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1.
Eur J Endocrinol ; 183(6): R197-R215, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33112280

RESUMO

An increased calcitonin serum level is suggestive of a medullary thyroid cancer (MTC), but is not pathognomonic. The possibility of false positives or other calcitonin-secreting neuroendocrine neoplasms (NENs) should be considered. Serum calcitonin levels are generally assessed by immunoradiometric and chemiluminescent assays with high sensitivity and specificity; however, slightly moderately elevated levels could be attributable to various confounding factors. Calcitonin values >100 pg/mL are strongly suspicious of malignancy, whereas in patients with moderately elevated values (10-100 pg/mL) a stimulation test may be applied to improve diagnostic accuracy. Although the standard protocol and the best gender-specific cut-offs for calcium-stimulated calcitonin are still controversial, the fold of the calcitonin increase after stimulation seems to be more reliable. Patients with MTC show stimulated calcitonin values at least three to four times higher than the basal values, whereas calcitonin-secreting NENs can be distinguished from a C-cell disease by the absence of or

Assuntos
Peptídeo Relacionado com Gene de Calcitonina/sangue , Calcitonina/sangue , Carcinoma Neuroendócrino/diagnóstico , Neoplasias das Glândulas Endócrinas/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Biomarcadores Tumorais/sangue , Diagnóstico Diferencial , Reações Falso-Positivas , Feminino , Humanos , Janus Quinases/sangue , Masculino , Pessoa de Meia-Idade , Valores de Referência , Sensibilidade e Especificidade
2.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(5): 1746-1749, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33067984

RESUMO

AbstractObjective: To evaluate the diagnostic value of serum PCT, CRP and SAA for bloodstream infection(BSI) in patients with hematopathy. METHODS: Sixty hematopathy patients with bloodstream infection from July 2016 to June 2018 were selected and enroued in bloodstream infection group. Sixty-five patients with negative blood culture during the same period were selected and enrolled in non-bloodstream infection group. The ROC curves were drawn and used to eualuate the diagnostic value of above montioned indexes. RESULTS: The levels of PCT, CRP and SAA in the bloodstream infection group were higher than those in the non-bloodstream infection group (P<0.05). ROC curve showed that AUC values of PCT, CRP, SAA and the combined test detection were 0.868, 0.746, 0.678 and 0.900, respectively, there was no significant difference in AUC between combined test and PCT test (P>0.05). AUC of combined test and PCT test were higher than those of CRP and SAA test, and the difference was statistically significant (P<0.05), but there was no significant difference in AUC between CRP and SAA (P>0.05). The optimal PCT detection threshold was 0.49 ng/ml, the sensitivity and specificity were 75.0% and 83.1%, respectively. The optimal critical value for CRP detection was 15.76 mg/L, the sensitivity and specificity were 60.0% and 80.0% respectively. The optimal SAA detection threshold was 35.66 mg/L, the sensitivity and specificity were 81.7% and 53.8%, respectively. CONCLUSION: PCT, CRP and SAA detection have good diagnostic value for blood stream infection in patients with hematopathy. The diagnostic value of PCT is better than CRP and SAA, and there is no significant difference in diagnostic value between combined test and PCT test.


Assuntos
Bacteriemia , Calcitonina , Bacteriemia/diagnóstico , Proteína C-Reativa/análise , Humanos , Curva ROC , Sensibilidade e Especificidade
3.
Cochrane Database Syst Rev ; 9: CD009185, 2020 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-32911567

