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1.
Chemistry ; 30(3): e202302416, 2024 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-37792811

RESUMEN

Transition-metal-catalyzed coupling reactions that involve the direct functionalization of insert C-H bond represent one of the most efficient strategies for forming carbon-carbon bonds. Herein, a palladium-catalyzed intramolecular C-H bond arylation of triaryl phosphates is reported to access seven-membered cyclic biarylphosphonate targets. The reaction is achieved via a unique eight-membered palladacyclic intermediate and shows good functional group compatibility. Meanwhile, the product can be readily converted into other valuable phosphate compounds.

2.
Clin Immunol ; 255: 109737, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37586672

RESUMEN

BACKGROUND: The clinical characteristics and pathomechanism for immune-mediated alopecia following COVID-19 vaccinations are not clearly characterized. OBJECTIVE: We investigated the causality and immune mechanism of COVID-19 vaccines-related alopecia areata (AA). STUDY DESIGN: 27 new-onset of AA patients after COVID-19 vaccinations and 106 vaccines-tolerant individuals were enrolled from multiple medical centers for analysis. RESULTS: The antinuclear antibody, total IgE, granulysin, and PARC/CCL18 as well as peripheral eosinophil count were significantly elevated in the patients with COVID-19 vaccines-related AA compared with those in the tolerant individuals (P = 2.03 × 10-5-0.039). In vitro lymphocyte activation test revealed that granulysin, granzyme B, and IFN-γ released from the T cells of COVID-19 vaccines-related AA patients could be significantly increased by COVID-19 vaccine excipients (polyethylene glycol 2000 and polysorbate 80) or spike protein (P = 0.002-0.04). CONCLUSIONS: Spike protein and excipients of COVID-19 vaccines could trigger T cell-mediated cytotoxicity, which contributes to the pathogenesis of immune-mediated alopecia associated with COVID-19 vaccines.


Asunto(s)
Alopecia Areata , COVID-19 , Humanos , Vacunas contra la COVID-19/efectos adversos , Glicoproteína de la Espiga del Coronavirus , Alopecia Areata/etiología , Alopecia Areata/patología , Vacunación/efectos adversos
3.
World J Surg Oncol ; 21(1): 224, 2023 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-37491250

RESUMEN

BACKGROUND: To summarize the chemo-radio effect of metformin in rectal cancers with neoadjuvant chemoradiotherapy on pathological response, tumor regression grade (TRG), and T/N downstaging. METHODS: PubMed, MEDLINE, Embase, and Cochrane Database of collected reviews were searched up to June 30, 2022. This study conducted systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) sheet. Odds ratios (ORs) and confidence intervals (CIs) which calculated by random-effects models were displayed in forest plots. Newcastle-Ottawa scale was used to assess the risk of bias of the observational cohort studies. RESULTS: This systematic review and meta-analysis comprised eight cohorts out of seven studies, with 2294 patients in total. We performed two-way comparison for metformin in diabetic patients vs (1) non-metformin drugs in diabetic patients and (2) nondiabetic patients. In diabetes patient studies, the metformin group had a significantly increased pathological response on TRG (OR: 3.28, CI: 2.01-5.35, I2 = 0%, p < 0.001) and T downstaging (OR: 2.14, CI: 1.24-3.67, I2 = 14%, p = 0.006) in comparison with a non-metformin group. When compared with nondiabetic patients, the pathological response on TRG (OR: 2.67, CI: 1.65-4.32, I2 = 43%, p < 0.001) and T downstaging (OR: 1.96, CI: 1.04-3.71, I2 = 66%, p = 0.04) were also higher in metformin group. The limitation was that no randomized controlled trials were available based on current literature review. Small sample sizes for diabetic metformin or non-metformin users in rectal cancer patients reduced the power of the study. CONCLUSIONS: For patients with rectal cancer and treated with neoadjuvant chemoradiotherapy, metformin administration in diabetic patients increased the pathological response on tumor-regression grade and T downstaging. Further well-designed, high-quality randomized controlled trials are required to reveal the actual effect of metformin.


