RESUMEN
Abuse and addiction to prescription opioids such as oxycodone (a short-acting Mu opioid receptor (MOP-r) agonist) in adolescence is a pressing public health issue. We have previously shown differences in oxycodone self-administration behaviors between adolescent and adult C57BL/6J mice and expression of striatal neurotransmitter receptor genes, in areas involved in reward. In this study, we aimed to determine whether oxycodone self-administration differentially affects genes regulating synaptic plasticity in the hippocampus of adolescent compared to adult mice, since the hippocampus may be involved in learning aspects associated with chronic drug self administration. Hippocampus was isolated for mRNA analysis from mice that had self administered oxycodone (0.25 mg/kg/infusion) 2h/day for 14 consecutive days or from yoked saline controls. Gene expression was analyzed with real-time polymerase chain reaction (PCR) using a commercially available "synaptic plasticity" PCR array containing 84 genes. We found that adolescent and adult control mice significantly differed in the expression of several genes in the absence of oxycodone exposure, including those coding for mitogen-activated protein kinase, calcium/calmodulin-dependent protein kinase II gamma subunit, glutamate receptor, ionotropic AMPA2 and metabotropic 5. Chronic oxycodone self administration increased proviral integration site 1 (Pim1) and thymoma viral proto-oncogene 1 mRNA levels compared to controls in both age groups. Both Pim1 and cadherin 2 mRNAs showed a significant combined effect of Drug Condition and Age × Drug Condition. Furthermore, the mRNA levels of both cadherin 2 and cAMP response element modulators showed an experiment-wise significant difference between oxycodone and saline control in adult but not in adolescent mice. Overall, this study demonstrates for the first time that chronic oxycodone self-administration differentially alters synaptic plasticity gene expression in the hippocampus of adolescent and adult mice.
Asunto(s)
Hipocampo/efectos de los fármacos , Hipocampo/crecimiento & desarrollo , Narcóticos/administración & dosificación , Trastornos Relacionados con Opioides/metabolismo , Oxicodona/administración & dosificación , Envejecimiento/efectos de los fármacos , Envejecimiento/metabolismo , Animales , Cadherinas/metabolismo , Proteína Quinasa Tipo 2 Dependiente de Calcio Calmodulina/metabolismo , Modulador del Elemento de Respuesta al AMP Cíclico/metabolismo , Expresión Génica , Regulación del Desarrollo de la Expresión Génica/efectos de los fármacos , Hipocampo/metabolismo , Masculino , Ratones Endogámicos C57BL , Proteína Quinasa 1 Activada por Mitógenos/metabolismo , Proteínas Proto-Oncogénicas c-pim-1/metabolismo , ARN Mensajero/metabolismo , Receptor del Glutamato Metabotropico 5/metabolismo , Receptores AMPA/metabolismo , AutoadministraciónRESUMEN
In heroin-dependent individuals, the drive to avoid or ameliorate the negative affective/emotional state associated with the discontinuation of heroin contributes to the chronic relapsing nature of the disease. Here, we investigate changes in proopiomelanocortin (POMC) expression at three time points across an extended period of heroin withdrawal in a clinically relevant rodent model of addiction using conditioned place aversion (CPA) in POMC-EGFP (POMC-enhanced green fluorescent protein) bacterial artificial chromosome (BAC) transgenic mice. Neurons expressing POMC-EGFP were found in the medial nucleus of the amygdala (MeA), basomedial amygdala (BMA) and dentate gyrus of hippocampus (DG), as well as the arcuate nucleus of hypothalamus (ARC). Heroin-treated mice displayed robust CPA after acute spontaneous withdrawal (12h), which persisted across the extended (14days) withdrawal period. After 12-h withdrawal, heroin-treated mice showed lower signal intensity of POMC-EGFP-positive cells in the ARC, higher levels of POMC mRNA in the amygdala but lower levels in the hippocampus than saline controls. After 7-d withdrawal, heroin-treated mice showed fewer POMC-EGFP-positive cells in the MeA and lower POMC mRNA in the amygdala than saline controls. After extended (14days) withdrawal, heroin-treated mice showed more POMC-EGFP-positive cells in BMA and DG, increased intensity of POMC-EGFP signal in DG, and higher POMC mRNA levels in the hippocampus compared to controls. Our results show dynamic changes in POMC in hypothalamic and extra-hypothalamic regions that may contribute to the negative affective/emotional state of heroin withdrawal shown by CPA from acute to extended periods of heroin withdrawal.
