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1.
Cell Stress Chaperones ; 29(2): 300-311, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38508444

RESUMEN

Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal hematopoietic stem cell malignancies characterized by abnormal hematopoietic cell maturation, increased apoptosis of bone marrow cells, and anemia. They are the most common myeloid blood cancers in American adults. The full complement of gene mutations that contribute to the phenotypes or clinical symptoms in MDS is not fully understood. Around 10%-25% of MDS patients harbor an interstitial heterozygous deletion on the long arm of chromosome 5 [del(5q)], creating haploinsufficiency for a large set of genes, including HSPA9. The HSPA9 gene encodes for the protein mortalin, a highly conserved heat shock protein predominantly localized in mitochondria. Our prior study showed that knockdown of HSPA9 induces TP53-dependent apoptosis in human CD34+ hematopoietic progenitor cells. In this study, we explored the role of HSPA9 in regulating erythroid maturation using human CD34+ cells. We inhibited the expression of HSPA9 using gene knockdown and pharmacological inhibition and found that inhibition of HSPA9 disrupted erythroid maturation as well as increased expression of p53 in CD34+ cells. To test whether the molecular mechanism of HSPA9 regulating erythroid maturation is TP53-dependent, we knocked down HSPA9 and TP53 individually or in combination in human CD34+ cells. We found that the knockdown of TP53 partially rescued the erythroid maturation defect induced by HSPA9 knockdown, suggesting that the defect in cells with reduced HSPA9 expression is TP53-dependent. Collectively, these findings indicate that reduced levels of HSPA9 may contribute to the anemia observed in del(5q)-associated MDS patients due to the activation of TP53.


Asunto(s)
Anemia , Síndromes Mielodisplásicos , Humanos , Proteína p53 Supresora de Tumor/genética , Proteína p53 Supresora de Tumor/metabolismo , Células Madre Hematopoyéticas/metabolismo , Células Madre Hematopoyéticas/patología , Síndromes Mielodisplásicos/genética , Síndromes Mielodisplásicos/metabolismo , Síndromes Mielodisplásicos/patología , Anemia/metabolismo , Proteínas HSP70 de Choque Térmico/genética , Proteínas HSP70 de Choque Térmico/metabolismo , Proteínas Mitocondriales/genética , Proteínas Mitocondriales/metabolismo
2.
Int J Mol Sci ; 25(3)2024 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-38339143

RESUMEN

Miscarriages affect 50-70% of all conceptions and 15-20% of clinically recognized pregnancies. Recurrent pregnancy loss (RPL, ≥2 miscarriages) affects 1-5% of recognized pregnancies. Nevertheless, our knowledge about the etiologies and pathophysiology of RPL is incomplete, and thus, reliable diagnostic/preventive tools are not yet available. Here, we aimed to define the diagnostic value of three placental proteins for RPL: human chorionic gonadotropin free beta-subunit (free-ß-hCG), pregnancy-associated plasma protein-A (PAPP-A), and placental growth factor (PlGF). Blood samples were collected from women with RPL (n = 14) and controls undergoing elective termination of pregnancy (n = 30) at the time of surgery. Maternal serum protein concentrations were measured by BRAHMS KRYPTOR Analyzer. Daily multiple of median (dMoM) values were calculated for gestational age-specific normalization. To obtain classifiers, logistic regression analysis was performed, and ROC curves were calculated. There were differences in changes of maternal serum protein concentrations with advancing healthy gestation. Between 6 and 13 weeks, women with RPL had lower concentrations and dMoMs of free ß-hCG, PAPP-A, and PlGF than controls. PAPP-A dMoM had the best discriminative properties (AUC = 0.880). Between 9 and 13 weeks, discriminative properties of all protein dMoMs were excellent (free ß-hCG: AUC = 0.975; PAPP-A: AUC = 0.998; PlGF: AUC = 0.924). In conclusion, free-ß-hCG and PAPP-A are valuable biomarkers for RPL, especially between 9 and 13 weeks. Their decreased concentrations indicate the deterioration of placental functions, while lower PlGF levels indicate problems with placental angiogenesis after 9 weeks.


Asunto(s)
Aborto Habitual , Proteínas Gestacionales , Embarazo , Femenino , Humanos , Proteína Plasmática A Asociada al Embarazo/metabolismo , Factor de Crecimiento Placentario , Primer Trimestre del Embarazo , Placenta/metabolismo , Gonadotropina Coriónica Humana de Subunidad beta , Biomarcadores , Aborto Habitual/diagnóstico , Proteínas Sanguíneas
3.
J Reprod Immunol ; 161: 104172, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38141514

RESUMEN

The prevention of pre-eclampsia is difficult due to the syndromic nature and multiple underlying mechanisms of this severe complication of pregnancy. The current clinical distinction between early- and late-onset disease, although clinically useful, does not reflect the true nature and complexity of the pathologic processes leading to pre-eclampsia. The current gaps in knowledge on the heterogeneous molecular pathways of this syndrome and the lack of adequate, specific diagnostic methods are major obstacles to early screening and tailored preventive strategies. The development of novel diagnostic tools for detecting the activation of the identified disease pathways would enable early, accurate screening and personalized preventive therapies. We implemented a holistic approach that includes the utilization of different proteomic profiling methods of maternal plasma samples collected from various ethnic populations and the application of systems biology analysis to plasma proteomic, maternal demographic, clinical characteristic, and placental histopathologic data. This approach enabled the identification of four molecular subclasses of pre-eclampsia in which distinct and shared disease mechanisms are activated. The current review summarizes the results and conclusions from these studies and the research and clinical implications of our findings.


