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Sex-Linked Differences in Cardiac Atrophy After Heterotopic Heart Transplantation: No Direct Relation to the Actions of Sex Steroid Hormones. 异位心脏移植后心脏萎缩的性别差异:与性类固醇激素的作用无直接关系
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2024-11-29
D M Kolesár, P Kujal, I Mrázová, M Pokorný, P Škaroupková, Z Vaňourková, J Sadowski, L Červenka, I Netuka

An important complication of prolonged support of the left ventricle with an assist device when implanted in patients with heart failure is unloading-induced cardiac atrophy. Our recent study suggested that sex-linked differences in the development of atrophy induced by heterotopic heart transplantation (HTX) do exist, however, the role of the environmental conditions dependent on plasma concentrations of sex hormones remains elusive. We aimed to compare the course of HTX-induced cardiac atrophy in male and female rats after gonadectomy with substitution of steroid hormones of the opposite sex. In a separate series of experiments, we evaluated the course of unloading-induced cardiac atrophy in the female heart transplanted into a male recipient and vice versa. Cardiac atrophy was assessed as the ratio of the transplanted heart weight to native heart weight (HW), which was determined 14 days after HTX. In female rats, studied in both experimental variants, HTx resulted in significantly smaller decreases in whole HW when compared to those observed in male rats exposed to the same experimental conditions (-9 ± 1 and - 11 + 1 vs. -44 ± 2 and -42 ± 2 %, p?0.05 in both cases). The dynamic of changes in left and right ventricle was similar as in the whole HW. Our results show that the process of unloading-induced cardiac atrophy exhibits important sex-linked differences and that attenuation of this process in female rats cannot be simply ascribed to the protective effects of estradiol or to the absence of deleterious actions of testosterone. Keywords: Cardiac atrophy, Sex differences, Gonadectomy, Hormonal substitution, Heterotopic heart transplantation, Mechanical heart unloading.

心力衰竭患者植入辅助装置长期支持左心室的一个重要并发症是无负荷诱发的心脏萎缩。我们最近的研究表明,在异位心脏移植(HTX)诱导的萎缩发展过程中确实存在性别差异,但是,取决于血浆中性激素浓度的环境条件的作用仍然难以确定。我们的目的是比较雄性和雌性大鼠在性腺切除和异性类固醇激素替代后 HTX 诱导的心脏萎缩的过程。在一系列单独的实验中,我们评估了将雌性心脏移植到雄性受体后,雌性心脏和雄性心脏在卸载诱导下的心肌萎缩过程。心脏萎缩以移植心脏重量与原生心脏重量(HW)的比值进行评估,该比值在 HTX 14 天后测定。在两种实验变体中研究的雌性大鼠中,HTX 导致的整体 HW 下降幅度明显小于在相同实验条件下观察到的雄性大鼠(-9 ± 1 和 - 11 + 1 vs. -44 ± 2 和 -42 ± 2 %,两种情况下的 p?0.05)。左心室和右心室的变化动态与整个 HW 相似。我们的研究结果表明,卸载诱导的心脏萎缩过程表现出重要的性别差异,雌性大鼠这一过程的减弱不能简单地归因于雌二醇的保护作用或睾酮的无损作用。关键词心肌萎缩 性别差异 性腺切除 荷尔蒙替代 异位心脏移植 机械心脏卸载
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引用次数: 0
Hypoxic Pulmonary Vasoconstriction: An Important Component of the Homeostatic Oxygen Sensing System. 缺氧性肺血管收缩:体内平衡氧传感系统的重要组成部分
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2024-11-29
S L Archer, K J Dunham-Snary, Ret Bentley, E Alizadeh, E K Weir

