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1.
Sci Total Environ ; : 172915, 2024 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-38719035

RESUMEN

The increasing trend regarding the use of plastics has arisen an exponential concern on the fate of their derived products to the environment. Among these derivatives, microplastics and nanoplastics (MNPs) have been featured for their associated environmental impact due to their low molecular size and high surface area, which has prompted their ubiquitous transference among all environmental interfaces. Due to the heterogenous chemical composition of MNPs, the study of these particles has focused a high number of studies, as a result of the myriad of associated physicochemical properties that contribute to the co-transference of a wide range of contaminants, thus becoming a major challenge for the scientific community. In this sense, both primary and secondary MNPs are well-known to be adscribed to industrial and urbanized areas, from which they are massively released to the environment through a multiscale level, involving the atmosphere, hydrosphere, and lithosphere. Consequently, much research has been conducted on the understanding of the interconnection between those interfaces, that motivate the spread of these contaminants to biological systems, being mostly represented by the biosphere, especially phytosphere and, finally, the anthroposphere. These findings have highlighted the potential hazardous risk for human health through different mechanisms from the environment, requiring a much deeper approach to define the real risk of MNPs exposure. As a result, there is a gap of knowledge regarding the environmental impact of MNPs from a high-throughput perspective. In this review, a metabolomics-based overview on the impact of MNPs to all environmental interfaces was proposed, considering this technology a highly valuable tool to decipher the real impact of MNPs on biological systems, thus opening a novel perspective on the study of these contaminants.

2.
MethodsX ; 12: 102663, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38559387

RESUMEN

Numerous protocols for dissolved organic carbon (DOC) measurements on natural water are used in the literature. An ISO protocol for the determination of DOC exists since 2018, but it is certified for DOC values ≥ 1 mg L-1, while many publications report DOC values much lower. In addition, this ISO protocol does not include indications on vials cleaning, filtering material, and type of caps and septa to be used. The purpose of this study was to evaluate protocols for measurements of low DOC concentrations (≤ 1 mg L-1). The effect of the sample container, type of septum, filtration material, nature of acid used for storage, and matrix effects on DOC concentration were evaluated.•The use of glass vials decontaminated at 450 °C or 500 °C for at least 1 h, 0.45 µm hydrophilic polytetrafluoroethylene (PTFE) membranes previously rinsed with 20 mL ultra-pure water and HCl acidification gives the lowest DOC contamination,•Sulfides (ΣH2S), sodium (Na+) or calcium (Ca2+) do not induce high matrix effect for the analysis (≤ 10%),•At low DOC concentrations (≤ 1 mg L-1), the use of pierced PTFE septa with acidified samples induce slight DOC contamination after storage at 4 °C, and dramatic contamination after storage at -18 °C.

3.
Rev Esp Enferm Dig ; 2024 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-38685895

RESUMEN

We present the case of a 61-year-old male with no relevant history of interest who was admitted to hospital due to constitutional syndrome and discomfort in the right hypochondrium. On admission, abdominal ultrasound was performed with findings of chronic liver disease and innumerable well-defined hypoechogenic lesions of small size. Although the study was extended with other imaging tests, they did not provide more information than what was available at the time. Subsequently, an ultrasound-guided liver biopsy was performed with pathological anatomy compatible with infiltration by malignant melanoma. Subsequently, a search for the primary origin of the melanoma was performed and it was found in the right thigh. Hepatic involvement by melanoma is infrequent and both the symptoms and the findings in the complementary tests are non-specific, characteristics that make diagnosis difficult. Therefore, in these cases liver biopsy plays a fundamental role in the diagnosis.

4.
J Funct Biomater ; 15(4)2024 Apr 11.
Artículo en Inglés | MEDLINE | ID: mdl-38667558

RESUMEN

This study aims to analyse, using a finite element analysis, the effects of Ti-base abutment height on the distribution and magnitude of transferred load and the resulting bone microstrain in the bone-implant system. A three-dimensional bone model of the mandibular premolar section was created with an implant placed in a juxta-osseous position. Three prosthetic models were designed: a 1 mm-high titanium-base (Ti-base) abutment with an 8 mm-high cemented monolithic zirconia crown was designed for model A, a 2 mm-high Ti-base abutment with a 7 mm-high crown for model B, and a 3 mm-high abutment with a 6 mm-high crown for model C. A static load of 150 N was applied to the central fossa at a six-degree angle with respect to the axial axis of the implant to evaluate the magnitude and distribution of load transfer and microstrain. The results showed a trend towards a direct linear association between the increase in the height of the Ti-base abutments and the increase in the transferred stress and the resulting microstrain to both the prosthetic elements and the bone/implant system. An increase in transferred stress and deformation of all elements of the system, within physiological ranges, was observed as the size of the Ti-base abutment increased.

