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Rab11a Controls Cell Shape via C9orf72 Protein: Possible Relationships to Frontotemporal Dementia/Amyotrophic Lateral Sclerosis (FTDALS) Type 1 Rab11a 通过 C9orf72 蛋白控制细胞形状:与额颞叶痴呆/肌萎缩侧索硬化症(FTDALS)1 型的可能关系
Q2 Medicine Pub Date : 2024-02-09 DOI: 10.3390/pathophysiology31010008
Shoya Fukatsu, Hinami Sashi, Remina Shirai, Norio Takagi, Hiroaki Oizumi, Masahiro Yamamoto, Katsuya Ohbuchi, Y. Miyamoto, J. Yamauchi
Abnormal nucleotide insertions of C9orf72, which forms a complex with Smith–Magenis syndrome chromosomal region candidate gene 8 (SMCR8) protein and WD repeat-containing protein 41 (WDR41) protein, are associated with an autosomal-dominant neurodegenerative frontotemporal dementia and/or amyotrophic lateral sclerosis type 1 (FTDALS1). The differentially expressed in normal and neoplastic cells (DENN) domain-containing C9orf72 and its complex with SMCR8 and WDR41 function as a guanine-nucleotide exchange factor for Rab GTP/GDP-binding proteins (Rab GEF, also called Rab activator). Among Rab proteins serving as major effectors, there exists Rab11a. However, it remains to be established which Rab protein is related to promoting or sustaining neuronal morphogenesis or homeostasis. In this study, we describe that the knockdown of Rab11a decreases the expression levels of neuronal differentiation marker proteins, as well as the elongation of neurite-like processes, using N1E-115 cells, a well-utilized neuronal differentiation model. Similar results were obtained in primary cortical neurons. In contrast, the knockdown of Rab11b, a Rab11a homolog, did not significantly affect their cell morphological changes. It is of note that treatment with hesperetin, a citrus flavonoid (also known as Vitamin P), recovered the neuronal morphological phenotypes induced by Rab11a knockdown. Also, the knockdown of Rab11a or Rab11b led to a decrease in glial marker expression levels and in morphological changes in FBD-102b cells, which serve as the oligodendroglial differentiation model. Rab11a is specifically involved in the regulation of neuronal morphological differentiation. The knockdown effect mimicking the loss of function of C9orf72 is reversed by treatment with hesperetin. These findings may reveal a clue for identifying one of the potential molecular and cellular phenotypes underlying FTDALS1.
C9orf72 与 Smith-Magenis 综合征染色体区域候选基因 8(Smith-Magenis syndrome chromosomal region candidate gene 8,SMCR8)蛋白和含 WD 重复蛋白 41(WDR41)蛋白形成复合物,C9orf72 的异常核苷酸插入与常染色体显性神经退行性额颞叶痴呆和/或肌萎缩侧索硬化症 1 型(FTDALS1)有关。含有在正常细胞和肿瘤细胞中差异表达(DENN)结构域的 C9orf72 及其与 SMCR8 和 WDR41 的复合物是 Rab GTP/GDP 结合蛋白(Rab GEF,又称 Rab 激活因子)的鸟嘌呤核苷酸交换因子。在作为主要效应物的 Rab 蛋白中,存在 Rab11a。然而,哪种 Rab 蛋白与促进或维持神经元形态发生或稳态有关,仍有待确定。在这项研究中,我们描述了利用N1E-115细胞(一种很好利用的神经元分化模型)敲除Rab11a会降低神经元分化标志蛋白的表达水平,以及神经元样过程的伸长。在原代皮质神经元中也得到了类似的结果。相反,Rab11a 的同源物 Rab11b 的敲除并没有显著影响细胞形态的变化。值得注意的是,用一种柑橘类黄酮(又称维生素 P)--橙皮素(hesperetin)处理后,Rab11a 敲除诱导的神经元形态表型得以恢复。此外,在作为少突胶质细胞分化模型的FBD-102b细胞中,Rab11a或Rab11b的敲除导致胶质标记物表达水平下降和形态变化。Rab11a 特别参与神经元形态分化的调控。模拟 C9orf72 功能缺失的基因敲除效应可通过使用橙皮素逆转。这些发现可能为确定FTDALS1潜在的分子和细胞表型之一提供了线索。
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引用次数: 0
Rab11a Controls Cell Shape via C9orf72 Protein: Possible Relationships to Frontotemporal Dementia/Amyotrophic Lateral Sclerosis (FTDALS) Type 1 Rab11a 通过 C9orf72 蛋白控制细胞形状:与额颞叶痴呆/肌萎缩侧索硬化症(FTDALS)1 型的可能关系
