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1.
Proc Biol Sci ; 290(2009): 20231965, 2023 10 25.
Article in English | MEDLINE | ID: mdl-37876196

ABSTRACT

Understanding the ecological and evolutionary processes that drive host-pathogen interactions is critical for combating epidemics and conserving species. The Varroa destructor mite and deformed wing virus (DWV) are two synergistic threats to Western honeybee (Apis mellifera) populations across the globe. Distinct honeybee populations have been found to self-sustain despite Varroa infestations, including colonies within the Arnot Forest outside Ithaca, NY, USA. We hypothesized that in these bee populations, DWV has been selected to produce an avirulent infection phenotype, allowing for the persistence of both host and disease-causing agents. To investigate this, we assessed the titre of viruses in bees from the Arnot Forest and managed apiaries, and assessed genomic variation and virulence differences between DWV isolates. Across groups, we found viral abundance was similar, but DWV genotypes were distinct. We also found that infections with isolates from the Arnot Forest resulted in higher survival and lower rates of symptomatic deformed wings, compared to analogous isolates from managed colonies, providing preliminary evidence to support the hypothesis of adaptive decreased viral virulence. Overall, this multi-level investigation of virus genotype and phenotype indicates that host ecological context can be a significant driver of viral evolution and host-pathogen interactions in honeybees.


Subject(s)
RNA Viruses , Varroidae , Bees , Animals , Virulence , RNA Viruses/genetics , Host-Pathogen Interactions
2.
Dev Cell ; 58(18): 1748-1763.e6, 2023 09 25.
Article in English | MEDLINE | ID: mdl-37480844

ABSTRACT

Adherens junctions (AJs) allow cell contact to inhibit epithelial migration yet also permit epithelia to move as coherent sheets. How, then, do cells identify which contacts will inhibit locomotion? Here, we show that in human epithelial cells this arises from the orientation of cortical flows at AJs. When the leader cells from different migrating sheets make head-on contact with one another, they assemble AJs that couple together oppositely directed cortical flows. This applies a tensile signal to the actin-binding domain (ABD) of α-catenin, which provides a clutch to promote lateral adhesion growth and inhibit the lamellipodial activity necessary for migration. In contrast, AJs found between leader cells in the same migrating sheet have cortical flows aligned in the same direction, and no such mechanical inhibition takes place. Therefore, α-catenin mechanosensitivity in the clutch between E-cadherin and cortical F-actin allows cells to interpret the direction of motion via cortical flows and signal for contact to inhibit locomotion.


Subject(s)
Actins , Locomotion , Humans , alpha Catenin , Cadherins , Epithelial Cells
3.
Macromol Rapid Commun ; 44(14): e2300094, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37191104

ABSTRACT

ortho-Phenylenes are one of the simplest classes of aromatic foldamers, adopting helical geometries because of aromatic stacking interactions. The folding and misfolding of ortho-phenylenes are slow on the NMR timescale at or below room temperature, allowing detection of folding states using 1 H NMR spectroscopy. Herein, an ortho-phenylene hexamer is coupled with a RAFT chain transfer agent (CTA) on each repeat unit. A variety of acrylic monomers are polymerized onto the CTA-functionalized ortho-phenylene using PET-RAFT to yield functionalized star polymers with ortho-phenylene cores. The steric bulk of the acrylate monomer units as well as the chain length of each arm of the star polymer is varied. 1 H NMR spectroscopy shows that the folding of the ortho-phenylenes do not vary, providing a robust helical core for star polymer systems.


