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1.
Genome Res ; 34(6): 967-978, 2024 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-39038849

RESUMEN

The human gut microbiota is of increasing interest, with metagenomics a key tool for analyzing bacterial diversity and functionality in health and disease. Despite increasing efforts to expand microbial gene catalogs and an increasing number of metagenome-assembled genomes, there have been few pan-metagenomic association studies and in-depth functional analyses across different geographies and diseases. Here, we explored 6014 human gut metagenome samples across 19 countries and 23 diseases by performing compositional, functional cluster, and integrative analyses. Using interpreted machine learning classification models and statistical methods, we identified Fusobacterium nucleatum and Anaerostipes hadrus with the highest frequencies, enriched and depleted, respectively, across different disease cohorts. Distinct functional distributions were observed in the gut microbiomes of both westernized and nonwesternized populations. These compositional and functional analyses are presented in the open-access Human Gut Microbiome Atlas, allowing for the exploration of the richness, disease, and regional signatures of the gut microbiota across different cohorts.


Asunto(s)
Microbioma Gastrointestinal , Metagenoma , Metagenómica , Humanos , Microbioma Gastrointestinal/genética , Metagenómica/métodos , Aprendizaje Automático , Fusobacterium nucleatum/genética , Bacterias/clasificación , Bacterias/genética
2.
Sci Rep ; 10(1): 14977, 2020 09 11.
Artículo en Inglés | MEDLINE | ID: mdl-32917913

RESUMEN

Gut mucosal microbes evolved closest to the host, developing specialized local communities. There is, however, insufficient knowledge of these communities as most studies have employed sequencing technologies to investigate faecal microbiota only. This work used shotgun metagenomics of mucosal biopsies to explore the microbial communities' compositions of terminal ileum and large intestine in 5 healthy individuals. Functional annotations and genome-scale metabolic modelling of selected species were then employed to identify local functional enrichments. While faecal metagenomics provided a good approximation of the average gut mucosal microbiome composition, mucosal biopsies allowed detecting the subtle variations of local microbial communities. Given their significant enrichment in the mucosal microbiota, we highlight the roles of Bacteroides species and describe the antimicrobial resistance biogeography along the intestine. We also detail which species, at which locations, are involved with the tryptophan/indole pathway, whose malfunctioning has been linked to pathologies including inflammatory bowel disease. Our study thus provides invaluable resources for investigating mechanisms connecting gut microbiota and host pathophysiology.


Asunto(s)
Bacteroides , Heces/microbiología , Microbioma Gastrointestinal , Íleon/microbiología , Mucosa Intestinal/microbiología , Intestino Grueso/microbiología , Bacteroides/clasificación , Bacteroides/genética , Bacteroides/metabolismo , Femenino , Humanos , Masculino
3.
Mol Cell Proteomics ; 19(4): 655-671, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32102971

RESUMEN

Protein phosphorylation cascades play a central role in the regulation of cell growth and protein kinases PKA, Sch9 and Ypk1 take center stage in regulating this process in S. cerevisiae To understand how these kinases co-ordinately regulate cellular functions we compared the phospho-proteome of exponentially growing cells without and with acute chemical inhibition of PKA, Sch9 and Ypk1. Sites hypo-phosphorylated upon PKA and Sch9 inhibition were preferentially located in RRxS/T-motifs suggesting that many are directly phosphorylated by these enzymes. Interestingly, when inhibiting Ypk1 we not only detected several hypo-phosphorylated sites in the previously reported RxRxxS/T-, but also in an RRxS/T-motif. Validation experiments revealed that neutral trehalase Nth1, a known PKA target, is additionally phosphorylated and activated downstream of Ypk1. Signaling through Ypk1 is therefore more closely related to PKA- and Sch9-signaling than previously appreciated and may perform functions previously only attributed to the latter kinases.


