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Transgenerational epigenetic inheritance in mammals remains a debated subject. Here, we demonstrate that DNA methylation of promoter-associated CpG islands (CGIs) can be transmitted from parents to their offspring in mice. We generated DNA methylation-edited mouse embryonic stem cells (ESCs), in which CGIs of two metabolism-related genes, the Ankyrin repeat domain 26 and the low-density lipoprotein receptor, were specifically methylated and silenced. DNA methylation-edited mice generated by microinjection of the methylated ESCs exhibited abnormal metabolic phenotypes. Acquired methylation of the targeted CGI and the phenotypic traits were maintained and transmitted across multiple generations. The heritable CGI methylation was subjected to reprogramming in parental PGCs and subsequently reestablished in the next generation at post-implantation stages. These observations provide a concrete step toward demonstrating transgenerational epigenetic inheritance in mammals, which may have implications in our understanding of evolutionary biology as well as the etiology, diagnosis, and prevention of non-genetically inherited human diseases.
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Metilação de DNA , Epigênese Genética , Camundongos , Humanos , Animais , Ilhas de CpG , Padrões de Herança , Mamíferos/genéticaRESUMO
A single mouse blastomere from an embryo until the 8-cell stage can generate an entire blastocyst. Whether laboratory-cultured cells retain a similar generative capacity remains unknown. Starting from a single stem cell type, extended pluripotent stem (EPS) cells, we established a 3D differentiation system that enabled the generation of blastocyst-like structures (EPS-blastoids) through lineage segregation and self-organization. EPS-blastoids resembled blastocysts in morphology and cell-lineage allocation and recapitulated key morphogenetic events during preimplantation and early postimplantation development in vitro. Upon transfer, some EPS-blastoids underwent implantation, induced decidualization, and generated live, albeit disorganized, tissues in utero. Single-cell and bulk RNA-sequencing analysis revealed that EPS-blastoids contained all three blastocyst cell lineages and shared transcriptional similarity with natural blastocysts. We also provide proof of concept that EPS-blastoids can be generated from adult cells via cellular reprogramming. EPS-blastoids provide a unique platform for studying early embryogenesis and pave the way to creating viable synthetic embryos by using cultured cells.
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Blastocisto/citologia , Linhagem da Célula , Implantação do Embrião , Células-Tronco Pluripotentes Induzidas/citologia , Células-Tronco Embrionárias Murinas/citologia , Criação de Embriões para Pesquisa/métodos , Animais , Blastocisto/metabolismo , Diferenciação Celular , Linhagem Celular , Células Cultivadas , Técnicas de Reprogramação Celular/métodos , Feminino , Humanos , Células-Tronco Pluripotentes Induzidas/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos ICR , Células-Tronco Embrionárias Murinas/metabolismo , TranscriptomaRESUMO
We have demonstrated simultaneous detection of the polarization states and wavefront of light using a 7 × 7 array of angular variant micro-retarder-lenses. Manipulating the angular variant polarization with our optical element allows us to determine the two-dimensional distribution of polarization states. We have also proposed a calibration method for polarization measurements using our micro-retarder-lens array, allowing accurate detection of polarization states with an ellipticity of ± 0.01 and an azimuth of ± 1.0°. We made wavefront measurements using the micro-retarder-lens array, achieving a resolution of 25â nm. We conducted simultaneous detection of the polarization states and wavefront on four types of structured beam as samples. The results show that the two-dimensional distributions of the polarization states and wavefront for the four types of structured light are radially and azimuthally polarized beams, as well as left- and right-hand optical vortices. Our sensing technology has the potential to enhance our understanding of the nature of light in the fields of laser sciences, astrophysics, and even ophthalmology.
