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1.
J Comp Neurol ; 532(4): e25611, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38625816

RESUMEN

A core component of the avian pallial cognitive network is the multimodal nidopallium caudolaterale (NCL) that is considered to be analogous to the mammalian prefrontal cortex (PFC). The NCL plays a key role in a multitude of executive tasks such as working memory, decision-making during navigation, and extinction learning in complex learning environments. Like the PFC, the NCL is positioned at the transition from ascending sensory to descending motor systems. For the latter, it sends descending premotor projections to the intermediate arcopallium (AI) and the medial striatum (MSt). To gain detailed insight into the organization of these projections, we conducted several retrograde and anterograde tracing experiments. First, we tested whether NCL neurons projecting to AI (NCLarco neurons) and MSt (NCLMSt neurons) are constituted by a single neuronal population with bifurcating neurons, or whether they form two distinct populations. Here, we found two distinct projection patterns to both target areas that were associated with different morphologies. Second, we revealed a weak topographic projection toward the medial and lateral striatum and a strong topographic projection toward AI with clearly distinguishable sensory termination fields. Third, we investigated the relationship between the descending NCL pathways to the arcopallium with those from the hyperpallium apicale, which harbors a second major descending pathway of the avian pallium. We embed our findings within a system of parallel pallio-motor loops that carry information from separate sensory modalities to different subpallial systems. Our results also provide insights into the evolution of the avian motor system from which, possibly, the song system has emerged.


Asunto(s)
Encéfalo , Columbidae , Animales , Columbidae/fisiología , Corteza Cerebral/fisiología , Cuerpo Estriado , Neostriado/fisiología , Mamíferos
2.
Nat Commun ; 13(1): 6941, 2022 11 17.
Artículo en Inglés | MEDLINE | ID: mdl-36396957

RESUMEN

Chronic obstructive airway diseases are a global medical burden that is expected to increase in the near future. However, the underlying mechanistic processes are poorly understood so far. Herein, we show that the endocannabinoid anandamide (AEA) induces prominent airway relaxation in vitro and in vivo. In contrast to 2-arachidonlyglycerol-induced airway relaxation, this is mediated by fatty acid amide hydrolase (FAAH)-dependent metabolites. In particular, we identify mouse and also human epithelial and airway smooth muscle cells as source of AEA-induced prostaglandin E2 production and cAMP as direct mediator of AEA-dependent airway relaxation. Mass spectrometry experiments demonstrate reduced levels of endocannabinoid-like compounds in lungs of ovalbumin-sensitized mice indicating a pathophysiological relevance of endocannabinoid signalling in obstructive airway disease. Importantly, AEA inhalation protects against airway hyper-reactivity after ovalbumin sensitization. Thus, this work highlights the AEA/FAAH axis as a critical regulator of airway tone that could provide therapeutic targets for airway relaxation.


Asunto(s)
Ácidos Araquidónicos , Endocannabinoides , Animales , Ratones , Humanos , Endocannabinoides/metabolismo , Ovalbúmina , Ácidos Araquidónicos/metabolismo , Alcamidas Poliinsaturadas/metabolismo
3.
Monatsschr Kinderheilkd ; : 1-4, 2022 Feb 17.
Artículo en Alemán | MEDLINE | ID: mdl-35194247

RESUMEN

This article reports the case of a 3-year-old boy who was presented with a significant hypercalcemia caused by vitamin D toxicity. The parents had bought over the counter high-dose vitamin D drops online and administered the drops without following the dosage recommendation. The refractory hypercalcemia was treated with one dose of a bisphosphonate, which quickly caused a stabilization of serum calcium levels. The boy could be discharged free of complaints.

