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1.
bioRxiv ; 2024 Apr 03.
Article in English | MEDLINE | ID: mdl-38903076

ABSTRACT

Lysosomes are dynamic cellular structures that adaptively remodel their membrane in response to stimuli, including membrane damage. We previously uncovered a process we term LYTL (LYsosomal Tubulation/sorting driven by Leucine-Rich Repeat Kinase 2 [LRRK2]), wherein damaged lysosomes generate tubules sorted into mobile vesicles. LYTL is orchestrated by the Parkinson's disease-associated kinase LRRK2 that recruits the motor adaptor protein and RHD family member JIP4 to lysosomes via phosphorylated RAB proteins. To identify new players involved in LYTL, we performed unbiased proteomics on isolated lysosomes after LRRK2 kinase inhibition. Our results demonstrate that there is recruitment of RILPL1 to ruptured lysosomes via LRRK2 activity to promote phosphorylation of RAB proteins at the lysosomal surface. RILPL1, which is also a member of the RHD family, enhances the clustering of LRRK2-positive lysosomes in the perinuclear area and causes retraction of LYTL tubules, in contrast to JIP4 which promotes LYTL tubule extension. Mechanistically, RILPL1 binds to p150Glued, a dynactin subunit, facilitating the transport of lysosomes and tubules to the minus end of microtubules. Further characterization of the tubulation process revealed that LYTL tubules move along tyrosinated microtubules, with tubulin tyrosination proving essential for tubule elongation. In summary, our findings emphasize the dynamic regulation of LYTL tubules by two distinct RHD proteins and pRAB effectors, serving as opposing motor adaptor proteins: JIP4, promoting tubulation via kinesin, and RILPL1, facilitating tubule retraction through dynein/dynactin. We infer that the two opposing processes generate a metastable lysosomal membrane deformation that facilitates dynamic tubulation events.

2.
Emerg Infect Dis ; 30(6): 1173-1181, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38781950

ABSTRACT

Understanding changes in the transmission dynamics of mpox requires comparing recent estimates of key epidemiologic parameters with historical data. We derived historical estimates for the incubation period and serial interval for mpox and contrasted them with pooled estimates from the 2022 outbreak. Our findings show the pooled mean infection-to-onset incubation period was 8.1 days for the 2022 outbreak and 8.2 days historically, indicating the incubation periods remained relatively consistent over time, despite a shift in the major mode of transmission. However, we estimated the onset-to-onset serial interval at 8.7 days using 2022 data, compared with 14.2 days using historical data. Although the reason for this shortening of the serial interval is unclear, it may be because of increased public health interventions or a shift in the mode of transmission. Recognizing such temporal shifts is essential for informed response strategies, and public health measures remain crucial for controlling mpox and similar future outbreaks.


Subject(s)
Disease Outbreaks , Infectious Disease Incubation Period , Mpox (monkeypox) , Humans , Mpox (monkeypox)/epidemiology , Mpox (monkeypox)/history , Mpox (monkeypox)/transmission , Mpox (monkeypox)/virology , History, 21st Century , Global Health
3.
Anal Chem ; 96(17): 6566-6574, 2024 Apr 30.
Article in English | MEDLINE | ID: mdl-38642077

ABSTRACT

Quantitative liquid chromatography-mass spectrometry (LC-MS)-based metabolomics is becoming an important approach for studying complex biological systems but presents several technical challenges that limit its widespread use. Computing metabolite concentrations using standard curves generated from standard mixtures of known concentrations is a labor-intensive process that is often performed manually. Currently, there are few options for open-source software tools that can automatically calculate metabolite concentrations. Herein, we introduce SCALiR (standard curve application for determining linear ranges), a new web-based software tool specifically built for this task, which allows users to automatically transform LC-MS signals into absolute quantitative data (https://www.lewisresearchgroup.org/software). SCALiR uses an algorithm that automatically finds the equation of the line of best fit for each standard curve and uses this equation to calculate compound concentrations from the LC-MS signal. Using a standard mix containing 77 metabolites, we show a close correlation between the concentrations calculated by SCALiR and the expected concentrations of each compound (R2 = 0.99 for a y = x curve fitting). Moreover, we demonstrate that SCALiR reproducibly calculates concentrations of midrange standards across ten analytical batches (average coefficient of variation 0.091). SCALiR can be used to calculate metabolite concentrations either using external calibration curves or by using internal standards to correct for matrix effects. This open-source and vendor agnostic software offers users several advantages in that (1) it requires only 10 s of analysis time to compute concentrations of >75 compounds, (2) it facilitates automation of quantitative workflows, and (3) it performs deterministic evaluations of compound quantification limits. SCALiR therefore provides the metabolomics community with a simple and rapid tool that enables rigorous and reproducible quantitative metabolomics studies.


