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One of the main hallmarks of Alzheimer's Disease is the formation of ß-amyloid plaques, whose formation may be enhanced by metal binding or the appearance of familial mutations. In the present study, the simultaneous effect of familial mutations (E22Q, E22G, E22K, and D23N) and binding to metal ions (Cu(II) or Al(III)) is studied at the Aß42 monomeric and fibrillar levels. With the application of GaMD and MD simulations, it is observed that the effects of metal binding and mutations differ in the monomeric and fibrillar forms. In the monomeric structures, without metal binding, all mutations reduce the amount of α-helix and increase, in some cases, the ß-sheet content. In the presence of Cu(II) and Al(III) metal ions, the peptide becomes less flexible, and the ß-sheet content decreases in favor of forming α-helix motifs that stabilize the system through interhelical contacts. Regarding the fibrillar structures, mutations decrease the opening of the fiber in the vertical axis, thereby stabilizing the S-shaped structure of the fiber. This effect is, in general, enhanced upon metal binding. These results may explain the different Aß42 aggregation patterns observed in familial mutations.
Assuntos
Doença de Alzheimer , Peptídeos beta-Amiloides , Humanos , Peptídeos beta-Amiloides/química , Doença de Alzheimer/genética , Doença de Alzheimer/metabolismo , Mutação , Metais , Íons , Fragmentos de Peptídeos/químicaRESUMO
BACKGROUND: Perceptual and action systems seem to be related to complex cognitive processes, but the scope of grounded or embodied cognition has been questioned. Zwaan and Yaxley (2003) proposed that cognitive processes of making semantic relatedness judgments can be facilitated when word pairs are presented in ways that their referents maintain their iconic configuration rather than their reverse-iconic configuration (the spatial iconicity effect). This effect has been observed in different semantic categories using specific experiments, but it is known that embodiment is highly dependent on task demands. METHOD: The present study analyzed the spatial iconicity effect in three semantic categories (physical, abstract, and social) using the same experimental criteria to determine the scope of embodied cognition. In this reaction-time experiment, 75 participants judged the semantic relatedness of 384 word pairs whose experimental items were presented in their iconic or reverse-iconic configurations. RESULTS: Two mixed-effects models with crossed random effects revealed that the interaction between word meaning and spatial position was present only for physical concepts but neither for abstract nor social concepts. CONCLUSIONS: Within the framework of strong and weak embodiment theories, the data support weak embodiment theory as the most explicative one.
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Cognição , Semântica , Humanos , Tempo de Reação , Julgamento , Diferencial SemânticoRESUMO
With a large amount of research dedicated to decoding how metallic species bind to proteins, in silico methods are interesting allies for experimental procedures. To date, computational predictors mostly work by identifying the best possible sequence or structural match of the target protein with metal-binding templates. These approaches are fundamentally focused on the first coordination sphere of the metal. Here, we present the BioMetAll predictor that is based on a different postulate: the formation of a potential metal-binding site is related to the geometric organization of the protein backbone. We first report the set of convenient geometric descriptors of the backbone needed for the algorithm and their parameterization from a statistical analysis. Then, the successful benchmark of BioMetAll on a set of more than 90 metal-binding X-ray structures is presented. Because BioMetAll allows structural predictions regardless of the exact geometry of the side chains, it appears extremely valuable for systems whose structures (either experimental or theoretical) are not optimal for metal-binding sites. We report here its application on three different challenging cases: (i) the modulation of metal-binding sites during conformational transition in human serum albumin, (ii) the identification of possible routes of metal migration in hemocyanins, and (iii) the prediction of mutations to generate convenient metal-binding sites for de novo biocatalysts. This study shows that BioMetAll offers a versatile platform for numerous fields of research at the interface between inorganic chemistry and biology and allows to highlight the role of the preorganization of the protein backbone as a marker for metal binding. BioMetAll is an open-source application available at https://github.com/insilichem/biometall.