Asunto(s)
Encéfalo/metabolismo , Dependencia de Heroína/metabolismo , Proopiomelanocortina/biosíntesis , Síndrome de Abstinencia a Sustancias/metabolismo , Animales , Condicionamiento Operante , Modelos Animales de Enfermedad , Proteínas Fluorescentes Verdes/genética , Proteínas Fluorescentes Verdes/metabolismo , Ratones , Ratones Transgénicos , Regiones Promotoras GenéticasRESUMEN
BACKGROUND: Doxycycline is reported to inhibit alveolar bone destruction by blocking matrix metalloproteinases (MMPs). Nevertheless, MMPs are not involved in osteoclastic bone resorption; osteoclasts directly resorb bone. An acidic microenvironment, which is formed by vacuolar adenosine 5'-triphosphatase (V-ATPase) expressed in the plasma membranes of osteoclasts, is indispensable for osteoclastic bone resorption. In the present study, we investigated the potential role of the acidic environment on periodontal bone destruction using a novel and specific V-ATPase inhibitor, FR202126, which we compared to doxycycline. METHODS: Inhibitory activity against in vitro bone resorption was examined by measuring the Ca2+ release from murine calvariae cultured for 6 days, which were treated with interleukin-1 (IL-1), IL-6, or parathyroid hormone. Experimental periodontitis was induced by a ligature wire tied around the contact between the first and second maxillary molars of male Wistar rats. FR202126 and doxycycline were administered orally once daily for 6 days. Seven days after tying, the maxillae were dissected and mesiodistal longitudinal paraffin sections, including interdental alveolar bone, were processed for histopathologic analysis. RESULTS: FR202126 inhibited bone resorption almost completely in calvaria cultures induced by three stimulators, whereas doxycycline was unable to prevent in vitro bone resorption. Oral administration of FR202126 significantly prevented alveolar bone loss in experimental periodontitis. However, doxycycline did not inhibit alveolar bone destruction. CONCLUSION: These results suggest that an acidic microenvironment plays a more important role than MMPs in periodontal alveolar bone destruction and that V-ATPase inhibitors may offer a new approach to the treatment of periodontal disease.
Asunto(s)
Pérdida de Hueso Alveolar/prevención & control , Aminoquinolinas/uso terapéutico , Benzamidas/uso terapéutico , Doxiciclina/uso terapéutico , Inhibidores Enzimáticos/uso terapéutico , ATPasas de Translocación de Protón Vacuolares/antagonistas & inhibidores , Pérdida de Hueso Alveolar/etiología , Análisis de Varianza , Animales , Concentración de Iones de Hidrógeno , Ligadura , Masculino , Inhibidores de la Metaloproteinasa de la Matriz , Ratones , Ratones Endogámicos , Osteoclastos/enzimología , Periodontitis/complicaciones , Ratas , Ratas Wistar , Estadísticas no ParamétricasRESUMEN
A growing body of evidences suggests that receptor desensitization is implicated in the development of tolerance to opioids, which is generally regulated by protein kinases and receptor trafficking proteins. In the present study, we demonstrated that repeated s.c. treatment with etorphine, but not morphine, produced a significant increase in protein levels of G protein-coupled receptor kinase 2, dynamin II, beta-arrestin 2 and phosphorylated-conventional protein kinase C in membranes of the mouse spinal cord, suggesting that the etorphine-induced mu-opioid receptor desensitization may result from G protein-coupled receptor kinase 2/dynaminII/beta-arrestin2-dependent phosphorylation of mu-opioid receptors. Unlike etorphine, morphine failed to change the levels of these trafficking proteins. Furthermore, we found that the level of glial fibrillary acidic protein in the mouse spinal cord was clearly increased by chronic in vivo and in vitro treatment with morphine, whereas no such effect was noted by etorphine. In the behavioral study, intraperitoneal pretreatment with the glial-modulating agent propentofylline suppressed the development of tolerance to morphine-induced antinociception. In addition, intrathecal injection of astrocytes and astrocyte-conditioned medium mixture, which were obtained from cultured astrocytes of the newborn mouse spinal cord, aggravated the development of tolerance to morphine. In contrast, these agents failed to affect the development of tolerance induced by etorphine. These findings provide direct evidence for the distinct mechanisms between etorphine and morphine on the development of tolerance to spinal antinociception. These findings raise the possibility that the increased astroglia response produced by chronic morphine could be associated with the lack of mu-opioid receptor internalization.
