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1.
Animal Model Exp Med ; 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38720469

RESUMO

BACKGROUND: Atherosclerosis is a chronic cardiovascular disease of great concern. However, it is difficult to establish a direct connection between conventional small animal models and clinical practice. The pig's genome, physiology, and anatomy reflect human biology better than other laboratory animals, which is crucial for studying the pathogenesis of atherosclerosis. METHODS: We used whole-genome sequencing data from nine Bama minipigs to perform a genome-wide linkage analysis, and further used bioinformatic tools to filter and identify underlying candidate genes. Candidate gene function prediction was performed using the online prediction tool STRING 12.0. Immunohistochemistry and immunofluorescence were used to detect the expression of proteins encoded by candidate genes. RESULTS: We mapped differential single nucleotide polymorphisms (SNPs) to genes and obtained a total of 102 differential genes, then we used GO and KEGG pathway enrichment analysis to identify four candidate genes, including SLA-1, SLA-2, SLA-3, and TAP2. nsSNPs cause changes in the primary and tertiary structures of SLA-I and TAP2 proteins, the primary structures of these two proteins have undergone amino acid changes, and the tertiary structures also show slight changes. In addition, immunohistochemistry and immunofluorescence results showed that the expression changes of TAP2 protein in coronary arteries showed a trend of increasing from the middle layer to the inner layer. CONCLUSIONS: We have identified SLA-I and TAP2 as potential susceptibility genes of atherosclerosis, highlighting the importance of antigen processing and immune response in atherogenesis.

2.
J Therm Biol ; 118: 103696, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37871397

RESUMO

Heatstroke (HS) causes multiple organ dysfunction syndrome (MODS) with a mortality rate of 60% after hospitalization. Currently, there is no effective and targeted approach for the treatment of HS. Despite growing evidence that mesenchymal stem cells (MSCs) may reduce multiorgan damage and improve survival through immunomodulatory effects in several diseases, no one has tested whether MSCs have immunomodulatory effects in heatstroke. The present study focused on pathological changes and levels of the cytokines and immunoglobulins to investigate the mechanisms underlying the protective effect and the anti-inflammatory effects of MSCs. We found that MSCs treatment significantly reduced the 28-day mortality rate (P < 0.05), the levels of hepatic and renal function markers on day 1 (P < 0.01) and the pathological lesion scores of multiple organs in HS rats. The levels of IgG1, IgM, and IgA of the HS + MSC group was significantly higher than that in HS group on days 3 and 28(P < 0.05). In conclusion, MSCs contribute to protecting against multiorgan injury, reducing pro-inflammatory cytokines, stabilizing immunoglobulins, and reducing the mortality rate of HS rats.


Assuntos
Golpe de Calor , Células-Tronco Mesenquimais , Ratos , Masculino , Animais , Insuficiência de Múltiplos Órgãos/etiologia , Insuficiência de Múltiplos Órgãos/prevenção & controle , Golpe de Calor/terapia , Citocinas , Imunoglobulinas
3.
J Interferon Cytokine Res ; 42(1): 19-28, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35041514

RESUMO

CCL18 is a CC chemokine that exhibits diverse functions through interaction with various cell subsets with both proinflammatory anti-inflammatory properties through its receptors CCR8 (CC chemokine receptor 8) and PITPNM3 (phosphatidylinositol transfer protein 3). However, the function of CCL18 in microglia remains unclear. In this study, we show that CCL18 did not change the expression of the inflammatory factors, interleukin (IL)-1ß, IL-6, tumor necrosis factor alpha (TNF-α), or inducible nitric oxide synthase (iNOS), but significantly induced expression of the macrophage markers, MRC-1 and ARG-1 M2, in a human microglial clone 3 cell line (HMC3). Phagocytosis by HMC3 cells was significantly enhanced in the presence of CCL18, indicated by uptake of amyloid-ß and dextran. CCR8 and PITPNM3 were both expressed on HMC3 cells, but selective knockdown of CCR8 and PITPNM3 showed that only the former played a dominant role in phagocytosis of HMC3 through the nuclear factor kappa B (NF-κB)/Src signaling pathway. Our results suggest that CCL18 could have anti-inflammatory activity and activate the phagocytic function of microglia, which is involved in neural development, homeostasis, and repair mechanisms.


