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[PMID]:29428028
[Au] Autor:Bigatao AM; Herbella FAM; Del Grande LM; Nascimento OA; Jardim JR; Patti MG
[Ti] Título:Chronic Obstructive Pulmonary Disease Exacerbations Are Influenced by Gastroesophageal Reflux Disease.
[So] Source:Am Surg;84(1):51-55, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Gastroesophageal reflux disease (GERD) is associated with different pulmonary diseases, including chronic obstructive pulmonary disease (COPD). Whether GERD is contributory to COPD severity remains unclear. This study aims to evaluate the contribution of GERD to the clinical manifestation of COPD based on ventilatory parameters and yearly clinical exacerbations. We studied 48 patients (56% females, age 66 years) with COPD. All patients underwent high-resolution manometry and esophageal pH monitoring. The patients were separated into two groups according to the presence of GERD. GERD was present in 21 (44%) patients. GERD + and GERD - groups did not differ in regard to gender, age, and body mass index. Pulmonary parameters were not different in the absence or presence of GERD. The number of yearly exacerbations was higher in patients GERD+. The severity of GERD (as measured by DeMeester score) correlated with the number of exacerbations. Our results show the following: 1) GERD does not influence pulmonary parameters and 2) GERD is associated with a higher number of annual clinical exacerbations. We believe GERD must be objectively tested in patients with COPD because the prevalence of GERD in these patients is underestimated when only symptoms are considered. GERD treatment might decrease the frequency of episodes of exacerbation.
[Mh] Termos MeSH primário: Monitoramento do pH Esofágico
Refluxo Gastroesofágico/complicações
Doença Pulmonar Obstrutiva Crônica/complicações
[Mh] Termos MeSH secundário: Idoso
Índice de Massa Corporal
Feminino
Refluxo Gastroesofágico/diagnóstico
Refluxo Gastroesofágico/fisiopatologia
Seres Humanos
Masculino
Manometria
Meia-Idade
Doença Pulmonar Obstrutiva Crônica/diagnóstico
Doença Pulmonar Obstrutiva Crônica/fisiopatologia
Fatores de Risco
Índice de Gravidade de Doença
Fumar/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE


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[PMID]:29406039
[Au] Autor:Chedid V; Rosenblatt E; Gandhi KK; Dhalla S; Nandwani MC; Stein EM; Clarke JO
[Ad] Endereço:Department of Internal Medicine, Division of Gastroenterology & Hepatology, Mayo Clinic Rochester, Rochester, Minnesota. Electronic address: chedid.victor@mayo.edu.
[Ti] Título:The Effect of Race in Patients with Achalasia Diagnosed With High-Resolution Esophageal Manometry.
[So] Source:Am J Med Sci;355(2):126-131, 2018 Feb.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The advent of the Chicago Classification for esophageal motility disorders allowed for clinically reproducible subgrouping of patients with achalasia based on manometric phenotype. However, there are limited data with regards to racial variation using high-resolution esophageal manometry (HREM). The aim of our study was to evaluate the racial differences in patients with achalasia diagnosed with HREM using the Chicago Classification. We evaluated the clinical presentation, treatment decisions and outcomes between blacks and non-blacks with achalasia to identify potential racial disparities. MATERIALS AND METHODS: We performed a retrospective review of consecutive patients referred for HREM at a single tertiary referral center from June 2008 through October 2012. All patients diagnosed with achalasia on HREM according to the Chicago Classification were included. Demographic, clinical and manometric data were abstracted. All studies interpreted before the Chicago Classification was in widespread use were reanalyzed. Race was defined as black or non-black. Patients who had missing data were excluded. Proportions were compared using chi-squared analysis and means were compared using the Student's t-test. RESULTS: A total of 1,268 patients underwent HREM during the study period, and 105 (8.3%) were manometrically diagnosed with achalasia (53% female, mean age: 53.8 ± 17.0 years) and also met the aforementioned inclusion and exclusion criteria. A higher percentage of women presented with achalasia in blacks as compared to whites or other races (P < 0.001). Non-blacks were more likely to present with reflux than blacks (P = 0.01), while blacks were more likely to be treated on the inpatient service than non-blacks (P < 0.001). There were no other significant differences noted in clinical presentation, treatment decisions and treatment outcomes among blacks and non-blacks. CONCLUSIONS: Our study highlights possible racial differences between blacks and non-blacks, including a higher proportion of black women diagnosed with achalasia and most blacks presenting with dysphagia. There is possibly a meaningful interaction of race and sex in the development of achalasia that might represent genetic differences in its pathophysiology. Further prospective studies are required to identify such differences.