Asunto(s)
Etorfina/farmacología , Morfina/farmacología , Neuronas/fisiología , Dolor/fisiopatología , Receptores Opioides mu/agonistas , Receptores Opioides mu/metabolismo , Médula Espinal/fisiología , Animales , Relación Dosis-Respuesta a Droga , Tolerancia a Medicamentos , Encefalina Ala(2)-MeFe(4)-Gli(5)/administración & dosificación , Encefalina Ala(2)-MeFe(4)-Gli(5)/farmacología , Inyecciones Espinales , Masculino , Ratones , Ratones Endogámicos ICR , Neuroglía/efectos de los fármacos , Neuroglía/fisiología , Neuronas/efectos de los fármacos , Dolor/prevención & control , Fosforilación , Transporte de Proteínas/efectos de los fármacos , Médula Espinal/efectos de los fármacos , Xantinas/administración & dosificación , Xantinas/farmacologíaRESUMEN
Catalytic reactions of DNA polymerase I from E. coli (Klenow fragment, KF) were monitored directly with a template/primer (40/25- or 75/25-mer)-immobilized 27-MHz quartz-crystal microbalance (QCM). The 27-MHz QCM is a very sensitive mass-measuring device in aqueous solution, as the frequency decreases linearly with increasing mass on the QCM electrode at the nanogram level. Three steps in polymerase reactions which include 1) binding of DNA polymerase to the primer on the QCM (mass increase); 2) elongation of complementary nucleotides along the template (mass increase); and 3) release of the enzyme from the completely polymerized DNA (mass decrease), could be monitored continuously from the time dependencies of QCM frequency changes. The binding constant (Ka) of KF to the template/primer DNA was 10(8)M(-1) (k(on) = 10(5)M(-1)s(-1) and k(off)= 10(-3)s(-1)), and decreased to 10(6)M(-1) (k'on = 10(4)M(-1)s(-1) and k'off = 10(-2)s(-1)) for completely polymerized DNA. This is due to the 10-fold decrease in binding rate constant (k(on)) and 10-fold increase in dissociation rate constant (k(off)) for completed DNA strands. Ka values depended slightly on the template and primer sequences. The kinetic parameters in the elongation process (k(cat) and Km) depended only slightly on the DNA sequences. The repair process during the elongation catalyzed by KF could also be monitored in real time as QCM frequency changes.