Asunto(s)
Diabetes Mellitus , Metformina , Neoplasias del Recto , Humanos , Metformina/uso terapéutico , Terapia Neoadyuvante , Quimioradioterapia , Neoplasias del Recto/patología , Diabetes Mellitus/tratamiento farmacológico , Resultado del Tratamiento
4.
J Am Acad Dermatol ; 84(6): 1782-1791, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32828861

RESUMEN

BACKGROUND: Patients with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) have high mortality rates. Disseminated intravascular coagulation has been reported in SJS/TEN patients. The influence of this lethal complication in patients with SJS/TEN is not well known. OBJECTIVE: This study aimed to investigate the risk and outcomes of disseminated intravascular coagulation in patients with SJS/TEN. METHODS: We analyzed the disseminated intravascular coagulation profiles of patients receiving a diagnosis of SJS/TEN between 2010 and 2019. RESULTS: We analyzed 150 patients with SJS/TEN (75 with SJS, 22 with overlapping SJS/TEN, and 53 with TEN) and their complete disseminated intravascular coagulation profiles. Disseminated intravascular coagulation was diagnosed in 32 patients (21.3%), primarily those with TEN. It was significantly associated with systemic complications, including gastrointestinal bleeding, respiratory failure, renal failure, liver failure, infection, and bacteremia. Additionally, SJS/TEN patients with disseminated intravascular coagulation had elevated procalcitonin levels. Among patients with SJS/TEN, disseminated intravascular coagulation was associated with a greater than 10-fold increase in mortality (78.1% vs 7%). LIMITATIONS: The study limitations include small sample size and a single hospital system. CONCLUSION: Disseminated intravascular coagulation is a potential complication of SJS/TEN and associated with higher mortality. Early recognition and appropriate management of this critical complication are important for patients with SJS/TEN.


Asunto(s)
Coagulación Intravascular Diseminada/etiología , Coagulación Intravascular Diseminada/mortalidad , Hemorragia Gastrointestinal/complicaciones , Síndrome de Stevens-Johnson/complicaciones , Síndrome de Stevens-Johnson/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Bacteriemia/complicaciones , Bacteriemia/microbiología , Femenino , Humanos , Estimación de Kaplan-Meier , Fallo Hepático/complicaciones , Masculino , Persona de Mediana Edad , Insuficiencia Renal/complicaciones , Insuficiencia Respiratoria/complicaciones , Tasa de Supervivencia
5.
J Ren Nutr ; 31(2): 189-198, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-32900583

RESUMEN

OBJECTIVES: This study was performed to determine the effects of probiotic supplementation on cholesterol-triglyceride ratio, an indirect marker of insulin resistance, protein-bound uremic toxins, biomarkers of inflammation, and microbial translocation in end-stage renal disease patients on hemodialysis. METHODS: Fifty-six patients aged 39-75 years were assigned into two groups to receive either probiotic sachets (n = 28) or a placebo (n = 28) in a randomized double-blinded placebo-controlled clinical trial. The patients in the probiotic group received twice daily sachets that contained a mixture of three viable and freeze-dried strains: Lactococcus lactis subsp. Lactis LL358, Lactobaccillus salivarius LS159, and Lactobaccillus pentosus LPE588 at high dose (100 billion; 1 × 1011 cfu/day) for 6 months. RESULTS: A total of 50 patients were available for final analysis. Probiotic supplementation did not have a significant influence on cholesterol-triglyceride ratio. Probiotic supplementation for 6 months caused a significant decrease in serum levels of indoxyl sulfate. Compared with the placebo, probiotic supplementation did not result in significant changes in hemoglobin levels, blood urea nitrogen, blood glucose, serum p-cresyl sulfate, inflammatory, and microbial translocation markers. No clinically significant changes in body composition were observed between the two groups during the study period. The probiotic supplementation was well tolerated by all subjects with minimal adverse effects during the 6-month-long study. CONCLUSION: Our results suggest that high-dose multistrain lactobaccillus probiotic supplementation over 6 months as a monotherapy did not significantly decrease markers of insulin resistance, cholesterol-triglyceride ratio, and most of the studied markers, with the exception of levels of indoxyl sulfate in patients on HD.


