RESUMO
Glutamate transmission is an important mediator of the development of substance use disorders, particularly with regard to relapse. The present review summarizes the changes in glutamate levels in the reward system (the prefrontal cortex, nucleus accumbens, dorsal striatum, hippocampus, and ventral tegmental area) observed in preclinical studies at different stages of cocaine exposure and withdrawal as well as after reinstatement of cocaine-seeking behavior. We also summarize changes in the glutamate transporters xCT and GLT-1 and metabotropic glutamate receptors mGlu2/3, mGlu1, and mGlu5 based on preclinical and clinical studies with an emphasis on their role in cocaine-seeking. Glutamate transporters, such as GLT-1 and xc-, play a key role in maintaining glutamate homeostasis. In preclinical models, agents reversing cocaine-induced decreases in GLT-1 and xc- in the nucleus accumbens attenuate relapse. Very recent studies indicate that other mechanisms of action, such as reversing the mGlu2 receptor downregulation, contribute to these compounds' anti-relapse efficacy. In preclinical models, antagonism of mGlu5 receptors and stimulation of mGlu2/3 autoreceptors decrease relapse. Therefore, analysis of the above glutamatergic adaptations seems to be crucial because, so far, there are no prognostic biomarkers that can forecast relapse vulnerability in clinical practice, which would be helpful in alleviating or suppressing this phenomenon. Moreover, these receptor sites can be molecular targets for the development of effective medication for cocaine use disorder.
Assuntos
Sistema X-AG de Transporte de Aminoácidos , Transtornos Relacionados ao Uso de Cocaína , Receptores de Glutamato Metabotrópico , Sistema X-AG de Transporte de Aminoácidos/metabolismo , Transtornos Relacionados ao Uso de Cocaína/tratamento farmacológico , Transtornos Relacionados ao Uso de Cocaína/metabolismo , Ácido Glutâmico/metabolismo , Humanos , Receptores de Glutamato Metabotrópico/metabolismo , RecidivaRESUMO
Introduction: Primary cutaneous lymphomas are lymphoproliferative skin infiltrates of T-, B- or NK-cells, classified according to the World Health Organization - European Organization of the Research and Treatment of Cancer (WHO-EORTC) criteria. They are the second most common group of extranodal non-Hodgkin lymphomas, that present in the skin with no evidence of systemic involvement at the time of diagnosis. Aims: The aim of the study was the analysis of clinical profile of cutaneous lymphomas in the tertiary referral center in Poland. Material and Methods: We analyzed case records of 63 patients (26 women, 37 men aged 19 - 86) referred to the Department of Dermatology, University Hospital in Cracow for the diagnosis and treatment of cutaneous lymphoma. Results: After analysis of clinical and histological data, the final diagnoses were: mycosis fungoides (42 patients), primary cutaneous CD30+ lymphoproliferative disorder (7), Sezary syndrome (3), parapsoriasis (3), primary cutaneous B-cell lymphoma (1), acute myeloid leukemia (1), Hodgkin lymphoma coexistent with mycosis fungoides (1), generalized allergic contact dermatitis (2) and erythema elevatum diutinum (1). We excluded 2 patients due to incomplete data. The most common location of skin lesions was the lower limb (52.46%) and most common clinical presentation was raised erythematous lesion (26.23%). Pruritus was present in 45.9% of the patients and 39.3% had extracutaneous symptoms, with lymphadenopathy as the most common symptom. 37.7% of patients presented with mild eosinophilia and another 37.7% with mild monocytosis. Prior to referral to our center, general practitioners misdiagnosed the lymphomas commonly as: atopic and contact dermatitis, borreliosis, drug-induced exanthema. Conclusions: The diagnosis of cutaneous lymphoma is often delayed due to their indolent, often recurring course, non-specific symptoms and uncommon appearance. The cooperation of a clinician and pathologist is essential in the diagnostic process.
Assuntos
Hospitais Universitários , Linfoma/patologia , Neoplasias Cutâneas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Dermatologia , Feminino , Humanos , Linfoma/diagnóstico , Linfoma/epidemiologia , Linfoma de Células B/diagnóstico , Linfoma de Células B/epidemiologia , Linfoma de Células B/patologia , Masculino , Pessoa de Meia-Idade , Micose Fungoide/diagnóstico , Micose Fungoide/epidemiologia , Micose Fungoide/patologia , Parapsoríase/diagnóstico , Parapsoríase/epidemiologia , Parapsoríase/patologia , Polônia/epidemiologia , Síndrome de Sézary/diagnóstico , Síndrome de Sézary/epidemiologia , Síndrome de Sézary/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Adulto JovemRESUMO
INTRODUCTION: Superficial fungal infections are a major epidemiological issue with increasing prevalence. Mycological examination is crucial for proper diagnosis. The aim of this study was to determine the epidemiological and etiological factors of superficial fungal infections in Malopolska and the incidence of superficial fungal infections in relation to sex and age. MATERIALS AND METHODS: We analyzed 4608 results of mycological examinations taken from patients in 2010-2014 in Mycology Laboratory in Krakow. Materials were collected from affected areas: nails, skin of feet and hands, the smooth skin and hairy skin. The material was examined directly and cultured. RESULTS: Among 4608 collected materials culture was positive in 1765 cases. Dermatophytes were the most common isolates (865; 49%), followed by yeasts (702; 39.8%) and non-dermatophytic molds (161; 9.1%). There were 37 (2.1%) co-infections. Trichophyton rubrum (745; 86%) and Trichophyton mentagrophytes (90; 10%) were the most prevalent species among dermatophytes. Dermatophyte infections occurred significantly more frequent in males, whereas yeast and non-dermatophytic molds in females. CONCLUSIONS: The type, and change in etiological factors of fungal infections in patients is a reflection of social behavior modification and changes in the ecosystem of the region and may be an indication for the sanitary-epidemiological actions.