5.
R Soc Open Sci ; 11(4): 231978, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38633346

RESUMEN

Human activities have an overwhelming impact on the natural environment, leading to a deep biodiversity crisis whose effects range from genes to ecosystems. Here, we analysed the effect of such anthropogenic impacts on bdelloid rotifers (Rotifera Bdelloidea), for whom these effects are poorly understood. We targeted bdelloid rotifers living in lichen patches across urbanization gradients in Flanders and Brussels (Belgium). Urbanization was measured as the percentage of built-up area (BU) across different spatial scales, at circles from 50 to 3200 m of radius around the lichen. Urbanization effects on biodiversity were assessed on abundance, species richness and community-weighted mean body size of bdelloid rotifers, as well as on genetic diversity of a mitochondrial marker (cytochrome c oxidase subunit I) of one of the most common and widespread bdelloid species, Adineta vaga. Overall, no negative effect of urbanization was found at any diversity level and any spatial scale. Counterintuitively, the BU area quantified at the largest spatial scale had a positive effect on abundance. These results leave open the question of whether negative effects of urbanization are present for bdelloid rotifers, if they are mediated by other unexplored drivers, or if such effects are only visible at even larger spatial scales.

6.
Microorganisms ; 12(3)2024 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-38543484

RESUMEN

Nowadays, the discharge of wastewater is a global concern due to the damage caused to human and environmental health. Wastewater treatment has progressed to provide environmentally and economically sustainable technologies. The biological treatment of wastewater is one of the fundamental bases of this field, and the employment of new technologies based on granular biofilm systems is demonstrating success in tackling the environmental issues derived from the discharge of wastewater. The granular-conforming microorganisms must be evaluated as functional entities because their activities and functions for removing pollutants are interconnected with the surrounding microbiota. The deep knowledge of microbial communities allows for the improvement in system operation, as the proliferation of microorganisms in charge of metabolic roles could be modified by adjustments to operational conditions. This is why engineering must consider the intrinsic microbiological aspects of biological wastewater treatment systems to obtain the most effective performance. This review provides an extensive view of the microbial ecology of biological wastewater treatment technologies based on granular biofilms for mitigating water pollution.

7.
Nano Lett ; 24(12): 3670-3677, 2024 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-38483128

RESUMEN

Functionalization of metallic surfaces by molecular monolayers is a key process in fields such as nanophotonics or biotechnology. To strongly enhance light-matter interaction in such monolayers, nanoparticle-on-a-mirror (NPoM) cavities can be formed by placing metal nanoparticles on such chemically functionalized metallic monolayers. In this work, we present a novel functionalization process of gold surfaces using 5-amino-2-mercaptobenzimidazole (5-A-2MBI) molecules, which can be used for upconversion from THz to visible frequencies. The synthesized surfaces and NPoM cavities are characterized by Raman spectroscopy, atomic force microscopy (AFM), and advancing-receding contact angle measurements. Moreover, we show that NPoM cavities can be efficiently integrated on a silicon-based photonic chip performing pump injection and Raman-signal extraction via silicon nitride waveguides. Our results open the way for the use of 5-A-2MBI monolayers in different applications, showing that NPoM cavities can be effectively integrated with photonic waveguides, enabling on-chip enhanced Raman spectroscopy or detection of infrared and THz radiation.

