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1.
Artículo en Inglés | MEDLINE | ID: mdl-38717549

RESUMEN

Myotropes are pharmaceuticals that have recently been developed or are under investigation for the treatment of heart diseases. Myotropes have had varied success in clinical trials. Initial research into myotropes have widely focused on animal models of cardiac dysfunction in comparison with normal animal cardiac physiology-primarily using males. In this study we examined the effect of danicamtiv, which is one type of myotrope within the class of myosin activators, on contractile function in permeabilized (skinned) myocardial strips from male and female Sprague-Dawley rats. We found that danicamtiv increased steady-state isometric force production at sub-maximal calcium levels, leading to greater Ca2+-sensitivity of contraction for both sexes. Danicamtiv did not affect maximal Ca2+-activated force for either sex. Sinusoidal length-perturbation analysis was used to assess viscoelastic myocardial stiffness and cross-bridge cycling kinetics. Data from these measurements did not vary with sex, and the data suggest that danicamtiv slows cross-bridge cycling kinetics. These findings imply that danicamtiv increases force production via increasing cross-bridge contributions to activation of contraction, especially at sub-maximal Ca2+-activation. The inclusion of both sexes in animal models during the formative stages of drug development could be helpful for understanding the efficacy or limitation of a drug's therapeutic impact on cardiac function.

2.
PLoS One ; 19(3): e0297212, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38437198

RESUMEN

Mechanical Control of Relaxation refers to the dependence of myocardial relaxation on the strain rate just prior to relaxation, but the mechanisms of enhanced relaxation are not well characterized. This study aimed to characterize how crossbridge kinetics varied with strain rate and time-to-stretch as the myocardium relaxed in early diastole. Ramp-stretches of varying rates (amplitude = 1% muscle length) were applied to intact rat cardiac trabeculae following a load-clamp at 50% of the maximal developed twitch force, which provides a first-order estimate of ejection and coupling to an afterload. The resultant stress-response was calculated as the difference between the time-dependent stress profile between load-clamped twitches with and without a ramp-stretch. The stress-response exhibited features of the step-stretch response of activated, permeabilized myocardium, such as distortion-dependent peak stress, rapid force decay related to crossbridge detachment, and stress recovery related to crossbridge recruitment. The peak stress was strain rate dependent, but the minimum stress and the time-to-minimum stress values were not. The initial rapid change in the stress-response indicates enhanced crossbridge detachment at higher strain rates during relaxation in intact cardiac trabeculae. Physiologic considerations, such as time-varying calcium, are discussed as potential limitations to fitting these data with traditional distortion-recruitment models of crossbridge activity.


Asunto(s)
Allium , Corazón , Animales , Ratas , Miocardio , Calcio de la Dieta , Hueso Esponjoso
3.
Neurology ; 102(4): e208007, 2024 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-38290094

RESUMEN

BACKGROUND AND OBJECTIVE: Patients with presumed nonlesional focal epilepsy-based on either MRI or histopathologic findings-have a lower success rate of epilepsy surgery compared with lesional patients. In this study, we aimed to characterize a large group of patients with focal epilepsy who underwent epilepsy surgery despite a normal MRI and had no lesion on histopathology. Determinants of their postoperative seizure outcomes were further studied. METHODS: We designed an observational multicenter cohort study of MRI-negative and histopathology-negative patients who were derived from the European Epilepsy Brain Bank and underwent epilepsy surgery between 2000 and 2012 in 34 epilepsy surgery centers within Europe. We collected data on clinical characteristics, presurgical assessment, including genetic testing, surgery characteristics, postoperative outcome, and treatment regimen. RESULTS: Of the 217 included patients, 40% were seizure-free (Engel I) 2 years after surgery and one-third of patients remained seizure-free after 5 years. Temporal lobe surgery (adjusted odds ratio [AOR]: 2.62; 95% CI 1.19-5.76), shorter epilepsy duration (AOR for duration: 0.94; 95% CI 0.89-0.99), and completely normal histopathologic findings-versus nonspecific reactive gliosis-(AOR: 4.69; 95% CI 1.79-11.27) were significantly associated with favorable seizure outcome at 2 years after surgery. Of patients who underwent invasive monitoring, only 35% reached seizure freedom at 2 years. Patients with parietal lobe resections had lowest seizure freedom rates (12.5%). Among temporal lobe surgery patients, there was a trend toward favorable outcome if hippocampectomy was part of the resection strategy (OR: 2.94; 95% CI 0.98-8.80). Genetic testing was only sporadically performed. DISCUSSION: This study shows that seizure freedom can be reached in 40% of nonlesional patients with both normal MRI and histopathology findings. In particular, nonlesional temporal lobe epilepsy should be regarded as a relatively favorable group, with almost half of patients achieving seizure freedom at 2 years after surgery-even more if the hippocampus is resected-compared with only 1 in 5 nonlesional patients who underwent extratemporal surgery. Patients with an electroclinically identified focus, who are nonlesional, will be a promising group for advanced molecular-genetic analysis of brain tissue specimens to identify new brain somatic epilepsy genes or epilepsy-associated molecular pathways.