Asunto(s)
Proteínas Quinasas Dependientes de AMP Cíclico/metabolismo , Proteínas Serina-Treonina Quinasas/metabolismo , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/enzimología , Saccharomyces cerevisiae/genética , Secuencias de Aminoácidos , Secuencia de Aminoácidos , Secuencia de Consenso , Proteínas Quinasas Dependientes de AMP Cíclico/química , Fosforilación/efectos de los fármacos , Inhibidores de Proteínas Quinasas/farmacología , Proteínas Serina-Treonina Quinasas/química , Proteoma/metabolismo , Proteínas de Saccharomyces cerevisiae/química , Trehalasa/metabolismo
4.
Elife ; 82019 09 25.
Artículo en Inglés | MEDLINE | ID: mdl-31552825

RESUMEN

Quiescence is essential for the long-term maintenance of adult stem cells but how stem cells maintain quiescence is poorly understood. Here, we show that neural stem cells (NSCs) in the adult mouse hippocampus actively transcribe the pro-activation factor Ascl1 regardless of their activated or quiescent states. We found that the inhibitor of DNA binding protein Id4 is enriched in quiescent NSCs and that elimination of Id4 results in abnormal accumulation of Ascl1 protein and premature stem cell activation. Accordingly, Id4 and other Id proteins promote elimination of Ascl1 protein in NSC cultures. Id4 sequesters Ascl1 heterodimerization partner E47, promoting Ascl1 protein degradation and stem cell quiescence. Our results highlight the importance of non-transcriptional mechanisms for the maintenance of NSC quiescence and reveal a role for Id4 as a quiescence-inducing factor, in contrast with its role of promoting the proliferation of embryonic neural progenitors.


Asunto(s)
Células Madre Adultas/fisiología , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/metabolismo , Proliferación Celular , Hipocampo/citología , Proteínas Inhibidoras de la Diferenciación/metabolismo , Células-Madre Neurales/fisiología , Animales , Células Cultivadas , Ratones , Unión Proteica , Factor de Transcripción 3/metabolismo
5.
J Proteome Res ; 16(2): 831-841, 2017 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-27936760

RESUMEN

Advances in mass spectrometry have made the quantitative measurement of proteins across multiple samples a reality, allowing for the study of complex biological systems such as the metabolic syndrome. Although the deregulation of lipid metabolism and increased hepatic storage of triacylglycerides are known to play a part in the onset of the metabolic syndrome, its molecular basis and dependency on dietary and genotypic factors are poorly characterized. Here, we used an experimental design with two different mouse strains and dietary and metabolic perturbations to generate a compendium of quantitative proteome data using three mass spectrometric techniques. The data reproduce known properties of the metabolic system and indicate differential molecular adaptation of the two mouse strains to perturbations, contributing to a better understanding of the metabolic syndrome. We show that high-quality, high-throughput proteomic data sets provide an unbiased broad overview of the behavior of complex systems after perturbation.


Asunto(s)
Genotipo , Hepatocitos/metabolismo , Hígado/metabolismo , Síndrome Metabólico/metabolismo , Proteoma/aislamiento & purificación , Animales , Línea Celular , Dieta Alta en Grasa/efectos adversos , Modelos Animales de Enfermedad , Regulación de la Expresión Génica , Hepatocitos/patología , Marcaje Isotópico , Hígado/patología , Espectrometría de Masas/métodos , Redes y Vías Metabólicas/genética , Síndrome Metabólico/etiología , Síndrome Metabólico/genética , Síndrome Metabólico/patología , Ratones de la Cepa 129 , Ratones Endogámicos C57BL , Análisis de Componente Principal , Proteoma/genética , Proteoma/metabolismo , Triglicéridos/aislamiento & purificación , Triglicéridos/metabolismo
6.
J Biol Chem ; 290(24): 14963-78, 2015 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-25882841

RESUMEN

Target of rapamycin is a Ser/Thr kinase that operates in two conserved multiprotein complexes, TORC1 and TORC2. Unlike TORC1, TORC2 is insensitive to rapamycin, and its functional characterization is less advanced. Previous genetic studies demonstrated that TORC2 depletion leads to loss of actin polarization and loss of endocytosis. To determine how TORC2 regulates these readouts, we engineered a yeast strain in which TORC2 can be specifically and acutely inhibited by the imidazoquinoline NVP-BHS345. Kinetic analyses following inhibition of TORC2, supported with quantitative phosphoproteomics, revealed that TORC2 regulates these readouts via distinct pathways as follows: rapidly through direct protein phosphorylation cascades and slowly through indirect changes in the tensile properties of the plasma membrane. The rapid signaling events are mediated in large part through the phospholipid flippase kinases Fpk1 and Fpk2, whereas the slow signaling pathway involves increased plasma membrane tension resulting from a gradual depletion of sphingolipids. Additional hits in our phosphoproteomic screens highlight the intricate control TORC2 exerts over diverse aspects of eukaryote cell physiology.