Assuntos
Quimiocina CCL18 , Microglia , Proteínas de Ligação ao Cálcio/metabolismo , Quimiocinas CC , Humanos , Lipopolissacarídeos , Macrófagos/metabolismo , Proteínas de Membrana/metabolismo , Microglia/metabolismo , NF-kappa B/metabolismo , Óxido Nítrico Sintase Tipo II/metabolismo , Fagocitose , Receptores CCR8/metabolismo , Fator de Necrose Tumoral alfa/metabolismo
4.
Anaesthesist ; 70(Suppl 1): 60-67, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34143234

RESUMO

BACKGROUND: Postoperative cognitive dysfunction (POCD) is one of the main causes of morbidity after noncardiac surgery; however, the pathogenic mechanisms of POCD have remained unclear until now. In this study, we performed a pilot study to investigate the association between apolipoprotein E (ApoE) ε4 and POCD in older patients undergoing intravenous anesthesia (IVA) and inhalation anesthesia (IAA). METHODS: In total, 180 patients from Shenzhen People's Hospital were recruited and randomly divided into an IVA group and an IAA group. The IVA group and IAA group received propofol and sevoflurane treatment, respectively. Within 7 days after surgery, the mini-mental state examination (MMSE) was used daily to assess the cognitive function of both groups of patients. The genotypes of the ApoE gene were detected using the restriction fragment length polymorphism technique. In addition, the serum levels of (soluble protein-100ß) S­100ß and (Interleukin- 6) L­6 were also analyzed. RESULTS: Compared to the preoperative and IVA groups, the MMSE score in the IAA group significantly decreased at 3 days after surgery. Furthermore, the IAA group had a higher percentage of patients who scored less than 25 points than the IVA group at 3 days after surgery. The decrease in the MMSE score was closely related to the ApoE ε4 allele in the IAA group, but this correlation was not observed in the IVA group. The levels of S­100ß and IL­6 were increased sharply in patients with the ε4/ε4 genotype who received IAA compared with IVA at 1 day after surgery. CONCLUSION: The results of the study indicated that the ApoΕ Îµ4/ε4 genotype was a risk factor for early POCD in older patients undergoing sevoflurane anesthesia.


Assuntos
Complicações Cognitivas Pós-Operatórias , Idoso , Alelos , Anestesia por Inalação , Apolipoproteínas , Genótipo , Humanos , Testes Neuropsicológicos , Projetos Piloto
5.
Braz J Med Biol Res ; 52(3): e7905, 2019 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-30810621

RESUMO

Dexmedetomidine (DEX), a selective agonist of α2-adrenergic receptors, has anti-inflammation properties and potential beneficial effects against trauma, shock, or infection. Therefore, this study aimed to investigate whether DEX might protect against multiple-organ dysfunction in a two-hit model of hemorrhage/resuscitation (HS) and subsequent endotoxemia. Eighty Wistar rats were randomized into four groups: NS (normal saline), HS/L (HS plus lipopolysaccharide), HS/L+D (HS/L plus dexmedetomidine), and HS/L+D+Y (HS/L+D plus yohimbine). Six hours after resuscitation, blood gas (PaO2) and serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urine nitrogen (BUN), creatinine (Cr), TNF-α, IL-ß, IL-6, IL-8, IL-10, and nitric oxide (NO) were measured. The histopathology was assayed by staining. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels and heme oxygenase-1 (HO-1) were assayed. The PaO2 levels in HS/L rats were lower whereas the ALT, AST, BUN, Cr, TNF-α, IL-ß, IL-6, IL-8, IL-10, and NO levels were higher compared to the control group. The HS/L+D increased PaO2 and further increased IL-10 and decreased ALT, AST, BUN, Cr, TNF-α, IL-ß, IL-6, IL-8, and NO levels of the HS/L groups. In addition, the MDA in the HS/L groups increased whereas SOD activity decreased compared to the control group. Moreover, the HO-1 expression levels were increased by DEX administration in lung, liver, and kidney tissues. Lungs, livers, and kidneys of the HS/L group displayed significant damage, but such damage was attenuated in the HS/L+D group. All of the above-mentioned effects of DEX were partly reversed by yohimbine. DEX reduced multiple organ injury caused by HS/L in rats, which may be mediated, at least in part, by α2-adrenergic receptors.