Assuntos
Metais , Proteínas , Algoritmos , Sítios de Ligação , Humanos , Domínios ProteicosRESUMO
Metal ions have been found to play an important role in the formation of extracellular ß-amyloid plaques, a major hallmark of Alzheimer's disease. In the present study, the conformational landscape of Aß42 with Al(iii) and Cu(ii) has been explored using Gaussian accelerated molecular dynamics. Both metals reduce the flexibility of the peptide and entail a higher structural organization, although to different degrees. As a general trend, Cu(ii) binding leads to an increased α-helix content and to the formation of two α-helices that tend to organize in a U-shape. By contrast, most Al(iii) complexes induce a decrease in helical content, leading to more extended structures that favor the appearance of transitory ß-strands.
Assuntos
Alumínio/química , Peptídeos beta-Amiloides/química , Complexos de Coordenação/química , Cobre/química , Simulação de Dinâmica Molecular , Fragmentos de Peptídeos/química , Humanos , Conformação Molecular , TermodinâmicaRESUMO
Although largely overlooked in peptide engineering, coordination chemistry offers a new set of interactions that opens unexplored design opportunities for developing complex molecular structures. In this context, we report new artificial peptide ligands that fold into chiral helicates in the presence of labile metal ions such as FeII and CoII . Heterochiral ß-turn-promoting sequences encode the stereoselective folding of the peptide ligands and define the physicochemical properties of their corresponding metal complexes. Circular dichroism and NMR spectroscopy in combination with computational methods allowed us to identify and determine the structure of two isochiral ΛΛ-helicates, folded as topological isomers. Finally, in addition to the in-vitro characterization of their selective binding to DNA three-way junctions, cell-microscopy experiments demonstrated that a rhodamine-labeled FeII helicate was internalized and selectively stains DNA replication factories in functional cells.
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DNA/química , Peptídeos/química , Replicação do DNA , Células HeLa , Humanos , Peptídeos/síntese química , Conformação Proteica , EstereoisomerismoRESUMO
A comprehensive review of optical biosensors for the detection of biomarkers associated with rheumatoid arthritis (RA) is presented here, including microRNAs (miRNAs), C-reactive protein (CRP), rheumatoid factor (RF), anti-citrullinated protein antibodies (ACPA), interleukin-6 (IL-6) and histidine, which are biomarkers that enable RA detection and/or monitoring. An overview of the different optical biosensors (based on fluorescence, plasmon resonances, interferometry, surface-enhanced Raman spectroscopy (SERS) among other optical techniques) used to detect these biomarkers is given, describing their performance and main characteristics (limit of detection (LOD) and dynamic range), as well as the connection between the respective biomarker and rheumatoid arthritis. It has been observed that the relationship between the corresponding biomarker and rheumatoid arthritis tends to be obviated most of the time when explaining the mechanism of the optical biosensor, which forces the researcher to look for further information about the biomarker. This review work attempts to establish a clear association between optical sensors and rheumatoid arthritis biomarkers as well as to be an easy-to-use tool for the researchers working in this field.
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Artrite Reumatoide , Biomarcadores/análise , Técnicas Biossensoriais , Anticorpos Antiproteína Citrulinada/análise , Artrite Reumatoide/diagnóstico , Histidina/análise , Humanos , Interleucina-6/análise , Fator Reumatoide/análiseRESUMO
Several commercial immobilized metal affinity chromatography sorbents were evaluated in this study for the analysis of two small peptide fragments of the amyloid ß-protein (Aß) (Aß(1-15) and Aß(10-20) peptides) by on-line immobilized metal affinity SPE-CE (IMA-SPE-CE). The performance of a nickel metal ion (Ni(II)) sorbent based on nitrilotriacetic acid as a chelating agent was significantly better than two copper metal ion (Cu(II)) sorbents based on iminodiacetic acid. A BGE of 25 mM phosphate (pH 7.4) and an eluent of 50 mM imidazole (in BGE) yielded a 25-fold and 5-fold decrease in the LODs by IMA-SPE-CE-UV for Aß(1-15) and Aß(10-20) peptides (0.1 and 0.5 µg/mL, respectively) with regard to CE-UV (2.5 µg/mL for both peptides). The phosphate BGE was also used in IMA-SPE-CE-MS, but the eluent needed to be substituted by a 0.5% HAc v/v solution. Under optimum preconcentration and detection conditions, reproducibility of peak areas and migration times was acceptable (23.2 and 12.0%RSD, respectively). The method was more sensitive for Aß(10-20) peptide, which could be detected until 0.25 µg/mL. Linearity for Aß(10-20) peptide was good in a narrow concentration range (0.25-2.5 µg/mL, R(2) = 0.93). Lastly, the potential of the optimized Ni(II)-IMA-SPE-CE-MS method for the analysis of amyloid peptides in biological fluids was evaluated by analyzing spiked plasma and serum samples.