Asunto(s)
Epilepsias Parciales , Epilepsia del Lóbulo Temporal , Epilepsia , Humanos , Estudios de Cohortes , Electroencefalografía , Epilepsias Parciales/diagnóstico por imagen , Epilepsias Parciales/cirugía , Epilepsia/diagnóstico por imagen , Epilepsia/cirugía , Epilepsia del Lóbulo Temporal/cirugía , Imagen por Resonancia Magnética , Estudios Retrospectivos , Convulsiones , Resultado del Tratamiento
4.
Mol Inform ; 43(1): e202300262, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37833243

RESUMEN

The COVID-19 pandemic continues to pose a substantial threat to human lives and is likely to do so for years to come. Despite the availability of vaccines, searching for efficient small-molecule drugs that are widely available, including in low- and middle-income countries, is an ongoing challenge. In this work, we report the results of an open science community effort, the "Billion molecules against COVID-19 challenge", to identify small-molecule inhibitors against SARS-CoV-2 or relevant human receptors. Participating teams used a wide variety of computational methods to screen a minimum of 1 billion virtual molecules against 6 protein targets. Overall, 31 teams participated, and they suggested a total of 639,024 molecules, which were subsequently ranked to find 'consensus compounds'. The organizing team coordinated with various contract research organizations (CROs) and collaborating institutions to synthesize and test 878 compounds for biological activity against proteases (Nsp5, Nsp3, TMPRSS2), nucleocapsid N, RdRP (only the Nsp12 domain), and (alpha) spike protein S. Overall, 27 compounds with weak inhibition/binding were experimentally identified by binding-, cleavage-, and/or viral suppression assays and are presented here. Open science approaches such as the one presented here contribute to the knowledge base of future drug discovery efforts in finding better SARS-CoV-2 treatments.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , Pandemias , Bioensayo , Descubrimiento de Drogas
5.
Arch Biochem Biophys ; 747: 109753, 2023 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-37714251

RESUMEN

The MF30 monoclonal antibody, which binds to the myosin subfragment-2 (S2), was found to increase the extent of myofibril shortening. Yet, previous observations found no effect of this antibody on actin sliding over myosin during in vitro motility assays with purified proteins in which myosin binding protein C (MyBPC) was absent. MF30 is hypothesized to enhance the availability of myosin heads (subfragment-1 or S1) to bind actin by destabilizing the myosin S2 coiled-coil and sterically blocking S2 from binding S1. The mechanism of action likely includes MF30's substantial size, thereby inhibiting S1 heads and MyBPC from binding S2. Hypothetically, MF30 should enhance the ON state of myosin, thereby increasing muscle contraction. Our findings indicate that MF30 binds preferentially to the unfolded heavy chains of S2, displaying positive cooperativity. However, the dose-response curve of MF30's enhancement of myofibril shortening did not suggest complex interactions with S2. Single, double, and triple-stained myofibrils with increasing amounts of antibodies against myosin rods indicate a possible competition with MyBPC. Additional assays revealed decreased fluorescence intensity at the C-zone (central zone in the sarcomere, where MyBPC is located), where MyBPC may inhibit MF30 binding. Another monoclonal antibody named MF20, which binds to the light meromyosin (LMM) without affecting myofibril contraction, showed less reduction in fluorescence intensity at the C-zone in expansion microscopy than MF30. Expansion microscopy images of myofibrils labeled with MF20 revealed labeling of the A-band (anisotropic band) and a slight reduction in the labeling at the C-zone. The staining pattern obtained from the expansion microscopy image was consistent with images from photolocalization microscopy which required the synthesis of unique photoactivatable quantum dots, and Zeiss Airyscan imaging as well as alternative expansion microscopy digestion methods. Consistent with the hypothesis that MF30 competes with MyBPC binding to S2, cardiac tissue from MyBPC knockout mice was stained more intensely, especially in the C-zone, by MF30 compared to the wild type.


