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BACKGROUND: Circular RNAs (circRNAs) are regarded as vital regulatory factors in various cancers. However, the biological functions of circDNER in the paclitaxel (PTX) resistance of lung cancer remain largely unexplored. METHODS: Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to analyze circDNER, miR-139-5p, and ITGB8. Cell proliferation was assessed via colony formation and MTT assays. Cell apoptosis was evaluated by flow cytometry. Western blot was performed to assess protein expression. The targeted interaction among circDNER, miR-139-5p, and ITGB8 were validated using dual-luciferase reporter or RNA immunoprecipitation assays. RESULTS: Inhibition of circDNER reduced IC50 of PTX, inhibited cell proliferation, invasion and migration, as well as promoted cell apoptosis in PTX-resistant lung cancer cells. Mechanistically, circDNER sponged miR-139-5p to upregulate ITGB8 expression. Overexpression of miR-139-5p reversed the biological functions mediated by circDNER in PTX-resistant lung cancer cells. MiR-139-5p overexpression suppressed PTX resistance and malignant behaviors of PTX-resistant lung cancer cells, with ITGB8 elevation rescued the impacts. Moreover, we demonstrated that circDNER was upregulated in plasma exosomes from lung cancer patients. The plasma exosomes derived from these patients are the key factors enhancing the migration and invasion potential of lung cancer cells. CONCLUSION: The circDNER mediated miR-139-5p/ITGB8 axis suppresses lung cancer progression. Our findings suggest that circDNER might act as a potential prognostic biomarker and therapeutic target for lung cancer treatment.
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Neoplasias Pulmonares , MicroARNs , Proliferación Celular , Resistencia a Antineoplásicos , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/genética , MicroARNs/genética , MicroARNs/metabolismo , Paclitaxel/farmacología , Paclitaxel/uso terapéutico , ARN Circular/genéticaRESUMEN
Circular RNA (circRNA) is a class of endogenous non-coding RNAs without 5' and 3' ends; an increasing number of studies show that circRNA is involved in skeletal muscle development. From our previous sequencing data, the circRNAome in breast muscle of two chicken lines with a distinct rate of muscle development, which included a fast muscle growing broiler (FMGB) and a slow muscle growing layer (SMGL), we found a novel differentially expressed circRNA generated by intersectin 2 (ITSN2) gene (named circITSN2). We verified that circITSN2 is a skeletal muscle-enriched circRNA that promotes chicken primary myoblast (CPM) proliferation and differentiation. Further molecular mechanism analysis of circITSN2 in chicken myogenesis was performed, and we found circITSN2 directly targeting miR-218-5p. Besides, miR-218-5p inhibits CPM proliferation and differentiation, which is contrary to circITSN2. Commonly, circRNAs act as a miRNA sponge to alleviate the inhibition of miRNAs on mRNAs. Thus, we also identified that a downstream gene LIM domain 7 (LMO7) was inhibited by miR-218-5p, while circITSN2 could block the inhibitory effect of miR-218-5p by targeting it. Functional analysis revealed that LMO7 also accelerates CPM proliferation and differentiation, which was similar to circITSN2 but contrary to miR-218-5p. Taken together, these results suggested that circITSN2 promotes chicken embryonic skeletal muscle development via relieving the inhibition of miR-218-5p on LMO7. Our findings revealed a novel circITSN2/miR-218-5p/LMO7 axis in chicken embryonic skeletal muscle development, which expands our understanding of the complex muscle development regulatory network.
