Assuntos
Serviço Hospitalar de Cardiologia/organização & administração , Doenças Cardiovasculares/prevenção & controle , Promoção da Saúde/organização & administração , Adulto , Idoso , Serviço Hospitalar de Cardiologia/economia , Análise Custo-Benefício , Gerenciamento Clínico , Humanos , Programas de Assistência Gerenciada , Pessoa de Meia-Idade , Modelos Organizacionais , Avaliação de Resultados em Cuidados de Saúde , Medição de Risco , TexasAssuntos
Doenças Cardiovasculares/prevenção & controle , Promoção da Saúde/organização & administração , Serviços Preventivos de Saúde/organização & administração , Adulto , Idoso , Doenças Cardiovasculares/epidemiologia , Ensaios Clínicos como Assunto , Análise Custo-Benefício , Gerenciamento Clínico , Feminino , Promoção da Saúde/economia , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Cooperação do Paciente , Prevalência , Serviços Preventivos de Saúde/economia , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
The purpose of this study was to investigate the role of cytokines and growth factors in cardiac allograft rejection and vasculopathy (CAV). The polymerase chain reaction (PCR) was used to detect the expression of IL-1, IL-2, IL-4, IL-5, IL-6, TNF-alpha, IFN-gamma, TGF-beta, TCR-beta chain and aFGF genes in 21 myocardial biopsies obtained from 9 heart transplant patients. There was no statistically significant correlation between cytokine gene expression and rejection, although a trend toward increased IL-6 and TGF-beta expression was noted with rejection (6 of 10 biopsies with vs. 1 of 7 without rejection, and 4 of 9 biopsies with vs. none of 7 without rejection, respectively). IL-2 gene expression was detected in only 2 of 21 biopsies, both positive for rejection. IL-1, IL-4, IL-5, CD8, IFN-gamma, and TNF-alpha were not detected in any of the biopsies. TCR-beta chain mRNA was found in all biopsies, indicating the invariable presence of T cells regardless of histologic diagnosis of rejection. The aFGF gene was expressed in the majority (18 of 21) of biopsies, and its presence was not correlated with rejection. In addition to mRNA for the complete coding sequence of aFGF, two alternatively spliced mRNAs for aFGF were present in myocardial biopsies. Because aFGF and TCR beta genes were expressed in most biopsies, we determined whether aFGF mRNA was expressed in T cells; aFGF transcripts were found in 2 of 5 T-cell clones examined. Thus, aFGF mRNA in cardiac allografts may have been induced within the myocardium or elaborated by infiltrating T cells. The presence of mRNA for aFGF, a potent endothelial and smooth muscle cell mitogen, in allograft myocardium suggests that aFGF may play a role in the pathogenesis of CAV.
Assuntos
Citocinas/genética , Fator 1 de Crescimento de Fibroblastos/genética , Expressão Gênica , Transplante de Coração , Miocárdio/metabolismo , Linfócitos T/metabolismo , Processamento Alternativo , Sequência de Aminoácidos , Sequência de Bases , Fator 1 de Crescimento de Fibroblastos/fisiologia , Transplante de Coração/efeitos adversos , Humanos , Dados de Sequência Molecular , Transcrição Gênica , Transplante Homólogo , Doenças Vasculares/etiologiaRESUMO
The entire genomic RNA of clover yellow mosaic virus was sequenced from cDNA clones and run-off cDNA transcripts. The genomic RNA is 7015 nucleotides in length [excluding a 3' poly(A) tail], with six open reading frames (ORFs) greater than 150 nucleotides in length. The first five ORFs encode proteins of Mr 191K, 26K, 12K, 6.5K and 28K, respectively. The sixth ORF lies completely within ORF1 and codes for a protein of Mr 14K. The capsid protein coding region (Mr 23K) is found within ORF5 which encodes the Mr 28K protein. Proteins encoded by ORFs 1 to 3 and ORF5 show strong homology with proteins of other potexviruses, especially papaya mosaic virus.
