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1.
Osteoarthritis Cartilage ; 25(6): 926-934, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27651153

RESUMO

OBJECTIVE: Emerging evidence suggests that osteoarthritis (OA) has a neuropathic component; however, the identity of the molecules responsible for this peripheral neuropathy is unknown. The aim of this study was to determine the contribution of the bioactive lipid lysophosphatidic acid (LPA) to joint neuropathy and pain. DESIGN: Male Lewis rats received an intra-articular injection of 50 µg of LPA into the knee and allowed to recover for up to 21 days. Saphenous nerve myelination was assessed by g-ratio calculation from electron micrographs and afferent nerve damage visualised by activation transcription factor-3 (ATF-3) expression. Nerve conduction velocity was measured electrophysiologically and joint pain was determined by hindlimb incapacitance. The effect of the LPA antagonist Ki-16425 was also evaluated. Experiments were repeated in the sodium monoiodoacetate (MIA) model of OA. RESULTS: LPA caused joint nerve demyelination which resulted in a drop in nerve conduction velocity. Sensory neurones were ATF-3 positive and animals exhibited joint pain and knee joint damage. MIA-treated rats also showed signs of demyelination and joint neuropathy with concomitant pain. Nerve damage and pain could be ameliorated by Ki-16425 pre-treatment. CONCLUSION: Intra-articular injection of LPA caused knee joint neuropathy, joint damage and pain. Pharmacological blockade of LPA receptors inhibited joint nerve damage and hindlimb incapacitance. Thus, LPA is a candidate molecule for the development of OA nerve damage and the origin of joint neuropathic pain.


Assuntos
Fator 3 Ativador da Transcrição/efeitos dos fármacos , Artrite Experimental/fisiopatologia , Lisofosfolipídeos/farmacologia , Condução Nervosa/efeitos dos fármacos , Osteoartrite/fisiopatologia , Nervos Periféricos/efeitos dos fármacos , Fator 3 Ativador da Transcrição/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Artralgia , Artrite Experimental/induzido quimicamente , Artrite Experimental/metabolismo , Artrite Experimental/patologia , Comportamento Animal , Estudos de Casos e Controles , Cromatografia Líquida , Inibidores Enzimáticos/toxicidade , Feminino , Humanos , Injeções Intra-Articulares , Ácido Iodoacético/toxicidade , Isoxazóis/farmacologia , Lisofosfolipídeos/antagonistas & inibidores , Lisofosfolipídeos/metabolismo , Masculino , Pessoa de Meia-Idade , Neuralgia , Osteoartrite/induzido quimicamente , Osteoartrite/metabolismo , Osteoartrite/patologia , Osteoartrite do Joelho/metabolismo , Nervos Periféricos/metabolismo , Nervos Periféricos/ultraestrutura , Propionatos/farmacologia , Ratos Endogâmicos Lew , Líquido Sinovial/química
2.
Osteoarthritis Cartilage ; 25(6): 935-942, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27638130

RESUMO

OBJECTIVE: Autotaxin is a secreted lysophospholipase that mediates the conversion of lysophosphatidyl choline (LPC) to lysophosphatidic acid (LPA), a bioactive lipid mediator. Autotaxin levels in plasma and synovial fluid correlate with disease severity in patients with knee osteoarthritis (OA). The goal of this study was to develop and characterize a novel small molecule inhibitor of autotaxin to inhibit LPA production in vivo and determine its efficacy in animal models of musculoskeletal pain. DESIGN: Compound libraries were screened using an LPC coupled enzyme assay that measures the amount of choline released from LPC by the action of autotaxin. Hits from this assay were tested in a plasma assay to assess inhibition of endogenous plasma autotaxin and subsequently tested for their ability to lower plasma LPA levels upon oral dosing of rats. The best compounds were then tested in animal models of musculoskeletal pain. RESULTS: Compound screening led to the identification of compounds with nanomolar potency for inhibition of autotaxin activity. Studies in rats demonstrated a good correlation between compound exposure levels and a decrease in LPA levels in plasma. The leading molecule (compound-1) resulted in a dose dependent decrease in joint pain in the mono-sodium iodoacetate (MIA) and meniscal tear models and a decrease in bone fracture pain in the osteotomy model in rats. CONCLUSION: We have identified and characterized a novel small molecule inhibitor of autotaxin and demonstrated its efficacy in animal models of musculoskeletal pain. The inhibitor has the potential to serve as an analgesic for human OA and bone fracture.