Assuntos
Peptídeos beta-Amiloides/sangue , Eletroforese Capilar/métodos , Espectrometria de Massas/métodos , Extração em Fase Sólida/métodos , Peptídeos beta-Amiloides/química , Quelantes , Cromatografia de Afinidade , Humanos , Níquel/químicaRESUMO
BACKGROUND: Sedentary behavior is associated with type II diabetes, though little is known about prevalence of this behavior across racial/ethnic groups or how it may contribute to disparities in diabetes prevalence. In this study, we examined the association between sedentary behavior and diabetes in a diverse data set, and explored whether differences in sedentary behavior across racial/ethnic groups could contribute to disparities in diabetes. METHODS: Participants were 27 141 adults from the 2010 US National Health Interview Survey. Logistic regression was used to assess associations between self-reported, non-occupational sitting time, race/ethnicity and physician diagnosis of type II diabetes. RESULTS: In fully adjusted models, each hour of daily sitting was associated with 4% increased odds of diabetes (P < 0.01). Odds of diabetes were nearly double in Latinos (odds ratio [OR] = 1.83, confidence interval [CI] = 1.59-2.13) and Blacks (OR = 1.83, CI = 1.59-2.11) after adjusting for demographics and lifestyle factors. However, Blacks reported only slightly more sitting than Whites, and Latinos reported significantly less. Further adjustment for sitting hours in multivariate models did not attenuate disparities and slightly increased odds for Latinos (OR = 2.03, CI = 1.74-2.36). CONCLUSIONS: Sitting appears to be an independent risk factor for diabetes across racial/ethnic groups, though it does not appear to account for disparities in diabetes.
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Negro ou Afro-Americano , Diabetes Mellitus Tipo 2/epidemiologia , Hispânico ou Latino , Comportamento Sedentário/etnologia , População Branca , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , PrevalênciaRESUMO
ALCAM/CD166 is a member of the immunoglobulin superfamily of cell adhesion molecules (Ig-CAMs) which mediates intercellular adhesion through either homophilic (ALCAM-ALCAM) or heterophilic (ALCAM-CD6) interactions. ALCAM-mediated adhesion is crucial in different physiological and pathological phenomena, with particular relevance in leukocyte extravasation, stabilization of the immunological synapse, T cell activation and proliferation and tumor growth and metastasis. Although the functional implications of ALCAM in these processes is well established, the mechanisms regulating its adhesive capacity remain obscure. Using confocal microscopy colocalization, and biochemical and functional analyses, we found that ALCAM directly associates with the tetraspanin CD9 on the leukocyte surface in protein complexes that also include the metalloproteinase ADAM17/TACE. The functional relevance of these interactions is evidenced by the CD9-induced upregulation of both homophilic and heterophilic ALCAM interactions, as reflected by increased ALCAM-mediated cell adhesion and T cell migration, activation and proliferation. The enhancement of ALCAM function induced by CD9 is mediated by a dual mechanism involving (1) augmented clustering of ALCAM molecules, and (2) upregulation of ALCAM surface expression due to inhibition of ADAM17 sheddase activity.