4.
World J Urol ; 38(6): 1423-1435, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31506747

RESUMEN

OBJECTIVES: The benign prostatic syndrome, comprising lower urinary tract symptomatology secondary to benign prostatic hyperplasia/enlargement, represents a major health care issue in westernized countries. The pharmacological management involves alpha-adrenoceptor antagonists, intervention into the hormonal control of prostate growth using inhibitors of the enzyme 5-alpha-reductase, and stimulation of the nitric oxide/cyclic GMP pathway by tadalafil, an inhibitor of the phosphodiesterase type 5. METHODS: This review summarizes the achievements which have been made in the development of drug candidates assumed to offer opportunities as beneficial treatment options in the management of the benign prostatic syndrome. RESULTS: A review of the literature has revealed that the line of development is focusing on drugs interfering with peripheral neuromuscular/neuronal mechanisms (nitric oxide donor drugs, agonists/antagonists of endogenous peptides, botulinum toxin, NX-1207), the steroidal axis (cetrorelix) or the metabolic turn-over (lonidamine), as well as the combination of drugs already established in the treatment of lower urinary tract symptomatology/benign prostatic hyperplasia (phosphodiesterase 5 inhibitor plus alpha-adrenoceptor antagonist). CONCLUSION: Many research efforts have provided the basis for the development of new therapeutic modalities for the management of lower urinary tract dysfunctions, some of which might be offered to the patients in the near future.


Asunto(s)
Síntomas del Sistema Urinario Inferior/tratamiento farmacológico , Hiperplasia Prostática/tratamiento farmacológico , Antagonistas Adrenérgicos alfa/uso terapéutico , Toxinas Botulínicas/uso terapéutico , Humanos , Síntomas del Sistema Urinario Inferior/etiología , Masculino , Óxido Nítrico/antagonistas & inhibidores , Hiperplasia Prostática/complicaciones , Transducción de Señal/efectos de los fármacos
5.
FASEB J ; 32(5): 2519-2530, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29295855

RESUMEN

Pulmonary hypertension is a severe, incurable disease with a poor prognosis. Although treatment regimens have improved during the last 2 decades, current pharmacologic strategies are limited and focus on the modulation of only a few pathways related to endothelin, NO, and prostacyclin signaling. Therefore, the identification of novel molecular targets is urgently needed. We found that the ß2 adrenoceptor (AR) agonists terbutaline (TER) and salbutamol induced a dose-dependent vasorelaxation in large pulmonary arteries but not aortas of mouse. This effect was found to be independent of ß ARs and the endothelium but was determined by the type of the preconstrictor. Vasodilation by ß2 AR agonists occurred after pretreatment of pulmonary arteries with phenylephrine and serotonin, both agonists of α1 ARs, but was absent after preconstriction with the thromboxane analog U46619. These data indicated α-adrenolytic activity of ß2 AR agonists, which was confirmed by a right shift of the phenylephrine dose-response curve by TER. This effect was physiologically relevant because TER also relaxed small intrapulmonary arteries in lung slices and diminished pulmonary arterial pressure in an isolated perfused lung model under normoxia and hypoxia. Finally, TER applied as an aerosol also selectively decreased pulmonary arterial pressure without effects on systemic blood pressure and heart rate in mouse in vivo. Thus, ß2 AR agonists display α-adrenolytic activity in pulmonary arteries ex vivo and in vivo, and may provide a novel option to reduce pulmonary arterial pressure in pulmonary hypertension.-Neumann, V., Knies, R., Seidinger, A., Simon, A., Lorenz, K., Matthey, M., Breuer, J., Wenzel, D. The ß2 agonist terbutaline specifically decreases pulmonary arterial pressure under normoxia and hypoxia via α adrenoceptor antagonism.


Asunto(s)
Agonistas de Receptores Adrenérgicos beta 2/farmacología , Presión Sanguínea/efectos de los fármacos , Hipertensión Pulmonar/fisiopatología , Hipoxia/fisiopatología , Pulmón , Arteria Pulmonar/fisiopatología , Receptores Adrenérgicos alfa 1/metabolismo , Terbutalina/farmacología , Ácido 15-Hidroxi-11 alfa,9 alfa-(epoximetano)prosta-5,13-dienoico/farmacología , Animales , Hipertensión Pulmonar/metabolismo , Hipoxia/metabolismo , Pulmón/irrigación sanguínea , Pulmón/fisiopatología , Ratones , Fenilefrina/farmacología , Arteria Pulmonar/metabolismo
6.
Front Physiol ; 8: 888, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29249973