RESUMO

BACKGROUND: In children with urinary tract infection (UTI), only those with pyelonephritis (and not cystitis) are at risk for developing long-term renal sequelae. If non-invasive biomarkers could accurately differentiate children with cystitis from children with pyelonephritis, treatment and follow-up could potentially be individualized. This is an update of a review first published in 2015. OBJECTIVES: The objectives of this review were to 1) determine whether procalcitonin (PCT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) can replace the acute DMSA scan in the diagnostic evaluation of children with UTI; 2) assess the influence of patient and study characteristics on the diagnostic accuracy of these tests, and 3) compare the performance of the three tests to each other. SEARCH METHODS: We searched MEDLINE, EMBASE, DARE, Web of Science, and BIOSIS Previews through to 17th December 2019 for this review. The reference lists of all included articles and relevant systematic reviews were searched to identify additional studies not found through the electronic search. SELECTION CRITERIA: We only considered published studies that evaluated the results of an index test (PCT, CRP, ESR) against the results of an acute-phase 99Tc-dimercaptosuccinic acid (DMSA) scan (conducted within 30 days of the UTI) in children aged 0 to 18 years with a culture-confirmed episode of UTI. The following cut-off values were used for the primary analysis: 0.5 ng/mL for procalcitonin, 20 mg/L for CRP and 30 mm/hour for ESR. DATA COLLECTION AND ANALYSIS: Two authors independently applied the selection criteria to all citations and independently abstracted data. We used the bivariate model to calculate pooled random-effects pooled sensitivity and specificity values. MAIN RESULTS: A total of 36 studies met our inclusion criteria. Twenty-five studies provided data for the primary analysis: 12 studies (1000 children) included data on PCT, 16 studies (1895 children) included data on CRP, and eight studies (1910 children) included data on ESR (some studies had data on more than one test). The summary sensitivity estimates (95% CI) for the PCT, CRP, ESR tests at the aforementioned cut-offs were 0.81 (0.67 to 0.90), 0.93 (0.86 to 0.96), and 0.83 (0.71 to 0.91), respectively. The summary specificity values for PCT, CRP, and ESR tests at these cut-offs were 0.76 (0.66 to 0.84), 0.37 (0.24 to 0.53), and 0.57 (0.41 to 0.72), respectively. AUTHORS' CONCLUSIONS: The ESR test does not appear to be sufficiently accurate to be helpful in differentiating children with cystitis from children with pyelonephritis. A low CRP value (< 20 mg/L) appears to be somewhat useful in ruling out pyelonephritis (decreasing the probability of pyelonephritis to < 20%), but unexplained heterogeneity in the data prevents us from making recommendations at this time. The procalcitonin test seems better suited for ruling in pyelonephritis, but the limited number of studies and the marked heterogeneity between studies prevents us from reaching definitive conclusions. Thus, at present, we do not find any compelling evidence to recommend the routine use of any of these tests in clinical practice.


Assuntos
Sedimentação Sanguínea , Proteína C-Reativa/análise , Calcitonina/sangue , Cistite/diagnóstico , Pró-Calcitonina/sangue , Pielonefrite/diagnóstico , Doença Aguda , Biomarcadores/sangue , Criança , Cistite/sangue , Diagnóstico Diferencial , Humanos , Pielonefrite/sangue , Pielonefrite/complicações , Ensaios Clínicos Controlados Aleatórios como Assunto , Sensibilidade e Especificidade , Infecções Urinárias/sangue
4.
Yakugaku Zasshi ; 140(8): 1013-1024, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32741859

RESUMO

Novel dosage form designs aiming at patient centric drug therapy are summarized here based on my carrier research in this field. The common key word for this research is particle design. The topics will be divided into two parts, based on the type of particle: coarse particles (powder) and colloidal particles. The former includes the preparation and characterization of functional particles prepared using a spray dryer. Solid dispersions, solvent deposition particles and dry emulsion systems are described. Polymer coated liposomes are described as a useful drug delivery carrier in several administration routes. As chitosan, a mucoadhesive polymer, was used as a coating polymer, the resultant chitosan-coated liposome was found to work as a good carrier for peptide drugs such as insulin and calcitonin in the gastrointestinal tract after oral administration. In another administration route (inhalation), polymer-coated liposomes enhanced the absorption of the drugs. Liposomal carriers applied to the surface of the eye as eye drops are able to deliver drugs to the posterior part of the eye, such as the retina. As a typical example of patient centric dosage form design, particle designs for the preparation of orally disintegrating tablets and films were introduced in one of our recent studies on oral dosage form design.


Assuntos
Formas de Dosagem , Sistemas de Liberação de Medicamentos , Desenho de Fármacos , Lipossomos , Tamanho da Partícula , Administração por Inalação , Administração Oral , Calcitonina/administração & dosagem , Quitosana , Coloides , Humanos , Insulina/administração & dosagem , Polímeros
5.
Georgian Med News ; (303): 173-177, 2020 Jun.
Artigo em Russo | MEDLINE | ID: mdl-32841201

RESUMO

The aim of research - to study the level of biomarkers of bacterial translocation in the dynamics of the development of two types of intestinal obstruction. In the experiment, 60 white male rats (2 groups with a model of obstructive (OIO) and strangulated (SIO) intestinal obstruction and the Sham control group) determined the level of biomarkers PCT, LBP, IL-6 in blood serum by ELISA. Statistically significant differences in the levels of PCT and LBP were detected in the subgroups of OIO 1 day and SIO 1h/6h, the maximum values were found in the subgroup of OIO 1 day, with SIO the levels of PCT and LBP gradually increased in the post-reperfusion period. The level of IL-6 is statistically significantly increased in the subgroups of OIO 1 day and both SIO. LBP and IL-6 levels are moderately elevated in the Sham group. LBP and PCT are the most valuable markers of bacterial translocation at intestinal obstruction, while LBP is an effective marker IL-6 the degree of systemic inflammatory response.