Asunto(s)
Lactobacillus , Probióticos , Método Doble Ciego , Humanos , Lactobacillus acidophilus , Diálisis Renal , Tóxinas Urémicas
6.
J Am Acad Dermatol ; 82(1): 101-109, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31400455

RESUMEN

BACKGROUND: Previous studies have suggested that biologic therapy for psoriasis might relate to body weight gain. OBJECTIVE: To assess the changes in body weight and body mass index (BMI) in psoriasis patients after receiving various biologics. METHODS: We conducted a systematic review and network meta-analysis to evaluate the changes in body weight and BMI in psoriasis patients receiving biologics. On March 1, 2019, we searched Medline, Embase, and Cochrane Central Register of Controlled Trials for relevant studies. The Newcastle-Ottawa scale was used to assess the risk of bias. RESULTS: We included 6 studies with 862 psoriasis patients. Compared with conventional systemic treatments, treatment with tumor necrosis factor α inhibitors was associated with a significant increase in body weight (mean difference 1.40 kg, 95% confidence interval 0.88-1.93 kg) and BMI (0.39 kg/m2, 95% confidence interval 0.24-0.54 kg/m2). In contrast, no significant increase in body weight or BMI was found among patients receiving anti-interleukin (IL)-12/23 or anti-IL-17 biologics. LIMITATIONS: Only 1 study reported body weight and BMI for patients receiving the anti-IL-17 biologic. CONCLUSION: Tumor necrosis factor α inhibitor treatment appears to be associated with an increase in body weight and BMI, and treatment with anti-IL-12/23 and anti-IL-17 biologics do not. This association should be considered before initiating biologics for overweight and obese patients.


Asunto(s)
Productos Biológicos/efectos adversos , Índice de Masa Corporal , Peso Corporal/efectos de los fármacos , Psoriasis/tratamiento farmacológico , Aumento de Peso/efectos de los fármacos , Productos Biológicos/uso terapéutico , Femenino , Estudios de Seguimiento , Humanos , Masculino , Metaanálisis en Red , Psoriasis/diagnóstico , Medición de Riesgo , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
8.
Mediators Inflamm ; 2017: 1070959, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29200664

RESUMEN

Despite the continuous progression in dialysis medicine, mortality and the burden of cardiovascular disease (CVD) among hemodialysis patients are still substantial. Substantial evidence suggests that proinflammatory (CD16+) monocytes contribute to the development of atherosclerosis. A cohort of 136 stable hemodialysis patients (follow-up: 6.25 year) was assessed to investigate the association between the proportion of CD16+ monocytes for all-cause and CVD mortalities. The CD16+ monocytes were associated with both mortalities after adjusting for a preexisting CVD history. Compared to the reference group (CD16+ monocytes within [15.6-18.6], the first and second quartile), patients with CD16+ monocytes above the highest quartile level (>21.5) had an adjusted hazard ratio (HR) of 30.85 (95% confidence interval [CI]: 7.12-133.8) for CVD mortality and 5.28 (2.07-13.49) for all-cause mortality, and those with CD16+ monocytes below the lowest quartile ≤15.6), had significantly elevated death risks after 3.5-year follow-up (HR [95% CI]: 10.9 [2.42-48.96] and 4.38 [1.45-13.24] for CV and all-cause mortalities, respectively). The hemodialysis patients with CD16+ monocyte level in a low but mostly covering normal range also portended a poor prognosis. The findings shed some light for nephrologists on future prospects of early recognizing immune dysfunction and improving early intervention outcomes.