8.
Int J Gynecol Cancer ; 2024 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-38479803

RESUMEN

BACKGROUND: Currently, a lively debate exists within the scientific community regarding the most suitable procedure for treating stages IIIB-IVB carcinoma of the ovary, fallopian tubes, and peritoneum. The options under most consideration are primary cytoreductive surgery or neoadjuvant chemotherapy followed by interval cytoreductive surgery. PRIMARY OBJECTIVE: To compare overall survival at 5 years in patients who underwent primary cytoreductive surgery versus neoadjuvant chemotherapy and interval cytoreductive surgery for stage IIIB-IVB ovarian cancer STUDY HYPOTHESIS: The treatment with primary cytoreductive surgery results in superior patient survival compared with neoadjuvant chemotherapy followed by interval cytoreductive surgery. TRIAL DESIGN: This is a multicenter, retrospective cohort observational study. Data will be collected from patients undergoing surgery in hospitals worldwide. Two arms will be compared: primary cytoreductive surgery and neoadjuvant chemotherapy followed by interval cytoreductive surgery. MAJOR INCLUSION/EXCLUSION CRITERIA: Patients must have suspected or histologically confirmed International Federation of Gynecology and Obstetrics (FIGO) stages IIIB-IVB ovarian, peritoneal, or fallopian tube cancers. They must have undergone primary surgery or first course of neoadjuvant chemotherapy between January 1, 2018 and December 31, 2019. Based on all available information before the surgery (primary or interval), the patient must have been considered completely resectable. PRIMARY ENDPOINT: Overall survival at 5 years from the first treatment (chemotherapy in the case of neoadjuvant chemotherapy and cytoreduction in the case of primary cytoreductive surgery). SAMPLE SIZE: An estimated total of 5000 patients will be enrolled in the study. ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS: March 2025 TRIAL REGISTRATION: NCT06223763.

9.
Heliyon ; 10(2): e24813, 2024 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-38312648

RESUMEN

The post-pandemic stage covid-19 has revealed overloads, ambiguities, and conflicts of teachers in the performance of new roles in hybrid classrooms that demanded an urgent adaptation, this highlighted the need for priority attention to the mental health of teachers, however, there are still insufficient studies that transcend the diagnosis and are committed to establish proposals for improvement. OBJECTIVE: This study aims to establish a proposal for the promotion of positive mental health (PMH). METHODS: The study was deployed from a qualitative approach; using an ethnomethodological design that allowed studying how teachers create meanings and sense in their work context, an appreciative interview was conducted with an affirmative theme that allowed teachers to expose their experiences that were systematized and processed with ATLAS. ti software. The application of the interview was conducted online through a Google form, during the months of February and March 2023. Three hundred university professors who experienced the pandemic in universities in Brazil, Chile, Colombia, Ecuador, Mexico, and Peru participated, based on a convenience sampling. RESULTS: The results of the deductive phase confirmed Lluch's PMH theoretical framework; however, new nuances or variations have been identified, which must be considered in the complex and dynamic nature of each PMH factor. From there, the results of the inductive phase allowed revealing emerging concepts, that is, new categories that would have the function of improving the PMH factors, which is why they have been denominated: dynamizing nuclei. PMH dynamizing nuclei are adjustment to work environment, soft skills, work-family balance, self-motivation, self-efficacy, subjective well-being, proactive strategies, engagement, resilience. CONCLUSIONS: Finally, with the results of both phases, the creation of an integrated model was generated, which was evaluated by six experts in a round of feedback, who highlighted the relevance of the findings and offered recommendations that were considered in the study. The new integrated model has revealed an interesting association, since it not only legitimizes the PMH's dynamizing cores, but also informs on which specific factor of the PMH these cores have the greatest impact, which has a high guiding value for intervention and improvement based on focused strategies.

10.
J Chem Inf Model ; 64(5): 1605-1614, 2024 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-38416513

RESUMEN

Drug development is a complex, costly, and time-consuming endeavor. While high-throughput screening (HTS) plays a critical role in the discovery stage, it is one of many factors contributing to these challenges. In certain contexts, virtual screening can complement the HTS, potentially offering a more streamlined approach in the initial stages of drug discovery. Molecular docking is an example of a popular virtual screening technique that is often used for this purpose; however, its effectiveness can vary greatly. This has led to the use of consensus docking approaches that combine results from different docking methods to improve the identification of active compounds and reduce the occurrence of false positives. However, many of these methods do not fully leverage the latest advancements in molecular docking. In response, we present ESSENCE-Dock (Effective Structural Screening ENrichment ConsEnsus Dock), a new consensus docking workflow aimed at decreasing false positives and increasing the discovery of active compounds. By utilizing a combination of novel docking algorithms, we improve the selection process for potential active compounds. ESSENCE-Dock has been made to be user-friendly, requiring only a few simple commands to perform a complete screening while also being designed for use in high-performance computing (HPC) environments.