Asunto(s)
Preeclampsia , Embarazo , Femenino , Humanos , Preeclampsia/diagnóstico , Preeclampsia/prevención & control , Placenta/metabolismo , Proteómica , Objetivos , Primer Trimestre del Embarazo , Biomarcadores/metabolismo
4.
Geroscience ; 43(5): 2305-2320, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34460063

RESUMEN

The current COVID-19 pandemic, caused by the highly contagious respiratory pathogen SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), has already claimed close to three million lives. SARS-CoV-2 is a zoonotic disease: it emerged from a bat reservoir and it can infect a number of agricultural and companion animal species. SARS-CoV-2 can cause respiratory and intestinal infections, and potentially systemic multi-organ disease, in both humans and animals. The risk for severe illness and death with COVID-19 significantly increases with age, with older adults at highest risk. To combat the pandemic and protect the most susceptible group of older adults, understanding the human-animal interface and its relevance to disease transmission is vitally important. Currently high infection numbers are being sustained via human-to-human transmission of SARS-CoV-2. Yet, identifying potential animal reservoirs and potential vectors of the disease will contribute to stronger risk assessment strategies. In this review, the current information about SARS-CoV-2 infection in animals and the potential spread of SARS-CoV-2 to humans through contact with domestic animals (including dogs, cats, ferrets, hamsters), agricultural animals (e.g., farmed minks), laboratory animals, wild animals (e.g., deer mice), and zoo animals (felines, non-human primates) are discussed with a special focus on reducing mortality in older adults.


Asunto(s)
COVID-19 , Pandemias , Anciano , Animales , Gatos , Perros , Hurones , Humanos , Ratones , SARS-CoV-2 , Zoonosis/epidemiología
5.
Cureus ; 13(4): e14740, 2021 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-34084668

RESUMEN

Kounis syndrome (KS) is defined as an allergic or hypersensitivity reaction leading to coronary vasospasm and acute coronary syndrome. The inflammatory mediators released during the body's reaction to an allergen causes vasoconstriction, plaque rupture, platelet aggregation, and even thrombosis of an existing coronary stent. Over the years, many allergens including drugs, environmental exposures, and animal and insect bites have been implicated in KS. Patients may present with elevated cardiac enzymes and electrocardiographic changes. We describe a case of a patient with no prior cardiac history who presented to the emergency department seeking treatment after multiple bee stings. The patient had non-specific electrocardiogram (ECG) changes and elevated cardiac enzymes consistent with a non-ST-elevation myocardial infarction. The patient underwent a pharmacologic stress test and myocardial perfusion imaging, which showed a perfusion defect consistent with ischemia. Selective right and left coronary angiography revealed a critical lesion at the proximal left circumflex artery. This was managed with percutaneous coronary intervention utilizing a bare-metal stent.

6.
Placenta ; 99: 197-207, 2020 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-32747003

RESUMEN

INTRODUCTION: Placental Protein 1 (PP1), PP8, and PP22 were isolated from the placenta. Herein, we aimed to identify PP1, PP8, and PP22 proteins and their placental and trophoblastic expression patterns to reveal potential involvement in pregnancy complications. METHODS: We analyzed PP1, PP8, and PP22 proteins with LC-MS. We compared the placental behaviors of PP1, PP8, and PP22 to the predominantly placenta-expressed PP5/TFPI-2. Placenta-specificity scores were generated from microarray data. Trophoblasts were isolated from healthy placentas and differentiated; total RNA was isolated and subjected to microarray analysis. We assigned the placentas to the following groups: preterm controls, early-onset preeclampsia, early-onset preeclampsia with HELLP syndrome, term controls, and late-onset preeclampsia. After histopathologic examination, placentas were used for tissue microarray construction, immunostaining with anti-PP1, anti-PP5, anti-PP8, or anti-PP22 antibodies, and immunoscoring. RESULTS: PP1, PP8, and PP22 were identified as 'nicotinate-nucleotide pyrophosphorylase', 'serpin B6', and 'protein disulfide-isomerase', respectively. Genes encoding PP1, PP8, and PP22 are not predominantly placenta-expressed, in contrast with PP5. PP1, PP8, and PP22 mRNA expression levels did not increase during trophoblast differentiation, in contrast with PP5. PP1, PP8, and PP22 immunostaining were detected primarily in trophoblasts, while PP5 expression was restricted to the syncytiotrophoblast. The PP1 immunoscore was higher in late-onset preeclampsia, while the PP5 immunoscore was higher in early-onset preeclampsia. DISCUSSION: PP1, PP8, and PP22 are expressed primarily in trophoblasts but do not have trophoblast-specific regulation or functions. The distinct dysregulation of PP1 and PP5 expression in either late-onset or early-onset preeclampsia reflects different pathophysiological pathways in these preeclampsia subsets.