Asunto(s)
Actinas , Microscopía , Animales , Ratones , Actinas/metabolismo , Unión Competitiva , Miosinas/metabolismo , Subfragmentos de Miosina/metabolismo , Anticuerpos Monoclonales
6.
Circ Res ; 133(5): 430-443, 2023 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-37470183

RESUMEN

BACKGROUND: Modulating myosin function is a novel therapeutic approach in patients with cardiomyopathy. Danicamtiv is a novel myosin activator with promising preclinical data that is currently in clinical trials. While it is known that danicamtiv increases force and cardiomyocyte contractility without affecting calcium levels, detailed mechanistic studies regarding its mode of action are lacking. METHODS: Permeabilized porcine cardiac tissue and myofibrils were used for X-ray diffraction and mechanical measurements. A mouse model of genetic dilated cardiomyopathy was used to evaluate the ability of danicamtiv to correct the contractile deficit. RESULTS: Danicamtiv increased force and calcium sensitivity via increasing the number of myosins in the ON state and slowing cross-bridge turnover. Our detailed analysis showed that inhibition of ADP release results in decreased cross-bridge turnover with cross bridges staying attached longer and prolonging myofibril relaxation. Danicamtiv corrected decreased calcium sensitivity in demembranated tissue, abnormal twitch magnitude and kinetics in intact cardiac tissue, and reduced ejection fraction in the whole organ. CONCLUSIONS: As demonstrated by the detailed studies of Danicamtiv, increasing myosin recruitment and altering cross-bridge cycling are 2 mechanisms to increase force and calcium sensitivity in cardiac muscle. Myosin activators such as Danicamtiv can treat the causative hypocontractile phenotype in genetic dilated cardiomyopathy.


Asunto(s)
Cardiomiopatía Dilatada , Ratones , Animales , Porcinos , Cardiomiopatía Dilatada/tratamiento farmacológico , Calcio/fisiología , Miocardio , Miosinas , Miocitos Cardíacos , Cardiotónicos
7.
bioRxiv ; 2023 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-36778318

RESUMEN

Modulating myosin function is a novel therapeutic approach in patients with cardiomyopathy. Detailed mechanism of action of these agents can help predict potential unwanted affects and identify patient populations that can benefit most from them. Danicamtiv is a novel myosin activator with promising preclinical data that is currently in clinical trials. While it is known danicamtiv increases force and cardiomyocyte contractility without affecting calcium levels, detailed mechanistic studies regarding its mode of action are lacking. Using porcine cardiac tissue and myofibrils we demonstrate that Danicamtiv increases force and calcium sensitivity via increasing the number of myosin in the "on" state and slowing cross bridge turnover. Our detailed analysis shows that inhibition of ADP release results in decreased cross bridge turnover with cross bridges staying on longer and prolonging myofibril relaxation. Using a mouse model of genetic dilated cardiomyopathy, we demonstrated that Danicamtiv corrected calcium sensitivity in demembranated and abnormal twitch magnitude and kinetics in intact cardiac tissue. Significance Statement: Directly augmenting sarcomere function has potential to overcome limitations of currently used inotropic agents to improve cardiac contractility. Myosin modulation is a novel mechanism for increased contraction in cardiomyopathies. Danicamtiv is a myosin activator that is currently under investigation for use in cardiomyopathy patients. Our study is the first detailed mechanism of how Danicamtiv increases force and alters kinetics of cardiac activation and relaxation. This new understanding of the mechanism of action of Danicamtiv can be used to help identify patients that could benefit most from this treatment.

8.
J Gen Physiol ; 155(3)2023 03 06.
Artículo en Inglés | MEDLINE | ID: mdl-36633584

RESUMEN

In healthy hearts, myofilaments become more sensitive to Ca2+ as the myocardium is stretched. This effect is known as length-dependent activation and is an important cellular-level component of the Frank-Starling mechanism. Few studies have measured length-dependent activation in the myocardium from failing human hearts. We investigated whether ischemic and non-ischemic heart failure results in different length-dependent activation responses at physiological temperature (37°C). Myocardial strips from the left ventricular free wall were chemically permeabilized and Ca2+-activated at sarcomere lengths (SLs) of 1.9 and 2.3 µm. Data were acquired from 12 hearts that were explanted from patients receiving cardiac transplants; 6 had ischemic heart failure and 6 had non-ischemic heart failure. Another 6 hearts were obtained from organ donors. Maximal Ca2+-activated force increased at longer SL for all groups. Ca2+ sensitivity increased with SL in samples from donors (P < 0.001) and patients with ischemic heart failure (P = 0.003) but did not change with SL in samples from patients with non-ischemic heart failure. Compared with donors, troponin I phosphorylation decreased in ischemic samples and even more so in non-ischemic samples; cardiac myosin binding protein-C (cMyBP-C) phosphorylation also decreased with heart failure. These findings support the idea that troponin I and cMyBP-C phosphorylation promote length-dependent activation and show that length-dependent activation of contraction is blunted, yet extant, in the myocardium from patients with ischemic heart failure and further reduced in the myocardium from patients with non-ischemic heart failure. Patients who have a non-ischemic disease may exhibit a diminished contractile response to increased ventricular filling.