Assuntos
Interleucina-6 , Obstrução Intestinal , Animais , Biomarcadores , Proteína C-Reativa , Calcitonina , Masculino , Pró-Calcitonina , Ratos , Soro
6.
Arch Osteoporos ; 15(1): 134, 2020 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-32820451

RESUMO

This study demonstrates a low anti-osteoporosis drug treatment rate (22.1% in women, 9.5% in men) after osteoporotic fracture in the real-world setting of Fujian, China. The primary medication was calcitonin. The suboptimal treatment was particularly critical among men, low-level hospitals, wrist/vertebral fracture, and the younger elderly patients. INTRODUCTION: The objective of this study was to investigate the prescription patterns and related influencing factors of anti-osteoporosis drug prescribing after osteoporotic fracture in Fujian, China, between 2010 and 2016. METHODS: This is a retrospective cohort study based on an existing electronic health record database (National Healthcare Big Data in Fuzhou, China, 37 hospitals included). Patients over 50 years old with newly diagnosed osteoporotic fractures between 2010 and 2016 were included. Postfracture osteoporosis therapies were summarized by overall and fracture site. Multivariate logistic regression was performed to identify influencing factors of anti-osteoporosis medication (AOM) prescription. RESULTS: Overall, 22.1% of women and 9.5% of men over 50 years old received AOM treatment after osteoporotic fracture within 1 year during 2010-2016, with particular low use of bisphosphonates, 5.3% in women and 1.5% in men. The highest rate of AOM treatment was found in patients with hip fracture (24.5%), followed by vertebral fracture (14.2%) and wrist fracture (2.3%). Of the AOM-treated patients, 90.5% received calcitonin therapy. The treatment rate of AOM showed a slight decline during 2010-2016, but steady rise trends were observed in Ca/vitamin D (VD) prescription. Hospital level, age, sex, previous osteoporosis, previous AOM prescription, and previous oral glucocorticoid prescription were strong predicting factors of AOM prescription. CONCLUSION: In a real-world setting, AOM treatment was suboptimal and the treatment rate even decreased over time among osteoporosis fracture patients in Fujian, China. The suboptimal treatment was particularly critical among men, low-level hospitals, wrist/vertebral fracture, and the younger elderly patients.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Calcitonina/uso terapêutico , Difosfonatos/uso terapêutico , Fraturas Ósseas/etiologia , Osteoporose/tratamento farmacológico , Fraturas por Osteoporose/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea/efeitos dos fármacos , China/epidemiologia , Estudos de Coortes , Prescrições de Medicamentos/estatística & dados numéricos , Revisão de Uso de Medicamentos , Registros Eletrônicos de Saúde , Feminino , Fraturas Ósseas/tratamento farmacológico , Fraturas do Quadril/tratamento farmacológico , Fraturas do Quadril/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/epidemiologia , Fraturas por Osteoporose/epidemiologia , Estudos Retrospectivos
7.
J Headache Pain ; 21(1): 87, 2020 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-32640973

RESUMO

BACKGROUND: Stimulation of trigeminovascular pathway is widely used to establish the headache animal model. Headache is a common neurological disorder, in which symptomatic attacks are mediated by calcitonin-gene-related peptide (CGRP). CGRP is synthesized and released from the trigeminal ganglion to transmit pain signals under stimulation. On the other hand, Neuropeptide FF (NPFF) is a candidate transmitter/modulator for migraine, and stimulation of its receptor, NPFFR2, increases the expression and release of CGRP in mice sensory neurons. Here, we investigate the impact of NPFFR2 on trigeminal CGRP level in a capsaicin-induced headache mouse model. METHODS: Mice were intracisternally injected with capsaicin into the cisterna magna to activate the trigeminovascular pathway and induce headache symptoms. Mice pretreated with Npffr2-shRNA or NPFFR2 knockouts were adopted to test the impact of NPFFR2 on capsaicin-induced CGRP upregulation in trigeminal ganglion. The gene silencing effect of Npffr2-shRNA in trigeminal ganglion was confirmed by real-time PCR. Trigeminal CGRP level was determined by immunofluorescence staining, and the percentage of CGRP-positive cell was calculated after setting the signal intensity threshold by Image J software. Amount of trigeminal CGRP in NPFFR2 overexpressed mice was also measured by CGRP ELISA. FINDINGS: Infusion of capsaicin into the cisterna magna upregulated the CGRP in trigeminal ganglion and induced spontaneous pain behaviors including the reduction of locomotor activity and the increase of freezing behavior. Intracisternal injection of Npffr2-shRNA reduced the mRNA of Npffr2 in trigeminal ganglion. Mice pretreatment with Npffr2-shRNA prevented capsaicin-induced CGRP upregulation in trigeminal ganglion. Similarly, CGRP upregulation was also reduced in NPFFR2 knockout mice. On the contrary, trigeminal CGRP was increased in NPFFR2 overexpressed mice. CONCLUSIONS: Reducing the level of NPFFR2 leads to the downregulation of capsaicin-induced CGRP in trigeminal ganglion, which would consequently attenuate the activation of trigeminovascular pathway. Thus, NPFFR2 could serve as a potential target for neuromodulation of cephalic pain.