Q2 Medicine Pub Date : 2024-02-09 DOI: 10.3390/pathophysiology31010008
Shoya Fukatsu, Hinami Sashi, Remina Shirai, Norio Takagi, Hiroaki Oizumi, Masahiro Yamamoto, Katsuya Ohbuchi, Y. Miyamoto, J. Yamauchi
Abnormal nucleotide insertions of C9orf72, which forms a complex with Smith–Magenis syndrome chromosomal region candidate gene 8 (SMCR8) protein and WD repeat-containing protein 41 (WDR41) protein, are associated with an autosomal-dominant neurodegenerative frontotemporal dementia and/or amyotrophic lateral sclerosis type 1 (FTDALS1). The differentially expressed in normal and neoplastic cells (DENN) domain-containing C9orf72 and its complex with SMCR8 and WDR41 function as a guanine-nucleotide exchange factor for Rab GTP/GDP-binding proteins (Rab GEF, also called Rab activator). Among Rab proteins serving as major effectors, there exists Rab11a. However, it remains to be established which Rab protein is related to promoting or sustaining neuronal morphogenesis or homeostasis. In this study, we describe that the knockdown of Rab11a decreases the expression levels of neuronal differentiation marker proteins, as well as the elongation of neurite-like processes, using N1E-115 cells, a well-utilized neuronal differentiation model. Similar results were obtained in primary cortical neurons. In contrast, the knockdown of Rab11b, a Rab11a homolog, did not significantly affect their cell morphological changes. It is of note that treatment with hesperetin, a citrus flavonoid (also known as Vitamin P), recovered the neuronal morphological phenotypes induced by Rab11a knockdown. Also, the knockdown of Rab11a or Rab11b led to a decrease in glial marker expression levels and in morphological changes in FBD-102b cells, which serve as the oligodendroglial differentiation model. Rab11a is specifically involved in the regulation of neuronal morphological differentiation. The knockdown effect mimicking the loss of function of C9orf72 is reversed by treatment with hesperetin. These findings may reveal a clue for identifying one of the potential molecular and cellular phenotypes underlying FTDALS1.
C9orf72 与 Smith-Magenis 综合征染色体区域候选基因 8(Smith-Magenis syndrome chromosomal region candidate gene 8,SMCR8)蛋白和含 WD 重复蛋白 41(WDR41)蛋白形成复合物,C9orf72 的异常核苷酸插入与常染色体显性神经退行性额颞叶痴呆和/或肌萎缩侧索硬化症 1 型(FTDALS1)有关。含有在正常细胞和肿瘤细胞中差异表达(DENN)结构域的 C9orf72 及其与 SMCR8 和 WDR41 的复合物是 Rab GTP/GDP 结合蛋白(Rab GEF,又称 Rab 激活因子)的鸟嘌呤核苷酸交换因子。在作为主要效应物的 Rab 蛋白中,存在 Rab11a。然而,哪种 Rab 蛋白与促进或维持神经元形态发生或稳态有关,仍有待确定。在这项研究中,我们描述了利用N1E-115细胞(一种很好利用的神经元分化模型)敲除Rab11a会降低神经元分化标志蛋白的表达水平,以及神经元样过程的伸长。在原代皮质神经元中也得到了类似的结果。相反,Rab11a 的同源物 Rab11b 的敲除并没有显著影响细胞形态的变化。值得注意的是,用一种柑橘类黄酮(又称维生素 P)--橙皮素(hesperetin)处理后,Rab11a 敲除诱导的神经元形态表型得以恢复。此外,在作为少突胶质细胞分化模型的FBD-102b细胞中,Rab11a或Rab11b的敲除导致胶质标记物表达水平下降和形态变化。Rab11a 特别参与神经元形态分化的调控。模拟 C9orf72 功能缺失的基因敲除效应可通过使用橙皮素逆转。这些发现可能为确定FTDALS1潜在的分子和细胞表型之一提供了线索。
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引用次数: 0
High Glucose Induces Oxidative Stress That Alters Glycocalyx Proteoglycan Levels in Primary Rat Retinal Microvascular Endothelial Cells and in Isolated Ophthalmic Arteries 高血糖诱导氧化应激,改变原代大鼠视网膜微血管内皮细胞和离体眼动脉的糖萼蛋白多糖水平
Q2 Medicine Pub Date : 2024-02-06 DOI: 10.3390/pathophysiology31010007
Ivan A. Alvarez, Minsup Lee, Randa S. Eshaq, Wendy Leskova, Norman R. Harris