Asunto(s)
Placenta/metabolismo , Preeclampsia/metabolismo , Proteínas Gestacionales/metabolismo , Adulto , Cromatografía Liquida , Femenino , Humanos , Espectrometría de Masas , Embarazo , Proteómica
7.
Transl Oncol ; 13(6): 100775, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32408199

RESUMEN

Breast cancer patients presenting with symptomatic brain metastases have poor prognosis, and current chemotherapeutic agents are largely ineffective. In this study, we evaluated the hypomethylating agent azacitidine (AZA) for its potential as a novel therapeutic in preclinical models of brain metastasis of breast cancer. We used the parental triple-negative breast cancer MDA-MB-231 (231) cells and their brain colonizing counterpart (231Br) to ascertain phenotypic differences in response to AZA. We observed that 231Br cells have higher metastatic potential compared to 231 cells. With regard to therapeutic value, the AZA IC50 value in 231Br cells is significantly lower than that in parental cells (P < .01). AZA treatment increased apoptosis and inhibited the Wnt signaling transduction pathway, angiogenesis, and cell metastatic capacity to a significantly higher extent in the 231Br line. AZA treatment in mice with experimental brain metastases significantly reduced tumor burden (P = .0112) and increased survival (P = .0026) compared to vehicle. Lastly, we observed a decreased expression of keratin 18 (an epithelial maker) in 231Br cells due to hypermethylation, elucidating a potential mechanism of action of AZA in treating brain metastases from breast cancer.

8.
Eklem Hastalik Cerrahisi ; 30(2): 106-11, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31291857

RESUMEN

OBJECTIVES: This study aims to compare mechanical stability of osteosynthesis (plate and screw fixation) alone versus the same method supplemented with hip arthroplasty (hybrid solution) for double column fractures in elderly. PATIENTS AND METHODS: Mechanical investigations were performed on an advanced finite element pelvis model developed for double column fractures. The following simulated implant combinations were analyzed: modular acetabular basket with a ring with polyaxial screws and U-plate; plates with polyaxial screws placed on the medial-horizontal (linea terminalis) and quadrilateral bone surfaces; modular acetabular cup with U-plates; and polyaxial screws in sizes optimized based on a finite element model (FEM). Using the models, the possible shifts in peak load positions arising in different movement patterns caused by load and tension and implant deformation were measured. RESULTS: Hybrid systems resulted in minimal deformation of the implants already available on the market. We observed less possible shifts and greater stability in the acetabular fracture zones, compared to conventional osteosynthesis alone. Optimization with available and compatible implant sizes led to a further significant increase in stability. CONCLUSION: Hybrid method combining osteosynthesis and prosthesis implantation provide more stability in biomechanical models in the treatment of double column fractures in elderly.


Asunto(s)
Acetábulo/lesiones , Acetábulo/cirugía , Fijación Interna de Fracturas/instrumentación , Fracturas Óseas/cirugía , Anciano , Anciano de 80 o más Años , Fenómenos Biomecánicos , Placas Óseas , Tornillos Óseos , Análisis de Elementos Finitos , Fijación Interna de Fracturas/métodos , Humanos , Modelos Biológicos
9.
Front Immunol ; 9: 1661, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30135684

RESUMEN

Preeclampsia is a disease of the mother, fetus, and placenta, and the gaps in our understanding of the complex interactions among their respective disease pathways preclude successful treatment and prevention. The placenta has a key role in the pathogenesis of the terminal pathway characterized by exaggerated maternal systemic inflammation, generalized endothelial damage, hypertension, and proteinuria. This sine qua non of preeclampsia may be triggered by distinct underlying mechanisms that occur at early stages of pregnancy and induce different phenotypes. To gain insights into these molecular pathways, we employed a systems biology approach and integrated different "omics," clinical, placental, and functional data from patients with distinct phenotypes of preeclampsia. First trimester maternal blood proteomics uncovered an altered abundance of proteins of the renin-angiotensin and immune systems, complement, and coagulation cascades in patients with term or preterm preeclampsia. Moreover, first trimester maternal blood from preterm preeclamptic patients in vitro dysregulated trophoblastic gene expression. Placental transcriptomics of women with preterm preeclampsia identified distinct gene modules associated with maternal or fetal disease. Placental "virtual" liquid biopsy showed that the dysregulation of these disease gene modules originates during the first trimester. In vitro experiments on hub transcription factors of these gene modules demonstrated that DNA hypermethylation in the regulatory region of ZNF554 leads to gene down-regulation and impaired trophoblast invasion, while BCL6 and ARNT2 up-regulation sensitizes the trophoblast to ischemia, hallmarks of preterm preeclampsia. In summary, our data suggest that there are distinct maternal and placental disease pathways, and their interaction influences the clinical presentation of preeclampsia. The activation of maternal disease pathways can be detected in all phenotypes of preeclampsia earlier and upstream of placental dysfunction, not only downstream as described before, and distinct placental disease pathways are superimposed on these maternal pathways. This is a paradigm shift, which, in agreement with epidemiological studies, warrants for the central pathologic role of preexisting maternal diseases or perturbed maternal-fetal-placental immune interactions in preeclampsia. The description of these novel pathways in the "molecular phase" of preeclampsia and the identification of their hub molecules may enable timely molecular characterization of patients with distinct preeclampsia phenotypes.