Subject(s)
Mass Spectrometry , Metabolomics , Software , Metabolomics/methods , Mass Spectrometry/methods , Chromatography, Liquid/methods , Internet , Algorithms , Automation , Animals
6.
Front Microbiol ; 14: 1305899, 2023.
Article in English | MEDLINE | ID: mdl-38075927

ABSTRACT

The plant pathogenic bacterium Pseudomonas syringae pv tomato DC3000 (Pst DC3000) causes disease in tomato, in the model plant Arabidopsis thaliana, and conditionally in Nicotiana benthamiana. The pathogenicity of Pst DC3000 is mostly due to bacterial virulence proteins, known as effectors, that are translocated into the plant cytoplasm through the type III secretion system (T3SS). Bacterial type III secreted effectors (T3SEs) target plants physiological processes and suppress defense responses to enable and support bacterial proliferation. The Pst DC3000 T3SE HopD1 interferes with plant defense responses by targeting the transcription factor NTL9. This work shows that HopD1 also targets the immune protein AtNHR2B (Arabidopsis thaliana nonhost resistance 2B), a protein that localizes to dynamic vesicles of the plant endomembrane system. Live-cell imaging of Nicotiana benthamiana plants transiently co-expressing HopD1 fused to the epitope haemagglutinin (HopD1-HA) with AtNHR2B fused to the red fluorescent protein (AtNHR2B-RFP), revealed that HopD1-HA interferes with the abundance and cellular dynamics of AtNHR2B-RFP-containing vesicles. The results from this study shed light into an additional function of HopD1 while contributing to understanding how T3SEs also target vesicle trafficking-mediated processes in plants.

7.
Nat Commun ; 14(1): 4797, 2023 08 09.
Article in English | MEDLINE | ID: mdl-37558661

ABSTRACT

The human leucine-rich repeat kinases (LRRKs), LRRK1 and LRRK2 are large and unusually complex multi-domain kinases, which regulate fundamental cellular processes and have been implicated in human disease. Structures of LRRK2 have recently been determined, but the structure and molecular mechanisms regulating the activity of the LRRK1 as well as differences in the regulation of LRRK1 and LRRK2 remain unclear. Here, we report a cryo-EM structure of the LRRK1 monomer and a lower-resolution cryo-EM map of the LRRK1 dimer. The monomer structure, in which the kinase is in an inactive conformation, reveals key interdomain interfaces that control kinase activity as we validate experimentally. Both the LRRK1 monomer and dimer are structurally distinct compared to LRRK2. Overall, our results provide structural insights into the activation of the human LRRKs, which advance our understanding of their physiological and pathological roles.


Subject(s)
Leucine , Protein Serine-Threonine Kinases , Humans , Phosphorylation , Protein Serine-Threonine Kinases/chemistry
8.
J Phys Chem B ; 127(26): 5764-5771, 2023 07 06.
Article in English | MEDLINE | ID: mdl-37343227