Assuntos
Artralgia/metabolismo , Artrite Experimental/metabolismo , Osteoartrite do Joelho/metabolismo , Inibidores de Fosfodiesterase/farmacologia , Diester Fosfórico Hidrolases/efeitos dos fármacos , Animais , Artralgia/etiologia , Artralgia/fisiopatologia , Artrite Experimental/induzido quimicamente , Artrite Experimental/complicações , Artrite Experimental/fisiopatologia , Cães , Humanos , Ácido Iodoacético/toxicidade , Lisofosfatidilcolinas/metabolismo , Lisofosfolipídeos/metabolismo , Masculino , Meniscos Tibiais/cirurgia , Osteoartrite do Joelho/induzido quimicamente , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/fisiopatologia , Osteotomia , Diester Fosfórico Hidrolases/metabolismo , Ratos , Ratos Endogâmicos Lew , Lesões do Menisco Tibial
3.
Osteoarthritis Cartilage ; 22(4): 578-85, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24508775

RESUMO

OBJECTIVE: Investigate a role for calcitonin gene-related peptide (CGRP) in osteoarthritis (OA)-related pain. DESIGN: Neutralizing antibodies to CGRP were generated de novo. One of these antibodies, LY2951742, was characterized in vitro and tested in pre-clinical in vivo models of OA pain. RESULTS: LY2951742 exhibited high affinity to both human and rat CGRP (KD of 31 and 246 pM, respectively). The antibody neutralized CGRP-mediated induction of cAMP in SK-N-MC cells in vitro and capsaicin-induced dermal blood flow in the rat. Neutralization of CGRP significantly reduced pain behavior as measured by weight bearing differential in the rat monoiodoacetate model of OA pain in a dose-dependent manner. Moreover, pain reduction with neutralization of CGRP occurred independently of prostaglandins, since LY2951742 and NSAIDs worked additively in the NSAID-responsive version of the model and CGRP neutralization remained effective in the NSAID non-responsive version of the model. Neutralization of CGRP also provided dose-dependent and prolonged (>60 days) pain reduction in the rat meniscal tear model of OA after only a single injection of LY2951742. CONCLUSIONS: LY2951742 is a high affinity, neutralizing antibody to CGRP. Neutralization of CGRP is efficacious in several OA pain models and works independently of NSAID mechanisms of action. LY2951742 holds promise for the treatment of pain in OA patients.


Assuntos
Anticorpos Neutralizantes/farmacologia , Peptídeo Relacionado com Gene de Calcitonina/efeitos dos fármacos , Osteoartrite/tratamento farmacológico , Dor/prevenção & controle , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Peptídeos Catiônicos Antimicrobianos , Catelicidinas/metabolismo , Modelos Animais de Doenças , Humanos , Masculino , Ratos , Ratos Endogâmicos Lew , Fluxo Sanguíneo Regional , Pele/irrigação sanguínea
4.
Osteoarthritis Cartilage ; 18 Suppl 3: S17-23, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20864019

RESUMO

AIM: To describe a histologic scoring system for murine osteoarthritis (OA) that can be applied universally to instability, enzymatic, transgenic and spontaneous OA models. METHODS: Scientists with expertise in assessing murine OA histopathology reviewed the merits and drawbacks of methods described in the literature. A semi-quantitative scoring system that could reasonably be employed in any basic cartilage histology laboratory was proposed. This scoring system was applied to a set of 10 images of the medial tibial plateau and femoral condyle to yield 20 scores. These images were scored twice by four experienced scorers (CL, SG, MC, TA), with a minimum time interval of 1 week between scores to obtain intra-observer variability. An additional three novice scorers (CR, CL and MM) with no previous experience evaluated the images to determine the ease of use and reproducibility across laboratories. RESULTS: The semi-quantitative scoring system was relatively easy to apply for both experienced and novice scorers and the results had low inter- and intra-scorer variability. The variation in scores across both the experienced and novice scorers was low for both tibia and femur, with the tibia always having greater consistency. CONCLUSIONS: The semi-quantitative scoring system recommended here is simple to apply and required no specialized equipment. Scoring of the tibial plateaus was highly reproducible and more consistent than that of the femur due to the much thinner femoral cartilage. This scoring system may be a useful tool for both new and experienced scorers to sensitively evaluate models and OA mechanisms, and also provide a common paradigm for comparative evaluation across the many groups performing these analyses.


Assuntos
Artrite Experimental/patologia , Modelos Animais de Doenças , Osteoartrite/patologia , Índice de Gravidade de Doença , Animais , Cartilagem Articular/patologia , Articulações/patologia , Camundongos , Variações Dependentes do Observador , Proteoglicanas/metabolismo , Reprodutibilidade dos Testes , Membrana Sinovial/patologia
5.
Osteoarthritis Cartilage ; 18(9): 1159-66, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20633676

