ABSTRACT
Objective:Pretibial myxedema (PTM) is a localized myxedema characterized by excessive dermal hya-luronan (HA) deposition and elevated serum TSH receptor antibody (TRAb). In this study, we investigated the effects of TRAb and its subtypes, stimulating antibody [TSAb (M22)] and inhibitory antibody[TBAb (K1-70)], on the synthesis of hyaluronic acid produced by PTM primary dermal fibroblasts.Methods:Normal and PTM dermal fibroblasts were isolated and stimulated with M22, K1-70, and IgG from patients respectively. HA concentration in the supernatant before and after stimulation was tested by ELISA. The protein level and phosphorylation variation of CEMIP, HAS2 and PI3K-AKT pathway were detected by Western blot.Results:IgG from patients (TRAb 8.4 IU/L) significantly stimulated the extracellular accumulation of HA in PTM primary fibroblasts. Similarly, both M22 and K1-70 also upregulated HA level in the supernatant, though K1-70 seemed much more effecitve. After treatment with IgG, M22, and K1-70, the expression of HAS2 increased and the expression of CEMIP decreased; meanwhile, p-PI3K and p-AkT increased. Among them, further study on K1-70, promoting HA production by regulating PI3K-AkT signal pathway could be inhibited by PI3K inhibitor (LY294002).Conclusion:TSAb (M22) and TBAb (K1-70), especially TBAb, increase HAS2 and inhibit CEMIP expression by activating PI3-AKT signaling pathway in PTM fibroblasts, leading to increased extracellular HA level.
ABSTRACT
To explore therapeutic effect of cortex‐pharynx‐tongue root acupuncture (CPTA ) combined buccal muscle electrical stimulation (BMES) on patients with dysphagia after stroke .Methods :According to pro‐spective randomized controlled method ,a total of 92 patients with dysphagia after stroke were randomly and equally divided into routine rehabilitation group and electrical stimulation acupuncture group (ESP group ,received BMES combined sequential CPTA based on routine rehabilitation group ) ,both groups were continuously treated for four weeks .Classes of functional oral intake scale (FOIS) and water swallowing test (WST) before and after treatment , and total effective rate were observed and compared between two groups .Results :Compared with before treatment , there was significant rise in FOIS class ,and significant reduction in WST class in two groups after treatment , P＝0.001 all ; compared with routine rehabilitation group after treatment , there was significant rise in FOIS class [ (4. 41 ± 0.47) classes vs.(5.45 ± 0. 21) classes] and significant reduction in WST class [ (2.76 ± 0.27) classes vs . (2.02 ± 0. 23) classes] in ESP group , P＝0.001 both .Total effective rate of ESP group was higher than that of rou‐tine rehabilitation group (95.65% vs.84.78%) , but without significant difference , P＝0.160. Conclusion :Cortex‐pharynx‐tongue root acupuncture combined buccal muscle electrical stimulation possesses significant therapeutic effect for ingestion and drinking water in patients with dysphagia after stroke ,which is worth extending .