Asunto(s)
Enfermedades Cardiovasculares/metabolismo , Monocitos/metabolismo , Adulto , Femenino , Humanos , Estimación de Kaplan-Meier , Receptores de Lipopolisacáridos/metabolismo , Masculino , Receptores de IgG/metabolismo , Diálisis Renal
9.
Org Lett ; 26(25): 5274-5279, 2024 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-38885640

RESUMEN

Chiral α-aminophosphonates with adjacent carbon and phosphonate stereogenic centers have been employed as ligands in the copper-catalyzed oxidative coupling of 2-naphthols, resulting in the production of chiral BINOLs in favorable yields and moderate to good enantiomeric excess. This represents the first application of chiral P-based ligands to enable such a transformation. The synthesis of these chiral α-aminophosphonate ligands offers a significant advantage over approaches that typically necessitate elaborate synthetic processes for chiral ligand production.

10.
Zhonghua Xin Xue Guan Bing Za Zhi ; 40(10): 854-7, 2012 Oct.
Artículo en Zh | MEDLINE | ID: mdl-23302674

RESUMEN

OBJECTIVE: To summary the efficacy and safety of aerosolized iloprost in patients with pulmonary hypertensive crisis. METHODS: On the basis of conventional therapy, aerosolized iloprost (10 µg per time for 10 - 15 min in 2 hours interval, 8 times per day) was administered to four patients with idiopathic pulmonary arterial hypertension and pulmonary hypertensive crisis. Blood pressure, heart rate, systemic artery oxygen saturation, systolic pulmonary arterial pressure (sPAP) measured by echocardiography and the adverse events were analyzed. RESULTS: After aerosolized iloprost therapy, sPAP was significantly decreased and systemic artery oxygen saturation was improved. Adverse events (nausea, vomiting, diarrhea, dry cough) were observed in two patients, and the iloprost use was stopped in one patient due to severe vomiting and diarrhea. CONCLUSION: Aerosolized iloprost could significantly reduce the sPAP and improve the systemic artery oxygen saturation in patients with pulmonary hypertension crisis.


Asunto(s)
Hipertensión Pulmonar/tratamiento farmacológico , Iloprost/administración & dosificación , Iloprost/uso terapéutico , Administración por Inhalación , Adulto , Presión Sanguínea , Niño , Hipertensión Pulmonar Primaria Familiar , Femenino , Humanos , Hipertensión Pulmonar/fisiopatología , Masculino , Persona de Mediana Edad , Adulto Joven
11.
Zhonghua Xin Xue Guan Bing Za Zhi ; 40(7): 554-9, 2012 Jul.
Artículo en Zh | MEDLINE | ID: mdl-22943681

RESUMEN

OBJECTIVE: To analyze the cause of in-hospital death among acute myocardial infarction patients undergoing primary percutaneous coronary intervention (PPCI) in Beijing area to evoke better individualized preventive approach. METHODS: In-hospital mortality and causes were analyzed based on database from Beijing percutaneous coronary intervention registry study (BJPCI Registry) in 2010. RESULTS: A total of 4660 PPCI patients from 48 hospitals were included. In-hospital mortality was 2.4% (n = 110). Cardiogenic shock (39.1%, 43/110), mechanical complications (28.2%, 31/110) and intervention-related complications [28.2%, 31/110: procedure related (n = 28), drug related (n = 3)] were the leading causes of in-hospital death. Five deaths was attributed to comorbidity related reason (4.5%, 5/110). The in-hospital mortality had no significant difference among hospitals of different grade or total annual PCI (all P > 0.05). In-hospital mortality was slightly higher in hospital with annual PPCI < 300 than in hospitals with annual PPCI ≥ 300 (2.9% vs. 1.8%, P < 0.05). CONCLUSION: Cardiogenic shock, mechanical complications and intervention-related complications are the main causes of in-hospital death among acute myocardial infarction patients receiving PPCI.