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Large cutaneous ulcers are, in severe cases, life threatening1,2. As the global population ages, non-healing ulcers are becoming increasingly common1,2. Treatment currently requires the transplantation of pre-existing epithelial components, such as skin grafts, or therapy using cultured cells2. Here we develop alternative supplies of epidermal coverage for the treatment of these kinds of wounds. We generated expandable epithelial tissues using in vivo reprogramming of wound-resident mesenchymal cells. Transduction of four transcription factors that specify the skin-cell lineage enabled efficient and rapid de novo epithelialization from the surface of cutaneous ulcers in mice. Our findings may provide a new therapeutic avenue for treating skin wounds and could be extended to other disease situations in which tissue homeostasis and repair are impaired.
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Reprogramação Celular , Células Epiteliais/citologia , Úlcera Cutânea/patologia , Pele/citologia , Ferimentos e Lesões/patologia , Animais , Linhagem da Célula , Células Epiteliais/metabolismo , Células Epiteliais/patologia , Feminino , Fibroblastos/citologia , Fibroblastos/metabolismo , Perfilação da Expressão Gênica , Humanos , Queratinócitos/citologia , Queratinócitos/metabolismo , Masculino , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/patologia , Camundongos , Medicina Regenerativa , Pele/patologia , Úlcera Cutânea/terapia , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Cicatrização , Ferimentos e Lesões/terapiaRESUMO
Polypharmacy exacerbates lower urinary tract symptoms (LUTS). Japan exhibits a higher prevalence of concomitant medication use in drug therapy than other countries. Previous age- and sex-specific reports exist; however, none include patients of all ages. Therefore, this retrospective study determined the impact of polypharmacy and its associated risk factors on LUTS exacerbation in outpatients with urological conditions. We included patients receiving medication who visited the Department of Urology at the Gifu Municipal Hospital (Gifu, Japan) between January, 2018 and December, 2018. The association between LUTS and polypharmacy and the risk factors for LUTS exacerbation were investigated. Patients were categorized into two groups according to their polypharmacy status. We performed propensity score matching and compared the International Prostate Symptom Score (IPSS) between the groups using the unpaired t-test. Multiple logistic regression analysis was performed to examine the risk factors, including "polypharmacy" and "taking multiple anticholinergic medications" for LUTS exacerbation. When comparing the IPSS between the groups, the polypharmacy group was found to have significantly higher scores than the non-polypharmacy group in six items, including "total score" and "storage score." Multiple logistic regression analysis results showed high significance in three items, including "polypharmacy" (odds ratio (OR) = 1.67, 95% confidence interval (CI): 1.03-2.71) and "taking multiple anticholinergic medications" (OR = 8.68, 95% CI: 1.05-71.7). In conclusion, this study revealed that "polypharmacy" and "taking multiple anticholinergic medications" were risk factors for LUTS. Particularly, "polypharmacy" is associated with storage symptom exacerbation. Therefore, eliminating "polypharmacy" and "taking multiple anticholinergic medications" is expected to improve LUTS.
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Sintomas do Trato Urinário Inferior , Polimedicação , Masculino , Feminino , Humanos , Estudos Retrospectivos , Japão/epidemiologia , Hospitais Municipais , Fatores de Risco , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/diagnóstico , Antagonistas Colinérgicos/efeitos adversosRESUMO
We demonstrate a calibration method for endoscopic three-dimensional shape measurement with cone beam projection. In this method, changes in the shape of the optical sectioning profiles are quantified and fitted while scanning a calibration board in the depth direction, using a cubic function. In accuracy tests using a flat plate and a ring reference gauge, the proposed method obtains an accuracy of 0.02 mm in the depth dimension and 0.09 mm in the radial dimension. These results represent 88% and 55% improvements compared to previous analysis. For medical applications, an ear examination simulator was employed, and our measurement results were compared to ground truth data obtained by microfocus X-ray computed tomography. The surface deviation of our method relative to the ground truth data was ±0.36m m during manual operation. A comparison of the measurement results before and after calibration revealed an improvement in the peak agreement with the ground truth data, with the deviation shifting from 0.2 mm to -0.05m m. Our strategy achieves a digital transformation of 3D endoscopy, which would benefit a number of medical fields.