Asunto(s)
Insuficiencia Cardíaca , Sarcómeros , Humanos , Sarcómeros/metabolismo , Calcio/metabolismo , Troponina I/metabolismo , Contracción Miocárdica/fisiología , Miocardio/metabolismo , Insuficiencia Cardíaca/metabolismo
9.
J Gen Physiol ; 155(4)2023 04 03.
Artículo en Inglés | MEDLINE | ID: mdl-36715675

RESUMEN

Hypertrophic cardiomyopathy (HCM) is the leading genetic cause of heart disease. The heart comprises several proteins that work together to properly facilitate force production and pump blood throughout the body. Cardiac myosin binding protein-C (cMyBP-C) is a thick-filament protein, and mutations in cMyBP-C are frequently linked with clinical cases of HCM. Within the sarcomere, the N-terminus of cMyBP-C likely interacts with the myosin regulatory light chain (RLC); RLC is a subunit of myosin located within the myosin neck region that modulates contractile dynamics via its phosphorylation state. Phosphorylation of RLC is thought to influence myosin head position along the thick-filament backbone, making it more favorable to bind the thin filament of actin and facilitate force production. However, little is known about how these two proteins interact. We tested the effects of RLC phosphorylation on Ca2+-regulated contractility using biomechanical assays on skinned papillary muscle strips isolated from cMyBP-C KO mice and WT mice. RLC phosphorylation increased Ca2+ sensitivity of contraction (i.e., pCa50) from 5.80 ± 0.02 to 5.95 ± 0.03 in WT strips, whereas RLC phosphorylation increased Ca2+ sensitivity of contraction from 5.86 ± 0.02 to 6.15 ± 0.03 in cMyBP-C KO strips. These data suggest that the effects of RLC phosphorylation on Ca2+ sensitivity of contraction are amplified when cMyBP-C is absent from the sarcomere. This implies that cMyBP-C and RLC act in concert to regulate contractility in healthy hearts, and mutations to these proteins that lead to HCM (or a loss of phosphorylation with disease progression) may disrupt important interactions between these thick-filament regulatory proteins.


Asunto(s)
Calcio , Cardiomiopatía Hipertrófica , Ratones , Animales , Fosforilación/fisiología , Calcio/metabolismo , Ratones Noqueados , Miocardio/metabolismo , Cadenas Ligeras de Miosina/metabolismo , Cardiomiopatía Hipertrófica/genética , Contracción Miocárdica/fisiología
10.
Int J Mol Sci ; 23(23)2022 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-36499408

RESUMEN

Myosin cross-bridges dissociate from actin following Mg2+-adenosine triphosphate (MgATP) binding. Myosin hydrolyses MgATP into inorganic phosphate (Pi) and Mg2+-adenosine diphosphate (ADP), and release of these hydrolysis products drives chemo-mechanical energy transitions within the cross-bridge cycle to power muscle contraction. Some forms of heart disease are associated with metabolic or enzymatic dysregulation of the MgATP-MgADP nucleotide pool, resulting in elevated cytosolic [MgADP] and impaired muscle relaxation. We investigated the mechanical and structural effects of increasing [MgADP] in permeabilized myocardial strips from porcine left ventricle samples. Sarcomere length was set to 2.0 µm at 28 °C, and all solutions contained 3% dextran T-500 to compress myofilament lattice spacing to near-physiological values. Under relaxing low [Ca2+] conditions (pCa 8.0, where pCa = -log10[Ca2+]), tension increased as [MgADP] increased from 0-5 mM. Complementary small-angle X-ray diffraction measurements show that the equatorial intensity ratio, I1,1/I1,0, also increased as [MgADP] increased from 0 to 5 mM, indicating myosin head movement away from the thick-filament backbone towards the thin-filament. Ca2+-activated force-pCa measurements show that Ca2+-sensitivity of contraction increased with 5 mM MgADP, compared to 0 mM MgADP. These data show that MgADP augments tension at low [Ca2+] and Ca2+-sensitivity of contraction, suggesting that MgADP destabilizes the quasi-helically ordered myosin OFF state, thereby shifting the cross-bridge population towards the disordered myosin ON state. Together, these results indicate that MgADP enhances the probability of cross-bridge binding to actin due to enhancement of both thick and thin filament-based activation mechanisms.