Asunto(s)
Algoritmos , Descubrimiento de Drogas , Simulación del Acoplamiento Molecular , Consenso , Descubrimiento de Drogas/métodos , Ensayos Analíticos de Alto Rendimiento , Ligandos
11.
J Hazard Mater ; 467: 133674, 2024 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-38335605

RESUMEN

Increased concerns exist about the presence of anticancer drugs in wastewater. However, knowledge of the impacts of anticancer drugs on the performance of the system and microbial communities during wastewater treatment processes is limited. We examined the effect of three anticancer drugs commonly detected in influents of wastewater treatment plants applied at three different concentration levels on the performance, efficiency of anticancer drug removal, and prokaryotic microbiome in an aerobic granular sludge system (AGS) operated in a sequential batch reactor (SBR). We showed that an AGS can efficiently remove anticancer drugs, with removal rates in the range of 53-100% depending on the type of drug and concentration level. Anticancer drugs significantly decreased the abundance of total bacterial and archaeal communities, an effect that was linked to reduced nitrogen removal efficiency. Anticancer drugs also reduced the diversity, altered the prokaryotic community composition, reduced network complexity, and induced a decrease of a wide range of predicted bacterial functions. Specific bacterial taxa responsive to the addition of anticancer drugs with known roles in nitrification and denitrification were identified. This study shows anticancer drugs should be monitored in the future as they can induce changes in the performance and microbiome of wastewater treatment technologies.


Asunto(s)
Microbiota , Aguas del Alcantarillado , Archaea , Aguas Residuales , Nitrificación
12.
PLoS One ; 19(2): e0291402, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38300968

RESUMEN

Due to the enormous diversity of non-culturable viruses, new viruses must be characterized using culture-independent techniques. The associated host is an important phenotypic feature that can be inferred from metagenomic viral contigs thanks to the development of several bioinformatic tools. Here, we compare the performance of recently developed virus-host prediction tools on a dataset of 1,046 virus-host pairs and then apply the best-performing tools to a metagenomic dataset derived from a highly diverse transiently hypersaline site known as the Archaean Domes (AD) within the Cuatro Ciénegas Basin, Coahuila, Mexico. Among host-dependent methods, alignment-based approaches had a precision of 66.07% and a sensitivity of 24.76%, while alignment-free methods had an average precision of 75.7% and a sensitivity of 57.5%. RaFAH, a virus-dependent alignment-based tool, had the best overall performance (F1_score = 95.7%). However, when predicting the host of AD viruses, methods based on public reference databases (such as RaFAH) showed lower inter-method agreement than host-dependent methods run against custom databases constructed from prokaryotes inhabiting AD. Methods based on custom databases also showed the greatest agreement between the source environment and the predicted host taxonomy, habitat, lifestyle, or metabolism. This highlights the value of including custom data when predicting hosts on a highly diverse metagenomic dataset, and suggests that using a combination of methods and qualitative validations related to the source environment and predicted host biology can increase the number of correct predictions. Finally, these predictions suggest that AD viruses infect halophilic archaea as well as a variety of bacteria that may be halophilic, halotolerant, alkaliphilic, thermophilic, oligotrophic, sulfate-reducing, or marine, which is consistent with the specific environment and the known geological and biological evolution of the Cuatro Ciénegas Basin and its microorganisms.


Asunto(s)
Virus , México , Filogenia , Virus/genética , Bacterias , Ecosistema
13.
Int Psychogeriatr ; : 1-12, 2024 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-38380470