Asunto(s)
Actinas/metabolismo , Endocitosis , Complejos Multiproteicos/fisiología , Saccharomyces cerevisiae/metabolismo , Serina-Treonina Quinasas TOR/fisiología , Proteínas Fúngicas/metabolismo , Diana Mecanicista del Complejo 2 de la Rapamicina , Fosforilación , Análisis de Componente Principal , Proteínas Quinasas/metabolismo , Proteómica , Proteínas de Saccharomyces cerevisiae/metabolismo , Transducción de Señal
7.
Integr Biol (Camb) ; 7(4): 412-22, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25734609

RESUMEN

Tight regulation of the MAP kinase Hog1 is crucial for survival under changing osmotic conditions. Interestingly, we found that Hog1 phosphorylates multiple upstream components, implying feedback regulation within the signaling cascade. Taking advantage of an unexpected link between glucose availability and Hog1 activity, we used quantitative single cell measurements and computational modeling to unravel feedback regulation operating in addition to the well-known adaptation feedback triggered by glycerol accumulation. Indeed, we found that Hog1 phosphorylates its activating kinase Ssk2 on several sites, and cells expressing a non-phosphorylatable Ssk2 mutant are partially defective for feedback regulation and proper control of basal Hog1 activity. Together, our data suggest that Hog1 activity is controlled by intertwined regulatory mechanisms operating with varying kinetics, which together tune the Hog1 response to balance basal Hog1 activity and its steady-state level after adaptation to high osmolarity.


Asunto(s)
Retroalimentación Fisiológica/fisiología , Glucosa/metabolismo , Sistema de Señalización de MAP Quinasas/fisiología , Proteínas Quinasas Activadas por Mitógenos/metabolismo , Osmorregulación/fisiología , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/fisiología , Simulación por Computador , Modelos Biológicos , Presión Osmótica/fisiología
8.
Mol Syst Biol ; 10: 767, 2014 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-25492886

RESUMEN

Cells respond to environmental stimuli via specialized signaling pathways. Concurrent stimuli trigger multiple pathways that integrate information, predominantly via protein phosphorylation. Budding yeast responds to NaCl and pheromone via two mitogen-activated protein kinase cascades, the high osmolarity, and the mating pathways, respectively. To investigate signal integration between these pathways, we quantified the time-resolved phosphorylation site dynamics after pathway co-stimulation. Using shotgun mass spectrometry, we quantified 2,536 phosphopeptides across 36 conditions. Our data indicate that NaCl and pheromone affect phosphorylation events within both pathways, which thus affect each other at more levels than anticipated, allowing for information exchange and signal integration. We observed a pheromone-induced down-regulation of Hog1 phosphorylation due to Gpd1, Ste20, Ptp2, Pbs2, and Ptc1. Distinct Ste20 and Pbs2 phosphosites responded differently to the two stimuli, suggesting these proteins as key mediators of the information exchange. A set of logic models was then used to assess the role of measured phosphopeptides in the crosstalk. Our results show that the integration of the response to different stimuli requires complex interconnections between signaling pathways.


Asunto(s)
Feromonas/metabolismo , Proteoma/metabolismo , Saccharomyces cerevisiae/genética , Transducción de Señal , Regulación hacia Abajo , Proteínas Quinasas Activadas por Mitógenos/genética , Proteínas Quinasas Activadas por Mitógenos/metabolismo , Modelos Teóricos , Concentración Osmolar , Fosforilación , Proteínas de Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/metabolismo , Cloruro de Sodio/metabolismo
9.
Sci Signal ; 7(333): ra64, 2014 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-25005228

