Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 25
Filtrar
1.
J Bone Miner Metab ; 38(6): 894-902, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32656645

RESUMO

INTRODUCTION: Rapid descent in bone mineral density (BMD) and ascent in bone turnover marker (BTM) occur within the short period following denosumab (Dmab) discontinuation. In addition, the incidence of vertebral fracture also rises within the short period. The purpose of this study is to investigate the effects of sequential therapy using zoledronic acid (ZOL) on any adverse events after Dmab discontinuation. MATERIALS AND METHODS: This study was a multicenter retrospective observational study, and the subjects were osteoporosis patients who visited our institutions between 2013 and 2018. We performed sequential therapy using ZOL for 30 patients who had difficulty continuing Dmab, due to physical or social reasons, and investigated the fracture incidence and BMD/BTM changes at 4 time points (at the start of Dmab, the start of ZOL, 6 months after ZOL and 12 months after ZOL). RESULTS: No new vertebral/nonvertebral fractures were observed at each time point after switching from Dmab to ZOL in any of the 30 patients. The BMD/BTM changes were evaluated in 18 of the 30 cases, since all data of lumbar/femoral neck BMDs and TRACP-5b at 4 time points was only available in 18 cases. BMDs significantly increased at each time point compared with that at the start of Dmab. Serum TRACP-5b significantly decreased at each time point compared with that at the start of Dmab. CONCLUSION: It was suggested that sequential therapy using ZOL could suppress the decrease of BMD, and increase of BTM, if the period of Dmab administration was less than 3 years.


Assuntos
Denosumab/uso terapêutico , Suspensão de Tratamento , Ácido Zoledrônico/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Densidade Óssea/efeitos dos fármacos , Conservadores da Densidade Óssea/efeitos adversos , Conservadores da Densidade Óssea/uso terapêutico , Remodelação Óssea/efeitos dos fármacos , Denosumab/efeitos adversos , Feminino , Fraturas Ósseas/sangue , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/sangue , Estudos Retrospectivos , Fosfatase Ácida Resistente a Tartarato/sangue , Ácido Zoledrônico/efeitos adversos
2.
Bone Rep ; 12: 100268, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32373678

RESUMO

Calcium balance is important in bone homeostasis. The transient receptor potential vanilloid (TRPV) channel is a nonselective cation channel permeable to calcium and is activated by various physiological and pharmacological stimuli. TRPV1 and TRPV4, in particular, have important roles in intracellular Ca2+ signaling and extracellular calcium homeostasis in bone cells. TRPV1 and TRPV4 separately mediate osteoclast and osteoblast differentiation, and deficiency in any of these channels leads to increased bone mass. However, it remains unknown whether bone mass increases in the absence of both TRPV1 and TRPV4. In this study, we used TRPV1 and TRPV4 double knockout (DKO) mice to evaluate their bone mass in vivo, and osteoclast and osteoblast differentiation in vitro. Our results showed that DKO mice and wild type (WT) mice had no significant difference in body weight and femur length. However, the results of dual-energy X-ray absorption, microcomputed tomography, and bone histomorphometry clearly showed that DKO mice had higher bone mass than WT mice. Furthermore, DKO mice had less multinucleated osteoclasts and had lower bone resorption. In addition, the results of cell culture using flushed bone marrow from mouse femurs and tibias showed that osteoclast differentiation was suppressed, whereas osteoblast differentiation was promoted in DKO mice. In conclusion, our results suggest that the increase in bone mass in DKO mice was induced not only by the suppression of osteoclast differentiation and activity but also by the augmentation of osteoblast differentiation and activity. Our findings reveal that both the single deficiency of TRPVs and the concurrent deficiency of TRPVs result in an increase in bone mass. Furthermore, our data showed that DKO mice and single KO mice had varying approaches to osteoclast and osteoblast differentiation in vitro, and therefore, it is important to conduct further studies on TRPVs regarding the increase in bone mass to explore not only individual but also a combination of TRPVs.

3.
J Bone Miner Metab ; 38(2): 230-239, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31586241

RESUMO

INTRODUCTION: Zoledronic acid infusion is used to treat osteoporosis but patients, especially Japanese patients, often experience acute-phase reactions (APRs). In this multicenter, randomized, open-label, parallel-group study, we examined the efficacy of the most commonly used non-steroidal anti-inflammatory drug loxoprofen in Japan in reducing the incidence rate of zoledronic acid-induced APRs and body temperature, and investigated risk/protective factors for APRs in this population. MATERIALS AND METHODS: Patients aged ≥ 60 years with primary osteoporosis (n = 368) were allocated randomly to zoledronic acid plus loxoprofen (ZOL + LOX) or zoledronic acid alone (ZOL). All patients received 5-mg zoledronic acid infusion on day 1, and patients in the ZOL + LOX group also received 120 mg and 180 mg of oral loxoprofen on days 1 and 2, respectively. Adverse events and body temperature were recorded during the 7-day observation period. RESULTS: The incidence rates of APRs were 34.4% (64/186 patients) and 47.8% (87/182 patients) in the ZOL + LOX and ZOL groups, respectively (P = 0.0109). The proportions of patients with increased body temperature (≥ 1 °C and ≥ 37.5 °C) were similar in both groups (P = 0.1186). Past bisphosphonate users had a significantly lower incidence rate of APRs than treatment-naïve patients (odds ratio 0.444, 95% confidence interval 0.285-0.692, P = 0.0003). CONCLUSIONS: Zoledronic acid-induced APRs appeared to be suppressed by loxoprofen. Known risk/protective factors, including prior osteoporosis treatment, were applicable to Japanese patients.


