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1.
Artículo en Inglés | MEDLINE | ID: mdl-39266878

RESUMEN

Current human risk assessments often rely on animal toxicity data to establish point of departure (POD) values, followed by the application of uncertainty factors. Consequently, there is growing interest in alternative toxicity testing methods that reduce reliance on animal models. In this study, we propose a novel approach for inhalation toxicity risk assessment that integrates in silico and in vitro methods. Human primary alveolar epithelial cells were exposed to aerosolized didecyldimethylammonium chloride (DDAC) to assess cytotoxicity. This was followed by transcriptome analysis and biological pathway investigation, utilizing adverse outcome pathway (AOP), to calculate the POD. Additionally, human DDAC exposure was simulated using a multiple-path particle dosimetry (MPPD) model to predict exposure levels in the human alveolar region via inhalation. The results from in silico and in vitro studies were then compared, and a comprehensive risk assessment was performed. The POD for AOP 452 key events-oxidative stress, inflammation, epithelial-mesenchymal transition (EMT), apoptosis, and autophagy-was found to range between 19.0 and 23.89 ng/cm2, according to benchmark dose calculation tools. The estimated human exposure to DDAC in the alveolar region under actual exposure conditions was 0.164 ng/cm2/day, resulting in a margin of exposure (MOE) ranging from 121 to 145, suggesting caution regarding DDAC inhalation exposure. This study presents a novel risk assessment method that compares estimated human inhalation exposure values to in vitro results, applying the human equivalent concentration concept. Our findings demonstrate the potential for conducting human risk assessments using both in silico and in vitro methods as alternatives to traditional in vivo studies.

2.
Int J Mol Sci ; 25(14)2024 Jul 21.
Artículo en Inglés | MEDLINE | ID: mdl-39063213

RESUMEN

Human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) have emerged as a promising tool for studying cardiac physiology and drug responses. However, their use is largely limited by an immature phenotype and lack of high-throughput analytical methodology. In this study, we developed a high-throughput testing platform utilizing hPSC-CMs to assess the cardiotoxicity and effectiveness of drugs. Following an optimized differentiation and maturation protocol, hPSC-CMs exhibited mature CM morphology, phenotype, and functionality, making them suitable for drug testing applications. We monitored intracellular calcium dynamics using calcium imaging techniques to measure spontaneous calcium oscillations in hPSC-CMs in the presence or absence of test compounds. For the cardiotoxicity test, hPSC-CMs were treated with various compounds, and calcium flux was measured to evaluate their effects on calcium dynamics. We found that cardiotoxic drugs withdrawn due to adverse drug reactions, including encainide, mibefradil, and cetirizine, exhibited toxicity in hPSC-CMs but not in HEK293-hERG cells. Additionally, in the effectiveness test, hPSC-CMs were exposed to ATX-II, a sodium current inducer for mimicking long QT syndrome type 3, followed by exposure to test compounds. The observed changes in calcium dynamics following drug exposure demonstrated the utility of hPSC-CMs as a versatile model system for assessing both cardiotoxicity and drug efficacy. Overall, our findings highlight the potential of hPSC-CMs in advancing drug discovery and development, which offer a physiologically relevant platform for the preclinical screening of novel therapeutics.


Asunto(s)
Diferenciación Celular , Evaluación Preclínica de Medicamentos , Miocitos Cardíacos , Células Madre Pluripotentes , Humanos , Miocitos Cardíacos/efectos de los fármacos , Miocitos Cardíacos/metabolismo , Miocitos Cardíacos/citología , Evaluación Preclínica de Medicamentos/métodos , Diferenciación Celular/efectos de los fármacos , Células Madre Pluripotentes/efectos de los fármacos , Células Madre Pluripotentes/citología , Células Madre Pluripotentes/metabolismo , Fármacos Cardiovasculares/farmacología , Calcio/metabolismo , Cardiotoxicidad , Ensayos Analíticos de Alto Rendimiento/métodos , Células HEK293 , Señalización del Calcio/efectos de los fármacos
3.
Epidemiol Health ; : e2024060, 2024 Jul 07.
Artículo en Inglés | MEDLINE | ID: mdl-39026433