Asunto(s)
Actinas , Movimientos de la Cabeza , Animales , Porcinos , Adenosina Difosfato/farmacología , Adenosina Difosfato/metabolismo , Actinas/metabolismo , Calcio/química , Cinética , Miosinas/metabolismo , Contracción Muscular , Adenosina Trifosfato/metabolismo , Contracción Miocárdica
11.
Cardiovasc Intervent Radiol ; 45(9): 1391-1398, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35790566

RESUMEN

STUDY PURPOSE: The DRAGON 1 trial aims to assess training, implementation, safety and feasibility of combined portal- and hepatic-vein embolization (PVE/HVE) to accelerate future liver remnant (FLR) hypertrophy in patients with borderline resectable colorectal cancer liver metastases. METHODS: The DRAGON 1 trial is a worldwide multicenter prospective single arm trial. The primary endpoint is a composite of the safety of PVE/HVE, 90-day mortality, and one year accrual monitoring of each participating center. Secondary endpoints include: feasibility of resection, the used PVE and HVE techniques, FLR-hypertrophy, liver function (subset of centers), overall survival, and disease-free survival. All complications after the PVE/HVE procedure are documented. Liver volumes will be measured at week 1 and if applicable at week 3 and 6 after PVE/HVE and follow-up visits will be held at 1, 3, 6, and 12 months after the resection. RESULTS: Not applicable. CONCLUSION: DRAGON 1 is a prospective trial to assess the safety and feasibility of PVE/HVE. Participating study centers will be trained, and procedures standardized using Work Instructions (WI) to prepare for the DRAGON 2 randomized controlled trial. Outcomes should reveal the accrual potential of centers, safety profile of combined PVE/HVE and the effect of FLR-hypertrophy induction by PVE/HVE in patients with CRLM and a small FLR. TRIAL REGISTRATION: Clinicaltrials.gov: NCT04272931 (February 17, 2020). Toestingonline.nl: NL71535.068.19 (September 20, 2019).


Asunto(s)
Embolización Terapéutica , Neoplasias Hepáticas , Acreditación , Embolización Terapéutica/métodos , Hepatectomía/métodos , Venas Hepáticas/patología , Hepatomegalia , Humanos , Hipertrofia/etiología , Hipertrofia/patología , Hipertrofia/cirugía , Hígado/cirugía , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/terapia , Estudios Multicéntricos como Asunto , Vena Porta/patología , Estudios Prospectivos , Resultado del Tratamiento
12.
Chemosphere ; 301: 134672, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35472617

RESUMEN

Although Glyphosate-based herbicides are often marketed as environmentally friendly and easily biodegradable, its bioavailability and risks to wildlife raise significant concerns. Among non-target organisms, earthworms which live in close contact with the soil can be directly exposed to pesticides and harmed. We investigated soil contamination and the exposure of earthworms to glyphosate, its metabolite AMPA, and glufosinate in an arable landscape in France, both in treated (i.e. temporary grasslands and cereal fields under conventional farming), and nontreated habitats (i.e. hedgerows, permanent grasslands and cereal fields under organic farming) (n = 120 sampling sites in total). Glyphosate, AMPA and glufosinate were detected in 88%, 58% and 35% of the soil samples, and in 74%, 38% and 12% of the earthworm samples, respectively. For both glyphosate and AMPA, concentrations in soils were at least 10 times lower than predicted environmental concentrations. However, the maximum glyphosate soil concentration measured (i.e., 0.598 mg kg-1) was only 2 to 3 times lower than the concentrations revealed to affect earthworms (survival and avoidance) in the literature. These compounds were found both in conventional and organic farming fields, thus supporting a recent study, and for the first time they were detected in hedgerows and grasslands. However, glyphosate and AMPA were more frequently detected in soils from cereal fields and hedgerows than in grasslands, and median concentrations measured in soils from cereal fields were significantly higher than in the two other habitats. Bioaccumulation of glyphosate and AMPA in earthworms was higher than expected according to the properties of the molecules. Our findings raised issues about the high occurrence of glyphosate and AMPA in soils from cropped and more natural areas in arable landscapes. They also highlight the potential for transfer of these molecules in terrestrial food webs as earthworms are prey for numerous animals.