ABSTRACT

The activation of T cells is typically accompanied by inhibitory mechanisms within which the programmed cell death (PD1) receptor stands out. Upon binding the ligands PDL1 and PDL2, PD1 drives T cells to an unresponsive state called exhaustion, characterized by a markedly decreased capacity to exert effector functions. For this reason, PD1 has become one of the most important targets in cancer immunotherapy. Despite the numerous studies about PD1 signaling modulation, how the PD1 signaling is activated upon the ligands' binding remains an open question. Several experimental facts suggest that the activation of the PD1-PLD1 pathway depends on the interaction with an unknown partner at the cellular membrane. In this work, we investigate the possibility that the target of PD1-PDL1 is the same PD1-PDL1 complex. We combined molecular docking with molecular dynamics and umbrella sampling simulations to explore different binding modes and assess the complexes' stability. We predicted a stable dimeric form of the extracellular domains of the PD1-PDL1 complex. This dimeric complex has an affinity comparable to the PD1-PDL1 interaction and resembles the form of a linear lattice. We proposed a new model for PD1 activation where the PD1-PDL1 dimeric form could facilitate the interaction of the intracellular domains of PD1 and the further binding and activation of the SHP2 phosphatase. This model might explain the inhibitory effect of anti-PD1/PDL1 antibodies through the prevention of the formation of the PD1-PDL1 dimers and, subsequently, the abrogation of the SHP2 phosphatase activation.


Subject(s)
Molecular Dynamics Simulation , Protein Tyrosine Phosphatase, Non-Receptor Type 11 , Molecular Docking Simulation , Ligands
9.
BMC Womens Health ; 22(1): 525, 2022 12 17.
Article in English | MEDLINE | ID: mdl-36526995

ABSTRACT

BACKGROUND: Endometriosis is a pathophysiological condition characterized by glands and stroma outside the uterus in regions such as the bladder, ureter, fallopian tubes, peritoneum, ovaries, and even in extra pelvic sites. One of the main clinical problems of endometriosis is chronic pelvic pain (CPP), which considerably affects the patients' quality of life. Patients with endometriosis may, cyclically or non-cyclically (80% of cases) experience CPP. High levels of anxiety and depression have been described in patients with endometriosis related to CPP; however, this has not been evaluated in endometriosis women with different types of CPP. Therefore, the research question of this study was whether there is a difference in the emotional dysregulation due to the type of pain experienced by women with endometriosis? METHODS: This work was performed in the National Institute of Perinatology (INPer) in Mexico City from January 2019 to March 2020 and aimed to determine if there are differences in emotional dysregulation in patients with cyclical and non-cyclical CPP. 49 women from 18 to 52 years-old diagnosed with endometriosis presenting cyclical and non-cyclical CPP answered several batteries made up of Mini-Mental State Examination, Visual Analog Scale, Beck's Depression Inventory, State Trait-Anxiety Inventory, and Generalized Anxiety Inventory. Mann-Whitney U and Student's t-test for independent samples to compare the difference between groups was used. Relative risk estimation was performed to determine the association between non-cyclical and cyclical CPP with probability of presenting emotional dysregulation. RESULTS: We observed that patients with non-cyclical CPP exhibited higher levels of depression and anxiety (trait-state and generalized anxiety) than patients with cyclical pain, p < 0.05 was considered significant. No differences were observed in pain intensity, but there was a higher probability of developing emotional dysregulation (anxiety or depression) in patients with non-cyclical CPP. No differences were observed in cognitive impairment. CONCLUSIONS: Our data suggest that patients with non-cyclical (persistent) CPP present a higher emotional dysregulation than those with cyclical pain.


Subject(s)
Chronic Pain , Endometriosis , Humans , Female , Adolescent , Young Adult , Adult , Middle Aged , Endometriosis/diagnosis , Quality of Life/psychology , Pelvic Pain/etiology , Pelvic Pain/psychology , Anxiety/psychology
10.
Proc Natl Acad Sci U S A ; 119(43): e2205492119, 2022 10 25.
Article in English | MEDLINE | ID: mdl-36256825