RESUMEN

Objectives: Exposure to humidifier disinfectants has been linked to respiratory diseases, including interstitial lung disease, asthma, and pneumonia. Consequently, numerous toxicological studies have explored respiratory damage as both a necessary and sufficient condition for these diseases. We systematically reviewed and integrated evidence from toxicological studies by applying the evidence integration method established in previous research to confirm the biological plausibility of the association between exposure and disease. Methods: We conducted a literature search focusing on polyhexamethylene guanidine phosphate (PHMG) and chloromethylisothiazolinone/methylisothiazolinone (CMIT/MIT), the primary ingredients in humidifier disinfectants. We selected relevant studies based on their quality and the population, exposure, comparator, outcome (PECO) statements. These studies were categorized into 3 lines of evidence: hazard information, animal studies, and mechanistic studies. Based on a systematic review, we integrated the evidence to develop an aggregate exposure pathway-adverse outcome pathway (AEP-AOP) model for respiratory damage. The reliability and relevance of our findings were assessed by comparing them with the hypothesized pathogenic mechanisms of respiratory diseases. Results: The integration of each AEP-AOP component for PHMG and CMIT/MIT led to the development of an AEP-AOP model, wherein disinfectants released from humidifiers in aerosol or gaseous form reached target sites, causing respiratory damage through molecular initiating events and key events. The model demonstrated high reliability and relevance to the pathogenesis of respiratory diseases. Conclusion: The AEP-AOP model developed in this study provides strong evidence that exposure to humidifier disinfectants causes respiratory diseases. This model demonstrates the pathways leading to respiratory damage, a hallmark of these conditions.

4.
J Hazard Mater ; 476: 134986, 2024 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-38944992

RESUMEN

Next-generation risk assessment (NGRA) has emerged as a promising alternative to non-animal studies owing to the increasing demand for the risk assessment of inhaled toxicants. In this study, NGRA was used to assess the inhalation risks of two biocides commonly used as humidifier disinfectants: polyhexamethylene guanidine phosphate (PHMG-p) and chloromethylisothiazolinone/methylisothiazolinone (CMIT/MIT). Human bronchial epithelial cell transcriptomic data were processed based on adverse outcome pathways and used to establish transcriptome-based points of departure (tPODs) for each biocide. tPOD values were 0.00500-0.0510 µg/cm2 and 0.0342-0.0544 µg/cm2 for PHMG-p and CMIT/MIT, respectively. tPODs may provide predictive power comparable to that of traditional animal-based PODs (aPODs). The tPOD-based NGRA determined that both PHMG-p and CMIT/MIT present a high inhalation risk. Moreover, the identified PHMG-p posed a higher risk than CMIT/MIT, and children were identified as more susceptible population compared to adults. This finding is consistent with observations from actual exposure events. Our findings suggest that NGRA with transcriptomics offers a reliable approach for risk assessment of specific humidifier disinfectant biocides, while acknowledging the limitations of current models and in vitro systems, particularly regarding uncertainties in pharmacokinetics (PK) and pharmacodynamics (PD).


Asunto(s)
Desinfectantes , Guanidinas , Tiazoles , Desinfectantes/toxicidad , Medición de Riesgo , Humanos , Tiazoles/toxicidad , Guanidinas/toxicidad , Fibrosis Pulmonar/inducido químicamente , Fibrosis Pulmonar/genética , Transcriptoma/efectos de los fármacos , Perfilación de la Expresión Génica , Exposición por Inhalación/efectos adversos , Células Epiteliales/efectos de los fármacos , Humidificadores
5.
Arch Craniofac Surg ; 25(2): 90-94, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38742336

RESUMEN

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignancy of the sweat glands that most commonly affects the periorbital area. It is characterized by slow growth over a prolonged period, and its morphology can be easily confused with a benign tumor, such as an epidermal cyst. Consequently, many patients experience recurrence after undergoing multiple resections. However, there are few reports concerning the surgical management of PCMC. We present two cases of PCMC originating in the periorbital area. The first case involved a 76-year-old man with a mass measuring 3.0× 1.5 cm that had been increasing in size. The second case was a 61-year-old man with two masses, each measuring 1.0× 1.0 cm, that were also growing. Both patients underwent wide excision with a 5-mm safety margin, which was determined based on the widest view of the cross-section of the mass on the magnetic resonance imaging. Subsequently, based on the intraoperative frozen biopsy results, both patients underwent additional excision with a 5-mm safety margin in only one direction. This report shows that, when determining the surgical margin of PCMC in periorbital area, employing imaging modalities and intraoperative frozen biopsies can be helpful for narrowing the surgical margin.

