & inhibidores , Receptores de Complemento/uso terapéutico , Daño por Reperfusión/mortalidad , Respiración Artificial , Infección de la Herida Quirúrgica/etiología , Infección de la Herida Quirúrgica/mortalidad , Infección de la Herida Quirúrgica/prevención & control , Análisis de Supervivencia , Resultado del Tratamiento
17.
Immunol Res ; 24(2): 177-90, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11594455

RESUMEN

Major advancements in the field of lung transplantation have occurred over the past thirty-five years. Despite these advancements, limitations in our ability to obtain sufficient numbers of organs and in our comprehension of the problems associated with the procedure persist. The purpose of this article is to review the current understanding of both the surgical procedure and its most unfortunate complication, bronchiolitis obliterans. Even now, after over three decades of experience, this complication remains the most significant cause of morbidity and mortality following lung transplantation. This article is not meant to be an exhaustive review, and certainly there are important topics not covered herein. We have focused the discussion on ongoing studies, which attempt to understand bronchiolitis obliterans at both the clinical as well as the immunopathological level.


Asunto(s)
Bronquiolitis Obliterante/etiología , Trasplante de Pulmón/efectos adversos , Animales , Bronquiolitis Obliterante/inmunología , Modelos Animales de Enfermedad , Antígenos de Histocompatibilidad/inmunología , Humanos , Enfermedades Pulmonares Obstructivas/etiología , Enfermedades Pulmonares Obstructivas/inmunología , Trasplante de Pulmón/inmunología , Ratones
18.
Transplantation ; 69(9): 1802-5, 2000 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-10830214

RESUMEN

BACKGROUND: Cationic lipids have been successfully employed as vectors for gene transfer in lung grafts, yet those lipid vectors have potential toxicity. Furthermore, the optimal concentration of cationic lipids for gene transfection to lung grafts has not been determined. We evaluated liposome concentration/toxicity relationships in an in vivo rat lung transplantation model. METHODS: Left lungs were harvested and infused via the pulmonary artery with chloramphenicol acetyl-transferase (CAT)-DNA/lipid 67 (cationic lipid)/dioleoylphosphatidylethanolamine complex (4:1:2 in a final concentration ratio). Donor lungs were allocated into six groups according to lipid 67 concentration: group 1, 0 microM (control); group 2, 10 microM; group 3, 50 microM; group 4, 100 microM; group 5, 250 microM; group 6, 500 microM. Forty-eight hours after orthotopic transplantation, the recipient contralateral right main pulmonary artery and bronchus were ligated. The graft was ventilated with 100% oxygen for 5 min. Arterial blood gas analysis (PaO2, PaCO2), peak airway pressure (PAP), and CAT activity of the grafts were measured. RESULTS: Recipient survival, and PaO2, PAP, and CAT levels correlated with the lipid-DNA complex concentration. The grafts in groups 4-6 were more injured as evidenced by decreased PaO2 and increased PAP levels in comparison to the control group. CAT level was significantly lower in group 2 than in groups 3-6. CONCLUSIONS: The pulmonary toxicity of cationic lipid is dose-dependent. The balance between lung graft function and transgene expression is optimal at a lipid 67 concentration of 50 microM.


Asunto(s)
ADN/administración & dosificación , Terapia Genética , Liposomas/toxicidad , Trasplante de Pulmón , Animales , Relación Dosis-Respuesta a Droga , Liposomas/administración & dosificación , Pulmón/efectos de los fármacos , Masculino , Oxígeno/sangre , Ratas , Ratas Endogámicas F344 , Transgenes , Trasplante Isogénico
19.
Transplantation ; 70(8): 1263-7, 2000 Oct 27.
Artículo en Inglés | MEDLINE | ID: mdl-11063355