ABSTRACT

Genetic variation at the leucine-rich repeat kinase 2 (LRRK2) locus contributes to an enhanced risk of familial and sporadic Parkinson's disease. Previous data have demonstrated that recruitment to various membranes of the endolysosomal system results in LRRK2 activation. However, the mechanism(s) underlying LRRK2 activation at endolysosomal membranes and the cellular consequences of these events are still poorly understood. Here, we directed LRRK2 to lysosomes and early endosomes, triggering both LRRK2 autophosphorylation and phosphorylation of the direct LRRK2 substrates Rab10 and Rab12. However, when directed to the lysosomal membrane, pRab10 was restricted to perinuclear lysosomes, whereas pRab12 was visualized on both peripheral and perinuclear LRRK2+ lysosomes, suggesting that lysosomal positioning provides additional regulation of LRRK2-dependent Rab phosphorylation. Anterograde transport of lysosomes to the cell periphery by increasing the expression of ARL8B and SKIP or by knockdown of JIP4 blocked the recruitment and phosphorylation of Rab10 by LRRK2. The absence of pRab10 from the lysosomal membrane prevented the formation of a lysosomal tubulation and sorting process we previously named LYTL. Conversely, overexpression of RILP resulted in lysosomal clustering within the perinuclear area and increased LRRK2-dependent Rab10 recruitment and phosphorylation. The regulation of Rab10 phosphorylation in the perinuclear area depends on counteracting phosphatases, as the knockdown of phosphatase PPM1H significantly increased pRab10 signal and lysosomal tubulation in the perinuclear region. Our findings suggest that LRRK2 can be activated at multiple cellular membranes, including lysosomes, and that lysosomal positioning further provides the regulation of some Rab substrates likely via differential phosphatase activity or effector protein presence in nearby cellular compartments.


Subject(s)
Lysosomes , rab GTP-Binding Proteins , Leucine-Rich Repeat Serine-Threonine Protein Kinase-2/genetics , Leucine-Rich Repeat Serine-Threonine Protein Kinase-2/metabolism , Phosphorylation , Leucine/metabolism , rab GTP-Binding Proteins/genetics , rab GTP-Binding Proteins/metabolism , Lysosomes/metabolism , Phosphoric Monoester Hydrolases/metabolism , Mutation
11.
Emerg Infect Dis ; 28(10): 2051-2059, 2022 10.
Article in English | MEDLINE | ID: mdl-36104202

ABSTRACT

An unprecedented surge of COVID-19 cases in Taiwan in May 2021 led the government to implement strict nationwide control measures beginning May 15. During the surge, the government was able to bring the epidemic under control without a complete lockdown despite the cumulative case count reaching >14,400 and >780 deaths. We investigated the effectiveness of the public health and social measures instituted by the Taiwan government by quantifying the change in the effective reproduction number, which is a summary measure of the ability of the pathogen to spread through the population. The control measures that were instituted reduced the effective reproduction number from 2.0-3.3 to 0.6-0.7. This decrease was correlated with changes in mobility patterns in Taiwan, demonstrating that public compliance, active case finding, and contact tracing were effective measures in preventing further spread of the disease.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Contact Tracing , Humans , SARS-CoV-2 , Taiwan/epidemiology
12.
Mol Biol Cell ; 33(13): ar124, 2022 11 01.
Article in English | MEDLINE | ID: mdl-36044336

ABSTRACT

Lysosomes are dynamic organelles that can remodel their membrane as an adaptive response to various cell signaling events including membrane damage. Recently, we have discovered that damaged lysosomes form and sort tubules into moving vesicles. We named this process LYTL for LYsosomal Tubulation/sorting driven by LRRK2, as the Parkinson's disease protein LRRK2 promotes tubulation by recruiting the motor adaptor protein JIP4 to lysosomes via phosphorylated RAB proteins. Here we use spinning-disk microscopy combined with superresolution to further characterize LYTL after membrane damage with LLOMe (l-leucyl-l-leucine methyl ester). We identified the endoplasmic reticulum (ER) colocalizing with sites of fission of lysosome-derived tubules. In addition, modifying the morphology of the ER by reducing ER tubules leads to a decrease in LYTL sorting, suggesting that contact with tubular ER is necessary for lysosomal membrane sorting. Given the central roles of LRRK2 and lysosomal biology in Parkinson's disease, these discoveries are likely relevant to disease pathology and highlight interactions between organelles in this model.