Our purpose in this study was to identify the role played by oxidative stress in the changes to proteoglycans that occur under hyperglycemic conditions, using primary rat retinal microvascular endothelial cells (RRMEC) and cultured ophthalmic arteries. The cells and blood vessels obtained from rats were cultured in normal glucose (5.6 mM) and high glucose (25 mM) with or without N-acetylcysteine (NAC), an antioxidant. Intracellular oxidative stress was determined by measuring dihydroethidium (DHE) fluorescence and malondialdehyde (MDA)-modified protein levels. mRNA and protein levels were evaluated using quantitative real-time polymerase chain reaction and immunoblot, respectively. High glucose increased levels of glypican-1 mRNA and protein. The level of syndecan-1 mRNA also was increased, but its protein level was decreased, by high glucose. Evaluation of DHE and MDA showed that high glucose increased oxidative stress. These changes caused by high glucose were significantly reversed by NAC treatment. Matrix metalloproteinase-9 (MMP-9) levels, which increased under high glucose conditions, were suppressed by NAC treatment. Oxidative stress caused by hyperglycemia may be responsible for significant changes to the ocular endothelial glycocalyx.
本研究的目的是利用原代大鼠视网膜微血管内皮细胞(RRMEC)和培养的眼动脉,确定氧化应激在高血糖条件下蛋白聚糖变化中所起的作用。在正常葡萄糖(5.6 mM)和高葡萄糖(25 mM)条件下培养大鼠视网膜微血管内皮细胞和血管,同时添加或不添加抗氧化剂 N-乙酰半胱氨酸(NAC)。细胞内氧化应激是通过测量二氢乙锭(DHE)荧光和丙二醛(MDA)修饰蛋白水平来确定的,mRNA 和蛋白水平则分别通过实时定量聚合酶链反应和免疫印迹来评估。高血糖增加了甘丙聚糖-1 mRNA和蛋白质的水平。高血糖也增加了辛迪加-1 mRNA 的水平,但降低了其蛋白质水平。对 DHE 和 MDA 的评估表明,高糖增加了氧化应激。NAC 处理可明显逆转高糖引起的这些变化。基质金属蛋白酶-9(MMP-9)水平在高糖条件下升高,而 NAC 治疗抑制了这一水平。高血糖引起的氧化应激可能是眼内皮糖萼发生重大变化的原因。
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引用次数: 0
High Glucose Induces Oxidative Stress That Alters Glycocalyx Proteoglycan Levels in Primary Rat Retinal Microvascular Endothelial Cells and in Isolated Ophthalmic Arteries 高血糖诱导氧化应激,改变原代大鼠视网膜微血管内皮细胞和离体眼动脉的糖萼蛋白多糖水平
Q2 Medicine Pub Date : 2024-02-06 DOI: 10.3390/pathophysiology31010007
Ivan A. Alvarez, Minsup Lee, Randa S. Eshaq, Wendy Leskova, Norman R. Harris
Our purpose in this study was to identify the role played by oxidative stress in the changes to proteoglycans that occur under hyperglycemic conditions, using primary rat retinal microvascular endothelial cells (RRMEC) and cultured ophthalmic arteries. The cells and blood vessels obtained from rats were cultured in normal glucose (5.6 mM) and high glucose (25 mM) with or without N-acetylcysteine (NAC), an antioxidant. Intracellular oxidative stress was determined by measuring dihydroethidium (DHE) fluorescence and malondialdehyde (MDA)-modified protein levels. mRNA and protein levels were evaluated using quantitative real-time polymerase chain reaction and immunoblot, respectively. High glucose increased levels of glypican-1 mRNA and protein. The level of syndecan-1 mRNA also was increased, but its protein level was decreased, by high glucose. Evaluation of DHE and MDA showed that high glucose increased oxidative stress. These changes caused by high glucose were significantly reversed by NAC treatment. Matrix metalloproteinase-9 (MMP-9) levels, which increased under high glucose conditions, were suppressed by NAC treatment. Oxidative stress caused by hyperglycemia may be responsible for significant changes to the ocular endothelial glycocalyx.