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COVID-19 (coronavirus disease 2019) has spread successfully worldwide in a matter of weeks. After the example of China, all the affected countries are taking hard-confinement measures to control the infection and to gain some time to reduce the significant amount of cases that arrive at the hospital. Although the measures in China reduced the percentages of new cases, this is not seen in other countries that have taken similar measures, such as Italy and Spain. After the first weeks, the worry was whether or not the healthcare system would collapse rather than its response to the patient's needs who are infected and require hospitalization. Using China as a mirror of what could happen in our countries and with the data available, we calculated a model that forecasts the peak of the curve of infection, hospitalization, and ICU bed numbers. We aimed to review the patterns of spread of the virus in the two countries and their regions, looking for similarities that reflect the existence of a typical path in this expansive virulence and the effects of the intervention of the authorities with drastic isolation measures, to contain the outbreak. A model based on Autorregressive and moving average models (ARMA) methodology and including Chinese disease pattern as a proxy, predicts the contagious pattern robustly. Based on the prediction, the hospitalization and intensive care unit (ICU) requirements were also calculated. Results suggest a reduction in the speed of contagion during April in both countries, earlier in Spain than in Italy. The forecast advanced a significant increase in the ICU needs for Spain surpassing 8,000 units by the end of April, but for Italy, ICU needs would decrease in the same period, according to the model. We present the following predictions to inform political leaders because they have the responsibility to maintain the national health systems away from collapsing. We are confident these data could help them into decision-taking and place the capitals (from hospital beds to human resources) into the right place.
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COVID-19/epidemiología , COVID-19/transmisión , Exactitud de los Datos , Brotes de Enfermedades/estadística & datos numéricos , Análisis de Regresión , Humanos , Incidencia , Italia/epidemiología , Prevalencia , SARS-CoV-2 , España/epidemiologíaRESUMEN
BACKGROUND: Lung cancer has high morbidity and mortality across the globe, and lung adenocarcinoma (LUAD) is the most common histologic subtype. Disordered lipid metabolism is related to the development of cancer. Analysis of lipid-related transcriptome helps shed light on the diagnosis and prognostic biomarkers of LUAD. METHODS: In this study, expression analysis of 1045 lipid metabolism-related genes was performed between LUAD tumors and normal tissues derived from the Cancer Genome Atlas Lung Adenocarcinoma (TCGA-LUAD) cohort. The interaction network of differentially expressed genes (DEGs) was constructed to identify the hub genes. The association between hub genes and overall survival (OS) was evaluated and formed a model to predict the prognosis of LUAD using a nomogram. The model was validated by another cohort, GSE13213. RESULTS: A total of 217 lipid metabolism-related DEGs were detected in LUAD. Genes were significantly enriched in glycerophospholipid metabolism, fatty acid metabolic process, and eicosanoid signaling. Through network analysis and cytoHubba, 6 hub genes were identified, including INS, LPL, HPGDS, DGAT1, UGT1A6, and CYP2C9. High expression of CYP2C9, UGT1A6, and INS, and low expressions of DGAT1, HPGDS, and LPL, were associated with worse overall survival for 1925 LUAD patients. The model showed that the high-risk score group had a worse OS, and the validated cohort showed the same result. CONCLUSIONS: In this study, a signature of 6 lipid metabolism genes was constructed, which was significantly associated with the diagnosis and prognosis of LUAD patients. Thus, the gene signature can be used as a biomarker for LUAD.
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Adenocarcinoma del Pulmón/genética , Metabolismo de los Lípidos/genética , Lípidos/genética , Transcriptoma/genética , Adenocarcinoma del Pulmón/patología , Adulto , Anciano , Biomarcadores de Tumor/genética , Citocromo P-450 CYP2C9/genética , Diacilglicerol O-Acetiltransferasa/genética , Femenino , Regulación Neoplásica de la Expresión Génica/genética , Glucuronosiltransferasa/genética , Humanos , Insulina/genética , Oxidorreductasas Intramoleculares/genética , Lipoproteína Lipasa/genética , Masculino , Persona de Mediana Edad , PronósticoRESUMEN
Fufang Danshen Dripping Pill (FDDP) and Clopidogrel Bisulfate Tablet (CBT) are usually combined for treatment of coronary artery diseases in clinical. To investigate the pharmacokinetic interaction between FDDP and CBT after oral administration of FDDP, CBT and their combination in rats, a novel LC-MS method with segmented scan modes (multiple reaction monitoring and selected ion monitoring) and polarity (positive and negative ionization) was developed. Clopidogrel and the main active ingredients of FDDP, with different chemical and ionization properties, were simultaneously quantified in plasma in a single run. The method was validated in terms of specificity, linearity, precision, accuracy, recovery, matrix effect and stability. As a result, co-administration of FDDP and CBT significantly altered the pharmacokinetic parameters of danshensu, ginsenoside Rb1, dihydrotanshinone I, tanshinone I and tanshinone IIA of FDDP, as well as clopidogrel. Mechanism studies suggested that induction of liver cytochrome P450 isozymes CYP2C11 and CYP3A1 by co-administration, as well as inhibition of carboxyl esterase 1, was partly responsible for FDDP-CBT pharmacokinetic interactions. The developed LC-MS method could be used to simultaneously quantify different types of in vivo analytes in a single run, and the results could be used for clinical medication guidance of FDDP and CBT.