Subject(s)
Polymers , Positron-Emission Tomography , Polymerization , Polymers/chemistry , Magnetic Resonance Spectroscopy
4.
Sci Signal ; 16(782): eabq1366, 2023 04 25.
Article in English | MEDLINE | ID: mdl-37098119

ABSTRACT

Macrophages are key cellular contributors to the pathogenesis of COVID-19, the disease caused by the virus SARS-CoV-2. The SARS-CoV-2 entry receptor ACE2 is present only on a subset of macrophages at sites of SARS-CoV-2 infection in humans. Here, we investigated whether SARS-CoV-2 can enter macrophages, replicate, and release new viral progeny; whether macrophages need to sense a replicating virus to drive cytokine release; and, if so, whether ACE2 is involved in these mechanisms. We found that SARS-CoV-2 could enter, but did not replicate within, ACE2-deficient human primary macrophages and did not induce proinflammatory cytokine expression. By contrast, ACE2 overexpression in human THP-1-derived macrophages permitted SARS-CoV-2 entry, processing and replication, and virion release. ACE2-overexpressing THP-1 macrophages sensed active viral replication and triggered proinflammatory, antiviral programs mediated by the kinase TBK-1 that limited prolonged viral replication and release. These findings help elucidate the role of ACE2 and its absence in macrophage responses to SARS-CoV-2 infection.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , SARS-CoV-2/physiology , Angiotensin-Converting Enzyme 2/genetics , Cytokines , Peptidyl-Dipeptidase A/genetics , Peptidyl-Dipeptidase A/metabolism , Macrophages/metabolism , Virion/metabolism
5.
Bioethics ; 37(2): 130-134, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36399109

ABSTRACT

Pharmacological cognitive enhancements nontherapeutically improve cognitive functioning, though recent critics have challenged their use by claiming that cognitive success, aided by the use of cognitive enhancement, is less valuable than otherwise. We criticize two recent responses to this objection, due to Carter and Pritchard and Wang, and propose a different response on behalf of proponents of cognitive enhancement that is shown to be more promising.


Subject(s)
Achievement , Cognition , Humans
7.
Vet Sci ; 9(8)2022 Aug 12.
Article in English | MEDLINE | ID: mdl-36006341

ABSTRACT

The objectives of this study were to determine if horses located near an outbreak of leptospirosis in alpacas had Leptospira titres indicative of a previous or current infection and, if so, to determine the magnitude in change of titres over time. Further, the objective was to determine if horses with high titre results were shedding Leptospira in their urine. Blood samples were collected from twelve horses located on or next to the farm with the outbreak in alpacas, on day zero and at four subsequent time points (two, four, six and nine weeks). The microscopic agglutination test was used to test sera for five serovars endemic in New Zealand: Ballum, Copenhageni, Hardjo, Pomona and Tarassovi. A reciprocal MAT titre cut-off of ≥1:100 was used to determine positive horses. Seven out of twelve horses (58%) were positive to at least one serovar during one of the time points. Two horses recorded titres of ≥1600, one for both Pomona and Copenhageni and the other for Hardjo, and these two horses were both PCR positive for Leptospira in their urine samples. For five out of seven horses, the titres either remained the same or changed by one dilution across the sampling time points. The study confirmed endemic exposure to five endemic Leptospira serovars in New Zealand in a group of horses located near a confirmed leptospirosis outbreak in alpacas.

8.
Nano Lett ; 22(15): 6313-6319, 2022 08 10.
Article in English | MEDLINE | ID: mdl-35877081

ABSTRACT

The electrochemical breakdown of a metal oxide film can directly affect the performance of functional electrochemical devices. However, revealing the structural insight into the breakdown sites is challenging because of heterogeneity: different breakdown sites are spatially distributed over the surface. Herein, we combine scanning electrochemical cell microscopy with identical-location microscopies to reveal the heterogeneity in the breakdown of NiO film on Ni in a site-by-site manner. Local critical breakdown potential varies by ∼500 mV, corresponding to an excess energy of 0.02-0.12 J/m2. Correlative composition imaging using time-of-flight secondary ion mass spectrometry shows Ni crystal grains with thinner NiO films are more resistant to breakdown. This high resistance is explained using classical nucleation theory, where the electrical energy is affected by the film thickness through the local interfacial capacitance. The correlative imaging approach overcomes the issue of heterogeneity, providing conclusive insight into the stability of the electrochemical interfaces.


