RESUMEN
Integrated forest management (IFM) can help reconcile critical trade-offs between goals in forest management, such as nature conservation and biomass production. The challenge of IFM is dealing with these trade-offs at the level of practical forest management, such as striving for compromises between biomass extraction and habitat retention. This paper reviews some of the driving factors that influence the integration of nature conservation into forest management. The review was conducted in three steps - a literature review, an expert workshop and an expert-based cooperative analysis. Of 38 driving factors identified, three were prioritised by more of the participants than any of the others: two are socio-cultural factors, identity (how people identify with forest) as well as outreach and education, and one is economic - competitiveness in forest value chains. These driving factors correspond to what are considered in the literature as enablers for IFM. The results reveal that targeted, group-oriented, adaptive and innovative policy designs are needed to integrate nature conservation into forest management. Further, the results reveal that a "one-size-fits-all" governance approach would be ineffective, implying that policy instruments need to consider contextually specific driving factors. Understanding the main driving factors and their overall directions can help to better manage trade-offs between biodiversity conservation and biomass production in European forests.
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Agricultura Forestal , Madera , Biodiversidad , Conservación de los Recursos Naturales , Europa (Continente) , Bosques , ÁrbolesRESUMEN
AIM: Over the last decades, the shift in age distribution towards older ages and the progressive ageing which has occurred in most populations have been paralleled by a global epidemic of obesity and its related metabolic disorders, primarily, type 2 diabetes (T2D). Dysfunction of the adipose tissue (AT) is widely recognized as a significant hallmark of the ageing process that, in turn, results in systemic metabolic alterations. These include insulin resistance, accumulation of ectopic lipids and chronic inflammation, which are responsible for an elevated risk of obesity and T2D onset associated to ageing. On the other hand, obesity and T2D, the paradigms of AT dysfunction, share many physiological characteristics with the ageing process, such as an increased burden of senescent cells and epigenetic alterations. Thus, these chronic metabolic disorders may represent a state of accelerated ageing. MATERIALS AND METHODS: A more precise explanation of the fundamental ageing mechanisms that occur in AT and a deeper understanding of their role in the interplay between accelerated ageing and AT dysfunction can be a fundamental leap towards novel therapies that address the causes, not just the symptoms, of obesity and T2D, utilizing strategies that target either senescent cells or DNA methylation. RESULTS: In this review, we summarize the current knowledge of the pathways that lead to AT dysfunction in the chronological ageing process as well as the pathophysiology of obesity and T2D, emphasizing the critical role of cellular senescence and DNA methylation. CONCLUSION: Finally, we highlight the need for further research focused on targeting these mechanisms.
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Tejido Adiposo/fisiopatología , Envejecimiento/fisiología , Enfermedades Metabólicas , Tejido Adiposo/metabolismo , Tejido Adiposo/patología , Anciano , Anciano de 80 o más Años , Envejecimiento/genética , Envejecimiento/patología , Senescencia Celular/genética , Enfermedad Crónica , Metilación de ADN/fisiología , Humanos , Enfermedades Metabólicas/etiología , Enfermedades Metabólicas/genética , Enfermedades Metabólicas/metabolismo , Enfermedades Metabólicas/patología , Persona de Mediana Edad , Transducción de Señal/genética , Transducción de Señal/fisiologíaRESUMEN
Type 2 diabetes (T2D) and obesity are the major public health problems. Substantial efforts have been made to define loci and variants contributing to the individual risk of these disorders. However, the overall risk explained by genetic variation is very modest. Epigenetics is one of the fastest growing research areas in biomedicine as changes in the epigenome are involved in many biological processes, impact on the risk for several complex diseases including diabetes and may explain susceptibility. In this review, we focus on the role of DNA methylation in contributing to the risk of T2D and obesity.