Asunto(s)
Herbicidas , Oligoquetos , Contaminantes del Suelo , Aminobutiratos , Animales , Glicina/análogos & derivados , Herbicidas/análisis , Herbicidas/toxicidad , Suelo , Contaminantes del Suelo/análisis , Ácido alfa-Amino-3-hidroxi-5-metil-4-isoxazol Propiónico , Glifosato
13.
Clin Case Rep ; 10(3): e05609, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35317066

RESUMEN

We report a case of adult-onset, sporadic, hyperkalemic periodic paralysis with primary brainstem musculature symptoms masquerading as recurrent transient ischemic attacks. Unilateral brainstem weakness could be induced with rapid eye blinking, which was followed by lower extremity weakness and cramping. Treatment with acetazolamide and albuterol ameliorated the patient's attacks.

14.
Cancer Radiother ; 26(3): 433-439, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-34366239

RESUMEN

PURPOSE: We report our experience of 86 consecutive patients with locally advanced nasopharyngeal carcinoma who were treated with volumetric modulated arc therapy. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 86 patients with histologically proven primary nasopharyngeal carcinoma treated with volumetric modulated arctherapy technique radiotherapy. Primary endpoints were local, regional, distant control, and overall survival, second endpoint was late toxicity. RESULTS: The median age was 47.5 years (range: 13-79 years) with sex ratio 1.09. At diagnosis, rhinologic symptoms represented the most common clinical presentation, reported by 61 patients (70.9%). Almost 88.4% of patients presented non-keratinizing undifferentiated carcinoma histology (n=76). Most of the patients presented a locally advanced disease defined by stage III and IVa (95.3%). Therefore, 31 patients were treated by concurrent chemoradiation (36%), 52 patients received induction chemotherapy followed by concurrent chemoradiotherapy (57%), three patients received induction chemotherapy followed by exclusive radiotherapy (3.5%). and three patients treated with exclusive irradiation (3.5%). With a median follow up of 15.7 months (range: 4-33.3 months), nine patients died (10.4%), three presented local or locoregional relapse (3.4%), while nine patients presented distant recurrences (10.4%). The two years overall and disease-free survival rates were 88.7% and 83.1% respectively, locoregional control was 100% at 12 months and 96.2% at 24 months, and the two years distant failure-free survival was 86.7%. Time to relapse was the only prognostic factor in univariate analysis for overall survival in our study. The therapeutic tolerance was good with 61.7% of grade 3 and 2.3% grade 4 hyposialia respectively, 46.5% of otological disorders and no radionecrosis was noted. CONCLUSION: Volumetric modulated arctherapy technique with concurrent chemoradiotherapy is an effective treatment for nasopharyngeal carcinoma with excellent overall and locoregional control without severe toxicity. Distant metastasis is the major site of failure, so induction chemotherapy added to chemoradiotherapy must be discussed in multidisciplinary consultation meeting because it significantly improved recurrence-free survival and overall survival, as compared with chemoradiotherapy alone.


Asunto(s)
Neoplasias Nasofaríngeas , Radioterapia de Intensidad Modulada , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioradioterapia/métodos , Cisplatino , Humanos , Persona de Mediana Edad , Carcinoma Nasofaríngeo/terapia , Neoplasias Nasofaríngeas/tratamiento farmacológico , Neoplasias Nasofaríngeas/radioterapia , Recurrencia Local de Neoplasia/patología , Estadificación de Neoplasias , Radioterapia de Intensidad Modulada/efectos adversos , Radioterapia de Intensidad Modulada/métodos , Estudios Retrospectivos , Resultado del Tratamiento
15.
Public Health ; 200: 91-98, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34710719

RESUMEN

OBJECTIVES: The addition of green spaces (GS) in cities is perceived as an efficient solution to combat climate change and biodiversity loss while also improving human health. Quantitative health impact assessment (QHIA) is a powerful tool to assess the health benefits of GS and support policy-making decisions. In France, a preliminary analysis of the literature led to the decision of developing guidance for QHIA applied to GS and mortality. This paper focuses on the choice of exposure-response functions (ERF) for those QHIA. STUDY DESIGN: Literature review and analysis of the key steps of QHIA. METHODS: Articles providing ERF for all-cause, cardiovascular and respiratory mortality in relation to GS were identified through a literature review and ranked based on a quality score. ERF from the articles with the highest scores was pooled in meta-analyses. RESULTS: In total, 13 ERF were selected for all-cause mortality, 10 for cardiovascular mortality and 5 for respiratory mortality. Meta-risk for a 0.1 increase in the normalised differential vegetation index were, 0.96 (95% confidence interval [CI] 0.94; 0.97), 0.98 (95% CI 0.96; 0.99) and 0.97 (95% CI 0.92; 1.02) for all-cause, cardiovascular and respiratory mortality, respectively. CONCLUSIONS: While current knowledge makes it possible to use QHIA on GS and mortality, interdisciplinary research is still needed to clarify the shape of the relationship and its temporality and to assess exposure in a meaningful way for decision-making.


