RESUMEN
Bevacizumab is widely used in the treatment of colorectal cancer, liver cancer, and other advanced solid tumors because of its multiple targets, no genetic testing and better safety. Globally, the use of bevacizumab in the clinic has been climbing year by year based on several large-scale, multicenter prospective studies. While bevacizumab undeniably has a good clinical safety profile, it has also been associated with adverse effects such as drug-related hypertension and anaphylaxis. In our recent clinical work, we met a female patient with acute aortic coarctation previously treated with multiple cycles of bevacizumab, who was admitted with sudden onset of back pain. Because the patient had just had an enhanced CT of the chest and abdomen a month earlier, no abnormal lesions apparently associated with low back pain were found. So when the patient was seen on this occasion, our clinical diagnosis was first considered to be neuropathic pain, but a further multiphase enhancement CT was done again for further exclusion and the final diagnosis was acute aortic dissection. The patient later died within 1 hour after the chest pain had worsened again while waiting for a surgical blood supply within 72 hours of presentation. The risk of fatal acute aortic dissection is not sufficiently emphasized in the revised instructions for bevacizumab, although the adverse effects associated with aortic dissection and aneurysm are mentioned. Our report is of high practical value in raising clinicians' vigilance and safe management of patients using bevacizumab worldwide.
RESUMEN
Background: The competing endogenous RNA (CeRNA) network plays important roles in the occurrence and development of colon cancer. This research is aimed at constructing a miRNA-mRNA network associated with exosomes in colon cancer. Methods: We explored the GEO database and then analyzed the RNAs of 722 samples to obtain differentially expressed miRNAs (DEMs) and mRNAs (DEGs) alongside the progress of colon cancer. Next, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of DEM target genes and DEGs were performed. In addition, a miRNA-mRNA network related to exosomes in colon cancer was constructed based on DEMs and DEGs. Finally, the expression of miRNA and mRNA in the network was verified by GEPIA2 on the base of TCGA database. Results: Through our analysis, 19 DEMs (17 up and 2 down) and 1672 DEGs (954 up and 718 down) were screened. The GO and KEGG results show that these DEGs were mainly enriched in ribonucleoprotein complex biogenesis, noncoding RNA metabolic process, cell-substrate junction, cadherin binding, transcription coregulator activity, and regulation of the human T-cell leukemia virus 1 infection-related pathway. Besides, a miRNA-mRNA network, including 4 miRNAs (hsa-miR-623, hsa-miR-320c, hsa-miR-486-5p, and hsa-miR-1290) and 7 mRNAs (GNAI1, CADM1, PGRMC2, etc.), was constructed. Three of these seven mRNAs were downregulated in colon cancer. Ultimately, the GNAI1, CADM1, and PGRMC2 expression levels were verified by TCGA database. Conclusions: This study reveals the network relationship between colon cancer exosome-derived miRNA and targeted mRNA. It deepens our understanding of new molecular mechanisms and pathways that may play a role in the occurrence and metastasis of colon cancer.