本研究的目的是利用原代大鼠视网膜微血管内皮细胞(RRMEC)和培养的眼动脉,确定氧化应激在高血糖条件下蛋白聚糖变化中所起的作用。在正常葡萄糖(5.6 mM)和高葡萄糖(25 mM)条件下培养大鼠视网膜微血管内皮细胞和血管,同时添加或不添加抗氧化剂 N-乙酰半胱氨酸(NAC)。细胞内氧化应激是通过测量二氢乙锭(DHE)荧光和丙二醛(MDA)修饰蛋白水平来确定的,mRNA 和蛋白水平则分别通过实时定量聚合酶链反应和免疫印迹来评估。高血糖增加了甘丙聚糖-1 mRNA和蛋白质的水平。高血糖也增加了辛迪加-1 mRNA 的水平,但降低了其蛋白质水平。对 DHE 和 MDA 的评估表明,高糖增加了氧化应激。NAC 处理可明显逆转高糖引起的这些变化。基质金属蛋白酶-9(MMP-9)水平在高糖条件下升高,而 NAC 治疗抑制了这一水平。高血糖引起的氧化应激可能是眼内皮糖萼发生重大变化的原因。
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引用次数: 0
Gut Microbiome Changes in Anorexia Nervosa: A Comprehensive Review 神经性厌食症的肠道微生物组变化:全面回顾
Q2 Medicine Pub Date : 2024-02-02 DOI: 10.3390/pathophysiology31010006
Wendi Zhao, P. Kodancha, Soumitra Das
Anorexia nervosa (AN) remains a challenging condition in psychiatric management and its pathogenesis is not yet fully understood. An imbalance in the gut microbiota composition may contribute to its pathophysiology. This review aims to explore the link between the human gut microbiota and AN (objective 1) or refeeding syndrome in AN (objective 2). The online databases MEDLINE and PsycINFO were searched for relevant studies. A total of 14 studies met the inclusion and exclusion criteria and only answered objective 1. A total of 476 AN patients, 554 healthy-weight (HC) controls, and 0 patients with other psychiatric disorders were included. Compared to HC, there were consistently reduced abundances of Faecalibacterium prausnitzii and Roseburia inulinivorans, and increased Methanobrevibacter smithii, in AN patients. Changes in alpha diversity were inconsistent, while beta diversity increased in four of six studies. Our model suggests that an imbalance in gut microbiota composition leads to reduced short-chain fatty acids, contributing to a proinflammatory state in AN, which is also common in other psychiatric comorbidities. Microbial changes may also contribute to the semistarvation state through endocrine changes and altered energy utilization.
神经性厌食症(AN)仍然是精神病治疗中的一个难题,其发病机制尚未完全明了。肠道微生物群组成的失衡可能是导致其病理生理学的原因之一。本综述旨在探讨人类肠道微生物群与厌食症(目标 1)或厌食症再喂养综合征(目标 2)之间的联系。我们在在线数据库 MEDLINE 和 PsycINFO 中检索了相关研究。共有 14 项研究符合纳入和排除标准,且只回答了目标 1。共纳入了 476 名 AN 患者、554 名健康体重(HC)对照者和 0 名其他精神疾病患者。与健康体重对照组相比,自闭症患者体内的普氏粪杆菌(Faecalibacterium prausnitzii)和Roseburia inulinivorans的数量持续减少,而Methanobrevibacter smithii的数量持续增加。在六项研究中,有四项研究的α多样性变化不一致,而β多样性则有所增加。我们的模型表明,肠道微生物群组成失衡会导致短链脂肪酸减少,从而导致AN的促炎症状态,这在其他精神合并症中也很常见。微生物的变化还可能通过内分泌变化和能量利用的改变导致半饥饿状态。
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引用次数: 0
Gut Microbiome Changes in Anorexia Nervosa: A Comprehensive Review 神经性厌食症的肠道微生物组变化:全面回顾
Q2 Medicine Pub Date : 2024-02-02 DOI: 10.3390/pathophysiology31010006
Wendi Zhao, P. Kodancha, Soumitra Das
Anorexia nervosa (AN) remains a challenging condition in psychiatric management and its pathogenesis is not yet fully understood. An imbalance in the gut microbiota composition may contribute to its pathophysiology. This review aims to explore the link between the human gut microbiota and AN (objective 1) or refeeding syndrome in AN (objective 2). The online databases MEDLINE and PsycINFO were searched for relevant studies. A total of 14 studies met the inclusion and exclusion criteria and only answered objective 1. A total of 476 AN patients, 554 healthy-weight (HC) controls, and 0 patients with other psychiatric disorders were included. Compared to HC, there were consistently reduced abundances of Faecalibacterium prausnitzii and Roseburia inulinivorans, and increased Methanobrevibacter smithii, in AN patients. Changes in alpha diversity were inconsistent, while beta diversity increased in four of six studies. Our model suggests that an imbalance in gut microbiota composition leads to reduced short-chain fatty acids, contributing to a proinflammatory state in AN, which is also common in other psychiatric comorbidities. Microbial changes may also contribute to the semistarvation state through endocrine changes and altered energy utilization.
