ABSTRACT
Una de las infecciones virales más comunes -sobretodo en personas de mayor edad- es el Herpes Zóster (HZ). Su característica clínica, hace sospechar al médico de forma temprana, para otorgar un tratamiento adecuado y oportuno. Dentro de las complicaciones más frecuentes se encuentran las sensitivas, como la neuralgia postherpética.1 Sin embargo, existen un grupo de complicaciones motoras de menor incidencia, como lo es la Pseudohernia abdominal. Ésta corresponde a una paresia segmentaria, que se manifiesta como una protrusión de la pared abdominal sin un defecto real, que aumenta con maniobras de valsalva.1 Generalmente se puede presentar en hombres, mayores de 60 años, inmunosuprimidos o con neoplasias hematológicas.1,2,3 El diagnóstico es clínico, aunque se puede confirmar con estudio imagenológico, que evidencie una musculatura de la pared abdominal adelgazada con respecto a la contralateral y que descarta un orificio herniario por un defecto estructural. 2 La electromiografía también puede jugar un rol al evidenciar anormalidades en la conducción nerviosa. 2 La pseudohernia por HZ tiene un buen pronóstico en la mayoría de los pacientes con recuperación completa: entre 2-18 meses. 3 Su principal riesgo es la pseudobstrucción intestinal, que se puede manifestar como constipación.2,4 En el siguiente reporte de caso, se analiza a la pseudohernia abdominal como complicación motora infrecuente del HZ y sus características.
One of the most common viral infections -especially in elderly- is Herpes Zoster (HZ). Its clinical characteristic makes the doctor suspect early, to grant adequate and timely treatment. Among the most frequent complications are the sensitive ones, such as postherpetic neuralgia1 . However, there is a group of motor complications of lower incidence, such as abdominal pseudohernia. This corresponds to a segmental paresis, which manifests as a protrusion of the abdominal wall without a real defect that increases with valsalva maneuvers1 . It can generally present in men, older than 60 years, immunosuppressed or with hematological neoplasms1,2,3, The diagnosis is clinical, although it can be confirmed with an imaging study, which shows a thinner abdominal wall musculature with regard to the contralateral wall, and which rules out a hernial orifice due to a structural defect2 . Electromyography can also play a role in show abnormalities in nerve conduction2 . HZ pseudohernia has a good prognosis in most patients with complete recovery: between 2-18 months.3 Its main risk is intestinal pseudoobstruction, which can manifest as constipation2,4. In the following case report, abdominal pseudohernia is analyzed as a rare motor complication of HZ and its characteristics.
Subject(s)
Humans , Male , Aged , Abdominal Wall , Herpes Zoster/complications , Herpes Zoster/diagnostic imagingABSTRACT
ObjectiveTo investigate the role of N-methyl-D-aspartate receptor subunit 2B (NR2B) antagonist CP-101.606 in behaviour and expression of related signal proteins in a rat model of levodopa-induced motor complications.MethodsThe hemi-parkinsonian rat model was produced by injecting stereotaxically 6-OHDA to right medial forebrain bundle.Then,rats were intraperitoneally treated with levodopa (50 mg/kg with benserazide 12.5 mg/kg,twice daily) for 22 days.On 23th day,rats received CP-101.606 before levodopa administration.Rotational duration was estimated.After sacrificed,phosphorylated NR2B and Ca2+/calmodulin-dependent protein kinase Ⅱ (CaMKⅡ) and glutamate receptor 1 ( GluR1S831 ) were observed by western blot.ResultsThe results showed that NR2B antagonist CP-101.606 reversed the levodopa-induced shortened rotational duration.Chronic levodopa treatment increased abundance of the phosphorylated NR2B and downstream related signal proteins CaMKⅡ and GluR1S831 to (145.3±6.5)％ and (132.5±5.7)％ and (105.6±6.3)％,respectively.Moreover,CP-101.606 could reduce hyperphosphorylation of NR2B and CaMKⅡ and GluR1 S831 to (102 ± 4.9 )％,(98.4±3.9)％ and (49.5 ± 4.2 )％,respectively.ConclusionsThese results indicate that the enhancement of N-methyl-D-aspartate (NMDA) receptor function mediated by NR2B phosphorylation contribute to development of motor complications,through a mechanism that involved the downstream signal mediators of NMDA receptor overactivation.Pharmaceuticals which act to inhibit NR2B may be useful in the treatment of the motor complications in parkinsonian patients.
ABSTRACT
Objective To investigate the alteration of phosphorylated GluR1Ser831 and behavioural effects in a rat model of levodopa-induced motor complications after Ca2 +/calmodulin-dependent protein kinase Ⅱ (CaMKⅡ) inhibitor KN-93 treatment. Methods The hemi-parkinsonian rat model was produced by injecting stereotaxically 6-OHDA to right medial forebrain bundle. Then, rats were intraperitoneally treated with levodopa ( 50 mg/kg with benserazide 12.5 mg/kg,twice daily) for 22 days. On day 23 ,rats received KN-93 before levodopa administration. Rotational duration was estimated. After sacrificed, subcellualr distribution of GluR1 and phosphorylated GluR1Ser831 were observed by western blot. Results The study showed that CaMKⅡ inhibitor KN-93 prolonged rotational duration. Moreover, KN-93 could regulate subcellular distribution of GluR1 and reduce hyperphosphorylation of GluR1 Ser831, which was closely associated with levodopa-induced motor complications. The expression of membrane GluR1 and phosphorylated GluR1Ser831 was (83.4 ±4.2)% and (47.2 ±5.2)% ,respectively. Conclusions These results indicated that activation of CaMKⅡ contributed to development of motor complications, through a mechanism that involved an increase in phosphorylated GluR1 Ser831. Pharmaceuticals which act to inhibit CaMKⅡ may be useful in the treatment of the motor complications in parkinsonian patients.