Asunto(s)
Enfermedades Placentarias , Preeclampsia , Adulto , Biomarcadores/sangre , Femenino , Humanos , Enfermedades Placentarias/sangre , Enfermedades Placentarias/genética , Enfermedades Placentarias/fisiopatología , Preeclampsia/sangre , Preeclampsia/genética , Preeclampsia/fisiopatología , Embarazo , Proteómica , Biología de Sistemas , Trofoblastos/metabolismo , Trofoblastos/patología
10.
Eur J Hosp Pharm ; 25(e2): e139-e143, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31157085

RESUMEN

OBJECTIVE: In intensive care units numerous drugs have to be infused simultaneously, resulting inline incompatibility. Propofol is formulated as a lipid emulsion and it is well known that electrolytes can affect the stability of an emulsion system. Our goal was to evaluate and to compare the physical compatibility of three commercial propofol lipid emulsions of different manufacturers, mixing them with the most commonly used crystalloids in intensive care units. METHODS: Simulated Y-site administration was accomplished by mixing the 2% MCT/LCT propofol emulsions with the commonly used crystalloids in the intensive care unit in a 1:1 ratio in a polypropylene syringe. The aliquot samples were evaluated immediately and at 15, 30, 60 and 120 min after preparation by visual observation, pH and droplet size measurement. RESULTS: There was no emulsion breakdown or any visible change during the study period. Mixing the propofols with crystalloids, 10% magnesium sulphate or 10% potassium chloride there was no significant change in the droplet size compared with the original propofol emulsions. A slight alteration in droplet size was noticed in a few of the propofol samples, when magnesium, potassium or both were the secondary additives to the crystalloids, but this is not considered clinically relevant. CONCLUSION: The physical properties of emulsions are determined by component, therefore the compatibility data in literature has to be evaluated prudently. All three commercially available MCT/LCT propofol emulsions are considered physically compatible with the tested crystalloids.

11.
Circ Heart Fail ; 10(12)2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29203562

RESUMEN

BACKGROUND: Sustained inflammation in the heart is sufficient to provoke left ventricular dysfunction and left ventricular remodeling. Although inflammation has been linked to many of the biological changes responsible for adverse left ventricular remodeling, the relationship between inflammation and protein quality control in the heart is not well understood. METHODS AND RESULTS: To study the relationship between chronic inflammation and protein quality control, we used a mouse model of dilated cardiomyopathy driven by cardiac restricted overexpression of TNF (tumor necrosis factor; Myh6-sTNF). Myh6-sTNF mice develop protein aggregates containing ubiquitin-tagged proteins within cardiac myocytes related to proteasome dysfunction and impaired autophagy. The 26S proteasome was dysfunctional despite normal function of the core 20S subunit. We found an accumulation of autophagy substrates in Myh6-sTNF mice, which were also seen in tissue from patients with end-stage heart failure. Moreover, there was evidence of impaired autophagosome clearance after chloroquine administration in these mice indicative of impaired autophagic flux. Finally, there was increased mammalian target of rapamycin complex 1 (mTORC1) activation, which has been linked to inhibition of both the proteasome and autophagy. CONCLUSIONS: Myh6-sTNF mice with sustained inflammatory signaling develop proteasome dysfunction and impaired autophagic flux that is associated with enhanced mTORC1 activation.


Asunto(s)
Cardiomiopatía Dilatada/enzimología , Ventrículos Cardíacos/enzimología , Mediadores de Inflamación/metabolismo , Miocitos Cardíacos/enzimología , Complejo de la Endopetidasa Proteasomal/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Disfunción Ventricular Izquierda/enzimología , Función Ventricular Izquierda , Remodelación Ventricular , Animales , Autofagosomas/enzimología , Autofagosomas/patología , Autofagia , Cardiomiopatía Dilatada/genética , Cardiomiopatía Dilatada/patología , Cardiomiopatía Dilatada/fisiopatología , Modelos Animales de Enfermedad , Predisposición Genética a la Enfermedad , Insuficiencia Cardíaca/enzimología , Insuficiencia Cardíaca/patología , Ventrículos Cardíacos/patología , Ventrículos Cardíacos/fisiopatología , Humanos , Diana Mecanicista del Complejo 1 de la Rapamicina/metabolismo , Ratones Transgénicos , Miocitos Cardíacos/patología , Cadenas Pesadas de Miosina/genética , Fenotipo , Regiones Promotoras Genéticas , Agregado de Proteínas , Agregación Patológica de Proteínas , Factores de Tiempo , Factor de Necrosis Tumoral alfa/genética , Ubiquitinación , Regulación hacia Arriba , Disfunción Ventricular Izquierda/genética , Disfunción Ventricular Izquierda/patología , Disfunción Ventricular Izquierda/fisiopatología
12.
Eur J Cardiothorac Surg ; 51(6): 1171-1176, 2017 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-28186275