Assuntos
Reação de Fase Aguda/induzido quimicamente , Reação de Fase Aguda/tratamento farmacológico , Anti-Inflamatórios não Esteroides/uso terapêutico , Grupo com Ancestrais do Continente Asiático , Conservadores da Densidade Óssea/uso terapêutico , Ácido Zoledrônico/efeitos adversos , Reação de Fase Aguda/epidemiologia , Idoso , Temperatura Corporal , Difosfonatos/uso terapêutico , Feminino , Humanos , Incidência , Japão , Modelos Logísticos , Masculino , Análise Multivariada , Razão de Chances , Fatores de Risco , Resultado do Tratamento , Ácido Zoledrônico/uso terapêutico
4.
J Bone Miner Metab ; 38(1): 44-53, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31297652

RESUMO

The objective of the present multicenter randomized study was to compare weekly teriparatide with alendronate in their inhibition of vertebral collapse, effects on delayed union, pain relief, and improvement of quality of life (QOL) in women with new osteoporotic vertebral fractures within 1 week after onset of the fracture. Patients were randomly allocated to the teriparatide and alendronate groups. Vertebral collapse, low back pain assessed by a visual analog scale, and QOL assessed by EuroQol 5 dimension at weeks 1, 2, 4, 8, and 12 after the start of the treatment were compared between the groups. Lumbar bone mineral density (BMD) at baseline and week 12 and the rate of delayed union at week 12 were also compared. Each group consisted of 48 subjects. Vertebral collapse progressed over time in both groups, with no significant difference between the groups. Pain on rising up from lying position, turning over in bed, and resting in the lying position improved over time in both groups, with no significant difference between the groups. There were no significant differences in increase in BMD and delayed union. QOL in the teriparatide group showed significant improvement in comparison with that in the alendronate group at week 12. The weekly formulation of teriparatide showed comparable inhibition of vertebral collapse, increase in BMD, promotion of bone union, and improvement of pain and significant improvement of QOL at week 12 in comparison with alendronate in patients with a new osteoporotic vertebral fracture within 1 week after onset of the fracture. The weekly formulation of teriparatide may have improved components of QOL other than pain at week 12.


Assuntos
Alendronato/uso terapêutico , Fraturas da Coluna Vertebral/tratamento farmacológico , Teriparatida/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Alendronato/farmacologia , Densidade Óssea/efeitos dos fármacos , Conservadores da Densidade Óssea/farmacologia , Conservadores da Densidade Óssea/uso terapêutico , Esquema de Medicação , Feminino , Humanos , Qualidade de Vida , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/fisiopatologia , Teriparatida/farmacologia , Escala Visual Analógica
5.
Artigo em Inglês | MEDLINE | ID: mdl-33485858

RESUMO

BACKGROUND: Thin-cap fibroatheroma (TCFA) has been suggested as a precursor lesion of coronary plaque rupture. As elevated plasma matrix metalloproteinase-9 (MMP-9) levels have been documented in patients with acute coronary syndrome (ACS), we sought to determine whether the presence of TCFA is linked to MMP-9 levels in these patients. METHODS: We evaluated 51 ACS patients with de novo culprit lesions who were examined via optical coherence tomography and intravascular ultrasound. Blood samples were obtained from the peripheral vein (PV) and the ostium and culprit lesion of the infarct-related coronary artery (CA) in the acute phase of ACS and from the PV in the chronic phase (8 months after ACS). RESULTS: The plasma MMP-9 level in the acute phase was significantly higher than that in the chronic phase. Plasma MMP-9 levels at the culprit lesion of the infarct-related CA were significantly higher than, but positively correlated with those in the PV (10.9 (5.9-16.1) ng/mL and 8.9 (5.6-13.0) ng/mL, p < 0.0001, respectively; Spearman ρ = 0.84, p < 0.0001). Significantly higher PV plasma MMP-9 levels were observed in patients with TCFA than in patients without TCFA (12.1 (7.0-13.5) and 5.7 (4.0-8.2) ng/ml, p<0.0001, respectively). Further, plasma MMP-9 levels in the PV were positively correlated with the remodeling index (Spearman ρ = 0.29, p = 0.039) and negatively correlated with fibrous cap thickness (Spearman ρ = -0.42, p = 0.0021). Receiver operating characteristic curve analysis showed that the plasma MMP-9 levels in the PV could predict the presence of TCFA at a cut-off value of 9.9 ng/mL. CONCLUSIONS: Plasma MMP-9 levels were closely associated with MMP-9 levels in the CA and were further linked with TCFA in patients with ACS.

