RESUMEN
Depression is one of the major psychiatric diseases affecting the quality of life for individuals worldwide. Numerous reports have investigated depression, although its etiology remains to be elucidated. microRNA (miR)146a is suggested to regulate innate immune and inflammatory responses. However, it is unclear whether miR146a is involved in depression. Depression model mice were established using lipopolysaccharideinduced depression and chronic unpredictable mild stress, separately. miR146a mimic and short interfering RNA were used to treat depressed mice. Depressionlike behaviors and levels of proinflammatory cytokines were measured, while ionized calcium binding adapter molecule 1 (Iba1) expression in hippocampus was quantified by immunohistochemistry. Neuroinflammatory factor levels in hippocampus were measured by western blotting. BV2 cells were used to confirm that miR146a suppressed microglia activation. Compared with control mice, the two depressed mouse models showed clearly decreased sucrose preference and significantly increased immobility time in the forced swimming test and tail suspension test (P<0.05). miR146a overexpression significantly increased sucrose preference and reduced immobility time in depressed mice (P<0.05). However, total distance traveled in the locomotor activity test did not differ among groups. Compared with controls, expression levels of Iba1, inducible nitric oxide, IL1ß, TNFα, interleukin 1 receptor associated kinase 1 (IRAK1), TNF receptorassociated factor 6 (TRAF6) and phosphorylated NFκB p65 were significantly increased in depressed mice (P<0.05). miR146a overexpression effectively inhibited expression of these neuroinflammatory proteins, while miR146a silencing significantly upregulated their expression (P<0.05). Consistent with these in vivo results, miR146a mimic treatment inhibited TNFα, IL1ß, IRAK1 and TRAF6 expression in BV2 cells. miR146a improved depressive behaviors in depressed model mice by inhibiting microglial activation and neuroinflammatory factor expression.
Asunto(s)
Depresión/tratamiento farmacológico , MicroARNs/farmacología , Microglía/efectos de los fármacos , Microglía/metabolismo , Animales , Conducta Animal , Proteínas de Unión al Calcio/metabolismo , Citocinas/metabolismo , Modelos Animales de Enfermedad , Suspensión Trasera , Hipocampo/metabolismo , Inmunidad Innata , Quinasas Asociadas a Receptores de Interleucina-1 , Lipopolisacáridos/efectos adversos , Masculino , Ratones , Ratones Endogámicos C57BL , MicroARNs/genética , Proteínas de Microfilamentos/metabolismo , Calidad de Vida , Natación , Factor 6 Asociado a Receptor de TNF/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Regulación hacia ArribaRESUMEN
BACKGROUND: This study explored whether docetaxel/cisplatin and radiotherapy (TP-R) increases overall survival (OS) and recurrence-free survival (RFS) compared to single-agent cisplatin and radiotherapy (C-R) in patients with high-risk early-stage cervical cancer post surgery. METHODS: Patients with clinical stage IB and IIA carcinoma of the cervix, initially treated with radical hysterectomy and pelvic lymphadenectomy, and who had positive pelvic lymph nodes and/or positive margins and/or the diameter of the primary tumor ≥4 cm and/or depth of interstitial infiltration ≥1/2 and/or lymphovascular space invasion were eligible for this study. Patients were randomized to receive C-R or TP-R. Radiotherapy in both groups was external radiation (46-54 Gy) followed by high-dose rate brachytherapy (12-24 Gy). Patients were given cisplatin (40 mg/m(2)) every week for five cycles (C-R group) or docetaxel (30 mg/m(2)) and cisplatin (30 mg/m(2)) every week for five cycles (TP-R group). RESULTS: Between 2003 and 2008, 320 patients were entered onto the study. Final analyses included 285 patients. One hundred and forty patients comprised the C-R group and 145 were in the TP-R group. The 5-year OS were 74.3 % in the C-R group and 82.8 % in the TP-R group. The hazard ratio (HR) for death was 0.65 in the TP-R group (95 % CI: 0.39-1.09, P = 0.098). The RFS were 69.3 % in the C-R group and 79.3 % in the TP-R group, and the HR for recurrence was 0.64 in the TP-R group (95 % CI: 0.40-1.03, P = 0.061). Recurrence rates were similar in both groups (27 in the C-R group and 18 in the TP-R group, P = 0.112). The seriousness of late side effects was similar in the two groups, with a higher rate of reversible hematological effects in the TP-R group. CONCLUSIONS: Compared with single-agent cisplatin and radiotherapy, docetaxel/cisplatin in combination with radiotherapy does not increase OS but has the trend of increasing RFS in patients with high-risk early-stage cervical cancer. However, docetaxel/cisplatin in combination with radiotherapy is associated with a higher incidence of side effects, this effect was reversible, and the incidence of late side effects was similar in the two treatment groups.