Assuntos
Dexmedetomidina/uso terapêutico , Endotoxemia/tratamento farmacológico , Hemorragia/tratamento farmacológico , Insuficiência de Múltiplos Órgãos/tratamento farmacológico , Substâncias Protetoras/uso terapêutico , Ressuscitação , Animais , Biomarcadores/sangue , Modelos Animais de Doenças , Endotoxemia/patologia , Hemorragia/patologia , Masculino , Insuficiência de Múltiplos Órgãos/patologia , Estresse Oxidativo/efeitos dos fármacos , Ratos , Ratos Wistar , Receptores Adrenérgicos beta 2/efeitos dos fármacos , Receptores Adrenérgicos beta 2/metabolismo , Fatores de Tempo
6.
Braz. j. med. biol. res ; 52(3): e7905, 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-984036

RESUMO

Dexmedetomidine (DEX), a selective agonist of α2-adrenergic receptors, has anti-inflammation properties and potential beneficial effects against trauma, shock, or infection. Therefore, this study aimed to investigate whether DEX might protect against multiple-organ dysfunction in a two-hit model of hemorrhage/resuscitation (HS) and subsequent endotoxemia. Eighty Wistar rats were randomized into four groups: NS (normal saline), HS/L (HS plus lipopolysaccharide), HS/L+D (HS/L plus dexmedetomidine), and HS/L+D+Y (HS/L+D plus yohimbine). Six hours after resuscitation, blood gas (PaO2) and serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urine nitrogen (BUN), creatinine (Cr), TNF-α, IL-β, IL-6, IL-8, IL-10, and nitric oxide (NO) were measured. The histopathology was assayed by staining. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels and heme oxygenase-1 (HO-1) were assayed. The PaO2 levels in HS/L rats were lower whereas the ALT, AST, BUN, Cr, TNF-α, IL-β, IL-6, IL-8, IL-10, and NO levels were higher compared to the control group. The HS/L+D increased PaO2 and further increased IL-10 and decreased ALT, AST, BUN, Cr, TNF-α, IL-β, IL-6, IL-8, and NO levels of the HS/L groups. In addition, the MDA in the HS/L groups increased whereas SOD activity decreased compared to the control group. Moreover, the HO-1 expression levels were increased by DEX administration in lung, liver, and kidney tissues. Lungs, livers, and kidneys of the HS/L group displayed significant damage, but such damage was attenuated in the HS/L+D group. All of the above-mentioned effects of DEX were partly reversed by yohimbine. DEX reduced multiple organ injury caused by HS/L in rats, which may be mediated, at least in part, by α2-adrenergic receptors.


Assuntos
Animais , Masculino , Ratos , Ressuscitação , Endotoxemia/tratamento farmacológico , Substâncias Protetoras/uso terapêutico , Dexmedetomidina/uso terapêutico , Hemorragia/tratamento farmacológico , Insuficiência de Múltiplos Órgãos/tratamento farmacológico , Fatores de Tempo , Biomarcadores/sangue , Ratos Wistar , Receptores Adrenérgicos beta 2/efeitos dos fármacos , Receptores Adrenérgicos beta 2/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Endotoxemia/patologia , Modelos Animais de Doenças , Hemorragia/patologia , Insuficiência de Múltiplos Órgãos/patologia
7.
Exp Ther Med ; 15(4): 3516-3522, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29545877

