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1.
Lupus ; 25(9): 997-1003, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26846690

RESUMO

OBJECTIVE: To determine whether the intrathecal concentrations of cytokines/chemokines are associated with, or influenced by, serum concentrations in patients with central neuropsychiatric systemic lupus erythematosus (NPSLE), and to ascertain whether the increased production of cytokines/chemokines intrathecally relative to serum levels is associated with the presence of central NPSLE. METHODS: 52 SLE patients (30 with central NPSLE and 22 with non-NPSLE), for whom the CSF and serum samples were obtained at the same time, were enrolled. 27 kinds of cytokine/chemokine concentrations other than IFN-α in the cerebrospinal fluid (CSF) and serum samples were measured by Bio-Plex Pro Assays. IFN-α concentration and anti-ribosomal P protein antibody (anti-P) titres in CSF and serum samples were measured by ELISA. RESULTS: The mean concentrations of IL-6, IL-8, IP-10, MCP-1, G-CSF and GM-CSF were higher in the CSF than in the sera, respectively, while the mean concentrations of other 22 cytokines/chemokines, including RANTES and IFN-α, in the CSF were much lower than those in the sera, respectively. Furthermore, the concentrations of IL-6, IL-8, IP-10, MCP-1 and G-CSF in the CSF of the 30 patients with NPSLE were significantly higher than in the 22 patients with non-NPSLE (p = 6.82 × 10(-5), p = 0.00037, p = 0.0028, p = 0.00065, and p = 0.0001, respectively), while the concentration of GM-CSF in the CSF of the 30 patients with NPSLE was not significantly higher than in the 22 patients with non-NPSLE. Most importantly, the largest difference occurred in CSF IL-6 concentrations. A significant positive correlation between CSF anti-P titres and serum anti-P titres in 52 patients with SLE (r = 0.6316, p = 6.44 × 10(-6)) was found, while no significant positive correlation was observed between CSF levels and serum levels of each cytokine/chemokine in the 52 SLE patients. CONCLUSION: In central NPSLE the production of IL-6, IL-8, IP-10, MCP-1 and G-CSF might take place in the central nervous system (CNS). These increased CSF cytokines/chemokines along with anti-P might have a prerequisite role in the pathogenesis of central NPSLE.


Assuntos
Quimiocinas/sangue , Quimiocinas/líquido cefalorraquidiano , Fator Estimulador de Colônias de Granulócitos/sangue , Fator Estimulador de Colônias de Granulócitos/líquido cefalorraquidiano , Vasculite Associada ao Lúpus do Sistema Nervoso Central/sangue , Vasculite Associada ao Lúpus do Sistema Nervoso Central/líquido cefalorraquidiano , Adolescente , Adulto , Idoso , Quimiocina CCL2/sangue , Quimiocina CCL2/líquido cefalorraquidiano , Quimiocina CXCL10/sangue , Quimiocina CXCL10/líquido cefalorraquidiano , Feminino , Humanos , Interleucina-6/sangue , Interleucina-6/líquido cefalorraquidiano , Interleucina-8/sangue , Interleucina-8/líquido cefalorraquidiano , Vasculite Associada ao Lúpus do Sistema Nervoso Central/imunologia , Masculino , Pessoa de Meia-Idade , Regulação para Cima , Adulto Jovem
2.
Eur J Neurol ; 23(4): 780-6, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26787509

RESUMO

BACKGROUND AND PURPOSE: Migraine is frequent in patients with systemic lupus erythematosus (SLE), but the pathogenesis and pathophysiology are poorly understood. Migraine is assumed to be a consequence of abnormal neuronal excitability. Based on the hypothesis that the threshold for migraine is lower in SLE patients due to cerebral disturbances, whether structural abnormalities of the brain or relevant biomarkers are associated with headaches in SLE was investigated. METHODS: Sixty-seven SLE patients and age- and gender-matched healthy subjects participated. Volumes of grey matter (GM) and white matter (WM) were estimated from cerebral magnetic resonance images with SPM8 software. Anti-NR2 and anti-P antibodies and protein S100B were measured in cerebrospinal fluid. RESULTS: In regression analyses, larger GM volumes in SLE patients reduced the odds for headache in general [odds ratio (OR) 0.98, P = 0.048] and for migraine in particular (OR 0.95, P = 0.004). No localized loss of GM was observed. Larger WM volumes in patients increased the odds for migraine (OR 1.04, P = 0.007). These findings could not be confirmed in healthy subjects. Neither anti-NR2 and anti-P antibodies nor S100B were associated with headaches in SLE patients. CONCLUSIONS: Systemic lupus erythematosus patients with migraine have a diffuse reduction in GM compared to patients without migraine. This finding was not observed in healthy subjects with migraine, and selected biomarkers did not indicate specific pathophysiological processes in the brain. These findings indicate that unknown pathogenic processes are responsible for the increased frequency of migraine in SLE patients.