Asunto(s)
Infarto del Miocardio/mortalidad , Infarto del Miocardio/terapia , Intervención Coronaria Percutánea/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , China , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad
12.
Clin Nutr ; 40(5): 3288-3295, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33190991

RESUMEN

BACKGROUND & AIMS: The Body Composition Monitor (BCM), a multifrequency bioimpedance spectroscopy device, has been widely used to assess body composition in hemodialysis patients because its measurement is not affected by overhydration commonly seen in chronic kidney disease. We aimed to develop and validate an equation for obtaining appendicular skeletal muscle mass (ASM) from BCM taking dual-energy X-ray absorptiometry (DXA) as the reference among hemodialysis patients. METHODS: A total of 322 consecutive body composition measurements with BCM and DXA in 263 hemodialysis patients were randomly divided at a ratio of 2:1 into development and validation groups. Stepwise multiple regression modeling was applied to develop the ASM prediction equation. We evaluated the model as a diagnostic tool for sarcopenia using cutoffs of ASM defined by the Asian Working Group for Sarcopenia (AWGS). We further explored the association between ASM predicted by the BCM equation and all-cause mortality in two independent cohorts: one with 326 stage 3-5 CKD patients and one with 629 hemodialysis patients. RESULTS: BCM yielded the following equation: ASM (kg) = -1.838 + 0.395 × total body water (L) + 0.105 × body weight (kg) + 1.231 × male sex - 0.026 × age (years) (R2 = 0.914, standard error of estimate = 1.35 kg). In the validation group, Bland-Altman reliability analysis showed no significant bias of 0.098 kg and limits of agreement ±2.440 kg. Using the AWGS criteria, the model was found to have a sensitivity of 94.1%, a specificity of 98.8%, a positive predictive value of 84.2%, and a negative predictive value of 99.6% for the diagnosis of sarcopenia. Low ASM predicted by the BCM equation was associated with significantly worse overall survival among CKD patients but not hemodialysis patients. CONCLUSIONS: The new BCM equation provides a feasible and valid option for assessing ASM in hemodialysis patients.


Asunto(s)
Composición Corporal , Impedancia Eléctrica , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/terapia , Diálisis Renal/métodos , Sarcopenia/complicaciones , Sarcopenia/diagnóstico , Absorciometría de Fotón , Femenino , Humanos , Fallo Renal Crónico/fisiopatología , Masculino , Persona de Mediana Edad , Músculo Esquelético/fisiopatología , Diálisis Renal/efectos adversos , Reproducibilidad de los Resultados , Sarcopenia/fisiopatología
13.
Int J Biol Sci ; 16(2): 353-364, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31929762

RESUMEN

Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) are rare but life-threatening severe cutaneous adverse reactions. Current studies have suggested that the pathobiology of drug-mediated SJS/TEN involves a dysregulation of cellular immunity with overwhelming activation of cytotoxic T lymphocytes. The canonical Wnt signaling pathway plays important roles in T cell development and activation, which may provide potential avenues for alleviating dysregulated immunity in SJS/TEN. In this study, we aimed to assess the implication of Wnt signaling in drug-reactive T cells in SJS/TEN. We showed downregulation of Wnt signaling components, including T cell factor 1 (TCF-1)/lymphoid enhancer binding factor 1 (LEF-1) transcription factors, in SJS/TEN patients, suggesting that canonical Wnt signaling is regulated during cytotoxic T cell responses in SJS/TEN. Further analyses demonstrated that engagement of the T cell receptor by antigen encounter and treatment of a prognostic marker of SJS/TEN, IL-15, in vitro led to the downregulation of LEF-1 and TCF-1 expression in CD8+ T cells. Enhancement of Wnt signaling by adding the Wnt activators attenuated ex vivo activation of drug-specific T cells from SJS/TEN patients, indicating a functional involvement of Wnt signaling in the pathomechanism of SJS/TEN. These findings provide additional insight into the immunopathogenesis and therapeutic intervention of this devastating condition.


Asunto(s)
Síndrome de Stevens-Johnson/tratamiento farmacológico , Síndrome de Stevens-Johnson/metabolismo , Vía de Señalización Wnt/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Predisposición Genética a la Enfermedad/genética , Humanos , Factor de Unión 1 al Potenciador Linfoide/metabolismo , Masculino , Persona de Mediana Edad , Piel , Factor 1 de Transcripción de Linfocitos T/metabolismo , Linfocitos T/metabolismo , Vía de Señalización Wnt/genética , Adulto Joven
14.
Blood Purif ; 28(2): 144-9, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19590181