RESUMEN

BACKGROUND: Cognition in MCI has responded poorly to pharmacological interventions, leading to use of computerized training. Combining computerized cognitive training (CCT) and functional skills training software (FUNSAT) produced improvements in 6 functional skills in MCI, with effect sizes >0.75. However, 4% of HC and 35% of MCI participants failed to master all 6 tasks. We address early identification of characteristics that identify participants who do not graduate, to improve later interventions. METHODS: NC participants (n = 72) received FUNSAT and MCI (n = 92) participants received FUNSAT alone or combined FUNSAT and CCT on a fully remote basis. Participants trained twice a week for up to 12 weeks. Participants "graduated" each task when they made one or fewer errors on all 3-6 subtasks per task. Tasks were no longer trained after graduation. RESULTS: Between-group comparisons of graduation status on baseline completion time and errors found that failure to graduate was associated with more baseline errors on all tasks but no longer completion times. A discriminant analysis found that errors on the first task (Ticket purchase) uniquely separated the groups, F = 41.40, p < .001, correctly classifying 94% of graduators. An ROC analysis found an AUC of .83. MOCA scores did not increase classification accuracy. CONCLUSIONS: More baseline errors, but not completion times, predicted failure to master all FUNSAT tasks. Accuracy of identification of eventual mastery was exceptional. Detection of risk to fail to master training tasks is possible in the first 15 minutes of the baseline assessment. This information can guide future enhancements of computerized training.

14.
J Craniofac Surg ; 2024 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-38345947

RESUMEN

Considering the esthetic goals involved in orthognathic surgeries, one of the challenges is to define the horizontal projection of the jaws. Most of the cephalometric analyses are focused on the position of the upper incisor and upper lip. Planning the correction of a mandibular retrognathism can be simplified by clinical simulation asking the patient to project their mandible. A forced esthetic position protocol is presented as a starting point for the planning in orthognathic cases.

15.
Mol Neurobiol ; 2024 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-38349515

RESUMEN

Parkinson's disease (PD) is a neurological disorder that affects dopaminergic neurons. The lack of understanding of the underlying molecular mechanisms of PD pathology makes treating it a challenge. Several pieces of evidence support the protective role of enriched environment (EE) and exercise on dopaminergic neurons. The specific aspect(s) of neuroprotection after exposure to EE have not been identified. Therefore, we have investigated the protective role of EE on dopamine dysregulation and subsequent downregulation of DJ1 protein using in vitro and in vivo models of PD. Our study for the first time demonstrated that DJ1 expression has a direct correlation with dopamine downregulation in PD models and exposure to EE has a significant impact on improving the behavioral changes in PD mice. This research provides evidence that exercise in EE has a positive effect on PD without interfering with the current line of therapy.

16.
Eur J Ophthalmol ; : 11206721241230347, 2024 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-38321862

RESUMEN

PURPOSE: To evaluate the prediction accuracy of 9 IOL power calculation formulas using a heteroscedastic statistical analysis and a novel method for IOL constant optimization. DESIGN: Retrospective case series. METHODS: The LenStar LS900 (Haag-Streit, Koeniz, Switzerland) was used for the preoperative biometry. The predicted SE refraction of the implanted IOL were calculated for: Barrett Universal II, EVO-2.0, Hill RBF-3.0, Hill-RBF 2.0, Kane, PEARL-DGS, SRK-T, Hoffer-Q and Holladay-1. IOL constants were optimized prior to the analysis. A heteroscedastic statistical method was used to compare the standard deviation (SD) of prediction errors (PE). RESULTS: Two hundred seventy-eight eyes of 278 patients were included. The SD of the Kane was 0.4214D and was the lowest in this database. The SD of the PE of the Kane and EVO 2.0 were significantly lower than the SRK-T, Holladay 1, and Hoffer-Q. The SD of the PE of the PEARL formula was significantly lower than the SRK-T and Hoffer-Q. The SD of the PE of the Hill-RBF 3.0 was not significantly different to the Hill-RBF 2.0, Kane, EVO 2.0, Barrett Universal II and PEARL. No significant difference was found between the SD of the PE of the new generation formulas analysed. CONCLUSIONS: the lowest SD of the prediction error was provided by Kane, followed by EVO 2.0 and PERL-DGS formulas. However, no statistically significant differences were found between the SD of the PE of new generation formulas. Further studies are necessary to evaluate the accuracy of these formulas in extreme eyes.