RESUMO

OBJECTIVE: To develop a short-term in vivo model in rats, with an enzyme-linked immunosorbent assay (ELISA) readout for specific aggrecanase-cleaved aggrecan fragments, to facilitate testing of aggrecanase inhibitors. METHODS: Monosodium iodoacetate (MIA), a metabolic inhibitor, was injected into the right knee joint of male Lewis rats and the release of aggrecanase-cleaved fragments of aggrecan containing the NITEGE or ARGN neoepitope was measured in the synovial fluid at 7 days post MIA injection using novel ELISAs. The ELISAs utilize a commercial antibody directed against the hyaluronic-acid binding region (HABR) of aggrecan, in combination with either an alpha-NITEGE antibody (NITEGE ELISA) or an alpha-ARGS/BC3 antibody (ARGS ELISA), to detect aggrecanase-cleavage of aggrecan within the interglobular domain (IGD). Aggrecan fragments present in in vitro digests, in cytokine-treated cartilage explant culture supernatants and in rat synovial fluid lavage samples were detected and quantified using the two ELISAs. Small molecule inhibitors of aggrecanase activity were dosed orally on days 3-7 to determine their ability to inhibit MIA-induced generation of the NITEGE and ARGN neoepitopes measured in the rat synovial fluid. RESULTS: The NITEGE assay was shown to specifically detect the N-terminal fragment of aggrecan comprising the G1 domain and the NITEGE neoepitope sequence. This assay can readily measure aggrecanase-cleaved bovine, human and rat aggrecan without the need for deglycosylation. The ARGS assay specifically detects C-terminal fragments of aggrecan comprising the ARGS/ARGN neoepitope and the G2 domain. Keratan sulfate (KS) residues of aggrecan interfere with this ELISA, and hence this assay works well with native rat articular cartilage aggrecan (that lacks KS residues) and with deglycosylated bovine and human aggrecan. Injection of MIA into the rat knee joints resulted in a time-dependent increase in the release of aggrecanase-cleaved aggrecan fragments into the synovial fluid and treatment with an aggrecanase inhibitor resulted in a dose-dependent inhibition of the generation of these neoepitopes. CONCLUSIONS: We have established a short-term in vivo model in rats that involves measurement of synovial fluid biomarkers that are dependent on aggrecanase activity in the joint. The short duration of the model combined with the mechanistic biomarker readout makes it very useful for the initial in vivo screening of aggrecanase inhibitors prior to testing them in time and resource-intensive disease models of osteoarthritis (OA).


Assuntos
Agrecanas/metabolismo , Endopeptidases/farmacocinética , Iodoacetatos/farmacologia , Líquido Sinovial/metabolismo , Animais , Biomarcadores/metabolismo , Bovinos , Endopeptidases/metabolismo , Ensaio de Imunoadsorção Enzimática/métodos , Epitopos/análise , Humanos , Articulação do Joelho/metabolismo , Masculino , Ratos , Ratos Endogâmicos Lew
6.
Osteoarthritis Cartilage ; 18(7): 992-1000, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20434574

RESUMO

OBJECTIVE: The purpose of this study was to use microarray technology to: (1) understand the early molecular events underlying the damage of articular cartilage initiated by this surgical procedure, and (2) determine whether these changes mimic those that are occurring in human osteoarthritic (OA) cartilage. DESIGN: Cartilage was harvested from both medial and lateral sides of the tibial plateaus and femoral condyles of both meniscal tear (MT) and sham surgery groups on days 3, 7 and 21 post-surgery. mRNA prepared from these rat cartilage samples was used for microarray analysis. RESULTS: Statistical analysis identified 475 genes that were differentially expressed between the sham and MT groups, at one or more of the time points that were analyzed. By integrating these genes with OA-related genes reported previously in a rat OA model and in human OA array studies, we identified 20 commonly changed genes. Six out of these 20 genes (Col5A1, Col6A2, INHBA, LTBP2, NBL1 and SERPINA1) were differentially expressed in two animal models and in human OA. Pathway analysis identified some key features of OA pathology, namely cartilage extracellular matrix remodeling, angiogenesis, and chondrocyte cell death that were recapitulated in the animal models. The rat models suggested increased inflammation and cholesterol metabolic pathways may play important role in early cartilage degeneration. CONCLUSION: We identified a large number of differentially expressed genes in the articular cartilage of the MT model. While there was lack of overall identity in cartilage gene expression between the rat models and human OA, several key biological processes were recapitulated in the rat MT OA model.


Assuntos
Lesões do Ligamento Cruzado Anterior , Artrite Experimental/metabolismo , Cartilagem Articular/metabolismo , Osteoartrite/metabolismo , Lesões do Menisco Tibial , Animais , Fêmur/metabolismo , Humanos , Masculino , Análise em Microsséries , Modelos Animais , Ratos , Ratos Endogâmicos Lew , Tíbia/metabolismo
7.
J Thromb Haemost ; 15(6): 1167-1179, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28397397