6.
Health Sci Rep ; 2(1): e107, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30697599

RESUMO

Background and aims: Clinical data regarding alendronate jelly are limited. We compared the efficacy and safety of once-weekly alendronate oral jelly with once-weekly alendronate tablet formulations in the context of primary osteoporosis. Methods: In this 6-month, open-label, prospective, observational study, Japanese patients aged ≥60 years with primary osteoporosis were included from 14 primary care centres in Japan. The effects of once-weekly alendronate oral jelly and tablet formulations on bone mineral density (BMD), bone turnover markers, and quality of life related to gastrointestinal symptoms were assessed at baseline and 6 months. Treatment was allocated by patient preference. This potentially confounding factor was adjusted for statistically. Results: In total, 170 patients were enrolled (jelly, n = 97; tablet, n = 73). Mean percent changes in radius, lumbar spine, femoral neck, and hip BMD were similar in both treatment groups at 6 months. Both formulations decreased tartrate-resistant acid phosphatase 5b (TRACP-5b) and procollagen 1 N-terminal peptide (P1NP) between baseline and 6 months (by about 50% and 60%, respectively); no significant differences in mean changes were noted in these markers between groups. At 6 months, no significant differences were noted in visual analogue scale or EuroQOL five-dimension questionnaire scores between groups. The jelly group had significantly lower scores than the tablet group in the Izumo scale domains of heartburn (-0.81, P = 0.0040), epigastralgia (-0.94, P = 0.0003), and epigastric fullness (-0.49, P = 0.044). During treatment, more patients discontinued for upper gastrointestinal symptoms in the tablet group (n = 4) than the jelly group (n = 1). Conclusions: Once-weekly alendronate oral jelly 35 mg may be a suitable alternative therapeutic agent for primary osteoporosis in Japan.

7.
Osteoporos Sarcopenia ; 4(2): 61-68, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30775544

RESUMO

Objectives: The purpose of this study was to investigate the influences of interruption and reinitiation of monthly minodronate therapy on the bone mineral density (BMD) and bone metabolism markers in postmenopausal women with osteoporosis. Methods: Study patients were included if they had been administered monthly minodronate therapy for ≥6 months, interrupted the therapy, and reinitiated the therapy for ≥12 months. The BMD and bone metabolism markers were assessed at 4 time points: initiation, interruption, reinitiation and 1 year after reinitiation of therapy. Results: A total of 23 patients were enrolled. The mean monthly minodronate treatment period was 23.8 ±â€¯12.9 months following a mean interruption period of 11.9 ±â€¯5.4 months. Once increased by monthly minodronate treatment for 2 years on average, the BMD of lumbar spine and radius did not significantly decrease even after an interruption for 1 year on average. However, the BMD of the femoral neck did decrease after interruption. The BMD of the lumbar spine and radius increased further after 1 year of monthly minodronate retreatment. The BMD of the femoral neck did not change. Once decreased after the treatment for an average of 2 years followed by an interruption for 1 year, bone metabolism markers increased gradually but did not recover to baseline levels. A potent suppressive effect on bone resorption was noted. The change rate was greater for the bone formation marker procollagen 1 N-terminal propeptide. Conclusions: Monthly minodronate treatment increases BMD and reduces bone metabolism markers. The effect lessens after treatment interruptions, and can be restored by retreatment.

8.
J Orthop Sci ; 23(2): 371-376, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29229239

RESUMO

BACKGROUND: We hypothesized that ceramic bipolar shows less impingement between stem neck and outer head compared to metal bipolar, because of its low coefficient of friction with the acetabulum cartilage. In this paper, a three dimensional (3D) postoperative motion analysis has been used to assess the different motion characteristics of metal and ceramic bipolar hip hemiarthroplasty systems. METHODS: This study was conducted on 40 patients divided in two matched cohorts: 20 patients with metal bipolar and 20 patients with the ceramic bipolar. We obtained motion pictures from standing position to maximum abduction in flexion by fluoroscopy then analyzed by 2D-3D image matching method. The motion range of the "Outer head angle", "Stem neck angle" and the "Stem neck and outer head angle" was compared between the metal bipolar group and the ceramic bipolar group. RESULTS: The metal bipolar group's inner head's range of movement was greater than the ceramic bipolar group. Impingement between stem neck and outer head occurred in 30% of metal group patients. There were no impingement cases for the ceramic bipolar group. CONCLUSIONS: The ceramic bipolar shows less impingement between stem neck and outer head compared to the metal bipolar. Ceramic bipolar may reduce the typical bipolar related complication and exert less effect on the acetabular cartilage due to less surface coefficient of friction.