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Diabetes Mellitus Tipo 2/genética , Epigénesis Genética/genética , Obesidad/genética , HumanosRESUMEN
BACKGROUND/OBJECTIVES: The genomic bases of the adipose tissue abnormalities induced by chronic positive calorie excess have been only partially elucidated. We adopted a genome-wide approach to directly test whether long-term high-fat diet (HFD) exposure affects the DNA methylation profile of the mouse adipose tissue and to identify the functional consequences of these changes. SUBJECTS/METHODS: We have used epididymal fat of mice fed either high-fat (HFD) or regular chow (STD) diet for 5 months and performed genome-wide DNA methylation analyses by methylated DNA immunoprecipitation sequencing (MeDIP-seq). Mouse Homeobox (Hox) Gene DNA Methylation PCR, RT-qPCR and bisulphite sequencing analyses were then performed. RESULTS: Mice fed the HFD progressively expanded their adipose mass accompanied by a significant decrease in glucose tolerance (P<0.001) and insulin sensitivity (P<0.05). MeDIP-seq data analysis revealed a uniform distribution of differentially methylated regions (DMR) through the entire adipocyte genome, with a higher number of hypermethylated regions in HFD mice (P<0.005). This different methylation profile was accompanied by increased expression of the Dnmt3a DNA methyltransferase (Dnmt; P<0.05) and the methyl-CpG-binding domain protein Mbd3 (P<0.05) genes in HFD mice. Gene ontology analysis revealed that, in the HFD-treated mice, the Hox family of development genes was highly enriched in differentially methylated genes (P=0.008). To validate this finding, Hoxa5, which is implicated in fat tissue differentiation and remodeling, has been selected and analyzed by bisulphite sequencing, confirming hypermethylation in the adipose tissue from the HFD mice. Hoxa5 hypermethylation was associated with downregulation of Hoxa5 mRNA and protein expression. Feeding animals previously exposed to the HFD with a standard chow diet for two further months improved the metabolic phenotype of the animals, accompanied by return of Hoxa5 methylation and expression levels (P<0.05) to values similar to those of the control mice maintained under standard chow. CONCLUSIONS: HFD induces adipose tissue abnormalities accompanied by epigenetic changes at the Hoxa5 adipose tissue remodeling gene.
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Tejido Adiposo/metabolismo , Metilación de ADN , Dieta Alta en Grasa , Regulación hacia Abajo , Proteínas de Homeodominio/genética , Fosfoproteínas/genética , Transcripción Genética , Animales , Modelos Animales de Enfermedad , Epigénesis Genética , Inmunohistoquímica , Masculino , Ratones , Ratones Endogámicos C57BL , Obesidad/genética , Factores de TranscripciónRESUMEN
The pathogenesis of infant acute lymphoblastic leukemia (ALL) is still not well defined. Short latency to leukemia and very high concordance rate for ALL in Mixed-Lineage Leukemia (MLL)-positive infant twins suggest that the MLL rearrangement itself could be sufficient for overt leukemia. Attempts to generate a suitable mouse model for MLL-AF4-positive ALL did not thoroughly resolve the issue of whether cooperating mutations are required to reduce latency and to generate overt leukemia in vivo. In this study, we applied single-nucleotide polymorphism array technology to perform genomic profiling of 28 infant ALL cases carrying t(4;11) to detect MLL-cooperating aberrations hidden to conventional techniques and to gain new insights into infant ALL pathogenesis. In contrast to pediatric, adolescent and adult ALL cases, the MLL rearrangement in infant ALL is associated with an exceptionally low frequency of copy-number abnormalities, thus confirming the unique nature of this disease. By contrast, additional genetic aberrations are acquired at disease relapse. Small-segmental uniparental disomy traits were frequently detected, mostly constitutional, and widely distributed throughout the genome. It can be argued that the MLL rearrangement as a first hit, rather than inducing the acquisition of additional genetic lesions, has a major role to drive and hasten the onset of leukemia.