Assuntos
Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Capsaicina/farmacologia , Receptores de Neuropeptídeos/metabolismo , Gânglio Trigeminal/metabolismo , Animais , Calcitonina/genética , Modelos Animais de Doenças , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Transtornos de Enxaqueca/metabolismo , Neurônios Aferentes/metabolismo , Ratos , Regulação para Cima/efeitos dos fármacos
8.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(3): 313-318, 2020 Jun 30.
Artigo em Chinês | MEDLINE | ID: mdl-32616125

RESUMO

Objective To investigate the effects of Helicobacter pylori(H.pylori)infection on autonomic nervous function and calcitonin gene-related peptide in patients with functional dyspepsia(FD). Methods Thirty-one patients with FD matching Rome Ⅳ criteria were included and divided into H.pylori-positive group and H.pylori-negative group.All patients were evaluated by Symptom Index of Dyspepsia(SID),Nepean Dyspepsia Index(NDI),and Hospital Anxiety and Depression Scale(HADS).Their heart rate variability(HRV)and calcitonin gene-related peptide(CGRP)level were also measured. Results There were no significant differences in SID(Z=-0.858, P=0.858),NDI(Z=-1.464, P=0.143),and Hospital Depression Scale score(Z=0.699, P=0.485).However,the Hospital Anxiety Scale score was significantly higher in H.pylori-positive group than the H.pylori-negative group(Z=-2.470, P=0.014).The level of CGRP in H.pylori-positive group[(0.999±0.274)ng/ml]was significantly higher than that in the H.pylori-negative group[(0.812±0.172)ng/ml;t=2.238, P=0.033].HRV data showed no significant difference between these two groups at very low frequency(t=-1.210, P=0.236),low frequency(LF)(t=0.419, P=0.678),high frequency(HF)(t=0.612, P=0.546),LF/HF(t=-0.882, P=0.399),and total power(t=-0.963, P=0.344). Conclusion In FD patients,patients with H.pylori-positive FD patients have higher depression and CGRP levels than those without H.pylori infection,although their dyspepsia symptoms and HRV show no notable changes.


Assuntos
Dispepsia , Infecções por Helicobacter , Helicobacter pylori , Ansiedade , Calcitonina , Peptídeo Relacionado com Gene de Calcitonina , Humanos
9.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(6): 686-690, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-32684213

RESUMO

OBJECTIVE: To investigate the level and changing trend of microparticles (MPs) in super-elderly infected patients, and explore its early warning effect on infection. METHODS: The infected patients ≥ 85 years old admitted to the Second Medical Center of Chinese PLA General Hospital from December 2018 to March 2019 were selected as the observation group, and the healthy volunteers ≥ 85 years old in the same period were selected as the control group. Venous blood samples were collected at the 2nd hour, the 2nd day and the 7th day after fever, and the inflammatory markers such as white blood cell count (WBC), neutrophil percentage (NEUT), C-reactive protein (CRP) and procalcitonin (PCT) were measured. The levels of MPs were determined by flow cytometry. Annexin V labeled CD11b positive MPs (Annexin V+/CD11b+ MPs) represented leukocyte microparticles (LMPs), and Annexin V labeled CD66b positive MPs (Annexin V+/CD66b+ MPs) represented neutrophil microparticle (NMPs). The differences of each index at different time points between the two groups were compared, and the predictive value of each index to the infection of elderly patients was analyzed by receiver operating characteristic (ROC) curve. RESULTS: A total of 38 subjects were enrolled, including 28 cases in the observation group and 10 cases in the control group. The levels of LMPs and NMPs in the observation group increased to the peak at the 2nd hour after fever, and were significantly higher than those in the control group [LMPs (cells/µL): 55.0 (28.8, 197.2) vs. 19.0 (13.5, 28.3), NMPs (cells/µL): 226.5 (123.3, 516.5) vs. 26.5 (22.0, 48.8), both P < 0.01]. With the control of the disease, LMPs and NMPs decreased gradually. The NMPs on the 2nd day was significantly lower than that at the 2nd hour of fever [cells/µL: 106.0 (40.0, 309.0) vs. 226.5 (123.3, 516.5), P < 0.05], and the LMPs and NMPs on the 7th day were significantly lower than those on the 2nd day [LMPs (cells/µL): 17.0 (12.5, 43.8) vs. 42.0 (13.0, 117.0), NMPs (cells/µL): 30.0 (15.8, 62.0) vs. 106.0 (40.0, 309.0), both P < 0.05]. There was no significant difference in the levels of LMPs and NMPs between the two groups on the 7th day. Among the inflammatory markers, the NEUT in the observation group was significantly higher than that in the control group at the 2nd hour of fever (0.70±0.09 vs. 0.59±0.04, P < 0.01), but there was no significant difference in WBC, CRP and PCT between the two groups. On the 2nd day, the inflammatory markers in the observation group reached the peak and were significantly higher than those in the control group [WBC (×109/L): 9.33±2.44 vs. 6.37±1.28, NEUT: 0.78±0.08 vs. 0.57±0.04, CRP (mg/L): 5.67±2.99 vs. 0.33±0.18, PCT (µg/L): 0.80±0.67 vs. 0.07±0.03, all P < 0.01]. On the 7th day, the inflammatory markers in the observation group decreased significantly, and there was no significant difference between the observation group and the control group. ROC curve analysis showed that the area under ROC curve (AUC) and 95% confidence interval (95%CI) of LMPs and NMPs on the day of fever were higher than those of WBC, NEUT, CRP and PCT [0.888 (0.763-1.000), 0.973 (0.931-1.000) vs. 0.679 (0.346-0.811), 0.829 (0.700-0.958), 0.607 (0.404-0.811), 0.554 (0.358-0.749)]. CONCLUSIONS: LMPs and NMPs are significantly increased in the early stage of fever, which can predict the incidence of infection in the super-elderly patients.