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Clopidogrel/farmacocinética , Medicamentos Herbarios Chinos/farmacocinética , Abietanos/farmacocinética , Administración Oral , Animales , Hidrocarburo de Aril Hidroxilasas/metabolismo , Canfanos , Cromatografía Liquida , Citocromo P-450 CYP3A/metabolismo , Familia 2 del Citocromo P450/metabolismo , Ginsenósidos/farmacocinética , Lactatos/farmacocinética , Modelos Lineales , Masculino , Panax notoginseng , Ratas , Ratas Sprague-Dawley , Reproducibilidad de los Resultados , Salvia miltiorrhiza , Esteroide 16-alfa-Hidroxilasa/metabolismo , Espectrometría de Masas en TándemRESUMEN
BACKGROUND: Herbal compatibility of compound formulas can enhance therapeutic effects or reduce side effects of the monarch drugs, but majority of compatibility mechanisms are still unknown. Sangju-Yin, a well-known Chinese compound formula, is currently used to treat common cold in clinical. PURPOSE: In this study, we proposed a strategy to explore the compatibility mechanism of Sangju-Yin by investigating P450 enzymes-based metabolic interactions between monarch drugs and the other constituent herbs. METHODS: Under the guidance of traditional Chinese medicine theory, the constituent herbs of Sangju-Yin were divided into four groups, including monarch drugs, monarch drugs with addition of minister drugs, monarch drugs with addition of minister and adjuvant drugs, as well as the whole recipe, namely monarch drugs with addition of minister, adjuvant and conductant drugs. Their effects on rats in vivo P450 (CYP1A2, CYP2A3, CYP2C6, CYP2C11 and CYP3A1) activities after oral administration were evaluated using probe drug assay based on LC-MS/MS. Moreover, effects of the four groups of herbs on mRNA expression of P450 enzymes after oral administration, as well as in vitro P450 activities after co-incubation, were investigated to explore the underlying mechanisms. RESULTS: Comparing with monarch drugs, addition of different constituent herbs significantly enhanced CYP1A2 and CYP2C6 activities, and inhibited CYP2A3 and CYP3A1 activities, indicating their possible influences on plasma concentrations of active constituents in the monarch drugs. Mechanism study suggested that these herbs affected P450 activities by transcriptional regulation and/or direct interaction with the enzymes. CONCLUSION: This study clarified the compatibility mechanism of Sangju-Yin from the aspect of P450 enzymes-based metabolic interactions, which would benefit better understanding of the therapeutic basis of Sangju-Yin.