Asunto(s)
ADN Polimerasa I/análisis , ADN Polimerasa I/metabolismo , Cartilla de ADN/metabolismo , Replicación del ADN/fisiología , ADN Complementario/metabolismo , Disparidad de Par Base/genética , Disparidad de Par Base/fisiología , Secuencia de Bases/fisiología , Sitios de Unión/fisiología , Cartilla de ADN/química , Electrodos , Escherichia coli/enzimología , Cinética , Magnesio/metabolismo , Cuarzo/química , Moldes GenéticosRESUMEN
We have systematically designed and synthesized six kinds of 16-17 mer alanine-based peptides containing four to six lysine (K) and one to four asparagine (N) residues to achieve the selective binding to A.T base pairs of DNA duplexes. The position and number of K and N residues were changed in the helical structure according to common features of the DNA-binding proteins, in which K and N residues are expected to interact electrostatically with phosphate groups and to interact with A.T base pairs by hydrogen bonding, respectively. The time courses of binding of these peptides to dA(30).dT(30) and dG(30).dC(30) duplexes immobilized on a 27 MHz quartz crystal microbalance (QCM) were studied in 10 mM phosphate buffer (pH 7.5) and 40 mM NaCl at 10 degrees C. The maximum binding amounts (Deltam(max)) on a nanogram scale and binding constants (K(a)) could be obtained from the frequency decrease (mass increase) of the oligonucleotide-immobilized QCM. The conformation changes of the peptides upon binding to DNAs were monitored by circular dichroism (CD) spectroscopy. The four properly arranged N residues in the six-cationic K peptide, K6N4(d), resulted in a 5-fold higher affinity for A.T base pairs (K(a) = 5.9 x 10(5) M(-1)) than for G.C base pairs (K(a) = 1.2 x 10(5) M(-1)), and alpha-helices were clearly promoted by the binding to A.T base pairs from CD spectral changes.
Asunto(s)
Alanina/química , Asparagina/química , Técnicas Biosensibles , Lisina/química , Péptidos/síntesis química , Péptidos/metabolismo , Polidesoxirribonucleótidos/química , Adenina/química , Secuencia de Aminoácidos , Emparejamiento Base , Técnicas Biosensibles/instrumentación , Dicroismo Circular , Proteínas de Unión al ADN/síntesis química , Cinética , Modelos Químicos , Datos de Secuencia Molecular , Ácidos Nucleicos Heterodúplex/química , Unión Proteica , Estructura Secundaria de Proteína , Timina/químicaRESUMEN
Previous reports have clarified that focal and segmental glomerulosclerosis(FSGS) appearing in membranous nephropathy(MN) is associated with a poorer prognosis than that of MN without FSGS. However, the etiology and pathogenesis of such FSGS lesions may show substantial individual differences. In some patients, hemodynamic alterations secondary to hypertension and vascular disorders seem to play a crucial role in the development of such FSGS lesions. In such instances, steady regulation of blood pressure might slow down further progression of FSGS lesions. Here we describe two cases of biopsy-proven MN with FSGS. Case I was a 44-year-old man who had shown massive proteinuria with hematuria at the age of 39 years. Renal biopsy specimens obtained at the age of 40 and 41 years showed MN without FSGS and MN with FSGS, respectively. His blood pressure control was fairly good throughout the course. Although he was on a steroid, an immunosuppressant, a low protein diet, and an ACE inhibitor, his renal function declined in 5 years. Case 2 was a 61-year-old woman who showed nephrotic syndrome at the age of 39 years. A renal biopsy specimen obtained at the age of 58 years showed MN with FSGS and remarkable atherosclerotic changes of the interlobular arteries. Her blood pressure control was rather poor throughout the course. Her renal function gradually declined over 22 years. Since parts of the FSGS lesions of the second case may have been caused by hypertension, it is tempting to speculate that day-to-day control of blood pressure could improve the long-term prognosis. We believe that, at least in some patients of MN with FSGS, careful management may lead to a more favorable course of decline in renal function.
Asunto(s)
Glomerulonefritis Membranosa/fisiopatología , Glomeruloesclerosis Focal y Segmentaria/fisiopatología , Riñón/fisiopatología , Adulto , Progresión de la Enfermedad , Femenino , Glomerulonefritis Membranosa/patología , Glomeruloesclerosis Focal y Segmentaria/patología , Humanos , Riñón/patología , Masculino , Persona de Mediana EdadRESUMEN
A case of hemophagocytic syndrome (HPS) refractory to corticosteroid therapy was successfully treated by plasma exchange. The patient was a 56-year-old woman who had undergone regular hemodialysis for 10 years for complicated myelodysplastic syndrome (MDS) and then had had lung tuberculosis. After the onset of tuberculosis, she suffered from HPS and was treated by antituberculosis agents and high dose corticosteroid administration without any effect on the HPS. After adding a series of plasma exchanges, the HPS improved gradually, and her MDS began to respond to corticosteroid therapy. Plasma hypercytokinemia due to HPS was corrected by plasma exchange, and the correction of a high level of plasma inflammatory cytokine was considered to be one of the contributing factors for the improvement of HPS. These results suggest that therapeutic plasma exchange should be considered as a therapeutic tool for HPS refractory to conventional therapy.