Assuntos
Autoanticorpos/líquido cefalorraquidiano , Proteínas do Líquido Cefalorraquidiano/análise , Substância Cinzenta/patologia , Lúpus Eritematoso Sistêmico , Transtornos de Enxaqueca , Neuroglia/metabolismo , Adulto , Idoso , Feminino , Humanos , Lúpus Eritematoso Sistêmico/líquido cefalorraquidiano , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/patologia , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/líquido cefalorraquidiano , Transtornos de Enxaqueca/etiologia , Transtornos de Enxaqueca/patologia , Receptores de N-Metil-D-Aspartato/imunologia , Proteínas Ribossômicas/imunologia , Subunidade beta da Proteína Ligante de Cálcio S100/líquido cefalorraquidiano , Substância Branca/patologia , Adulto Jovem
3.
Lupus ; 22(5): 497-503, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23554038

RESUMO

SH2D1A, also known as signaling lymphocytic activation molecule (SLAM)-associated protein (SAP), is an adaptor protein. Recently, it was reported that SAP deficient mice were protected from systemic lupus erythematosus (SLE). In this study, we postulated SH2D1A gene to be a candidate susceptibility gene for SLE and analyzed its association with SLE. A case-control association study was conducted on 5 tag single nucleotide polymorphisms (SNPs) in SH2D1A region in 506 Japanese female SLE patients and 330 healthy female controls. The luciferase assay was performed to determine the functional role of the SNP associated with SLE. One SNP in the intron 2, rs2049995, showed association with SLE (p=0.0110, odds ratio (OR) 1.97, 95% confidence interval (CI) 1.16-3.34, under the dominant model). The association of rs2049995 seemed to be stronger in the subset with the age of onset less than 20 years (p=0.0067, OR 2.65, 95% CI 1.28-5.46). Functional evaluation of rs2049995 showed that reporter gene activity was increased 1.9-fold for the susceptible allele compared with the resistant allele. An intronic SNP of SH2D1A is associated with SLE.


Assuntos
Peptídeos e Proteínas de Sinalização Intracelular/genética , Lúpus Eritematoso Sistêmico/genética , Adulto , Povo Asiático , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Íntrons , Japão , Células Jurkat , Leucócitos Mononucleares/metabolismo , Leucócitos Mononucleares/patologia , Luciferases , Lúpus Eritematoso Sistêmico/metabolismo , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Proteína Associada à Molécula de Sinalização da Ativação Linfocitária
4.
Osteoarthritis Cartilage ; 19(2): 222-32, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21094261

RESUMO

OBJECTIVE: To investigate the mechanism of mechanical stress-induced expression and regulation of aggrecanases and examine the role of runt-related transcription factor 2 (RUNX-2) in chondrocyte-like cells. METHODS: SW1353 cells were seeded onto stretch chambers at a concentration of 5×104 cells/chamber, and a uni-axial cyclic tensile strain (CTS) (0.5 Hz, 10% stretch) was applied for 30 min. Total RNA was extracted, reverse transcribed, and analyzed by polymerase chain reaction (PCR) and real-time PCR. RUNX-2 overexpression and small interfering RNA (siRNA) targeting RUNX-2 were used to investigate the role of RUNX-2 in CTS-induced gene expression. The involvement of diverse mitogen-activated protein kinase (MAPK) pathways in the activation of RUNX-2, MMP-13 and ADAMTS-5 during CTS was examined by Western blotting. RESULTS: CTS induced expression of RUNX-2, MMP-13, ADAMTS-4, -5, and -9. Overexpression of RUNX-2 up-regulated expression of MMP-13 and ADAMTS-5, whereas RUNX-2 siRNA resulted in significant down-regulation of mechanically-induced MMP-13 and ADAMTS-5 expression. CTS induced activation of p38 MAPK, and CTS induction of RUNX-2, MMP-13 and ADAMTS-5 mRNA was down-regulated by the selective p38 MAPK inhibitor SB203580 but not by the p44/42 MAPK inhibitor U0126, or the JNK MAPK inhibitor JNK inhibitor II. CONCLUSIONS: RUNX-2 might have a role as a key downstream mediator of p38's ability to regulate mechanical stress-induced MMP-13 and ADAMTS-5 expression.


Assuntos
Proteínas ADAM/metabolismo , Condrócitos/fisiologia , Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Metaloproteinase 13 da Matriz/metabolismo , Estresse Mecânico , Proteína ADAMTS5 , Células Cultivadas , Condrócitos/efeitos dos fármacos , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Regulação para Baixo , Inibidores Enzimáticos/farmacologia , Regulação da Expressão Gênica , Humanos , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Reação em Cadeia da Polimerase/métodos , Regulação para Cima , Proteínas Quinases p38 Ativadas por Mitógeno/antagonistas & inibidores
5.
Clin Exp Rheumatol ; 29(4): 604-8, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21906428