Assuntos
Hemiartroplastia/métodos , Articulação do Quadril/cirurgia , Prótese de Quadril , Imageamento Tridimensional , Desenho de Prótese/métodos , Amplitude de Movimento Articular/fisiologia , Idoso , Idoso de 80 Anos ou mais , Fenômenos Biomecânicos , Cerâmica , Estudos de Coortes , Análise de Falha de Equipamento , Feminino , Hemiartroplastia/instrumentação , Articulação do Quadril/diagnóstico por imagem , Humanos , Masculino , Metais , Pessoa de Meia-Idade , Postura , Estudos Prospectivos
9.
Orthop J Sports Med ; 3(3): 2325967115573701, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26665028

RESUMO

BACKGROUND: Humeral retroversion angles determined by previous techniques are varied and/or biased by morphologic variations of the proximal and distal humerus, and their validity should be revisited. To overcome the limitations of previous studies associated with 2-dimensional (2D) images and the reference axes, a 3-dimensional (3D) measurement of humeral retroversion is required. However, comparisons of 2D imaging methods with the 3D computed tomography (CT) measurement as a reference standard have not been heretofore performed. PURPOSE: To determine whether the 3D CT humeral retroversion angle in baseball players is correlated with conventional humeral retroversion measurements. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: A total of 28 humeri from 14 male baseball players were used for measuring humeral retroversion. Participants underwent CT scans, and geometric bone models were created for measuring the 3D CT humeral retroversion angle. Using CT slices, the 2D CT humeral retroversion angle was also determined. Bicipital forearm angle was assessed using the indirect ultrasound technique. Linear regressions and Bland-Altman plots were used to determine whether there were agreements among 3 variables: the 3D CT retroversion, 2D CT retroversion, and bicipital forearm angles. RESULTS: In linear regression analyses, the 3D humeral retroversion angle was not predicted by the 2D CT retroversion (R = 0.167, R (2) = 0.028, P = .395) or the bicipital forearm angle (R = 0.049, R (2) = 0.002, P = .805). The bias of these 2 methods was 20.9° and -15.3°, respectively. Regression analysis demonstrated that the bicipital forearm angle was a significant predictor of the 2D CT retroversion angle (R = 0.632, R (2) = 0.400, P < .001). CONCLUSION: The 3D CT humeral retroversion angle was found to be underestimated by the 2D CT retroversion angle and overestimated by the bicipital forearm angle obtained by the indirect ultrasound, although a previously observed relationship between the 2D CT retroversion and bicipital forearm angles was confirmed. CLINICAL RELEVANCE: Precise measurement of humeral retroversion angle is important because retroversion has been linked to upper extremity disorders, including throwing-related shoulder and elbow disorders in baseball players.

10.
J Sport Rehabil ; 24(2): 91-8, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25996221

RESUMO

CONTEXT: Abnormal scapular kinematics during throwing motion in baseball players with shoulder disorders has not yet been clarified, although altered scapular position has been suggested to be associated with shoulder disorder. OBJECTIVE: To determine if the shoulders of baseball players with throwing disorders demonstrate abnormal scapular kinematics during the simulated arm-cocking phase of throwing activity. DESIGN: Cross-sectional study. SETTING: Laboratory. PARTICIPANTS: Eleven baseball players (age 21.1 ± 1.2 y) with a unilateral shoulder disorder volunteered to participate, including 9 players at the college level and 2 at the adult level. The mean playing experience was 12.1 ± 2.7 y. MAIN OUTCOME MEASURES: Scapular upward/downward rotation, anteroposterior tilting, and external/internal rotation during simulated arm-cocking motion were analyzed using a 3-to-2-dimensional registration technique. RESULTS: Scapular external rotation in the throwing shoulder was significantly smaller by 2.0-6.0° than that of the contralateral shoulder. There were no detectable differences in scapular upward/downward rotation or anteroposterior tilting between the throwing and contralateral shoulders. CONCLUSIONS: Compared with that in the contralateral shoulder, scapular external rotation was smaller in the throwing shoulder, which would increase glenohumeral horizontal abduction during the arm-cocking phase and be related to the throwing-shoulder disorder.


Assuntos
Beisebol , Fenômenos Biomecânicos/fisiologia , Escápula/fisiologia , Articulação do Ombro/lesões , Traumatismos em Atletas/etiologia , Estudos Transversais , Humanos , Imageamento Tridimensional , Tomografia Computadorizada por Raios X , Adulto Jovem
11.
J Shoulder Elbow Surg ; 24(5): 809-13, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25457190

