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Expressão dos microRNAs miR-145, miR-181c, miR-199a e miR-1183 em hipocampo e sangue de pacientes com epilepsia do lobo temporal mesial / Expression of microRNAs miR-145, miR-181c, miR-199a and miR-1183 in blood and hippocampus of patients with mesial temporal lobe epilepsyLourenço, Luana Grupioni 27 October 2015 (has links)
Introdução: A epilepsia do lobo temporal mesial (ELTM) é a forma mais comum de epilepsia parcial e com índices significativos de resistência aos tratamentos farmacológicos. Um dos grandes desafios para a neurociência na atualidade é o desenvolvimento de biomarcadores que facilitem o diagnóstico e prognóstico para a epilepsia. Recentemente, algumas pesquisas demonstraram que microRNAs circulantes no sangue são biomarcadores sensíveis e específicos para várias doenças, incluindo do SNC, podendo ser obtido de forma não invasiva e representando um método de detecção eficiente e de baixo custo. Portanto, nosso trabalho teve como objetivo analisar o perfil de expressão dos microRNAs miR-145, miR-181c, miR199a e miR-1183 no hipocampo e fração leucocitária do sangue de pacientes com ELTM e investigar se os mesmos podem auxiliar como biomarcadores de diagnóstico e prognóstico para a epilepsia. Pacientes e métodos: Foram utilizadas amostras de hipocampo e sangue de 20 pacientes com ELTM, sendo 10 com boa evolução pós-operatória (Engel I) e 10 com evolução pósoperatória insatisfatória (Engel III e IV), e para controle foram utilizados hipocampos de necropsias e sangue de indivíduos saudáveis. A análise de expressão dos miRNAs foi feita utilizando a técnica de RQ-PCR. Resultados e Conclusões: As expressões dos miRNAs se comportaram de forma diferente no hipocampo e sangue de pacientes com ELTM quando comparados aos grupos controles. O miR- 145 apresentou-se hipoexpresso no hipocampo e hiperexpresso no sangue. Os miRNAs miR-145, miR-181c, miR199a e miR-1183 apresentaram-se hiperexpressos na fração leucocitária do sangue de pacientes com ELTM, podendo estes contribuir como possíveis biomarcadores para auxiliarem no diagnóstico. Ainda, não encontramos diferenças estatística desses miRNAs no sangue e hipocampo de pacientes Engel I versus Engel III e IV, no entanto, o miR-1183 apresentou-se progressivamente mais expresso no sangue dos pacientes nos grupos controle, no grupo Engel I e no grupo Engel III e IV respectivamente. / Introduction: The mesial temporal lobe epilepsy (MTLE) is the most common form of partial epilepsy and also presents significant resistance to pharmacological treatment. A major challenge for neuroscience today is the development of biomarkers that facilitate the diagnosis and prognosis for epilepsy. Recently, research has shown that microRNAs circulating in the blood are sensitive and specific biomarkers for various diseases, including CNS, they can be obtained noninvasively and represent a low cost detection method. Thus, our study aimed to analyze the expression profile of microRNAs miR-145, miR-181c, miR199a and miR- 1183 in the hippocampus and leukocyte fraction of the blood of patients with MTLE and investigate whether they can assist as diagnostic and prognosis biomarkers for epilepsy. Patients and Methods: Hippocampus and blood samples of 20 patients with MTLE were used; ten with good postoperative outcome (Engel I) and ten with poor postoperative outcome (Engel III and IV), and for the control group hippocampus of necropsy and blood of healthy individuals were used. The analysis of the expression of miRNAs was performed using RQ-PCR. Results and Conclusions: The expression of miRNAs behaved differently in the hippocampus and blood of patients with MTLE when compared with the control groups. This different behavior was most evident in miR-145, which was hypo-expressed in the hippocampus and hyper-expressed in the blood. MiRNAs miR-145, miR-181c, miR199a and miR-1183 were hyper-expressed in the leukocyte fraction from the blood of patients with MTLE, and these can be potential biomarkers to aid in the diagnosis. We found no statistical differences of these miRNAs in blood and hippocampus of patients Engel I versus Engel III and IV, however, miR-1183 was progressively expressed in the blood of patients in the control groups, Engel I and Engel III and IV respectively.