Hypoxic pulmonary vasoconstriction (HPV) rapidly and reversibly matches lung ventilation (V) and perfusion (Q), optimizing oxygen uptake and systemic oxygen delivery. HPV occurs in small pulmonary arteries (PA), which uniquely constrict to hypoxia. Although HPV is modulated by the endothelium the core mechanism of HPV resides in PA smooth muscle cells (PASMC). The PASMC's mitochondrial oxygen sensor lies within the electron transport chain (ETC) and includes NDUFS2 in ETC Complex-I. PASMC mitochondria respond to hypoxia by varying production of reactive oxygen species (ROS) and hydrogen peroxide in proportion to alveolar oxygen tension. Hypoxic ROS inhibition results in a state of reduction which triggers a redox-mediated inhibition of oxygen-sensitive, voltage-gated, potassium channels, including Kv1.5 and Kv2.1. Kv channel inhibition depolarizes the PASMC, opening of large-conductance calcium channels (CaL), elevating cytosolic calcium and activating the contractile apparatus. HPV is strongest in small PAs where sensors (hypoxia-responsive mitochondria) and effectors (oxygen-sensitive K+ channels) are enriched. Oxygenation at birth reverses fetal HPV, contributing to the rapid neonatal drop in pulmonary vascular resistance (PVR). A similar mitochon-drial-K+ channel sensor-effector mechanism exists in the ductus arteriosus (DA), however in DASMC it is oxygen-induced increases in mitochondrial ROS that inhibit DASMC K+ channels, causing DA constriction. Atelectasis and pneumonia elicit HPV, which optimises V/Q matching, increasing systemic oxygenation. Whilst HPV in response to localized hypoxia in a single lung lobe does not increase PA pressure; global airway hypoxia, as occurs with altitude or sleep apnea, causes pulmonary hypertension. HPV can be inhibited by drugs, including calcium channel blockers, or used to maintain a dry operative field during single lung anesthesia for lung surgery. HPV does not normally cause lung edema but excessive, heterogenous HPV contributes to high altitude pulmonary edema. HPV is suppressed in COVID-19 pneumonia by a SARS-CoV-2 mitochondriopathy. HPV is a component of the body's homeostatic oxygen sensing system. Keywords: Ductus arteriosus, Redox, NDUFS2, Oxygen sensitive potassium, Channels, High altitude pulmonary edema (HAPE), Mitochondrial electron transport chain, COVID-19 pneumonia, Atelectasis.

缺氧性肺血管收缩(HPV)可快速、可逆地匹配肺通气量(V)和灌注量(Q),优化氧气吸收和全身供氧。HPV 发生在肺小动脉 (PA),它们在缺氧时会发生独特的收缩。虽然 HPV 受内皮调节,但 HPV 的核心机制在于肺动脉平滑肌细胞(PASMC)。PASMC 线粒体氧传感器位于电子传递链(ETC)中,包括 ETC 复合物 I 中的 NDUFS2。PASMC 线粒体对缺氧的反应是根据肺泡氧张力的比例改变活性氧(ROS)和过氧化氢的产生。缺氧性 ROS 抑制会导致还原状态,从而引发氧化还原介导的对氧敏感的电压门控钾通道(包括 Kv1.5 和 Kv2.1)抑制。Kv 通道抑制会使 PASMC 去极化,打开大电导钙通道(CaL),使细胞膜钙升高并激活收缩装置。HPV 在传感器(缺氧反应线粒体)和效应器(氧敏感 K+ 通道)丰富的小 PA 中最强。出生时的吸氧会逆转胎儿的 HPV,导致新生儿肺血管阻力(PVR)迅速下降。在动脉导管(DA)中也存在类似的线粒体-心房-K+通道传感器-效应器机制,但在DASMC中,是氧诱导的线粒体ROS增加抑制了DASMC K+通道,导致DA收缩。肺不张和肺炎会引起 HPV,从而优化 V/Q 匹配,增加全身氧合。虽然单个肺叶局部缺氧时产生的 HPV 不会增加 PA 压力,但高原或睡眠呼吸暂停时出现的整体气道缺氧会导致肺动脉高压。HPV 可被药物(包括钙通道阻滞剂)抑制,或在肺部手术的单肺麻醉中用于保持术野干燥。HPV 通常不会导致肺水肿,但过量的异源 HPV 会导致高海拔肺水肿。在 COVID-19 肺炎中,SARS-CoV-2 线粒体病变抑制了 HPV。HPV是机体平衡氧传感系统的一个组成部分。关键词动脉导管 氧化还原 NDUFS2 氧敏感钾 通道 高海拔肺水肿 线粒体电子传递链 COVID-19肺炎 肺不张
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引用次数: 0
Does Hypoxia Prompt Fetal Brain-Sparing in the Absence of Fetal Growth Restriction? 在胎儿生长受限的情况下,缺氧是否会促使胎儿切脑?
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2024-11-29
L G Moore, C G Julian, R A Lorca, D Cioffi-Ragan, D Gumina, J C Hobbins