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Cromosomas Humanos Par 11 , Cromosomas Humanos Par 4 , Dosificación de Gen , Proteína de la Leucemia Mieloide-Linfoide/genética , Proteínas de Fusión Oncogénica/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Translocación Genética , Femenino , Humanos , Lactante , Masculino , Polimorfismo de Nucleótido SimpleRESUMEN
AIM: The aim of the present study was to investigate if there are differences in salivary hormonal responses to resistance exercise between long-term strength-trained and untrained men. METHODS: Twenty-eight subjects were recruited to this study, matched into a strength-trained group (SG, N=13) and an untrained group (UG, N=15). Upper and lower body absolute muscle strength was measured through the one-repetition maximum (1-RM) test. Saliva samples were collected at rest and after a resistance exercise protocol (REP) with intensity relative to 1-RM values. With these samples, testosterone (TES), dehydroepiandrosterone (DHEA) and cortisol (COR) were determined. RESULTS: SG subjects demonstrated significantly higher values in all muscle strength variables. While a significant increase in TES after REP was found in the SG (0.114 + or - 0.1 vs. 0.15 + or - 0.09 pg/mL, P<0.05), no differences were observed in the UG (0.144 + or - 0.1 vs. 0.17 + or - 0.1 pg/mL). In both groups, there were increases in salivary COR (SG: 1.4 + or - 0.6 vs. 2.06 + or - 1; UG: 1.5 + or - 0.8 vs. 2.3 + or - 1.2 ug/dL, P<0.05) and DHEA (SG: 0.6 + or - 0.3 vs. 0.9 + or - 0.6; UG: 0.65 + or - 0.3 vs. 0.97 + or - 0.7 ng/dL, P<0.05). CONCLUSIONS: These results suggest the possible presence of adaptation of TES responses to resistance exercise in long-term strength-trained men, with these subjects presenting higher responses to the same stimulus, compared with untrained subjects, while no such adaptation was seen at the adrenocortical level in these subjects as the responses observed were similar in both groups.
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Biomarcadores/análisis , Hormonas/análisis , Entrenamiento de Fuerza/métodos , Saliva/química , Adaptación Fisiológica , Adulto , Análisis de Varianza , Composición Corporal , Deshidroepiandrosterona/análisis , Humanos , Hidrocortisona/análisis , Masculino , Fuerza Muscular/fisiología , Estadísticas no Paramétricas , Testosterona/análisisRESUMEN
Multidrug-resistant isolates of a clonal lineage of Pseudomonas aeruginosa producing the VIM-2 metallo-beta-lactamase (MBL), involved in a large outbreak in an Italian hospital, were compared with MBL-negative strains that had caused outbreaks in two French hospitals. Although the isolates had different carbapenem MICs, the VIM-2-producing isolates from Italy carried identical, or very similar, allelic forms of the oprD gene, harboured a common class 1 integron, belonged to the same multilocus sequence type (ST111), and showed macrorestriction profiles that were related to those of the MBL-negative French strains. These results support the concept of independent acquisition of resistance determinants by members of a widespread clonal lineage of P. aeruginosa.
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Carbapenémicos/farmacología , Farmacorresistencia Bacteriana/genética , Pseudomonas aeruginosa/efectos de los fármacos , Pseudomonas aeruginosa/genética , Dermatoglifia del ADN , ADN Bacteriano/química , ADN Bacteriano/genética , Brotes de Enfermedades , Francia/epidemiología , Humanos , Integrones , Italia/epidemiología , Pruebas de Sensibilidad Microbiana , Epidemiología Molecular , Datos de Secuencia Molecular , Polimorfismo de Longitud del Fragmento de Restricción , Porinas/genética , Infecciones por Pseudomonas/epidemiología , Infecciones por Pseudomonas/microbiología , Pseudomonas aeruginosa/clasificación , Pseudomonas aeruginosa/aislamiento & purificación , Análisis de Secuencia de ADN , beta-Lactamasas/análisisRESUMEN
Na evolução eritropoética, os reticulócitos representam a hemácia mais imatura do sangue circulante. A diminuição de hemoglobina, contida nas hemácias, chama-se anemia e é causada principalmente pelo déficit de ferro. Objetivou-se fazer uma análise do comportamento dos valores de hemoglobina e da contagem de reticulócitos, antes e após a suplementação dietética. Trabalhouse com crianças anêmicas, com idade entre 1 e 13 anos, num grupo inicial de 125 crianças, pertencentes às creches Mãezinha do Céu, Obra Santa Marta e do Centro de Atendimento à Família Erechinense (CAFE). O aporte férrico fornecido contém leite enriquecido com ferro aminoácido quelato, na quantidade 15mg/dia, adicionados a 500ml de leite, com duração de 2 meses, sem interrupções O presente trabalho indicou, através do hemograma, um total de 53 crianças anêmicas. Destas, 43 fizeram ambas as coletas, caracterizando,portanto, o grupo de estudo (n). Ao final deste período, procedeu-se a novos hemogramas, com acompanhamento médico.Obteve-se após a intervenção, um incremento nos resultados dos parâmetros analisados. Percebeu-se que o metal utilizado, juntamente com o veículo empregado, foi efetivo para a melhora nos níveis de hemoglobina e hamatócrito. Observou-se, também, uma melhora nos valores reticulocitários analisados, tanto quanto da hemoglobina.