RESUMO

OBJECTIVES: Previous studies showed that angiopoietin-1(Ang-1) expression was increased in the synovium in early rheumatoid arthritis (RA) patients. The present study was therefore designed to examine whether determination of serum Ang-1 might be effective in diagnosis of early RA. METHODS: One hundred and five serum samples of RA (21 males, 84 females) were studied for serum Ang-1 level. Serum samples were also collected from other collagen diseases, including 35 cases of SLE, 29 cases of systemic sclerosis, 16 cases of polymyositis/dermatomyositis. Serum samples were additionally obtained from 34 patients who visited our clinic for evaluation of symmetrical polyarthritis with morning stiffness. After one year of follow-up, those patients who satisfied the ACR 1987 classification criteria for RA were defined as 'early RA'. Serum Ang-1 levels were measured by sandwich ELISA using anti-angiopoietin-1 antibodies (both monoclonal and polyclonal antibodies). Serum anti-CCP antibody and rheumatoid factor (RF) were measured by ELISA and by laser nepherometry, respectively. RESULTS: Serum Ang-1 in RA patients was significantly higher than those in other collagen diseases. Serum Ang-1 levels in 50 normal healthy individuals were 5.8 ± 0.31 pg/ml (mean ± SEM). There was no significant difference in CRP and serum RF at the first visit between early RA patients and non-RA patients, whereas serum Ang-1 levels at the first visit were significantly higher in early RA (58.7 ± 17.9 pg/ml [mean ± SEM]) than those in non-RA (8.2 ± 4.5 pg/ml). ROC analysis revealed that serum Ang-1 (cut-off 23.91 pg/ml) could diagnose early RA at sensitivity 57.1% and specificity 84.6%, providing comparable area under the curve (0.71, 95% CI: 0.54-0.88) to that of serum anti-CCP antibody (0.72, 95% CI: 0.53-0.92). There was no significant correlation between anti-CCP antibody and Ang-1. CONCLUSIONS: These results indicate that serum Ang-1 is as useful a marker for the diagnosis of early RA as serum anti-CCP antibody.


Assuntos
Angiopoietina-1/sangue , Artrite Reumatoide/diagnóstico , Adolescente , Adulto , Idoso , Artrite Reumatoide/sangue , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/imunologia , Autoanticorpos/sangue , Biomarcadores/sangue , Estudos de Casos e Controles , Diagnóstico Precoce , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunossupressores/uso terapêutico , Japão , Masculino , Pessoa de Meia-Idade , Nefelometria e Turbidimetria , Peptídeos Cíclicos/imunologia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Fator Reumatoide/sangue , Fatores de Tempo , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Regulação para Cima , Adulto Jovem
6.
Lupus ; 19(6): 717-26, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20026524

RESUMO

Using proteomic analysis, we identified candidate autoantigens specific for central nervous system (CNS) involvement in systemic lupus erythematosus (SLE). Proteins, extracted from cultured human neuroblastoma cells, were separated both by SDS-PAGE (1-DE) and two-dimensional electrophoresis (2-DE), and transferred to membranes. Western blot analysis was performed using serum samples from 30 SLE patients with CNS involvement (CNS-Lupus) and from 30 SLE patients without CNS involvement (non-CNS-SLE). The detected autoantigens were identified using MALDI-TOF/TOF MS. On the 1-DE Western blot, we detected 32 antigenic bands in the serum samples from the CNS-Lupus patients. Among them, four bands were detected significantly more frequently in the CNS-Lupus patients than in the non-CNS-SLE patients. Three bands were detected in four or more of the CNS-Lupus patients but in only one or none of the non-CNS-SLE patients. We thus selected these seven bands for the next investigations. Next, we detected protein spots corresponding to the selected seven bands by 2-DE Western blot and identified four proteins. They are peroxiredoxin-4, ubiquitin carboxyl-terminal hydrolase isozyme L1, splicing factor arginine/serine-rich 3, and histone H2A type 1. These four candidate autoantigens for the anti-neuronal cell antibodies would be a useful marker for CNS-Lupus.


Assuntos
Autoantígenos/imunologia , Vasculite Associada ao Lúpus do Sistema Nervoso Central/imunologia , Adulto , Autoanticorpos/sangue , Autoanticorpos/imunologia , Autoantígenos/sangue , Biomarcadores/sangue , Linhagem Celular Tumoral , Eletroforese em Gel Bidimensional , Feminino , Histonas/imunologia , Humanos , Vasculite Associada ao Lúpus do Sistema Nervoso Central/sangue , Vasculite Associada ao Lúpus do Sistema Nervoso Central/fisiopatologia , Masculino , Pessoa de Meia-Idade , Neuroblastoma , Peroxirredoxinas/imunologia , Proteínas de Ligação a RNA/imunologia , Fatores de Processamento de Serina-Arginina , Ubiquitina Tiolesterase/imunologia , Adulto Jovem
7.
Clin Exp Rheumatol ; 28(1): 87-90, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20346245