RESUMEN

The odorant receptor 51E2 (OR51E2), which is well-characterized in prostate cancer cells and epidermal pigment cells, was identified for the first time as the most highly expressed OR in human fetal and adult retinal pigment epithelial (RPE) cells. Immunofluorescence staining and Western blot analysis revealed OR51E2 localization throughout the cytosol and in the plasma membrane. Additionally, immunohistochemical staining of diverse layers of the eye showed that the expression of OR51E2 is restricted to the pigment cells of the RPE and choroid. The results of Ca2+-imaging experiments demonstrate that activation of OR51E2 triggers a Ca2+ dependent signal pathway in RPE cells. Downstream signaling of OR51E2 involves the activation of adenylyl cyclase, ERK1/2 and AKT. The activity of these protein kinases likely accounts for the demonstrated increase in the migration and proliferation of RPE cells upon stimulation with the OR51E2 ligand ß-ionone. These findings suggest that OR51E2 is involved in the regulation of RPE cell growth. Thus, OR51E2 represents a potential target for the treatment of proliferative disorders.

7.
Sci Transl Med ; 9(407)2017 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-28904224

RESUMEN

Obstructive lung diseases are common causes of disability and death worldwide. A hallmark feature is aberrant activation of Gq protein-dependent signaling cascades. Currently, drugs targeting single G protein (heterotrimeric guanine nucleotide-binding protein)-coupled receptors (GPCRs) are used to reduce airway tone. However, therapeutic efficacy is often limited, because various GPCRs contribute to bronchoconstriction, and chronic exposure to receptor-activating medications results in desensitization. We therefore hypothesized that pharmacological Gq inhibition could serve as a central mechanism to achieve efficient therapeutic bronchorelaxation. We found that the compound FR900359 (FR), a membrane-permeable inhibitor of Gq, was effective in silencing Gq signaling in murine and human airway smooth muscle cells. Moreover, FR both prevented bronchoconstrictor responses and triggered sustained airway relaxation in mouse, pig, and human airway tissue ex vivo. Inhalation of FR in healthy wild-type mice resulted in high local concentrations of the compound in the lungs and prevented airway constriction without acute effects on blood pressure and heart rate. FR administration also protected against airway hyperreactivity in murine models of allergen sensitization using ovalbumin and house dust mite as allergens. Our findings establish FR as a selective Gq inhibitor when applied locally to the airways of mice in vivo and suggest that pharmacological blockade of Gq proteins may be a useful therapeutic strategy to achieve bronchorelaxation in asthmatic lung disease.


Asunto(s)
Asma/metabolismo , Asma/fisiopatología , Subunidades alfa de la Proteína de Unión al GTP Gq-G11/antagonistas & inhibidores , Pulmón/metabolismo , Pulmón/fisiopatología , Relajación Muscular , Transducción de Señal , Animales , Asma/tratamiento farmacológico , Asma/parasitología , Broncoconstricción , Depsipéptidos/farmacología , Depsipéptidos/uso terapéutico , Modelos Animales de Enfermedad , Subunidades alfa de la Proteína de Unión al GTP Gq-G11/metabolismo , Humanos , Ratones , Relajación Muscular/efectos de los fármacos , Miocitos del Músculo Liso/metabolismo , Ovalbúmina , Neumonía/complicaciones , Neumonía/tratamiento farmacológico , Neumonía/patología , Pyroglyphidae , Sus scrofa
8.
Oncotarget ; 7(30): 48231-48249, 2016 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-27374083

RESUMEN

The development of prostate cancer (PCa) is regulated by the androgen-dependent activity of the androgen receptor (AR). Androgen-deprivation therapy (ADT) is therefore the gold standard treatment to suppress malignant progression of PCa. Nevertheless, due to the development of castration resistance, recurrence of disease after initial response to ADT is a major obstacle to successful treatment. As G-protein coupled receptors play a fundamental role in PCa physiology, they might represent promising alternative or combinatorial targets for advanced diseases. Here, we verified gene expression of the olfactory receptors (ORs) OR51E1 [prostate-specific G-protein coupled receptor 2 (PSGR2)] and OR51E2 (PSGR) in human PCa tissue by RNA-Seq analysis and RT-PCR and elucidated the subcellular localization of both receptor proteins in human prostate tissue. The OR51E1 agonist nonanoic acid (NA) leads to the phosphorylation of various protein kinases and growth suppression of the PCa cell line LNCaP. Furthermore, treatment with NA causes reduction of androgen-mediated AR target gene expression. Interestingly, NA induces cellular senescence, which coincides with reduced E2F1 mRNA levels. In contrast, treatment with the structurally related compound 1-nonanol or the OR2AG1 agonist amyl butyrate, neither of which activates OR51E1, did not lead to reduced cell growth or an induction of cellular senescence. However, decanoic acid, another OR51E1 agonist, also induces cellular senescence. Thus, our results suggest the involvement of OR51E1 in growth processes of PCa cells and its impact on AR-mediated signaling. These findings provide novel evidences to support the functional importance of ORs in PCa pathogenesis.