RESUMEN

OBJECTIVES: The overall prognosis of lung cancer is poor: Only every 8 patient survives 5 years after diagnosis. This outcome is partly attributable to late diagnosis. To implement a screening program for early diagnosis, selection of high-risk individuals is essential. Our aim was to construct a personalized lung cancer risk assessment tool using geographic localization to lead the high-risk individuals to the local health care provider. METHODS: A smartphone application was created for Android and iOS mobile platforms using a risk assessment questionnaire. The software provides immediate classification into low, moderate and high-risk groups. The high-risk group is directed to the nearest screening centre based on GPS location. The complete test data set is recorded on a collection server database for further analysis. RESULTS: The application was downloaded 13 890 times and completed by 89 500 persons over a period of 20 months. The mean age of the tested users was 36.91 years (9-93 years); the majority were men living in an urban area (62.3%). The test was completed by 38 850 active smokers and 26 710 persons who reported having already quit smoking, resulting in 30 072 moderate and 10 740 high-risk users. CONCLUSIONS: This free application is an active communication tool for most smartphone owners. It helps those who might need further medical attention. The affected users can be easily connected and localized via the smartphone, which helps recruit individuals into screening programs.


Asunto(s)
Neoplasias Pulmonares , Aplicaciones Móviles , Medición de Riesgo/métodos , Teléfono Inteligente , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiología , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
13.
Int J Clin Pharm ; 39(2): 408-415, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28188510

RESUMEN

Background Geriatric falls are leading causes of hospital trauma admissions and injury-related deaths. Medication use is a crucial element among extrinsic risk factors for falls. To reduce fall risk and the prevalence of adverse drug reactions, potentially inappropriate medication (PIM) lists are widely used. Objective Our aim was to investigate the possible predictors of geriatric falls annualized over a 5-year-long period, as well as to evaluate the medication use of nursing home residents. Setting Nursing home residents were recruited from the same institution between 2010 and 2015 in Szeged, Hungary. Method A retrospective epidemiological study was performed. Patient data were analysed for the first 12 months of residency. Chi-squared test and Fisher's-test were applied to compare the categorical variables, Student's t test to compare the continuous variables between groups. Binary logistic regression analysis was carried out to determine the association of falls with other variables found significant in univariate analysis. Microsoft Excel, IBM SPSS Statistics (version 23) and R (3.2.2) programs were used for data analysis. Main outcome measure Falls affected by age, gender, number of chronic medications, polypharmacy, PIM meds. Results A total of 197 nursing home residents were included, 150 (76.2%) women and 47 (23.8%) men, 55 fallers (annual fall prevalence rate was 27.9%) and 142 non-fallers. Gender was not a predisposing factor for falls (prevalence in males: 23.4 vs 29.3% in females, p > 0.05). Fallers were older (mean years ± SD; 84.0 ± 7.0) than non-fallers (80.1 ± 9.3, p < 0.01). The age ≥80 years was a significant risk factor for falls (p < 0.001). The number of chronic medications was higher in male fallers (12.4 ± 4.0) than in non-fallers (6.9 ± 4.2, p < 0.001). Polypharmacy (taking four or more chronic medications) was a significant risk factor of falls (p < 0.01). Those PIMs carrying fall risk were taken by 70.9% of fallers and 75.3% of non-fallers (p > 0.05). Taking pantoprazole, vinpocetine or trimetazidine was a significant risk factor for falls. Conclusion Older age, polypharmacy and the independent use of pantoprazole, vinpocetine, and trimetazidine were found to be major risk factors for falls. Further real-life epidemiological studies are necessary to confirm the role of particular active agents, and to help professionals prescribe, evaluate and review geriatric medication use.


Asunto(s)
Accidentes por Caídas/estadística & datos numéricos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Casas de Salud/estadística & datos numéricos , Lista de Medicamentos Potencialmente Inapropiados/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Hungría/epidemiología , Masculino , Persona de Mediana Edad , Polifarmacia , Estudios Retrospectivos , Factores de Riesgo
14.
Placenta ; 43: 90-7, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-26947613

RESUMEN

INTRODUCTION: To evaluate changes in placental perfusion with advancing gestation in normal murine pregnancy using dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). METHODS: Seven timed-pregnant CD-1 mice underwent DCE-MRI scanning longitudinally on gestational days (GD) 13, 15 and 17. Placentas were segmented into high (HPZ) and low perfusion zones (LPZ) using tissue similarity mapping. Blood perfusion of the respective regions and the whole placenta was quantified using the steepest slope method. The diameter of the maternal central canal (CC) was also measured. RESULTS: An increase in perfusion was observed between GD13 and GD17 in the overall placenta (p = 0.04) and in the HPZ (p = 0.02). Although perfusion in the LPZ showed a slight increasing trend, it was not significant (p = 0.07). Perfusion, in units of ml/min/100 ml, in the overall placenta and the HPZ was respectively 61.2 ± 31.2 and 106.2 ± 56.3 at GD13 (n = 19 placentas); 90.3 ± 43.7 and 139 ± 55.4 at GD15 (n = 20); and 104.9 ± 76.1 and 172.2 ± 85.6 at GD17 (n = 14). The size of the CC increased with advancing gestation (p < 0.05). DISCUSSION: Using longitudinal DCE-MRI, the gestational age-dependent perfusion change in the normal murine placenta and in its regional compartments was quantified. In mid and late gestations, placental constituent regions differ significantly in their perfusion rates. The CC diameter also showed increase with advancing gestation, which may be playing an important role toward the gestational age-dependent increase in placental perfusion.


