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1.
J Hepatol ; 80(4): 610-621, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38242326

RESUMO

BACKGROUND & AIMS: Patients with metastatic, treatment-refractory, and relapsed hepatoblastoma (HB) have survival rates of less than 50% due to limited treatment options. To develop new therapeutic strategies for these patients, our laboratory has developed a preclinical testing pipeline. Given that histone deacetylase (HDAC) inhibition has been proposed for HB, we hypothesized that we could find an effective combination treatment strategy utilizing HDAC inhibition. METHODS: RNA sequencing, microarray, NanoString, and immunohistochemistry data of patient HB samples were analyzed for HDAC class expression. Patient-derived spheroids (PDSp) were used to screen combination chemotherapy with an HDAC inhibitor, panobinostat. Patient-derived xenograft (PDX) mouse models were developed and treated with the combination therapy that showed the highest efficacy in the PDSp drug screen. RESULTS: HDAC RNA and protein expression were elevated in HB tumors compared to normal livers. Panobinostat (IC50 of 0.013-0.059 µM) showed strong in vitro effects and was associated with lower cell viability than other HDAC inhibitors. PDSp demonstrated the highest level of cell death with combination treatment of vincristine/irinotecan/panobinostat (VIP). All four models responded to VIP therapy with a decrease in tumor size compared to placebo. After 6 weeks of treatment, two models demonstrated necrotic cell death, with lower Ki67 expression, decreased serum alpha fetoprotein and reduced tumor burden compared to paired VI- and placebo-treated groups. CONCLUSIONS: Utilizing a preclinical HB pipeline, we demonstrate that panobinostat in combination with VI chemotherapy can induce an effective tumor response in models developed from patients with high-risk, relapsed, and treatment-refractory HB. IMPACT AND IMPLICATIONS: Patients with treatment-refractory hepatoblastoma have limited treatment options with survival rates of less than 50%. Our manuscript demonstrates that combination therapy with vincristine, irinotecan, and panobinostat reduces the size of high-risk, relapsed, and treatment-refractory tumors. With this work we provide preclinical evidence to support utilizing this combination therapy as an arm in future clinical trials.


Assuntos
Hepatoblastoma , Neoplasias Hepáticas , Humanos , Camundongos , Animais , Panobinostat/farmacologia , Panobinostat/uso terapêutico , Hepatoblastoma/tratamento farmacológico , Irinotecano/uso terapêutico , Vincristina/uso terapêutico , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/induzido quimicamente , Inibidores de Histona Desacetilases/uso terapêutico , Neoplasias Hepáticas/patologia , Ácidos Hidroxâmicos/farmacologia
2.
FASEB J ; 37(6): e22958, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37171267

RESUMO

In Type 2 diabetes (T2D), elevated lipid levels have been suggested to contribute to insulin resistance and ß-cell dysfunction. We previously reported that the expression of the PGE2 receptor EP3 is elevated in islets of T2D individuals and is preferentially stimulated by palmitate, leading to ß-cell failure. The mouse EP3 receptor generates three isoforms by alternative splicing which differ in their C-terminal domain and are referred to as mEP3α, mEP3ß, and mEP3γ. We bring evidence that the expression of the mEP3γ isoform is elevated in islets of diabetic db/db mice and is selectively upregulated by palmitate. Specific knockdown of the mEP3γ isoform restores the expression of ß-cell-specific genes and rescues MIN6 cells from palmitate-induced dysfunction and apoptosis. This study indicates that palmitate stimulates the expression of the mEP3γ by a posttranscriptional mechanism, compared to the other spliced isoforms, and that the de novo synthesized ceramide plays an important role in FFA-induced mEP3γ expression in ß-cells. Moreover, induced levels of mEP3γ mRNA by palmitate or ceramide depend on p38 MAPK activation. Our findings suggest that mEP3γ gene expression is regulated at the posttranscriptional level and defines the EP3 signaling axis as an important pathway mediating ß-cell-impaired function and demise.