In the eritropoetic evolution the reticulocytes represent the most immature blood circulating red cell. The diminishing of the hemoglobin contained in the red cell is called anemia and is cause by the iron deficit. The experiment aimed to analyse the hemoglobin values and reticulocytes number before the dietetic supplementation. The subjects were 125 anemic children from 1 to 13 years old of the Mãezinha do Céu and Obra Santa Marta nurseries belonged to the Centro de Atendimento à Familia Erechinense (CAFE). The iron quantity supplied containes enriched milk with quelato mino cid iron in an amount of mg a day added to ml of milk during two months with no interruption. The experiment results indicated, based on the hemograma, a total of 53 anemic children.43 out of them, the study group, did the two blood harvesting. Later on this new hemograms were made supported by medical aid. Results showed that the iron used together with the enriched milk were effective in the anemia improvement levels. Improvement related to the analysed reticulocitary values as the hemoglobin, was notice.
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Humanos , Lactante , Preescolar , Niño , Adolescente , Anemia Ferropénica , Suplementos Dietéticos , Recuento de Reticulocitos , ReticulocitosRESUMEN
A wastewater tertiary treatment system based on membrane ultrafiltration and fed with secondary-treated municipal wastewater was evaluated for its Giardia cyst and Cryptosporidium oocyst removal efficiency. Giardia duodenalis (assemblages A and B) and Cryptosporidium parvum were identified in feed water but were found in filtered water only during occasional failure of the filtration system.
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Cryptosporidium/aislamiento & purificación , Agua Dulce/parasitología , Giardia/aislamiento & purificación , Ultrafiltración , Purificación del Agua/métodos , Agricultura , Animales , Ciudades , Cryptosporidium/crecimiento & desarrollo , Giardia/crecimiento & desarrollo , Membranas Artificiales , Filtros Microporos , Oocistos/crecimiento & desarrollo , Ultrafiltración/instrumentación , Ultrafiltración/métodos , Eliminación de Residuos Líquidos/métodosRESUMEN
Single nucleotide polymorphisms (SNPs) are often determined using TaqMan real-time PCR assays (Applied Biosystems) and commercial software that assigns genotypes based on reporter probe signals at the end of amplification. Limitations to the large-scale application of this approach include the need for positive controls or operator intervention to set signal thresholds when one allele is rare. In the interest of optimizing real-time PCR genotyping, we developed an algorithm for automatic genotype calling based on the full course of real-time PCR data. Best cycle genotyping algorithm (BCGA), written in the open source language R, is based on the assumptions that classification depends on the time (cycle) of amplification and that it is possible to identify a best discriminating cycle for each SNP assay. The algorithm is unique in that it classifies samples according to the behavior of blanks (no DNA samples), which cluster with heterozygous samples. This method of classification eliminates the need for positive controls and permits accurate genotyping even in the absence of a genotype class, for example when one allele is rare. Here, we describe the algorithm and test its validity, compared to the standard end-point method and to DNA sequencing.