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Sistema Enzimático del Citocromo P-450/efectos de los fármacos , Composición de Medicamentos , Interacciones Farmacológicas , Medicamentos Herbarios Chinos/administración & dosificación , Medicina Tradicional China , Animales , Cromatografía Liquida , Sistema Enzimático del Citocromo P-450/metabolismo , Medicamentos Herbarios Chinos/química , Masculino , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Espectrometría de Masas en TándemRESUMEN
Sangju Ganmao tablet (SGT), a well-known Chinese patent medicine used to treat cold symptoms, is made from eight herbal medicines. In this study, an off-line hydrophilic interaction × reversed-phase two-dimensional liquid chromatography (HILIC × RP 2D-LC) method was developed to comprehensively separate the chemical constituents of SGT. Through optimization of the experimental conditions, a total of 465 peaks were finally detected in SGT, and the structures of 54 selected compounds were fully identified or tentatively characterized by quadrupole time-of-flight mass spectrometry (qTOF-MS) analysis. The established 2D-LC analysis showed high orthogonality (63.62%) and approximate 11-fold improvement in peak capacity (2399 and 1099, obtained by two calculation methods), in contrast to conventional one-dimensional RPLC separation. The eight component herbs of SGT were also respectively separated by using the 2D-LC system, and we found that a total of 12 peaks detected in SGT were not discovered in any component herbs. These newly generated chemical constituents would benefit better understanding of the compatibility mechanism of the component herbs. The strategy established in this study could be used for systematic chemical comparison of SGT and its component herbs, which contributes to exploration of herbal compatibility mechanism.
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Herbal medicines are complicated chemical systems containing hundreds of small molecules of various polarities, structural types, and contents. Thus far, the chromatographic separation of herbal extracts is still a big challenge. Two-dimensional liquid chromatography (2DLC) has become an attractive separation tool in the past few years. Particularly, a lot of attention has been paid to on-line 2DLC. In this review, we aim to give an overview on applications of on-line 2DLC in the chemical analysis of herbal medicines since 2010. Firstly, classification and general configurations of on-line 2DLC were briefly introduced. Then, we summarized main applications in herbal medicines of heart-cutting 2DLC (LC-LC), comprehensive 2DLC (LC × LC), and their combinations, with emphasis on LC × LC. Mass spectrometry is the most popular detector coupled with 2DLC, which allows sensitive and accurate structural characterization of herbal compounds. Finally, future developments in on-line 2DLC techniques were also discussed.
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Cromatografía Liquida/métodos , Fitoquímicos/análisis , Plantas Medicinales/química , Espectrometría de MasasRESUMEN
Oral squamous cell carcinoma (OSCC), one of the 10 most common types of neoplasms in the US, constitutes ~90% of all cases of oral malignancies. Chemoresistance and metastasis are difficult to avoid during the course of treatment, leading to a poor prognosis and a high mortality rate for patients with OSCC. Autophagy, a critical conserved cellular process, has been reported to be highly associated with the regulation of chemoresistance and metastasis of cancer cells. The present study investigated the role of karyopherin α2 (KPNA2), a member of the importin α family, which may serve an important role in p53 nucleocytoplasmic transport in the process of OSCC autophagy. In the CAL27, SCC15 and Tca8113 OSCC cell lines, we observed that the downregulation of KPNA2 suppressed cell migration and cisplatin resistance, using woundhealing, Transwell and CCK8 assays. Additionally, the results of western blot analysis and transmission electron microscopy (TEM) analysis indicated that the knockdown of KPNA2 inhibited autophagy. We confirmed that the inhibition of autophagy with antiautophagy agents decreased the migration and cisplatin resistance of OSCC cells. We hypothesized that the suppression of cell migration and cisplatin resistance induced by KPNA2 knockdown may be associated with the inhibition of autophagy. To identify the underlying mechanism, further experiments determined that KPNA2 affects the level of autophagy via regulating the p53 nuclear import. Thus, the present study demonstrated that the function of KPNA2 in the process of autophagy may be p53dependent, and by regulating the translocation of p53, KPNA2 can support autophagy to promote the chemoresistance and metastasis of OSCC cells.