RESUMO

The aim of the present study was to investigate the effects of 3-methyladenine (3-MA) and dexmedetomidine (DEX) pretreatment on lipopolysaccharide (LPS)-induced acute lung injury (ALI) and the potential mechanism underlying the effects. LPS was instilled into the trachea of BALB/c mice to induce the ALI model. Solutions of 3-MA or DEX were intravenously injected into the mice 1 h later to establish the 3-MA and DEX groups. On days 1, 3 and 5 after the injections, arterial blood gas analysis was conducted, and the lung wet-dry weight ratio (W/D) was determined. In addition, albumin, cytokine and myeloperoxidase (MPO) contents were evaluated using ELISAs, and hematoxylin and eosin (H&E) staining was conducted. Furthermore, western blot analysis was used to evaluate the protein expression levels of microtubule-associated protein 1A/1B-light chain 3 (LC3)-I, LC3-II, autophagy protein 5 (ATG5), Rab7 and lysosome-associated membrane protein 1 (LAMP1), and reverse transcription quantitative polymerase chain reaction (RT-qPCR) was used to detect the mRNA expression levels of nuclear factor-κB (NF-κB) and Toll-like receptor 4 (TLR4). Treatment with 3-MA or DEX increased the blood partial pressure of oxygen level compared with that in the model group, and restored the W/D and blood partial pressure of carbon dioxide to normal levels. The content of tumor necrosis factor-α, interleukin-6 and albumin in bronchoalveolar fluid and MPO in lung tissue was significantly decreased in the 3-MA and DEX groups compared with the model group (P<0.05). H&E staining demonstrated that 3-MA and DEX each reversed the ALI. In addition, 3-MA and DEX reduced the protein expression levels of LC3-I, LC3-II, ATG5, Rab7 and LAMP1. Also, RT-qPCR results revealed that NF-κB and TLR4 mRNA expression levels were clearly decreased in the 3-MA and DEX groups compared with the model group. In conclusion, LPS-induced ALI was effectively reversed by treatment with 3-MA and DEX through the reduction of inflammation and autophagy and inhibition of the TLR4-NF-κB pathway.

8.
Exp Ther Med ; 14(5): 4521-4526, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29104660

RESUMO

The aim of the present study was to investigate the effects of target-controlled infusion (TCI) of propofol and remifentanil combined with dexmedetomidine on functional endoscopic sinus surgery (FESS) bleeding and surgical field. 62 patients scheduled to undergo FESS were randomly divided into experimental group (intravenous 0.5 µg kg-1 h-1 dexmedetomidine after 0.5 µg kg-1 bolus within 15 min until the end of surgery) or control group (intravenous saline administration at the same dose). All patients underwent endotracheal intubation under general anesthesia with TCI of propofol and remifentanil for anesthesia induction and maintenance. During anesthesia, arterial pressure (MAP), heart rate (HR), intraoperative propofol and remifentanil dosage and intraoperative blood loss were recorded. Surgeons rated their satisfaction with the surgical field using the Numeric Rating Scale (NRS). Following surgery, visual analog scale (VAS) was assessed. During tracheal intubation and extubation, HR and MAP in the experimental group were significantly lower compared with the control group (P<0.05); HR was also significantly lower compared with the control group throughout surgery (P<0.05). The mean infusion rate of propofol and remifentanil was significantly lower in the experimental group compared with the control group (P=0.001 and P=0.045, respectively). Blood loss in the experimental group was significantly lower compared with the control group (P=0.007). NRS and VAS scores in the experimental group were significantly improved compared with control group (P<0.01). In conclusion, TCI of propofol and remifentanil for FESS combined with dexmedetomidine reduced intraoperative bleeding and improved the quality of surgical field compared with the same procedure without dexmedetomidine. Dexmedetomidine also reduced the increase in MAP and HR during tracheal intubation and extubation, and improved postoperative analgesia quality.

9.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 41(11): 1128-1136, 2016 Nov 28.
Artigo em Chinês | MEDLINE | ID: mdl-27932756

RESUMO

OBJECTIVE: To investigate the effect of jianpi-jiedu (JPJD) prescription-contained serum on colorectal cancer SW48 cell proliferation and the underlying mechanisms.
 Methods: Crude extract from JPJD was made by water extract method and the main components of crude extract from JPJD were analyzed by ultra-performance liquid phase high resolution time of flight mass spectrometry (UPLC-Q-TOF/MS). The low, medium, and high-concentration of JPJD-contained serum were prepared by the serum pharmacological method. The effect of serum containing JPJD on SW48 cell proliferation was determined by MTT assay. The cell cycle was detected by flow cytometric method. The protein levels of mammalian target of rapamycin (mTOR), phospho-mTOR, P-P53, and -P21, and the mRNA level of mTOR were examined by Western blot and RT-PCR, respectively.
 Results: Seven compounds including calycosin-7-glucoside, astragaloside, ginsenoside-Re, ginsenoside-Rb1, glycyrrhizinic acid, apigenin, atractylenolide-II were identified. MTT assays demonstrated that the SW48 cell proliferation was inhibited by medium and high concentration of JPJD-contained serum and the percentages of cells at G1 phase in SW48 cell cultured in the medium and high concentration of JPJD serum group were significantly higher than those in the control group (P<0.05). Meanwhile, the levels of mTOR mRNA and phospho-mTOR protein in the medium and high concentration of JPJD serum groups were substantially lower than those in the control group (P<0.05). Conversely, the expressions of phospho-P53 and P21 protein were significantly increased in the medium and high concentration of JPJD serum group compared with those in the control group.
 Conclusion: JPJD prescription-contained serum can inhibit SW48 cell proliferation, which may be related to mTOR-P53-P21 signaling pathways.