Asunto(s)
Evaluación del Impacto en la Salud , Parques Recreativos , Ciudades , Francia , Humanos
17.
Proc Biol Sci ; 288(1950): 20202895, 2021 05 12.
Artículo en Inglés | MEDLINE | ID: mdl-33975478

RESUMEN

Muscle contraction results from force-generating cross-bridge interactions between myosin and actin. Cross-bridge cycling kinetics underlie fundamental contractile properties, such as active force production and energy utilization. Factors that influence cross-bridge kinetics at the molecular level propagate through the sarcomeres, cells and tissue to modulate whole-muscle function. Conversely, movement and changes in the muscle length can influence cross-bridge kinetics on the molecular level. Reduced, single-molecule and single-fibre experiments have shown that increasing the strain on cross-bridges may slow their cycling rate and prolong their attachment duration. However, whether these strain-dependent cycling mechanisms persist in the intact muscle tissue, which encompasses more complex organization and passive elements, remains unclear. To investigate this multi-scale relationship, we adapted traditional step-stretch protocols for use with mouse soleus muscle during isometric tetanic contractions, enabling novel estimates of length-dependent cross-bridge kinetics in the intact skeletal muscle. Compared to rates at the optimal muscle length (Lo), we found that cross-bridge detachment rates increased by approximately 20% at 90% of Lo (shorter) and decreased by approximately 20% at 110% of Lo (longer). These data indicate that cross-bridge kinetics vary with whole-muscle length during intact, isometric contraction, which could intrinsically modulate force generation and energetics, and suggests a multi-scale feedback pathway between whole-muscle function and cross-bridge activity.


Asunto(s)
Contracción Isométrica , Miosinas , Animales , Cinética , Ratones , Contracción Muscular , Músculo Esquelético/metabolismo , Miosinas/metabolismo , Sarcómeros
18.
Arch Biochem Biophys ; 703: 108855, 2021 05 30.
Artículo en Inglés | MEDLINE | ID: mdl-33781771

RESUMEN

Striated muscle contraction is initiated by Ca2+ binding to, and activating, thin filament regulatory units (RU) within the sarcomere, which then allows myosin cross-bridges from the opposing thick filament to bind actin and generate force. The amount of overlap between the filaments dictates how many potential cross-bridges are capable of binding, and thus how force is generated by the sarcomere. Myopathies and atrophy can impair muscle function by limiting cross-bridge interactions between the filaments, which can occur when the length of the thin filament is reduced or when RU function is disrupted. To investigate how variations in thin filament length and RU density affect ensemble cross-bridge behavior and force production, we simulated muscle contraction using a spatially explicit computational model of the half-sarcomere. Thin filament RUs were disabled either uniformly from the pointed end of the filament (to model shorter thin filament length) or randomly throughout the length of the half-sarcomere. Both uniform and random RU 'knockout' schemes decreased overall force generation during maximal and submaximal activation. The random knockout scheme also led to decreased calcium sensitivity and cooperativity of the force-pCa relationship. We also found that the rate of force development slowed with the random RU knockout, compared to the uniform RU knockout or conditions of normal RU activation. These findings imply that the relationship between RU density and force production within the sarcomere involves more complex coordination than simply the raw number of RUs available for myosin cross-bridge binding, and that the spatial pattern in which activatable RU are distributed throughout the sarcomere influences the dynamics of force production.