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Carcinoma de Células Escamosas/tratamiento farmacológico , Neoplasias de la Boca/tratamiento farmacológico , Proteína p53 Supresora de Tumor/genética , alfa Carioferinas/genética , Transporte Activo de Núcleo Celular/genética , Apoptosis/efectos de los fármacos , Autofagia/efectos de los fármacos , Autofagia/genética , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patología , Línea Celular Tumoral , Linaje de la Célula/genética , Movimiento Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Cisplatino/farmacología , Resistencia a Antineoplásicos/genética , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Técnicas de Silenciamiento del Gen , Humanos , Neoplasias de la Boca/genética , Neoplasias de la Boca/patología , Transporte de Proteínas/genética , alfa Carioferinas/antagonistas & inhibidoresRESUMEN
Flavonoid glycosides and triterpenoid saponins are the main chemical constituents of licorice. In this study, an ionic liquids-ultrasound based extraction (IL-UAE) method was established to simultaneously extract liquiritin (LQ), liquiritin apioside (LA), isoliquiritin (ILQ), isoliquiritin apioside (ILA) and glycyrrhizic acid (GA) from licorice. A series of 1-alkyl-3-methylimidazolium ILs with different anions and alkyl chain lengths of cations were investigated and compared, and 1-butyl-3-methylimidazolium acetate ([C4MIM]Ac) was finally selected as the extractant. The extraction parameters of the IL-UAE procedure were optimized, and the established method was validated in linearity, stability, precision, repeatability and recovery. The IL-UAE approach exhibited much higher extraction efficiency comparing with conventional UAE, and needed shorter extraction time and smaller solvent to solid ratio comparing with the pharmacopoeia method. In addition, the microstructures of licorice powders were observed before and after extraction with help of a scanning electron microscope (SEM) in order to explore the extraction mechanism. The results suggested that ILs as green solvents were effective for extraction of flavonoid glycosides and triterpenoid saponins from licorice.
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@#Objective To compare the clinical effect of three operations for one-stage radical correction of small left ventricle in children with tetralogy of Fallot (TOF). Methods We retrospectively analyzed the clinical data of 120 patients with left ventricular dysplasia and TOF undergoing one-stage radical surgery in the First Hospital of Hebei Medical University from December 2004 to May 2017. According to the different types of operation used, they were divided into 3 groups, including a routine group (30 patients, 16 males and 14 females, aged 11.58±2.05 months ranging from 3-24 months), a large patch group (40 patients, 22 males, 18 females, aged 11.22±2.24 months ranging from 3-25 months) who were treated with a large patch, and an enlarged ventricular septal defect group (50 patients, 26 males, 24 females, aged 10.17±2.15 months ranging from 3-22 months) using new left ventricular enlargement technique to enlarge ventricular septal defect. The clinical effect of the three operations were compared. Results The incidence of postoperative low cardiac output syndrome (6.0% vs. 40.0% vs. 50.0%, P<0.05), renal failure (4.0% vs. 37.5% vs. 46.7%, P<0.05), infection rate (10.0% vs. 50.0% vs. 66.7%, P<0.05), mortality (2.0% vs. 12.5% vs. 20.0%, P<0.05), ventilator-assisted time (8.34±5.24 h vs. 36.14±10.91 h vs. 38.58±10.12 h, P<0.05), ICU stay (4.13±1.01 d vs. 7.64±2.11 d vs. 8.03±3.03 d, P<0.05), hospital stay (10.48±4.26 d vs. 21.02±3.23 d vs. 22.52±2.93 d, P<0.05) and hospitalization costs (51 300±9 400 yuan vs. 103 200±39 300 yuan vs. 115 500±35 200 yuan, P<0.05) were less in the enlarged ventricular septal defect group compared with the other two groups. Conclusion The clinical effect of enlarged ventricular septal defect is better than that of the routine and large patch methods, and long-term efficacy should be further followed up.
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Previous studies suggest that leptin (LEP) has an important role in glucose metabolism in the nonpregnant state. During pregnancy, circulating maternal concentrations of leptin rise significantly, mainly due to increased secretion of leptin from maternal adipose tissue and placenta. This study aimed to analyze the impact of maternal and fetal common LEP variants on glucose homeostasis in the pregnant state. Several glycemic traits, including fasting plasma glucose, fasting plasma insulin (FPI), and plasma glucose 1 hour after a 50-g oral glucose load, were measured in 1,112 unrelated Chinese Han pregnant women at 24-28 weeks gestation. Homeostatic model assessment (HOMA) was used to assess beta cell function (HOMA1-ß and HOMA2-ß) and insulin resistance (HOMA1-IR and HOMA2-IR).The relationships between glycemic traits and 12 LEP variants were determined. After applying the Bonferroni correction, we detected that (1) maternal rs10954173 and fetal rs10244329 were associated with maternal FPI although the effect of fetal rs10244329 may be not independent of maternal rs10244329, and (2) maternal rs12537573 was associated with maternal FPI and HOMA2-IR. This study provides genetic evidence that both maternal and fetal LEP polymorphisms may affect maternal glucose metabolism in pregnancy.