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Elevated lactate levels are associated with a poor prognosis in patients with sepsis and shock. Intravenous glycerol administration is often used in Japan to treat patients with acute stroke or brain trauma, but such treatment can cause elevated lactate levels. We experienced a case of transient hyperlactatemia induced by intravenous glycerol administration in a patient with brain trauma. A 74-year-old woman underwent decompressive craniotomy because of loss of consciousness and brain edema. Glycerol was administered after the operation for management of the brain edema. Although the patient's hemodynamics remained stable, her lactate level decreased and increased repeatedly. We recognized that the elevation in her lactate level was associated with the administration of intravenous glycerol. This case suggests that intravenous glycerol administration can induce transient hyperlactatemia.
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Edema Encefálico , Lesões Encefálicas Traumáticas , Hiperlactatemia , Humanos , Feminino , Idoso , Hiperlactatemia/induzido quimicamente , Hiperlactatemia/complicações , Glicerol/efeitos adversos , Edema Encefálico/complicações , Lactatos , Estudos RetrospectivosRESUMO
BACKGROUND: Message framing is frequently used to advocate health perceptions and behaviors. The effects of message framing on various health behaviors have been examined; however, its effects on social participation, a key determinant of healthy aging, are unclear. This study investigated the effects of message framing on older adults' attitudes and intentions toward social participation. METHODS: A questionnaire survey conducted in 2020 targeted community-dwelling people aged ≥ 65 years in two rural areas in Japan. Participants were randomly allocated to four groups according to the types of framed messages to promote social participation activities: "private gain-framed message," "private loss-framed message," "public gain-framed message," or "no message." Outcomes included attitudes and intentions toward social participation (impression, interest, and readiness for social participation activities). RESULTS: A total of 1,524 participants were analyzed (men: 46.3%; average age: 75.7 ± 7.9 years). Ordinal logistic regression analyses of individuals who engaged in any social participation activity showed no significant intergroup difference in the outcomes after adjusting for potential covariates. Among people who did not engage in any activity, the private loss-framed message was associated with a more favorable impression and higher interest and readiness than no message. The private gain-framed message was related to a higher interest in social participation. CONCLUSIONS: Private loss-framed messages are possibly most effective in reinforcing attitudes and intentions toward social participation, particularly among individuals without social participation experience. These findings highlight the possibility of using a message-framing approach to promote social participation in older adults.
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Intenção , Participação Social , Masculino , Humanos , Idoso , Idoso de 80 Anos ou mais , Comportamentos Relacionados com a Saúde , Comportamento Social , AtitudeRESUMO
ObjectivesãMedical insurers have applied a reminder (i.e., recall) system to improve the implementation rate of specific health guidance. However, the effectiveness of the system has not been verified. This study aims to examine the effectiveness of two methods of specific health guidance reminders (i.e., letter and telephone) using a randomized controlled trial.MethodsãSubscribers of National Health Insurance in Yokohama City, Kanagawa Prefecture, who were eligible for specific health guidance in 2020, were recruited. A specific health examination questionnaire was used to identify participants intending to use health guidance. The intervention period was from September to November 2020, with 252 people being randomly assigned to one of the three groups: a "no-reminder group," "a letter-reminder group," or "a telephone-reminder group" (84 people each). Those in the letter-reminder group received a reminder by mail and those in the telephone-reminder group received a reminder by phone from a public health nurse two weeks after the specific health guidance coupon was sent to the participants by mail. The outcome showed the utilization rate of specific health guidance. Chi-square tests were performed to compare the three groups and conduct multiple comparisons (post-hoc test).ResultsãThe participants had a mean age of 61.4±11.0 years and 70.6% were male. There was no difference among the three groups in terms of demographic characteristics and the results of specific health examinations. The utilization rates of specific health guidance were 20.2% in the no-reminder group, 22.6% in the letter-reminder group, and 20.2% in the telephone-reminder group; thus, the three groups did not significantly differ (χ2=0.191, P=0.909). Multiple comparisons also showed no difference between any two groups. However, in the telephonereminder group, 56.0% of the participants themselves or their family members could be reached by a public health nurse, and their utilization rate was higher than those participants whom a public health nurse could not reach.ConclusionãNeither letter nor telephone reminders changed the participants' utilization rates of specific health guidance compared to those with no reminder. Although the effectiveness of a telephone reminder might be underestimated, this study suggests setting a lower priority in reminding those who intend to use health guidance.