Assuntos
Infecções/diagnóstico , Idoso , Proteína C-Reativa , Calcitonina , Peptídeo Relacionado com Gene de Calcitonina , Humanos , Pró-Calcitonina , Prognóstico , Precursores de Proteínas , Curva ROC , Estudos Retrospectivos
10.
Sheng Li Xue Bao ; 72(3): 399-406, 2020 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-32572437

RESUMO

Calcitonin gene-related peptide (CGRP) is a neuropeptide coded by the calcitonin gene and divided into α and ß subtypes. CGRP is widely distributed throughout the human body and highly expressed in the peripheral and central nervous system. Studies have shown that CGRP plays a role in a variety of physiological and pathophysiological activities, such as the formation and transmission of nociceptive signal, as well as the regulation of cardiovascular function. Recently, more and more researches have shown that CGRP is involved in the regulation of synaptic plasticity, cognitive function and learning memory in the central nervous system. This paper reviews the role of CGRP in regulation of synaptic plasticity and process of emotional memory, hoping to provide a new molecular target and theoretical basis for clinical treatment of neurological diseases.


Assuntos
Peptídeo Relacionado com Gene de Calcitonina , Calcitonina , Sistema Nervoso Central , Humanos , Memória , Plasticidade Neuronal
13.
Pediatrics ; 145(6)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32404432

RESUMO

BACKGROUND: Host biomarkers predict disease severity in adults with community-acquired pneumonia (CAP). We evaluated the association of the white blood cell (WBC) count, absolute neutrophil count (ANC), C-reactive protein (CRP), and procalcitonin with the development of severe outcomes in children with CAP. METHODS: We performed a prospective cohort study of children 3 months to 18 years of age with CAP in the emergency department. The primary outcome was disease severity: mild (discharged from the hospital), mild-moderate (hospitalized but not moderate-severe or severe), moderate-severe (eg, hospitalized with receipt of intravenous fluids, supplemental oxygen, complicated pneumonia), and severe (eg, intensive care, vasoactive infusions, chest drainage, severe sepsis). Outcomes were examined within the cohort with suspected CAP and in a subset with radiographic CAP. RESULTS: Of 477 children, there were no statistical differences in the median WBC count, ANC, CRP, or procalcitonin across severity categories. No biomarker had adequate discriminatory ability between severe and nonsevere disease (area under the curve [AUC]: 0.53-0.6 for suspected CAP and 0.59-0.64 for radiographic CAP). In analyses adjusted for age, antibiotic use, fever duration, and viral pathogen detection, CRP was associated with moderate-severe disease (odds ratio 1.12; 95% confidence interval, 1.0-1.25). CRP and procalcitonin revealed good discrimination of children with empyema requiring chest drainage (AUC: 0.83) and sepsis with vasoactive infusions (CRP AUC: 0.74; procalcitonin AUC: 0.78), although prevalence of these outcomes was low. CONCLUSIONS: WBC count, ANC, CRP, and procalcitonin are generally not useful to discriminate nonsevere from severe disease in children with CAP, although CRP and procalcitonin may have some utility in predicting the most severe outcomes.


