RESUMEN
Liver fibrosis is one of the common complications of transient myeloproliferative disorder (TMD) in Down syndrome (DS), but the exact molecular pathogenesis is largely unknown. We herein report a neonate of DS with liver fibrosis associated with TMD, in which we performed the serial profibrogenic cytokines analyses. We found the active monocyte chemoattractant protein-1 expression in the affected liver tissue and also found that both serum and urinary monocyte chemoattractant protein-1 concentrations are noninvasive biomarkers of liver fibrosis. We also showed a prospective of the future anticytokine therapy with herbal medicine for the liver fibrosis associated with TMD in DS.
Asunto(s)
Quimiocina CCL2/análisis , Síndrome de Down/complicaciones , Reacción Leucemoide/complicaciones , Cirrosis Hepática/diagnóstico , Biomarcadores , Citocinas/análisis , Diagnóstico Diferencial , Humanos , Recién Nacido , Hígado/química , Hígado/patología , Cirrosis Hepática/etiologíaRESUMEN
PURPOSE: We retrospectively evaluated the imaging spectrum of Pelizaeus-Merzbacher disease (PMD) in correlation with the clinical course and genetic abnormality. METHODS: We collected the magnetic resonance imaging (MRI) findings of 19 genetically proven PMD patients (all males, aged 0-29years old) using our integrated web-based MRI data collection system from 14 hospitals. The patterns of hypomyelination were determined mainly by the signals of the cerebrum, corticospinal tract, and brainstem on T2-weighted images (T2WI). We assessed the degree of myelination age on T1-weighted images (T1WI) and T2WI independently, and we evaluated cerebellar and callosal atrophy. The clinical severity and genetic abnormalities (causal mutations of the proteolipid protein gene PLP1) were analyzed together with the imaging findings. RESULTS: The clinical stage tended to be more severe when the whole brainstem, or corticospinal tract in the internal capsule showed abnormally high intensity on T2WI. Diffuse T2-high signal of brainstem was observed only in the patients with PLP1 point mutation. Myelination age "before birth" on T1WI is a second manifestation correlated with the clinically severe phenotypes. On the other hand, eight patients whose myelination ages were > 4months on T1WI were associated with mild clinical phenotypes. Four of them showed almost complete myelination on T1WI with a discrepancy in myelination age between T1WI and T2WI. A random and patchy pattern of myelination on T2WI was noted in one patient with PLP1 point mutation. Advanced myelination was observed in three of the seven followed-up patients. Four patients had atrophy of the cerebellum, and 17 patients had atrophy of the corpus callosum. CONCLUSION: Our multicenter study has demonstrated a wide variety of imaging findings of PMD. Signal intensity of brainstem and corticospinal tract of internal capsule would be the points to presume clinical severity in PMD patients. The spectrum of MRI findings should be kept in mind to diagnose PMD and to differentiate from other demyelinating leukodystrophies.
Asunto(s)
Encéfalo/diagnóstico por imagen , Imagen por Resonancia Magnética , Enfermedad de Pelizaeus-Merzbacher/diagnóstico por imagen , Adolescente , Adulto , Niño , Preescolar , Progresión de la Enfermedad , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Masculino , Mutación , Proteína Proteolipídica de la Mielina/genética , Enfermedad de Pelizaeus-Merzbacher/genética , Enfermedad de Pelizaeus-Merzbacher/fisiopatología , Fenotipo , Tractos Piramidales/diagnóstico por imagen , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
Toriello-Carey syndrome is rare condition characterized by agenesis of the corpus callosum, the Pierre Robin sequence, and facial anomalies such as telecanthus, short palpebral fissures, and a small nose with anteverted nares [Toriello and Carey, 1988]. In addition, tracheal and laryngeal anomalies are common complications in patients with Toriello-Carey syndrome, and these anomalies can lead to death [Kataoka et al., 2003]. Congenital tracheal stenosis is a life-threatening condition with high mortality. Even if surgery is successful, several serious complications can result in a high risk of mortality. We describe a case of a Japanese boy with Toriello-Carey syndrome who had severe congenital tracheal stenosis, in whom surgical tracheal plasty was avoided because of adequate respiratory care, allowing the patient to be alive at 18 months of age.
Asunto(s)
Agenesia del Cuerpo Calloso/diagnóstico , Constricción Patológica/diagnóstico , Anomalías Craneofaciales/diagnóstico , Cardiopatías Congénitas/diagnóstico , Deformidades Congénitas de las Extremidades/diagnóstico , Síndrome de Pierre Robin/diagnóstico , Tráquea/anomalías , Anomalías Urogenitales/diagnóstico , Encéfalo/patología , Facies , Humanos , Lactante , Recién Nacido , Imagen por Resonancia Magnética , Masculino , Fenotipo , Síndrome , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Since antigen-specific IgE and eosinophils are major inducing factors of allergic inflammation of the airways, both factors are therapeutic targets of asthma. We investigated the effects of ONO-4007, a nontoxic lipid A analogue, on antigen-specific antibody response and the recruitment of eosinophils into airways in murine systems. METHODS: BALB/c mice were injected ONO-4007 intraperitoneally during sensitization with ovalbumin (OVA) and aluminium hydroxide to determine its effects on the antigen-specific antibody response. ONO-4007 was also injected intravenously during either systemic sensitization and inhalation with OVA, or sensitization or inhalation alone to determine its effects on antigen-induced airway inflammation. In vitro effects of ONO-4007 on the functional differentiation of naive CD4+ T cells were investigated by culturing naive CD4+ T cells derived from DO11.10 mice and OVA-pulsed dendritic cells (CDCs) with ONO-4007. RESULTS: ONO-4007 inhibited antigen-specific IgE and IgG1, but not IgG2a responses. ONO-4007 decreased the recruitment of eosinophils and the levels of IL-5 in bronchoalveolar lavage fluid, not only when it was injected during systemic sensitization and inhalation with OVA, but also during inhalation alone. ONO-4007 inhibited the differentiation of IL-4- and IL-13-producing CD4+ T cells in vitro, which was partly mediated by DCs. CONCLUSIONS: ONO-4007 inhibited antigen-specific IgE and IgG1 responses and antigen-induced eosinophil recruitment into the airways in BALB/c mice. These effects were mediated, at least partly, by the modulation of DCs, although there may also be other mechanisms.