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Sistemas de Alerta , Telefone , Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Feminino , Família , Inquéritos e QuestionáriosRESUMO
The rapid spread of the Delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) became a serious concern worldwide in summer 2021. We examined the copy number and variant types of all SARS-CoV-2-positive patients who visited our hospital from February to August 2021 using polymerase chain reaction (PCR) tests. Whole genome sequencing was performed for some samples. The R.1 variant (B.1.1.316) was responsible for most infections in March, replacing the previous variant (B.1.1.214); the Alpha (B.1.1.7) variant caused most infections in April and May; and the Delta variant (B.1.617.2) was the most prevalent in July and August. There was no significant difference in the copy numbers among the previous variant cases (n = 29, median 3.0 × 104 copies/µl), R.1 variant cases (n = 28, 2.1 × 105 copies/µl), Alpha variant cases (n = 125, 4.1 × 105 copies/µl), and Delta variant cases (n = 106, 2.4 × 105 copies/µl). Patients with Delta variant infection were significantly younger than those infected with R.1 and the previous variants, possibly because many elderly individuals in Tokyo were vaccinated between May and August. There was no significant difference in mortality among the four groups. Our results suggest that the increased infectivity of Delta variant may be caused by factors other than the higher viral loads. Clarifying these factors is important to control the spread of Delta variant infection.
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COVID-19/epidemiologia , COVID-19/virologia , SARS-CoV-2/fisiologia , Carga Viral , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Reação em Cadeia da Polimerase , RNA Viral/genética , SARS-CoV-2/classificação , SARS-CoV-2/genética , Tóquio/epidemiologia , Sequenciamento Completo do GenomaRESUMO
Patients infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 has increased worldwide since the beginning of 2022 and the variant has spread more rapidly than the Delta variant, which spread in the summer of 2021. It is important to clarify the cause of the strong transmissibility of the Omicron variant to control its spread. In 694 patients with coronavirus disease 2019, the copy numbers of virus in nasopharyngeal swab-soaked samples and the viral genotypes were examined using quantitative polymerase chain reaction (PCR) and PCR-based melting curve analysis, respectively. Whole-genome sequencing was also performed to verify the viral genotyping data. There was no significant difference (p = 0.052) in the copy numbers between the Delta variant cases (median 1.5 × 105 copies/µl, n = 174) and Omicron variant cases (median 1.2 × 105 copies/µl, n = 328). During this study, Omicron BA.1 cases (median 1.1 ×105 copies/µl, n = 275) began to be replaced by BA.2 cases (median 2.3 × 105 copies/µl, n = 53), and there was no significant difference between the two groups (p = 0.33). Our results suggest that increased infectivity of the Omicron variant and its derivative BA.2 is not caused by higher viral loads but by other factors, such as increased affinity to cell receptors or immune escape.