Assuntos
Pneumonia/sangue , Pneumonia/diagnóstico por imagem , Índice de Gravidade de Doença , Adolescente , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Calcitonina/sangue , Criança , Pré-Escolar , Estudos de Coortes , Infecções Comunitárias Adquiridas/sangue , Infecções Comunitárias Adquiridas/diagnóstico por imagem , Infecções Comunitárias Adquiridas/epidemiologia , Humanos , Lactente , Pneumonia/epidemiologia , Estudos Prospectivos
14.
J Endod ; 46(7): 950-956, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32387076

RESUMO

INTRODUCTION: Pulpitis is an inflammation of dental pulp caused by bacterial proliferation near or within pulpal tissues. In advanced stages, when the inflammation is associated with pulp necrosis, pulp preservation is dependent on dental pulp stem cells (DPSCs) that can differentiate into odontoblastlike cells and produce reparative dentin. In this study, we evaluated the influence of sensory neurons through calcitonin gene-related peptide (CGRP) on DPSC viability and proliferation and the ability of DPSCs to differentiate into mineralizing cells. METHODS: Commercially available DPSCs were treated with varying doses of CGRP, and metabolic activity, viability, proliferation, and cell death were evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assays, trypan blue staining, 5-bromo-2'-deoxyuridine cell proliferation assay, and caspase-3 staining, respectively. DPSC differentiation was assessed with alizarin red staining and by quantifying messenger RNA expression of odontoblast makers. RESULTS: CGRP induced a dose-dependent decrease of DPSC metabolic activity that was prevented by the CGRP receptor antagonist CGRP 8-37. The decrease in the proportion of live cells induced by CGRP is associated with a decrease of cell proliferation but not with caspase-3-dependent apoptosis. Interestingly, dexamethasone-induced DPSC differentiation into mineralizing cells was neither inhibited nor enhanced by CGRP treatment. CONCLUSIONS: The neuropeptide CGRP has an inhibitory effect on DPSC proliferation but does not enhance or inhibit the differentiation of DPSCs into mineralizing cells. This suggests that CGRP might negatively influence the ability of DPSCs to contribute to regenerative or tissue repair processes.


Assuntos
Peptídeo Relacionado com Gene de Calcitonina , Polpa Dentária , Calcitonina , Diferenciação Celular , Proliferação de Células , Sobrevivência Celular , Células Cultivadas , Células-Tronco
15.
Sci Rep ; 10(1): 7581, 2020 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-32371888

RESUMO

Biomineralization is the process by which living organisms acquired the capacity to accumulate minerals in tissues. Shells are the biomineralized exoskeleton of marine molluscs produced by the mantle but factors that regulate mantle shell building are still enigmatic. This study sought to identify candidate regulatory factors of molluscan shell mineralization and targeted family B G-protein coupled receptors (GPCRs) and ligands that include calcium regulatory factors in vertebrates, such as calcitonin (CALC). In molluscs, CALC receptor (CALCR) number was variable and arose through lineage and species-specific duplications. The Mediterranean mussel (Mytilus galloprovincialis) mantle transcriptome expresses six CALCR-like and two CALC-precursors encoding four putative mature peptides. Mussel CALCR-like are activated in vitro by vertebrate CALC but only receptor CALCRIIc is activated by the mussel CALCIIa peptide (EC50 = 2.6 ×10-5 M). Ex-vivo incubations of mantle edge tissue and mantle cells with CALCIIa revealed they accumulated significantly more calcium than untreated tissue and cells. Mussel CALCIIa also significantly decreased mantle acid phosphatase activity, which is associated with shell remodelling. Our data indicate the CALC-like system as candidate regulatory factors of shell mineralization. The identification of the CALC system from molluscs to vertebrates suggests it is an ancient and conserved calcium regulatory system of mineralization.


Assuntos
Biomineralização , Calcitonina/metabolismo , Sequência de Aminoácidos , Animais , Evolução Biológica , Transporte Biológico , Biomineralização/genética , Bivalves , Calcificação Fisiológica , Calcitonina/genética , Cálcio/metabolismo , Biologia Computacional/métodos , Sequência Conservada , Ativação Enzimática , Receptores da Calcitonina/genética , Receptores da Calcitonina/metabolismo , Receptores Acoplados a Proteínas-G/classificação , Receptores Acoplados a Proteínas-G/genética , Receptores Acoplados a Proteínas-G/metabolismo
17.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(4): 316-322, 2020 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-32312368