RESUMO

HYPOTHESIS AND BACKGROUND: Humeral retroversion is defined as the orientation of the humeral head relative to the distal humerus. Because none of the previous methods used to measure humeral retroversion strictly follow this definition, values obtained by these techniques vary and may be biased by morphologic variations of the humerus. The purpose of this study was 2-fold: to validate a method to define the axis of the distal humerus with a virtual cylinder and to establish the reliability of 3-dimensional (3D) measurement of humeral retroversion by this cylinder fitting method. METHODS: Humeral retroversion in 14 baseball players (28 humeri) was measured by the 3D cylinder fitting method. The root mean square error was calculated to compare values obtained by a single tester and by 2 different testers using the embedded coordinate system. To establish the reliability, intraclass correlation coefficient (ICC) and precision (standard error of measurement [SEM]) were calculated. RESULTS: The root mean square errors for the humeral coordinate system were <1.0 mm/1.0° for comparison of all translations/rotations obtained by a single tester and <1.0 mm/2.0° for comparison obtained by 2 different testers. Assessment of reliability and precision of the 3D measurement of retroversion yielded an intratester ICC of 0.99 (SEM, 1.0°) and intertester ICC of 0.96 (SEM, 2.8°). DISCUSSION AND CONCLUSION: The error in measurements obtained by a distal humerus cylinder fitting method was small enough not to affect retroversion measurement. The 3D measurement of retroversion by this method provides excellent intratester and intertester reliability.


Assuntos
Retroversão Óssea/diagnóstico por imagem , Simulação por Computador , Cabeça do Úmero/diagnóstico por imagem , Imageamento Tridimensional , Tomografia Computadorizada por Raios X , Pontos de Referência Anatômicos , Beisebol , Humanos , Úmero/diagnóstico por imagem , Masculino , Reprodutibilidade dos Testes , Adulto Jovem
12.
J Bone Miner Metab ; 31(2): 153-60, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23076293

RESUMO

The purpose of the present study was to precisely compare both the efficacy and abdominal symptom-related quality of life after treatment with daily minodronate and weekly alendronate in patients with primary postmenopausal osteoporosis. The efficacy of the two drugs was assessed based on improvements in a bone turnover marker, back pain, and gastrointestinal symptoms that impair quality of life, which was assessed using the Izumo scale questionnaire. In the minodronate group, there were no significant changes during the treatment period in the specific scores for heartburn, epigastralgia and epigastric fullness, whereas all of the scores were significantly elevated at some time point after drug administration in the alendronate group. Urinary N-telopeptide of type I collagen (uNTX), a bone resorption marker, and bone-specific alkaline phosphatase, a bone formation marker, significantly decreased in both groups, but decreases in uNTX in the minodronate group was observed significantly earlier compared with those in the alendronate group. The back pain scores, which were obtained using a visual analog scale, were significantly reduced in both groups. However, analgesic effects were detected earlier in the minodronate group. In conclusion, compared with weekly alendronate, daily minodronate improved bone turnover and back pain more promptly without causing upper gastrointestinal symptoms.


Assuntos
Alendronato/efeitos adversos , Alendronato/uso terapêutico , Dor nas Costas/tratamento farmacológico , Reabsorção Óssea/tratamento farmacológico , Difosfonatos/efeitos adversos , Trato Gastrointestinal/efeitos dos fármacos , Imidazóis/efeitos adversos , Osteoporose Pós-Menopausa/tratamento farmacológico , Idoso , Alendronato/administração & dosagem , Dor nas Costas/complicações , Dor nas Costas/fisiopatologia , Dor nas Costas/urina , Biomarcadores/metabolismo , Densidade Óssea/efeitos dos fármacos , Conservadores da Densidade Óssea/administração & dosagem , Conservadores da Densidade Óssea/efeitos adversos , Conservadores da Densidade Óssea/uso terapêutico , Remodelação Óssea/efeitos dos fármacos , Reabsorção Óssea/complicações , Reabsorção Óssea/fisiopatologia , Reabsorção Óssea/urina , Colágeno Tipo I/urina , Difosfonatos/administração & dosagem , Difosfonatos/uso terapêutico , Esquema de Medicação , Feminino , Trato Gastrointestinal/patologia , Humanos , Imidazóis/administração & dosagem , Imidazóis/uso terapêutico , Osteoporose Pós-Menopausa/complicações , Osteoporose Pós-Menopausa/fisiopatologia , Osteoporose Pós-Menopausa/urina , Medição da Dor , Peptídeos/urina , Inquéritos e Questionários
13.
Atherosclerosis ; 213(1): 268-72, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20832064

RESUMO

OBJECTIVE: CD40 ligand (CD40L) plays a crucial role in atherogenesis and plaque destabilization. The purpose of this study was to clarify the association of CD40L levels in the culprit coronary arteries (CA) with the subsequent cardiovascular events in patients with acute myocardial infarction (AMI). METHODS: We enrolled 68 patients with AMI whose CA were treated using thrombectomy devices. Blood samples were collected from the peripheral veins (PV), the ascending aortae (AO) and CA. RESULTS: CD40L levels in the CA were significantly greater than those in the PV and AO. Statistical analyses revealed that CD40L levels in CA correlated positively with the corrected TIMI frame counts and maximal serum creatine kinase-MB in throughout clinical course, and inversely with myocardial blush grade and left ventricular ejection fraction 6 months after AMI. In logistic regression analyses, the group with high CD40L levels in CA was associated with an 8.58-fold increase in the odds of a cardiovascular event rate compared with the group with low CD40L levels. CONCLUSIONS: In patients with AMI, enhanced CD40L levels in CA might affect myocardial perfusion, myocardial damage, and subsequent cardiovascular events, and could be a predictive marker for the prognosis of AMI.


