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1.
ACS Omega ; 9(23): 24477-24488, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38882095

RESUMO

Iron oxide nanoparticles (NPs) are nontoxic and abundant materials which have long been investigated as reusable catalysts in oxidation reactions, but their use so far has been hampered by a low selectivity. Here, unsupported iron oxide NPs have been found to successfully catalyze the microwave-assisted oxidation of primary and secondary alcohols to their respective aldehydes and ketones with a high selectivity when N-methylmorpholine N-oxide was used as the terminal oxidant. The crystalline phase and size of the iron-based catalyst have a drastic effect on its activity, with small magnetite (Fe3O4) NPs being the optimal catalyst for this reaction. The nanocatalyst could be easily recovered by magnetoseparation and successfully recycled four times without any need for special pretreatment or reactivation step and with a minimal loss of activity. The subsequent loss of activity was attributed to the transition from magnetite (Fe3O4) to maghemite (γ-Fe2O3), as confirmed by X-ray diffraction, Fourier transform infrared, and X-ray absorption near-edge spectroscopy. The nanocatalyst could then be reactivated by the high-temperature microwave treatment and used again for the microwave-assisted oxidation reaction.

3.
Brain Nerve ; 76(5): 473-479, 2024 May.
Artigo em Japonês | MEDLINE | ID: mdl-38741485

RESUMO

Neuropathological findings rarely lead to a definitive diagnosis of autoimmune and inflammatory peripheral nerve diseases, and indications for invasive nerve biopsy with subsequent disability should be carefully determined. In addition to disease-specific pathological findings, identifying findings that facilitate differential diagnosis in clinical practice is necessary. This article reviews the neuropathological findings that are valuable in the differential diagnosis of autoimmune and inflammatory peripheral nerve diseases.


Assuntos
Doenças do Sistema Nervoso Periférico , Humanos , Doenças do Sistema Nervoso Periférico/diagnóstico , Doenças do Sistema Nervoso Periférico/patologia , Diagnóstico Diferencial , Biópsia , Neuropatologia
4.
J Neurosurg ; : 1-9, 2024 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-38788234

RESUMO

OBJECTIVE: The purpose of this study was to understand the anatomical and functional connections between the paracentral lobule (PCL) and the primary motor cortex (M1) of the human brain. METHODS: This retrospective study included 16 patients who underwent resection of lesions located near M1. Nine patients had lesions in the dominant hemisphere. Tractography was performed to visualize the connectivity between two regions of interest (ROIs)-the convexity and the interhemispheric fissure-that were shown by functional MRI to be activated during a finger tapping task. The number, mean length, and fractional anisotropy (FA) of the fibers between the ROIs were estimated. During surgery, subdural electrodes were placed on the brain surface, including the ROIs, using a navigation system. Cortico-cortical evoked potentials (CCEPs) were evoked by applying electrical stimuli to the hand region of M1 using electrodes placed on the convexity and were measured with electrodes placed on the interhemispheric fissure. To verify CCEP bidirectionality, electrical stimuli were applied to electrodes on the interhemispheric fissure that showed CCEP responses. Correlations of CCEP amplitudes and latencies with the number, mean length, and mean FA value obtained from tractography were determined. The correlations between these parameters and perioperative motor functions were also analyzed. RESULTS: Fibers of 14 patients were visualized by diffusion tensor imaging (DTI). Unidirectional CCEPs between the PCL and M1 were measurable in all 16 patients, and bidirectional CCEPs between them were measurable in 14 patients. There was no significant difference between the two directions in the maximum CCEP amplitude or latency (amplitude, p = 0.391; latency, p = 0.583). Neither the amplitude nor latency showed any apparent correlation with the number, mean length, or mean FA value of the fibers obtained from tractography. Pre- and postoperative motor function of the hands was not significantly correlated with CCEP amplitude or latency. The number and mean FA value of fibers obtained by DTI, as well as the maximum CCEP amplitude, varied between patients. CONCLUSIONS: This study demonstrated an anatomical connection and a bidirectional functional connection between the PCL, including the supplementary motor area, and M1 of the human brain. The observed variability between patients suggests possible motor function plasticity. These findings may serve as a foundation for further studies.