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COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/genética , Carga ViralRESUMO
A dicationic triruthenium complex containing a µ3 -η3 -C3 ring, [(Cp*Ru)3 (µ3 -η3 -C3 MeH2 -)(µ3 -CH)(µ-H)]2+ (1 a, Cp*=η5 -C5 Me5 ), reacted with ammonia to yield a µ-amido complex, [(Cp*Ru)3 (µ3 -η3 -CHCMeCH) (µ3 -CH)(µ-NH2 )]2+ (5), via N-H bond scission. Subsequent treatment with base resulted in C-N bond formation to yield a µ3 -η2 :η2 -1-azabutadien-4-yl complex, [(Cp*Ru)3 (µ3 -CH)(µ3 -η2 :η2 -NH=CH-CMe=CH-)]+ (6 a). The azaruthenacyclopentadiene skeleton was alternatively synthesized by the photolysis of mono-cationic complex [(Cp*Ru)3 (µ3 -η3 -C3 RH2 -)(µ3 -CH)]+ (2 a; R=Me, 2 b; R=H) in the presence of ammonia. The C3 ring skeleton was broken via the electron transfer to the π*(C-C) orbital in the C3 ring, and a transiently generated unsaturated µ3 -allylic species can take up ammonia, resulting in N-H bond scission followed by C-N bond formation.
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Cacalia delphiniifolia and Cacalia hastata are edible wild plants in Japan. We found that these plants have anti-melanogenic activity in B16F10 mouse melanoma cells. Three furanoeremophilanes, cacalol (from C. delphiniifolia), dehydrocacalohastin, and cacalohastin (from C. hastata), were identified as the main active components. The genus Cacalia may be a good source of beneficial materials with anti-melanogenic effects.
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Asteraceae , Melanoma Experimental , Sesquiterpenos de Eudesmano , Animais , Linhagem Celular Tumoral , Japão , Melaninas , Camundongos , Monofenol Mono-Oxigenase , Plantas ComestíveisRESUMO
In the original publication [...].
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Background and Objectives: Oral implant restorations are an excellent treatment option for edentulous patients; however, periodontopathogenic bacteria have been found in the microgaps between implant-abutment junctions. Implant designs to limit the microgaps have been extensively studied. However, studies have shown microgaps continue to exist, allowing for the leakage of bacteria into the implant system. Screw access hole materials are used to fill the access hole void. The use of materials with beneficial properties could provide bacterial leakage prevention. The aim of this study was to examine the surface free energy, cytotoxicity, and bacterial adhesion of selected screw access hole materials such as cotton, polytetrafluoroethylene (PTFE) tape, paraffin wax-polyolefin thermoplastic (PF), paraffin wax (Wax), gutta-percha (GP), and caviton EX (CE). Materials and Methods: A sessile drop test was performed to observe the contact angle and calculate the surface free energy of each material in order to determine the level of hydrophobicity. Cytotoxicity was examined in a mouse gingival epithelial cell line for day 1 and day 3. Bacterial adhesion was tested with Porphyromonas gingivalis, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans. Results: PTFE, PF, and wax presented low surface free energies of 19.34, 23.041, and 24.883 mN.m-1, respectively. No cytotoxicity was observed, except for GP and CE. Concurrently, the bacterial adhesion was also the lowest in PTFE and PF. Conclusions: Within the limits of this study, PTFE and PF showed an excellent biocompatibility with few bacterial adhesions. These materials could be potential screw access hole materials in clinical settings.