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Leptina/genética , Leptina/fisiología , Intercambio Materno-Fetal/genética , Adulto , Pueblo Asiatico/genética , Glucemia/análisis , Glucemia/metabolismo , China , Etnicidad/genética , Femenino , Feto/metabolismo , Glucosa/metabolismo , Homeostasis , Humanos , Insulina/análisis , Insulina/sangre , Resistencia a la Insulina/genética , Células Secretoras de Insulina/metabolismo , Fenotipo , Placenta/metabolismo , Embarazo , Atención PrenatalRESUMEN
Recent studies suggested that maternal and placental leptin receptor (LEPR) may be involved in maternal glucose metabolism in pregnancy. To identify maternal and fetal LEPR common variants influencing gestational glycemic traits, we performed association study of 24-28-week maternal fasting glucose, glucose 1 hour after the consumption of a 50-g oral glucose load, fasting insulin and indices of beta-cell function (HOMA-ß) and insulin resistance (HOMA-IR) in 1,112 unrelated women and their children. Follow-up of 36 LEPR loci identified 3 maternal loci (rs10889567, rs1137101 and rs3762274) associated with fasting glucose, these 3 fetal loci associated with fasting insulin and HOMA1-IR, as well as these 3 maternal-fetal loci combinations associated with HOMA2-ß. We also demonstrated association of maternal locus rs7554485 with HOMA2-ß and HOMA2-IR, maternal locus rs10749754 with fasting glucose, fetal locus rs10749754 with HOMA2-IR. However, these associations were no longer statistically significant after Bonferroni correction. In conclusion, our results first revealed multiple associations between maternal and fetal LEPR common variants and gestational glycemic traits. These associations did not survive Bonferroni correction. These corrections are overly conservative for association studies. We therefore believe the influence of these nominally significant variants on gestational glycometabolism will be confirmed by additional studies.
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Glucemia , Variación Genética , Placenta/metabolismo , Carácter Cuantitativo Heredable , Receptores de Leptina/genética , Femenino , Genotipo , Humanos , Desequilibrio de Ligamiento , Polimorfismo de Nucleótido Simple , EmbarazoRESUMEN
Elevated plasma glucose levels in pregnancy increase adverse pregnancy outcomes. Cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1 (CDKAL1) has been shown to be involved in insulin secretion in pancreatic ß cells. In this study, we investigated the impact of genetic variants in CDKAL1 on plasma glucose, insulin values, ß cell function and insulin resistance in the fasted state as well as plasma glucose 1 h after the consumption of a 50-g oral glucose load between 24 and 28 weeks of pregnancy among 929 unrelated pregnant Han Chinese women. Seven common variants previously reported to associate with diabetes were genotyped. Insulin resistance and ß cell function were assessed by homeostasis model assessment. The genetic impacts were analyzed using analysis of variance and analysis of covariance. The results showed that there was no significant association between any of the seven variants and those gestational glycemic traits. Therefore, this study suggests that the seven common variants in CDKAL1 are not significant factors for the variations of several gestational glycemic traits in the Han Chinese population. However, further well-designed studies with larger sample size, more ethnic groups and more CDKAL1 variants are required to validate the association between CDKAL1 and gestational glycemic traits.