Asunto(s)
Fenómenos Mecánicos , Modelos Biológicos , Contracción Muscular , Miosinas/metabolismo , Fenómenos Biomecánicos , Calcio/metabolismo
19.
Am J Physiol Heart Circ Physiol ; 320(5): H1822-H1835, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33666504

RESUMEN

Cardiac myosin binding protein-C (cMyBP-C) is a thick filament protein that influences sarcomere stiffness and modulates cardiac contraction-relaxation through its phosphorylation. Phosphorylation of cMyBP-C and ablation of cMyBP-C have been shown to increase the rate of MgADP release in the acto-myosin cross-bridge cycle in the intact sarcomere. The influence of cMyBP-C on Pi-dependent myosin kinetics has not yet been examined. We investigated the effect of cMyBP-C, and its phosphorylation, on myosin kinetics in demembranated papillary muscle strips bearing the ß-cardiac myosin isoform from nontransgenic and homozygous transgenic mice lacking cMyBP-C. We used quick stretch and stochastic length-perturbation analysis to characterize rates of myosin detachment and force development over 0-12 mM Pi and at maximal (pCa 4.8) and near-half maximal (pCa 5.75) Ca2+ activation. Protein kinase A (PKA) treatment was applied to half the strips to probe the effect of cMyBP-C phosphorylation on Pi sensitivity of myosin kinetics. Increasing Pi increased myosin cross-bridge detachment rate similarly for muscles with and without cMyBP-C, although these rates were higher in muscle without cMyBP-C. Treating myocardial strips with PKA accelerated detachment rate when cMyBP-C was present over all Pi, but not when cMyBP-C was absent. The rate of force development increased with Pi in all muscles. However, Pi sensitivity of the rate force development was reduced when cMyBP-C was present versus absent, suggesting that cMyBP-C inhibits Pi-dependent reversal of the power stroke or stabilizes cross-bridge attachment to enhance the probability of completing the power stroke. These results support a functional role for cMyBP-C in slowing myosin detachment rate, possibly through a direct interaction with myosin or by altering strain-dependent myosin detachment via cMyBP-C-dependent stiffness of the thick filament and myofilament lattice. PKA treatment reduces the role for cMyBP-C to slow myosin detachment and thus effectively accelerates ß-myosin detachment in the intact myofilament lattice.NEW & NOTEWORTHY Length perturbation analysis was used to demonstrate that ß-cardiac myosin characteristic rates of detachment and recruitment in the intact myofilament lattice are accelerated by Pi, phosphorylation of cMyBP-C, and the absence of cMyBP-C. The results suggest that cMyBP-C normally slows myosin detachment, including Pi-dependent detachment, and that this inhibition is released with phosphorylation or absence of cMyBP-C.


Asunto(s)
Proteínas Portadoras/metabolismo , Fuerza Muscular , Contracción Miocárdica , Miocardio/metabolismo , Miosinas Ventriculares/metabolismo , Animales , Fenómenos Biomecánicos , Proteínas Portadoras/genética , Proteínas Quinasas Dependientes de AMP Cíclico/metabolismo , Cinética , Masculino , Ratones Noqueados , Modelos Cardiovasculares , Fosforilación , Unión Proteica
20.
Dent Mater ; 37(5): 832-839, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33640173

RESUMEN

OBJECTIVE: Recommendations to obtain the best bonding to silica-based ceramics are to prepare its surface by hydrofluoric-acid HF etching and regular application of a silane. This study investigated how the HF-etching following by ultrasonic water bath cleaning (recommended protocol to improve the bonding with a composite resin), modifies the surface chemistry of a lithium disilicate glass-ceramic and impacts the chemical bonding with silane. METHODS: Lithium disilicate glass-ceramic discs (IPS Emax Press, Ivoclar Vivadent) were mirror polished, etched with 9% HF for 20 s and rinsed 1 min under water. Two post-etching cleaning were compared: (1) no additional cleaning and (2) immersion in water ultrasonic bath for 4 min. Morphology evolution of the surfaces was carried out by scanning electron microscopy. Chemical changes were studied using X-ray Photoelectron Spectroscopy and Nano Auger Electron Spectroscopy analyses. Identification of the compounds formed with fluorine was based on by High Resolution Transmission Tlectronic Microscopy . RESULTS: Residues left on the surface of the discs after etching, the fluorine salts, were eliminated after the ultrasonic bath cleaning. However, analyses showed presence of fluorine on the lithium disilicate needles associated among others with the lithium. HR-TEM validates the presence of Li2SiF6 crystallized phased. A mechanism to explain silane bonding when Li2SiF6 phase is formed on the Li2Si2O5 needles, is proposed. SIGNIFICANCE: HF-etching leads to the formation of lithium and fluorine contain LiSi2F6 nano-precipitates on the Li2Si2O5 needles which helps to improve the bonding with silane.


Asunto(s)
Recubrimiento Dental Adhesivo , Silanos , Cerámica , Porcelana Dental , Ácido Fluorhídrico , Ensayo de Materiales , Cementos de Resina , Dióxido de Silicio , Propiedades de Superficie , Ultrasonido
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