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Algoritmos , Reacción en Cadena de la Polimerasa/métodos , Polimorfismo de Nucleótido Simple , Genotipo , HumanosRESUMEN
The purpose of this study was to evaluate the prevalence of intestinal parasites in 277 healthy subjects in the city of Mamuras (Albania, South Eastern Europe) and the correlation between parasitic infections and possible risk factors. Faecal samples collected with sodium-acetate-formalin fixative were concentrated by formalin ethylacetate sedimentation and examined as wet mounts, permanent stains and by anti-Giardia/Cryptosporidium fluorescent antibodies. Data concerning age, sex, level of education, availability of piped water, number of people living in the same house, and residence in rural or urban area were collected for each subject. Statistical analysis was performed by chi-square test and regression logistic analysis. The overall prevalence of intestinal parasites was 183/277 (66.06%). In particular, pathogenic protozoa or helminths were found in 67 subjects (24.18%), including Trichuris trichiura in 34 (12.27%), Giardia duodenalis in 31 (11.19%), Hymenolepis nana in 5 (1.8%), Ascaris lumbricoides in 3 (1.08%). A significant correlation was observed only between parasite colonization and older age and between Trichuris trichiura infection and residence in rural areas.
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Ingestión de Líquidos , Heces/parasitología , Parasitosis Intestinales/parasitología , Microbiología del Agua , Adolescente , Adulto , Anciano , Albania , Animales , Niño , Preescolar , Femenino , Humanos , Lactante , Parasitosis Intestinales/epidemiología , Masculino , Persona de Mediana Edad , Población RuralRESUMEN
An rK39 immunochromatographic test and immunofluorescent-antibody test (IFAT) for serodiagnosis of canine leishmaniasis were evaluated. The two tests showed correlation for all but one of the sera obtained from 68 dogs confirmed as leishmaniasis cases and 40 dogs (22 healthy dogs and 18 dogs with other diseases) from areas where the disease is not endemic. Specificity was 100% for both tests, while sensitivity was 97% for the rapid test and 99% for IFAT.
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Enfermedades de los Perros/diagnóstico , Leishmaniasis/veterinaria , Animales , Cromatografía , Perros , Técnica del Anticuerpo Fluorescente , Reacción en Cadena de la Polimerasa , Sensibilidad y Especificidad , Pruebas SerológicasRESUMEN
Polymeric cytotoxic conjugates are being developed with the aim of preferential delivery of the anticancer agent to tumour. MAG-CPT comprises the topoisomerase I inhibitor camptothecin linked to a water-soluble polymeric backbone methacryloylglycynamide (average molecular weight 18 kDa, 10% CPT by weight). It was administered as a 30-min infusion once every 4 weeks to patients with advanced solid malignancies. The objectives of our study were to determine the maximum tolerated dose, dose-limiting toxicities, and the plasma and urine pharmacokinetics of MAG-CPT, and to document responses to this treatment. The starting dose was 30 mg m(-2) (dose expressed as mg equivalent camptothecin). In total, 23 patients received 47 courses at six dose levels, with a maximum dose of 240 mg m(-2). Dose-limiting toxicities were myelosuppression, neutropaenic sepsis, and diarrhoea. One patient died after cycle 1 MAG-CPT at the maximum dose. The maximum tolerated dose and dose recommended for further clinical study was 200 mg m(-2). The half-lives of both MAG-CPT and released CPT were prolonged (>6 days) and measurable levels of MAG-CPT were retrieved from plasma and urine 4 weeks after treatment. However, subsequent pharmacodynamic studies of this agent have led to its withdrawal from clinical development.
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Acrilamidas/farmacocinética , Camptotecina/análogos & derivados , Neoplasias/tratamiento farmacológico , Acrilamidas/administración & dosificación , Acrilamidas/efectos adversos , Adulto , Anciano , Antineoplásicos Fitogénicos/farmacocinética , Diarrea/inducido químicamente , Femenino , Humanos , Infusiones Intravenosas , Masculino , Dosis Máxima Tolerada , Persona de Mediana Edad , Neoplasias/metabolismo , Neutropenia/inducido químicamente , Sepsis/inducido químicamente , Trombocitopenia/inducido químicamenteRESUMEN
Chemokines exert their actions through G-proteinlinked receptors, which are expressed to variable extents by different cell types. In accordance with the chemokine classification, these receptors are designated as CXC, CC, XC, and CX(3)C, followed by R and a number. The purpose of this investigation was to evaluate CCR1 expression in human peripheral blood-derived macrophages and the human monocytic U-937 cell line. Cells in vitro were infected with live Leishmania infantum promastigotes (zymodeme MON1); cell lysates were then subjected to SDS-PAGE and immunoblotting, by using an anti-CCR1 affinity purified polyclonal antibody. The expression of the CCR1 gene was analyzed by RT-PCR, using specific human primers. The results of both immunoblotting and RT-PCR showed that CCR1 expression in Leishmania-infected cells was lower than in uninfected control cells. These results indicate that Leishmania infantum infection causes a down-regulation of the CCR1 gene and protein expression, suggesting that reduced phagocyte recruitment at the inflammation sites could favor parasite progression and the spread of Leishmania infection.