RESUMO

Essentials Recombinant factor VIII (rFVIII) Fc fusion protein has a 1.5-fold longer half-life than rFVIII. Five orthogonal methods were used to characterize the structure of rFVIIIFc compared to rFVIII. The C-terminal Fc fusion does not perturb the structure of FVIII in rFVIIIFc. The FVIII and Fc components of rFVIIIFc are flexibly tethered and functionally independent. SUMMARY: Background Fusion of the human IgG1 Fc domain to the C-terminal C2 domain of B-domain-deleted (BDD) factor VIII (FVIII) results in the recombinant FVIII Fc (rFVIIIFc) fusion protein, which has a 1.5-fold longer half-life in humans. Objective To assess the structural properties of rFVIIIFc by comparing its constituent FVIII and Fc elements with their respective isolated components, and evaluating their structural independence within rFVIIIFc. Methods rFVIIIFc and its isolated FVIII and Fc components were compared by the use of hydrogen-deuterium exchange mass spectrometry (HDX-MS). The structure of rFVIIIFc was also evaluated by the use of X-ray crystallography, small-angle X-ray scattering (SAXS), and electron microscopy (EM). The degree of steric interference by the appended Fc domain was assessed by EM and surface plasmon resonance (SPR). Results HDX-MS analysis of rFVIIIFc revealed that fusion caused no structural perturbations in FVIII or Fc. The rFVIIIFc crystal structure showed that the FVIII component is indistinguishable from published BDD FVIII structures. The Fc domain was not observed, indicating high mobility. SAXS analysis was consistent with an ensemble of rigid-body models in which the Fc domain exists in a largely extended orientation relative to FVIII. Binding of Fab fragments of anti-C2 domain antibodies to BDD FVIII was visualized by EM, and the affinities of the corresponding intact antibodies for BDD FVIII and rFVIIIFc were comparable by SPR analysis. Conclusions The FVIII and Fc components of rFVIIIFc are structurally indistinguishable from their isolated constituents, and show a high degree of structural independence, consistent with the functional comparability of rFVIIIFc and unmodified FVIII.


Assuntos
Fator VIII/química , Hemofilia A/tratamento farmacológico , Fragmentos Fc das Imunoglobulinas/química , Proteínas Recombinantes de Fusão/química , Cristalografia por Raios X , Fator VIII/administração & dosagem , Células HEK293 , Meia-Vida , Hemofilia A/imunologia , Hemorragia , Humanos , Fragmentos Fc das Imunoglobulinas/administração & dosagem , Cinética , Espectrometria de Massas , Microscopia Eletrônica , Fragmentos de Peptídeos/química , Domínios Proteicos , Proteínas Recombinantes de Fusão/administração & dosagem , Espalhamento a Baixo Ângulo , Ressonância de Plasmônio de Superfície , Difração de Raios X
8.
J Orthop Res ; 8(1): 101-4, 1990 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-2293624

RESUMO

At least 80% of male STR/ORT mice naturally develop osteoarthritis that predominantly affects the medial tibial cartilage. Overt osteoarthritic changes, as judged by radiological and histological abnormalities, become apparent after 30 weeks of age. Consequently, mice less than 30 weeks of age were used to investigate early changes in the cartilage matrix related to the natural development of osteoarthritis, without the need for experimental intervention to induce this condition. Quantitative Alcian blue staining showed little change in the total amount of proteoglycans in mice of this age. Polarized light microscopy of the birefringence induced by such staining demonstrated a progressive decline in the orientation of the proteoglycans in the medial cartilage of these mice. This decline was not found in CBA mice, which only very rarely develop osteoarthritis of this joint. Such progressive disorganization of the proteoglycans would be likely to permit the increase free water-content characteristic of osteoarthritic cartilage.


Assuntos
Osteoartrite/veterinária , Proteoglicanas/metabolismo , Doenças dos Roedores/metabolismo , Envelhecimento/metabolismo , Azul Alciano , Animais , Birrefringência , Cartilagem/metabolismo , Cartilagem/patologia , Colágeno/metabolismo , Masculino , Camundongos/genética , Camundongos Endogâmicos , Osteoartrite/genética , Osteoartrite/metabolismo
9.
Intensive Crit Care Nurs ; 15(6): 346-56, 1999 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11868582

RESUMO

This study was exploratory and describes how nursing was viewed and practised by nurses who worked in an operating department. It also highlighted factors that might influence the role performance of operating department nurses. The research involved interviews with a sample of 6 nurses working in an operating department, observation of 32 hours of nursing work over 6 operating sessions, in addition to the analysis of various documents, including the nursing care plans of 22 patients. Data were triangulated and analysed by constant comparison. Findings indicated that nurses had difficulty in articulating exactly what it was that operating department nursing entailed, but rather viewed their role in terms of the functions they performed. Observations indicated that the nursing role was primarily orientated toward the physical rather than the psychological aspects of care-giving. Furthermore, it appeared that the medical profession, nursing philosophy/leadership and the characteristics of patients all influenced the manner in which nurses enacted their role. These findings suggest that further research into the role of the nurse within the operating department environment is warranted. Key factors from this study were developed into a framework suitable for guiding future study of the nursing role in this environment.