[Mh] Termos MeSH primário: Afroamericanos
Acalasia Esofágica/diagnóstico
Acalasia Esofágica/fisiopatologia
Acalasia Esofágica/terapia
Grupo com Ancestrais do Continente Europeu
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Manometria
Meia-Idade
Estudos Retrospectivos
Fatores Sexuais
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE


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[PMID]:29465580
[Au] Autor:Höhne S; Hesse V
[Ti] Título:Standard values for gas-perfusion manometry of the esophagus.
[So] Source:Medicine (Baltimore);97(8):e9910, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The manometry with water-perfused or solid-state catheters is the predominant diagnostic procedure to detect motility disorders of the esophagus. Another method is the manometry using gas-perfused catheters. Although the high-resolution manometry is the method of first choice, the conventional manometry with helium has some advantages: the simple and hygienically unproblematic use and the absence of any artefacts by the perfusion medium compared with water-perfusion, and the considerably lower costs compared with the solid-state catheters. Every method has own normal values because of the specific pressure transmission and the design of the catheter probes. To our knowledge, normal values for gas-perfusion manometry of the esophagus have not yet been published.The esophageal manometry with helium-perfused catheters was performed in 30 healthy volunteers. The main parameters of the esophageal motility and the lower esophageal sphincter were analyzed by liquid and bolus-like swallows and compared with the previous published values in other manometric procedures.The values of the motility in the distal esophagus are consistent; the pressure of the lower esophageal sphincter is generally lower than with other methods. The distal wave amplitude and the propagation velocity are significant higher in the distal esophagus than in the middle. The perfusion medium is well tolerated by the investigated volunteers.
[Mh] Termos MeSH primário: Esôfago/fisiologia
Manometria/métodos
[Mh] Termos MeSH secundário: Adulto
Cateterismo/métodos
Esfíncter Esofágico Inferior/fisiologia
Feminino
Hélio
Seres Humanos
Masculino
Satisfação do Paciente
Perfusão
Pressão
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
206GF3GB41 (Helium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009910


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[PMID]:29390507
[Au] Autor:Hermida-Ameijeiras A; Crujeiras V; Roca I; Calvo C; Leis R; Couce ML
[Ad] Endereço:Unit of Diagnosis and Treatment of Congenital Metabolic Diseases, Service of Neonatology, Department of Pediatrics, Hospital Clínico Universitario de Santiago, CIBERER, Health Research Institute of Santiago de Compostela (IDIS), A Choupana.
[Ti] Título:Arterial stiffness assessment in patients with phenylketonuria.