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Regulación de la Expresión Génica , Leishmania infantum/fisiología , Macrófagos/metabolismo , Macrófagos/parasitología , Receptores de Quimiocina/biosíntesis , Receptores de Quimiocina/genética , Animales , Western Blotting , Densitometría , Humanos , Receptores CCR1 , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Células U937RESUMEN
The case is described of mucocele of the right frontoethmoidal sinus with bilateral maxillary sinusitis and a large polyp in the right nasal cavity. The mucocele had determined erosion of the anterior and posterior walls of the frontal sinus and superomedial wall of the orbit. The patient was operated upon by a surgical team comprising ENT and maxillofacial specialists. Right maxillary sinusotomy (Caldwell-Luc procedure) was performed, and an osteoplastic flap was prepared, repositioned in the canine fossa and fixed with a titanium plate. Debris was removed from the left osteomeatal complex during endoscopy. To reach the mucocele, an external surgical approach was used, through a bitemporal coronal cutaneous incision, according to Unterberger. This approach was used in order to gain better access to the area of the lesion and in order to make reconstruction easier, with a view to achieving good functional results without untoward scarring. The scalp was detached down to the root of the nose to allow optimal visualisation of the anterior area of erosion determined by the mucocele, and, after excision and removal of the latter from the bony walls, of the posterior bony breach and underlying dura mater. Another bony breach involved the medial and superior walls of the orbit. The nasofrontal canal was obliterated with bone fragments and Tissucol; the posterior breach, with Surgical and Tissucol. The orbit wall was repaired with high-density porous polyethylene sheeting; the frontal sinus was filled with fat. The anterior wall of the frontal sinus was repaired with two split of calvarial bone grafts harvested from the parietal bone and fixed with a titanium microplate. The morphological outcome of reconstruction was satisfactory, with no recurrences, as confirmed at post-operative follow-up, including computed tomography scan, at 5 months. Ocular motility and patency of the tear drainage system were also normal. No diplopia, or inflammation occurred.
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Senos Etmoidales/cirugía , Seno Frontal/cirugía , Imagen por Resonancia Magnética/métodos , Mucocele/cirugía , Anciano , Endoscopía , Espacio Epidural , Senos Etmoidales/patología , Seno Frontal/patología , Humanos , Masculino , Mucocele/diagnóstico , Procedimientos de Cirugía Plástica/métodos , CráneoAsunto(s)
Infecciones por Protozoos/prevención & control , Infecciones por Protozoos/terapia , Criptosporidiosis/inmunología , Criptosporidiosis/prevención & control , Criptosporidiosis/terapia , Equinococosis/inmunología , Equinococosis/prevención & control , Equinococosis/terapia , Humanos , Inmunoterapia , Leishmaniasis/inmunología , Leishmaniasis/prevención & control , Leishmaniasis/terapia , Malaria/inmunología , Malaria/prevención & control , Malaria/terapia , Infecciones por Protozoos/inmunología , Esquistosomiasis/inmunología , Esquistosomiasis/prevención & control , Esquistosomiasis/terapia , Toxoplasmosis/inmunología , Toxoplasmosis/prevención & control , Toxoplasmosis/terapia , Triquinelosis/inmunología , Triquinelosis/prevención & control , Triquinelosis/terapia , Tripanosomiasis/inmunología , Tripanosomiasis/prevención & control , Tripanosomiasis/terapiaRESUMEN
Chemokines are a group of structurally defined small proteins that act as chemoattractants for leukocytes and are involved in many different biological activities, including leukocyte activation for antimicrobial mechanisms. We studied the effect of the chemokines monocyte chemotactic protein (MCP)-1 and macrophage inflammatory protein (MIP)-1 alpha on nitric oxide release and parasitocidal ability of peripheral blood-derived human macrophages in vitro infected with Leishmania infantum, zymodeme MON1. In infected human macrophages, treatment with MCP-1 or MIP-1 alpha significantly enhanced nitric oxide production and leishmanicidal ability, compared with untreated cells, to the same levels induced by interferon-gamma. Both nitric oxide release and parasitocidal ability of macrophages were significantly reduced by addition of L- N(G)monomethylarginine ( L-NMMA), which is a competitive inhibitor of the L-arginine nitric oxide pathway. These data suggest that MCP-1 and MIP-1 alpha mediate macrophage activation for nitric oxide release and subsequent parasite clearance, and thus may play a role in the containment of Leishmania infection.