Assuntos
Atitude do Pessoal de Saúde , Descrição de Cargo , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem Hospitalar/psicologia , Enfermagem de Centro Cirúrgico/organização & administração , Antropologia Cultural , Atitude Frente a Saúde , Comunicação , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Liderança , Modelos de Enfermagem , Relações Enfermeiro-Paciente , Pesquisa Metodológica em Enfermagem , Processo de Enfermagem , Filosofia em Enfermagem , Relações Médico-Enfermeiro , Poder Psicológico , Inquéritos e Questionários , Reino Unido
10.
Intensive Crit Care Nurs ; 15(5): 288-97, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10808825

RESUMO

The UK literature contains few references to nursing in the operating department and even fewer to methods for researching nursing in what is often a complex and stressful environment. Nursing staff work under intense pressure and this presents a challenge, not only for nurses who work in the operating department, but also for researchers who choose to study nursing within its bounds. This paper focuses on some of the key issues which emerged during one study of nursing in the operating department where an observational methodology was used. The author suggests that observation, as a research method, is an important feature of contextual investigation. However, like other methods of investigation, it requires careful planning and preparation. Furthermore, the author believes that sensitivity and skill are required for the enactment of the observer role when researching nursing within this specialized environment.


Assuntos
Coleta de Dados/métodos , Descrição de Cargo , Pesquisa em Avaliação de Enfermagem/métodos , Recursos Humanos de Enfermagem Hospitalar/organização & administração , Observação/métodos , Enfermagem de Centro Cirúrgico/organização & administração , Projetos de Pesquisa , Interpretação Estatística de Dados , Humanos , Relações Interprofissionais , Recursos Humanos de Enfermagem Hospitalar/psicologia , Pesquisadores/psicologia
11.
J Telemed Telecare ; 7 Suppl 1: 54-5, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11576492

RESUMO

We have developed a knowledge-based multimedia telecare system, based on a multimedia PC connected by ISDN at 128 kbit/s. The user display is a television. Multimedia material is accessed through a browser-based interface. A remote-control handset is used as the main means of interaction, to ensure ease of use and overcome any initial reservations resulting from 'technophobia' on the part of the informal carer. The system was used in 13 family homes and four professional sites in Northern Ireland. The evaluations produced positive comments from the informal carers. There are plans to expand the use of the system.


Assuntos
Cuidadores , Pessoas com Deficiência , Multimídia , Telemedicina , Interface Usuário-Computador , Idoso , Humanos , Apoio Social , Software
12.
Clin Pharmacol Ther ; 84(2): 263-6, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18547999

RESUMO

Although it is commonly believed that the innovation of new medicines is of paramount importance for improving the health and quality of life of patients, there is also a keen recognition regarding upward-spiraling costs of innovation, drug discovery, and drug development against a backdrop of dwindling successes in research and development (R&D) efforts. We propose a new model of valuation of pharmacotherapies that attempts to secure an adequate return on investment in innovation by ensuring optimal pricing and reimbursement.


Assuntos
Pesquisa Biomédica/economia , Custos de Medicamentos/tendências , Desenho de Fármacos , Tratamento Farmacológico/economia , Farmacoeconomia , Modelos Econômicos , Ensaios Clínicos como Assunto , Análise Custo-Benefício , Indústria Farmacêutica/economia , Medicina Baseada em Evidências , Humanos , Cobertura do Seguro , Modelos Econométricos , Anos de Vida Ajustados por Qualidade de Vida , Projetos de Pesquisa , Estados Unidos
13.
Osteoarthritis Cartilage ; 14(5): 486-95, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16443378

RESUMO

OBJECTIVE: To investigate the role of adenosine in chondrocyte death in murine osteoarthritis (OA). METHODS: 5'-Nucleotidase (5'NT) generates adenosine. Enzyme activity was measured histochemically in normal murine and osteoarthritic STR/ort strain tibial cartilage. Adenosine-mediated cell death was investigated in MC615 chondrocyte cultures. Adenosine receptors (ARs) were assessed by reverse transcriptase polymerase chain reaction (RT-PCR). Cellular uptake of [(3)H] adenosine was measured with or without the inhibitor, nitrobenzylthioinosine (NBTI). Cell death was assessed by cell counting and DNA laddering following selective receptor stimulation, or after modulating adenosine metabolism with adenosine deaminase (ADA) or adenosine kinase (AK) inhibitors [erythro-9-(2-hydroxy-3-nonyl)adenine (EHNA) and Iodotubericidin (Itub)], or with homocysteine (HC). Markers of apoptosis were assessed by Western blotting. Cell studies were validated by incubating normal murine knee joints in a medium containing adenosine and metabolic inhibitors. Apoptotic chondrocytes were identified with the TUNEL reaction. RESULTS: 5'NT activity in STR/ort tibial cartilage increased with development of OA, especially close to OA lesions. Adenosine induced MC615 cell death in the presence of ADA inhibition (100 microM EHNA), or 1mM HC, or both. Adenosine uptake, mediated by NBTI-sensitive adenosine transporters, was required for cell death. ARs were expressed (A2b>A2a>A1) but were not involved in mediating cell death. Cell death involved the activation of caspase-3 and DNA fragmentation and was prevented by inhibiting caspase activity. However, neither caspase-8 nor caspase-9 was detected. Adenosine+EHNA induced chondrocyte apoptosis in normal murine knee joints. CONCLUSION: Increased adenosine production may induce chondrocyte apoptosis and play a role in OA in STR/ort mice.