Assuntos
Ligante de CD40/biossíntese , Vasos Coronários/metabolismo , Infarto do Miocárdio/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Aorta/patologia , Angiografia Coronária/métodos , Circulação Coronária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Trombectomia/métodos
14.
Circ Heart Fail ; 3(1): 140-8, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19933407

RESUMO

BACKGROUND: In patients with chronic heart failure (CHF), the presence of sleep-disordered breathing, including either obstructive sleep apnea or Cheyne-Stokes respiration-central sleep apnea, is associated with a poor prognosis. A large-scale clinical trial showed that continuous positive airway pressure (CPAP) did not improve the prognosis of such patients with CHF, probably because of insufficient sleep-disordered breathing suppression. Recently, it was reported that adaptive servo-ventilation (ASV) can effectively treat sleep-disordered breathing. However, there are no specific data about the efficacy of flow-triggered ASV for cardiac function in patients with CHF with sleep-disordered breathing. The aim of this study was to compare the efficacy of flow-triggered ASV to CPAP in patients with CHF with coexisting obstructive sleep apnea and Cheyne-Stokes respiration-central sleep apnea. METHODS AND RESULTS: Thirty-one patients with CHF, defined as left ventricular ejection fraction <50% and New York Heart Association class >or=II, with coexisting obstructive sleep apnea and Cheyne-Stokes respiration-central sleep apnea, were randomly assigned to either CPAP or flow-triggered ASV. The suppression of respiratory events, changes in cardiac function, and compliance with the devices during the 3-month study period were compared. Although both devices decreased respiratory events, ASV more effectively suppressed respiratory events (DeltaAHI [apnea-hypopnea index], -35.4+/-19.5 with ASV; -23.2+/-12.0 with CPAP, P<0.05). Compliance was significantly greater with ASV than with CPAP (5.2+/-0.9 versus 4.4+/-1.1 h/night, P<0.05). The improvements in quality-of-life and left ventricular ejection fraction were greater in the ASV group (DeltaLVEF [left ventricular ejection fraction], +9.1+/-4.7% versus +1.9+/-10.9%). CONCLUSIONS: These results suggest that patients with coexisting obstructive sleep apnea and Cheyne-Stokes respiration-central sleep apnea may receive greater benefit from treatment with ASV than with CPAP.


Assuntos
Respiração de Cheyne-Stokes/complicações , Insuficiência Cardíaca/complicações , Oxigenoterapia/métodos , Apneia Obstrutiva do Sono/complicações , Ventilação/métodos , Idoso , Respiração de Cheyne-Stokes/terapia , Doença Crônica , Pressão Positiva Contínua nas Vias Aéreas , Feminino , Insuficiência Cardíaca/terapia , Humanos , Masculino , Apneia Obstrutiva do Sono/terapia , Resultado do Tratamento
15.
Angiology ; 59(6): 757-60, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18388071

RESUMO

Bronchial artery aneurysm (BAA) is a rare condition. Rupture of BAA can cause critical hemorrhage, and intervention for BAA is thus recommended. A 69-year-old woman presented with BAA 70 mm in diameter in the right hilum of the lung. Transcatheter arterial embolization for afferent arteries of the BAA was performed and the BAA has subsequently been shrinking as observed by radiography. We present this case and a brief review of management of BAA based on the literature.


Assuntos
Aneurisma/terapia , Artérias Brônquicas , Embolização Terapêutica , Idoso , Aneurisma/diagnóstico por imagem , Artérias Brônquicas/diagnóstico por imagem , Feminino , Humanos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
16.
J Gene Med ; 10(4): 368-74, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18205252

RESUMO

BACKGROUND: Inflammation plays an important role in the pathogenesis of hypertension and hypertensive organ damage. Interleukin (IL)-10, a pleiotropic anti-inflammatory cytokine, exerts vasculoprotective effects in many animal models. In the present study, we examined the preventive effects of adeno-associated virus (AAV) vector-mediated sustained IL-10 expression against hypertensive heart disease and renal dysfunction in Dahl salt-sensitive rats. METHODS: We injected the rats intramuscularly with an AAV type 1-based vector encoding rat IL-10 or enhanced green fluorescent protein (EGFP) at 5 weeks of age; subsequently, the rats were fed a high-sodium diet from 6 weeks of age. RESULTS: Sustained IL-10 expression significantly improved survival rate of Dahl salt-sensitive rats compared with EGFP expression (62.5% versus 0%, p < 0.001); it also caused 26.0% reduction in systolic blood pressure at 15 weeks (p < 0.0001). Echocardiography exhibited a 22.0% reduction in hypertrophy (p < 0.0001) and a 26.3% improvement in fractional shortening (p < 0.0001) of the rat left ventricle in the IL-10 group compared to the EGFP group. IL-10 expression also caused a 21.7% decrease in the heart weight/body weight index and cardiac atrial natriuretic peptide levels. Histopathological studies revealed that IL-10 decreased inflammatory cell infiltration, fibrosis, and transforming growth factor-beta(1) levels in the failing heart. Furthermore, IL-10 expression significantly reduced urine protein excretion with increased glomerular filtration rates. CONCLUSIONS: This is the first study to demonstrate that the anti-inflammatory cytokine IL-10 has a significant anti-hypertensive effect. AAV vector-mediated IL-10 expression potentially prevents the progression of refractory hypertension and hypertensive organ damage in humans.