RESUMO

OBJECTIVE: Recent studies have disclosed that several genes are up-regulated in bone marrow (BM) mononuclear cells from rheumatoid arthritis (RA) patients. However, it remains unclear whether such abnormalities result from systemic inflammation or from abnormalities at stem cell level. The current study therefore examined the expression of several representative genes, including amphiregulin (AREG), chemokine receptor 4 (CXCR4), and FK506-binding protein 5 (FKBP5) in RA BM CD34+ cells. METHODS: BM samples were obtained from 52 patients with RA and 35 patients with osteroarthritis (OA) during joint operations. CD34+ cells were purified from the BM mononuclear cells by positive selection with magnetic beads. The mRNA expression for AREG, CXCR4, and FKBP5 was measured using quantitative real-time PCR. RESULTS: The expression of mRNA for FKBP5, but not that of AREG or CXCR4, was significantly higher in RA BM CD34+ cells than in OA BM CD34+ cells. The FKBP5 mRNA expression level was not correlated with serum CRP or treatment. In addition, tumour necrosis factor-alpha did not enhance the expression of FKBP5 mRNA in BM CD34+ cells from healthy donors. CONCLUSION: The results suggest that the enhanced expression of FKBP5 in BM CD34+ cells might be an intrinsic abnormality of RA BM CD34+ cells, whereas the enhanced expression of AREG and CXCR4 in BM mononuclear cells might be secondary to systemic inflammation.


Assuntos
Artrite Reumatoide/fisiopatologia , Células da Medula Óssea/fisiologia , Proteínas de Ligação a Tacrolimo/genética , Idoso , Anfirregulina , Antígenos CD34/metabolismo , Células da Medula Óssea/citologia , Células da Medula Óssea/efeitos dos fármacos , Células Cultivadas , Família de Proteínas EGF , Feminino , Expressão Gênica/fisiologia , Glicoproteínas/genética , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/genética , Masculino , Pessoa de Meia-Idade , Osteoartrite/fisiopatologia , RNA Mensageiro/metabolismo , Receptores CXCR4/genética , Fator de Necrose Tumoral alfa/metabolismo , Fator de Necrose Tumoral alfa/farmacologia
8.
Lupus ; 18(13): 1154-68, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19880562

RESUMO

Helicobacter pylori (H. pylori) is a predominant pathogen that causes not only gastroduodenal diseases but also extra-alimentary tract diseases. In this study, we demonstrated that H. pylori infection promoted atherogenesis in heterozygous apoe(+/ --) ldlr(+/--) mice. The male mice were fed with high fat diet from the age of 6 weeks. At the age of 16 weeks, development of atherosclerotic lesions was observed in the H. pylori-infected mice, and it seemed to be associated with an elevation of Th1-immune response against H. pylori origin-heat shock protein 60 (Hp-HSP60) and an increment of transendothelial migration of T cells. Subcutaneous immunisation with Hp-HSP60 or H. pylori eradication with antibiotics significantly reduced the progression of atherosclerosis, accompanied by a decline of Th1 differentiation and reduction of their chemotaxis beyond the endothelium. Thus, oral infection with H. pylori accelerates atherosclerosis in mice and the active immunisation with Hp-HSP60 or the eradication of H. pylori with antibiotics can moderate/prevent cellular immunity, resulting in a reduction of atherosclerosis.


Assuntos
Aterosclerose/etiologia , Aterosclerose/microbiologia , Infecções por Helicobacter , Helicobacter pylori/imunologia , Imunidade Celular/imunologia , Animais , Apolipoproteínas E/genética , Apolipoproteínas E/metabolismo , Aterosclerose/imunologia , Aterosclerose/patologia , Movimento Celular/fisiologia , Chaperonina 60/genética , Chaperonina 60/imunologia , Quimiocinas/imunologia , Gorduras na Dieta , Células Endoteliais/citologia , Células Endoteliais/metabolismo , Infecções por Helicobacter/complicações , Infecções por Helicobacter/imunologia , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Receptores CXCR3/genética , Receptores CXCR3/metabolismo , Receptores de LDL/genética , Receptores de LDL/metabolismo , Células Th1/imunologia
9.
Clin Exp Rheumatol ; 27(2 Suppl 53): S91-5, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19796542