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Fusobacterium nucleatum , Porphyromonas gingivalis , Animais , Parafusos Ósseos , Humanos , Camundongos , PolitetrafluoretilenoRESUMO
Cytochrome P450 1A1 (CYP1A1) catalyzes the metabolic activation of polycyclic aromatic hydrocarbons (PAHs) such as benzo[a]pyrene (B[a]P) and is transcriptionally regulated by the aryl hydrocarbon receptor (AhR)/AhR nuclear translocator (ARNT) complex upon exposure to PAHs. Accordingly, inhibition of CYP1A1 expression reduces production of carcinogens from PAHs. Although transcription of the CYP1A1 gene is known to be repressed by transforming growth factor-ß (TGF-ß), how TGF-ß signaling is involved in the suppression of CYP1A1 gene expression has yet to be clarified. In this study, using mammalian cell lines, along with shRNA-mediated gene silencing, CRISPR/Cas9-based genome editing, and reporter gene and quantitative RT-PCR assays, we found that TGF-ß signaling dissociates the B[a]P-mediated AhR/ARNT heteromeric complex. Among the examined Smads, Smad family member 3 (Smad3) strongly interacted with both AhR and ARNT via its MH2 domain. Moreover, hypoxia-inducible factor 1α (HIF-1α), which is stabilized upon TGF-ß stimulation, also inhibited AhR/ARNT complex formation in the presence of B[a]P. Thus, TGF-ß signaling negatively regulated the transcription of the CYP1A1 gene in at least two different ways. Of note, TGF-ß abrogated DNA damage in B[a]P-exposed cells. We therefore conclude that TGF-ß may protect cells against carcinogenesis because it inhibits CYP1A1-mediated metabolic activation of PAHs as part of its anti-tumorigenic activities.
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Citocromo P-450 CYP1A1/genética , Receptores de Hidrocarboneto Arílico/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Células A549 , Animais , Translocador Nuclear Receptor Aril Hidrocarboneto/genética , Translocador Nuclear Receptor Aril Hidrocarboneto/metabolismo , Benzo(a)pireno/toxicidade , Células COS , Chlorocebus aethiops , Citocromo P-450 CYP1A1/metabolismo , Expressão Gênica/genética , Regulação da Expressão Gênica/genética , Células HEK293 , Humanos , Fator 1 Induzível por Hipóxia/metabolismo , Hidrocarbonetos Policíclicos Aromáticos/metabolismo , Pirenos , Transdução de Sinais , Proteína Smad3/metabolismo , Fator de Crescimento Transformador beta/fisiologiaRESUMO
The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, such as B.1.1.7 and B.1.351, has become a crucial issue worldwide. Therefore, we began testing all patients with COVID-19 for the N501Y and E484K mutations by using polymerase chain reaction (PCR)-based methods. Nasopharyngeal swab samples from 108 patients who visited our hospital between February and April 2021 were analyzed. The samples were analyzed using reverse transcription-PCR with melting curve analysis to detect the N501Y and E484K mutations. A part of the samples was also subjected to whole-genome sequencing (WGS). Clinical parameters such as mortality and admission to the intensive care unit were analyzed to examine the association between increased disease severity and the E484K mutation. The ratio of cases showing the 501N + 484K mutation rapidly increased from 8% in February to 46% in March. WGS revealed that the viruses with 501N + 484K mutation are R.1 lineage variants. Evidence of increased disease severity related to the R.1 variants was not found. We found that the R.1 lineage variants rapidly prevailed in Tokyo in March 2021, which suggests the increased transmissibility of R.1 variants, while they showed no increased severity.
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COVID-19/epidemiologia , COVID-19/virologia , SARS-CoV-2/genética , Idoso , Feminino , Humanos , Masculino , Mutação/genética , Glicoproteína da Espícula de Coronavírus/genética , Tóquio/epidemiologia , Sequenciamento Completo do Genoma/métodosRESUMO
Pluripotency, the ability to generate any cell type of the body, is an evanescent attribute of embryonic cells. Transitory pluripotent cells can be captured at different time points during embryogenesis and maintained as embryonic stem cells or epiblast stem cells in culture. Since ontogenesis is a dynamic process in both space and time, it seems counterintuitive that these two temporal states represent the full spectrum of organismal pluripotency. Here we show that by modulating culture parameters, a stem-cell type with unique spatial characteristics and distinct molecular and functional features, designated as region-selective pluripotent stem cells (rsPSCs), can be efficiently obtained from mouse embryos and primate pluripotent stem cells, including humans. The ease of culturing and editing the genome of human rsPSCs offers advantages for regenerative medicine applications. The unique ability of human rsPSCs to generate post-implantation interspecies chimaeric embryos may facilitate our understanding of early human development and evolution.