17.
Glob Chang Biol ; 30(1): e17066, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38273563

RESUMEN

Groundwater is a vital ecosystem of the global water cycle, hosting unique biodiversity and providing essential services to societies. Despite being the largest unfrozen freshwater resource, in a period of depletion by extraction and pollution, groundwater environments have been repeatedly overlooked in global biodiversity conservation agendas. Disregarding the importance of groundwater as an ecosystem ignores its critical role in preserving surface biomes. To foster timely global conservation of groundwater, we propose elevating the concept of keystone species into the realm of ecosystems, claiming groundwater as a keystone ecosystem that influences the integrity of many dependent ecosystems. Our global analysis shows that over half of land surface areas (52.6%) has a medium-to-high interaction with groundwater, reaching up to 74.9% when deserts and high mountains are excluded. We postulate that the intrinsic transboundary features of groundwater are critical for shifting perspectives towards more holistic approaches in aquatic ecology and beyond. Furthermore, we propose eight key themes to develop a science-policy integrated groundwater conservation agenda. Given ecosystems above and below the ground intersect at many levels, considering groundwater as an essential component of planetary health is pivotal to reduce biodiversity loss and buffer against climate change.


Asunto(s)
Ecosistema , Agua Subterránea , Biodiversidad , Agua Dulce , Contaminación Ambiental
19.
Int J Mol Sci ; 25(2)2024 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-38255943

RESUMEN

Poly-ADP-Ribose Polymerase (PARP-1) is an overexpressed enzyme in several carcinomas; consequently, the design of PARP-1 inhibitors has acquired special attention. Hence, in the present study, three compounds (8-10) were produced through a Michael addition protocol, using phenylmethanethiol, 5-fluoro-2-mercaptobenzyl alcohol, and 4-mercaptophenylacetic acid, respectively, as nucleophiles and perezone as the substrate, expecting them to be convenient candidates that inhibit PARP-1. It is convenient to note that in the first stage of the whole study, the molecular dynamics (MD) simulations and the quantum chemistry studies of four secondary metabolites, i.e., perezone (1), perezone angelate (2), hydroxyperezone (3), and hydroxyperezone monoangelate (4), were performed, to investigate their interactions in the active site of PARP-1. Complementarily, a docking study of a set of eleven sulfur derivatives of perezone (5-15) was projected to explore novel compounds, with remarkable affinity to PARP-1. The molecules 8-10 provided the most adequate results; therefore, they were evaluated in vitro to determine their activity towards PARP-1, with 9 having the best IC50 (0.317 µM) value. Additionally, theoretical calculations were carried out using the density functional theory (DFT) with the hybrid method B3LYP with a set of base functions 6-311++G(d,p), and the reactivity properties were compared between the natural derivatives of perezone and the three synthesized compounds, and the obtained results exhibited that 9 has the best properties to bind with PARP-1. Finally, it is important to mention that 9 displays significant inhibitory activity against MDA-MB-231 and MCF-7 cells, i.e., 145.01 and 83.17 µM, respectively.


Asunto(s)
Ciclohexenos , Neoplasias , Inhibidores de Poli(ADP-Ribosa) Polimerasas , Sesquiterpenos , Humanos , Inhibidores de Poli(ADP-Ribosa) Polimerasas/farmacología , Células MCF-7 , Simulación de Dinámica Molecular , Neoplasias/tratamiento farmacológico
20.
J Clin Immunol ; 44(2): 44, 2024 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-38231408

RESUMEN

Defining monogenic drivers of autoinflammatory syndromes elucidates mechanisms of disease in patients with these inborn errors of immunity and can facilitate targeted therapeutic interventions. Here, we describe a cohort of patients with a Behçet's- and inflammatory bowel disease (IBD)-like disorder termed "deficiency in ELF4, X-linked" (DEX) affecting males with loss-of-function variants in the ELF4 transcription factor gene located on the X chromosome. An international cohort of fourteen DEX patients was assessed to identify unifying clinical manifestations and diagnostic criteria as well as collate findings informing therapeutic responses. DEX patients exhibit a heterogeneous clinical phenotype including weight loss, oral and gastrointestinal aphthous ulcers, fevers, skin inflammation, gastrointestinal symptoms, arthritis, arthralgia, and myalgia, with findings of increased inflammatory markers, anemia, neutrophilic leukocytosis, thrombocytosis, intermittently low natural killer and class-switched memory B cells, and increased inflammatory cytokines in the serum. Patients have been predominantly treated with anti-inflammatory agents, with the majority of DEX patients treated with biologics targeting TNFα.


Asunto(s)
Artritis , Síndrome de Behçet , Productos Biológicos , Enfermedades Inflamatorias del Intestino , Masculino , Humanos , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/genética , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/genética , Artralgia , Proteínas de Unión al ADN , Factores de Transcripción/genética
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