RESUMO

OBJECTIVE: Vascular involvement (vasculo-Behçet's disease) is relatively common in Behçet's disease. Although pulmonary artery aneurysm (PAA) is rare, it is the most serious and sometimes fatal complication. However, the mechanism of the development of PAA is unclear. In the present study, we carried out immunohistological examination of the ruptured pulmonary aneurysm in a patient with vasculo-Behçets disease. METHODS: Light microscopic examination was carried out on paraffin-embedded sections of autopsied pulmonary arteries of a Behçet's disease patient who died of the rupture of the left pulmonary artery aneurysm. RESULTS: Histopathology of the ruptured aneurysm revealed the formation of thrombus and recanalization. In addition, there was proliferation of small vessels in the vascular wall, as if the recanalization was extended to the vascular wall. Of note, marked perivascular cuffing of mononuclear cells, consisting of CD45RO+ T cells and CD68+ monocytes, were observed around the recanalizing capillaries as well as around the proliferating small vessels in the wall of the pulmonary artery. Of note, pericapillary infiltration of CD20+ B cells was noted exclusively in the vascular wall. The ruptured portion of the aneurysm lacks the lamina elastica, indicating that the aneurysm was so called pseudo-aneurysm. CONCLUSION: It is likely that the first event might be the formation of inflammatory thrombus in the pulmonary artery. During the process of recanalization of the thrombus, the basic inflammatory process of Behçet's disease caused marked angiogenesis as well as perivascular cuffing of inflammatory cells in the thrombus and the wall, leading to fragility of the wall.


Assuntos
Aneurisma Roto/complicações , Aneurisma Roto/patologia , Síndrome de Behçet/complicações , Artéria Pulmonar/patologia , Adulto , Evolução Fatal , Humanos , Masculino
10.
Rheumatology (Oxford) ; 47(9): 1373-8, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18577548

RESUMO

OBJECTIVE: To survey and elucidate the clinical characteristics of CMV infection in rheumatic disease patients. METHODS: A detailed questionnaire survey on CMV infection was carried out against rheumatic disease patients hospitalized in member hospitals, and the obtained clinical and/or laboratory data were analysed. RESULTS: Out of 7377 patients, 151 were diagnosed as having CMV infection. The underlying diseases ranged broadly, but SLE, microscopic polyangiitis, and dermatomyositis were the most common. Four were diagnosed histopathologically, and the others via positive CMV antigenaemia. In addition to oral corticosteroid for all but one patient, 81 were treated with pulsed methylprednisolone (MPSL), 64 with cyclophosphamide (CYC) and 36 with other immunosuppressants. Forty-four had a fatal outcome, for which presence of clinical symptoms, other infectious complications, lymphopenia, an older age (>59.3 yrs) and the use of pulsed MPSL were significant risk factors (P < 0.05) by univariate analysis. Multivariate analysis retained the first three (P < 0.05). The CMV antigenaemia count was significantly higher for the symptomatic than asymptomatic [10.1 (0.0-2998.0) vs 4.0 (1.3-1144.4)/10(5) PMNs, respectively, P < 0.05; threshold count: 5.6/10(5) PMNs]. No treatment benefit by anti-viral agent was observed as for survival. CONCLUSION: CMV infection was mostly diagnosed by antigenaemia, and occurred among patients under strong immunosuppressive therapy using pulsed MPSL and/or immunosuppressants. Lymphopenia, presence of symptoms and other infections are significant risk factors for a poor outcome and pulsed MPSL and an older age may predict it. Patients were prone to be symptomatic with anti-genaemia count over 5.6/10(5) PMNs.


Assuntos
Infecções por Citomegalovirus/complicações , Infecções Oportunistas/complicações , Doenças Reumáticas/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos Virais/sangue , Criança , Ciclofosfamida/administração & dosagem , Citomegalovirus/imunologia , Citomegalovirus/isolamento & purificação , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/epidemiologia , Esquema de Medicação , Feminino , Glucocorticoides/administração & dosagem , Hospitalização , Humanos , Imunossupressores/administração & dosagem , Japão/epidemiologia , Masculino , Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/epidemiologia , Prognóstico , Estudos Retrospectivos , Doenças Reumáticas/tratamento farmacológico , Doenças Reumáticas/epidemiologia , Fatores de Risco
11.
Respir Med ; 102(9): 1287-95, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18602805

RESUMO

There are no prospective comparison of the etiology and clinical outcome between hospital-acquired pneumonia (HAP) and nursing home-acquired pneumonia (NHAP) in non-intubated elderly. This study prospectively evaluated the etiology of HAP and NHAP in non-intubated elderly. A prospective cohort study was carried out in a rural region of Japan where the population over 65 years of age represents 30% of the population. A total of 108 patients were enrolled. There were 33 patients with HAP and 75 with NHAP. Etiologic diagnosis was established in 78.8% of HAP and in 72% of NHAP patients. The most frequent pathogens were Chlamydophila pneumoniae followed by Streptococcus pneumoniae, Staphylococcus aureus and Influenza virus. The frequency of Streptococcus pneumoniae and Influenza virus was significantly higher, whereas the frequency of Staphylococcus aureus and Enterobacteriaceae was significantly lower in NHAP compared to HAP. Performance and nutritional status were significantly worse in patients with HAP than in those with NHAP. Hospital mortality was significantly lower in patients with NHAP compared to those with HAP. This study demonstrated that C. pneumoniae, Streptococcus pneumoniae, Staphylococcus aureus and Influenza virus are frequent causative agents of pneumonia in non-intubated elderly and that the responsible pathogens and clinical outcome differ between NHAP and HAP.