Asunto(s)
Proteínas de Neoplasias/metabolismo , Neoplasias de la Próstata/metabolismo , Receptores Acoplados a Proteínas G/metabolismo , Línea Celular Tumoral , Proliferación Celular/fisiología , Senescencia Celular , Progresión de la Enfermedad , Humanos , Masculino , Proteínas de Neoplasias/biosíntesis , Fosforilación , Neoplasias de la Próstata/genética , Neoplasias de la Próstata/patología , Neoplasias de la Próstata Resistentes a la Castración/genética , Neoplasias de la Próstata Resistentes a la Castración/metabolismo , Neoplasias de la Próstata Resistentes a la Castración/patología , Receptores Androgénicos/metabolismo , Receptores Acoplados a Proteínas G/biosíntesis , Transducción de Señal , Transfección
9.
J Comp Neurol ; 524(2): 343-61, 2016 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-26179777

RESUMEN

The anterior commissure (AC) and the much smaller hippocampal commissure constitute the only interhemispheric pathways at the telencephalic level in birds. Since the degeneration study from Zeier and Karten (), no detailed description of the topographic organization of the AC has been performed. This information is not only necessary for a better understanding of interhemispheric transfer in birds, but also for a comparative analysis of the evolution of commissural systems in the vertebrate classes. We therefore examined the fiber connections of the AC by using choleratoxin subunit B (CTB) and biotinylated dextran amine (BDA). Injections into subareas of the arcopallium and posterior amygdala (PoA) demonstrated contralateral projection fields within the anterior arcopallium (AA), intermediate arcopallium (AI), PoA, lateral, caudolateral and central nidopallium, dorsal and ventral mesopallium, and medial striatum (MSt). Interestingly, only arcopallial and amygdaloid projections were reciprocally organized, and all AC projections originated within a rather small area of the arcopallium and the PoA. The commissural neurons were not GABA-positive, and thus possibly not of an inhibitory nature. In sum, our neuroanatomical study demonstrates that a small group of arcopallial and amygdaloid neurons constitute a wide range of contralateral projections to sensorimotor and limbic structures. Different from mammals, in birds the neurons that project via the AC constitute mostly heterotopically organized and unidirectional connections. In addition, the great majority of pallial areas do not participate by themselves in interhemispheric exchange in birds. Instead, commissural exchange rests on a rather small arcopallial and amygdaloid cluster of neurons.


Asunto(s)
Comisura Anterior Cerebral/metabolismo , Columbidae/anatomía & histología , Animales , Biotina/análogos & derivados , Biotina/metabolismo , Toxina del Cólera/metabolismo , Cuerpo Estriado , Dextranos/metabolismo , Femenino , Masculino , Vías Nerviosas/metabolismo , Neuroquímica , Tirosina 3-Monooxigenasa/metabolismo , Ácido gamma-Aminobutírico/metabolismo
10.
Arch Biochem Biophys ; 566: 100-9, 2015 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-25513961