Asunto(s)
Histiocitosis de Células no Langerhans/etiología , Histiocitosis de Células no Langerhans/terapia , Síndromes Mielodisplásicos/complicaciones , Plasmaféresis/métodos , Tuberculosis Pulmonar/complicaciones , Adolescente , Femenino , Estudios de Seguimiento , Histiocitosis de Células no Langerhans/diagnóstico , Humanos , Persona de Mediana Edad , Síndromes Mielodisplásicos/diagnóstico , Síndromes Mielodisplásicos/terapia , Recurrencia , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Tuberculosis Pulmonar/diagnósticoRESUMEN
WF14861, 3-(N-(1-(N-(4-aminobutyl)-N-(3-aminopropyl)carbamoyl)-2-(4-hydroxyphenyl )ethyl)carbamoyl)oxirane-2-carboxylic acid, was obtained from the culture mycelium of Colletotrichum sp. as a novel cathepsins B and L inhibitor. WF14861 also showed inhibitory activities against bone derived crude protease and other cysteine proteases in vitro. The compound ameliorated the tissue damage and the bone destruction models of low-calcium-diet-fed mouse and adjuvant arthritis rat model.
Asunto(s)
Catepsina B/antagonistas & inhibidores , Catepsinas/antagonistas & inhibidores , Colletotrichum/metabolismo , Inhibidores de Cisteína Proteinasa/farmacología , Endopeptidasas , Compuestos Epoxi/farmacología , Tirosina/análogos & derivados , Animales , Artritis Experimental/tratamiento farmacológico , Resorción Ósea/etiología , Resorción Ósea/prevención & control , Huesos/enzimología , Calcio de la Dieta/administración & dosificación , Catepsina L , Embrión de Pollo , Cisteína Endopeptidasas , Compuestos Epoxi/uso terapéutico , Femenino , Humanos , Ratones , Ratas , Ratas Endogámicas Lew , Tirosina/farmacología , Tirosina/uso terapéuticoRESUMEN
Specific protein-DNA interaction was studied quantitatively by using a highly sensitive 27-MHz quartz-crystal microbalance (QCM). Biotinylated DNA double strands (21 bp, having a CRE site of 5'ATGACGTCAT3') were immobilized on an avidin-bound QCM surface, and sequence-specific binding of bZIP 56-mer peptides (having both the basic region for binding and the leucine zipper region for dimerization) to the DNA strand on the QCM was observed. The binding amount (Deltam) at the nanogram level and kinetic parameters such as association constants (Ka) and binding and dissociation rate constants (k1 and k-1) could be obtained from time courses of QCM frequency decreases. A bZIP peptide as a dimer was observed to bind sequence-specifically to one DNA strand having a CRE site. Ka values of ss-bZIP, in which the leucine-zipper region of bZIP was substituted by a Cys-Cys linkage, were largely decreased, and the sequence selectivity also disappeared. Ka values obtained by the QCM method showed good agreement with those obtained from the conventional gel mobility shift assay or from circular dichroism spectrum changes. When the specific sequence of the CRE site of DNA strands was partly changed, Ka values decreased by about a half due to the increase of the dissociation rate constant (k-1) independent of the binding rate constant (k1).