Assuntos
Infecção Hospitalar/epidemiologia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Pneumonia/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Infecções por Chlamydophila/epidemiologia , Infecções por Chlamydophila/mortalidade , Infecção Hospitalar/mortalidade , Feminino , Mortalidade Hospitalar , Hospitalização , Humanos , Controle de Infecções , Japão/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pneumonia/mortalidade , Estudos Prospectivos , Fatores de Risco , Estatísticas não Paramétricas
12.
Cancer Res ; 53(18): 4175-81, 1993 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-8364912

RESUMO

It has been considered that growth of human lung cancer cells, like other malignant cells, is positively and negatively regulated by a variety of growth factors via autocrine as well as paracrine mechanisms. The autocrine mechanism is considered to be important in the autonomy of proliferation of cancer cells. Recently, the role of autocrine growth-inhibiting factors such as transforming growth factor beta attracts special attention for better understanding of growth regulation of malignant cells. Here, we have demonstrated that a multifunctional cytokine interleukin 6 (IL-6) had an inhibitory effect on the proliferation of human non-small cell lung cancer cell lines, as shown by the growth accelerating effect of the specific anti-IL-6 antibody as well as the effect of exogenously added IL-6. Moreover, IL-6 can be expressed and released by human lung cancer cells, and these cells had specific IL-6 receptors on their cell surfaces, suggesting an autocrine mechanism. The growth-inhibitory effect of IL-6 was additive to that of transforming growth factor beta, and could not be neutralized by the addition of anti-transforming growth factor beta antibody. These results suggested that IL-6 may function as another class of autocrine growth-inhibiting factor in the growth regulation of human lung cancer. Relatively lower IL-6 sensitivity of these cells than noncarcinogenic human bronchial epithelial cells also suggested that escape from growth regulation by inhibitory factors such as IL-6 could be involved in lung cancer oncogenesis.


Assuntos
Adenocarcinoma/patologia , Interleucina-6/farmacologia , Neoplasias Pulmonares/patologia , Divisão Celular/efeitos dos fármacos , Humanos , Interleucina-6/genética , Interleucina-6/fisiologia , Receptores Imunológicos/análise , Receptores Imunológicos/genética , Receptores de Interleucina-6 , Proteínas Recombinantes/farmacologia , Fator de Crescimento Transformador beta/fisiologia , Células Tumorais Cultivadas
13.
Cancer Res ; 61(15): 5796-802, 2001 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-11479218

RESUMO

Because the apoptotic pathway is often disrupted in tumor cells, its genetic restoration is a very attractive approach for the treatment of tumors. To treat malignant gliomas with this approach, it would be preferred to restrict induction of apoptosis to tumor cells by establishing a tumor-specific expression system. Telomerase is an attractive target because the vast majority of malignant gliomas have telomerase activity whereas normal brain cells do not. Activation of telomerase is tightly regulated at the transcriptional level of the telomerase catalytic subunit [human telomerase reverse transcriptase, (hTERT)]. Therefore, we hypothesized that using a hTERT promoter-driven vector system, an apoptosis-inducible gene may be preferentially restricted to telomerase- or hTERT-positive tumor cells. In this study, we constructed an expression vector consisting of the constitutively active caspase-6 (rev-caspase-6) under the hTERT promoter (hTERT/rev-caspase-6) and then investigated its antitumor effect on malignant glioma cells. The rationale for using the rev-caspase-6 gene is because it induces apoptosis independent of the initiator caspases. We demonstrated that the hTERT/rev-caspase-6 construct induced apoptosis in hTERT-positive malignant glioma cells, but not in hTERT-negative astrocytes, fibroblasts, and alternative lengthening of telomeres cells. In addition, the growth of s.c. tumors in nude mice was significantly suppressed by the treatment with hTERT/rev-caspase-6 construct. The present results strongly suggest that the telomerase-specific transfer of the rev-caspase-6 gene under the hTERT promoter is a novel targeting approach for the treatment of malignant gliomas.


Assuntos
Caspases/genética , Terapia Genética/métodos , Glioma/terapia , Regiões Promotoras Genéticas/genética , RNA , Telomerase/genética , Animais , Apoptose/genética , Caspase 6 , Caspases/biossíntese , Caspases/metabolismo , Proteínas de Ligação a DNA , Técnicas de Transferência de Genes , Vetores Genéticos/genética , Glioma/enzimologia , Glioma/genética , Glioma/patologia , Humanos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , Telomerase/biossíntese , Ativação Transcricional , Células Tumorais Cultivadas , Ensaios Antitumorais Modelo de Xenoenxerto
14.
J Leukoc Biol ; 70(3): 413-21, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11527991