Assuntos
Diabetes Mellitus Tipo 2 , Células Secretoras de Insulina , Camundongos , Animais , Receptores de Prostaglandina E/metabolismo , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/metabolismo , Células Secretoras de Insulina/metabolismo , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Palmitatos/metabolismo , Ceramidas/metabolismo , Receptores de Prostaglandina E Subtipo EP3/genética , Receptores de Prostaglandina E Subtipo EP3/metabolismo
3.
Amino Acids ; 55(10): 1361-1370, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37796355

RESUMO

Tellurium (Te) containing amino acids and their derivatives have the potential to participate in biological processes, which are currently being studied extensively to understand the function of Te in biological and pharmacological activities. Here, we are reporting the synthesis of two novel Te-containing unnatural amino acids; 1,3-Tellurazolidine-4-carboxylic acid [Te{CH2CH(COOH)NHCH2}] 5, and 4,4'-(1,2-Ditellurdiyl)bis(2-aminobutanoic acid), i.e., tellurohomocystine [TeCH2CH2CH(NH2)COOH]2 7, synthesized from tellurocystine, and L-methionine as precursors, respectively. These telluro-amino acids were thoroughly characterized by multinuclear (1H, 13C, 125Te) NMR spectroscopy, high-resolution ESI-mass spectrometry (ESI-MS), and elemental analysis. The telluro-amino acids 5 and 7 demonstrated good biocompatibility when in vitro cytotoxicity was analyzed on two fibroblast cell lines L929 and NIH/3T3. The treatment of telluro-amino acids 1,3-Tellurazolidine-4-carboxylic acid 5 and tellurohomocystine 7 on breast cancer cell line MCF-7 showed anticancer activity with IC50 values of 7.29 ± 0.27 µg/mL and 25.36 ± 0.12 µg/mL, respectively. The cell cycle distribution studies also revealed arrest at the sub-G1 phase suggesting telluro-amino acids to be apoptotic.


Assuntos
Antineoplásicos , Ácidos Carboxílicos , Aminoácidos , Linhagem Celular , Espectrometria de Massas por Ionização por Electrospray , Ciclo Celular , Antineoplásicos/química , Linhagem Celular Tumoral , Ensaios de Seleção de Medicamentos Antitumorais
4.
Amino Acids ; 55(7): 891-902, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37227510

RESUMO

Organotellurium compounds are being well researched as potential candidates for their functional roles in therapeutic and clinical biology. Here, we report the in vitro anticancer and antibacterial activities of an AS101 analog, cyclic zwitterionic organotellurolate (IV) compound 2 [Te-{CH2CH(NH3+)COO}(Cl)3]. Different concentrations of compound 2 were exposed to fibroblast L929 and breast cancer MCF-7 cell lines to study its effect on cell viability. The fibroblast cells with good viability confirmed the biocompatibility, and compound 2 also was less hemolytic on RBCs. A cytotoxic effect on MCF-7 breast cancer cell line investigated compound 2 to be anti-cancerous with IC50 value of 2.86 ± 0.02 µg/mL. The apoptosis was confirmed through the cell cycle phase arrest of the organotellurolate (IV) compound 2. Examination of the antibacterial potency compound 2 was done based on the agar disk diffusion, minimum inhibitory concentration, and time-dependent assay for the Gram-positive Bacillus subtilis and Gram-negative Pseudomonas putida. For both bacterial strains, tests were performed with the concentration range of 3.9-500 µg/mL, and the minimum inhibition concentration value was found to be 125 µg/mL. The time-dependent assay suggested the bactericidal activity of organotellurolate (IV) compound, 2 against the bacterial strains.


Assuntos
Antineoplásicos , Neoplasias da Mama , Humanos , Feminino , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Etilenos , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Testes de Sensibilidade Microbiana
5.
HPB (Oxford) ; 25(6): 659-666, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36872110

RESUMO

BACKGROUND: Proton pump inhibitors (PPIs) are effective in reducing marginal ulcers after pancreatoduodenectomy. However, their impact on perioperative complications has not been defined. METHODS: We retrospectively analyzed the effect of postoperative PPIs on 90-day perioperative outcomes in all patients who underwent pancreatoduodenectomy at our institution from April 2017 to December 2020. RESULTS: 284 patients were included; 206 (72.5%) received perioperative PPIs, 78 (27.5%) did not. The two cohorts were similar in demographics and operative variables. Postoperatively, the PPI cohort had significantly higher rates of overall complications (74.3% vs. 53.8%) and delayed gastric emptying (28.6% vs. 11.5%), p < 0.05. However, no differences in infectious complications, postoperative pancreatic fistula, or anastomotic leaks were seen. On multivariate analysis, PPI was independently associated with a higher risk of overall complications (OR 2.46, CI 1.33-4.54) and delayed gastric emptying (OR 2.73, CI 1.26-5.91), p = 0.011. Four patients developed marginal ulcers within 90-days postoperatively; all were in the group who received PPIs. CONCLUSION: Postoperative proton pump inhibitor use was associated with a significantly higher rate of overall complications and delayed gastric emptying after pancreatoduodenectomy.