RESUMEN

BACKGROUND: In recent years, sleep apnea syndrome (SAS) has been widely considered to be a cardiovascular disease (CVD) risk factor. Although several plausible mechanisms have been put forth to explain such association in patients with SAS, oxidative stress has been suggested to play a major role. In patients with SAS, the repetitive ischemia-reperfusion state causes excessive production of oxygen free radicals and may subsequently lead to oxidative injury of various biomolecules. Due to the high prevalence of SAS in dialysis patients, this possible uremia-specific CVD risk factor may definitely need more medical attention. METHODS: We, therefore, performed a case control study to investigate the relationship between oxidative stress and SAS in a group of dialysis patients, using some well-established oxidative biomarkers. RESULTS: Our results showed that plasma nitrotyrosine, protein carbonyl and malonaldehyde levels were significantly elevated in patients with SAS. Markers of endothelial activation such as soluble CD40 ligand were also increased in this subgroup of patients. However, there was no significant difference in serum C-reactive protein levels between these groups. CONCLUSIONS: Our results indicate that patients with SAS manifest evidence for higher oxidative stress and endothelial activation. Thus, intermittent hypoxia represents a form of oxidative stress and low-grade chronic inflammatory state that may be associated with increased cardiovascular disease in these patients.


Asunto(s)
Estrés Oxidativo , Diálisis Renal/efectos adversos , Síndromes de la Apnea del Sueño/complicaciones , Anciano , Biomarcadores/sangre , Enfermedades Cardiovasculares/etiología , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo
15.
Cutis ; 104(3): E11-E15, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31675404

RESUMEN

The expanding use of novel targeted anticancer agents such as sorafenib has led to an increasing number of dermatologic adverse events. Although cutaneous adverse events are commonly described in patients taking sorafenib, there are few reports describing psoriasis secondary to this medication. In this report, we describe 3 patients with sorafenib-induced psoriasiform drug eruption and review the available literature of similar patient cases. Our findings highlight shared characteristics among affected patients and potential treatment options for patients in whom sorafenib cannot be discontinued. Increased awareness of such drug eruptions and management options is critical to prevent suboptimal dosing and decreased quality of life.


Asunto(s)
Antineoplásicos/efectos adversos , Carcinoma Hepatocelular/tratamiento farmacológico , Erupciones por Medicamentos/etiología , Neoplasias Hepáticas/tratamiento farmacológico , Sorafenib/efectos adversos , Anciano , Antineoplásicos/uso terapéutico , Carcinoma Hepatocelular/virología , Hepatitis B Crónica/complicaciones , Humanos , Neoplasias Hepáticas/virología , Masculino , Psoriasis/etiología , Sorafenib/uso terapéutico
16.
Cells ; 8(10)2019 10 08.
Artículo en Inglés | MEDLINE | ID: mdl-31597242

RESUMEN

Immune checkpoint receptors with co-stimulatory and co-inhibitory signals are important modulators for the immune system. However, unrestricted co-stimulation and/or inadequate co-inhibition may cause breakdown of self-tolerance, leading to autoimmunity. Systemic lupus erythematosus (SLE) is a complex multi-organ disease with skewed and dysregulated immune responses interacting with genetics and the environment. The close connections between co-signaling pathways and SLE have gradually been established in past research. Also, the recent success of immune checkpoint blockade in cancer therapy illustrates the importance of the co-inhibitory receptors in cancer immunotherapy. Moreover, immune checkpoint blockade could result in substantial immune-related adverse events that mimic autoimmune diseases, including lupus. Together, immune checkpoint regulators represent viable immunotherapeutic targets for the treatment of both autoimmunity and cancer. Therefore, it appears reasonable to treat SLE by restoring the out-of-order co-signaling axis or by manipulating collateral pathways to control the pathogenic immune responses. Here, we review the current state of knowledge regarding the relationships between SLE and the co-signaling pathways of T cells, B cells, dendritic cells, and neutrophils, and highlight their potential clinical implications. Current clinical trials targeting the specific co-signaling axes involved in SLE help to advance such knowledge, but further in-depth exploration is still warranted.