RESUMEN

Terpenes are the major constituents of essential oils in plants. In recent years, terpenes have become of clinical relevance due to their ability to suppress cancer development. Their effect on cellular proliferation has made them promising agents in the prevention or treatment of many types of cancer. In the present study, a subset of different monoterpenes was investigated for their molecular effects on the hepatocellular carcinoma cell line Huh7. Using fluorometric calcium imaging, acyclic monoterpene (-)-citronellal was found to induce transient Ca(2+) signals in Huh7 cells by activating a cAMP-dependent signaling pathway. Moreover, we detected the (-)-citronellal-activated human olfactory receptor OR1A2 at the mRNA and protein levels and demonstrated its potential involvement in (-)-citronellal-induced calcium signaling in Huh7 cells. Furthermore, activation of OR1A2 results in phosphorylation of p38 MAPK and reduced cell proliferation, indicating an effect on hepatocellular carcinoma progression. Here, we provide for the first time data on the molecular mechanism evoked by (-)-citronellal in human hepatocellular carcinoma cells. The identified olfactory receptor could serve as a potential therapeutic target for cancer diagnosis and treatment.


Asunto(s)
Aldehídos/farmacología , Antineoplásicos Fitogénicos/farmacología , Regulación Neoplásica de la Expresión Génica , Hepatocitos/efectos de los fármacos , Monoterpenos/farmacología , ARN Mensajero/genética , Receptores Odorantes/genética , Monoterpenos Acíclicos , Calcio/metabolismo , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , AMP Cíclico/metabolismo , Hepatocitos/metabolismo , Hepatocitos/patología , Humanos , Transporte Iónico/efectos de los fármacos , Fosforilación/efectos de los fármacos , ARN Mensajero/agonistas , ARN Mensajero/metabolismo , Receptores Odorantes/agonistas , Receptores Odorantes/metabolismo , Transducción de Señal/efectos de los fármacos , Proteínas Quinasas p38 Activadas por Mitógenos/genética , Proteínas Quinasas p38 Activadas por Mitógenos/metabolismo
11.
J Orthop Sci ; 18(1): 38-44, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23001127

RESUMEN

BACKGROUND: Treating patellofemoral articular cartilage lesions remains a challenging task in orthopedic surgery. Whereas microfracture and autologous chondrocyte implantation yield good results on femoral condyles, the therapeutic state of the art for treating patellofemoral lesions is yet to be determined. In this study, we compared the CaReS technique, which is a matrix-associated autologous chondrocyte implantation technique, to microfracture for treating patellofemoral articular cartilage lesions. METHODS: Between May 2003 and December 2005, 17 patients with an isolated patellofemoral cartilage defect (International Cartilage Repair Society III/IV) were treated with the CaReS technique at our department. After adjusting for inclusion and exclusion criteria, ten of these patients could be included in this study; ten patients treated with microfracture were chosen as a matched-pair group. Clinical outcome was evaluated 3 years after surgery by the 36-item Short Form Health Survey Questionnaire (SF-36), International Knee Documentation Committee (IKDC) subjective evaluation of the knee, Lysholm Score, and Cincinnati Modified Rating Scale scores. RESULTS: Patients treated with CaReS had statistically significantly improved IKDC, Lysholm, and Cincinnati scores 36 months after surgery compared with preoperatively. When comparing outcome between groups 36 months after surgery, there was no statistically difference in IKDC, Lysholm, and Cincinnati scores. CONCLUSIONS: This is the first trial comparing the CaReS technique and microfracture for treating patellofemoral articular cartilage lesions, and results show that CaReS(®) yields comparable results to microfracture. The small number of patients is a limiting factor of the study, leading to results without statistical significance. A multicentric prospective randomized study comparing the two procedures is desirable.


Asunto(s)
Artroplastia Subcondral/métodos , Enfermedades de los Cartílagos/cirugía , Cartílago Articular/cirugía , Traumatismos de la Rodilla/cirugía , Articulación Patelofemoral/cirugía , Adulto , Artroscopía , Biopsia , Enfermedades de los Cartílagos/diagnóstico , Enfermedades de los Cartílagos/etiología , Cartílago Articular/lesiones , Cartílago Articular/patología , Condrocitos/trasplante , Femenino , Estudios de Seguimiento , Humanos , Traumatismos de la Rodilla/diagnóstico , Imagen por Resonancia Magnética , Masculino , Articulación Patelofemoral/lesiones , Articulación Patelofemoral/patología , Estudios Prospectivos , Estudios Retrospectivos , Trasplante Autólogo
12.
Technol Health Care ; 19(6): 469-79, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-22129947