[So] Source:Medicine (Baltimore);96(51):e9322, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In patients with phenylketonuria (PKU) compliant to diet greater tendency to overweight and higher inflammatory biomarkers levels than controls were reported. Although this could lead to atherogenesis, the elastic properties of large arteries in PKU patients have never been assessed. The aim of this study was to assess arterial stiffness measured by applanation tonometry in PKU patients compared to healthy controls.We carried out a cross-sectional study in 41 PKU patients (range age: 6-50 years old) and 41 age- and gender-matched healthy controls. Evaluated data included pharmacological treatment with sapropterin, clinical, and biochemical parameters. Aortic stiffness was assessed noninvasively by applanation tonometry measuring central blood pressure, aortic augmentation index (Aix@HR75), augmentation pressure (AP), and pulse wave velocity (PWV).We found higher PWV in classic PKU patients (6.60 m/second vs 5.26 m/second; P: .044). Percentage of PKU patients with PWV above 90 percentile was higher than controls (14.63% vs 2.32%; P: .048). A positive relationship was observed between the annual Phe median and PWV (r: 0.496; P: .012). PKU subjects with lower Phe tolerance showed more body weight (67.6 kg vs 56.8 kg; P: .012) and more PWV than those with higher Phe tolerance (6.55 m/second vs 5.42 m/second; P: .044).Our data show increased aortic stiffness in PKU patients, measured by applanation tonometry, when compared to healthy controls. Higher Phe levels are associated with a bigger PWV increase, which is not present in those subjects compliant to diet or under sapropterin treatment. These results could have marked effects in both research and clinical daily practice for a proper evaluation of cardiovascular risk in PKU subjects.
[Mh] Termos MeSH primário: Fenilcetonúrias/fisiopatologia
Rigidez Vascular/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Índice de Massa Corporal
Estudos de Casos e Controles
Criança
Estudos Transversais
Feminino
Seres Humanos
Masculino
Manometria
Meia-Idade
Análise de Onda de Pulso
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009322


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[PMID]:29241851
[Au] Autor:Costamagna G
[Ad] Endereço:Digestive Endoscopy Unit, Fondazione Policlinico A. Gemelli, Università Cattolica, Rome, Italy; IHU-USIAS University of Strasbourg, Strasbourg, France.
[Ti] Título:Sphincter of Oddi dysfunction: the never-ending story has come to a conclusion.
[So] Source:Gastrointest Endosc;87(1):211-212, 2018 01.
[Is] ISSN:1097-6779
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Disfunção do Esfíncter da Ampola Hepatopancreática
Esfíncter da Ampola Hepatopancreática
[Mh] Termos MeSH secundário: Doenças do Ducto Colédoco
Seres Humanos
Manometria
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


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[PMID]:29226662
[Au] Autor:Ihara E; Muta K; Fukaura K; Tanaka Y; Bai X; Aso A; Iwasa T; Nakamura K
[Ti] Título:New Approach to Diagnosis and Treatment of Esophageal Motility Disorders by High-Resolution manometry.
[So] Source:Fukuoka Igaku Zasshi;107(7):121-30, 2016 07.
[Is] ISSN:0016-254X
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:Esophageal motility disorders (EMD) is characterized by impaired coordinated esophageal motility function with symptoms including dysphasia, heartburn or noncardiac chest pain. Since EMDs is functional disorders, it is usually difficult to make a diagnosis by conventional examinations including endoscopy and esophagography. Recently developed high-resolution manometry allows us to evaluate esophageal motility function precisely and to make a differential diagnosis of EMDs, together with Chicago Classification (CC) version 3.0 (CC ver3.0). In this article, we reviewed diagnosis of EMDs based on CC ver3.0 and current treatment strategy for EMDs.
[Mh] Termos MeSH primário: Transtornos da Motilidade Esofágica/fisiopatologia
Manometria
[Mh] Termos MeSH secundário: Transtornos da Motilidade Esofágica/diagnóstico
Transtornos da Motilidade Esofágica/terapia
Junção Esofagogástrica/fisiopatologia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; ENGLISH ABSTRACT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


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[PMID]:28746079
[Au] Autor:George NS; Rangan V; Geng Z; Khan F; Kichler A; Gabbard S; Ganocy S; Fass R
[Ad] Endereço:*The Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center †The Esophageal Center, The Cleveland Clinic Foundation, Cleveland, OH.
[Ti] Título:Distribution of Esophageal Motor Disorders in Diabetic Patients With Dysphagia.
[So] Source:J Clin Gastroenterol;51(10):890-895, 2017 Nov/Dec.