The fetus develops normally in a hypoxic environment but exaggerated hypoxia late in pregnancy is a worrisome sign often observed in hypertensive disorders of pregnancy, placental insufficiency, or fetal growth restriction (FGR). Serial fetal biometry and the cerebroplacental ratio (CPR, calculated as the middle cerebral artery [MCA] / the umbilical artery [UmbA] pulsatility indices [PI]), are commonly used to indicate fetal "brain sparing" resulting from exaggerated fetal hypoxia. But unclear is the extent to which a low CPR indicates pathology or is a physiological response for maintaining cerebral blood flow. We studied 31 appropriate for gestational age (AGA) pregnancies at low (LA, 1670 m) or high (HA, 2879 m) altitude, given the chronic hypoxia imposed by HA residence, and 54 LA women with a clinical diagnosis of FGR. At week 34, the MCA PI was lower in the LA-FGR than the LA-AGA group but lower still in the HA-AGA compared to either LA groups due to a trend toward higher end-diastolic velocity (EDV). We concluded that the lower MCA PI was likely due to greater cerebral vasodilation in the HA AGA group and an indication of physiological versus pathological fetal hypoxia. Future reporting of serial MCA and UmbA values and their determinants along with the CPR could improve our ability to distinguish between physiological and pathological fetal brain sparing. Keywords: Birth weight, Cerebroplacental ratio, Fetal physiology, HDP, High altitude.

胎儿在缺氧环境中正常发育,但妊娠晚期的过度缺氧是一个令人担忧的征兆,通常见于妊娠高血压疾病、胎盘功能不全或胎儿生长受限(FGR)。序列胎儿生物测量和脑-胎盘比值(CPR,计算方法为大脑中动脉[MCA]/脐动脉[UmbA]搏动指数[PI])通常用于显示胎儿缺氧导致的胎儿 "脑疏松"。但是,低 CPR 在多大程度上表示病理变化,或者是维持脑血流的生理反应,目前尚不清楚。我们研究了 31 名在低海拔地区(LA,1670 米)或高海拔地区(HA,2879 米)的适合孕龄(AGA)的孕妇(考虑到 HA 居住环境造成的长期缺氧),以及 54 名临床诊断为 FGR 的 LA 孕妇。第 34 周时,LA-FGR 组的 MCA PI 低于 LA-AGA 组,但 HA-AGA 组的 MCA PI 仍低于 LA 组,原因是舒张末期速度 (EDV) 呈上升趋势。我们的结论是,MCA PI较低可能是由于HA-AGA组的脑血管扩张较强,也是胎儿生理性缺氧与病理性缺氧的一种表现。未来报告连续的 MCA 和 UmbA 值及其决定因素以及心肺复苏可提高我们区分生理性和病理性胎儿脑疏松的能力。关键词出生体重 脑-胎盘比率 胎儿生理学 HDP 高海拔地区
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引用次数: 0
Gut Microbiome and Pulmonary Arterial Hypertension - A Novel and Evolving Paradigm. 肠道微生物组与肺动脉高压--一个不断发展的新范例。
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2024-11-29
T Thenappan, E K Weir

Pulmonary arterial hypertension is characterized by perivascular and systemic inflammation. The gut microbiome influences the host immune system. Here we review the emerging preclinical and clinical evidence that strongly suggests that alterations in the gut microbiome may either initiate or facilitate progression of established pulmonary arterial hypertension by modifying the systemic immune responses. We also briefly review the relationship between the gut microbiome and preeclampsia, a vascular disease also characterized by inflammation. Key words: Dysbiosis, Right ventricle, Inflammation.

肺动脉高压的特点是血管周围和全身炎症。肠道微生物组影响宿主免疫系统。在此,我们回顾了新出现的临床前和临床证据,这些证据有力地表明,肠道微生物组的改变可能会通过改变全身免疫反应来启动或促进已确立的肺动脉高压的进展。我们还简要回顾了肠道微生物组与子痫前期(一种同样以炎症为特征的血管疾病)之间的关系。关键词菌群失调 右心室 炎症
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引用次数: 0
Pediatric Chronic Heart Failure: Age-Specific Considerations of Medical Therapy. 小儿慢性心力衰竭:针对特定年龄段的药物治疗注意事项。
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2024-11-29
K Koubský