神经性厌食症(AN)仍然是精神病治疗中的一个难题,其发病机制尚未完全明了。肠道微生物群组成的失衡可能是导致其病理生理学的原因之一。本综述旨在探讨人类肠道微生物群与厌食症(目标 1)或厌食症再喂养综合征(目标 2)之间的联系。我们在在线数据库 MEDLINE 和 PsycINFO 中检索了相关研究。共有 14 项研究符合纳入和排除标准,且只回答了目标 1。共纳入了 476 名 AN 患者、554 名健康体重(HC)对照者和 0 名其他精神疾病患者。与健康体重对照组相比,自闭症患者体内的普氏粪杆菌(Faecalibacterium prausnitzii)和Roseburia inulinivorans的数量持续减少,而Methanobrevibacter smithii的数量持续增加。在六项研究中,有四项研究的α多样性变化不一致,而β多样性则有所增加。我们的模型表明,肠道微生物群组成失衡会导致短链脂肪酸减少,从而导致AN的促炎症状态,这在其他精神合并症中也很常见。微生物的变化还可能通过内分泌变化和能量利用的改变导致半饥饿状态。
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引用次数: 0
A Bird’s-Eye View of the Pathophysiologic Role of the Human Urobiota in Health and Disease: Can We Modulate It? 鸟瞰人类尿生物群在健康和疾病中的病理生理学作用:我们能调节它吗?
Q2 Medicine Pub Date : 2024-02-01 DOI: 10.3390/pathophysiology31010005
Emilio Jirillo, Raffele Palmirotta, Marica Colella, L. Santacroce
For a long time, urine has been considered sterile in physiological conditions, thanks to the particular structure of the urinary tract and the production of uromodulin or Tamm–Horsfall protein (THP) by it. More recently, thanks to the development and use of new technologies, i.e., next-generation sequencing and expanded urine culture, the identification of a microbial community in the urine, the so-called urobiota, became possible. Major phyla detected in the urine are represented by Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria. Particularly, the female urobiota is largely represented by Lactobacillus spp., which are very active against urinary pathogenic Escherichia (E.) coli (UPEC) strains via the generation of lactic acid and hydrogen peroxide. Gut dysbiosis accounts for recurrent urinary tract infections (UTIs), so-called gut–bladder axis syndrome with the formation of intracellular bacterial communities in the course of acute cystitis. However, other chronic urinary tract infections are caused by bacterial strains of intestinal derivation. Monomicrobial and polymicrobial infections account for the outcome of acute and chronic UTIs, even including prostatitis and chronic pelvic pain. E. coli isolates have been shown to be more invasive and resistant to antibiotics. Probiotics, fecal microbial transplantation, phage therapy, antimicrobial peptides, and immune-mediated therapies, even including vaccines for the treatment of UTIs, will be described.