Assuntos
Adenosina/metabolismo , Morte Celular/fisiologia , Condrócitos/fisiologia , Osteoartrite/fisiopatologia , 5'-Nucleotidase/metabolismo , Adenina/análogos & derivados , Adenina/farmacologia , Inibidores de Adenosina Desaminase , Adenosina Quinase/antagonistas & inibidores , Animais , Apoptose/fisiologia , Cartilagem Articular/metabolismo , Cartilagem Articular/fisiopatologia , Morte Celular/efeitos dos fármacos , Linhagem Celular , Condrócitos/efeitos dos fármacos , Condrócitos/metabolismo , Fragmentação do DNA/fisiologia , Inibidores Enzimáticos/farmacologia , Homocisteína/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos , Receptores Purinérgicos P1/análise , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Tubercidina/análogos & derivados , Tubercidina/farmacologia
14.
J Adv Nurs ; 32(5): 1092-100, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11114993

RESUMO

In the current cost-conscious National Health Service (NHS), the role of the nurse during anaesthesia and surgery is one that has interested health service managers keen to know what happens behind the closed doors of the operating department. It is clear that if nurses working within this specialized setting are to secure a future in providing care for surgical patients, then it is important to clarify and articulate exactly what it is that their role involves. The aim of this paper is to examine the role of the operating department nurse. First, it will illustrate how the role of the nurse has evolved alongside medical and technical advances in surgery, particularly in the last century. Second, it will highlight that while definition of the role has received attention in the North American literature, references in the British literature as to what it is that operating department nurses do, are scant. Finally, it will address the evolving role of the contemporary perioperative nurse highlighting the changes and challenges that nurses who work within this setting are currently facing. It is suggested here that nurses need to engage in role definition in order to be clear about their direction for the future, particularly within the fast changing, technologically driven environment of the operating department.


Assuntos
Descrição de Cargo , Enfermagem de Centro Cirúrgico/organização & administração , Especialização/tendências , Previsões , Humanos , América do Norte , Enfermeiros Anestesistas/organização & administração , Pesquisa em Avaliação de Enfermagem , Enfermagem de Centro Cirúrgico/educação , Auxiliares de Cirurgia/organização & administração , Inovação Organizacional , Assistência Perioperatória/enfermagem , Autonomia Profissional , Sociedades de Enfermagem/organização & administração , Reino Unido
15.
Cell Biochem Funct ; 14(1): 57-61, 1996 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-8907255

RESUMO

Up to nine out of 10 male STR/ORT mice develop osteoarthritis (OA) of the medial tibial cartilage at an early age. This has now been shown to be related to changes in the activity and distribution of monoamine oxidase which is related to the metabolism of catecholamines. Treatment with diclofenac sodium tended to normalize this activity but there was no significant histological improvement. It was therefore postulated that two influences were involved in the development of OA: a cellular and an extracellular factor. The first was improved by diclofenac sodium; the second, namely oedema of the matrix, was improved by tribenoside. In very preliminary studies, feeding the two drugs simultaneously resulted in 7/9 mice having no sign of OA.


Assuntos
Osteoartrite/tratamento farmacológico , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Cartilagem/enzimologia , Cartilagem/patologia , Densitometria , Diclofenaco/farmacologia , Modelos Animais de Doenças , Combinação de Medicamentos , Glicosídeos/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos , Monoaminoxidase/efeitos dos fármacos , Monoaminoxidase/metabolismo , Osteoartrite/enzimologia
16.
Osteoarthritis Cartilage ; 5(5): 301-8, 1997 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9497937

RESUMO

Eighty-five percent of male STR/ort mice develop osteoarthritic lesions of the knee joint by 35 weeks of age. We have developed a non-radioactive in-situ hybridization method using digoxigenin-labeled oligonucleotide probes to study the expression of the cytokines interleukin (IL) 1 alpha, Il-1 beta and IL-6 and the growth factors insulin-like growth factor-1 (IGF-1) and transforming growth factor beta (TGF beta 1) during the development of osteoarthritis (OA) in this model. Age- and sex-matched CBA mice, which do not develop OA, showed no detectable expression of any of the cytokines or growth factors studied. In contrast, 20-week-old STR/ort mice with no OA lesions showed positive expression [positive: (+)] for all the cytokines and growth factors studied. At 35 weeks of age, STR/ort mice with varying grades of OA showed positive (+) or strong (++) signals for both cytokines and growth factors throughout the tibial articular cartilage. The strongest signal was seen in areas where OA lesions were present. In areas of histologically-normal cartilage adjacent to the lesions, the signals were still positive but weaker. Fifty-week-old STR/ort mice with OA lesions showed a similar pattern of expression to 35-week-old mice. Thirty-five or 50-week-old STR/ort mice with no OA lesions had much reduced expression compared with those with OA lesions. These mice may be indicative of those STR/ort mice which do not develop OA. The results seen in the STR/ort together with previous biochemical analyses are consistent with an up-regulation of anabolic growth factors and catabolic cytokines in the prelesional stages of OA with anabolic effects predominating. At later stages of OA, the effects of catabolic factors appear to predominate and osteoarthritic lesions become evident.