6.
ACS Omega ; 9(10): 11895-11909, 2024 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-38497013

RESUMEN

An in-house Python-based algorithm was developed using simplified molecular-input line-entry specification (SMILES) strings and a dipole moment for estimating the normal boiling point, critical properties, standard enthalpy, vapor pressure, liquid molar volume, enthalpy of vaporization, heat capacity, viscosity, thermal conductivity, and surface tension of molecules. Normal boiling point, critical properties, and standard enthalpy were estimated by using the Joback group contribution method. Vapor pressure, liquid molar volume, enthalpy of vaporization, heat capacity, and surface tension were estimated by using the Riedel model, Gunn-Yamada model, Clausius-Clapeyron equation, Joback group contribution method, and Brock-Bird model, respectively. Viscosities of liquid and gas were estimated by using the Letsou-Stiel model and the Chapman-Enskog-Brokaw model, respectively. Thermal conductivities of liquid and gas were estimated by using the Sato-Riedel model and Stiel-Thodos model, respectively. Dipole moment was calculated through molecular dynamics simulation using the MMFF94 force field, performed with Avogadro software. A case study was conducted with dihydro-2-methyl-3-furanone (DHMF), 2-furaldehyde diethyl acetal (FDA), 1,1-diethoxy-3-methyl butane (DEMB), glutathione (GSH), vitamin B5 (VITB5), homocysteine (HCYS), and O-acetyl-l-homoserine (AH), which are not present in the existing property database. Cross-validation indicated that the developed Python-based algorithm provided pure component model parameters nearly identical with those obtained with the Aspen Property Constant Estimation System (PCES) method, except for the enthalpy of vaporization. The parameters for estimating the enthalpy of vaporization using the current Python-based algorithm accurately represented the behavior of the actual substances, as determined using the Clausius-Claperyon equation. This Python-based algorithm provides a detailed and clear reference for estimating pure property parameters.

7.
Clin Exp Reprod Med ; 51(1): 75-84, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38148475

RESUMEN

OBJECTIVE: The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients. METHODS: This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF). RESULTS: PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of early pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the non-PGT-A groups. CONCLUSION: PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.

8.
Children (Basel) ; 10(8)2023 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-37628351

RESUMEN

Hemihyperplasia is a kind of regional body growth asymmetry and can be a symptom of several congenital disorders and tumorous conditions. Torticollis is most commonly caused by asymmetric hypertrophy of the sternocleidomastoid muscle. Herein, we report a case of hemihyperplasia in an infant with ipsilateral torticollis. The baby was evaluated using physical examination and ultrasonography. We observed significant right-side torticollis that was ipsilateral to congenital right-side hemihypertrophy. No abnormal tumorous conditions were found during the evaluation in the pediatrics department. The patient was treated with physical therapy and exhibited mild improvements in torticollis and hemihyperplasia.

9.
Exp Mol Med ; 55(9): 2039-2050, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37653040

RESUMEN

Thus far, attempts to develop drugs that target corticotropin-releasing hormone receptor 1 (CRF1R), a drug target in stress-related therapy, have been unsuccessful. Studies have focused on using high-resolution G protein-coupled receptor (GPCR) structures to develop drugs. X-ray free-electron lasers (XFELs), which prevent radiation damage and provide access to high-resolution compositions, have helped accelerate GPCR structural studies. We elucidated the crystal structure of CRF1R complexed with a BMK-I-152 antagonist at 2.75 Å using fixed-target serial femtosecond crystallography. The results revealed that two unique hydrogen bonds are present in the hydrogen bond network, the stalk region forms an alpha helix and the hydrophobic network contains an antagonist binding site. We then developed two antagonists-BMK-C203 and BMK-C205-and determined the CRF1R/BMK-C203 and CRF1R/BMK-C205 complex structures at 2.6 and 2.2 Å, respectively. BMK-C205 exerted significant antidepressant effects in mice and, thus, may be utilized to effectively identify structure-based drugs against CRF1R.