Assuntos
Gastroparesia , Úlcera Péptica , Humanos , Inibidores da Bomba de Prótons/efeitos adversos , Pancreaticoduodenectomia/efeitos adversos , Gastroparesia/etiologia , Gastroparesia/prevenção & controle , Estudos Retrospectivos , Úlcera Péptica/induzido quimicamente , Complicações Pós-Operatórias/etiologia , Esvaziamento Gástrico
6.
HPB (Oxford) ; 25(1): 91-99, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36272956

RESUMO

BACKGROUND: Decreased preoperative physical fitness and low physical activity have been associated with preoperative functional reserve and surgical complications. We sought to evaluate daily step count as a measure of physical activity and its relationship with post-pancreatectomy outcomes. METHODS: Patients undergoing pancreatectomy were given a remote telemonitoring device to measure their preoperative levels of physical activity. Patient activity, demographics, and perioperative outcomes were collected and compared in univariate and multivariate logistic regression analysis. RESULTS: 73 patients were included. 45 (61.6%) patients developed complications, with 17 (23.3%) of those patients developing severe complications. These patients walked 3437.8 (SD 1976.7) average daily steps, compared to 5918.8 (SD 2851.1) in patients without severe complications (p < 0.001). In logistic regression analysis, patients who walked less than 4274.5 steps had significantly higher odds of severe complications (OR = 7.5 (CI 2.1, 26.8), p = 0.002). CONCLUSION: Average daily steps below 4274.5 before surgery are associated with severe complications after pancreatectomy. Preoperative physical activity levels may represent a modifiable target for prehabilitation protocols.


Assuntos
Pancreatectomia , Complicações Pós-Operatórias , Humanos , Pancreatectomia/efeitos adversos , Fatores de Risco , Complicações Pós-Operatórias/etiologia
7.
Small ; 18(31): e2200967, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35710979

RESUMO

Atherosclerosis is a major cause of mortality and morbidity worldwide. Left undiagnosed and untreated, atherosclerotic plaques can rupture and cause cardiovascular complications such as myocardial infarction and stroke. Atherosclerotic plaques are composed of lipids, including oxidized low-density lipoproteins and cholesterol crystals, and immune cells, including macrophages. 2-Hydroxypropyl-beta-cyclodextrin (CD) is FDA-approved for capturing, solubilizing, and delivering lipophilic drugs in humans. It is also known to dissolve cholesterol crystals and decrease atherosclerotic plaque size. However, its low retention time necessitates high dosages for successful therapy. This study reports CD delivery via air-trapped polybutylcyanoacrylate nanoparticles (with diameters of 388 ± 34 nm) loaded with CD (CDNPs). The multimodal contrast ability of these nanoparticles after being loaded with IR780 dye in mice is demonstrated using ultrasound and near-infrared imaging. It is shown that CDNPs enhance the cellular uptake of CD in murine cells. In an ApoE-/- mouse model of atherosclerosis, treatment with CDNPs significantly improves the anti-atherosclerotic efficacy of CD. Ultrasound triggering further improves CD uptake, highlighting that CDNPs can be used for ultrasound imaging and ultrasound-responsive CD delivery. Thus, CDNPs represent a theranostic nanocarrier for potential application in patients with atherosclerosis.