Subject(s)
Nickel , Oxides , Corrosion , Nickel/chemistry
9.
Anal Chem ; 94(25): 9058-9064, 2022 06 28.
Article in English | MEDLINE | ID: mdl-35700400

ABSTRACT

Understanding the structure-activity relationship in electrochemical metal dissolution reactions is fundamentally important, from designing higher density batteries to mitigating corrosions. The kinetics of metal dissolution reaction is highly dependent on surface structures, including grain boundaries and local defects. However, directly probing the electrochemical activity at these sites is difficult because the conventional bulk electrochemistry measures an averaged kinetics, obscuring the structure-activity correlation. Herein, we report the colocalized mapping of an electrochemical metal dissolution reaction using Ag as a model system. The local dissolution kinetics is voltammetrically mapped via scanning electrochemical cell microscopy (SECCM), which is correlated with local structures obtained via colocalized electron backscattering diffraction (EBSD). Individual pits of ∼200 nm are formed, and their geometries suggest dissolution is fastest in the direction parallel to the {111} planes. Enhanced dissolution kinetics is observed at the high-angle grain boundaries but not at twin boundaries, which are attributed to the different binding energy of Ag atoms. Furthermore, the faster local dissolution correlates with the geometrically necessary dislocation density. The work demonstrates the importance of nanoscale local electrochemical mapping and colocalized microscopic measurement in obtaining the structure-activity relationship for electrochemical reactions at complex interfaces.


Subject(s)
Electric Power Supplies , Electrochemistry , Kinetics , Microscopy, Electrochemical, Scanning , Solubility
10.
J Immunol ; 209(1): 118-127, 2022 07 01.
Article in English | MEDLINE | ID: mdl-35750334

ABSTRACT

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines have demonstrated strong immunogenicity and protection against severe disease, concerns about the duration and breadth of these responses remain. In this study, we show that codelivery of plasmid-encoded adenosine deaminase-1 (pADA) with SARS-CoV-2 spike glycoprotein DNA enhances immune memory and durability in vivo. Coimmunized mice displayed increased spike-specific IgG of higher affinity and neutralizing capacity as compared with plasmid-encoded spike-only-immunized animals. Importantly, pADA significantly improved the longevity of these enhanced responses in vivo. This coincided with durable increases in frequencies of plasmablasts, receptor-binding domain-specific memory B cells, and SARS-CoV-2-specific T follicular helper cells. Increased spike-specific T cell polyfunctionality was also observed. Notably, animals coimmunized with pADA had significantly reduced viral loads compared with their nonadjuvanted counterparts in a SARS-CoV-2 infection model. These data suggest that pADA enhances immune memory and durability and supports further translational studies.


Subject(s)
COVID-19 , Viral Vaccines , Adenosine Deaminase/genetics , Adjuvants, Immunologic , Animals , Antibodies, Neutralizing , Antibodies, Viral , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Mice , SARS-CoV-2
11.
Int J Popul Data Sci ; 7(1): 1718, 2022.
Article in English | MEDLINE | ID: mdl-35520099

ABSTRACT

Introduction: Administrative data are a valuable research resource, but are under-utilised in the UK due to governance, technical and other barriers (e.g., the time and effort taken to gain secure data access). In recent years, there has been considerable government investment in making administrative data "research-ready", but there is no definition of what this term means. A common understanding of what constitutes research-ready administrative data is needed to establish clear principles and frameworks for their development and the realisation of their full research potential. Objective: To define the characteristics of research-ready administrative data based on a systematic review and synthesis of existing literature. Methods: On 29th June 2021, we systematically searched seven electronic databases for (1) peer-reviewed literature (2) related to research-ready administrative data (3) written in the English language. Following supplementary searches and snowball screening, we conducted a thematic analysis of the identified relevant literature. Results: Overall, we screened 2,375 records and identified 38 relevant studies published between 2012 and 2021. Most related to administrative data from the UK and US and particularly to health data. The term research-ready was used inconsistently in the literature and there was some conflation with the concept of data being ready for statistical analysis. From the thematic analysis, we identified five defining characteristics of research-ready administrative data: (a) accessible, (b) broad, (c) curated, (d) documented and (e) enhanced for research purposes. Conclusions: Our proposed characteristics of research-ready administrative data could act as a starting point to help data owners and researchers develop common principles and standards. In the more immediate term, the proposed characteristics are a useful framework for cataloguing existing research-ready administrative databases and relevant resources that can support their development.