RESUMO

To assess the role of bone marrow in the pathogenesis of rheumatoid arthritis (RA), we examined the capacity of CD34(+) cells from bone marrow to generate fibroblast-like type B synoviocytes. CD34(+) cells from the bone marrow of 22 RA patients differentiated into cells with fibroblast-like morphology, which expressed prolyl 4-hydroxylase, in the presence of stem cell factor (SCF), granulocyte-macrophage colony-stimulating factor (GM-CSF), and tumor necrosis factor alpha (TNF-alpha), much more effectively than CD34(+) cells from bone marrow of 15 control subjects (10 patients with osteoarthritis and 5 healthy individuals). The generation of fibroblast-like cells was not at all observed in cultures with SCF, GM-CSF, and interleukin 4 (IL-4) with or without TNF-alpha. Generation of fibroblast-like cells was correlated with matrix metalloproteinase (MMP)-1 levels in culture supernatants. Thus, MMP-1 levels were significantly higher in TNF-alpha-stimulated cultures of bone marrow CD34(+) cells from patients with RA than in those from the control group. These results indicate that bone marrow CD34(+) cells from patients with RA have abnormal capacities to respond to TNF-alpha and to differentiate into fibroblast-like cells producing MMP-1, suggesting that bone marrow CD34(+) progenitor cells might generate type B synoviocytes and thus could play an important role in the pathogenesis of RA.


Assuntos
Antígenos CD34/análise , Artrite Reumatoide/etiologia , Células da Medula Óssea/citologia , Fibroblastos/citologia , Adulto , Idoso , Artrite Reumatoide/enzimologia , Artrite Reumatoide/patologia , Células da Medula Óssea/química , Células da Medula Óssea/efeitos dos fármacos , Diferenciação Celular , Células Cultivadas , Feminino , Fibroblastos/enzimologia , Fator Estimulador de Colônias de Granulócitos e Macrófagos/farmacologia , Humanos , Masculino , Metaloproteinase 1 da Matriz/biossíntese , Pessoa de Meia-Idade , Pró-Colágeno-Prolina Dioxigenase/biossíntese , Fator de Células-Tronco/farmacologia , Células-Tronco/química , Células-Tronco/citologia , Células-Tronco/efeitos dos fármacos , Membrana Sinovial/citologia , Fator de Necrose Tumoral alfa/farmacologia
15.
Arch Intern Med ; 145(10): 1843-6, 1985 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-3899036

RESUMO

Paired serum and cerebrospinal fluid (CSF) specimens from 13 patients with systemic lupus erythematosus (SLE) and central nervous system involvement (CNS-SLE) were studied for CSF IgM, IgA, and IgG indexes (indicators of intrathecal immunoglobulin synthesis) and CSF-serum albumin quotient (Q albumin) (an indicator of blood-brain-barrier function). We also studied 20 patients with noninflammatory neurologic diseases and seven patients with SLE without CNS involvement for comparison. In addition to an increase in the CSF IgG index, IgM and IgA indexes also were elevated in patients with CNS-SLE. All three indexes decreased significantly when CNS manifestations subsided by successful treatment. The Q albumin was normal in most patients. The elevation of CSF immunoglobulin indexes may be a result of polyclonal B-lymphocyte activation within the CNS, rather than the leak of immunoglobulins from the systemic circulation into the CNS. Since these indexes reflect CNS disease activity in SLE, they may be a successful tool for the management of SLE.


Assuntos
Doenças do Sistema Nervoso Central/diagnóstico , Imunoglobulina A/líquido cefalorraquidiano , Imunoglobulina G/líquido cefalorraquidiano , Imunoglobulina M/líquido cefalorraquidiano , Lúpus Eritematoso Sistêmico/líquido cefalorraquidiano , Adolescente , Corticosteroides/uso terapêutico , Adulto , Barreira Hematoencefálica , Doenças do Sistema Nervoso Central/líquido cefalorraquidiano , Doenças do Sistema Nervoso Central/etiologia , Feminino , Humanos , Técnicas Imunoenzimáticas , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Albumina Sérica/líquido cefalorraquidiano
16.
Arch Intern Med ; 146(12): 2409-10, 1986 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-3778078

RESUMO

A 65-year-old woman with adult Still's disease developed adult respiratory distress syndrome (ARDS), a fatal pulmonary complication. Intravenous administration of cyclophosphamide, 500 mg/d for three days, was much more effective than high doses of corticosteroids in the patient. Interestingly, hypersensitivity to flavoxate hydrochloride seemed to be a precipitating factor, but not a cause, for both a series of characteristic manifestations of adult Still's disease and development of ARDS in our patient. The association of ARDS with adult Still's disease has not yet been reported. Physicians should be aware of this fatal complication in adult Still's disease, especially in the presence of drug hypersensitivities.


Assuntos
Artrite Juvenil/complicações , Síndrome do Desconforto Respiratório/etiologia , Idoso , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Radiografia , Síndrome do Desconforto Respiratório/diagnóstico
17.
Arch Intern Med ; 145(6): 1134-7, 1985 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-4004441

RESUMO

Two men developed renal adenocarcinoma in association with situs ambiguous off with polysplenia (SAP) (also known as the polysplenia syndrome). Features of their diseases included (1) no normal spleen--just splenuli, (2) interruption of the inferior vena cava with azygos or hemiazygos continuation, (3) bilateral hyparterial bronchi, (4) cardiac malformations, (5) renal adenocarcinomas originating from the kidneys, ipsilateral to the anomalous spleens. The association of renal adenocarcinomas and SAP has not been previously reported, to our knowledge. We suggest that renal adenocarcinoma and SAP may share a common pathogenetic link.