Chronic heart failure (CHF) is a rare entity in children but carries a burden of high mortality and morbidity. Medical treatment of pediatric CHF is largely based on guidelines for the adult population. In contrast to adults, evidence for the efficacy of medications in treating CHF in children is sparse. This may be due to the difficulty of conducting high-powered studies in children or to true differences in the mechanisms of CHF pathophysiology. Recent observations suggest that CHF in children differs from adults at the molecular and cellular levels. Different pathways are involved, leading to less fibrosis and hypertrophy than in adults, with potential implications for therapy. The main pathophysiological goals of medical treatment of pediatric CHF due to systemic left ventricular dysfunction are discussed in this review. These include preload and afterload optimization, diminishing cardiomyocyte apoptosis and necrosis as well as interstitial fibrosis, and optimizing myocardial oxygen consumption. The pediatric myocardium should be provided with optimal conditions to achieve its regenerative potential. The cornerstones of medical CHF therapy are angiotensin converting enzyme inhibitors (ACEI), beta blockers and mineralocorticoid receptor antagonists. There are potential benefits of tissue ACEI and ?1-selective beta blockers in children. Angiotensin receptor blockers are an alternative to ACEI and their slightly different mechanism of action may confer certain advantages and disadvantages. Diuretics are employed to achieve a euvolemic state. Digoxin is used more frequently in children than in adults. Promising new drugs already routinely used in adults include angiotensin receptor-neprilysin inhibitors and sodium-glucose contransporter 2 inhibitors. Key words: Pediatric heart failure, Heart failure with reduced ejection fraction (HFrEF), ACE inhibitor, Beta blocker, Digoxin.

慢性心力衰竭(CHF)在儿童中很少见,但却带来了高死亡率和高发病率。儿科慢性心力衰竭的医疗方法主要以成人指南为基础。与成人相比,治疗儿童 CHF 的药物疗效证据很少。这可能是由于难以在儿童中开展高功率研究,也可能是由于 CHF 病理生理学机制的真正差异。最近的观察表明,儿童 CHF 在分子和细胞水平上与成人不同。其中涉及不同的途径,导致的纤维化和肥厚程度低于成人,这对治疗具有潜在的影响。本综述讨论了因全身性左心室功能障碍导致的小儿 CHF 的主要病理生理学治疗目标。这些目标包括优化前负荷和后负荷、减少心肌细胞凋亡和坏死以及间质纤维化,以及优化心肌耗氧量。应为小儿心肌提供最佳条件,以实现其再生潜能。血管紧张素转换酶抑制剂(ACEI)、β受体阻滞剂和矿物皮质激素受体拮抗剂是治疗慢性心力衰竭的基础药物。组织血管紧张素转换酶抑制剂和 "1-选择性 "β受体阻滞剂对儿童有潜在益处。血管紧张素受体阻滞剂是血管紧张素转换酶抑制剂(ACEI)的替代药物,其作用机制略有不同,可能各有利弊。利尿剂的使用是为了达到低血容量状态。地高辛在儿童中的使用频率高于成人。已在成人中常规使用的前景看好的新药包括血管紧张素受体-肾素抑制剂和钠-葡萄糖转运体 2 抑制剂。关键词小儿心力衰竭 射血分数降低的心力衰竭(HFrEF) ACE抑制剂 β受体阻滞剂 地高辛
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引用次数: 0
Influence of Hypoxia on the Airway Epithelium. 缺氧对气道上皮细胞的影响
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2024-11-29
K Procházková, J Uhlík

The necessity of oxygen for metabolic processes means that hypoxia can lead to serious cell and tissue damage. On the other hand, in some situations, hypoxia occurs under physiological conditions and serves as an important regulation factor. The airway epithelium is specific in that it gains oxygen not only from the blood supply but also directly from the luminal air. Many respiratory diseases are associated with airway obstruction or excessive mucus production thus leading to luminal hypoxia. The main goal of this review is to point out how the airway epithelium reacts to hypoxic conditions. Cells detect low oxygen levels using molecular mechanisms involving hypoxia-inducible factors (HIFs). In addition, the cells of the airway epithelium appear to overexpress HIFs in hypoxic conditions. HIFs then regulate many aspects of epithelial cell functions. The effects of hypoxia include secretory cell stimulation and hyperplasia, epithelial barrier changes, and ciliogenesis impairment. All the changes can impair mucociliary clearance, exacerbate infection, and promote inflammation leading to damage of airway epithelium and subsequent airway wall remodeling. The modulation of hypoxia regulatory mechanisms may be one of the strategies for the treatment of obstructive respiratory diseases or diseases with mucus hyperproduction. Keywords: Secretory cells, Motile cilia, Epithelial barrier, Oxygenation, Obstructive respiratory diseases.