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Biomarqueurs de la carcinogenèse associée aux papillomavirus humains / Biomarkers of human papillomavirus-associated carcinogenesisJacquin, Elise 03 December 2013 (has links)
La persistance d'une infection par un même papillomavirus humain à haut risque oncogène (HPV-HR) est le principal facteur de risque d'apparition et de progression des lésions précancéreuses et cancéreuses du col de l'utérus. La recherche des lésions précancéreuses et l'introduction des tests basés sur la détection des HPV-HR dans le dépistage ont permis de réduire l'incidence du cancer du col de l'utérus dans les pays développés. Un des enjeux actuels réside dans l'identification de nouveaux marqueurs qui permettraient d'améliorer le dépistage. Dans ce contexte, les objectifs de cette thèse étaient d'explorer l'histoire naturelle de l'infection par HPV-HR au travers de facteurs tels que la charge virale, l'intégration, l'expression des oncogènes viraux ou encore la méthylation du promoteur viral à partir de prélèvements biologiques et d'évaluer l'intérêt de ces facteurs en pratique clinique. Après optimisation et validation d'outils de biologie moléculaire, l'analyse de frottis cervico-utérins représentatifs de la progression des lésions du col de l'utérus a permis de mieux comprendre l'histoire naturelle de l'infection transformante par HPV16. Nos données confirment la valeur diagnostique de la charge virale, indiquent une méthylation tardive du promoteur viral et suggèrent que les niveaux d'expression des gènes viraux ne sont pas suffisamment robustes pour présenter un intérêt clinique. D'autre part, nos travaux ont mis en évidence de potentielles analogies de comportement virologique entre génotypes apparentés. Enfin, la caractérisation de tumeurs du canal anal à l'aide de nos marqueurs viraux a permis d'identifier une signature moléculaire des cancers associés à HPV16. / The main risk factor of precancerous and cancerous cervical lesions is a persistent infection with the same high-risk HPV (HR-HPV). Screening based on precancerous lesions and HR-HPV detection considerably reduced cervical cancer incidence in developed countries. A current challenge remains the identification of new biomarkers in order to improve cervical cancer screening. This work was conducted with the purpose of (i) exploring HR-HPV infection natural history through viral factors such as viral load, integration, viral oncogene expression and viral promoter methylation and (ii) evaluating the clinical value of these potential markers. After optimization and validation of several molecular biology methods, the analysis of cervical smears representative of the full spectrum of cervical diseases allowed a better knowledge of transforming HPVI6-infection natural history. Our data confirm the potential diagnostic value of viral load. show that HPVI6 promoter methylation seems to be a late event in cervical carcinogenesis, and suggest that viral oncogene expression levels are not robust enough to be transferred to clinical practice. Moreover, our data highlight similar molecular behavior between closely related HR-HPV genotypes. Finally, the characterization of anal tumors with markers identified a molecular signature pattern of HPVI6-associated tumors
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Oncoproteomic applications for detection of breast cancer : proteomic profiling of breast cancer models and biopsiesShaheed, Sadr-ul January 2017 (has links)
The heterogeneity of breast cancer (disease stage and phenotype) makes it challenging to differentiate between each subtype; luminal A, luminal B, HER2, basal-like and claudin-low, on the basis of a single gene or protein. Therefore, a collection of markers is required that can serve as a signature for diagnosing different types of breast cancer. New developments in proteomics have provided the opportunity to look at phenotype-specific breast cancer cell lines and stage-specific liquid biopsies (nipple aspirate fluid [NAF], plasma samples) to identify disease and phenotype specific signature. An 8-plex iTRAQ quantification strategy was employed to compare proteomic profiles of a range of breast cancer and ‘normal-like’ cell lines with primary breast epithelial cells. From this, 2467 proteins were identified on Orbitrap Fusion and Ultraflex II, of which 1430 were common. Matched pairs of NAF samples from four patients with different stages of breast cancer, were analysed by SCX-LC-MS and a total of 1990 unique gene products were identified. More than double the number of proteins previously published data, were detected in NAF, including 300 not detected in plasma. The NAF from the diseased patients have 138 potential phenotype biomarkers that were significantly changed compared to the healthy volunteer (7 for luminal A, 9 for luminal B, 11 for HER2, 14 for basal-like and 52 for claudin-low type). The average coefficient of variation for triplicate analyses by multiple reaction monitoring mass spectrometry (MRM-MS), was 9% in cell lines, 17 % in tissue biopsies, 22% in serum samples and 24% in NAF samples. Overall, the results provide a strong paradigm to develop a clinical assay based on proteomic changes in NAF samples for the early detection of breast cancer supplementary to established mammography programmes.