5.
Crit Care Explor ; 6(6): e1096, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38787296

RESUMO

OBJECTIVES: Measurement of blood pressure taken from different anatomical sites, are often perceived as interchangeable, despite them representing different parts of the systemic circulation. We aimed to perform a systematic review and meta-analysis on blood pressure differences between central and peripheral arterial cannulation in critically ill patients. DATA SOURCES: We searched MEDLINE, Cochrane Central Register of Controlled Trials, and Embase from inception to December 26, 2023, using Medical Subject Headings (MeSH) terms and keywords. STUDY SELECTION: Observation study of adult patients in ICUs and operating rooms who underwent simultaneous central (femoral, axillary, or subclavian artery) and peripheral (radial, brachial, or dorsalis pedis artery) arterial catheter placement in ICUs and operating rooms. DATA EXTRACTION: We screened and extracted studies independently and in duplicate. We assessed risk of bias using the revised Quality Assessment for Studies of Diagnostic Accuracy tool. DATA SYNTHESIS: Twenty-four studies that enrolled 1598 patients in total were included. Central pressures (mean arterial pressure [MAP] and systolic blood pressure [SBP]) were found to be significantly higher than their peripheral counterparts, with mean gradients of 3.5 and 8.0 mm Hg, respectively. However, there was no statistically significant difference in central or peripheral diastolic blood pressure (DBP). Subgroup analysis further highlighted a higher MAP gradient during the on-cardiopulmonary bypass stage of cardiac surgery, reperfusion stage of liver transplant, and in nonsurgical critically ill patients. SBP or DBP gradient did not demonstrate any subgroup specific changes. CONCLUSIONS: SBP and MAP obtained by central arterial cannulation were higher than peripheral arterial cannulation; however, clinical implication of a difference of 8.0 mm Hg in SBP and 3.5 mm Hg in MAP remains unclear. Our current clinical practices preferring peripheral arterial lines need not change.


Assuntos
Pressão Arterial , Cateterismo Periférico , Estado Terminal , Humanos , Pressão Arterial/fisiologia , Determinação da Pressão Arterial/métodos , Pressão Sanguínea/fisiologia , Unidades de Terapia Intensiva
6.
Commun Biol ; 7(1): 664, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38811802

RESUMO

Two mammalian homologs of systemic RNA interference defective protein 1 (SID-1) (SIDT1/2) are suggested to function as double-stranded RNA (dsRNA) transporters for extracellular dsRNA uptake or for release of incorporated dsRNA from lysosome to cytoplasm. SIDT1/2 is also suggested to be involved in cholesterol transport and lipid metabolism. Here, we determine the cryo-electron microscopy structures of human SIDT1, homodimer in a side-by-side arrangement, with two distinct conformations, the cholesterol-bound form and the unbound form. Our structures reveal that the membrane-spanning region of SIDT1 harbors conserved histidine and aspartate residues coordinating to putative zinc ion, in a structurally similar manner to alkaline ceramidases or adiponectin receptors that require zinc for ceramidase activity. We identify that SIDT1 has a ceramidase activity that is attenuated by cholesterol binding. Observations from two structures suggest that cholesterol molecules serve as allosteric regulator that binds the transmembrane region of SIDT1 and induces the conformation change and the reorientation of the catalytic residues. This study represents a contribution to the elucidation of the cholesterol-mediated mechanisms of lipid hydrolytic activity and RNA transport in the SID-1 family proteins.


Assuntos
Colesterol , Microscopia Crioeletrônica , Humanos , Colesterol/metabolismo , Hidrólise , Metabolismo dos Lipídeos , Modelos Moleculares , Ligação Proteica , Conformação Proteica
7.
Heart ; 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38589224