Asunto(s)
Hormona Liberadora de Corticotropina , Electrones , Ratones , Animales , Sitios de Unión , Descubrimiento de Drogas , Rayos Láser , Cristalografía por Rayos X
10.
J Obstet Gynaecol Res ; 49(9): 2343-2350, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37365000

RESUMEN

AIM: To evaluate the influence of insemination methods on clinical outcomes by assessing preimplantation genetic testing for aneuploidy (PGT-A) outcomes in embryos obtained using in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in sibling mature oocytes from high-risk patients. METHODS: This retrospective study involved 108 couples with nonmale or mild male factor infertility who underwent split insemination cycles from January 2018 to December 2021. PGT-A was performed using trophectoderm biopsy, array comparative genome hybridization, or next-generation sequencing with 24-chromosome screening. RESULTS: Mature oocytes were divided into IVF (n = 660) and ICSI (n = 1028) groups. The normal fertilization incidence was similar between the groups (81.1% vs. 84.6%). The total number of blastocysts biopsied was significantly higher in the IVF group than in the ICSI group (59.3% vs. 52.6%; p = 0.018). However, euploidy (34.4% vs. 31.9%) and aneuploidy (63.4% vs. 66.2%) rates per biopsy and clinical pregnancy rates (60.0% vs. 58.8%) were similar between the groups. Implantation (45.6% vs. 50.8%) and live birth or ongoing pregnancy (52.0% vs 58.8%) rates were slightly higher in the ICSI group than in the IVF group and miscarriage rate per transfer was slightly higher in the IVF group than in the ICSI group (12.0% vs 5.9%); however no significant difference was observed. CONCLUSIONS: IVF and ICSI using sibling mature oocytes had similar clinical outcomes, and euploidy and aneuploidy rates in couples with nonmale and mild male factor infertility. These results suggest that IVF is a useful option, along with ICSI, as an insemination method in PGT-A cycles, especially in high-risk patients.


Asunto(s)
Infertilidad , Inyecciones de Esperma Intracitoplasmáticas , Embarazo , Humanos , Femenino , Masculino , Inyecciones de Esperma Intracitoplasmáticas/métodos , Estudios Retrospectivos , Hermanos , Semen , Fertilización In Vitro/métodos , Índice de Embarazo , Pruebas Genéticas/métodos , Oocitos , Aneuploidia
11.
Arch Pharm Res ; 46(3): 149-159, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36894745

RESUMEN

Drug repositioning has gained significant attention over the past several years. The anti-rheumatoid arthritis drug auranofin has been investigated for the treatment of other diseases, including liver fibrosis. Because auranofin is rapidly metabolized, it is necessary to identify the active metabolites of auranofin that have detectable levels in the blood and reflect its therapeutic effects. In the present study, we investigated whether aurocyanide as an active metabolite of auranofin, can be used to evaluate the anti-fibrotic effects of auranofin. Incubation of auranofin with liver microsomes showed that auranofin was susceptible to hepatic metabolism. Previously, we found that the anti-fibrotic effects of auranofin are mediated via system xc--dependent inhibition of the NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) inflammasome. Therefore, we tried to identify active metabolites of auranofin based on their inhibitory effects on system xc- and NLRP3 inflammasome in bone marrow-derived macrophages. Among the seven candidate metabolites, 1-thio-ß-D-glycopyrano-sato-S-(triethyl-phosphine)-gold(I) and aurocyanide potently inhibited system xc- and NLRP3 inflammasome. A pharmacokinetics study on mice detected significant plasma levels of aurocyanide after auranofin administration. Oral administration of aurocyanide significantly prevented thioacetamide-induced liver fibrosis in mice. Moreover, the in vitro anti-fibrotic effects of aurocyanide were assessed in LX-2 cells, where aurocyanide significantly decreased the migratory ability of the cells. In conclusion, aurocyanide is metabolically stable and detectable in plasma, and has inhibitory effects on liver fibrosis, suggesting that it is a potential marker of the therapeutic effects of auranofin.