RESUMEN

Injuries of tendons and ligaments give rise to significant morbidity. Tissue engineering offers promising treatment concepts such as seeding a scaffold with human bone marrow stem cells (hBMSCs) to create high-quality tendon replacement tissue. HBMSCs are usually isolated and cultured prior to seeding. Studies evaluating if previous isolation is superior to seeding with bone marrow aspirates have not been published yet. The aim of this study was to compare these two seeding methods in terms of cell viability, proliferation and differentiation. HBMSCs were harvested from the iliac crest during routine trauma surgery. In group A the scaffold (human achilles tendons) was seeded with bone marrow aspirates, while in group B hBMSCs were isolated, harvested and then seeded. Constructs were stimulated in perfusion bioreactors according to established protocols. Mean cell proliferation was significantly increased (p< 0.05) on tendons seeded with bone marrow aspirates. Cell viability, the concentration of alkaline phosphatase in the perfused media and the synthesis of procollagen - III - polypeptide (PIIIP) were not significantly different when comparing the two groups. The synthesis of procollagen-I-polypeptide (PIP) was significantly increased on tendons seeded with previously isolated hBMSCs p < 0.05). The results indicate that seeding a human tendon matrix scaffold with bone marrow aspirates may be equal to seeding with previously isolated hBMSCs. This new seeding method could facilitate and speed up the tissue engineering process.


Asunto(s)
Tendón Calcáneo/citología , Células de la Médula Ósea/fisiología , Células Madre Mesenquimatosas/fisiología , Ingeniería de Tejidos/métodos , Tendón Calcáneo/fisiología , Adulto , Fosfatasa Alcalina/metabolismo , Proliferación Celular , Supervivencia Celular , Colágeno Tipo I/metabolismo , Colágeno Tipo II/metabolismo , Matriz Extracelular , Humanos , Péptidos y Proteínas de Señalización Intercelular/metabolismo , Persona de Mediana Edad , Procolágeno/metabolismo
14.
Expert Rev Anticancer Ther ; 9(10): 1429-34, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19828003

RESUMEN

Metastatic renal cell carcinoma (mRCC) is a highly vascularized tumor with a generally poor prognosis. It is largely resistant to conventional cancer treatment, including most schemes of hormonal and cytokine therapy as well as to modern chemotherapy. Although IFN-alpha has been the first choice in mRCC treatment strategies for more than a decade, recent recommendations of the European Association of Urology focus on so-called molecular-targeted therapies, with multikinase inhibitors, such as sorafenib and sunitinib, blocking the progression of cell proliferation and tumor angiogenesis, as preferential therapy. Sorafenib targets the VEGF receptor, the PDGF receptor beta and, finally, Raf kinase, and is approved for patients who have either received cytokines or are unsuitable for such a therapy. Although targeted therapies reveal superior efficacy compared with previous cytokine-based approaches, they do not cure patients with metastatic disease. Therefore, following tumor progression, most patients require a second-line or sequential therapy during the further progress of the disease. Owing to the fact that optimal sequencing of these new agents has not been fully elucidated, some recent mainly retrospective studies compared the sequence of sorafenib and sunitinib in order to assess the best clinical benefit in mRCC patients. Apparently, no cross-resistance could be observed in any trial, and most results demonstrated a superior efficacy of a sequence strategy when sorafenib was applied as first-line treatment. Regarding current investigations, the aim of the present article is to address and critically discuss the clinical data concerning the efficacy of sorafenib as part of a sequential treatment of mRCC.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Renales/tratamiento farmacológico , Neoplasias Renales/tratamiento farmacológico , Bencenosulfonatos/administración & dosificación , Carcinoma de Células Renales/diagnóstico , Carcinoma de Células Renales/fisiopatología , Ensayos Clínicos como Asunto , Sistemas de Liberación de Medicamentos , Resistencia a Antineoplásicos , Humanos , Indoles/administración & dosificación , Neoplasias Renales/diagnóstico , Neoplasias Renales/fisiopatología , Metástasis de la Neoplasia , Niacinamida/análogos & derivados , Compuestos de Fenilurea , Pronóstico , Piridinas/administración & dosificación , Pirroles/administración & dosificación , Sorafenib , Sunitinib
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