Assuntos
Anormalidades Múltiplas/diagnóstico , Adenocarcinoma/complicações , Neoplasias Renais/complicações , Baço/anormalidades , Adenocarcinoma/patologia , Adenocarcinoma/secundário , Ecocardiografia , Eletrocardiografia , Comunicação Interatrial/complicações , Humanos , Neoplasias Renais/patologia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Flebografia , Síndrome , Tomografia Computadorizada por Raios X
18.
Cardiovasc Res ; 30(5): 763-8, 1995 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-8595624

RESUMO

BACKGROUND: The effects of reperfusion on time-dependent alteration of type I collagen have not been examined. OBJECTIVES: We compared the sequential changes in the appearance and distribution of type I collagen in reperfused infarct rat hearts to those in non-reperfused hearts. METHODS: Using an experimental rat model of infarction, we performed immunohistochemical staining with a polyclonal antibody to type I collagen by the avidin-biotin-peroxidase method. Reperfusion was established after 2-h coronary ligation that produced complete necrosis of myocytes. RESULTS: In reperfused hearts, type I collagen appeared in the peripheral zone of the infarct at day 2, which was 1 day earlier than in non-reperfused hearts. The extent of distribution of type I collagen in reperfused hearts was comparable to that observed approximately 1 day later in non-reperfused hearts. CONCLUSION: Reperfusion can accelerate collagen matrix formation compared with that in non-reperfused hearts after acute myocardial infarction.


Assuntos
Colágeno/metabolismo , Infarto do Miocárdio/metabolismo , Animais , Colágeno/análise , Matriz Extracelular/metabolismo , Técnicas Imunoenzimáticas , Masculino , Reperfusão Miocárdica/efeitos adversos , Ratos , Ratos Sprague-Dawley , Fatores de Tempo
19.
Hum Gene Ther ; 11(10): 1397-406, 2000 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-10910137

RESUMO

Apoptosis is a genetically encoded cell death process and is a pathway that may be disrupted in tumor cells. Therefore, therapies that restore the ability to undergo apoptosis are promising for the treatment of tumor cells. We have demonstrated that the transfer of apoptosis-inducible genes inhibits the growth of tumors in vitro and in vivo through induction of apoptosis. However, to restrict induction of apoptosis to tumor cells, we need to explore a tumor-specific expression system of these genes. In the present study, we developed the telomerase-specific transfer system of apoptosis-inducible genes, utilizing the promoter of the human telomerase catalytic subunit (hTERT) gene. Approximately 90% of tumors have telomerase activity whereas most normal cells do not express the activity. These observations indicate that telomerase is a particularly attractive target for the tumor-specific expression system of vectors. We demonstrate here that by using the hTERT promoter-driven caspase-8 expression vector (hTERT/caspase-8), apoptosis is restricted to telomerase-positive tumor cells of wide range, and is not seen in normal fibroblast cells without telomerase activity. Furthermore, treatment of subcutaneous tumors in nude mice with the hTERT/caspase-8 construct inhibited tumor growth significantly because of induction of apoptosis (p < 0.01). The telomerase-specific expression of apoptosis-inducible genes afforded by the hTERT promoter, therefore, may be a novel and promising targeting approach for the treatment of tumors with telomerase activity.


Assuntos
Caspases/genética , Técnicas de Transferência de Genes , Terapia Genética/métodos , Regiões Promotoras Genéticas , RNA , Telomerase/genética , Animais , Apoptose , Caspase 8 , Caspase 9 , Domínio Catalítico , Proteínas de Ligação a DNA , Feminino , Fibroblastos , Humanos , Marcação In Situ das Extremidades Cortadas , Luciferases/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , RNA Mensageiro/metabolismo , Vírus 40 dos Símios/genética , Telomerase/metabolismo , Fatores de Tempo , Transfecção , Células Tumorais Cultivadas
20.
Matrix Biol ; 19(2): 185-7, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10842103

RESUMO

Adam9, Adam15 and Adam21, genes encoding members of the ADAM or MDC family of metalloproteases, have been mapped to mouse chromosomes 8, 1, and 12, respectively, using an interspecific cross. The mapping of these mouse loci and the extrapolated loci for their human orthologs may facilitate the mapping of diseases involving these genes.


Assuntos
Mapeamento Cromossômico , Desintegrinas/genética , Proteínas de Membrana/genética , Metaloendopeptidases/genética , Proteínas ADAM , Animais , Mapeamento Cromossômico/métodos , Ligação Genética , Humanos , Camundongos , Camundongos Endogâmicos C3H
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