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Quimera , Células-Tronco Pluripotentes/citologia , Animais , Técnicas de Cultura de Células/métodos , Linhagem Celular , Células-Tronco Embrionárias/citologia , Feminino , Camadas Germinativas/citologia , Humanos , Células-Tronco Pluripotentes Induzidas/citologia , Masculino , Camundongos , Pan troglodytes , Células-Tronco Pluripotentes/metabolismo , Medicina Regenerativa , Especificidade da EspécieRESUMO
As the nanoparticle albumin-bound paclitaxel (nab-PTX) is free of ethanol and premedication, the duration of administration is shorter and patients can drive themselves to and from the hospital. In the 2018 Japanese gastric cancer treatment guidelines, ramucirumab (RAM) plus weekly nab-PTX is conditionally recommended for previously treated patients with advanced gastric cancer. Here, we retrospectively analysed the efficacy and safety of RAM+nab-PTX for such patients in community hospitals. From January 2018 to December 2019, 43 patients with metastatic and recurrent gastric cancer received RAM+nab-PTX treatment. Six patients (13.9%) were older than 80 years and 9 patients (20.9%) showed ECOG-PS 2. Progression-free survival (PFS), overall survival (OS), overall response rate (ORR), disease control rate (DCR), and adverse events (AEs) were reviewed retrospectively. Median PFS was 114 days (95% confidence interval [CI]: 84-190) and median OS was 297 days (95% CI: 180-398). ORR and DCR were 32.4% and 72.2%, respectively. The incidence rates of ≥grade 3 neutropenia and febrile neutropenia were 53.5% and 2.3%, respectively. No treatment-related deaths occurred. RAM plus nab-PTX combination therapy demonstrated manageable toxicity even patients who were elderly or had an ECOG-PS 2. This treatment is useful in community hospital settings.
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Adenocarcinoma/tratamento farmacológico , Paclitaxel Ligado a Albumina/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Hospitais Comunitários , Neoplasias Gástricas/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , RamucirumabRESUMO
endo-ß-1,2-Glucanase (SGL) is an enzyme that hydrolyzes ß-1,2-glucans, which play important physiological roles in some bacteria as a cyclic form. To date, no eukaryotic SGL has been identified. We purified an SGL from Talaromyces funiculosus (TfSGL), a soil fungus, to homogeneity and then cloned the complementary DNA encoding the enzyme. TfSGL shows no significant sequence similarity to any known glycoside hydrolase (GH) families, but shows significant similarity to certain eukaryotic proteins with unknown functions. The recombinant TfSGL (TfSGLr) specifically hydrolyzed linear and cyclic ß-1,2-glucans to sophorose (Glc-ß-1,2-Glc) as a main product. TfSGLr hydrolyzed reducing-end-modified ß-1,2-gluco-oligosaccharides to release a sophoroside with the modified moiety. These results indicate that TfSGL is an endo-type enzyme that preferably releases sophorose from the reducing end of substrates. Stereochemical analysis demonstrated that TfSGL is an inverting enzyme. The overall structure of TfSGLr includes an (α/α)6 toroid fold. The substrate-binding mode was revealed by the structure of a Michaelis complex of an inactive TfSGLr mutant with a ß-1,2-glucoheptasaccharide. Mutational analysis and action pattern analysis of ß-1,2-gluco-oligosaccharide derivatives revealed an unprecedented catalytic mechanism for substrate hydrolysis. Glu-262 (general acid) indirectly protonates the anomeric oxygen at subsite -1 via the 3-hydroxy group of the Glc moiety at subsite +2, and Asp-446 (general base) activates the nucleophilic water via another water. TfSGLr is apparently different from a GH144 SGL in the reaction and substrate recognition mechanism based on structural comparison. Overall, we propose that TfSGL and closely-related enzymes can be classified into a new family, GH162.