RESUMO

OBJECTIVE: To study the value of procalcitonin (PCT) within 3 days after birth in the diagnosis of neonatal early-onset sepsis (EOS), as well as the thresholds of PCT in the diagnosis of EOS in neonates with different gestational ages and different ages. METHODS: A total of 109 neonates with a confirmed diagnosis of sepsis, 215 neonates with clinically diagnosed sepsis, and 367 neonates without sepsis were enrolled. Receiver operating characteristic (ROC) curves were plotted to determine the optimal cut-off values of PCT in the diagnosis of EOS in neonates with different gestational ages and different ages. The diagnostic value of PCT and blood culture was compared. RESULTS: In the confirmed diagnosis group, the neonates with a gestational age of <34 weeks had a significantly higher level of PCT than those with a gestational age of ≥34 weeks (P<0.05). For the neonates with a gestational age of ≥34 weeks, the optimal cut-off values of PCT in the diagnosis of EOS were 1.588 ng/mL (sensitivity 0.688, specificity 0.851) at age of <12 hours, 4.960 ng/mL (sensitivity 0.737, specificity 0.883) at age of 12 - <24 hours, 5.583 ng/mL (sensitivity 0.727, specificity 0.865) at age of 24 - <36 hours, 1.710 ng/mL (sensitivity 0.732, specificity 0.755) at age of 36 - <48 hours, 3.570 ng/mL (sensitivity 0.488, specificity 0.930) at age of 48 -<60 hours, and 3.574 ng/mL (sensitivity 0.333, specificity 0.900) at age of 60 - 72 hours. PCT had a larger area under the ROC curve in the diagnosis of EOS than blood culture within 36 hours after birth (P<0.05). CONCLUSIONS: The same criteria can be used for late preterm infants (with a gestational age of ≥34 weeks) and full-term infants, while early preterm infants (with a gestational age of <34 weeks) should be considered separately. PCT has different optimal cut-off values in the diagnosis of EOS in neonates with different ages, with a higher value than blood culture in the diagnosis of EOS within 36 hours after birth.


Assuntos
Sepse Neonatal , Biomarcadores , Calcitonina , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Pró-Calcitonina , Curva ROC
18.
Cochrane Database Syst Rev ; 3: CD010159, 2020 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-32176812

RESUMO

BACKGROUND: Thyroid nodules are very common in general medical practice, but rarely turn out to be a medullary thyroid carcinoma (MTC). Calcitonin is a sensitive tumour marker for the detection of MTC (basal calcitonin). Sometimes a stimulation test is used to improve specificity (stimulated calcitonin). Although the European Thyroid Association's guideline advocates calcitonin determination in people with thyroid nodules, the role of routine calcitonin testing in individuals with thyroid nodules is still questionable. OBJECTIVES: The objective of this review was to determine the diagnostic accuracy of basal and/or stimulated calcitonin as a triage or add-on test for detection of MTC in people with thyroid nodules. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase and Web of Science from inception to June 2018. SELECTION CRITERIA: We included all retrospective and prospective cohort studies in which all participants with thyroid nodules had undergone determination of basal calcitonin levels (and stimulated calcitonin, if performed). DATA COLLECTION AND ANALYSIS: Two review authors independently scanned all retrieved records. We extracted data using a standard data extraction form. We assessed risk of bias and applicability using the QUADAS-2 tool. Using the hierarchical summary receiver operating characteristic (HSROC) model, we estimated summary curves across different thresholds and also obtained summary estimates of sensitivity and specificity at a common threshold when possible. MAIN RESULTS: In 16 studies, we identified 72,368 participants with nodular thyroid disease in whom routinely calcitonin testing was performed. All included studies performed the calcitonin test as a triage test. Median prevalence of MTC was 0.32%. Sensitivity in these studies ranged between 83% and 100% and specificity ranged between 94% and 100%. An important limitation in 15 of the 16 studies (94%) was the absence of adequate reference standards and follow-up in calcitonin-negative participants. This resulted in a high risk of bias with regard to flow and timing in the methodological quality assessment. At the median specificity of 96.6% from the included studies, the estimated sensitivity (95% confidence interval (CI)) from the summary curve was 99.7% ( 68.8% to 100%). For the median prevalence of MTC of 0.23%, the positive predictive value (PPV) for basal calcitonin testing at a threshold of 10 pg/mL was 7.7% (4.9% to 12.1%). Summary estimates of sensitivity and specificity for the threshold of 10 pg/mL of basal calcitonin testing was 100% (95% CI 99.7 to 100) and 97.2% (95% CI 95.9 to 98.6), respectively. For combined basal and stimulated calcitonin testing, sensitivity ranged between 82% and 100% with specificity between 99% and 100%. The median specificity was 99.8% with an estimated sensitivity of 98.8% (95% CI 65.8 to 100) . AUTHORS' CONCLUSIONS: Both basal and combined basal and stimulated calcitonin testing have a high sensitivity and specificity. However, this may be an overestimation due to high risk of bias in the use and choice of reference standard The value of routine testing in patients with thyroid nodules remains questionable, due to the low prevalence, which results in a low PPV of basal calcitonin testing. Whether routine calcitonin testing improves prognosis in MTC patients remains unclear.