Asunto(s)
Imagen por Resonancia Magnética , Placenta/diagnóstico por imagen , Circulación Placentaria/fisiología , Animales , Femenino , Ratones , Placenta/irrigación sanguínea , Embarazo
15.
Gynecol Obstet Invest ; 81(3): 193-201, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26336923

RESUMEN

OBJECTIVE: To quantify gestation-dependent longitudinal changes in the magnetic resonance transverse relaxation time (T2) parameter of the major constituent regions of the mouse placenta and to evaluate their relative contributions to changes in overall placental T2. METHODS: Timed-pregnant CD-1 mice underwent magnetic resonance imaging at 7.0 T field strength, on gestational day 13 (GD13), GD15 and GD17. T2 of the placenta and its constituent high and low blood perfusion regions were quantified. A linear mixed-effects model was used to fit the T2 across gestation, and the significance of coefficients was tested. RESULTS: A decrease in the T2 values of the placenta and its constituent regions was observed across gestation. The temporal change in T2 was estimated to be -1.85 ms/GD (p < 0.0001) for the placenta, -1.00 ms/GD (p < 0.001) for the high-perfusion zones (HPZs) and -1.66 ms/GD (p < 0.0001) for the low-perfusion zones (LPZs). CONCLUSION: T2 of the constituent zones of the murine placenta decreases with advancing gestation. While the T2 of the LPZ is smaller than that of the HPZ, there is no difference in their decrease rate relative to that of the whole placenta (p = 0.24). The results suggest an increased role of constituent volume fractions in affecting overall gestation-dependent placental T2 decrease in mice.


Asunto(s)
Imagen por Resonancia Magnética/veterinaria , Placenta/diagnóstico por imagen , Placenta/fisiología , Animales , Femenino , Edad Gestacional , Ratones , Placenta/irrigación sanguínea , Embarazo
16.
PLoS One ; 10(4): e0119547, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25860260

RESUMEN

OBJECTIVE: Most anti-angiogenic preeclampsia models in rodents utilized the overexpression of a truncated soluble fms-like tyrosine kinase-1 (sFlt-1) not expressed in any species. Other limitations of mouse preeclampsia models included stressful blood pressure measurements and the lack of postpartum monitoring. We aimed to 1) develop a mouse model of preeclampsia by administering the most abundant human placental sFlt-1 isoform (hsFlt-1-e15a) in preeclampsia; 2) determine blood pressures in non-stressed conditions; and 3) develop a survival surgery that enables the collection of fetuses and placentas and postpartum (PP) monitoring. METHODS: Pregnancy status of CD-1 mice was evaluated with high-frequency ultrasound on gestational days (GD) 6 and 7. Telemetry catheters were implanted in the carotid artery on GD7, and their positions were verified by ultrasound on GD13. Mice were injected through tail-vein with adenoviruses expressing hsFlt-1-e15a (n = 11) or green fluorescent protein (GFP; n = 9) on GD8/GD11. Placentas and pups were delivered by cesarean section on GD18 allowing PP monitoring. Urine samples were collected with cystocentesis on GD6/GD7, GD13, GD18, and PPD8, and albumin/creatinine ratios were determined. GFP and hsFlt-1-e15a expression profiles were determined by qRT-PCR. Aortic ring assays were performed to assess the effect of hsFlt-1-e15a on endothelia. RESULTS: Ultrasound predicted pregnancy on GD7 in 97% of cases. Cesarean section survival rate was 100%. Mean arterial blood pressure was higher in hsFlt-1-e15a-treated than in GFP-treated mice (∆MAP = 13.2 mmHg, p = 0.00107; GD18). Focal glomerular changes were found in hsFlt-1-e15a -treated mice, which had higher urine albumin/creatinine ratios than controls (109.3 ± 51.7 µg/mg vs. 19.3 ± 5.6 µg/mg, p = 4.4 x 10(-2); GD18). Aortic ring assays showed a 46% lesser microvessel outgrowth in hsFlt-1-e15a-treated than in GFP-treated mice (p = 1.2 x 10(-2)). Placental and fetal weights did not differ between the groups. One mouse with liver disease developed early-onset preeclampsia-like symptoms with intrauterine growth restriction (IUGR). CONCLUSIONS: A mouse model of late-onset preeclampsia was developed with the overexpression of hsFlt-1-e15a, verifying the in vivo pathologic effects of this primate-specific, predominant placental sFlt-1 isoform. HsFlt-1-e15a induced early-onset preeclampsia-like symptoms associated with IUGR in a mouse with a liver disease. Our findings support that hsFlt-1-e15a is central to the terminal pathway of preeclampsia, and it can induce the full spectrum of symptoms in this obstetrical syndrome.