Subject(s)
Government , Publications , Databases, Factual , Humans , Research Personnel
12.
Anal Biochem ; 647: 114692, 2022 06 15.
Article in English | MEDLINE | ID: mdl-35461801

ABSTRACT

Despite the important role of membrane proteins in biological function and physiology, studying them remains challenging because of limited biomimetic systems for the protein to remain in its native membrane environment. Cryo electron microscopy (Cryo-EM) is emerging as a powerful tool for analyzing the structure of membrane proteins. However, Cryo-EM and other membrane protein analyses are better studied in a native lipid bilayer. Although traditional, mimetic systems have disadvantages that limit their use in the study of membrane proteins. As an alternative, styrene-maleic acid copolymers are used to form nanoparticles with POPC:POPG lipids. Traditional characterization of these styrene maleic acid lipid nanoparticles (SMALPs) includes dynamic light scattering (DLS), electron paramagnetic resonance (EPR), nuclear magnetic resonance (NMR), and transmission electron microscopy (TEM). In this study a new method was developed that utilizes SMALPs using a styrene-maleic acid copolymer (SMA) thin film on a TEM grid, acting as a substrate. By directly adding POPC:POPG lipid vesicles to the SMA coated grid SMALPs can be formed, visualized, and characterized by TEM without the need to make them in solution prior to imaging. We envision these functionalized grids could aid in single particle specimen preparation, increasing the efficiency of structural biology and biophysical techniques such as Cryo-EM.


Subject(s)
Maleates , Nanoparticles , Liposomes , Maleates/chemistry , Membrane Proteins/chemistry , Nanoparticles/chemistry
13.
Med Health Care Philos ; 25(2): 281-288, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35471685

ABSTRACT

In work on the ethics of cognitive enhancement use, there is a pervasive concern that such enhancement will-in some way-make us less authentic (e.g., Bublitz and Merkel 2009; Juth 2011). Attempts to clarify what this concern amounts to and how to respond to it often lead to debates on the nature of the "true self" (e.g., Maslen et al. 2014) and what constitutes "genuine human activity" (e.g., Kass 2003). This paper shows that a new and effective way to make progress on whether certain cases of cognitive enhancement problematically undermine authenticity is to make use of considerations from the separate debate on the nature of authentic emotion. Drawing in particular on Wasserman and Liao (2008), the present paper offers new conditions that can help us assess the impact of cognitive enhancements on authenticity.


Subject(s)
Cognition , Emotions , Humans
14.
J Vet Pharmacol Ther ; 45(3): 283-290, 2022 May.
Article in English | MEDLINE | ID: mdl-35170771

ABSTRACT

The study objective was to determine the disposition of gamithromycin in plasma, peripheral blood polymorphonuclear cells (PMNs), pulmonary epithelial lining fluid (PELF), and bronchoalveolar lavage (BAL) cells in alpacas. A single subcutaneous injection of gamithromycin (6.6 mg/kg) was administered to six healthy adult alpacas. At various time points after administration, gamithromycin concentrations were analyzed via LC-MS/MS in plasma, PMNs, PELF, and BAL cells until Day 14 post-injection. Plasma gamithromycin concentrations were measured in all six alpacas; the remaining three body compartments were analyzed in four alpacas. Gamithromycin rapidly concentrated in blood PMNs, BAL cells, and PELF. Shorter Tmax , and lower Cmax, and AUC were observed in plasma than in the other three compartments. Cmax was highest in BAL cells (26001.80 ± 12400.00 ng/ml) and PMNs (2573.00 ± 963.30 ng/ml) compared to PELF (660.80 ± 413.70 ng/ml) and plasma (452.30 ± 196.20 ng/ml). Mean terminal half-lives were 72.60 ± 14.10 h in plasma, 56.60 ± 10.60 h in PELF, 62.80 ± 85.30 h in PMNs, and 93.60 ± 124.80 h in BAL cells. No injection site reactions occurred. One alpaca developed colic but no other adverse reactions were noted. Overall, gamithromycin was highly concentrated in white blood cells and pulmonary fluids/cells. Clinical utilization of gamithromycin in alpacas should be done with caution until further investigation of potential for colic.