RESUMEN

Stresses, such as glucose depletion, activate Snf1, the Saccharomyces cerevisiae ortholog of adenosine monophosphate-activated protein kinase (AMPK), enabling adaptive cellular responses. In addition to affecting transcription, Snf1 may also promote mRNA stability in a gene-specific manner. To understand Snf1-mediated signaling, we used quantitative mass spectrometry to identify proteins that were phosphorylated in a Snf1-dependent manner. We identified 210 Snf1-dependent phosphopeptides in 145 proteins. Thirteen of these proteins are involved in mRNA metabolism. Of these, we found that Ccr4 (the major cytoplasmic deadenylase), Dhh1 (an RNA helicase), and Xrn1 (an exoribonuclease) were required for the glucose-induced decay of Snf1-dependent mRNAs that were activated by glucose depletion. Unexpectedly, deletion of XRN1 reduced the accumulation of Snf1-dependent transcripts that were synthesized during glucose depletion. Deletion of SNF1 rescued the synthetic lethality of simultaneous deletion of XRN1 and REG1, which encodes a regulatory subunit of a phosphatase that inhibits Snf1. Mutation of three Snf1-dependent phosphorylation sites in Xrn1 reduced glucose-induced mRNA decay. Thus, Xrn1 is required for Snf1-dependent mRNA homeostasis in response to nutrient availability.


Asunto(s)
Fosfoproteínas/metabolismo , Proteínas Serina-Treonina Quinasas/metabolismo , Estabilidad del ARN/fisiología , ARN de Hongos/metabolismo , ARN Mensajero/metabolismo , Saccharomyces cerevisiae/metabolismo , Transducción de Señal/fisiología , Exorribonucleasas/genética , Exorribonucleasas/metabolismo , Fosfoproteínas/genética , Proteína Fosfatasa 1/genética , Proteína Fosfatasa 1/metabolismo , Proteínas Serina-Treonina Quinasas/genética , Proteómica , ARN de Hongos/genética , ARN Mensajero/genética , Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/metabolismo
10.
Cell Rep ; 3(1): 16-22, 2013 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-23273919

RESUMEN

The TORC1 and PKA protein kinases are central elements of signaling networks that regulate eukaryotic cell proliferation in response to growth factors and/or nutrients. In yeast, attenuation of signaling by these kinases following nitrogen and/or carbon limitation activates the protein kinase Rim15, which orchestrates the initiation of a reversible cellular quiescence program to ensure normal chronological life span. The molecular elements linking Rim15 to distal readouts including the expression of Msn2/4- and Gis1-dependent genes involve the endosulfines Igo1/2. Here, we show that Rim15, analogous to the greatwall kinase in Xenopus, phosphorylates endosulfines to directly inhibit the Cdc55-protein phosphatase 2A (PP2A(Cdc55)). Inhibition of PP2A(Cdc55) preserves Gis1 in a phosphorylated state and consequently promotes its recruitment to and activation of transcription from promoters of specific nutrient-regulated genes. These results close a gap in our perception of and delineate a role for PP2A(Cdc55) in TORC1-/PKA-mediated regulation of quiescence and chronological life span.


Asunto(s)
Péptidos/metabolismo , Proteína Fosfatasa 2/metabolismo , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/enzimología , Saccharomyces cerevisiae/crecimiento & desarrollo , Secuencia de Aminoácidos , Péptidos y Proteínas de Señalización Intercelular , Datos de Secuencia Molecular , Fosforilación/efectos de los fármacos , Regiones Promotoras Genéticas/genética , Unión Proteica/efectos de los fármacos , Proteína Fosfatasa 2/antagonistas & inhibidores , Proteómica , Saccharomyces cerevisiae/citología , Proteínas de Saccharomyces cerevisiae/química , Sirolimus/farmacología , Coloración y Etiquetado
11.
J Magn Reson Imaging ; 35(5): 1145-51, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22128094