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Glucemia/genética , Predisposición Genética a la Enfermedad/genética , Variación Genética/genética , Índice Glucémico/genética , ARNt Metiltransferasas/genética , Adulto , Pueblo Asiatico/genética , Femenino , Genotipo , Humanos , Masculino , FenotipoRESUMEN
Prostacyclin analogs, such as epoprostenol, treprostinil, iloprost, and beraprost, have long been used for pulmonary arterial hypertension (PAH) treatment, yet their relative efficiency remains disputed. Eligible randomized controlled trials (RCTs) involving the 4 therapies mentioned above were retrieved from PubMed, Embase, and Cochrane (up to August 1, 2015). Odds ratios (ORs) were estimated for dichotomous data (mortality, functional class (FC) amelioration, and discontinuation); standardized mean differences (SMDs) with 95% confidence intervals (CIs) were estimated for continuous data (6-min walk distance [6-MWD]). Patients taking epoprostenol were anticipated to demonstrate more expedient 6-MWD than those taking placebo when network meta-analysis (NMA) was implemented (SMDâ=â52.19; 95% CI: 24.28-113.39), the trend of which was identical with that of pairwise meta-analysis (SMDâ=â69.28; 95% CI: 10.43-128.98). Nonetheless, the prominent advantages of treprostinil over placebo (SMDâ=â30.15; 95% CI: 19.29-40.01) in 6-MWD could not be replicated by NMA. Furthermore, direct and indirect (NMA) comparisons also differed in FC amelioration. For example, the superiority of epoprostenol over placebo as evident with the use of NMA (ORâ=â42.79; 95% CI: 10.63-301.98) could not be confirmed by pairwise meta-analysis. As suggested by indirect comparisons among 4 prostanoids, epoprostenol appears to result in remarkably favorable FC amelioration comparing to other regimens (all Pâ<â0.05). Participants taking beraprost were more probable to withdraw in comparison with those administrated with iloprost (ORâ=â10.07; 95% CI: 1.47-160.65). Taking mortality, FC amelioration, discontinuation, and 6-MWD into account, epoprostenol could be recommended as an alternative treatment for patients with moderate/advanced PAH.
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Antihipertensivos/uso terapéutico , Epoprostenol/uso terapéutico , Hipertensión Pulmonar/tratamiento farmacológico , Antihipertensivos/efectos adversos , Presión Arterial/efectos de los fármacos , Epoprostenol/efectos adversos , Epoprostenol/análogos & derivados , Humanos , Iloprost/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
PURPOSE: We aimed to investigate the roles of miR-184 in adaptation of hypoxic cardiomyocytes, as well as to elucidate the possible mechanisms of miR-184 in the development of cyanotic congenital heart diseases (CHD). MATERIALS AND METHODS: We conducted quantitative real-time polymerase chain reaction (qRT-PCR) to determine the expression of miR-184 in patients with cyanotic cardiac defects. The embryonic rat ventricular myocardial H9c2 cells were transfected with miR-184 inhibitor and negative scramble RNA. Mock group was untreated by anything. We then used MTT assay and in situ terminal deoxynucleotidyl transferase-mediated dUTP nick end-labelling (TUNEL) to determine whether inhibition of miR-184 in vitro affect cell proliferation and apoptosis under hypoxic conditions. Besides, the expression levels of caspase-3 and caspase-9 in hypoxic H9c2 cells were determined by western blot. RESULTS: MiR-184 was significantly down-regulated in CHD patients with cyanotic cardiac defects. In addition, miR-184 was successfully inhibited in hypoxic H9c2 cells. Moreover, inhibition of miR-184 markedly decreased cell viability and obviously induced apoptosis under hypoxic conditions in vitro. Besides, the expression levels of caspase-3 and caspase-9 in hypoxic H9c2 were significantly increased after miR-184 inhibition. CONCLUSIONS: Our findings indicate that inhibition of microRNA-184 may contribute to the development of cyanotic CHD via decreasing proliferation and inducing apoptosis of cardiomyocytes. Moreover, miR-184 inhibition may promote hypoxia-induced apoptosis via activation of caspase-3 and caspase-9. Congenital down-regulation of miR-184 may be a mechanism leading to CHD development.