Assuntos
Aterosclerose , Ciclodextrinas , Nanopartículas , Placa Aterosclerótica , Animais , Aterosclerose/diagnóstico por imagem , Aterosclerose/tratamento farmacológico , Colesterol , Humanos , Camundongos , Imagem Multimodal , Nanopartículas/química , Placa Aterosclerótica/diagnóstico por imagem , Placa Aterosclerótica/tratamento farmacológico , Medicina de Precisão , Ultrassonografia
8.
Pharmacology ; 107(1-2): 54-68, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34814141

RESUMO

INTRODUCTION: The present study deals with the synthesis of pregnane-oximino-amino-alkyl-ethers and their evaluation for antidiabetic and anti-dyslipidemic activities in validated animal and cell culture models. METHODS: The effect on glucose tolerance was measured in sucrose-loaded rats; antidiabetic activity was evaluated in streptozotocin (STZ)-induced diabetic rats and genetically diabetic db/db mice; the anti-dyslipidemic effect was characterized in high-fructose, high-fat diet (HFD)-fed dyslipidemic hamsters. The effect on glucose production and glucose utilization was analyzed in HepG2 liver and L6 skeletal muscle cells, respectively. RESULTS: From the synthesized molecules, pregnane-oximino-amino-alkyl-ether (compound 14b) improved glucose clearance in sucrose-loaded rats and exerted antihyperglycemic activity on STZ-induced diabetic rats. Further evaluation in genetically diabetic db/db mice showed temporal decrease in blood glucose, and improvement in glucose tolerance and lipid parameters, associated with mild improvement in the serum insulin level. Moreover, compound 14b treatment displayed an anti-dyslipidemic effect characterized by significant improvement in altered lipid parameters of the high-fructose, HFD-fed dyslipidemic hamster model. In vitro analysis in the cellular system suggested that compound 14b decreased glucose production in liver cells and stimulated glucose utilization in skeletal muscle cells. These beneficial effects of compound 14b were associated with the activation of the G-protein-coupled bile acid receptor TGR5. CONCLUSION: Compound 14b exhibits antidiabetic and anti-dyslipidemic activities through activating the TGR5 receptor system and can be developed as a lead for the management of type II diabetes and related metabolic complications.


Assuntos
Diabetes Mellitus Experimental/tratamento farmacológico , Dislipidemias/tratamento farmacológico , Hipoglicemiantes/farmacologia , Hipolipemiantes/farmacologia , Pregnanos/farmacologia , Receptores Acoplados a Proteínas G/agonistas , Animais , Glicemia/efeitos dos fármacos , Linhagem Celular , Cricetinae , Diabetes Mellitus Experimental/metabolismo , Dislipidemias/metabolismo , Fenofibrato/farmacologia , Fenofibrato/uso terapêutico , Transportador de Glucose Tipo 4/metabolismo , Humanos , Hipoglicemiantes/química , Hipoglicemiantes/farmacocinética , Hipoglicemiantes/uso terapêutico , Hipolipemiantes/química , Hipolipemiantes/farmacocinética , Hipolipemiantes/uso terapêutico , Masculino , Camundongos , Músculo Esquelético/efeitos dos fármacos , Pregnanos/química , Pregnanos/farmacocinética , Pregnanos/uso terapêutico , Ratos , Ratos Sprague-Dawley , Receptores Acoplados a Proteínas G/metabolismo
9.
Nanomedicine ; 41: 102529, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35104671

RESUMO

Hepatocellular carcinoma (HCC) is the most aggressive form of cancer with poor drug responses. Developing an effective drug treatment remains a major unmet clinical need for HCC. We report a comprehensive study of combinatorial Cetuximab (Cet) targeted polymeric poly(D, L-lactide-co-glycolide)-b-poly(ethylene glycol) nanocomplexes delivery of Combretastatin A4 (CA4) and 2-Methoxyestradiol (2ME) (Cet-PLGA-b-PEG-CA4 NP + Cet-PLGA-b-PEG-2ME NP) against metastatic HCC in SCID mice. 125I-Cet-PLGA-b-PEG NP showed potent accumulation and retention in HCC tumors with longer circulation time up to 48 h (18 ±â€¯1.0% ID/g, P < .0001). Combinatorial treatment with targeted polymeric nanocomplexes presented significant tumor growth inhibition (85%, P < .0001) than the free drug combinatorial counterpart, effectively inhibited orthotopic HCC and prevented lung metastasis. Combinatorial nanocomplexes treatment significantly blocked PRC1, a novel target of therapeutic response against HCC. Thus, the combinatorial cetuximab-targeted polymeric nanocomplexes possess superior antitumor activity against metastatic HCC and provide supports for the clinical translation ahead.