[Is] ISSN:1539-2031
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Diabetes mellitus can cause various gastrointestinal symptoms. Assessment of esophageal dysmotility in diabetic patients has been scarcely studied. The aim of this study was to determine the esophageal motor characteristics of diabetic versus nondiabetic patients who present with dysphagia. METHODS: High-resolution esophageal manometries (HREMs) of 83 diabetic patients and 83 age and gender-matched nondiabetic patients with dysphagia from 2 medical centers were included in this study. Demographic information, medical comorbidities, and medication usage were recorded for each patient in a single registry. HREM of each patient was evaluated and the different functional parameters were recorded. KEY RESULTS: Overall, 46% of diabetic patients were found to have an esophageal motor disorder. Diabetic patients with dysphagia were more likely to have failed swallows on HREM (50.6% vs. 33.7%; P=0.03) as compared with nondiabetic patients. Among diabetic patients, those being treated with insulin were more likely to have failed (69.0% vs. 40.7%; P=0.01) and weak (65.5% vs. 33.3%; P=0.005) swallows as compared with diabetic patients not on insulin. Among diabetic patients, those with abnormal manometry were more likely to demonstrate diabetic retinopathy (27.0% vs. 8.7%; P=0.04). There was a trend toward increased incidence of esophagogastric junction outflow obstruction in diabetic patients (10.8% vs. 2.4%; P=0.057) as compared with nondiabetic patients. CONCLUSIONS: Nearly half of diabetic patients with dysphagia have some type of an esophageal motility disorder. Diabetic retinopathy and the use of insulin are predictive of esophageal motor abnormalities among diabetic patients.
[Mh] Termos MeSH primário: Transtornos de Deglutição/epidemiologia
Complicações do Diabetes/epidemiologia
Transtornos da Motilidade Esofágica/epidemiologia
Manometria/métodos
[Mh] Termos MeSH secundário: Idoso
Estudos de Casos e Controles
Transtornos de Deglutição/etiologia
Diabetes Mellitus/tratamento farmacológico
Diabetes Mellitus/fisiopatologia
Retinopatia Diabética/epidemiologia
Junção Esofagogástrica/fisiopatologia
Feminino
Seres Humanos
Hipoglicemiantes/administração & dosagem
Hipoglicemiantes/efeitos adversos
Incidência
Insulina/administração & dosagem
Insulina/efeitos adversos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Hypoglycemic Agents); 0 (Insulin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1097/MCG.0000000000000894


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[PMID]:29244820
[Au] Autor:Lee JY; Kim N; Nam RH; Sohn SH; Lee SM; Choi D; Yoon H; Kim YS; Lee HS; Lee DH
[Ad] Endereço:Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, South Korea.
[Ti] Título:Probiotics reduce repeated water avoidance stress-induced colonic microinflammation in Wistar rats in a sex-specific manner.
[So] Source:PLoS One;12(12):e0188992, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The colonic response to stress is greater in female rats than in male rats. The aim of this study was to evaluate the effect of probiotics in the repeated water avoidance stress (rWAS)-induced colonic microinflammation model of Wistar rats in a sex-specific manner. The three groups (no-stress, WAS, and WAS with probiotics) were exposed to r-WAS for 1 h daily for 10 days, and Lactobacillus farciminis was administered by oral gavage for 10 days to animals in the probiotics group. The visceromotor response (VMR) to colorectal distension (CRD) was assessed using a barostat and noninvasive manometry before and after WAS exposure. Immunohistochemistry for mast cells and real-time polymerase chain reaction (RT-PCR) for detection of mucosal cytokines were performed using distal colon tissue after the animals were sacrificed. Significant reduction of VMR to CRD (visceral analgesia) was observed at 60 mmHg in the female WAS group (P = 0.045), but not in males. In addition, the female WAS with probiotics group showed a significantly lower colonic mucosal mast cell count in comparison to the female WAS group (P = 0.013), but this phenomenon was not observed in the male group. The colonic mucosal mRNA levels of interferon-γ (IFNR), tumor necrosis factor-α (TNFA), interleukin (IL) 6, and IL17 were higher in the female WAS group than in the male WAS group. The mRNA levels of IFNR, TNFA, and IL6 were significantly decreased in WAS females who received probiotics (all P < 0.050). In conclusion, rWAS is induced in a sex-specific manner. A 10-day-long treatment with L. farciminis is an effective therapy for rWAS-induced colonic microinflammation in female rates, but not in male rats.