Asunto(s)
Auranofina , Inflamasomas , Ratones , Animales , Auranofina/farmacología , Inflamasomas/metabolismo , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Ratones Endogámicos NOD , Oro , Cirrosis Hepática/tratamiento farmacológico
12.
Ecotoxicol Environ Saf ; 252: 114600, 2023 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-36736230

RESUMEN

Polyhexamethylene guanidine phosphate (PHMG-p), used as a humidifier disinfectant, causes interstitial lung disease, obliterative bronchiolitis, and lung fibrosis; however, little is known about its effect on intercellular interactions. Extracellular vesicles (EVs), which carry diverse compounds including proteins, RNA, and DNA to mediate cell-to-cell communication through their paracrine effects, have been highlighted as novel factors in lung fibrogenesis. This study aimed to identify the effect of proteins on small EVs (sEVs) from bronchoalveolar lavage fluid (BALF) of the recipient cells after PHMG-p exposure. A week after intratracheal administration of PHMG-p, sEVs were isolated from BALF of tissue showing overexpressed inflammatory and fibrosis markers. To investigate the role of sEVs in inflammation, naïve macrophages were cultured with sEVs, which induced their activation. To identify sEV proteins that are associated with these responses, proteomics analysis was performed. In the gene ontology analysis, coagulation, fibrinolysis, and hemostasis were associated with the upregulated proteins in sEVs. The highest increase was observed in fibrinogen levels, which was also related to those gene ontologies. We validated role of exosomal fibrinogen in inflammation using recombinant fibrinogen and an inhibitor of the integrin, which is the binding receptor for fibrinogen. Overall, we elucidated that increased fibrinogen levels in the early sEVs-PHMG activated inflammatory response during early fibrosis. These results suggest that sEVs from the BALF of PHMG-p-exposed mice could aggravate fibrogenesis by activating naïve macrophages via various proteins in the sEVs, Furthermore, this finding will be broadening the spectrum of communicating mediators.


Asunto(s)
Vesículas Extracelulares , Fibrosis Pulmonar , Ratones , Animales , Fibrinógeno , Fibrosis Pulmonar/inducido químicamente , Fibrosis Pulmonar/metabolismo , Guanidinas/toxicidad , Inflamación/inducido químicamente , Vesículas Extracelulares/metabolismo
13.
Environ Toxicol ; 38(2): 359-367, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36485005

RESUMEN

The detection of high levels of microplastics in indoor and outdoor air has increased concerns regarding its toxic effects on the respiratory system. They are not easily degradable and can be deposited deep in the lungs. Although several studies have reported inhalation toxicities of microplastics, they are still controversial due to a lack of evidence. Herein, we evaluated the inhalation toxicities of three differently charged polystyrene microplastics (PS-MPs), the most abundant microplastics in the air. Cytotoxicity and ROS generation were evaluated using WST-1 and DCF-DA assays, respectively. To evaluate the toxic effects on the lung, inflammatory responses were analyzed after repeated exposure to the PS-MPs through intratracheal instillation. To explore the mechanism of toxicity, autophagy and ER stress-associated proteins were analyzed. Only the positively charged PS-MPs (NH2 -PS-MPs) showed cytotoxicity and increased ROS generation in BEAS-2B cells. Similarly, only NH2 -PS-MPs significantly increased the expression and secretion of the pro-inflammatory cytokine IL-ß in the animal experiments. The expression of ER stress proteins indicated that NH2 -PS-MPs increased ER stress via PERK-EIF2α and ATF4-CHOP pathways. Moreover, accumulation of NH2 -PS-MPs in lysosomes and deformity of the nucleus were observed in BEAS-2B cells with autophagy induction. Taken together, our results demonstrated that NH2 -PS-MPs induced autophagic cell death in bronchial epithelial cells, leading to inflammatory responses in the lungs. These results suggest that repeated inhalation of microplastics can result in inflammatory responses in the lung through cellular damage of lung epithelial cells, and that inhalation microplastics should be monitored to reduce inhalation health risks.