Assuntos
Molécula de Adesão de Leucócito Ativado/metabolismo , Tetraspanina 29/metabolismo , Proteínas ADAM/metabolismo , Proteína ADAM17 , Animais , Células CHO , Adesão Celular , Linhagem Celular , Movimento Celular , Cricetinae , Humanos , Células Jurkat , Células K562 , Leucócitos/metabolismo , Ligação Proteica , Mapas de Interação de Proteínas , Interferência de RNA , RNA Interferente Pequeno/metabolismo , Linfócitos T/citologia , Linfócitos T/imunologia , Linfócitos T/metabolismo , Tetraspanina 29/antagonistas & inibidores , Tetraspanina 29/genética , Regulação para CimaRESUMO
Among the important questions in supramolecular peptide self-assemblies are their interactions with metallic compounds and ions. In the last decade, intensive efforts have been devoted to understanding the structural properties of these interactions including their dynamical and catalytic impact in natural and de novo systems. Since structural insights from experimental approaches could be particularly challenging, computational chemistry methods are interesting complementary tools. Here, we present the general multiscale strategies we developed and applied for the study of metallopeptide assemblies. These strategies include prediction of metal binding site, docking of metallic moieties, classical and accelerated molecular dynamics and finally QM/MM calculations. The systems of choice for this chapter are, on one side, peptides involved in neurodegenerative diseases and, on the other, de novo fibrillar systems with catalytic properties. Both successes and remaining challenges are highlighted so that the protocol could be apply to other system of this kind.
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Metaloproteínas , Simulação de Dinâmica Molecular , Peptídeos , Peptídeos/química , Metaloproteínas/química , Sítios de Ligação , Humanos , Simulação de Acoplamento Molecular/métodos , Metais/química , Teoria QuânticaRESUMO
Monocytes are versatile cells that can express different functional programs in response to microenvironmental signals. We show that primary blood monocytes secrete the CXCL12 chemokine, and express the CXCR4 and CXCR7 receptors, leading to an autocrine/paracrine loop that contribute to shape monocyte differentiation to a distinct type of macrophages, with an enhanced expression of CD4, CD14, and CD163, or dendritic cells, with a reduced functional ability to stimulate antigen-specific T-lymphocyte responses. The in vivo relevance of CXCL12 production by mononuclear phagocytes was studied in metastatic melanoma tissues by a thoroughly immunofluorescence phenotyping of CXCL12(high) expressing cells, which were CD45(+), coexpressed the macrophage antigens CD68, CD163, and CD209 and constituted the 60%-90% of tumor-associated macrophages. Microarray analysis of primary monocytes revealed that the vascular endothelial growth factor and the angiogenic chemokine CCL1 mRNA levels were up-regulated in response to CXCL12, leading to enhanced expression of both proteins. In addition, we found that CXCL12 autocrine/paracrine signaling down-regulates the expression of the transcription factor RUNX3 and contributes to maintain the long-term CD4 and CD14 expression in monocytes/macrophages. Together, these results suggest that autocrine CXCL12 production modulates differentiation of monocytes toward a distinct program with proangiogenic and immunosuppressive functions.
Assuntos
Diferenciação Celular/efeitos dos fármacos , Quimiocina CXCL12/farmacologia , Subunidade alfa 3 de Fator de Ligação ao Core/metabolismo , Macrófagos/citologia , Monócitos/citologia , Biomarcadores/metabolismo , Western Blotting , Subunidade alfa 3 de Fator de Ligação ao Core/genética , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Imunofluorescência , Perfilação da Expressão Gênica , Humanos , Técnicas Imunoenzimáticas , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Monócitos/efeitos dos fármacos , Monócitos/metabolismo , Análise de Sequência com Séries de Oligonucleotídeos , Fagócitos/imunologia , Fagócitos/metabolismo , RNA Mensageiro/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Linfócitos T/imunologia , Linfócitos T/metabolismoRESUMO
One of Alzheimer's disease major hallmarks is the aggregation of ß-amyloid peptide, a process in which metal ions play an important role. In the present work, an integrative computational study has been performed to identify the metal-binding regions and determine the conformational impact of Cu(II) and Al(III) ion binding to the ß-amyloid (Aß42) fibrillary structure. Through classical and Gaussian accelerated molecular dynamics, it has been observed that the metal-free fiber shows a hinge fan-like motion of the S-shaped structure, maintaining the general conformation. Upon metal coordination, distinctive patterns are observed depending on the metal. Cu(II) binds to the flexible N-terminal region and induces structural changes that could ultimately disrupt the fibrillary structure. In contrast, Al(III) binding takes place with the residues Glu22 and Asp23, and its binding reinforces the core stability of the system. These results give clues on the molecular impact of the interaction of metal ions with the aggregates and sustain their non-innocent roles in the evolution of the illness.