RESUMEN

PURPOSE: To evaluate the mid-term effects of implant of dynamic neutralization system (Dynesys) on disc tissue in patients with lumbar discopathy, through the quantification of glycosaminoglycans (GAG) concentration, both in treated and adjacent levels, by analysis of delayed gadolinium-enhanced MRI contrast (dGEMRIC) images. MATERIALS AND METHODS: Ten patients with low back pain underwent the dGEMRIC diagnostic protocol before, 6-months and after 2 years from surgery. Each patient was also evaluated with visual analog (VAS), Oswestry, and Prolo scales both at presurgery and during follow-up. From dGEMRIC images, a ΔT1 parametric map was obtained for each disc, as quantitative indicator of its GAG concentration, and divided in 13 sectors, which were classified at presurgery as normal or abnormal, based on a 70-ms threshold. Evolution of ΔT1 was studied during the follow-up. RESULTS: Nine of ten patients completed the follow-up. VAS, Oswestry, and Prolo grades showed an improvement. This was accompanied by a reduction of ΔT1 in abnormal segments while normal segments showed a pattern of initial worsening at 6 months, followed by an improvement after 2 years. CONCLUSION: Our study confirmed the improvement in clinical evaluation, and for the first time related this to the changes in discs GAG concentration.


Asunto(s)
Degeneración del Disco Intervertebral/cirugía , Desplazamiento del Disco Intervertebral/cirugía , Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/cirugía , Vértebras Lumbares/cirugía , Imagen por Resonancia Magnética/métodos , Prótesis e Implantes , Adulto , Medios de Contraste , Evaluación de la Discapacidad , Femenino , Gadolinio DTPA , Glicosaminoglicanos/metabolismo , Humanos , Degeneración del Disco Intervertebral/metabolismo , Degeneración del Disco Intervertebral/patología , Desplazamiento del Disco Intervertebral/metabolismo , Desplazamiento del Disco Intervertebral/patología , Vértebras Lumbares/patología , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Complicaciones Posoperatorias , Estadísticas no Paramétricas , Estrés Mecánico , Factores de Tiempo , Resultado del Tratamiento
12.
Mol Syst Biol ; 7: 545, 2011 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-22068328

RESUMEN

Nutrient sensing and coordination of metabolic pathways are crucial functions for all living cells, but details of the coordination under different environmental conditions remain elusive. We therefore undertook a systems biology approach to investigate the interactions between the Snf1 and the target of rapamycin complex 1 (TORC1) in Saccharomyces cerevisiae. We show that Snf1 regulates a much broader range of biological processes compared with TORC1 under both glucose- and ammonium-limited conditions. We also find that Snf1 has a role in upregulating the NADP(+)-dependent glutamate dehydrogenase (encoded by GDH3) under derepressing condition, and therefore may also have a role in ammonium assimilation and amino-acid biosynthesis, which can be considered as a convergence of Snf1 and TORC1 pathways. In addition to the accepted role of Snf1 in regulating fatty acid (FA) metabolism, we show that TORC1 also regulates FA metabolism, likely through modulating the peroxisome and ß-oxidation. Finally, we conclude that direct interactions between Snf1 and TORC1 pathways are unlikely under nutrient-limited conditions and propose that TORC1 is repressed in a manner that is independent of Snf1.


Asunto(s)
Proteínas Serina-Treonina Quinasas/metabolismo , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/metabolismo , Factores de Transcripción/metabolismo , Aminoácidos/biosíntesis , Ácidos Grasos/metabolismo , Regulación Fúngica de la Expresión Génica , Glutamato Deshidrogenasa/biosíntesis , Proteínas Serina-Treonina Quinasas/genética , Saccharomyces cerevisiae/citología , Proteínas de Saccharomyces cerevisiae/genética , Sirolimus/metabolismo , Biología de Sistemas/métodos , Factores de Transcripción/genética , Transcriptoma
13.
Cardiovasc Res ; 85(3): 503-13, 2010 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-19797426