RESUMO

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is often concomitant with sleep-disordered breathing (SDB), which can cause adverse cardiovascular events. Although an appropriate approach to SDB prevents cardiac remodelling, detection of concomitant SDB in patients with HCM remains suboptimal. Thus, we aimed to develop a machine learning-based discriminant model for SDB in HCM. METHODS: In the present multicentre study, we consecutively registered patients with HCM and performed nocturnal oximetry. The outcome was a high Oxygen Desaturation Index (ODI), defined as 3% ODI >10, which significantly correlated with the presence of moderate or severe SDB. We randomly divided the whole participants into a training set (80%) and a test set (20%). With data from the training set, we developed a random forest discriminant model for high ODI based on clinical parameters. We tested the ability of the discriminant model on the test set and compared it with a previous logistic regression model for distinguishing SDB in patients with HCM. RESULTS: Among 369 patients with HCM, 228 (61.8%) had high ODI. In the test set, the area under the receiver operating characteristic curve of the discriminant model was 0.86 (95% CI 0.77 to 0.94). The sensitivity was 0.91 (95% CI 0.79 to 0.98) and specificity was 0.68 (95% CI 0.48 to 0.84). When the test set was divided into low-probability and high-probability groups, the high-probability group had a higher prevalence of high ODI than the low-probability group (82.4% vs 17.4%, OR 20.9 (95% CI 5.3 to 105.8), Fisher's exact test p<0.001). The discriminant model significantly outperformed the previous logistic regression model (DeLong test p=0.03). CONCLUSIONS: Our study serves as the first to develop a machine learning-based discriminant model for the concomitance of SDB in patients with HCM. The discriminant model may facilitate cost-effective screening tests and treatments for SDB in the population with HCM.

8.
Angew Chem Int Ed Engl ; 63(20): e202401411, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38500479

RESUMO

A succinct synthetic approach to mugineic acids and 2'-hydroxynicotianamine was established. Unlike all other synthetic methods, this approach utilized epoxide ring-opening reactions to form two C-N bonds and is characterized by the absence of redox reactions. Mugineic acid was synthesized from three readily available fragments on a gram scale in 6 steps. The protected 2'-hydroxynicotianamine was also synthesized in 4 steps, and the dansyl group, serving as a fluorophore, was introduced through a click reaction after propargylation of the 2'-hydroxy group. The dansyl-labeled nicotianamine (NA) iron complexes were internalized by oocytes overexpressing ZmYS1 (from maize) or PAT1 (from human) transporters, indicating successful transport of the synthesized NA-probe through these transporters.


Assuntos
Ácido Azetidinocarboxílico/análogos & derivados , Compostos de Epóxi , Compostos de Epóxi/química , Compostos de Epóxi/metabolismo , Humanos , Estrutura Molecular , Ácido Azetidinocarboxílico/metabolismo , Ácido Azetidinocarboxílico/química
9.
Adv Exp Med Biol ; 1444: 97-108, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38467975

RESUMO

Nucleic acid (NA)-sensing Toll-like receptors (TLRs) reside in the endosomal compartment of innate immune cells, such as macrophages and dendritic cells. NAs transported to the endosomal compartment are degraded by DNases and RNases. Degradation products, including single-stranded DNA, oligoRNA, and nucleosides, are recognized by TLR7, TLR8, and TLR9 to drive the defense responses against pathogens. NA degradation influences endosomal TLR responses by generating and degrading TLR ligands. TLR ligand accumulation because of impaired NA degradation causes constitutive TLR activation, leading to autoinflammatory and autoimmune diseases. Furthermore, some genes associated with these diseases promote endosomal TLR responses. Therefore, endosomal TLRs are promising therapeutic targets for TLR-mediated inflammatory diseases, and novel drugs targeting TLRs are being developed.


Assuntos
Doenças Autoimunes , Ácidos Nucleicos , Humanos , Receptores Toll-Like , Doenças Autoimunes/tratamento farmacológico , Ácidos Nucleicos/metabolismo , Macrófagos/metabolismo
10.
ACS Nano ; 2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38316049

RESUMO

Lead halide perovskite nanocrystals (NCs) have attracted much attention as light-source materials for light-emitting diodes, lasers, and quantum light emitters. The luminescence properties of perovskite NCs and the performance of NC-based light-source devices depend on trion and biexciton dynamics. Here, we examined the size dependence of trion and biexciton binding energies by conducting low-temperature single-dot spectroscopy on three different perovskite NCs: CsPbBr3, CsPbI3, and FAPbBr3. While the photoluminescence spectral widths of the all-inorganic CsPbBr3 and CsPbI3 NCs were narrow, compared with those of the organic-inorganic hybrid FAPbBr3 NCs, the binding energies of trions and biexcitons of all three samples showed similar size dependences, independent of the A-site cation and halogen. The effective-mass approximation calculations implied the importance of dynamical dielectric screening on the formation of trions and biexcitons.