Assuntos
Condrócitos/metabolismo , Substâncias de Crescimento/metabolismo , Osteoartrite/metabolismo , Envelhecimento/metabolismo , Animais , Cartilagem Articular/metabolismo , Hibridização In Situ , Fator de Crescimento Insulin-Like I/metabolismo , Interleucinas/metabolismo , Articulação do Joelho/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos CBA , Camundongos Endogâmicos , Fator de Crescimento Transformador beta/metabolismo
17.
Br J Surg ; 88(8): 1029-36, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11488786

RESUMO

BACKGROUND: Faecal incontinence affects 1-2 per cent of the adult population. While many patients can be managed successfully with conservative therapy, a small proportion require surgery. Improved imaging techniques and technological advances have led to the availability of a wide range of surgical treatments. Decision-makers increasingly require clinical and cost-effectiveness studies of surgical treatments for faecal incontinence. This review examines the practical aspects of undertaking such studies. METHODS: The practical issues related to different aetiologies, different types of treatment, defining outcomes, the hidden costs of the condition and its treatment, the rapid changes in technology and issues of patient choice were all considered. A Medline search was undertaken to identify relevant publications, and the reference lists of identified papers were scanned manually. RESULTS: There are few randomized controlled studies and those that have been performed have been limited in their scope. There has also been very limited health economic analysis undertaken. Strategies for conducting such studies, and the criteria they use, have been outlined. CONCLUSION: Randomized trials have a limited role in this setting because of variations in aetiology, difficulty in standardizing procedures, continuing evolution of devices, small patient numbers, concerns for patient choice and the need for long-term follow-up. Issues to be addressed when evaluating interventions for faecal incontinence include choosing appropriate measures of surgical outcome, using new continence scoring systems and tools for quality-of-life assessment, and choosing appropriate cost perspectives and time horizons for economic evaluation.


Assuntos
Incontinência Fecal/cirurgia , Cirurgia Colorretal/economia , Cirurgia Colorretal/métodos , Análise Custo-Benefício , Incontinência Fecal/economia , Humanos , Fatores de Tempo , Resultado do Tratamento
18.
Osteoarthritis Cartilage ; 12(2): 131-41, 2004 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-14723872

RESUMO

OBJECTIVE: To determine whether chondrocyte apoptosis occurs during the progression of osteoarthritis (OA) in the STR/ort mouse model of OA. METHODS: Serial cryostat sections were cut (10 microns) through the knee joint of young and old male STR/ort mice and graded for the severity of OA lesions. Age- and sex-matched CBA mice were used as controls. Apoptotic chondrocytes were detected using the TUNEL assay. Ultrastructural changes were examined using electron microscopy (EM). Expression of biochemical markers associated with apoptosis (bax, bcl-2 and caspases-3, -8 & -9) was investigated using immunohistochemistry. RESULTS: TUNEL assays on histological sections of STR/ort knee joints showed that the number of TUNEL-positive chondrocytes in the tibial medial articular cartilage correlated with the severity of the OA damage. These cells were located close to the lesional area. Only very occasional TUNEL positive chondrocytes were detected in either morphologically normal STR/ort cartilage or in control CBA cartilage. Ultrastructural analysis of chondrocytes neighboring focal osteoarthritic lesions in STR/ort tibial cartilage revealed an abundance of abnormal cells exhibiting numerous morphological changes. These resembled, but in some cases differed, from changes reported in classical apoptosis. The changes include abnormal distribution of chromatin, cell shrinkage, membrane blebbing and deposition of cell remnants (apoptotic bodies) in the lacuna space. Despite the TUNEL and EM changes, immunohistochemistry failed to detect any changes in the ratio of bax to bcl-2 in tibial chondrocytes of STR/ort mice. Both bcl-2 and bax levels decreased with age in morphologically normal STR/ort and control CBA cartilage. None of the caspases tested for was detected in tibial chondrocytes of either strain. CONCLUSION: Chondrocyte cell death is correlated with the progression of OA in STR/ort mice and has many of the morphological characteristics of classical apoptosis. Absence of changes in bax to bcl-2 ratio in STR/ort chondrocytes indicate that the mitochondrial pathway of apoptosis is unlikely to be involved. Failure to detect caspases could be due to low levels of enzyme expression, expression within a very brief time period, or to a caspase-independent mechanism of cell death.