RESUMO
Enzymes typically fold into defined 3D protein structures exhibiting a high catalytic efficiency and selectivity. It has been proposed that the earliest enzymes may have arisen from the self-assembly of short peptides into supramolecular amyloid-like structures. Several artificial amyloids have been shown to display catalytic activity while offering advantages over natural enzymes in terms of modularity, flexibility, stability, and reusability. Hydrolases, especially esterases, are the most common artificial amyloid-like nanozymes with some reported to act as carbonic anhydrases (CA). Their hydrolytic activity is often dependent on the binding of metallic cofactors through a coordination triad composed of His residues in the ß-strands, which mimic the arrangement found in natural metalloenzymes. Tyr residues contribute to the coordination of metal ions in the active center of metalloproteins; however, their use has been mostly neglected in the design of metal-containing amyloid-based nanozymes. We recently reported that four different polar prion-inspired heptapeptides spontaneously self-assembled into amyloid fibrils. Their sequences lack His but contain three alternate Tyr residues exposed to solvent. We combine experiments and simulations to demonstrate that the amyloid fibrils formed by these peptides can efficiently coordinate and retain different divalent metal cations, functioning as both metal scavengers and nanozymes. The metallized fibrils exhibit esterase and CA activities without the need for a histidine triad. These findings highlight the functional versatility of prion-inspired peptide assemblies and provide a new sequential context for the creation of artificial metalloenzymes. Furthermore, our data support amyloid-like structures acting as ancestral catalysts at the origin of life.
Assuntos
Metaloproteínas , Príons , Amiloide , Peptídeos , Proteínas AmiloidogênicasRESUMO
BACKGROUND: Little is known about the incidence of influenza among admissions to the cardiac intensive care unit (C-ICU), accuracy of clinical suspicion, and influenza vaccination uptake. We evaluated the incidence of influenza at C-ICU admission during the influenza season, potential underdiagnosis, and vaccination uptake. METHODS: Prospective study at five C-ICUs during the 2017-2020 influenza seasons. A nasopharyngeal swab was collected at admission from patients who consented (n = 788). Testing was with Xpert®XpressFlu/RSV. RESULTS: Influenza was detected in 43 patients (5.5%) (40 FluA; 3 FluB) and clinically suspected in 27 (62.8%). Compared to patients without influenza, patients with influenza more frequently had heart failure (37.2% vs 22.8%, P = 0.031), previous contact with relatives with influenza-like illnesses (23.3% vs 12.5%, P = 0.042), antimicrobial use (67.4% vs 23.2%, P <0.01), and need for mechanical ventilation (25.6% vs 14.5%, P = 0.048). Patients received oseltamivir promptly. We found no differences in mortality (11.6% vs 5.2%, P = 0.076). Patients with influenza more frequently had myocarditis (9.3% vs 0.9%, P <0.01) and pericarditis (7.0% vs 0.8%, P = 0.01). Overall, 43.0% of patients (339/788) were vaccinated (51.9% of those with a clear indication [303/584]). CONCLUSION: Influenza seems to be a frequently underdiagnosed underlying condition in admissions to the C-ICU. Influenza should be screened for at C-ICU admission during influenza epidemics.
