RESUMEN
The muscle-relaxing 5-HT(2) receptor antagonist cyclobenzaprine is structurally closely related to amitriptyline. It is widely used to treat patients presenting with back pain and fibromyalgia. Very rarely cyclobenzaprine toxicity can result in extrapyramidal symptoms, but occurrence of torticollis has not been reported so far. We report on a patient presenting with torticollis and myoclonic movements after treatment with cyclobenzaprine, who was successfully treated with intravenous biperiden. This case might be additional evidence for the necessity of appropriate dosage in case of liver impairment. Secondly there are possibly consequences as regards the therapy of motor side effects.
Asunto(s)
Amitriptilina/análogos & derivados , Relajantes Musculares Centrales/efectos adversos , Tortícolis/inducido químicamente , Amitriptilina/efectos adversos , Amitriptilina/uso terapéutico , Biperideno/uso terapéutico , Humanos , Masculino , Antagonistas Muscarínicos/uso terapéutico , Relajantes Musculares Centrales/uso terapéutico , Mioclonía/inducido químicamente , Mioclonía/tratamiento farmacológico , Tortícolis/tratamiento farmacológico , Adulto JovenRESUMEN
Neonatal microglial cells respond to GM-CSF and M-CSF by acquiring different morphologies and phenotypes. To investigate the extent and consequences of this process, a global gene expression analysis was performed, with significant changes in transcript levels confirmed by biochemical analyses. Primary murine microglial cells underwent substantial expression reprogramming after treatment with GM-CSF or M-CSF with many differentially expressed transcripts important in innate and adaptive immunity. In particular, many gene products involved in Ag presentation were induced by GM-CSF, but not M-CSF, thus potentially priming relatively quiescent microglia cells for Ag presentation. This function of GM-CSF is distinct from its primary function in cell proliferation and survival.
Asunto(s)
Animales Recién Nacidos/genética , Animales Recién Nacidos/inmunología , Presentación de Antígeno/genética , Perfilación de la Expresión Génica , Factor Estimulante de Colonias de Granulocitos y Macrófagos/fisiología , Microglía/inmunología , Microglía/metabolismo , Animales , Biomarcadores/análisis , Catepsinas/biosíntesis , Catepsinas/genética , Células Cultivadas , Quimiocinas/biosíntesis , Quimiocinas/genética , Citocinas/biosíntesis , Citocinas/genética , Células Dendríticas/inmunología , Células Dendríticas/metabolismo , Perfilación de la Expresión Génica/métodos , Factor Estimulante de Colonias de Macrófagos/fisiología , Macrófagos/inmunología , Macrófagos/metabolismo , Metaloproteinasas de la Matriz/biosíntesis , Metaloproteinasas de la Matriz/genética , Ratones , Ratones Endogámicos , Análisis de Secuencia por Matrices de Oligonucleótidos , Fagocitosis/genética , Receptores de Quimiocina/biosíntesis , Receptores de Quimiocina/genética , Receptores de Citocinas/biosíntesis , Receptores de Citocinas/genética , Receptores Inmunológicos/biosíntesis , Receptores Inmunológicos/genéticaRESUMEN
Cultured mouse astrocytes respond to the CC chemokine RANTES by production of chemokine and cytokine transcripts. Stimulation of astrocytes with 1 nM RANTES or 3-10 nM of the structurally related chemokines (eotaxin, macrophage inflammatory protein-1alpha and -beta [MIP-1alpha, MIP-1beta]) induced transcripts for KC, monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-alpha), MIP-1alpha, MIP-2, and RANTES in a chemokine and cell-specific fashion. Synthesis of chemokine (KC and MCP-1) and cytokine (TNF-alpha) proteins was also demonstrated. RANTES-mediated chemokine synthesis was specifically inhibited by pertussis toxin, indicating that G-protein-coupled chemokine receptors participated in astrocyte signaling. Astrocytes expressed CCR1 and CCR5 (the redundant RANTES receptors). Astrocytes derived from mice with targeted mutations of either CCR1 or CCR5 respond after RANTES stimulation, suggesting multiple chemokine receptors may separately mediate RANTES responsiveness in astrocytes. Preliminary data suggest activation of the MAP kinase pathway is also critical for RANTES-mediated signaling in astrocytes. Treatment with RANTES specifically modulated astrocyte receptors upregulating intercellular adhesion molecule 1 (ICAM-1) and downregulating CX3CR1 expression. Thus, after chemokine treatment, astrocytes release proinflammatory mediators and reprogram their surface molecules. The combined effects of RANTES may serve to amplify inflammatory responses within the central nervous system.