11.
J Crit Care ; 81: 154532, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38330737

RESUMO

PURPOSE: Our understanding of hemodynamics in cirrhotic patients with sepsis remains limited. Our study aims to investigate differences in hemodynamic profiles using echocardiography between septic patients with and without cirrhosis. MATERIALS AND METHODS: This is a single-center, retrospective study of septic patients with echocardiogram within 3 days of ICU admission. We compared baseline characteristics, echocardiographic markers of LV systolic function arterial load between patients with and without cirrhosis. A propensity score-matched case-control model was developed to describe the differences in those echocardiography derived parameters between the groups. RESULTS: 3151 patients with sepsis were included of which 422 (13%) had cirrhosis. In the propensity score matched group with 828 patients, cirrhotic patients had significantly higher left ventricular ejection fraction (64 vs.56%, p < 0.001) and stroke volume (72 vs.48 ml, p < 0.001) along with lower arterial elastance (Ea) (1.35 1vs.20.3, p < 0.001) and systemic vascular resistance (SVR) (851 vs.1209 dynes/s/m-5, p = 0.001). The left ventricular elastance (Ees) (2.83 vs 2.45, p = 0.002) was higher and ventricular-arterial coupling (Ea/Ees) (0.48 vs. 0.86, p < 0.001) lower in cirrhotic compared to non-cirrhotic. CONCLUSIONS: Septic patients with cirrhosis had higher LVEF with lower Ea and SVR with higher Ees and significantly lower Ea/Ees suggesting vasodilation as the principal driver of the hyperdynamic profile in cirrhosis.


Assuntos
Sepse , Choque Séptico , Humanos , Choque Séptico/complicações , Volume Sistólico , Estudos de Casos e Controles , Estudos Retrospectivos , Pontuação de Propensão , Função Ventricular Esquerda , Sepse/complicações , Hemodinâmica , Cirrose Hepática/complicações
12.
J Invasive Cardiol ; 36(2)2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38335506

RESUMO

OBJECTIVES: The Impella (Abiomed) is a widely used percutaneous mechanical circulatory support device for high-risk percutaneous coronary intervention in patients with cardiogenic shock. This study aimed to determine the safety and feasibility of a non-angio-guided post-closure approach using the Perclose ProGlide (Abbott) to decannulate the Impella in the intensive care unit. METHODS: This retrospective study included consecutive patients who were successfully weaned from mechanical circulatory support using the Impella device between April 2019 and April 2022 at Hamamatsu University School of Medicine. Fifteen patients underwent complete post-closure of the femoral artery access sites at the bedside. Technical success of the post-closure hemostasis technique was defined as no evidence of bleeding or additional medical procedures after manual compression. The safety endpoints comprised the Valve Academic Research Consortium-3 and Bleeding Academic Research Consortium criteria. RESULTS: All patients achieved successful hemostasis with this novel technique without surgical conversion. There was no significant bleeding; however, procedure-related vessel occlusion was observed in 1 patient who was recanalized with balloon angioplasty. CONCLUSIONS: Bedside post-closure using the Perclose ProGlide device is a safe and feasible alternative to manual compression and surgical removal of the Impella device with low bleeding or vascular complications rates.