[Mh] Termos MeSH primário: Colo/microbiologia
Desidratação/prevenção & controle
Lactobacillus/fisiologia
Probióticos/farmacologia
Estresse Psicológico/prevenção & controle
[Mh] Termos MeSH secundário: Animais
Colo/imunologia
Desidratação/imunologia
Desidratação/microbiologia
Feminino
Expressão Gênica
Interferon gama/genética
Interferon gama/imunologia
Interleucina-17/genética
Interleucina-17/imunologia
Interleucina-6/genética
Interleucina-6/imunologia
Masculino
Manometria
Mastócitos/imunologia
Mastócitos/microbiologia
RNA Mensageiro/genética
RNA Mensageiro/imunologia
Ratos
Ratos Wistar
Fatores Sexuais
Estresse Psicológico/imunologia
Estresse Psicológico/microbiologia
Fator de Necrose Tumoral alfa/genética
Fator de Necrose Tumoral alfa/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Interleukin-17); 0 (Interleukin-6); 0 (RNA, Messenger); 0 (Tumor Necrosis Factor-alpha); 82115-62-6 (Interferon-gamma)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188992


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[PMID]:28449422
[Au] Autor:Jeong J; Kim SE; Park MI; Park SJ; Moon W; Kim JH; Jung K; Choi YJ; Lee JY; Lee YD
[Ad] Endereço:Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
[Ti] Título:The Effect of Anti-reflux Therapy on Patients Diagnosed with Minor Disorders of Peristalsis in High-resolution Manometry.
[So] Source:Korean J Gastroenterol;69(4):212-219, 2017 Apr 25.
[Is] ISSN:2233-6869
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background/Aims: Minor disorders of peristalsis are esophageal motility disorders categorized by the Chicago Classification (CC), version 3.0, which was announced in 2014. This study evaluated the efficacy of anti-reflux therapy in patients with minor peristaltic disorders. Methods: Patients with minor peristaltic disorders in accordance with CC v3.0 were included. We reviewed the medical records of patients with esophageal high-resolution manometry findings, and investigated the demographic and clinical information as well as the medical therapy. Thereafter, the response to treatment was assessed after at least 4 weeks of treatment. Results: A total of 24 patients were identified as having minor disorders of peristalsis from January 2010 to December 2015. The mean follow-up period was 497 days, and there were 17 patients (70.8%) patients with ineffective esophageal motility. In terms of anti-reflux therapy, proton pump inhibitors (PPIs) with prokinetic agents and PPIs alone were prescribed in 19 patients (79.2%) and 5 patients (20.8%), respectively. When the rate of response to the treatment was assessed, the responders rate (complete+satisfactory [≥50%] responses) was 54.2% and the non-responders rate (partial [<50%]+refractory responses) was 45.8%. Patients in the responder group were younger than those in the non-responder group (p=0.020). Among them, 13 patients underwent 24-hour multichannel intraluminal impedance-pH, and 10 patients (76.9%) were pathologic gastroesophageal reflux. Conclusions: The majority of esophageal minor peristaltic disorders were accompanied by gastroesophageal reflux, and therefore, they might respond to acid inhibitor. Further well-designed, prospective studies are necessary to confirm the effect of anti-reflux therapy in these patients.