Asunto(s)
Lupus Eritematoso Sistémico/inmunología , Animales , Autoinmunidad , Humanos , Tolerancia Inmunológica , Factores Inmunológicos
17.
Nephrology (Carlton) ; 13(8): 677-83, 2008 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-19019166

RESUMEN

AIM: The CD40-CD40L system has been implicated in the pathogenesis of atherothrombotic complications in cardiovascular disease. The aim of this study was to determine the relationship between plasma soluble CD40 ligand (sCD40L) and symptomatic coronary heart disease (CHD) in end-stage renal disease (ESRD) patients on maintenance haemodialysis (HD). METHODS: This cross-sectional study included 57 HD patients, 31 of whom had symptomatic CHD. Lipid profile, markers of endothelial activation such as sCD40L, and both inflammatory and oxidative stress markers were measured and analyzed. RESULTS: The sCD40L concentration was significantly higher in HD patients than in controls (1.34 +/- 0.53 vs 0.86 +/- 0.12 ng/mL, P < 0.01). Plasma concentration of sCD40L (P < 0.01), soluble vascular adhesion molecule-1 (sVCAM-1; P < 0.01) and high-sensitivity CRP (hsCRP; P < 0.01) were higher in HD patients with symptomatic CHD than in those without CHD. In addition, we also found that oxidative stress biomarkers such as nitrotyrosine (NT), malonaldehyde (MDA) and protein carbonyl (PC) were significantly elevated in patients with symptomatic CHD compared to those without. There was a strong overall positive relationship between sCD40L concentration and sVCAM-1 (r = 0.54, P < 0.001), MDA (r = 0.365, P < 0.01), NT (r = 0.293, r < 0.05) and log-transformed triglycerides (r = 0.275, P < 0.05). CONCLUSION: Circulating concentrations of sCD40L were elevated in HD patients with symptomatic CHD. This study suggests that CD40-CD40L may play a potentially important role in the atherosclerotic complications of HD patients.


Asunto(s)
Ligando de CD40/sangre , Enfermedad Coronaria/inmunología , Fallo Renal Crónico/terapia , Diálisis Renal , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , Enfermedad Coronaria/sangre , Enfermedad Coronaria/complicaciones , Estudios Transversales , Femenino , Humanos , Mediadores de Inflamación/sangre , Fallo Renal Crónico/sangre , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/inmunología , Lípidos/sangre , Masculino , Malondialdehído/sangre , Persona de Mediana Edad , Estrés Oxidativo , Proyectos Piloto , Carbonilación Proteica , Tirosina/análogos & derivados , Tirosina/sangre , Regulación hacia Arriba , Molécula 1 de Adhesión Celular Vascular/sangre
18.
Laryngoscope ; 128(7): 1653-1657, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28940518

RESUMEN

OBJECTIVES/HYPOTHESIS: Pseudocyst of the auricle is a benign, noninflammatory cystic disease that is more common in Asians than in Caucasians. When managed conservatively, the results are often unsatisfactory and recurrences are common. We aimed to introduce a novel modified surgical method that involves a deroofing technique followed by a sandwich compression suture using two rubber tourniquet sheets and an iodine-soaked cotton ball for the treatment of auricular pseudocysts and to ascertain its effectiveness. STUDY DESIGN: Case series with or without comparison. METHODS: The charts of 100 patients with auricular pseudocysts who were treated with this new method from 2004 to 2016 in a university-affiliated tertiary teaching hospital were retrospectively reviewed and analyzed. RESULTS: The mean patient age was 37.7 years, and 84% were male. All of the patients had unilateral lesions, with right-side lesions (53.0%) being slightly predominant. The cymba concha (44.1%) was the most common site. Seven patients (7.0%) had trauma to the ear within 3 months before presentation. Previous aspiration or drainage had been performed for the cysts in 35 patients (35.0%), and the recurrences had been treated conservatively. In comparison, 98 of the 100 patients recovered smoothly from surgery without further recurrence or complications after follow-up for at least 1 year. CONCLUSIONS: Based on our experience, not only does this surgical procedure yield reliable results in the treatment of pseudocysts of auricles, but it also has advantages such as using readily available materials, being simple to perform, improving efficacy, and lowering recurrence rates. LEVEL OF EVIDENCE: 4. Laryngoscope, 128:1653-1657, 2018.