长期以来,尿液一直被认为是生理条件下的无菌物,这要归功于泌尿道的特殊结构以及尿液中尿蛋白或 Tamm-Horsfall 蛋白(THP)的产生。最近,由于新技术(即下一代测序和扩大尿培养)的开发和使用,尿液中微生物群落(即所谓的尿生物群)的鉴定成为可能。在尿液中检测到的主要门类包括固缩菌、类杆菌、蛋白菌和放线菌。尤其是雌性尿液生物群主要以乳酸杆菌为代表,它们通过产生乳酸和过氧化氢对尿液中的致病性大肠杆菌(UPEC)菌株有很强的抵抗力。肠道菌群失调是导致反复尿路感染(UTI)的原因,即所谓的肠道-膀胱轴综合征,在急性膀胱炎过程中会形成细胞内细菌群落。然而,其他慢性尿路感染是由肠道细菌菌株引起的。急性和慢性尿路感染,甚至包括前列腺炎和慢性盆腔疼痛,都是由单微生物和多微生物感染引起的。大肠杆菌分离物已被证明具有更强的侵袭性和抗药性。将介绍益生菌、粪便微生物移植、噬菌体疗法、抗菌肽和免疫介导疗法,甚至包括用于治疗UTI 的疫苗。
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引用次数: 0
A Bird’s-Eye View of the Pathophysiologic Role of the Human Urobiota in Health and Disease: Can We Modulate It? 鸟瞰人类尿生物群在健康和疾病中的病理生理学作用:我们能调节它吗?
Q2 Medicine Pub Date : 2024-02-01 DOI: 10.3390/pathophysiology31010005
Emilio Jirillo, Raffele Palmirotta, Marica Colella, L. Santacroce
For a long time, urine has been considered sterile in physiological conditions, thanks to the particular structure of the urinary tract and the production of uromodulin or Tamm–Horsfall protein (THP) by it. More recently, thanks to the development and use of new technologies, i.e., next-generation sequencing and expanded urine culture, the identification of a microbial community in the urine, the so-called urobiota, became possible. Major phyla detected in the urine are represented by Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria. Particularly, the female urobiota is largely represented by Lactobacillus spp., which are very active against urinary pathogenic Escherichia (E.) coli (UPEC) strains via the generation of lactic acid and hydrogen peroxide. Gut dysbiosis accounts for recurrent urinary tract infections (UTIs), so-called gut–bladder axis syndrome with the formation of intracellular bacterial communities in the course of acute cystitis. However, other chronic urinary tract infections are caused by bacterial strains of intestinal derivation. Monomicrobial and polymicrobial infections account for the outcome of acute and chronic UTIs, even including prostatitis and chronic pelvic pain. E. coli isolates have been shown to be more invasive and resistant to antibiotics. Probiotics, fecal microbial transplantation, phage therapy, antimicrobial peptides, and immune-mediated therapies, even including vaccines for the treatment of UTIs, will be described.
长期以来,尿液一直被认为是生理条件下的无菌物,这要归功于泌尿道的特殊结构以及尿液中尿蛋白或 Tamm-Horsfall 蛋白(THP)的产生。最近,由于新技术(即下一代测序和扩大尿培养)的开发和使用,尿液中微生物群落(即所谓的尿生物群)的鉴定成为可能。在尿液中检测到的主要门类包括固缩菌、类杆菌、蛋白菌和放线菌。尤其是雌性尿液生物群主要以乳酸杆菌为代表,它们通过产生乳酸和过氧化氢对尿液中的致病性大肠杆菌(UPEC)菌株有很强的抵抗力。肠道菌群失调是导致反复尿路感染(UTI)的原因,即所谓的肠道-膀胱轴综合征,在急性膀胱炎过程中会形成细胞内细菌群落。然而,其他慢性尿路感染是由肠道细菌菌株引起的。急性和慢性尿路感染,甚至包括前列腺炎和慢性盆腔疼痛,都是由单微生物和多微生物感染引起的。大肠杆菌分离物已被证明具有更强的侵袭性和抗药性。将介绍益生菌、粪便微生物移植、噬菌体疗法、抗菌肽和免疫介导疗法,甚至包括用于治疗UTI 的疫苗。
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引用次数: 0
A Refractory Electrical Storm after Acute Myocardial Infarction: The Role of Temporary Ventricular Overdrive Pacing as a Bridge to ICD Implantation. 急性心肌梗死后的难治性电风暴:临时心室超速起搏作为植入 ICD 的桥梁的作用。
Q2 Medicine Pub Date : 2024-01-14 DOI: 10.3390/pathophysiology31010004
Mijo Meter, Josip Andelo Borovac

An electrical storm (ES) is defined as the presence of at least three episodes of sustained ventricular tachycardia or ventricular fibrillation within 24 h. This patient had a previously known arterial hypertension, type II diabetes mellitus, and chronic kidney disease and has presented to the Emergency Department (ED) with symptoms of retrosternal chest pain lasting for several hours prior. The initial 12-lead electrocardiogram revealed ST segment elevation in the anterior leads (V1-V6). Emergent coronary angiography revealed an acute occlusion of the proximal left anterior descending artery (pLAD) and percutaneous coronary intervention was performed with successful implantation of one drug-eluting stent in the pLAD. On day 8 of hospitalization, the patient developed a refractory ES for which he received 50 DC shocks and did not respond to multiple lines of antiarrhythmic medications. Due to a failure of medical therapy, we decided to implant a temporary pacemaker and initiate ventricular overdrive pacing (VOP) that was successful in terminating ES. Following electrical stabilization, the patient underwent a successful ICD implantation. This case demonstrates that VOP can contribute to hemodynamic and electrical stabilization of a patient that suffers from refractory ES and this treatment modality might serve as a temporary bridge to ICD implantation.