Subject(s)
Parkinson Disease , Dyneins/metabolism , Endoplasmic Reticulum/metabolism , Humans , Intracellular Membranes/metabolism , Leucine-Rich Repeat Serine-Threonine Protein Kinase-2/genetics , Leucine-Rich Repeat Serine-Threonine Protein Kinase-2/metabolism , Lysosomes/metabolism , Parkinson Disease/metabolism , Protein Transport
13.
Int J Infect Dis ; 122: 829-831, 2022 Sep.
Article in English | MEDLINE | ID: mdl-35872096

ABSTRACT

Although new cases of monkeypox have been expected in the Western Pacific Region (WPR) since the virus emerged in Europe earlier this year, there have been only a few reported cases across the WPR (New Zealand 2, Singapore 6, South Korea 1, Taiwan 2), other than a limited number of cases (compared to numbers of cases seen elsewhere in the world) in Australia (33), as of July 15, 2022. In our short communication, we highlight two key reasons for this: i) international travel has still not fully resumed in the WPR following the COVID-19 pandemic, and ii) local public health measures to counter the spread of COVID-19 have not been completely relaxed. We provide supporting evidence for both of these reasons.


Subject(s)
COVID-19 , Mpox (monkeypox) , Australia/epidemiology , COVID-19/epidemiology , Humans , Mpox (monkeypox)/epidemiology , Pandemics , Public Health
14.
Anal Chem ; 94(25): 8874-8882, 2022 06 28.
Article in English | MEDLINE | ID: mdl-35700271

ABSTRACT

Metabolomics is a mainstream approach for investigating the metabolic underpinnings of complex biological phenomena and is increasingly being applied to large-scale studies involving hundreds or thousands of samples. Although metabolomics methods are robust in smaller-scale studies, they can be challenging to apply to larger cohorts due to the inherent variability of liquid chromatography mass spectrometry (LC-MS). Much of this difficulty results from the time-dependent changes in the LC-MS system, which affects both the qualitative and quantitative performances of the instrument. Herein, we introduce an analytical strategy for addressing this problem in large-scale microbial studies. Our approach quantifies microbial boundary fluxes using two zwitterionic hydrophilic interaction liquid chromatography (ZIC-HILIC) columns that are plumbed to enable offline column equilibration. Using this strategy, we show that over 397 common metabolites can be resolved in 4.5 min per sample and that metabolites can be quantified with a median coefficient of variation of 0.127 across 1100 technical replicates. We illustrate the utility of this strategy via an analysis of 960 strains of Staphylococcus aureus isolated from bloodstream infections. These data capture the diversity of metabolic phenotypes observed in clinical isolates and provide an example of how large-scale investigations can leverage our novel analytical strategy.


Subject(s)
Cell Culture Techniques , Metabolomics , Chromatography, Liquid/methods , Humans , Hydrophobic and Hydrophilic Interactions , Mass Spectrometry/methods , Metabolomics/methods
16.
Neurobiol Dis ; 170: 105769, 2022 08.
Article in English | MEDLINE | ID: mdl-35580815

ABSTRACT

Coding mutations in the Leucine-rich repeat kinase 2 (LRRK2) gene, which are associated with dominantly inherited Parkinson's disease (PD), lead to an increased activity of the encoded LRRK2 protein kinase. As such, kinase inhibitors are being considered as therapeutic agents for PD. It is therefore of interest to understand the mechanism(s) by which LRRK2 is activated during cellular signaling. Lysosomal membrane damage represents one way of activating LRRK2 and leads to phosphorylation of downstream RAB substrates and recruitment of the motor adaptor protein JIP4. However, it is unclear whether the activation of LRRK2 would be seen at other membranes of the endolysosomal system, where LRRK2 has also shown to be localized, or whether these signaling events can be induced without membrane damage. Here, we use a rapamycin-dependent oligomerization system to direct LRRK2 to various endomembranes including the Golgi apparatus, lysosomes, the plasma membrane, recycling, early, and late endosomes. Irrespective of membrane location, the recruitment of LRRK2 to membranes results in local accumulation of phosphorylated RAB10, RAB12, and JIP4. We also show that endogenous RAB29, previously nominated as an activator of LRRK2 based on overexpression, is not required for activation of LRRK2 at the Golgi nor lysosome. We therefore conclude that LRRK2 signaling to RAB10, RAB12, and JIP4 can be activated once LRRK2 is accumulated at any cellular organelle along the endolysosomal pathway.