Asunto(s)
ADN de Hongos/metabolismo , Proteínas de Unión al ADN/metabolismo , ADN/metabolismo , Proteínas Fúngicas/metabolismo , Péptidos/metabolismo , Proteínas Quinasas/metabolismo , Proteínas de Saccharomyces cerevisiae , Factores de Transcripción/metabolismo , Secuencia de Aminoácidos , Secuencia de Bases , Factores de Transcripción con Cremalleras de Leucina de Carácter Básico , Sitios de Unión , Técnicas Biosensibles , Dicroismo Circular , Proteína de Unión a Elemento de Respuesta al AMP Cíclico/genética , Proteína de Unión a Elemento de Respuesta al AMP Cíclico/metabolismo , Dimerización , Factores de Unión a la G-Box , Cinética , Microelectrodos , Datos de Secuencia Molecular , CuarzoRESUMEN
A highly sensitive 27-MHz quartz-crystal microbalance, on which a 10-30-mer oligonucleotide was immobilized as a probe molecule, was employed to detect hybridization of complementary oligonucleotides in aqueous solution. From frequency decreases (mass increases due to the hybridization) with passage of time, kinetic parameters such as association constants (K(a)) and binding and dissociation rate constants (k(1) and k(-1)) could be obtained, as well as binding (hybridization) amount at the nanogram level (delta m). Kinetic studies were carried out by changing various parameters: (i) the immobilization method of a probe oligonucleotide on Au electrode, (ii) number of mismatching bases in sequences of target oligonucleotides, (iii) length of both probe and target oligonucleotides, (iv) hybridization temperature, and (v) ionic strength in solution. The obtained results were compared with those obtained by a surface plasmon resonance method using a BIAcore system.
Asunto(s)
ADN/química , Hibridación de Ácido Nucleico/métodos , Oligonucleótidos/química , Avidina/química , Emparejamiento Base , Biotina/química , Cinética , Sondas de Oligonucleótidos/química , Concentración Osmolar , Cuarzo/química , TemperaturaRESUMEN
The immobilization of two 30-mer oligonucleotides, one biotinylated (biotin-DNA) and the other having a mercaptohexyl group at the 5'-phosphate end (BS1-SH), onto modified gold surfaces has been examined using a quartz crystal microbalance (QCM). Both single-layer and multilayer DNA films were prepared. The single-layer films of biotin-DNA were constructed by binding to a precursor layer of avidin, which had been attached to the QCM either covalently using a water-soluble carbodiimide hydrochloride (EDC) and N-hydroxysuccinimide (NHS) or via electrostatic interaction with poly(allylamine hydrochloride) (PAH). Single-layer films of BS1-SH were also formed on PAH via the electrostatic attraction between the amine groups on PAH and the negatively charged phosphate backbone of DNA. Multilayer films of DNA were fabricated by the successive deposition of avidin and poly(styrenesulfonate) (PSS), up to a total of nine avidin/PSS layers, followed by DNA adsorption. DNA immobilization and hybridization of the immobilized DNAs was monitored in situ from QCM frequency changes. Hybridization was induced by exposure of the DNA-containing films to complementary DNA in solution. Equal frequency changes were observed for the DNA immobilization and hybridization steps for the single-layer films, indicating a DNA probe-to-hybridized DNA target ratio of 1:1. The multilayer DNA films also exhibited DNA hybridization, with a greater quantity of DNA hybridized compared with the single-layer films. The multilayer films provide a novel means for the fabrication of DNA-based thin films with increased capacity for nucleic acid detection.