Assuntos
Calcitonina/sangue , Carcinoma Medular/sangue , Carcinoma Neuroendócrino/sangue , Neoplasias da Glândula Tireoide/sangue , Biomarcadores Tumorais/sangue , Carcinoma Medular/diagnóstico , Carcinoma Neuroendócrino/diagnóstico , Diagnóstico Diferencial , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/sangue , Nódulo da Glândula Tireoide/diagnóstico
19.
Horm Metab Res ; 52(4): 216-219, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32168524

RESUMO

Fine-needle aspiration (FNA) is not necessary in adults with nodules ≤ 1 cm without apparent extrathyroidal extension (ETE) or lymph node (LN) involvement on ultrasonography (US). In the absence of FNA and serum calcitonin (Ctn) measurement, medullary thyroid microcarcinomas (microMTC) are not diagnosed. The aim of this prospective study was to evaluate Ctn levels in adults with a low clinical risk of MTC and nodules ≤ 1 cm without ETE or LN involvement on US. A total of 506 consecutively seen adults who had nodules with two or more suspicious features were included. Patients with elevated basal Ctn underwent a calcium stimulation test and FNA. Basal Ctn was normal in 490 patients (96.8%). In the 16 patients with elevated basal Ctn, FNA revealed MTC in only one patient and MTC was not suspected in the 15 patients with elevated basal Ctn. Three patients with stimulated Ctn<100 pg/ml and benign cytology were not submitted to surgery. MTC was excluded by histology in three patients with stimulated Ctn<100 pg/ml and indeterminate or suspicious cytology and in eight patients with stimulated Ctn>100 pg/ml. One patient with stimulated Ctn>100 pg/ml had MTC. Ctn was undetectable 6 months after surgery in two patients with MTC. Although uncommon, even subjects without a suspicious history and with nodules ≤ 1 cm without ETE or LN involvement on US, but with suspicious findings, can have microMTC. The measurement of Ctn permits the diagnosis of these cases.


Assuntos
Calcitonina/sangue , Nódulo da Glândula Tireoide/sangue , Nódulo da Glândula Tireoide/diagnóstico , Adulto , Idoso , Biomarcadores Tumorais/sangue , Biópsia por Agulha Fina , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Nódulo da Glândula Tireoide/patologia , Carga Tumoral , Ultrassonografia , Adulto Jovem
20.
Br J Oral Maxillofac Surg ; 58(4): 443-450, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32139146

RESUMO

Trigeminal neuralgia is one of the most common of the neuropathic pains, and it can seriously influence patients' quality of life. Calcitonin gene-related peptide (CGRP) is a type of nociceptive neurotransmitter that is expressed in neurons of the trigeminal ganglion and plays a major part in transmitting pain. The rat model of trigeminal neuralgia was established by causing a chronic constriction injury of the infraorbital nerve (CCI-ION). Male Sprague-Dawley rats (n=24) were randomly divided into a sham control group (sham, n=6), sham-treated with palmatine group (sham+palmatine, n=6), trigeminal nerve model group (TN, n=6), and trigeminal nerve treated with palmatine group (TN+palmatine, n=6). Fifteen days after the operation the mechanical response threshold was decreased in the TN group compared with the sham group. From postoperative day 7 to day 15, the mechanical response threshold in the TN+palmatine group significantly increased compared with the TN group. On postoperative day 15 the results of quantitative polymerase chain reaction (qPCR), immunohistochemical staining, and western blotting showed an obvious increase in expression of CGRP and its receptors, serum concentrations of interleukin-1ß (IL-1ß), and tumour necrosis factor-α (TNF-α), and phosphorylation of protein kinase C (PKC) in the trigeminal ganglia of the TN group compared with the sham group, but these increases could be down-regulated by treatment with palmatine. Palmatine might therefore have therapeutic potential for the treatment of trigeminal neuralgia by inhibiting the expression of CGRP and its receptors in trigeminal ganglia, suppressing the serum concentrations of IL-1ß and TNF-α, and decreasing the phosphorylation of PKC in the trigeminal ganglia of affected rats.


Assuntos
Peptídeo Relacionado com Gene de Calcitonina , Gânglio Trigeminal , Animais , Alcaloides de Berberina , Calcitonina , Constrição , Humanos , Hiperalgesia , Masculino , Qualidade de Vida , Ratos , Ratos Sprague-Dawley
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