Subject(s)
Camelids, New World , Colic , Animals , Anti-Bacterial Agents/pharmacokinetics , Chromatography, Liquid/veterinary , Colic/veterinary , Macrolides , Tandem Mass Spectrometry/veterinary
15.
PLoS Pathog ; 18(1): e1009903, 2022 01.
Article in English | MEDLINE | ID: mdl-35061851

ABSTRACT

It has been estimated that more than 390 million people are infected with Dengue virus every year; around 96 millions of these infections result in clinical pathologies. To date, there is only one licensed viral vector-based Dengue virus vaccine CYD-TDV approved for use in dengue endemic areas. While initially approved for administration independent of serostatus, the current guidance only recommends the use of this vaccine for seropositive individuals. Therefore, there is a critical need for investigating the influence of Dengue virus serostatus and immunological mechanisms that influence vaccine outcome. Here, we provide comprehensive evaluation of sero-status and host immune factors that correlate with robust immune responses to a Dengue virus vector based tetravalent vaccine (TV003) in a Phase II clinical cohort of human participants. We observed that sero-positive individuals demonstrate a much stronger immune response to the TV003 vaccine. Our multi-layered immune profiling revealed that sero-positive subjects have increased baseline/pre-vaccination frequencies of circulating T follicular helper (cTfh) cells and the Tfh related chemokine CXCL13/BLC. Importantly, this baseline/pre-vaccination cTfh profile correlated with the vaccinees' ability to launch neutralizing antibody response against all four sero-types of Dengue virus, an important endpoint for Dengue vaccine clinical trials. Overall, we provide novel insights into the favorable cTfh related immune status that persists in Dengue virus sero-positive individuals that correlate with their ability to mount robust vaccine specific immune responses. Such detailed interrogation of cTfh cell biology in the context of clinical vaccinology will help uncover mechanisms and targets for favorable immuno-modulatory agents.


Subject(s)
Antibodies, Viral/immunology , Dengue Vaccines/immunology , Immunogenicity, Vaccine/immunology , T Follicular Helper Cells/immunology , Antibodies, Neutralizing/immunology , Dengue/prevention & control , Female , Humans , Male , Vaccines, Combined/immunology
16.
Nat Cardiovasc Res ; 1(12): 1156-1173, 2022 Dec 07.
Article in English | MEDLINE | ID: mdl-37936984

ABSTRACT

Vascular endothelial (VE)-cadherin in endothelial adherens junctions is an essential component of the vascular barrier, critical for tissue homeostasis and implicated in diseases such as cancer and retinopathies. Inhibitors of Src cytoplasmic tyrosine kinase have been applied to suppress VE-cadherin tyrosine phosphorylation and prevent excessive leakage, edema and high interstitial pressure. Here we show that the Src-related Yes tyrosine kinase, rather than Src, is localized at endothelial cell (EC) junctions where it becomes activated in a flow-dependent manner. EC-specific Yes1 deletion suppresses VE-cadherin phosphorylation and arrests VE-cadherin at EC junctions. This is accompanied by loss of EC collective migration and exaggerated agonist-induced macromolecular leakage. Overexpression of Yes1 causes ectopic VE-cadherin phosphorylation, while vascular leakage is unaffected. In contrast, in EC-specific Src-deficiency, VE-cadherin internalization is maintained, and leakage is suppressed. In conclusion, Yes-mediated phosphorylation regulates constitutive VE-cadherin turnover, thereby maintaining endothelial junction plasticity and vascular integrity.