Assuntos
Proliferação de Células/efeitos dos fármacos , Medicamentos de Ervas Chinesas/farmacologia , Animais , Apigenina , Western Blotting , Ciclo Celular , Divisão Celular , Proliferação de Células/genética , Neoplasias Colorretais , Inibidor de Quinase Dependente de Ciclina p21/efeitos dos fármacos , Citometria de Fluxo , Ginsenosídeos , Ácido Glicirrízico , Humanos , Lactonas , Fosforilação/genética , RNA Mensageiro , Saponinas , Sesquiterpenos , Transdução de Sinais , Serina-Treonina Quinases TOR/efeitos dos fármacos , Triterpenos , Proteína Supressora de Tumor p53/efeitos dos fármacos
10.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 41(12): 1297-1304, 2016 Dec 28.
Artigo em Chinês | MEDLINE | ID: mdl-28070042

RESUMO

OBJECTIVE: To investigate the effect of the jianpi-jiedu formula (JPJD) on the expression of angiogenesis-relevant genes in colon cancer.
 Methods: Crude extract was obtained from JPJD by water extract method. The effect of JPJD crude extract on colon cancer cell proliferation capacity was determined by MTT assays. The IC50 value was calculated by GraphPad Prism5 software. Affymetrix gene expression profiling chip was used to detect significant differences in expressions of genes after JPJD intervention, and pathway enrichment analysis was performed to analyze the differentially expressed genes. Ingenuity Pathway Analysis software was applied to analyze differentially expressed genes relevant to tumor angiogenesis based on mammalian target of rapamycin (mTOR) signaling pathway and then the network diagram was built. Western blot was used to verify the protein levels of key genes related to tumor angiogenesis.
 Results: JPJD crud extract inhibited the proliferation capacity in colon cancer cells. The IC50 values in 24, 48, and 72 hours after treatment were 13.060, 9.646 and 8.448 mg/mL, respectively. The results of chip showed that 218 genes significantly upgraded, and 252 genes significantly downgraded after JPJD treatment. Most of the genes were related to the function of biosynthesis, metabolism, cell apoptosis, antigen extraction, angiogenesis and so on. There were 12 differentially expressed angiogenesis genes. IPA software analysis showed that the JPJD downregulated expression of sphingomyelin phosphodiesterase 3 (SMPD3), VEGF, vascular endothelial growth factor A (VEGFA), integrin subunit alpha 1 (ITGA1), cathepsin B (CTSB), and cathepsin S (CTSS) genes, while upregulated expressions of GAB2 and plasminogen activator, urokinase receptor (PLAUR) genes in the colorectal cancer cell. Western blot results demonstrated that JPJD obviously downregulated expressions of phospho-mTOR (P-mTOR), signal transducer and activator of transcription 3 (STAT3), hypoxia inducible factor-1α (HIF-1α), and VEGF proteins, while obviously upregulated the level of phospho-P53 (P-P53) protein.
 Conclusion: JPJD may inhibit colorectal tumor angiogenesis through regulation of the mTOR-HIF-1α-VEGF signal pathway.