Asunto(s)
Muerte Celular Autofágica , Poliestirenos , Animales , Humanos , Poliestirenos/toxicidad , Microplásticos/toxicidad , Plásticos/toxicidad , Especies Reactivas de Oxígeno , Células Epiteliales/metabolismo
14.
Arch Craniofac Surg ; 24(6): 273-277, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38176761

RESUMEN

BACKGROUND: The clinical characteristics of pediatric nasal fractures can vary depending on the child's age, social activities, and environment. Therefore, this study aimed to analyze these characteristics in different age groups. METHODS: We retrospectively reviewed of a series of patients aged under 12 years who received treatment between 2013 and 2021. The initial study design involved dividing the patients into four age groups, corresponding to different developmental ages, but there were no cases in infants aged 0 to 1 year. Therefore, the patients were divided into three groups: group I, between 2 and 5; group II, between 6 and 9; and group III, between 10 and 12 years of age. The following parameters were evaluated: sex, age, etiology, fracture type and severity, and the incidence of septal injuries. RESULTS: In total, 98 patients were included in this study. In group III, the ratio of boys to girls was 3.88:1, exceeding the overall ratio of 1.97:1. The most common cause varied with age: slipping down in group I, bumping accidents in group II, and sports accidents in group III. Concomitant septal injuries were present in 4.17% of patients in group I, 5.71% of patients in group II, and 28.21% of patients in group III. CONCLUSION: Increasing age was accompanied by a greater tendency for male predominance and a higher prevalence of sports-related causes and septal injuries. Violence was infrequent but started to become a contributing factor during school age. These varying environmental factors across age groups can offer valuable insights into the epidemiology and clinical characteristics of pediatric nasal bone fractures.

15.
Medicine (Baltimore) ; 101(36): e30495, 2022 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-36086689

RESUMEN

RATIONALE: Subcutaneous and epidural abscesses following epidural injection are a serious but rare complication. Epidural abscesses are typically caused by Staphylococcus aureus bacterial infection. In this case presented here, the causative bacterium was Enterococcus faecalis. PATIENT CONCERNS: A 67-year-old woman having chronic lower back and right leg pain with past history of 20 years of rheumatoid arthritis, diabetes mellitus, and osteoporosis (T-score: -2.7) visited the outpatient pain clinic. Magnetic resonance imaging (MRI) revealed L4-5 right central disc extrusion with inferior migration. We performed a continuous epidural block for 7 days without complications. After 10 days, she presented with worsened low back pain, erythematous skin change on the lower back, chilling, and elevated serum acute phase reactants. DIAGNOSIS: The diagnosis was subsequently confirmed by MRI suggesting subcutaneous and epidural abscess. Blood and pus cultures showed the growth of E. faecalis. INTERVENTIONS: Pigtail catheter drainage was performed and intravenous antibiotics (ampicillin-sulbactam) targeting E. faecalis were applied for 3 weeks. Oral antibiotics (amoxicillin/potassium clavulanate) were applied for 6 weeks after discharge. OUTCOMES: At the 2-month follow-up, improvement in both the clinical condition and serum acute phase reactants levels were noted. LESSONS: Epidural injection can lead to a subcutaneous abscess that is further extended into the epidural space. One of the key factors is the presence of comorbid conditions, including diabetes mellitus and prolonged steroid usage due to rheumatoid arthritis.


Asunto(s)
Artritis Reumatoide , Diabetes Mellitus , Absceso Epidural , Infecciones Estafilocócicas , Proteínas de Fase Aguda , Anciano , Antibacterianos/uso terapéutico , Artritis Reumatoide/complicaciones , Absceso Epidural/diagnóstico , Absceso Epidural/tratamiento farmacológico , Absceso Epidural/etiología , Espacio Epidural , Femenino , Humanos , Infecciones Estafilocócicas/complicaciones , Esteroides
16.
J Korean Med Sci ; 37(7): e58, 2022 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-35191234

RESUMEN

Guillain-Barre syndrome (GBS) is an immune-mediated acute polyradiculoneuropathy and commonly occurs after a preceding infection or immunization sequalae. Following the severe acute respiratory syndrome-coronavirus-2 virus pandemic with co-introduction of massive vaccinations, several GBS cases associated with coronavirus disease 2019 (COVID-19) infection per se or after vaccination for COVID-19 were reported internationally. Herein, we report two cases of Korean GBS presenting with tetraplegia after two different COVID-19 vaccinations (42-year old man by AstraZeneca and 48-year woman by Pfizer vaccines) within four weeks after vaccination. The patients were diagnosed with clinical examination, serial electromyography, and compatible laboratory results and improved after comprehensive rehabilitative treatment and intravenous immunoglobulin therapy. Furthermore, we performed an electrodiagnostic follow-up study of each case to examine their unique characteristics.