RESUMEN
The direct effects of recombinant human erythropoietin(rHuEPO) on coagulation and fibrinolysis factors were evaluated in a cultured endothelial cell (EC) system. Confluent quiescent ECs were incubated with or without 5.0 U/ml rHuEPO for 1, 6, and 18 hours, and supernatant concentrations of plasminogen activator inhibitor-1 (PAI-1): antigen (Ag), tissue plasminogen activator and thrombomodulin, and supernatant activities of tissue factor pathway inhibitor and von Willebrand factor were measured. The results showed that only PAI-1 levels were increased by the presence of rHuEPO. In order to assess the effect of rHuEPO on PAI-1 production by EC more precisely, confluent ECs were incubated with various doses of rHuEPO (0, 1.0, 2.5, 5.0, 10.0 U/ml) for 1, 6, 12, and 18 hours, and PAI-1:Ag concentrations in the supernatants of media were measured. PAI-1:Ag in the supernatants were increased by the presence of rHuEPO at all incubation times (P < 0.01) and the increase in PAI-1:Ag was dependent on rHuEPO concentration. The increases in PAI-1:Ag by 5.0 U/ml rHuEPO were comparable to those by 0.1 U/ml tumor necrosis factor-alpha, 1.0 microgram/ml lipopolysaccharide, and 0.5 U/ml thrombin. The increase in PAI-1:Ag by rHuEPO was suppressed by pre-incubation with 10 micrograms/ml cycloheximide (P < 0.01) or 0.2 microgram/ml actinomycin D (P < 0.01). These results indicate that rHuEPO directly stimulates PAI-1 production in cultured EC via de novo protein and RNA syntheses.
Asunto(s)
Endotelio Vascular/metabolismo , Eritropoyetina/farmacología , Inhibidor 1 de Activador Plasminogénico/biosíntesis , Células Cultivadas , Cicloheximida/farmacología , Dactinomicina/farmacología , Humanos , Proteínas RecombinantesRESUMEN
To clarify the incidence and contributing factors of hypoparathyroidism in a hemodialysis (HD) population, 224 patients undergoing maintenance HD were investigated. They were divided into 4 groups according to their high-sensitive parathyroid hormone levels: extra-high (EH) group > 420,000 pg/ml; high (H) group 20,000-420,000 pg/ml; moderate (M) group 4,500-20,000 pg/ml; low (L) group, < 4,500 pg/ml. In group L, a 25-mg/kg deferoxamine (DFO) infusion test was undertaken to estimate aluminum (Al) accumulation. The distribution in each group was 42, 35, 12, and 11% for groups L, M, H and EH, respectively. Group-L patients were relatively older than those of the other groups. Diabetes was seen in 20% of group-L patients, as opposed to no diabetes in groups H and EH. Among the 22 diabetics, 82% were in group L. 70% of group-L patients showed a less than 50-micrograms/l Al increment after the DFO infusion test. Bone mineral density (BMD) did not differ between the groups with relative hypoparathyroidism (RHP=L) and background-matched non-RHP, either at the initiation of HD or the recent period, and the changes in BMD were comparable between the 2 groups. These results suggest that a considerable number of HD patients show RHP. Diabetes, but not Al accumulation, was considered to be one of the predisposing factors of RHP. Though the outcome of RHP will be aplastic bone disease (ABD) in HD patients, the clinical significance of ABD has not been fully evaluated. Further studies are required to clarify the precise mechanisms of RHP and the significance of ABD.
Asunto(s)
Enfermedades Óseas Metabólicas/etiología , Hipoparatiroidismo/complicaciones , Diálisis Renal/efectos adversos , Adulto , Anciano , Densidad Ósea/fisiología , Estudios de Casos y Controles , Femenino , Humanos , Hipoparatiroidismo/epidemiología , Incidencia , Masculino , Persona de Mediana Edad , Factores de RiesgoRESUMEN
rhG-CSF (recombinant human granulocyte colony stimulating factor) promotes production and release of neutrophil from bone marrow, and it enhances neutrophil function. In this study, the pharmacokinetics, effects on neutrophil and immune functions and efficacy and safety of rhG-CSF were studied in patients with end-stage renal failure (CRF). To 9 patients with CRF; 2 patients on conservative therapy and 7 patients under regular hemodialysis, 50 micrograms/m2 rhG-CSF were administered intravenously under the schedule of single or 2 week consecutive injection. In single injection study, serial changes in plasma rhG-CSF concentration and peripheral blood cell count were examined following the administration. In consecutive injection study, plasma rhG-CSF concentration, anti-rhG-CSF antibody, peripheral blood cell counts, blood chemistry and coagulation factors, and neutrophil and immune functions were examined. As the results, 1) Half life of rhG-CSF, 2.87 +/- 0.65 hr, was about 2 times longer than that in healthy subjects, and it was not affected by hemodialysis treatment. 