Assuntos
Angioplastia Coronária com Balão , Coração Auxiliar , Intervenção Coronária Percutânea , Humanos , Choque Cardiogênico/diagnóstico , Choque Cardiogênico/cirurgia , Estudos Retrospectivos , Estudos de Viabilidade , Hemorragia , Resultado do Tratamento
13.
Ann Intensive Care ; 14(1): 22, 2024 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-38308701

RESUMO

PURPOSE: The prevalence of hyperdynamic left ventricular (LV) systolic function in septic patients and its impact on mortality remain controversial. In this systematic review and meta-analysis, we investigated the prevalence and association of hyperdynamic LV systolic function with mortality in patients with sepsis. METHODS: We searched MEDLINE, Cochrane Central Register of Controlled Trials, and Embase. Primary outcomes were the prevalence of hyperdynamic LV systolic function in adult septic patients and the associated short-term mortality as compared to normal LV systolic function. Hyperdynamic LV systolic function was defined using LV ejection fraction (LVEF) of 70% as cutoff. Secondary outcomes were heart rate, LV end-diastolic diameter (LVEDD), and E/e' ratio. RESULTS: Four studies were included, and the pooled prevalence of hyperdynamic LV systolic function was 18.2% ([95% confidence interval (CI) 12.5, 25.8]; I2 = 7.0%, P < 0.0001). Hyperdynamic LV systolic function was associated with higher mortality: odds ratio of 2.37 [95%CI 1.47, 3.80]; I2 = 79%, P < 0.01. No difference was found in E/e' (P = 0.43) between normal and hyperdynamic LV systolic function, while higher values of heart rate (mean difference: 6.14 beats/min [95%CI 3.59, 8.69]; I2 = 51%, P < 0.0001) and LVEDD (mean difference: - 0.21 cm [95%CI - 0.33, - 0.09]; I2 = 73%, P < 0.001) were detected in patients with hyperdynamic LV systolic function. CONCLUSION: The prevalence of hyperdynamic LV systolic function is not negligible in septic patients. Such a finding is associated with significantly higher short-term mortality as compared to normal LV systolic function.

14.
Chem Sci ; 15(7): 2425-2432, 2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38362422

RESUMO

Nanocrystal (NC) superlattices (SLs) have been widely studied as a new class of functional mesoscopic materials with collective physical properties. The arrangement of NCs in SLs governs the collective properties of SLs, and thus investigations of phenomena that can change the assembly of NC constituents are important. In this study, we investigated the dynamic evolution of NC arrangements in three-dimensional (3D) SLs, specifically the morphological transformation of NC constituents during the direct liquid-phase synthesis of 3D NC SLs. Electron microscopy and synchrotron-based in situ small angle X-ray scattering experiments revealed that the transformation of spherical Cu2S NCs in face-centred-cubic 3D NC SLs into anisotropic disk-shaped NCs collapsed the original ordered close-packed structure. The random crystallographic orientation of spherical Cu2S NCs in starting SLs also contributed to the complete disordering of the NC array via random-direction anisotropic growth of NCs. This work demonstrates that an understanding of the anisotropic growth kinetics of NCs in the post-synthesis modulation of NC SLs is important for tuning NC array structures.

15.
Rheumatol Int ; 44(3): 549-556, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38170205

RESUMO

IgG4-related disease (IgG4-RD) is a systemic condition in which IgG4+ plasma cell infiltration and fibrosis cause organ swelling and lead to diverse clinical manifestations. Although IgG4-RD typically responds to glucocorticoids (GCs), relapse during tapering occurs and an early GC-sparing approach might therefore be beneficial. Systemic lupus erythematosus (SLE) is a chronic inflammatory disease with multiple symptoms that is also treated with GCs as a first-line therapy. Recently, belimumab, a recombinant human IgG-1λ monoclonal antibody that inhibits B-cell activating factor, was approved, but reports of use for IgG4-RD are scarce. Here, we present a rare case of IgG4-RD complicated with SLE which was successfully treated with belimumab. A 67-year-old man was diagnosed with IgG4-RD based on a high serum IgG4 level and histopathological findings. Furthermore, he had pericardial effusion on echocardiography, and laboratory tests revealed thrombocytopenia, autoimmune hemolysis, positive anti-nuclear antibodies, positive anti-DNA antibodies, and hypocomplementemia. These data led to an SLE diagnosis. Treatment was started with prednisolone at 40 mg/day, plus hydroxychloroquine, which initially improved both the SLE and IgG4-RD symptoms. During the GC tapering, belimumab was added and clinical symptoms resolved completely. Our case and the literature review summarize reported rare overlapping cases of IgG4-RD and SLE and suggest that belimumab is a promising candidate for the treatment of IgG4-RD.