新陈代谢过程需要氧气,这意味着缺氧会导致严重的细胞和组织损伤。另一方面,在某些情况下,缺氧会在生理条件下发生,并成为重要的调节因素。气道上皮具有特殊性,它不仅从血液供应中获取氧气,还直接从管腔空气中获取氧气。许多呼吸道疾病都与气道阻塞或粘液分泌过多有关,从而导致管腔缺氧。本综述的主要目的是指出气道上皮细胞如何对缺氧条件做出反应。细胞通过涉及缺氧诱导因子(HIFs)的分子机制来检测低氧水平。此外,气道上皮细胞在缺氧条件下似乎会过度表达 HIFs。然后,HIFs 调节上皮细胞功能的许多方面。缺氧的影响包括分泌细胞刺激和增生、上皮屏障变化和纤毛生成障碍。所有这些变化都会影响粘膜纤毛清除,加剧感染,促进炎症,从而导致气道上皮细胞损伤和气道壁重塑。调节缺氧调节机制可能是治疗阻塞性呼吸道疾病或粘液分泌过多疾病的策略之一。关键词分泌细胞 动纤毛 上皮屏障 氧合作用 阻塞性呼吸道疾病
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引用次数: 0
Perinatal Hypoxia and Immune System Activation in Schizophrenia Pathogenesis: Critical Considerations During COVID-19 Pandemic. 围产期缺氧与精神分裂症发病机制中的免疫系统激活:COVID-19 大流行期间的关键考虑因素。
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2024-11-29
I Kawikova, K Hakenova, M Lebedeva, L Kleteckova, L Jakob, V Spicka, L Wen, F Spaniel, K Vales

Schizophrenia, a severe psychiatric, neurodevelopmental disorder affecting about 0.29-1 % of the global population, is characterized by hallucinations, delusions, cognitive impairments, disorganized thoughts and speech, leading to significant social withdrawal and emotional blunting. During the 1980s, considerations about diseases that result from complex interactions of genetic background and environmental factors started to appear. One of the critical times of vulnerability is the perinatal period. Concerning schizophrenia, obstetric complications that are associated with hypoxia of the fetus or neonate were identified as a risk. Also, maternal infections during pregnancy were linked to schizophrenia by epidemiological, serologic and genetic studies. Research efforts then led to the development of experimental models testing the impact of perinatal hypoxia or maternal immune activation on neurodevelopmental disorders. These perinatal factors are usually studied separately, but given that the models are now validated, it is feasible to investigate both factors together. Inclusion of additional factors, such as metabolic disturbances or chronic stress, may need to be considered also. Understanding the interplay of perinatal factors in schizophrenia's etiology is crucial for developing targeted prevention and therapeutic strategies.

精神分裂症是一种严重的精神和神经发育障碍疾病,约占全球人口的 0.29-1%,以幻觉、妄想、认知障碍、思维和言语混乱为特征,导致明显的社会退缩和情感迟钝。20 世纪 80 年代,人们开始考虑由遗传背景和环境因素的复杂相互作用导致的疾病。围产期是易感的关键时期之一。关于精神分裂症,与胎儿或新生儿缺氧有关的产科并发症被认为是一种风险。此外,流行病学、血清学和遗传学研究也发现,孕期母体感染与精神分裂症有关。随后,研究人员开发了实验模型,以测试围产期缺氧或母体免疫激活对神经发育障碍的影响。这些围产期因素通常是分开研究的,但鉴于模型现已得到验证,因此将这两种因素放在一起研究是可行的。可能还需要考虑纳入代谢紊乱或慢性压力等其他因素。了解围产期因素在精神分裂症病因学中的相互作用对于制定有针对性的预防和治疗策略至关重要。
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引用次数: 0
Sex Differences in Cardiac Tolerance to Oxygen Deprivation - 40 Years of Cardiovascular Research. 心脏对缺氧耐受性的性别差异--心血管研究 40 年。
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2024-11-29
B Ostadal, Z Drahota, M Hlavackova, P Ostadal