Asunto(s)
Vacuna BNT162/efectos adversos , ChAdOx1 nCoV-19/efectos adversos , Síndrome de Guillain-Barré/patología , Cuadriplejía/patología , Vacunación/efectos adversos , Adulto , Vacuna BNT162/inmunología , COVID-19/prevención & control , ChAdOx1 nCoV-19/inmunología , Electromiografía , Femenino , Síndrome de Guillain-Barré/rehabilitación , Síndrome de Guillain-Barré/terapia , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Masculino , Persona de Mediana Edad , Cuadriplejía/rehabilitación , Cuadriplejía/terapia , SARS-CoV-2/inmunología
17.
J Med Chem ; 65(4): 3539-3562, 2022 02 24.
Artículo en Inglés | MEDLINE | ID: mdl-35077170

RESUMEN

The sphingosine-1-phosphate-1 (S1P1) receptor agonists have great potential for the treatment of multiple sclerosis (MS) because they can inhibit lymphocyte egress through receptor internalization. We designed and synthesized triazole and isoxazoline derivatives to discover a novel S1P1 agonist for MS treatment. Of the two scaffolds, the isoxazoline derivative was determined to have excellent in vitro efficacy and drug-like properties. Among them, compound 21l was found to have superior drug-like properties as well as excellent in vitro efficacies (EC50 = 7.03 nM in ß-arrestin recruitment and EC50 = 11.8 nM in internalization). We also confirmed that 21l effectively inhibited lymphocyte egress in the peripheral lymphocyte count test and significantly improved the clinical score in the experimental autoimmune encephalitis MS mouse model.


Asunto(s)
Esclerosis Múltiple/tratamiento farmacológico , Receptores de Esfingosina-1-Fosfato/antagonistas & inhibidores , Animales , Perros , Diseño de Fármacos , Encefalomielitis Autoinmune Experimental/tratamiento farmacológico , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Isoxazoles/síntesis química , Isoxazoles/farmacocinética , Isoxazoles/farmacología , Recuento de Linfocitos , Linfocitos/efectos de los fármacos , Masculino , Ratones , Ratas , Relación Estructura-Actividad , Triazoles/síntesis química , Triazoles/farmacocinética , Triazoles/farmacología , beta-Arrestinas/efectos de los fármacos
18.
Toxicol Lett ; 356: 100-109, 2022 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-34902520

RESUMEN

Lung epithelial cells and fibroblasts play key roles in pulmonary fibrosis and are involved in fibrotic signaling and production of the extracellular matrix (ECM), respectively. Recently, 3D airway models consisting of both cell types have been developed to evaluate the fibrotic responses while facilitating cell-cell crosstalk. This study aimed to evaluate the fibrotic responses in these models using different fibrogenic agents, which are known as key events in adverse outcome pathways of pulmonary fibrosis. We quantified cell injury and several sequential steps in fibrogenesis, including inflammation, the epithelial-mesenchymal transition (EMT), fibroblast activation, and ECM accumulation, using two different 3D airway models, the EpiAirway™-full thickness (Epi/FT) and MucilAir™-human fibroblast (Mucil/HF) models. In the Epi/FT model, fibrogenic agents induced the expression of inflammation and EMT-associated markers, while in the Mucil/HF model, they induced fibroblast activation and ECM accumulation. Using this information, we conducted gene ontology term network analysis. In the Epi/FT model, the terms associated with cell migration and response to stimulus made up a large part of the network. In the Mucil/HF model, the terms associated with ECM organization and cell differentiation and proliferation constituted a great part of the network. Collectively, our data suggest that polyhexamethyleneguanidine phosphate and bleomycin induce different responses in the two 3D airway models. While Epi/FT was associated with inflammatory/EMT-associated responses, Mucil/HF was associated with fibroblast-associated responses. This study will provide an important basis for selecting proper 3D airway models and fibrogenic agents to further research or screen chemicals causing inhalation toxicity.