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Influenza Humana , Humanos , Influenza Humana/diagnóstico , Influenza Humana/tratamento farmacológico , Influenza Humana/epidemiologia , Estudos Prospectivos , Estações do Ano , Espanha/epidemiologia , Unidades de Terapia IntensivaAssuntos
Veias Cerebrais , Cefaleia/complicações , Hipotensão Intracraniana/complicações , Transtornos de Sensação/complicações , Trombose Venosa/complicações , Adulto , Encéfalo/diagnóstico por imagem , Veias Cerebrais/diagnóstico por imagem , Veias Cerebrais/fisiopatologia , Diagnóstico Diferencial , Feminino , Lateralidade Funcional , Cefaleia/diagnóstico , Cefaleia/tratamento farmacológico , Cefaleia/fisiopatologia , Humanos , Hipotensão Intracraniana/diagnóstico , Hipotensão Intracraniana/tratamento farmacológico , Hipotensão Intracraniana/fisiopatologia , Transtornos de Sensação/diagnóstico , Transtornos de Sensação/tratamento farmacológico , Transtornos de Sensação/fisiopatologia , Cefaleia do Tipo Tensional/complicações , Trombose Venosa/diagnóstico , Trombose Venosa/tratamento farmacológico , Trombose Venosa/fisiopatologiaRESUMO
PURPOSE: The purpose of the study was to examine the relationships between external and internal loads, and their ratio (efficiency index), with game performance between backcourt and frontcourt professional basketball players. METHODS: Game loads of 14 basketball players were monitored during 6 games. External load variables measured were total distance (TD); distance >18 km·h-1, commonly known as high-speed running (HSR); and number of accelerations (ACC) and decelerations (DEC) >3 m·s-2, whereas the internal load variable measured was average heart rate (HRmean). The ratio between external and internal load variables was calculated and defined through 4 efficiency indexes (TD:HRmean, HSR:HRmean, ACC:HRmean, and DEC:HRmean). Furthermore, basketball performance was quantified using game-related statistics. RESULTS: TD presented a small association with basketball performance, whereas the other external load variables and the 4 efficiency indexes calculated showed trivial relationships with game-related statistics. Furthermore, HRmean showed the greatest (small) associations with individual performance (P = .01-.02; r = .19 to .22). Regarding specific positions, the only 2 variables that presented significant differences were DEC (P = .01; d = 0.86) and DEC:HRmean (P = .01; d = 0.81), which showed higher values in backcourt players compared with frontcourt players. CONCLUSIONS: The results suggest that the best performances of basketball players during official competition are not associated with higher game loads. This illustrates the necessity to assess basketball performance from a holistic approach and consider more than just external and internal variables to better understand the players' performance during basketball competition.
Assuntos
Desempenho Atlético , Basquetebol , Corrida , Aceleração , Desempenho Atlético/fisiologia , Basquetebol/fisiologia , Humanos , Corrida/fisiologiaRESUMO
RAS oncoproteins are molecular switches associated with critical signaling pathways that regulate cell proliferation and differentiation. Mutations in the RAS family, mainly in the KRAS isoform, are responsible for some of the deadliest cancers, which has made this protein a major target in biomedical research. Here we demonstrate that a designed bis-histidine peptide derived from the αH helix of the cofactor SOS1 binds to KRAS with high affinity upon coordination to Pd(II). NMR spectroscopy and MD studies demonstrate that Pd(II) has a nucleating effect that facilitates the access to the bioactive α-helical conformation. The binding can be suppressed by an external metal chelator and recovered again by the addition of more Pd(II), making this system the first switchable KRAS binder, and demonstrates that folding-upon-binding mechanisms can operate in metal-nucleated peptides. In vitro experiments show that the metallopeptide can efficiently internalize into living cells and inhibit the MAPK kinase cascade.
RESUMO
Tumour cell dissemination through corporal fluids (blood, lymph and body cavity fluids) is a distinctive feature of the metastatic process. Tumour cell transition from fluid to adhesive conditions involves an early polarization event and major rearrangements of the submembrane cytoskeleton that remain poorly understood. As regulation of cortical actin-membrane binding might be important in this process, we investigated the role of ezrin and moesin, which are key crosslinking proteins of the ERM (ezrin, radixin, moesin) family. We used short interfering RNA (siRNA) to show that moesin is crucial for invasion by melanoma cells in 3D matrices and in early lung colonization. Using live imaging, we show that following initial adhesion to the endothelium or 3D matrices, moesin is redistributed away from the region of adhesion, thereby generating a polarized cortex: a stable cortical actin dome enriched in moesin and an invasive membrane domain full of blebs. Using Lifeact-GFP, a 17-amino-acid peptide that binds F-actin, we show the initial symmetry breaking of cortical actin cytoskeleton during early attachment of round cells. We also demonstrated that ezrin and moesin are differentially distributed during initial invasion of 3D matrices, and, specifically, that moesin controls adhesion-dependent activation of Rho and subsequent myosin II contractility. Our results reveal that polarized moesin plays a role in orienting Rho activation, myosin II contractility, and cortical actin stability, which is crucial for driving directional vertical migration instead of superficial spreading on the fluid-to-solid tissue interface. We propose that this mechanism of cortical polarization could sustain extravasation of fluid-borne tumour cells during the process of metastasis.