17.
J Vet Pharmacol Ther ; 45(1): 107-116, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34494277

ABSTRACT

This study aimed to evaluate pharmacokinetic profiles of morphine in goats following a single dose administered intravenously, intramuscularly, or subcutaneously at 0.1 mg/kg, 0.25 mg/kg, and 0.4 mg/kg. Study population included eight healthy adult goats in a randomized cross-over study. Serial plasma samples were collected and morphine was quantified using high-performance liquid chromatography/mass spectrometry. Data fit a two-compartment model following intravenous administration and a non-compartmental model following both intramuscular and subcutaneous administration. Plasma elimination half-life was 2.88 ± 1.13 h (0.1 mg/kg), 2.30 ± 0.49 h (0.25 mg/kg), and 2.67 ± 0.82 h (0.4 mg/kg) following IV morphine. Intramuscular Cmax values were 13.4 ± 2.77 ng/ml (0.1 mg/kg), 34 ± 11.50 ng/ml (0.25 mg/kg), and 68.9 ± 24.5 ng/ml (0.4 mg/kg). Intramuscular Tmax f(h) or IM dosing (in hrs) was 0.19 ± 0.14 (0.1 mg/kg), 0.24 ± 0.24 (0.25 mg/kg), and 0.21 ± 0.24 (0.4 mg/kg). Subcutaneous Cmax values were 9.88 ± 3.31 ng/ml (0.1 mg/kg), 28.5 ± 11.6 ng/ml (0.25 mg/kg), and 39.4 ± 14.3 ng/ml (0.4 mg/kg). Subcutaneous Tmax (h) values for SC dosing were 0.36 ± 0.21 (0.1 mg/kg), 0.31 ± 0.17 (0.25 mg/kg), and 0.4 ± 0.13 (0.4 mg/kg). Intramuscular bioavailability values were 153.77 ± 12.60% (0.4 mg/kg), 104.8 ± 25.12% (0.25 mg/kg), and 100.7 ± 29.57% (0.1 mg/kg). Subcutaneous bioavailability values were 130.58 ± 19.07% (0.4 mg/kg), 116.6 ± 27.03% (0.25 mg/kg), and 111.6 ± 23.24% (0.1 mg/kg). No adverse effects were observed. Assuming plasma concentration required to induce analgesia is 16 ± 9 ng/ml in goats, as demonstrated in humans, it is suggested to administer morphine intramuscularly at 0.4 mg/kg every 3-4 h or SC every 2-3 h. This is a speculative conclusion therefore further studies evaluating pharmacodynamics and plasma analgesic threshold in goats is recommended.


Subject(s)
Analgesia , Morphine , Animals , Administration, Intravenous/veterinary , Analgesia/veterinary , Area Under Curve , Biological Availability , Cross-Over Studies , Goats , Half-Life , Injections, Intramuscular/veterinary
18.
Kennedy Inst Ethics J ; 32(4): 329-357, 2022.
Article in English | MEDLINE | ID: mdl-38588215

ABSTRACT

An emerging line of research in bioethics questions whether enhanced love is less significant or valuable than otherwise, where "enhanced love" generally refers to cases where drugs (e.g., oxytocin, etc.) are relied on to maintain romantic relationships. Separate from these debates is a recent body of literature on the philosophy and psychology of "Virtual Reality (VR) dating," where romantic relationships are developed and sustained in a way that is mediated by VR. Interestingly, these discussions have proceeded largely independently from each other. This article considers whether and to what extent philosophical arguments leveled against the value of enhanced love in the pharmacological case extend to cases where loving relationships are technologically mediated via VR rather than pharmacologically mediated. It will be argued that, while some worries about the pharmacological case do not extend over in a way that will be particularly problematic for VR, two (of the four arguments considered) are more prima facie serious. I conclude by suggesting why even these stronger argument strategies are not insurmountable and, thus, that there is reason to be cautiously optimistic that VR-mediated love can largely withstand variations on the bioconservative critiques that target pharmacologically enhanced love.