Assuntos
Dependovirus , Terapia Genética , Vetores Genéticos , Hipertensão/complicações , Hipertrofia Ventricular Esquerda/terapia , Interleucina-10/genética , Animais , Proteínas de Fluorescência Verde/genética , Hipertensão/patologia , Hipertrofia Ventricular Esquerda/etiologia , Hipertrofia Ventricular Esquerda/patologia , Masculino , Ratos , Ratos Endogâmicos Dahl , Remodelação Ventricular
17.
Arterioscler Thromb Vasc Biol ; 27(2): 283-9, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17053169

RESUMO

OBJECTIVE: Since the macrophage colony-stimulating factor (M-CSF) has been shown to stimulate differentiation and proliferation of monocyte/macrophage lineage and to be involved in the process of neointimal formation after vascular injury, we tested the effects of M-CSF on the recruitment of bone marrow-derived progenitor cells in neointimal formation after vascular injury in mice. METHODS AND RESULTS: Wire-mediated vascular injury was produced in the femoral artery of C57BL/6 mice. Recombinant human M-CSF [500 microg/(kg x day)] or saline (control) was administered for 10 consecutive days, starting 4 days before the injury. Treatment with M-CSF accelerated neointimal formation in the early phase after injury, and this neointimal lesion mainly consisted of bone marrow-derived cells. M-CSF treatment had no effect on the mobilization of endothelial progenitor cells (EPCs: CD34+/Flk-1+) and reendothelialization after injury. The stromal cell-derived factor-1 (SDF-1) was markedly expressed in the neointima and media after injury, whereas CXCR4+ cells were observed in the neointima. Further, a novel CXCR4 antagonist, AMD3100, significantly attenuated the M-CSF-induced neointimal formation. CONCLUSIONS: These findings suggest that M-CSF accelerated neointimal formation after vascular injury via the SDF-1-CXCR4 system, and the inhibition of this system has therapeutic potential for the treatment of cardiovascular diseases.


Assuntos
Diferenciação Celular/efeitos dos fármacos , Quimiocinas CXC/fisiologia , Endotélio Vascular/efeitos dos fármacos , Fator Estimulador de Colônias de Macrófagos/farmacologia , Receptores CXCR4/fisiologia , Células-Tronco/efeitos dos fármacos , Animais , Células da Medula Óssea/citologia , Células da Medula Óssea/efeitos dos fármacos , Células da Medula Óssea/fisiologia , Diferenciação Celular/fisiologia , Proliferação de Células/efeitos dos fármacos , Quimiocina CCL2/genética , Quimiocina CCL2/fisiologia , Quimiocina CXCL12 , Quimiocinas CXC/genética , Endotélio Vascular/citologia , Endotélio Vascular/fisiologia , Regulação da Expressão Gênica/efeitos dos fármacos , Compostos Heterocíclicos/farmacologia , Interleucina-10/genética , Interleucina-10/fisiologia , Interleucina-6/genética , Interleucina-6/fisiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Receptores CXCR4/antagonistas & inibidores , Receptores CXCR4/efeitos dos fármacos , Receptores CXCR4/genética , Transdução de Sinais/fisiologia , Células-Tronco/citologia , Células-Tronco/fisiologia , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/fisiologia , Túnica Íntima/citologia , Túnica Íntima/efeitos dos fármacos , Túnica Íntima/fisiologia
18.
Curr Med Res Opin ; 22(4): 793-8, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16684440