RESUMEN

AIMS: The assessment of progenitor cell survival and efficacy after transplantation is one of the major challenges in cardiovascular cell therapy. Translation of currently used imaging techniques to patients is not immediate. Possible options include iron oxide particle loading into cells to be tracked using magnetic resonance (MR) and by MR-based water diffusion anisotropy analysis. The aim of the present study was to assess, using these techniques, the localization and survival of human 'early' endothelial progenitor cells (EPCs) and their effects on vascular and skeletal muscle regeneration in a mouse model of hind limb ischaemia. METHODS AND RESULTS: A paramagnetic iron oxide particle loading protocol of human peripheral blood-derived early EPCs was devised. The iron+ EPCs maintained their phenotype and in vitro functional activity. In addition, the presence of iron+ cells was observed by MR until 7 days after injection into a pharmacologically immunosuppressed mouse model of hind limb ischaemia. Immunohistochemistry with human major histocompatibility complex antibodies revealed the absence of human cells at 7 days post-ischaemia. EPC death was confirmed by staining of iron+ cells with an anti-mouse CD68 antibody and by qPCR performed on DNA extracted from injected ischaemic limbs, at different times following injection. Surprisingly, early EPC injection enhanced arteriogenesis but caused a significant increase in ischaemic tissue inflammation and a retarded muscle regeneration, as evidenced by water diffusion anisotropy analysis and histology. CONCLUSION: In line with recent reports, our results show that the use of iron-based contrast agents does not allow detection of long-term EPC engraftment into ischaemic tissues. They further show that early EPCs exert a potent arteriogenic effect on ischaemic tissues that is not dependent on their prolonged survival. Unexpectedly, injection of these cells elicited a long-term inflammatory response that reflected a delayed muscle healing process.


Asunto(s)
Células Endoteliales/citología , Isquemia/terapia , Imagen por Resonancia Magnética/métodos , Músculos/fisiología , Neovascularización Fisiológica , Regeneración , Trasplante de Células Madre , Animales , Células Cultivadas , Compuestos Férricos , Miembro Posterior/irrigación sanguínea , Humanos , Inflamación/etiología , Masculino , Ratones
14.
J Magn Reson Imaging ; 29(6): 1443-9, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19472420

RESUMEN

PURPOSE: To evaluate the effects of reducing the number of segments in which the intervertebral disc (IVD) can be subdivided on the accuracy in estimating its sGAG content by computation of the parameter DeltaT1 from delayed Gadolinium-Enhanced MRI of Cartilage (dGEMRIC) protocol. MATERIALS AND METHODS: Twenty-three herniectomy patients underwent dGEMRIC acquisitions for IVD. Thirty-one tissue samples were obtained at herniectomy from the same patients and biochemically analysed for their sGAG content. Eleven different division schemes (DS) were applied by processing dGEMRIC images, and DeltaT1 values of the segments related to the surgical sampling locations were computed and correlated to the corresponding biochemical data. For each DS, the linear regression and Pearson's coefficient were computed. RESULTS: Reducing the number of segments from 48 (4 annular rings and 12 angular sectors) to 12 (2 rings and 6 sectors), correlation with sGAG biochemical data did not decline (r > 0.7). CONCLUSION: A 12-segment DS provided the best compromise between preserving accuracy and reducing the number of segments.


Asunto(s)
Desplazamiento del Disco Intervertebral/patología , Disco Intervertebral/patología , Imagen por Resonancia Magnética/métodos , Medios de Contraste/administración & dosificación , Gadolinio DTPA/administración & dosificación , Humanos , Aumento de la Imagen/métodos , Procesamiento de Imagen Asistido por Computador/métodos , Modelos Lineales
15.
Eur Spine J ; 18 Suppl 1: 40-8, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19396475

RESUMEN

The dynamic stabilization of lumbar spine is a non-fusion stabilization system that unloads the disc without the complete loss of motion at the treated motion segment. Clinical outcomes are promising but still not definitive, and the long-term effect on instrumented and adjacent levels is still a matter of discussion. Several experiments have been devised in order to gain a better understanding of the effect of the device on the intervertebral disc. One of the hypotheses was that while instrumented levels are partially relieved from loading, adjacent levels suffer from the increased stress. But this has not been proved yet. The aim of this study was to investigate the long-term effect of dynamic stabilization in vivo, through the quantification of glycosaminoglycans (GAG) concentration within instrumented and adjacent levels by means of the delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) protocol. Ten patients with low back pain, unresponsive to conservative treatment and scheduled for Dynesys implantation at one to three lumbar spine levels, underwent the dGEMRIC protocol to quantify GAG concentration before and 6 months after surgery. Each patient was also evaluated with visual analog scale (VAS), Oswestry, Prolo, Modic and Pfirrmann scales, both at pre-surgery and at follow-up. Six months after implantation, VAS, Prolo and Oswestry scales had improved in all patients. Pfirrmann scale could not detect any change, while dGEMRIC data already showed a general improvement in the instrumented levels: GAG was increased in 61% of the instrumented levels, while 68% of the non-instrumented levels showed a decrease in GAG, mainly in the posterior disc portion. In particular, seriously GAG-depleted discs seemed to have the greatest benefit from the Dynesys implantation, whereas less degenerated discs underwent a GAG depletion. dGEMRIC was able to visualize changes in both instrumented and non-instrumented levels. Our results suggest that the dynamic stabilization of lumbar spine is able to stop and partially reverse the disc degeneration, especially in seriously degenerated discs, while incrementing the stress on the adjacent levels, where it induces a matrix suffering and an early degeneration.