Assuntos
Apoptose/fisiologia , Cartilagem Articular/fisiopatologia , Condrócitos/fisiologia , Osteoartrite/fisiopatologia , Animais , Biomarcadores/análise , Cartilagem Articular/patologia , Caspase 8 , Caspase 9 , Caspases/análise , Modelos Animais de Doenças , Membro Posterior , Imuno-Histoquímica/métodos , Marcação In Situ das Extremidades Cortadas/métodos , Masculino , Camundongos , Camundongos Endogâmicos , Microscopia Eletrônica/métodos , Osteoartrite/patologia , Proteínas Proto-Oncogênicas/análise , Proteínas Proto-Oncogênicas c-bcl-2/análise , Tíbia , Proteína X Associada a bcl-2
19.
Osteoarthritis Cartilage ; 12(1): 74-82, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14697685

RESUMO

OBJECTIVE: To investigate the expression of a novel member of the mannose receptor family, Endo180 (also known as uPARAP), and the distribution of Endo180 ligand(s) in the articular cartilage and growth plate of normal CBA mice and STR/ort mice, a well characterized model of spontaneous osteoarthritis. DESIGN: A polyclonal anti-Endo180 antibody was used to determine receptor expression. The Endo180 extracellular domain fused to a human immunoglobulin Fc tail was used to detect ligand. RESULTS: Endo180 receptor was strongly expressed in chondrocytes both in vitro and throughout the articular cartilage of young CBA and STR/ort mice. Expression decreased in older animals. In STR/ort mice with osteoarthritic lesions, no upregulation of Endo180 was detected. In the developing growth plate, Endo180 was expressed strongly by the proliferating chondrocytes. In contrast, Endo180 ligand was detected most strongly in hypertrophic zone of the growth plate and only at low levels in articular cartilage. In cultured chondrocytes, Endo180 was localized on the cell surface and in intracellular vesicles. CONCLUSION: Constitutively recycling endocytic receptors function to internalize ligand from the extracellular milieu and the ability of Endo180 to bind both glycosylated ligands and collagens suggests a role in extracellular matrix remodeling. Expression of Endo180 in articular cartilage chondrocytes of young, but not old, mice and the reciprocal expression of Endo180 and its ligands in the growth plate suggest that this receptor is involved in cartilage development but not in cartilage homeostasis. In addition, our data indicates that Endo180 does not appear to play a role in the development or progression of murine osteoarthritis.


Assuntos
Cartilagem Articular/metabolismo , Osteoartrite/metabolismo , Receptores Mitogênicos/análise , Animais , Anticorpos Monoclonais , Especificidade de Anticorpos , Cartilagem Articular/crescimento & desenvolvimento , Linhagem Celular , Condrócitos/metabolismo , Extremidades , Lâmina de Crescimento/metabolismo , Ligantes , Masculino , Camundongos , Camundongos Endogâmicos CBA , Camundongos Endogâmicos , Microscopia de Fluorescência/métodos
20.
Br J Exp Pathol ; 69(6): 845-53, 1988 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-3219287

RESUMO

A high incidence of natural osteoarthritis of the knee joint is found in male mice of the STR/ORT strain. The condition affects mainly the medial tibial cartilage and by the age of 27 weeks most male mice of this strain show some osteoarthritic change. Analysis of the oxidative metabolism of the chondrocytes during the development of the lesion has been facilitated by the techniques of quantitative cytochemistry. The activity of glucose-6-phosphate dehydrogenase (G6PD) has been investigated as indicative of the NADPH-generating pentose-phosphate pathway; the activities of glyceraldehyde-3-phosphate (G3PD) and lactate dehydrogenase (LDH) have been studied as indicators of glycolytic activity. In young STR/ORT mice the G6PD activity of the lateral tibial cartilage was greater and more variable than in the control mice of the CBA/HT6 strain. The activity in the medial cartilage, relative to that in the lateral cartilage, decreased with age; this change was not reflected in the activities of the other enzymes. In the lateral cartilage, the expected relationship was found between the G6PD and the G3PD activities and between the LDH and the G3PD activities. In the medial cartilage, the G6PD activities were not related to the G3PD activities. The decreased proportionality of the G6PD activities in the medial cartilage as against that in the lateral cartilage was detected in mice as young as 9 weeks; by 27 weeks of age nine of the 13 mice showed marked depression of medial as against lateral G6PD activities. In contrast, only four of the 13 mice showed any overt histological charge until up to the age of 28 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Cartilagem Articular/enzimologia , Articulação do Joelho/enzimologia , Osteoartrite/enzimologia , Animais , Cartilagem Articular/patologia , Glucosefosfato Desidrogenase/metabolismo , Gliceraldeído-3-Fosfato Desidrogenases/metabolismo , Articulação do Joelho/patologia , L-Lactato Desidrogenase/metabolismo , Camundongos , Camundongos Endogâmicos , Osteoartrite/patologia
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