RESUMEN

BACKGROUND: Immunosuppressive therapy has limited activity against the mesenchymal cell proliferation of obliterative bronchiolitis. Clotrimazole (CLT) has been shown to inhibit proliferation in normal and cancer cell lines. Here we investigate whether CLT inhibits the proliferation of lung mesenchymal cells. METHODS: Proliferation of human lung fibroblasts (MRC-5) in the presence of CLT was determined by [3H]thymidine incorporation. Messenger ribonucleic acid (mRNA) expression of platelet-derived growth factor (PDGF)-B and transforming growth factor (TGF)-beta after treatment with CLT was measured by reverse transcriptase-polymerase chain reaction. RESULTS: Treatment of MRC-5 cells with CLT resulted in a significant reduction in proliferation as assessed by DNA incorporation and cell counts compared with dimethylsulfoxide alone. There was no cytotoxic effect associated with CLT treatment. Reverse transcriptase-polymerase chain reaction demonstrated a marked decrease in PDGF-B and TGF-beta mRNA levels in cells treated with CLT compared with those treated with dimethylsulfoxide. CONCLUSION: CLT inhibits proliferation of human lung fibroblasts. This inhibitory effect is associated with decreased levels of PDGF-B and TGF-beta mRNA expression and may have value in the prevention and treatment of obliterative bronchiolitis.


Asunto(s)
Clotrimazol/farmacología , Fibroblastos/citología , Inhibidores de Crecimiento/farmacología , Pulmón/citología , Bronquiolitis Obliterante/etiología , Bronquiolitis Obliterante/prevención & control , Bronquiolitis Obliterante/terapia , División Celular/efectos de los fármacos , Línea Celular , Supervivencia Celular/efectos de los fármacos , Supervivencia Celular/efectos de la radiación , Radioisótopos de Cromo , Humanos , Trasplante de Pulmón/efectos adversos
20.
Transplantation ; 52(4): 626-30, 1991 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-1718066

RESUMEN

We studied the effect of a vasodilator (prostaglandin E1) as well as flush (F) and storage (S) temperatures (4 degrees C or 10 degrees C) on lung preservation in an isolated rabbit lung perfusion model. Low-potassium dextran (LPD) or Euro-Collins (E-C) solution was used as flush solution. Six groups of six animals were studied: group 1 (LPD, 4 degrees C F-S), group 2 (LPD with PGE1, 4 degrees C F-S), group 3 (E-C with PGE1, 4 degrees C F-S), group 4 (LPD, 10 degrees C F-S), group 5 (LPD with PGE1, 10 degrees C F-S), group 6 (E-C with PGE1, 10 degrees C F-S). After 18-hr preservation, left lungs alone were ventilated, and reperfused with fresh venous blood. PaO2, PaCO2, pulmonary artery pressure (PAP), tracheal pressure (Pt) during reperfusion, and wet/dry weight (W/D) ratios were measured. PaO2 after LPD with or without PGE1 was significantly higher than after E-C with PGE1 at 4 degrees C (95.8 +/- 11.5 mmHg in group 1 or 102.7 +/- 8.6 in group 2 vs. 41.8 +/- 10.5 in group 3, P less than 0.01) and at 10 degrees C (119.3 +/- 2.3 in group 4 or 131.1 +/- 6.2 in group 5 vs. 54.6 +/- 5.2 in group 6, P less than 0.01). PaCO2, PAP, Pt, and W/D ratios in the LPD groups were lower than in the E-C groups. LPD/PGE1 and LPD alone produced similar pulmonary preservation. PaO2 of lungs flushed with LPD and preserved at 10 degrees C was higher than that of lungs stored at 4 degrees C. We conclude that LPD solution is superior to E-C solution in this ex vivo rabbit lung preservation model, even when PGE1 is used. A moderate dose of PGE1 did not improve the performance of LPD as a flush solution. Pulmonary preservation with LPD at 10 degrees C is superior to preservation at 4 degrees C.


Asunto(s)
Alprostadil/farmacología , Trasplante de Pulmón/fisiología , Pulmón , Preservación de Órganos/métodos , Animales , Frío , Dextranos/farmacología , Soluciones Hipertónicas/farmacología , Pulmón/fisiología , Trasplante de Pulmón/métodos , Oxígeno/fisiología , Presión Parcial , Potasio/farmacología , Arteria Pulmonar/fisiología , Conejos , Temperatura
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