Subject(s)
Endosomes , rab GTP-Binding Proteins , Endosomes/metabolism , Leucine-Rich Repeat Serine-Threonine Protein Kinase-2/genetics , Leucine-Rich Repeat Serine-Threonine Protein Kinase-2/metabolism , Lysosomes/metabolism , Mutation , Phosphorylation , rab GTP-Binding Proteins/metabolism
17.
J Phys Chem B ; 126(7): 1441-1446, 2022 02 24.
Article in English | MEDLINE | ID: mdl-35167293

ABSTRACT

The activation of T cells is normally accompanied by inhibitory mechanisms within which the PD1 receptor stands out. PD1 drives T cells to an unresponsive state called exhaustion, characterized by a markedly decreased capacity to exert effector functions upon binding the ligands PDL1 and PDL2. For this reason, PD1 has become one of the most important targets in cancer immunotherapy. Despite the numerous studies about PD1 signaling modulation, how the PD1 signaling pathway is activated upon the ligands' binding remains an open question. In this work, we used molecular dynamics simulations to assess the differences of the PD1 motion in the free state and in complex with the ligands. We found that, in both human and murine systems, the binding of PDL1 and PDL2 stabilizes the conformation of the FG loop similarly. This result, combined with the conservation of the FG loop residues across species, suggests that the conformation of the FG loop is somehow related to the signaling process. We also found a high similarity between the PD1-PDL1 structures with the variable region of an antibody structure, where the FG loop occupies a similar position to the CDR3 light chain.


Subject(s)
B7-H1 Antigen , Programmed Cell Death 1 Receptor , Animals , B7-H1 Antigen/chemistry , B7-H1 Antigen/metabolism , Humans , Ligands , Mice , Molecular Conformation , Signal Transduction
18.
FEBS J ; 289(22): 6871-6890, 2022 11.
Article in English | MEDLINE | ID: mdl-34196120

ABSTRACT

Protein coding mutations in leucine-rich repeat kinase 2 (LRRK2) cause familial Parkinson's disease (PD), and noncoding variations around the gene increase the risk of developing sporadic PD. It is generally accepted that pathogenic LRRK2 mutations increase LRRK2 kinase activity, resulting in a toxic hyperactive protein that is inferred to lead to the PD phenotype. LRRK2 has long been linked to different membrane trafficking events, but the specific role of LRRK2 in these events has been difficult to resolve. Recently, several papers have reported the activation and translocation of LRRK2 to cellular organelles under specific conditions, which suggests that LRRK2 may influence intracellular membrane trafficking. Here, we review what is known about the role of LRRK2 at various organelle compartments.


Subject(s)
Parkinson Disease , Humans , Leucine-Rich Repeat Serine-Threonine Protein Kinase-2/genetics , Leucine-Rich Repeat Serine-Threonine Protein Kinase-2/metabolism , Parkinson Disease/pathology , Mutation , Phenotype , Organelles/genetics , Organelles/metabolism
19.
PLoS Biol ; 19(12): e3001480, 2021 12.
Article in English | MEDLINE | ID: mdl-34914695

ABSTRACT

Mutations in leucine-rich repeat kinase 2 (LRRK2) cause autosomal dominant Parkinson disease (PD), while polymorphic LRRK2 variants are associated with sporadic PD. PD-linked mutations increase LRRK2 kinase activity and induce neurotoxicity in vitro and in vivo. The small GTPase Rab8a is a LRRK2 kinase substrate and is involved in receptor-mediated recycling and endocytic trafficking of transferrin, but the effect of PD-linked LRRK2 mutations on the function of Rab8a is poorly understood. Here, we show that gain-of-function mutations in LRRK2 induce sequestration of endogenous Rab8a to lysosomes in overexpression cell models, while pharmacological inhibition of LRRK2 kinase activity reverses this phenotype. Furthermore, we show that LRRK2 mutations drive association of endocytosed transferrin with Rab8a-positive lysosomes. LRRK2 has been nominated as an integral part of cellular responses downstream of proinflammatory signals and is activated in microglia in postmortem PD tissue. Here, we show that iPSC-derived microglia from patients carrying the most common LRRK2 mutation, G2019S, mistraffic transferrin to lysosomes proximal to the nucleus in proinflammatory conditions. Furthermore, G2019S knock-in mice show a significant increase in iron deposition in microglia following intrastriatal LPS injection compared to wild-type mice, accompanied by striatal accumulation of ferritin. Our data support a role of LRRK2 in modulating iron uptake and storage in response to proinflammatory stimuli in microglia.