Assuntos
Antineoplásicos , Carcinoma Hepatocelular , Neoplasias Hepáticas , Nanopartículas , Animais , Antineoplásicos/farmacologia , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/patologia , Linhagem Celular Tumoral , Cetuximab/farmacologia , Cetuximab/uso terapêutico , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/patologia , Camundongos , Camundongos SCID , Polietilenoglicóis/uso terapêutico , Radioisótopos
10.
Sensors (Basel) ; 22(10)2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35632035

RESUMO

Biometrics is the term for measuring human characteristics. If the term is divided into two parts, bio means life, and metric means measurement. The measurement of humans through different computational methods is performed to authorize a person. This measurement can be performed via a single biometric or by using a combination of different biometric traits. The combination of multiple biometrics is termed biometric fusion. It provides a reliable and secure authentication of a person at a higher accuracy. It has been introduced in the UIDIA framework in India (AADHAR: Association for Development and Health Action in Rural) and in different nations to figure out which biometric characteristics are suitable enough to authenticate the human identity. Fusion in biometric frameworks, especially FKP (finger-knuckle print) and iris, demonstrated to be a solid multimodal as a secure framework. The proposed approach demonstrates a proficient and strong multimodal biometric framework that utilizes FKP and iris as biometric modalities for authentication, utilizing scale-invariant feature transform (SIFT) and speeded up robust features (SURF). Log Gabor wavelet is utilized to extricate the iris feature set. From the extracted region, features are computed using principal component analysis (PCA). Both biometric modalities, FKP and iris, are combined at the match score level. The matching is performed using a neuro-fuzzy neural network classifier. The execution and accuracy of the proposed framework are tested on the open database Poly-U, CASIA, and an accuracy of 99.68% is achieved. The accuracy is higher compared to a single biometric. The neuro-fuzzy approach is also tested in comparison to other classifiers, and the accuracy is 98%. Therefore, the fusion mechanism implemented using a neuro-fuzzy classifier provides the best accuracy compared to other classifiers. The framework is implemented in MATLAB 7.10.


Assuntos
Dedos , Iris , Biometria , Bases de Dados Factuais , Humanos , Redes Neurais de Computação
11.
J Assoc Physicians India ; 70(9): 11-12, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36082885

RESUMO

BACKGROUND: Acute kidney injury (AKI) is one of the most common clinical problems encountered by physicians in day-to-day practice which is associated with increased morbidity and mortality. The incidence of AKI is increasing so the right approach for interpretation of clinical clues and investigation may be lifesaving. AIM: The study aimed to document the variety of unusual cases of AKI and suggest a case-based approach for clinical evaluation and investigations to help physicians treat such cases. MATERIALS AND METHODS: This was a retrospective analysis of medical/electronic records of 10 patients who were admitted in medical wards between January 2020 and June 2021 and diagnosed to have AKI. RESULTS: We present the history, clinical findings, and investigations of 10 patients diagnosed with unusual causes of AKI. CONCLUSION: It is important for physicians to recognize unusual causes of AKI. A high index of suspicion and timely diagnosis and treatment interventions may bring complete recovery of renal functions in patients of AKI.


Assuntos
Injúria Renal Aguda , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/terapia , Hospitais , Humanos , Incidência , Estudos Retrospectivos , Fatores de Risco
12.
Chemistry ; 27(17): 5470-5482, 2021 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-33368715

RESUMO

Designing chiral AIEgens without aggregation-induced emission (AIE)-active molecules externally tagged to the chiral scaffold remains a long-standing challenge for the scientific community. The inherent aggregation-caused quenching phenomenon associated with the axially chiral (R)-[1,1'-binaphthalene]-2,2'-diol ((R)-BINOL) scaffold, together with its marginal Stokes shift, limits its application as a chiral AIE-active material. Here, in our effort to design chiral luminogens, we have developed a design strategy in which 2-substituted furans, when appropriately fused with the BINOL scaffold, will generate solid-state emissive materials with high thermal and photostability as well as colour-tunable properties. The excellent biocompatibility, together with the high fluorescence quantum yield and large Stokes shift, of one of the luminogens stimulated us to investigate its cell-imaging potential. The luminogen was observed to be well internalised and uniformly dispersed within the cytoplasm of MDA-MB-231 cancer cells, showing high fluorescence intensity.