RESUMO

OBJECTIVE: Implantation of bone marrow mononuclear cells (BM-MNCs), including endothelial progenitor cells, into ischemic lower limbs has been shown to improve symptoms in patients with peripheral arterial diseases (PAD). This study investigated whether BM-MNC implantation (BMI) is also effective for the ischemic hands of these patients. METHODS: Seven PAD patients with hand ischemia were enrolled: six patients had thromboangiitis obliterans and one had collagen disease. All seven had symptoms involving either resting pain or non-healing ischemic ulcers of the hand. Approximately 600 mL of MNCs were separated from BM and concentrated to a final volume of 40-50 mL, which were injected into ischemic hands. Ischemic status was evaluated by measuring the digital/brachial pressure index (DBI), visual analog pain scale, and the healing of ulcers before and 6 months after BMI. RESULTS: The mean number of implanted MNCs, CD34-positive cells, and CD34,133-positive cells was 3.67 +/- 0.53 x 10(9), 4.94 +/- 2.45 x 10(7), and 2.52 +/- 1.57 x 10(7), respectively. Mean DBI in those patients was 0.15 +/- 0.30 before BMI and significantly increased to 0.67 +/- 0.19 at 6 months after BMI (p = 0.004). All patients also showed improvement of pain scale and ischemic ulcers. There was no significant correlation between the number of implanted cells and improvement in the degree of DBI or the pain scale. CONCLUSION: Autologous BMI could be a promising and safe method of therapeutic angiogenesis for critical hand ischemia in PAD patients.


Assuntos
Transplante de Medula Óssea , Mãos/irrigação sanguínea , Isquemia/cirurgia , Leucócitos Mononucleares/transplante , Doenças Vasculares Periféricas/cirurgia , Adulto , Antígenos CD34/sangue , Biomarcadores/sangue , Doença Crônica , Doenças do Colágeno/cirurgia , Feminino , Mãos/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Tromboangiite Obliterante/cirurgia , Resultado do Tratamento
19.
Cardiovasc Res ; 70(1): 61-9, 2006 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-16448633

RESUMO

OBJECTIVE: Neointimal formation following percutaneous coronary intervention (PCI), termed restenosis, limits therapeutic revascularization. Since reendothelialization is one of the determinant factors for the development of neointimal formation, we examined the effects of granulocyte colony-stimulating factor (G-CSF) on reendothelialization and neointimal formation after vascular injury in mice. METHODS AND RESULTS: Wire-mediated vascular injury was produced in the femoral artery of C57BL/6 mice. G-CSF pretreatment significantly accelerated reendothelialization and decreased neointimal formation following vascular injury; however, this inhibitory effect of G-CSF was diminished when G-CSF was started following the injury. Flow cytometry analysis revealed that G-CSF treatment increased the number of endothelial progenitor cells (EPCs: CD34+/Flk-1+) in the peripheral circulation. Vascular injury was also produced in 2 types of mice whose bone marrow was replaced with that of enhanced green fluorescent protein- and Tie2/LacZ-transgenic mice. In the reendothelialized artery of these mice, few bone marrow-derived EPCs were detected. Furthermore, G-CSF treatment reduced the serum level of interleukin (IL)-6. CONCLUSION: G-CSF treatment accelerated reendothelialization and decreased neointimal formation following vascular injury, although there was little contribution of bone marrow-derived EPCs to the reendothelialization of the artery. These results suggest that G-CSF pretreatment has a therapeutic potential for prevention of restenosis following PCI.


Assuntos
Angioplastia Coronária com Balão/efeitos adversos , Endotélio Vascular/patologia , Fator Estimulador de Colônias de Granulócitos/administração & dosagem , Neovascularização Patológica/prevenção & controle , Animais , Transplante de Medula Óssea , Proliferação de Células/efeitos dos fármacos , Células Dendríticas/imunologia , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/imunologia , Artéria Femoral/imunologia , Artéria Femoral/lesões , Artéria Femoral/patologia , Citometria de Fluxo , Proteínas de Fluorescência Verde/genética , Humanos , Imuno-Histoquímica/métodos , Interleucina-6/sangue , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos , Camundongos Transgênicos , Modelos Animais , Molécula-1 de Adesão Celular Endotelial a Plaquetas/análise , Proteínas Recombinantes , Células-Tronco/patologia , Túnica Íntima/patologia , beta-Galactosidase/genética
20.
Curr Vasc Pharmacol ; 4(1): 59-65, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16472177

RESUMO

In the past decade, researchers have defined committed stem or progenitor cells from various tissues, including bone marrow, peripheral blood, brain, liver and reproductive organs, in both adult animals and humans. Recently, endothelial progenitor cells (EPCs) were isolated from peripheral blood mononuclear cells and were shown to be incorporated into foci of neovascularization. This finding that circulating EPCs may home into sites of neovascularization and differentiate into mature endothelial cells in situ is consistent with the concept of 'vasculogenesis' and suggests that vasculogenesis and angiogenesis might constitute complementary mechanisms for postnatal neovascularization. Furthermore, experimental and clinical studies on ischemic cardiovascular diseases suggest a therapeutic potential for EPC transplantation. In this review, we summarize the biological features of EPCs and discuss their therapeutic potential for the treatment of cardiovascular diseases.


Assuntos
Doenças Cardiovasculares/terapia , Neovascularização Fisiológica/fisiologia , Transplante de Células-Tronco , Células-Tronco/fisiologia , Adulto , Animais , Humanos , Estudos Multicêntricos como Assunto , Neovascularização Fisiológica/efeitos dos fármacos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...