Subject(s)
Leucine-Rich Repeat Serine-Threonine Protein Kinase-2/genetics , rab GTP-Binding Proteins/metabolism , Aged , Animals , Biological Transport , Corpus Striatum , Gain of Function Mutation/genetics , HEK293 Cells , Humans , Iron/metabolism , Leucine-Rich Repeat Serine-Threonine Protein Kinase-2/metabolism , Lysosomes/metabolism , Male , Mice , Mice, Inbred C57BL , Microglia , Middle Aged , Mutation , Parkinson Disease/genetics , Parkinson Disease/metabolism , Protein Serine-Threonine Kinases , Transferrin/metabolism , Transferrins/genetics , Transferrins/metabolism , rab GTP-Binding Proteins/genetics
20.
Rev. colomb. cardiol ; 28(2): 185-188, mar.-abr. 2021. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1341282

ABSTRACT

Resumen El infarto de miocardio con arterias coronarias no obstruidas (MINOCA, por sus siglas en inglés) ha ganado importancia en los últimos 20 años gracias a la dilucidación de etiologías fisiopatológicas diferentes de las causas obstructivas del flujo coronario. Diversos estudios han evidenciado una prevalencia variable, la cual es más alta en las mujeres. Se han descrito dos grupos de alteraciones en la reactividad coronaria que afectan el flujo: las causas epicárdicas y las causas microvasculares. El diagnóstico de MINOCA es de exclusión; por lo tanto, inicialmente se deben descartar otras posibles causas de isquemia, como miocarditis, miocardiopatía séptica, choque hipovolémico por trauma o quemaduras, y enfermedades renales o pulmonares. Los reportes y estudios de esta enfermedad suelen incluir pacientes adultos o mayores de 18 años. Se presenta el caso de una paciente de 16 años con antecedente de tetralogía de Fallot corregida en etapa de lactante menor y reemplazo valvular pulmonar con bioprótesis y ampliación del tronco pulmonar a los 11 años, quien ingresó con dolor torácico de características coronarias. Cursó con un diagnóstico de MINOCA por exclusión en una institución de cuarto nivel en Cali, Colombia. El diagnóstico de MINOCA en edad pediátrica es raro; sin embargo, es importante saber acerca de su existencia para brindar a los pacientes el mejor manejo disponible, de manera que se aseguren los mejores desenlaces a largo plazo.


Abstract Myocardial infarction with non-obstructed coronary arteries (MINOCA) has gained importance in the last 20 years, due to the elucidation of physiopathological etiologies different from the obstructive causes of coronary flow. Different studies have shown variable prevalence, being higher in women. Different causes have been evidenced in the studies found in two groups of alterations in coronary reactivity: epicardial causes and microvascular causes. The diagnosis of MINOCA must be a diagnosis of exclusion. Therefore, other possible causes of ischemia, such as myocarditis, septic cardiomyopathy, hypovolemic shock due to trauma or burns, renal or pulmonary diseases, should be ruled out initially. The reports and studies done around this pathology usually include adult patients and people older than 18 years. We present the case of a 16-year-old patient with a history of Tetralogy of Fallot corrected as an infant and pulmonary valve replacement with bioprothesis and enlargement of the pulmonary trunk at 11 years of age who was admitted with chest pain of coronary characteristics. The diagnosis after multiples studies and exclusion of other causes was MINOCA in a fourth level institution in Cali, Colombia.


Subject(s)
Humans , Female , Adolescent , Myocardial Infarction , Pediatrics , Coronary Disease/diagnosis , Coronary Vessels
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