Assuntos
Corantes Fluorescentes , Imagem Óptica
13.
Nanomedicine ; 37: 102437, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34273597

RESUMO

Photothermal-therapy (PTT) inculcates near-infrared laser guided local heating effect, where high degree of precision is expected, but not well proven to-date. An ex vivo tissue biochemical map with molecular/biochemical response showing the coverage area out of an optimized PTT procedure can reveal precision information. In this work, Raman-microscopic mapping and linear discriminant analysis of spectra of PTT treated and surrounding tissue areas ex vivo are done, revealing three distinct spectral clusters/zones, with minimal overlap between the core treated and adjacent untreated zone. The core treated zone showed intense nucleic-acid, cytochrome/mitochondria and protein damage, an adjacent zone showed lesser degree of damages and far zone showed minimal/no damage. Immunohistochemistry for γH2AX (DNA damage marker protein) in PTT exposed tissue also revealed similar results. Altogether, this study reveals the utility of Raman-microspectroscopy for fine-tuning safety parameters and precision that can be achieved from PTT mediated tumor ablation in preclinical/clinical application.


Assuntos
Nanopartículas Metálicas/química , Neoplasias/terapia , Terapia Fototérmica/métodos , Nanomedicina Teranóstica/tendências , Linhagem Celular Tumoral , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Regulação Neoplásica da Expressão Gênica/efeitos da radiação , Ouro/química , Ouro/farmacologia , Histonas/genética , Humanos , Neoplasias/genética , Neoplasias/patologia , Análise Espectral Raman
14.
J Med Internet Res ; 23(3): e23595, 2021 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-33734096

RESUMO

BACKGROUND: Pancreatic cancer is the third leading cause of cancer-related deaths, and although pancreatectomy is currently the only curative treatment, it is associated with significant morbidity. OBJECTIVE: The objective of this study was to evaluate the utility of wearable telemonitoring technologies to predict treatment outcomes using patient activity metrics and machine learning. METHODS: In this prospective, single-center, single-cohort study, patients scheduled for pancreatectomy were provided with a wearable telemonitoring device to be worn prior to surgery. Patient clinical data were collected and all patients were evaluated using the American College of Surgeons National Surgical Quality Improvement Program surgical risk calculator (ACS-NSQIP SRC). Machine learning models were developed to predict whether patients would have a textbook outcome and compared with the ACS-NSQIP SRC using area under the receiver operating characteristic (AUROC) curves. RESULTS: Between February 2019 and February 2020, 48 patients completed the study. Patient activity metrics were collected over an average of 27.8 days before surgery. Patients took an average of 4162.1 (SD 4052.6) steps per day and had an average heart rate of 75.6 (SD 14.8) beats per minute. Twenty-eight (58%) patients had a textbook outcome after pancreatectomy. The group of 20 (42%) patients who did not have a textbook outcome included 14 patients with severe complications and 11 patients requiring readmission. The ACS-NSQIP SRC had an AUROC curve of 0.6333 to predict failure to achieve a textbook outcome, while our model combining patient clinical characteristics and patient activity data achieved the highest performance with an AUROC curve of 0.7875. CONCLUSIONS: Machine learning models outperformed ACS-NSQIP SRC estimates in predicting textbook outcomes after pancreatectomy. The highest performance was observed when machine learning models incorporated patient clinical characteristics and activity metrics.


Assuntos
Pancreatectomia , Dispositivos Eletrônicos Vestíveis , Estudos de Coortes , Humanos , Aprendizado de Máquina , Complicações Pós-Operatórias , Estudos Prospectivos , Estudos Retrospectivos , Medição de Risco
15.
Bioconjug Chem ; 31(9): 2021-2045, 2020 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-32680422

RESUMO

The coronavirus disease 2019 (COVID-19) has dramatically challenged the healthcare system of almost all countries. The authorities are struggling to minimize the mortality along with ameliorating the economic downturn. Unfortunately, until now, there has been no promising medicine or vaccine available. Herein, we deliver perspectives of nanotechnology for increasing the specificity and sensitivity of current interventional platforms toward the urgent need of quickly deployable solutions. This review summarizes the recent involvement of nanotechnology from the development of a biosensor to fabrication of a multifunctional nanohybrid system for respiratory and deadly viruses, along with the recent interventions and current understanding about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Nanotecnologia/tendências , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Técnicas Biossensoriais , COVID-19 , Infecções por Coronavirus/tratamento farmacológico , Humanos , Pandemias , Tratamento Farmacológico da COVID-19
16.
FASEB J ; 33(4): 4975-4986, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30629897