2) Marked increase in leukocyte and neutrophil counts and mild increase in lymphocyte count were observed during single and consecutive administration of rhG-CSF. There was no significant change in other leukocyte differentiations, RBC, or platelet count. 3) Neutrophil alkaline phosphatase score increased significantly during single and consecutive administration, and other neutrophil function also improved in several patients with impaired neutrophil function. 4) Slight bone pain and increase in serum alkaline phosphatase were observed in about a half of patients during consecutive injection study. Neither antibody nor accumulation of rhG-CSF was noted.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Factor Estimulante de Colonias de Granulocitos/uso terapéutico , Fallo Renal Crónico/complicaciones , Neutropenia/terapia , Adulto , Anciano , Femenino , Factor Estimulante de Colonias de Granulocitos/farmacocinética , Humanos , Masculino , Persona de Mediana Edad , Proteínas Recombinantes/farmacocinética , Proteínas Recombinantes/uso terapéuticoRESUMEN
To evaluate the effects of correction of anemia with recombinant human erythropoietin (r-HuEPO) on the hemostatic defects in uremia, hemostatic parameters were examined in 18 patients with renal anemia receiving hemodialysis (HD). During the study, hematocrit (Ht) increased from 22.9 +/- 3.1% (mean +/- SD) at pre-treatment (stage-I) to 31.0 +/- 3.0% 12 weeks after 3000 IU intravenous r-HuEPO administration at the end of every HD (stage-II), and decreased to 26.2 +/- 4.2% 6 weeks after r-HuEPO discontinuation (stage III). Platelet count did not change among these three stages, however, mean platelet volume significantly increased at stage II compared to stage I. Ivy bleeding time (Ivy-BT) significantly shortened at stage II (I; 14.3 +/- 6.0, II; 10.1 +/- 6.5 min, p less than 0.01), and prolonged again at stage III (p less than 0.05 vs stage II). Among the patients, 6 out of 18 patients did not show any reduction in Ivy-BT (unchanged group). Though there were no significant changes in platelet aggregation rates, plasma TxB2, 6-keto-PGF1 alpha, F. VIII: C, and F. VIII: Ag levels throughout the study, platelet adhesion rate was significantly improved at stage II (I; 11.8 +/- 6.8, II; 19.6 +/- 12.8%, p less than 0.05), and similar augmentation in vWf: Ag was observed. Improvement in these two parameters were more remarkable in shortened Ivy-BT group (n = 12) than in unchanged group.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Anemia/tratamiento farmacológico , Coagulación Sanguínea/efectos de los fármacos , Eritropoyetina/uso terapéutico , Agregación Plaquetaria/efectos de los fármacos , Diálisis Renal/efectos adversos , Adulto , Anciano , Anemia/sangre , Anemia/etiología , Recuento de Células Sanguíneas , Factores de Coagulación Sanguínea/metabolismo , Eritropoyetina/farmacología , Femenino , Humanos , Fallo Renal Crónico/complicaciones , Masculino , Persona de Mediana Edad , Proteínas Recombinantes/farmacología , Proteínas Recombinantes/uso terapéuticoRESUMEN
Extraction of teeth from the lower jaw often results in atrophy of the alveolar process and mandibular body, and sometimes the atrophy progresses so severely as to seriously affect the fitness of the denture, especially the full denture. If the alveolar ridge is markedly resorbed, patients are not satisfied, unless the alveolar process is surgically heightened and the fitness of the denture is regained. Plastic operation of the alveolar process by visor osteotomy and grafting of the iliac bone was performed on a 54-year-old woman who presented at our Department with a complaint of unfitness of the full denture because of marked atrophy of the mandibular alveolar process. As a result of this operation, a functionally well-fitting denture could be fitted to the satisfaction of this patient. This paper describes the outline of the surgical procedure.