Assuntos
Linhagem Celular Tumoral/efeitos dos fármacos , Neoplasias Colorretais/genética , Medicamentos de Ervas Chinesas/farmacologia , Animais , Western Blotting , Catepsina B/efeitos dos fármacos , Catepsina B/metabolismo , Catepsinas/efeitos dos fármacos , Catepsinas/metabolismo , Neoplasias Colorretais/irrigação sanguínea , Regulação para Baixo , Perfilação da Expressão Gênica/métodos , Humanos , Subunidade alfa do Fator 1 Induzível por Hipóxia/efeitos dos fármacos , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Cadeias alfa de Integrinas/efeitos dos fármacos , Cadeias alfa de Integrinas/metabolismo , Neovascularização Patológica/genética , Receptores de Ativador de Plasminogênio Tipo Uroquinase/efeitos dos fármacos , Receptores de Ativador de Plasminogênio Tipo Uroquinase/metabolismo , Fator de Transcrição STAT3/efeitos dos fármacos , Fator de Transcrição STAT3/metabolismo , Transdução de Sinais , Esfingomielina Fosfodiesterase/efeitos dos fármacos , Esfingomielina Fosfodiesterase/metabolismo , Serina-Treonina Quinases TOR/efeitos dos fármacos , Serina-Treonina Quinases TOR/metabolismo , Proteína Supressora de Tumor p53/efeitos dos fármacos , Proteína Supressora de Tumor p53/metabolismo , Regulação para Cima , Fator A de Crescimento do Endotélio Vascular/efeitos dos fármacos , Fator A de Crescimento do Endotélio Vascular/metabolismo
11.
Oncol Lett ; 10(1): 417-421, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26171042

RESUMO

The aim of the present study was to investigate the clinical significance of Twist, vascular endothelial growth factor (VEGF) and CD34 expression in osteosarcoma (OS) in order to elucidate potential therapeutic targets for the treatment of OS. Immunohistochemistry was performed to detect the protein expression of Twist, VEGF and CD34 in OS and osteochondroma (OC) tissues. The ratio of the protein expression of Twist and VEGF in OS and OC tissues as well as at different phases of OS was compared using chi-squared tests. Microvessel density (MVD), as determined by CD34 labeling, in OS and OC tissue as well as at different phases of OS was compared using the Student's t-test. In addition, associations between Twist, VEGF and MVD were assessed using the Spearman's rank correlation test. The results revealed that out of the 32 OS tissues examined, 56.25% exhibited Twist positive expression, 71.88% exhibited VEGF positive expression and the MVD was increased compared with that of the OC tissue. The positive rate of Twist and VEGF expression in phase III OS tissues was significantly increased compared with that in phase I/II OS tissues (Twist: χ2=5.732, P=0.018; VEGF: χ2=7.513, P=0.006). The MVD in phase III OS tissues (31.08±3.36 per field) was significantly higher compared with that of the phase I/II OS tissues (41.2±4.17 per field; t=7.536, P<0.001). Spearman's rank correlation analysis revealed that Twist expression was positively associated with VEGF expression (r=0.371, P=0.002) and with MVD (r=0.393, P=0.001) in OS; in addition, VEGF expression was found to have a positive correlation with MVD (r=0.469, P=0.001). In conclusion, the results of the present study demonstrated that OS tissues exhibited elevated Twist and VEGF expression as well as MVD compared with OC tissue. In addition, metastatic OS (phase III) exhibited an increased positive rate of Twist and VEGF expression as well as MVD values compared with non-metastatic OS (phase I/II). Furthermore associations were detected between Twist and VEGF expression as well as VEGF and MVD. Therefore, inhibition of Twist expression may have potential therapeutic use for the treatment of OS.

12.
Exp Ther Med ; 4(5): 889-894, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23226744

RESUMO

The goal of this study was to determine outcomes related to limb salvage vs. amputation for treating high-grade and localized osteosarcoma in patients with pathological fractures. Literature search was conducted using Medline, Embase and the Cochrane Database. Two reviewers independently assessed all eligible publications. The primary outcome measurement was pooled odds ratio (OR) and 95% confidence interval (CI) for the risk of local recurrence, 5-year overall survival rate and metastatic occurrence calculated through the fixed-effects method. Seven eligible studies were identified, which included a total of 284 patients. The risk for local recurrence and 5-year overall survival rate did not differ significantly (P>0.05) between the limb salvage group and amputation group, with an OR of 1.48 (95% CI, 0.67-3.30) and 1.85 (95% CI, 0.86-3.98), respectively. The risk for metastatic occurrence differed significantly (P<0.05), with an OR of 0.30 (95% CI, 0.10-0.91). The occurrence of a pathological fracture is not regarded as an absolute contraindication to limb salvage in patients with high-grade and localized osteosarcoma. Limb salvage as an alternative for treating high-grade and localized osteosarcoma in patients with pathological fracture does not greatly increase the risk for local recurrence or 5-year overall survival rate compared to amputation and has a lower risk for metastatic occurrence.

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