RESUMO

Elevated levels of lipids, in particular saturated fatty acids, are known to be associated with type 2 diabetes (T2D) and to have a negative effect on ß-cell function and survival. We bring new evidence indicating that palmitate up-regulates cyclooxygenase-2 (COX-2) expression levels in human islets and in MIN6 ß cells, and that it is elevated in islets isolated from T2D donors. Both small interfering specific cyclooxygenase-2 small interfering RNA (siRNA) or the COX-2 inhibitor celecoxib significantly inhibited apoptosis induced by palmitate. Prostaglandin E2 (PGE2), the predominant product of COX-2 enzymatic activity, activates membrane receptors, which are members of the GPCR-family (EP1-EP4). In the present study, elevated expression of the PGE2 receptor subtype 3 (EP3) receptor was observed in ß cells exposed to palmitate and in islets from individuals with T2D. Down-regulation of the pathway using EP3 siRNA or the specific L-798,106 antagonist markedly decreased the levels of palmitate-induced apoptosis. Altogether, our data put forward the COX-2-PGE2-EP3 pathway as one of the mediators of palmitate-induced apoptosis in ß-cells.-Amior, L., Srivastava, R., Nano, R., Bertuzzi, F., Melloul, D. The role of Cox-2 and prostaglandin E2 receptor EP3 in pancreatic ß-cell death.


Assuntos
Ciclo-Oxigenase 2/metabolismo , Células Secretoras de Insulina/metabolismo , Receptores de Prostaglandina E Subtipo EP2/metabolismo , Receptores de Prostaglandina E Subtipo EP3/metabolismo , Celecoxib/farmacologia , Linhagem Celular , Ciclo-Oxigenase 2/genética , Inibidores de Ciclo-Oxigenase 2/farmacologia , Feminino , Humanos , Células Secretoras de Insulina/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Palmitatos/farmacologia , Receptores de Prostaglandina E Subtipo EP2/genética , Receptores de Prostaglandina E Subtipo EP3/genética
17.
Expert Opin Emerg Drugs ; 25(3): 337-351, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32799566

RESUMO

INTRODUCTION: The coronavirus-19 (COVID-19) disease pandemic can be characterized as the most critical and changeable hazard to healthcare systems in eras. The high fatality rate associated with coronavirus infection underlines the urgent need for an effective treatment to reduce disease severity and mortality. AREAS COVERED: A detailed search for treatments related to severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) was carried out using PubMed. Components of the virus relevant to the infectious mechanism were identified. We have highlighted all the latest emerging and repurposed drugs that were found to be active against this novel coronavirus and classified these drugs according to their category. Different drug targets are discussed in order to identify new molecules or new combinations as candidates to manage SARS-CoV2/COVID-19 infections. EXPERT OPINION: The development of novel molecules and vaccines has been a challenge during this urgent crisis. Nucleoside analogs and IL-6 receptor antagonists have been identified as the best candidates for treatment of this disease. Multi-drug therapy by targeting different pathways will need to be corroborated and then confirmed through clinical trials. Until a vaccine is available, an alternative drug regimen needs to be adopted by clinicians in the management of coronavirus symptoms.


Assuntos
Antivirais/administração & dosagem , Betacoronavirus/efeitos dos fármacos , Infecções por Coronavirus/tratamento farmacológico , Gerenciamento Clínico , Desenho de Fármacos , Pneumonia Viral/tratamento farmacológico , Animais , Anti-Inflamatórios/administração & dosagem , Anticoagulantes/administração & dosagem , Betacoronavirus/fisiologia , COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Humanos , Imunização Passiva , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , SARS-CoV-2 , Vasodilatadores/administração & dosagem , Vacinas Virais/administração & dosagem , Soroterapia para COVID-19
18.
Arch Pharm (Weinheim) ; 353(1): e1900180, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31631383