Asunto(s)
Glicosaminoglicanos/metabolismo , Desplazamiento del Disco Intervertebral/metabolismo , Desplazamiento del Disco Intervertebral/cirugía , Disco Intervertebral/metabolismo , Vértebras Lumbares/cirugía , Imagen por Resonancia Magnética/métodos , Adulto , Medios de Contraste , Diseño de Equipo/métodos , Matriz Extracelular/química , Matriz Extracelular/metabolismo , Femenino , Fibrocartílago/anatomía & histología , Fibrocartílago/metabolismo , Glicosaminoglicanos/análisis , Humanos , Disco Intervertebral/anatomía & histología , Desplazamiento del Disco Intervertebral/patología , Inestabilidad de la Articulación/patología , Inestabilidad de la Articulación/cirugía , Vértebras Lumbares/patología , Vértebras Lumbares/fisiopatología , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud/métodos , Dimensión del Dolor , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/prevención & control , Valor Predictivo de las Pruebas , Cuidados Preoperatorios/métodos , Estudios Prospectivos , Prótesis e Implantes/tendencias , Diseño de Prótesis/métodos , Falla de Prótesis , Fusión Vertebral/instrumentación , Fusión Vertebral/métodos , Estrés Mecánico , Tiempo , Resultado del Tratamiento , Soporte de Peso/fisiología
16.
Magn Reson Med ; 59(1): 85-95, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18050346

RESUMEN

Our hypothesis was that the enhanced MRI of cartilage (dGEMRIC) imaging protocol could be used in patients to quantify the sulfated glycosaminoglycan (sGAG) in intervertebral discs (IVD). To test this hypothesis, 23 patients with degenerative disc pathology scheduled for surgery were studied by a specific dGEMRIC protocol: each patient underwent two MRI scans, before and 3.5 hr after Gd(DTPA)2-injection of a nonconventional dose of 40 mL. Then, T(1PRE-ENH) and T(1POST-ENH) parametric images of the disc were obtained, from which a new index DeltaT(1) of the molecular status of the IVD was computed (T(1PRE-ENH) - T(1POST-ENH)). A total of 31 tissue samples (one or two from each patient) obtained at herniectomy were collected and biochemically analyzed for sGAG content and used as the gold standard for comparison. DeltaT(1) values in correspondence to degenerated sectors were higher (158 +/- 36 ms) compared to normal sectors (80 +/- 13 ms). Linear regression analysis between MRI-derived and biochemistry-derived measurements resulted in a significant correlation (r = 0.73, P < 0.0001). The DeltaT(1) parametric images, calculated using the modified dGEMRIC technique, provided noninvasive quantitative information about sGAG content within discal tissue in vivo, which resulted in agreement with biochemical analysis. The application of this new MRI method could provide diagnostic information for standard treatment of lumbar discopathy and for innovative therapies of regenerative medicine.


Asunto(s)
Cartílago Articular/metabolismo , Gadolinio DTPA , Glicosaminoglicanos/metabolismo , Desplazamiento del Disco Intervertebral/metabolismo , Imagen por Resonancia Magnética/métodos , Adolescente , Adulto , Cartílago Articular/patología , Medios de Contraste , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Desplazamiento del Disco Intervertebral/patología , Modelos Lineales , Vértebras Lumbares , Masculino
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