19.
Clin Transl Immunology ; 10(10): e1350, 2021.
Article in English | MEDLINE | ID: mdl-34721846

ABSTRACT

OBJECTIVES: Thrombotic and microvascular complications are frequently seen in deceased COVID-19 patients. However, whether this is caused by direct viral infection of the endothelium or inflammation-induced endothelial activation remains highly contentious. METHODS: Here, we use patient autopsy samples, primary human endothelial cells and an in vitro model of the pulmonary epithelial-endothelial cell barrier. RESULTS: We show that primary human endothelial cells express very low levels of the SARS-CoV-2 receptor ACE2 and the protease TMPRSS2, which blocks their capacity for productive viral infection, and limits their capacity to produce infectious virus. Accordingly, endothelial cells can only be infected when they overexpress ACE2, or are exposed to very high concentrations of SARS-CoV-2. We also show that SARS-CoV-2 does not infect endothelial cells in 3D vessels under flow conditions. We further demonstrate that in a co-culture model endothelial cells are not infected with SARS-CoV-2. Endothelial cells do however sense and respond to infection in the adjacent epithelial cells, increasing ICAM-1 expression and releasing pro-inflammatory cytokines. CONCLUSIONS: Taken together, these data suggest that in vivo, endothelial cells are unlikely to be infected with SARS-CoV-2 and that infection may only occur if the adjacent pulmonary epithelium is denuded (basolateral infection) or a high viral load is present in the blood (apical infection). In such a scenario, whilst SARS-CoV-2 infection of the endothelium can occur, it does not contribute to viral amplification. However, endothelial cells may still play a key role in SARS-CoV-2 pathogenesis by sensing adjacent infection and mounting a pro-inflammatory response to SARS-CoV-2.

20.
J Med Case Rep ; 15(1): 542, 2021 Oct 27.
Article in English | MEDLINE | ID: mdl-34706762

ABSTRACT

BACKGROUND: Neuroendocrine tumors are rare, heterogeneous neoplasms that produce a wide variety of clinical symptoms. Diarrhea in neuroendocrine tumors is incredibly common and is usually benign in nature. We report two extreme cases of diarrhea in metastatic neuroendocrine tumors that threatened fatality and provide evidence for steroids as a novel agent in the management of vasoactive intestinal peptide tumors. CASE PRESENTATION: A 63-year-old Caucasian male with a grade 2 (Ki-67 17%) metastatic small bowel neuroendocrine tumor, and a 43-year-old female with a grade 2 (Ki-67 5%) metastatic pancreatic vasoactive intestinal peptide tumor. Both patients suffered life-threatening diarrhea despite extensive treatment modalities, including new systemic agents. This case explains how a lack of compliance and patient under-reporting of symptoms contributed to their challenging clinical course. Only steroids had a significant sustained effect on the diarrhea of the patient with vasoactive intestinal peptide tumor. CONCLUSIONS: This report discusses two rare cases of life-threatening diarrhea in neuroendocrine tumors and stresses the importance of accurate clinical history taking, patient education, and compliance for symptom control. The report suggests steroids as a potential novel pharmaceutical option in the management of vasoactive intestinal peptide tumors; this is of great significance as it may provide a new approach to their management and potentially act as a life-saving agent in other oncology patients.


Subject(s)
Neuroendocrine Tumors , Pancreatic Neoplasms , Adult , Diarrhea/drug therapy , Diarrhea/etiology , Female , Humans , Male , Middle Aged , Neuroendocrine Tumors/complications , Neuroendocrine Tumors/diagnosis , Neuroendocrine Tumors/drug therapy , Pancreas , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/drug therapy , Vasoactive Intestinal Peptide
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