RESUMO

Antifungal drug resistance exhibits a major clinical challenge for treating nosocomial fungal infections. To find a possible solution, we synthesized and studied the antifungal activities of three different arginolipids (Nα -acyl-arginine ethyl ester) against clinical drug-resistant isolates of Candida. The most active arginolipid, oleoyl arginine ethyl ester (OAEE) consisting of a long unsaturated hydrophobic chain, was tested for its mode of action, which revealed that it altered ergosterol biosynthesis and compromised the fungal cell membrane. Also, OAEE was found to exhibit synergistic interactions with fluconazole (FLU) or amphotericin B (AmB) against planktonic Candida cells, wherein it reduced the inhibitory concentrations of these drugs to their in vitro susceptible range. Studies conducted against the C. tropicalis biofilm revealed that the OAEE+AmB combination synergistically reduced the metabolic activity and hyphal density in biofilms, whereas OAEE+FLU was found to be additive against most cases. Finally, the evaluated selective toxicity of OAEE toward fungal cells over mammalian cells could establish it as an alternative treatment for combating drug-resistant Candida infections.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Farmacorresistência Fúngica/efeitos dos fármacos , Antifúngicos/síntese química , Antifúngicos/química , Biofilmes/efeitos dos fármacos , Candida/citologia , Candida/isolamento & purificação , Membrana Celular/efeitos dos fármacos , Sinergismo Farmacológico , Testes de Sensibilidade Microbiana , Conformação Molecular , Simulação de Dinâmica Molecular
19.
Langmuir ; 35(24): 7805-7815, 2019 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-31090425

RESUMO

Integrating the concept of biodegradation and light-triggered localized therapy in a functional nanoformulation is the current approach in onco-nanomedicine. Morphology control with an enhanced photothermal response, minimal toxicity, and X-ray attenuation of polymer-based nanoparticles is a critical concern for image-guided photothermal therapy. Herein, we describe the simple design of cost-effective and degradable polycaprolactone-based plasmonic nanoshells for the integrated photothermolysis as well as localized imaging of cancer cells. The gold-deposited polycaprolactone-based plasmonic nanoshells (AuPCL NS) are synthesized in a scalable and facile way under ambient conditions. The synthesized nanoshells are monodisperse, fairly stable, and highly inert even at five times (250 µg/mL) the therapeutic concentration in a week-long test. AuPCL NS are capable of delivering standalone photothermal therapy for the complete ablation of cancer cells without using any anticancerous drugs and causing toxicity. It delivers the same therapeutic efficacy to different cancer cell lines, irrespective of their chemorefractory status and also works as a potential computed tomography contrast agent for the integrated imaging-directed photothermal cancer therapy. High biocompatibility, degradability, and promising photothermal efficacy of AuPCL NS are attractive aspects of this report that could open new horizons of localized plasmonic photothermal therapy for healthcare applications.


Assuntos
Nanomedicina/economia , Nanomedicina/métodos , Nanoconchas/uso terapêutico , Fototerapia/economia , Fototerapia/métodos , Animais , Linhagem Celular Tumoral , Análise Custo-Benefício , Humanos , Hipertermia Induzida , Polímeros/química
20.
Glia ; 66(5): 907-919, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29266673

RESUMO

Neurological disorders are a major threat to public health. Stem cell-based regenerative medicine is now a promising experimental paradigm for its treatment, as shown in pre-clinical animal studies. Initial attempts have been on the replacement of neuronal cells only, but glial progenitors (GPs) are now becoming strong alternative cellular therapeutic candidates to replace oligodendrocytes and astrocytes as knowledge accumulates about their important emerging role in various disease processes. There are many examples of successful therapeutic outcomes for transplanted GPs in small animal models, but clinical translation has proved to be challenging due to the 1,000-fold larger volume of the human brain compared to mice. Human GPs transplanted into the mouse brain migrate extensively and can induce global cell replacement, but a similar extent of migration in the human brain would only allow for local rather than global cell replacement. We review here the mechanisms that govern cell migration, which could potentially be exploited to enhance the migratory properties of GPs through cell engineering pre-transplantation. We furthermore discuss the (dis)advantages of the various cell delivery routes that are available, with particular emphasis on intra-arterial injection as the most suitable route for achieving global cell distribution in the larger brain. Now that therapeutic success has proven to be feasible in small animal models, future efforts will need to be directed to enhance global cell delivery and migration to make bench-to-bedside translation a reality.


Assuntos
Movimento Celular/fisiologia , Células-Tronco Neurais/fisiologia , Neuroglia/fisiologia , Neuroglia/transplante , Transplante de Células-Tronco , Animais , Humanos , Camundongos , Especificidade da Espécie , Transplante de Células-Tronco/métodos
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