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Quimiocina CCL2/farmacología , Leishmania infantum/inmunología , Proteínas Inflamatorias de Macrófagos/farmacología , Macrófagos/efectos de los fármacos , Macrófagos/parasitología , Óxido Nítrico/biosíntesis , Animales , Quimiocina CCL4 , Humanos , Técnicas In Vitro , Interferón gamma/farmacología , Leishmaniasis Visceral/inmunología , Activación de Macrófagos/efectos de los fármacos , Macrófagos/inmunología , Macrófagos/metabolismo , Proteínas Recombinantes/farmacologíaRESUMEN
An unusual presentation of leishmaniasis that occurred in an Italian immunocompetent woman is described. The patient had a long history of coagulopathy due to factor VIII deficiency and pain in the right lumbar region. Computed axial tomography demonstrated a cystic mass in the right adrenal gland. Histological examination of the surgically removed cyst showed the presence of histiocytes containing Leishmania amastigotes. Serodiagnosis for leishmaniasis performed through immunofluorescent antibody testing and the rK39 enzyme immunoassay was positive, whereas a bone marrow aspirate did not reveal any parasite. The patient was not treated for leishmaniasis and recovered well after surgery. Serological testing was still positive 2 years after surgery, but clinical follow-up did not reveal the signs typical of visceral leishmaniasis.
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Enfermedades de las Glándulas Suprarrenales/patología , Quistes/diagnóstico , Leishmaniasis Visceral/diagnóstico , Enfermedades de las Glándulas Suprarrenales/diagnóstico , Enfermedades de las Glándulas Suprarrenales/cirugía , Biopsia con Aguja , Quistes/patología , Quistes/cirugía , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Inmunocompetencia , Italia , Leishmaniasis Visceral/tratamiento farmacológico , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Polymeric drug conjugates are a new and experimental class of drug delivery systems with pharmacokinetic promises. The antineoplastic drug camptothecin was linked to a water-soluble polymeric backbone (MAG-CPT) and administrated as a 30 min infusion over 3 consecutive days every 4 weeks to patients with malignant solid tumours. The objectives of our study were to determine the maximal tolerated dose, the dose-limiting toxicities, and the plasma and urine pharmacokinetics of MAG-CPT, and to document anti-tumour activity. The starting dose was 17 mg m(-2) day(-1). Sixteen patients received 39 courses at seven dose levels. Maximal tolerated dose was at 68 mg m(-2) day(-1) and dose-limiting toxicities consisted of cumulative bladder toxicity. MAG-CPT and free camptothecin were accumulated during days 1-3 and considerable amounts of MAG-CPT could still be retrieved in plasma and urine after 4-5 weeks. The half-lives of bound and free camptothecin were equal indicating that the kinetics of free camptothecin were release rate dependent. In summary, the pharmacokinetics of camptothecin were dramatically changed, showing controlled prolonged exposure of camptothecin. Haematological toxicity was relatively mild, but serious bladder toxicity was encountered which is typical for camptothecin and was found dose limiting.