Asunto(s)
Preeclampsia/etiología , Receptor 1 de Factores de Crecimiento Endotelial Vascular/fisiología , Secuencia de Aminoácidos , Animales , Presión Sanguínea , Monitores de Presión Sanguínea , Modelos Animales de Enfermedad , Femenino , Perfilación de la Expresión Génica , Edad Gestacional , Proteínas Fluorescentes Verdes/genética , Humanos , Ratones , Ratones Transgénicos , Datos de Secuencia Molecular , Fenotipo , Placenta/diagnóstico por imagen , Placenta/patología , Placenta/fisiopatología , Preeclampsia/patología , Preeclampsia/fisiopatología , Embarazo , Isoformas de Proteínas/administración & dosificación , Isoformas de Proteínas/genética , Isoformas de Proteínas/fisiología , ARN Mensajero/genética , ARN Mensajero/metabolismo , Proteínas Recombinantes/administración & dosificación , Proteínas Recombinantes/genética , Homología de Secuencia de Aminoácido , Especificidad de la Especie , Telemetría , Ultrasonografía , Receptor 1 de Factores de Crecimiento Endotelial Vascular/administración & dosificación , Receptor 1 de Factores de Crecimiento Endotelial Vascular/genética
17.
PLoS One ; 9(11): e110867, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25393290

RESUMEN

OBJECTIVE: Soluble fms-like tyrosine kinase (sFlt)-1-e15a, a primate-specific sFlt-1-isoform most abundant in the human placenta in preeclampsia, can induce preeclampsia in mice. This study compared the effects of full-length human (h)sFlt-1-e15a with those of truncated mouse (m)sFlt-1(1-3) used in previous preeclampsia studies on pregnancy outcome and clinical symptoms in preeclampsia. METHODS: Mice were injected with adenoviruses or fiber-mutant adenoviruses overexpressing hsFlt-1-e15a, msFlt-1(1-3) or control GFP under the CMV or CYP19A1 promoters on gestational day 8 (GD8) and GD11. Placentas and pups were delivered by cesarean section, and dams were monitored postpartum. Blood pressure was telemetrically recorded. Urine samples were collected with cystocentesis and examined for albumin/creatinine ratios. Tissue specimens were evaluated for transgene as well as endogenous mFlt-1 and msFlt-1-i13 expression. H&E-, Jones- and PAS-stained kidney sections were histopathologically examined. Placental GFP expression and aortic ring assays were investigated with confocal microscopy. RESULTS: Mean arterial blood pressure (MAP) was elevated before delivery in hsFlt-1-e15a-treated mice compared to controls (GD18: ΔMAP = 7.8 mmHg, p = 0.009), while ΔMAP was 12.8 mmHg (GD18, p = 0.005) in msFlt-1(1-3)-treated mice. Urine albumin/creatinine ratio was higher in hsFlt-1-e15a-treated mice than in controls (GD18, p = 0.04; PPD8, p = 0.03), and msFlt-1(1-3)-treated mice had marked proteinuria postpartum (PPD8, p = 4 × 10(-5)). Focal glomerular changes were detected in hsFlt-1-e15a and msFlt-1(1-3)-treated mice. Aortic ring microvessel outgrowth was decreased in hsFlt-1-e15a (p = 0.007) and msFlt-1(1-3)-treated (p = 0.02) mice. Full-length msFlt-1-i13 expression was unique for the placenta. In hsFlt-1-e15a-treated mice, the number of pups (p = 0.046), total weight of living pups (p = 0.04) and maternal weights (p = 0.04) were higher than in controls. These differences were not observed in truncated msFlt-1(1-3)-treated mice. CONCLUSIONS: Truncated msFlt-1(1-3) simulated the preeclampsia-promoting effects of full-length hsFlt-1. MsFlt-1(1-3) had strong effect on maternal endothelium but not on placentas and embryos. In contrast, hsFlt-1-e15a induced preeclampsia-like symptoms; however, it also increased litter size. In accord with the predominant placental expression of hsFlt-1-e15a and msFlt-1-i13, full-length sFlt-1 may have a role in the regulation of embryonic development. These observations point to the difference in the biological effects of full-length and truncated sFlt-1 and the changes in the effect of full-length sFlt-1 during pregnancy, and may have important implications in the management of preeclampsia.


Asunto(s)
Preeclampsia/genética , Preeclampsia/fisiopatología , Resultado del Embarazo/genética , Receptor 1 de Factores de Crecimiento Endotelial Vascular/genética , Adenoviridae/genética , Albuminuria/orina , Animales , Presión Arterial/fisiología , Creatinina/orina , Femenino , Expresión Génica/genética , Vectores Genéticos/administración & dosificación , Vectores Genéticos/genética , Proteínas Fluorescentes Verdes/genética , Humanos , Riñón/fisiopatología , Tamaño de la Camada/genética , Tamaño de la Camada/fisiología , Ratones , Microvasos/fisiología , Neovascularización Fisiológica/genética , Péptidos/genética , Péptidos/metabolismo , Placenta , Embarazo , Proteínas Gestacionales/metabolismo , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Proteinuria/orina , Transgenes/genética , Receptor 1 de Factores de Crecimiento Endotelial Vascular/metabolismo
18.
J Am Assoc Lab Anim Sci ; 53(4): 336-43, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25199088