Assuntos
Polaridade Celular , Melanoma/fisiopatologia , Proteínas dos Microfilamentos/metabolismo , Invasividade Neoplásica , Actinas/genética , Actinas/metabolismo , Animais , Linhagem Celular Tumoral , Movimento Celular , Proteínas do Citoesqueleto/genética , Proteínas do Citoesqueleto/metabolismo , Citoesqueleto/genética , Citoesqueleto/metabolismo , Humanos , Pulmão/metabolismo , Pulmão/patologia , Melanoma/genética , Melanoma/metabolismo , Melanoma/patologia , Camundongos , Proteínas dos Microfilamentos/genéticaRESUMO
INTRODUCTION: Macrovascular invasion (MVI) in patients with hepatocellular carcinoma (HCC) is a very poor prognostic factor. Treatment in such cases is still a matter of debate. The goal of this study is to assess short- and long-term results of liver resection and thrombectomy in a series of patients with HCC and MVI. METHODS: Retrospective cohort study of patients who underwent liver resection for HCC in the period 2007-2015 (n=120). Of all the patients, 108 did not have MVI, while 12 presented with MVI: 1patient in the common portal vein (Vp4), 8patients in first-order portal branches (Vp3), 1patient in a sectorial branch (Vp2), 1patient in a segmental branch (Vp1); another patient presented with tumor thrombus in a main hepatic venous branch in the confluence with the vena cava (Vv2). RESULTS: Patients with MVI needed major hepatic resection more frequently than patients without MVI (83.3% vs 25.9%, P<.0001), with no differences in postoperative mortality or severe morbidity. Patients with MVI required a longer operative time and developed more frequently postoperative ascites (33.3% vs 9.3%, P=.034). Global survival at 1, 3 and 5years was 66.7%, 33.3% and 22.2% in patients with IMV, and 90.7%, 72.4% and 52.2% in patients without IMV (P=.009), respectively. CONCLUSIONS: Hepatectomy associated with thrombectomy might be justified in a selected group of patients with HCC and MVI, offering a potential benefit in survival with acceptable morbidity.
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Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/cirurgia , Hepatectomia , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Trombectomia , Idoso , Ascite/etiologia , Feminino , Seguimentos , Hepatectomia/efeitos adversos , Hepatectomia/métodos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Complicações Pós-Operatórias , Estudos Retrospectivos , Trombectomia/efeitos adversos , Trombectomia/métodosRESUMO
BACKGROUND: Non-invasive biomarkers of cognitive impairment are needed. We aim to evaluate transcranial sonographic markers as predictors of cognitive impairment in a prospective cohort. OBJECTIVE: To study the changes in the third ventricle diameter and the SN echogenicity between the baseline and the control visit, as well as its association with cognitive performance and the diagnosis of cognitive impairment in a prospective cohort. METHODS: From the longitudinal population-based Asymptomatic Intracranial Atherosclerosis Study, we selected those subjects that received a complete transcranial sonography (TCS) and extensive cognitive testing, both at baseline and follow-up. We evaluated third ventricle (IIIv) width, echogenicity of substantia nigra (SN), and temporal changes of these parameters. RESULTS: We included 289 participants with a median follow-up time of 7.16 years. Those subjects who developed cognitive decline (nâ=â23, 7.96%) had a larger IIIv at baseline than those who did not (0.54±0.14âcm versus 0.41±0.15âcm; pâ=â0.001). A cut-off point of 0.465âcm for the IIIv width was identified as an independent predictor of long-term cognitive impairment after adjustment for age, gender, educational level, and vascular risk score. Change in IIIv diameter after follow-up was not associated with diagnosis of cognitive impairment. The area of SN and the presence of hyperechogenicity of the SN remained stable over time and was not associated with the diagnosis of cognitive impairment. CONCLUSION: IIIv width assessed by TCS emerged as an independent predictor of long-term cognitive impairment.