Assuntos
Doença Relacionada a Imunoglobulina G4 , Lúpus Eritematoso Sistêmico , Masculino , Humanos , Idoso , Doença Relacionada a Imunoglobulina G4/complicações , Doença Relacionada a Imunoglobulina G4/diagnóstico , Doença Relacionada a Imunoglobulina G4/tratamento farmacológico , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Glucocorticoides/uso terapêutico , Imunoglobulina G , Imunossupressores/uso terapêutico , Resultado do Tratamento
16.
Adv Sci (Weinh) ; 11(10): e2307055, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38196298

RESUMO

Materials that intrinsically exhibit localized surface plasmon resonance (LSPR) in the visible region have been predominantly researched on nanoparticles (NPs) composed of coinage metals, namely Au, Ag, and Cu. Here, as a coinage metal-free intermetallic NPs, colloidal PtIn2 NPs with a C1 (CaF2 -type) crystal structure are synthesized by the liquid phase method, which evidently exhibit LSPR at wavelengths similar to face-centered cubic (fcc)-Au NPs. Computational simulations pointed out differences in the electronic structure and photo-excited electron dynamics between C1-PtIn2 and fcc-Au NPs; reduces interband transition and stronger screening with smaller number of bound d-electrons compare with fcc-Au are unique origins of the visible plasmonic nature of C1-PtIn2 NPs. These results strongly indicate that the intermetallic NPs are expected to address the development of alternative plasmonic materials by tuning their crystal structure and composition.

18.
J Cardiothorac Vasc Anesth ; 38(1): 207-213, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37852913

RESUMO

OBJECTIVES: To describe the current use and outcomes of temporary mechanical circulatory support (MCS) in patients with sepsis-associated cardiogenic shocks with and without acute myocardial infarction (AMI) in the United States. DESIGN: Retrospective cohort study. SETTING: The National Inpatient Sample database from 2017 to 2019. PARTICIPANTS: Adult patients with sepsis-associated cardiogenic shock with and without AMI. INTERVENTIONS: Temporary MCSs, including intra-aortic balloon pump (IABP), percutaneous left ventricular assist device (pLVAD), and extracorporeal membrane oxygenation (ECMO). MEASUREMENTS AND MAIN RESULTS: Multivariate logistic regression analyses adjusting for patient characteristics, organ failures, and socioeconomic status. Although the uses of IABP and pLVAD were associated with significantly lower odds of in-hospital mortality in patients with sepsis-associated cardiogenic shock (IABP: adjusted odds ratio [aOR] 0.57, 95% CI 0.44-0.73, p < .001; pLVAD: aOR 0.66, 95% CI 0.45-0.98, p = .037), ECMO was not (aOR 1.51, 95% CI 0.93-2.45, p = 0.096). In the subgroup with AMI, temporary MCSs were not associated with significantly lower or higher odds of in-hospital mortality. In the subgroup without AMI, IABP was associated with significantly lower odds of in-hospital mortality (aOR 0.43, 95% CI 0.28-0.65, p < 0.001). CONCLUSIONS: Although temporary MCS is deemed to be a feasible option in sepsis-associated cardiogenic shock, the selection of the right patients whose shock is driven mainly by cardiogenic shock rather than septic shock, as represented by low cardiac output and high systemic vascular resistance, plays a critical role in the feasibility of this approach in the absence of clinical trials.


Assuntos
Oxigenação por Membrana Extracorpórea , Coração Auxiliar , Infarto do Miocárdio , Sepse , Adulto , Humanos , Estados Unidos , Choque Cardiogênico/etiologia , Choque Cardiogênico/terapia , Estudos Retrospectivos , Infarto do Miocárdio/complicações , Infarto do Miocárdio/cirurgia , Sepse/complicações , Sepse/terapia , Balão Intra-Aórtico , Resultado do Tratamento
19.
Int Immunol ; 36(4): 183-196, 2024 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-38147536