Asunto(s)
Vendajes de Compresión , Quistes/cirugía , Pabellón Auricular/cirugía , Enfermedades del Oído/cirugía , Procedimientos Quirúrgicos Otológicos/métodos , Adolescente , Adulto , Anciano , Niño , Fibra de Algodón , Femenino , Humanos , Masculino , Persona de Mediana Edad , Torniquetes , Adulto Joven
19.
Biomed Res Int ; 2018: 2670312, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29581966

RESUMEN

BACKGROUND: There is accumulating evidence pointing to uremia-induced impairment of the intestinal epithelial barrier structure in advanced chronic kidney disease (CKD) and hemodialysis (HD) patients. In this study, the impact of intradialytic hypotension on intestinal barrier integrity is being explored. METHODS: Immunohistochemical staining was used to detect the expression of 4 types of tight junction (TJ) proteins such as occludin, zonula occludens-1 (ZO-1), claudin-1, and claudin-4, in colonic samples of a group of patients receiving segmental colectomy. Five patients with nondialysis CKD (group 2), 5 HD patients with intradialytic hypotension (group 3), and 5 non-CKD subjects (group 1) were examined. RESULTS: Both patients' groups 2 and 3 demonstrated significantly reduced expression of occludin as compared to group 1 (p < 0.05 and p < 0.01, resp.). Except for claudin-4, expression of all markers of TJ proteins was significantly reduced in patients' group 3 as compared to control (p < 0.01). In addition, decreased expressions of claudin-1 and ZO-1 were also more pronounced in group 3 when compared to group 2. CONCLUSIONS: This study extends the earlier finding by demonstrating that dialysis-related hypotension caused even marked depletion of the key protein constituents of the epithelial TJ.


Asunto(s)
Regulación de la Expresión Génica , Hipotensión , Mucosa Intestinal , Diálisis Renal , Insuficiencia Renal Crónica , Uniones Estrechas , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Hipotensión/metabolismo , Hipotensión/patología , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patología , Masculino , Persona de Mediana Edad , Insuficiencia Renal Crónica/metabolismo , Insuficiencia Renal Crónica/patología , Insuficiencia Renal Crónica/terapia , Estudios Retrospectivos , Uniones Estrechas/metabolismo , Uniones Estrechas/patología
20.
J Immunol Res ; 2018: 5376476, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29577050

RESUMEN

Cutaneous adverse drug reactions are commonly seen in patients with anticancer drug treatment. Anticancer drugs, including chemotherapy, target therapy, and recent immunotherapy causing skin reactions ranging from mild skin rash to life-threatening severe cutaneous adverse reactions (SCARs), such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) with increase morbidity and mortality while they are receiving cancer treatments, have been proposed to be a result of direct skin toxicity or drug hypersensitivity reactions (these are proposed mechanism, not definite). Differentiating SCARs from other more commonly seen reactions with a better outcome help prevent discontinuation of therapy and inappropriate use of systemic immunosuppressants for presumable allergic reactions, of which will affect the clinical outcome. In this article, we have reviewed published articles from 1950 to August 2017 for SJS/TEN associated with anticancer drugs, including chemotherapy, targeted therapy, and immunotherapy. We aimed to provide an overview of SJS/TEN associated with anticancer drugs to increase clinician recognition and accelerate future studies on the pathomechanism and managements.


Asunto(s)
Antineoplásicos/uso terapéutico , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/diagnóstico , Inmunoterapia/métodos , Neoplasias/terapia , Piel/patología , Animales , Antineoplásicos/efectos adversos , Diagnóstico Diferencial , Humanos , Inmunoterapia/efectos adversos , Terapia Molecular Dirigida/efectos adversos , Neoplasias/inmunología , Riesgo
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