Asunto(s)
Técnicas de Cultivo Tridimensional de Células/métodos , Células Epiteliales/fisiología , Fibroblastos/fisiología , Fibrosis/inducido químicamente , Sistema Respiratorio/citología , Antineoplásicos/toxicidad , Biomarcadores , Bleomicina/toxicidad , Citocinas/genética , Citocinas/metabolismo , Relación Dosis-Respuesta a Droga , Regulación de la Expresión Génica/efectos de los fármacos , Guanidinas/toxicidad , Humanos , Factor de Crecimiento Transformador beta
19.
Cells ; 10(4)2021 04 16.
Artículo en Inglés | MEDLINE | ID: mdl-33923707

RESUMEN

The overall five-year survival rate for late-stage patients of ovarian cancer is below 29% due to disease recurrence and drug resistance. Cancer stem cells (CSCs) are known as a major contributor to drug resistance and recurrence. Accordingly, therapies targeting ovarian CSCs are needed to overcome the limitations of present treatments. This study evaluated the effect of trimebutine maleate (TM) targeting ovarian CSCs, using A2780-SP cells acquired by a sphere culture of A2780 epithelial ovarian cancer cells. TM is indicated as a gastrointestinal motility modulator and is known to as a peripheral opioid receptor agonist and a blocker for various channels. The GI50 of TM was approximately 0.4 µM in A2780-SP cells but over 100 µM in A2780 cells, demonstrating CSCs specific growth inhibition. TM induced G0/G1 arrest and increased the AV+/PI+ dead cell population in the A2780-SP samples. Furthermore, TM treatment significantly reduced tumor growth in A2780-SP xenograft mice. Voltage gated calcium channels (VGCC) and calcium-activated potassium channels (BKCa) were overexpressed on ovarian CSCs and targeted by TM; inhibition of both channels reduced A2780-SP cells viability. TM reduced stemness-related protein expression; this tendency was reproduced by the simultaneous inhibition of VGCC and BKCa compared to single channel inhibition. In addition, TM suppressed the Wnt/ß-catenin, Notch, and Hedgehog pathways which contribute to many CSCs characteristics. Specifically, further suppression of the Wnt/ß-catenin pathway by simultaneous inhibition of BKCa and VGCC is necessary for the effective and selective action of TM. Taken together, TM is a potential therapeutic drug for preventing ovarian cancer recurrence and drug resistance.


Asunto(s)
Reposicionamiento de Medicamentos , Células Madre Neoplásicas/patología , Neoplasias Ováricas/tratamiento farmacológico , Neoplasias Ováricas/patología , Trimebutino/uso terapéutico , Calcio/metabolismo , Canales de Calcio/metabolismo , Muerte Celular/efectos de los fármacos , Línea Celular Tumoral , Femenino , Humanos , Activación del Canal Iónico/efectos de los fármacos , Subunidades alfa de los Canales de Potasio de Gran Conductancia Activados por Calcio/metabolismo , Modelos Biológicos , Células Madre Neoplásicas/efectos de los fármacos , Subunidades de Proteína/metabolismo , Sodio/metabolismo , Canales de Sodio/metabolismo , Factores de Transcripción/metabolismo , Trimebutino/química , Trimebutino/farmacología , Vía de Señalización Wnt/efectos de los fármacos
20.
Polymers (Basel) ; 13(8)2021 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-33920820

RESUMEN

The use of halogen-based materials has been regulated since toxic substances are released during combustion. In this study, polyurethane foam was coated with cationic starch (CS) and montmorillonite (MMT) nano-clay using a spray-assisted layer-by-layer (LbL) assembly to develop an eco-friendly, high-performance flame-retardant coating agent. The thickness of the CS/MMT coating layer was confirmed to have increased uniformly as the layers were stacked. Likewise, a cone calorimetry test confirmed that the heat release rate and total heat release of the coated foam decreased by about 1/2, and a flame test showed improved fire retardancy based on the analysis of combustion speed, flame size, and residues of the LbL-coated foam. More importantly, an additional cone calorimeter test was performed after conducting more than 1000 compressions to assess the durability of the flame-retardant coating layer when applied in real life, confirming the durability of the LbL coating by the lasting flame retardancy.

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