电风暴(ES)的定义是在 24 小时内出现至少三次持续性室性心动过速或心室颤动。该患者曾患有动脉高血压、II 型糖尿病和慢性肾脏疾病,因胸骨后胸痛症状就诊于急诊科(ED),疼痛持续数小时。最初的 12 导联心电图显示前导联(V1-V6)ST 段抬高。急诊冠状动脉造影显示左前降支动脉(pLAD)近端急性闭塞,于是进行了经皮冠状动脉介入治疗,并在 pLAD 成功植入了一个药物洗脱支架。住院第 8 天,患者出现难治性 ES,接受了 50 次直流电击,但对多种抗心律失常药物均无反应。由于药物治疗无效,我们决定植入临时起搏器并启动心室超速起搏(VOP),成功终止了 ES。电稳定后,患者成功接受了 ICD 植入术。本病例表明,VOP 可以帮助难治性 ES 患者稳定血流动力学和电学,这种治疗方式可以作为 ICD 植入的临时桥梁。
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引用次数: 0
Opportunities and Challenges in Catheter-Based Irreversible Electroporation for Ventricular Tachycardia 导管式不可逆电穿孔治疗室性心动过速的机遇与挑战
Q2 Medicine Pub Date : 2024-01-10 DOI: 10.3390/pathophysiology31010003
Matthew L Repp, I. Chinyere
The use of catheter-based irreversible electroporation in clinical cardiac laboratories, termed pulsed-field ablation (PFA), is gaining international momentum among cardiac electrophysiology proceduralists for the non-thermal management of both atrial and ventricular tachyrhythmogenic substrates. One area of potential application for PFA is in the mitigation of ventricular tachycardia (VT) risk in the setting of ischemia-mediated myocardial fibrosis, as evidenced by recently published clinical case reports. The efficacy of tissue electroporation has been documented in other branches of science and medicine; however, ventricular PFA’s potential advantages and pitfalls are less understood. This comprehensive review will briefly summarize the pathophysiological mechanisms underlying VT and then summarize the pre-clinical and adult clinical data published to date on PFA’s effectiveness in treating monomorphic VT. These data will be contrasted with the effectiveness ascribed to thermal cardiac ablation modalities to treat VT, namely radiofrequency energy and liquid nitrogen-based cryoablation.
在临床心脏实验室中使用基于导管的不可逆电穿孔术,即脉冲场消融术(PFA),正在国际心脏电生理程序专家中获得越来越大的发展势头,用于对房性和室性快速性心律失常基底进行非热处理。最近发表的临床病例报告显示,PFA 的一个潜在应用领域是在缺血介导的心肌纤维化情况下降低室性心动过速 (VT) 风险。组织电穿孔的疗效已在其他科学和医学分支中得到证实;然而,人们对心室 PFA 的潜在优势和隐患了解较少。这篇综合评论将简要概述 VT 的病理生理机制,然后总结迄今为止已发表的有关 PFA 治疗单形 VT 的有效性的临床前和成人临床数据。这些数据将与心脏热消融模式(即射频能量和基于液氮的低温消融)治疗 VT 的有效性进行对比。
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