RESUMO

In sarcoidosis, granulomas develop in multiple organs including the liver and lungs. Although mechanistic target of rapamycin complex 1 (mTORC1) activation in macrophages drives granuloma development in sarcoidosis by enhancing macrophage proliferation, little is known about the macrophage subsets that proliferate and mature into granuloma macrophages. Here, we show that aberrantly increased monocytopoiesis gives rise to granulomas in a sarcoidosis model, in which Tsc2, a negative regulator of mTORC1, is conditionally deleted in CSF1R-expressing macrophages (Tsc2csf1rΔ mice). In Tsc2csf1rΔ mice, common myeloid progenitors (CMPs), granulocyte-monocyte progenitors (GMPs), common monocyte progenitors / monocyte progenitors (cMoPs / MPs), inducible monocyte progenitors (iMoPs), and Ly6Cint CX3CR1low CD14- immature monocytes (iMOs), but not monocyte-dendritic cell progenitors (MDPs) and common dendritic cell progenitors (CDPs), accumulated and proliferated in the spleen. Consistent with this, monocytes, neutrophils, and neutrophil-like monocytes increased in the spleens of Tsc2csf1rΔ mice, whereas dendritic cells did not. The adoptive transfer of splenic iMOs into wild-type mice gave rise to granulomas in the liver and lungs. In these target organs, iMOs matured into Ly6Chi classical monocytes/macrophages (cMOs). Giant macrophages (gMAs) also accumulated in the liver and lungs, which were similar to granuloma macrophages in expression of cell surface markers such as MerTK and SLAMF7. Furthermore, the gMA-specific genes were expressed in human macrophages from sarcoidosis skin lesions. These results suggest that mTORC1 drives granuloma development by promoting the proliferation of monocyte/neutrophil progenitors and iMOs predominantly in the spleen, and that proliferating iMOs mature into cMOs and then gMAs to give rise to granuloma after migration into the liver and lungs in sarcoidosis.


Assuntos
Macrófagos , Sarcoidose , Camundongos , Humanos , Animais , Diferenciação Celular , Macrófagos/metabolismo , Monócitos/metabolismo , Granuloma/metabolismo , Granuloma/patologia , Alvo Mecanístico do Complexo 1 de Rapamicina/metabolismo
20.
Anaesth Crit Care Pain Med ; 43(2): 101339, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38128732

RESUMO

BACKGROUND: Septic cardiomyopathy is associated with poor outcomes but its definition remains unclear. In a previous meta-analysis, left ventricular (LV) longitudinal strain (LS) showed significant prognostic value in septic patients, but findings were not robust due to a limited number of studies, differences in effect size and no adjustment for confounders. METHODS: We conducted an updated systematic review (PubMed and Scopus up to 14.02.2023) and meta-analysis to investigate the association between LS and survival in septic patients. We included studies reporting global (from three apical views) or regional LS (one or two apical windows). A secondary analysis evaluated the association between LV ejection fraction (EF) and survival using data from the selected studies. RESULTS: We included fourteen studies (1678 patients, survival 69.6%) and demonstrated an association between better performance (more negative LS) and survival with a mean difference (MD) of -1.45%[-2.10, -0.80] (p < 0.0001;I2 = 42%). No subgroup differences were found stratifying studies according to number of views used to calculate LS (p = 0.31;I2 = 16%), severity of sepsis (p = 0.42;I2 = 0%), and sepsis criteria (p = 0.59;I2 = 0%). Trial sequential analysis and sensitivity analyses confirmed the primary findings. Grade of evidence was low. In the included studies, thirteen reported LVEF and we found an association between higher LVEF and survival (MD = 2.44% [0.44,4.45]; p = 0.02;I2 = 42%). CONCLUSIONS: We confirmed that more negative LS values are associated with higher survival in septic patients. The clinical relevance of this difference and whether the use of LS may improve understanding of septic cardiomyopathy and prognostication deserve further investigation. The association found between LVEF and survival is of unlikely clinical meaning. REGISTRATION: PROSPERO number CRD42023432354.


Assuntos
Cardiomiopatias , Sepse , Disfunção Ventricular Esquerda , Humanos , Função Ventricular Esquerda , Ecocardiografia , Volume Sistólico , Cardiomiopatias/complicações , Cardiomiopatias/diagnóstico por imagem , Sepse/diagnóstico por imagem , Disfunção Ventricular Esquerda/diagnóstico por imagem
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