RESUMEN

Deer mice (Peromyscus maniculatus) and congeneric species are used in a wide variety of research applications, particularly studies of developmental, physiologic, and behavioral characteristics associated with habitat adaptation and speciation. Because peromyscine mice readily adapt to colony conditions, animals with traits of interest in the field are moved easily into the laboratory where they can be studied under controlled conditions. The purpose of this study was to determine the serum chemistry and hematologic parameters of 4 frequently used species from the Peromyscus Genetic Stock Center species (P. californicus, P. leucopus, P. maniculatus, and P. polionotus) and to determine quantitative differences in these parameters among species and between sexes. Triglyceride values were substantially higher in female compared with male mice in all 4 species. Similar cross-species differences in MCH were present. Overall there was considerable interspecific variation for most blood parameters, with little evidence for covariation of any 2 or more parameters. Because crosses of P. maniculatus and P. polionotus produce fertile offspring, segregation analyses can be applied to determine the genetic basis of any traits that differ between them, such as their 3.8- and 2.1-fold interspecific differences in cholesterol and triglyceride levels, respectively. The current data provide a set of baseline values useful for subsequent comparative studies of species experiencing different circumstances, whether due to natural variation or anthropogenic environmental degradation. To enable such comparisons, the raw data are downloadable from a site maintained by the Stock Center (http://ww2.biol.sc.edu/∼peromyscus).


Asunto(s)
Células Sanguíneas/química , Peromyscus/sangre , Animales , Cruzamientos Genéticos , Femenino , Masculino , Ratones , Peromyscus/clasificación , Fenotipo , Caracteres Sexuales
19.
Wiley Interdiscip Rev Dev Biol ; 3(3): 211-30, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24896658

RESUMEN

Deer mice (Peromyscus) are the most common native North American mammals, and exhibit great natural genetic variation. Wild-derived stocks from a number of populations are available from the Peromyscus Genetic Stock Center (PGSC). The PGSC also houses a number of natural variants and mutants (many of which appear to differ from Mus). These include metabolic, coat-color/pattern, neurological, and other morphological variants/mutants. Nearly all these mutants are on a common genetic background, the Peromyscus maniculatus BW stock. Peromyscus are also superior behavior models in areas such as repetitive behavior and pair-bonding effects, as multiple species are monogamous. While Peromyscus development generally resembles that of Mus and Rattus, prenatal stages have not been as thoroughly studied, and there appear to be intriguing differences (e.g., longer time spent at the two-cell stage). Development is greatly perturbed in crosses between P. maniculatus (BW) and Peromyscus polionotus (PO). BW females crossed to PO males produce growth-restricted, but otherwise healthy, fertile offspring which allows for genetic analyses of the many traits that differ between these two species. PO females crossed to BW males produce overgrown but severely dysmorphic conceptuses that rarely survive to late gestation. There are likely many more uses for these animals as developmental models than we have described here. Peromyscus models can now be more fully exploited due to the emerging genetic (full linkage map), genomic (genomes of four stocks have been sequenced) and reproductive resources.


Asunto(s)
Desarrollo Embrionario , Modelos Animales , Peromyscus/embriología , Animales , Variación Genética , Peromyscus/genética , Pigmentación , Reproducción
20.
Gynecol Obstet Invest ; 78(1): 33-40, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24861575

RESUMEN

OBJECTIVE: To evaluate gestational age-dependent changes in the T2 relaxation time in normal murine placentas in vivo. The role of susceptibility-weighted imaging (SWI) in visualization of the murine fetal anatomy was also elucidated. METHODS: Timed-pregnant CD-1 mice at gestational day (GD) 12 and GD17 underwent magnetic resonance imaging. Multi-echo spin echo and SWI data were acquired. The placental T2 values on GD12 and GD17 were quantified. To account for the influence of systemic maternal physiological factors on placental perfusion, maternal muscle was used as a reference for T2 normalization. A linear mixed-effects model was used to fit the normalized T2 values, and the significance of the coefficients was tested. Fetal SWI images were processed and reviewed for venous vasculature and skeletal structures. RESULTS: The average placental T2 value decreased significantly on GD17 (40.17 ± 4.10 ms) compared to the value on GD12 (55.78 ± 8.13 ms). The difference in normalized T2 values also remained significant (p = 0.001). Using SWI, major fetal venous structures like the cardinal vein, the subcardinal vein, and the portal vein were visualized on GD12. In addition, fetal skeletal structures could also be discerned on GD17. CONCLUSION: The T2 value of a normal murine placenta decreases with advancing gestation. SWI provided clear visualization of the fetal venous vasculature and bony structures. © 2014 S. Karger AG, Basel.


Asunto(s)
Feto/anatomía & histología , Feto/irrigación sanguínea , Edad Gestacional , Imagen por Resonancia Magnética , Animales , Femenino , Ratones , Placenta/anatomía & histología , Placenta/irrigación sanguínea , Embarazo , Venas/embriología
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