Experimental and clinical studies have clearly demonstrated significant sex differences in myocardial structure and function, both under physiological and pathological conditions. The best example are significant sex differences in the cardiac tolerance to ischemia/reperfusion injury: pre-menopausal adult female hearts are more resistant as compared to the male myocardium. The importance of these findings is supported by the fact that the number of studies dealing with this issue increased significantly in recent years. Detailed molecular and cellular mechanisms responsible for sex differences are yet to be elucidated; however, it has been stressed that the differences cannot be explained only by the effect of estrogens. In recent years, a promising new hypothesis has been developed, suggesting that mitochondria may play a significant role in the sex differences in cardiac tolerance to oxygen deprivation. However, one is clear already today: sex differences are so important that they should be taken into consideration in the clinical practice for the selection of the optimal diagnostic and therapeutic strategy in the treatment of ischemic heart disease. The present review attempts to summarize the progress in cardiovascular research on sex-related differences in cardiac tolerance to oxygen deprivation during the last 40 years, i.e. from the first experimental observation. Particular attention was paid to the sex-related differences of the normal heart, sex-dependent tolerance to ischemia-reperfusion injury, the role of hormones and, finally, to the possible role of cardiac mitochondria in the mechanism of sex-dependent differences in cardiac tolerance to ischemia/reperfusion injury. Key words: Female heart, Cardiac hypoxic tolerance, Ischemia-reperfusion injury, Sex differences.