[Mh] Termos MeSH primário: Transtornos da Motilidade Esofágica/diagnóstico
Refluxo Gastroesofágico/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Transtornos da Motilidade Esofágica/complicações
Esfíncter Esofágico Inferior/fisiologia
Monitoramento do pH Esofágico
Junção Esofagogástrica/fisiologia
Esofagoscopia
Feminino
Refluxo Gastroesofágico/complicações
Refluxo Gastroesofágico/tratamento farmacológico
Seres Humanos
Masculino
Manometria
Meia-Idade
Peristaltismo
Inibidores da Bomba de Prótons/uso terapêutico
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Proton Pump Inhibitors)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180102
[Lr] Data última revisão:
180102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.4166/kjg.2017.69.4.212


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[PMID]:29112569
[Au] Autor:Sun L; Kuang M; Penn M; Damaser MS; Zutshi M
[Ad] Endereço:1 Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio 2 Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio 3 Summa Cardiovascular Institute, Akron, Ohio 4 Juventas Therapeutics Inc, Cleveland, Ohio 5 Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio 6 Advanced Platform Technology Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio.
[Ti] Título:Stromal Cell-Derived Factor 1 Plasmid Regenerates Both Smooth and Skeletal Muscle After Anal Sphincter Injury in the Long Term.
[So] Source:Dis Colon Rectum;60(12):1320-1328, 2017 Dec.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Regenerating muscle at a time remote from injury requires re-expression of cytokines to attract stem cells to start and sustain the process of repair. OBJECTIVE: We aimed to evaluate the sustainability of muscle regeneration after treatment with a nonviral plasmid expressing stromal cell-derived factor 1. DESIGN: This was a randomized study. SETTINGS: The study was conducted with animals in a single research facility. INTERVENTIONS: Fifty-six female age-/weight-matched Sprague-Dawley rats underwent excision of the ventral half of the anal sphincter complex. Three weeks later, rats were randomly allocated (n = 8) to one of the following groups: no treatment, 100 µg of plasmid encoding stromal cell-derived factor 1 injected locally, local injection of plasmid and 8 × 10 bone marrow-derived mesenchymal stem cells, and plasmid encoding stromal cell-derived factor 1 injected locally with injection of a gelatin scaffold mixed with bone marrow-derived mesenchymal stem cells. MAIN OUTCOME MEASURES: Anal manometry, histology, immunohistochemistrym and morphometry were performed 8 weeks after treatment. Protein expression of cytokines CXCR4 and Myf5 was investigated 1 week after treatment (n = 6 per group). ANOVA was used, with p < 0.0083 indicating significant differences for anal manometry and p < 0.05 for all other statistical analysis. RESULTS: Eight weeks after treatment, all of the groups receiving the plasmid had significantly higher anal pressures than controls and more organized muscle architecture in the region of the defect. Animals receiving plasmid alone had significantly greater muscle in the defect (p = 0.03) than either animals with injury alone (p = 0.02) or those receiving the plasmid, cells, and scaffold (p = 0.03). Both smooth and skeletal muscles were regenerated significantly more after plasmid treatment. There were no significant differences in the protein levels of CXCR4 or Myf5. LIMITATIONS: The study was limited by its small sample size and because stromal cell-derived factor 1 was not blocked. CONCLUSIONS: A plasmid expressing stromal cell-derived factor 1 may be sufficient to repair an injured anal sphincter even long after the injury and in the absence of mesenchymal stem cell or scaffold treatments. See Video Abstract at http://links.lww.com/DCR/A451.
[Mh] Termos MeSH primário: Canal Anal/cirurgia
Quimiocina CXCL12/farmacologia
Músculo Esquelético/cirurgia
Músculo Liso/cirurgia
Plasmídeos/farmacologia
Regeneração
[Mh] Termos MeSH secundário: Animais
Modelos Animais de Doenças
Feminino
Seres Humanos
Imuno-Histoquímica
Manometria
Transplante de Células-Tronco Mesenquimais
Fator Regulador Miogênico 5/metabolismo
Distribuição Aleatória
Ratos
Ratos Sprague-Dawley
Receptores CXCR5/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Chemokine CXCL12); 0 (Myogenic Regulatory Factor 5); 0 (Receptors, CXCR5)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171108
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000940



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