实验和临床研究清楚地表明,无论是在生理还是病理条件下,心肌结构和功能都存在明显的性别差异。最好的例子就是心脏对缺血/再灌注损伤的耐受性存在明显的性别差异:与男性心肌相比,绝经前的成年女性心脏具有更强的耐受性。近年来,有关这一问题的研究数量显著增加,这证明了这些发现的重要性。导致性别差异的详细分子和细胞机制尚待阐明;不过,有人强调,这些差异不能仅用雌激素的作用来解释。近年来,一种很有希望的新假说被提出,即线粒体可能在心脏对缺氧耐受性的性别差异中扮演重要角色。然而,如今有一点已经很清楚:性别差异是如此重要,以至于在临床实践中选择治疗缺血性心脏病的最佳诊断和治疗策略时应该考虑到性别差异。本综述试图总结过去 40 年间,即从首次实验观察开始,心血管研究在心脏对缺氧耐受性的性别差异方面所取得的进展。其中特别关注了正常心脏的性别差异、缺血再灌注损伤的性别相关耐受性、激素的作用,以及心脏线粒体在缺血再灌注损伤的性别相关耐受性差异机制中可能发挥的作用。关键词女性心脏 心脏缺氧耐受性 缺血再灌注损伤 性别差异
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引用次数: 0
Correlation Analysis of Serum 25-Hydroxyvitamin D Levels With Immune Function and Calcium-Phosphate Metabolism in Patients With Bronchial Asthma Treated With Combination Therapy. 接受联合疗法的支气管哮喘患者血清 25-羟维生素 D 水平与免疫功能和钙磷代谢的相关性分析
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2024-11-19 DOI: 10.33549/physiolres.935279
D Wu, J Wang, Y Wei, X Zhang, Z Hou
<p><p>It was to investigate the clinical efficacy of the combination therapy of fluticasone propionate inhalation aerosol and vitamin D (VD) in pediatric bronchial asthma (BA) and analyze the correlation between serum 25-(OH)-D3 levels and immune function, as well as calcium-phosphorus metabolism. A total of 110 patients with BA were recruited. Regarding treatment plan, patients were randomly rolled into a single-drug treatment group (SDT, treated with fluticasone propionate inhalation aerosol alone) and a dual-drug treatment group (TDT, treated with the combination of fluticasone propionate inhalation aerosol and VD). The changes in serum 25-(OH)-D3 levels, immunoglobulins, T lymphocyte subsets, and inflammatory cytokine levels in children with BA under different treatment modalities were compared. Clinical symptom disappearance, asthma control, and quality of life (QoL) were assessed, and the total effective rate and adverse reactions (ARs) were compared. A control group consisting of 60 healthy children who underwent concurrent physical examinations was included. The differences in serum 25-(OH)-D3 levels, immunoglobulins, and T lymphocyte subset levels between children with BA and healthy controls were compared, and their correlations were analyzed. The TDT group showed a drastic reduction in the disappearance time of lung wheezing and dyspnea relative to the SDT group. Furthermore, the TDT group exhibited notable improvements in lung function parameters, including forced vital capacity (FVC), forced expiratory volume at one second (FEV1), FEV1/FVC, and peak expiratory flow (PEF). Blood gas analysis revealed a great decrease in PaCO2 and an increase in PaO2. The Childhood Asthma Control Test (C-ACT) scores for asthma control and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) scores for QoL showed marked increases in the TDT group. Moreover, the TDT group demonstrated notable increases in serum 25-(OH)-D3 levels, immunoglobulins (IgA, IgG, and IgM), T lymphocyte subsets (CD4+ and CD8+), as well as blood calcium and phosphorus levels. Additionally, the TDT group exhibited a prominent increase in the anti-inflammatory cytokine interleukin (IL)-10 level and a drastic decrease in the pro-inflammatory cytokines IL-6 and tumor necrosis factor alpha (TNF-alpha) levels (all P<0.05). The total effective rates of treatment in the SDT group and TDT group were 83.64 % and 96.36 %, respectively, with AR rates of 16.36 % and 7.27 %. The TDT group exhibited a superior total effective rate and an inferior incidence of ARs to the SDT group (both P<0.05). Additionally, in contrast to the control group, the BA group showed notable decreases in serum 25-(OH)-D3 levels, immunoglobulins (IgA, IgG, and IgM), T lymphocyte subsets (CD4+, CD8+, and CD4+/CD8+), as well as blood calcium and phosphorus levels (all P<0.05). Prior to treatment, there was a positive correlation between serum 25-(OH)-D3 levels and immunoglobulins (IgA, IgG, and IgM), T lymphocyte subs
目的是研究丙酸氟替卡松吸入气雾剂和维生素 D(VD)联合疗法对小儿支气管哮喘(BA)的临床疗效,并分析血清 25-(OH)-D3 水平与免疫功能及钙磷代谢之间的相关性。该研究共招募了110名哮喘患者。在治疗方案方面,患者被随机分为单药治疗组(SDT,单独使用丙酸氟替卡松吸入气雾剂治疗)和双药治疗组(TDT,联合使用丙酸氟替卡松吸入气雾剂和VD治疗)。比较了不同治疗方法下 BA 患儿血清 25-(OH)-D3 水平、免疫球蛋白、T 淋巴细胞亚群和炎症细胞因子水平的变化。评估了临床症状消失情况、哮喘控制情况和生活质量(QoL),并比较了总有效率和不良反应(ARs)。对照组由 60 名同时接受体检的健康儿童组成。比较了 BA 患儿与健康对照组血清 25-(OH)-D3 水平、免疫球蛋白和 T 淋巴细胞亚群水平的差异,并分析了它们之间的相关性。与SDT组相比,TDT组肺部喘息和呼吸困难的消失时间大幅缩短。此外,TDT 组的肺功能参数也有明显改善,包括用力肺活量(FVC)、一秒用力呼气容积(FEV1)、FEV1/FVC 和呼气峰流速(PEF)。血气分析显示,PaCO2 显著下降,PaO2 上升。儿童哮喘控制测试(C-ACT)的哮喘控制评分和儿科哮喘生活质量问卷(PAQLQ)的 QoL 评分在 TDT 组均有显著提高。此外,TDT 组的血清 25-(OH)-D3 水平、免疫球蛋白(IgA、IgG 和 IgM)、T 淋巴细胞亚群(CD4+ 和 CD8+)以及血钙和血磷水平也有显著提高。此外,TDT 组的抗炎细胞因子白细胞介素(IL)-10 水平显著升高,而促炎细胞因子 IL-6 和肿瘤坏死因子α(TNF-α)水平大幅降低(均为 P<0.05)。
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引用次数: 0
The Expression Level of Inflammation-Related Genes in Patients With Bone Nonunion and the Effect of BMP-2 Infected Mesenchymal Stem Cells Combined With nHA/PA66 on the Inflammation Level of Femoral Bone Nonunion Rats. 骨不连患者炎症相关基因的表达水平及BMP-2感染间充质干细胞联合nHA/PA66对股骨骨不连大鼠炎症水平的影响
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2024-11-19 DOI: 10.33549/physiolres.935439
Y Huang, Q Zhang, Q Jing, X Li, F Dong

Bone nonunion delays fracture end repair and is associated with inflammation. Although bone nonunion can be effectively repaired in clinical practice, many cases of failure. Studies have confirmed that BMP-2 and nHA/PA66 repaired bone defects successfully. There are few studies on the effects of the combined application of BMP-2 and NHA/PA66 on bone nonunion osteogenesis and inflammation. We aimed to investigate the expression level of inflammation-related genes in patients with bone nonunion and the effect of BMP-2-infected mesenchymal stem cells combined with nHA/PA66 on the level of inflammation in femur nonunion rats. We searched for a gene expression profile related to bone nonunion inflammation (GSE93138) in the GEO public database. Bone marrow mesenchymal stem cells (MSCs) of SD rats were cultured and passed through. We infected the third generation of MSCs with lentivirus carrying BMP-2 and induced the infected MSCs to bone orientation. We detected the expression level of BMP-2 by RT-PCR and the cell viability and alkaline phosphatase (ALP) activity by CCK8 and then analyzed the cell adhesion ability. Finally, the levels of related inflammatory factors, including C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and Erythrocyte Sedimentation Rate (ESR), were detected in nonunion rats. Our findings: The patients with nonunion had up-regulated expression of 26 differentially inflammatory genes. These genes are mainly enriched in innate immune response, extracellular region, calcium ion binding, Pantothenate and CoA biosynthesis pathways. The expression level of BMP-2 in the Lenti-BMP-2 group was higher (vs. empty lentivirus vector group: t=5.699; vs. uninfected group t=3.996). The cell activity of the MSCs + BMP-2 + nHA/PA66 group increased gradually. After being combined with nHA/PA66, MSCs transfected with BMP-2 spread all over the surface of nHA/PA66 and grew into the material pores. MSCs + BMP-2 + nHA/PA66 cells showed positive ALP staining, and the OD value of ALP was the highest. The levels of CRP, IL-6, TNF-alpha, and ESR in the MSCs + BMP-2 + nHA/PA66 group were lower than those in the MSCs and MSCs + nHA/PA66 group but higher than those in MSCs + BMP-2 group. The above comparisons were all P<0.05. The findings demonstrated that the expression level of inflammation-related genes increased in the patients with bone nonunion. The infection of MSCs by BMP-2 could promote the directed differentiation of MSCs into osteoblasts in the bone marrow of rats, enhance the cell adhesion ability and ALP activity, and reduce inflammation in rats with bone nonunion.

骨不连会延迟骨折端修复,并与炎症有关。虽然在临床实践中骨不连可以有效修复,但失败的病例很多。研究证实,BMP-2 和 nHA/PA66 可成功修复骨缺损。关于 BMP-2 和 NHA/PA66 联合应用对骨不连成骨作用和炎症的影响的研究很少。我们旨在研究骨不连患者炎症相关基因的表达水平,以及 BMP-2 感染间充质干细胞与 NHA/PA66 联合应用对股骨不连大鼠炎症水平的影响。我们在GEO公共数据库中搜索了与骨不连炎症相关的基因表达谱(GSE93138)。培养并通过 SD 大鼠的骨髓间充质干细胞(MSCs)。我们用携带 BMP-2 的慢病毒感染第三代间充质干细胞,并诱导受感染的间充质干细胞进行骨定向。我们用 RT-PCR 检测了 BMP-2 的表达水平,用 CCK8 检测了细胞活力和碱性磷酸酶(ALP)活性,然后分析了细胞粘附能力。最后,我们检测了非椎体内髁大鼠相关炎症因子的水平,包括 C 反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和红细胞沉降率(ESR)。我们的研究结果非腱鞘炎患者有 26 个不同炎症基因的表达上调。这些基因主要集中在先天性免疫反应、细胞外区域、钙离子结合、泛酸和 CoA 生物合成途径。Lenti-BMP-2 组的 BMP-2 表达水平更高(与空慢病毒载体组相比:t=5.699;与未感染组相比 t=3.996)。间充质干细胞 + BMP-2 + nHA/PA66 组的细胞活性逐渐增加。转染了 BMP-2 的间充质干细胞与 nHA/PA66 结合后,布满了 nHA/PA66 的表面,并向材料孔中生长。间充质干细胞+BMP-2+nHA/PA66细胞的ALP染色呈阳性,且ALP的OD值最高。间充质干细胞 + BMP-2 + nHA/PA66 组的 CRP、IL-6、TNF-α 和 ESR 水平低于间充质干细胞组和间充质干细胞 + nHA/PA66 组,但高于间充质干细胞 + BMP-2 组。以上比较的 P
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