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Identification of serum biomarkers for hepatocellular carcinoma by glycoproteomic analysis. / CUHK electronic theses & dissertations collectionJanuary 2007 (has links)
Aim. In this study, we attempted to identify HCC-specific serum glycoproteins by using glycoproteomic technologies. We targeted at finding glycoforms with aberrant alpha-2,6-sialylation and alpha-1,6-fucosylation in sera of HCC patients. These glycoforms may have potentials to be used as tumor marker(s) in the diagnosis of HCC. / Among the validated differential glycoproteins, Hp was the only glycoprotein, glycoforms of which were found to be significantly up-regulated in the HCC group when examining both the sialylated glycoprotein profiles and the fucosylated glycoprotein profiles. This glycoprotein was selected for further investigation. In the independent validation group, increased serum levels of Hp (total), alpha-2,6 sialylated Hp and alpha-1,6 fucosylated Hp was observed in the HCC patients. A unique pattern of Hp glycoforms comprising both hypersialylated fucosylated and hyposialytated fucosylated species was found in the HCC patients. Serum concentrations of these glycoforms were significantly higher in the HCC patients with advanced tumor, suggesting their tumor-specific nature. Besides, we have performed quantitative profiling of N-glycans of serum Hp in the HCC patients, CLD patients and normal subjects, and have attempted to identify HCC-associated N-glycans for HCC diagnosis. Combined used of serum alpha-fetoprotein, serum Hp and its N-glycans, we could achieve 84% sensitivity at 100% and 93% specificities when distinguishing the HCC patients from the CLD patients and from the normal subjects, respectively. / Background. Hepatocellular carcinoma (HCC) often arises in patients with coexisting chronic liver disease (CLD). Since alpha-fetoprotein, a conventional biomarker, may also be raised in patients with uncomplicated CLD, the use of alpha-fetoprotein in early detection of HCC is limited. Identification of additional biomarkers may improve early detection. Previous studies have shown that levels of alpha-2,6-sialyltransferase and alpha-1,6-fucosyltransferase change in liver cancer, leading to aberrant glycosylations on some serum proteins. / Conclusion. By undertaking glycoproteomic approach, we have identified a panel of potential biomarkers for diagnosis of HCC. These biomarkers were useful for classifying among normal healthy subjects, CLD patients, patients with early HCC and patients with advanced HCC. Some of them were validated with the independent cases. Finally, we have identified a unique pattern of Hp glycoforms comprising both hypersialylated fucosylated and hyposialylated fucosylated species in the HCC patients. Serum Hp and its N-glycans have been shown to have potential values for aiding the diagnosis of HCC. / Methodology. There are four parts in this study. The first part is "method development". A method for obtaining quantitative profiles of serum glycoproteins with alpha-2,6-sialylation or alpha-1,6-fucosylation was developed by combined use of lectin affinity chromatography, two-dimensional polyacrylamide gel electrophoresis and enzyme-linked lectin assay. The second part is "biomarker discovery". The quantitative profiles of the serum glycoproteins from 20 HCC patients and 10 CLD patients (control) were compared by bioinformatic approaches to identify potential biomarkers for diagnosis of HCC. The protein identities of the potential targets were obtained by using MALDI-TOF/TOF mass spectrometry. The third part is "validation". An independent set of serum samples from 40 HCC patients, 30 CLD patients and 20 normal subjects was used to evaluate the diagnostic values of the potential biomarkers. The last part of this study was aimed to identify HCC-associated N-glycans on one of potential biomarkers found, and examine their values in diagnosis of HCC. / Result. When analyzing alpha-2,6-sialylated glycoproteins, 53 glycoprotein spots were significantly different between the HCC and CLD groups, of which 44 spots belonged to 13 glycoproteins. Bioinformatic analyses revealed that these differential sialoglycoprotein profiles contained valuable information for differentiating the HCC patients from CLD patients, and classifying between early HCC and advanced HCC patients. When analyzing alpha-1,6-fucosylated proteins, 11 glycoprotein spots were significant different between the two study groups, of which 8 spots belonged to 1 glycoprotein. Majority of the protein identities were successfully obtained by MALDI-TOF/TOF mass spectrometry. Among the differential glycoproteins, we have identified a subgroup with a unique pattern of glycosylation. These glycoproteins were characterized by the presence of hypersialylated and fucosylated glycoforms. The differential patterns and the diagnostic values of some of these serum glycoproteins were confirmed in the independent validation group by measuring their serum levels with immunoassays. The results of the logistic regression analyses suggest that complement factor B and haptoglobin (Hp) can be used in combination with alpha-fetoprotein to improve the diagnosis of HCC. / Ang, Ling. / Adviser: Tereng Chuen Wai Poon. / Source: Dissertation Abstracts International, Volume: 69-02, Section: B, page: 0947. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (leaves 215-238). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese. / School code: 1307.
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Discovery of retinal biomarkers for vascular conditions through advancement of artery-vein detection and fractal analysisRelan, Devanjali January 2016 (has links)
Research into automatic retina image analysis has become increasingly important, not just in ophthalmology but also in other clinical specialities such as cardiology and neurology. In the retina, blood vessels can be directly visualised non-invasively in-vivo, and hence it serves as a "window" to cardiovascular and neurovascular complications. Biomarker research, i.e. investigating associations between the morphology of the retinal vasculature (as a means of revealing microvascular health or disease) and particular conditions affecting the body or brain could play an important role in detecting disease early enough to impact on patient treatment and care. A fundamental requirement of biomarker research is access to large datasets to achieve sufficient power and significance when ascertaining associations between retinal measures and clinical characterisation of disease. Crucially, the vascular changes that appear can affect arteries and veins differently. An essential part of automatic systems for retinal morphology quantification and biomarker extraction is, therefore, a computational method for classifying vessels into arteries and veins. Artery-vein classification enables the efficient extraction of biomarkers such as the Arteriolar to Venular Ratio, which is a well-established predictor of stroke and other cardiovascular events. While structural parameters of the retinal vasculature such as vessels calibre, branching angle, and tortuosity may individually convey some information regarding specific aspects of the health of the retinal vascular network, they do not convey a global summary of the branching pattern and its state or condition. The retinal vascular tree can be considered a fractal structure as it has a branching pattern that exhibits the property of self-similarity. Fractal analysis, therefore, provides an additional means for the quantitative study of changes to the retinal vascular network and may be of use in detecting abnormalities related to retinopathy and systemic diseases. In this thesis, new developments to fully automated retinal vessel classification and fractal analysis were explored in order to extract potential biomarkers. These novel processes were tested and validated on several datasets of retinal images acquired with fundus cameras. The major contributions of this thesis include: 1) developing a fully automated retinal blood vessel classification technique, 2) developing a fractal analysis technique that quantifies regional as well as global branching complexity, 3) validating the methods using multiple datasets, and 4) applying the proposed methods in multiple retinal vasculature analysis studies.
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Avaliação do estresse oxidativo em pacientes esquizofrênicosBorghi, Fábio Aparecido 26 September 2016 (has links)
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Previous issue date: 2016-09-26 / Introduction: Schizophrenia is a complex Neuropsychiatric disorder of uncertain
etiology. About 30% of the affected population do not respond to the usual
treatment with antipsychotic medication, therefore, they are considered a subgroup
of refractory schizophrenics. Several different lines of research has been
developed to understand the mechanisms related to the pathophysiology of
Schizophrenia, standing out the role of oxidative stress. Objectives: To evaluate
the oxidative stress biomarkers in Schizophrenia, and uncover a possible
association to patients known to be refractory to antipsychotic treatment, also
comparing positive and negative symptoms of schizophrenia on the schizophrenic
population currently being treated at a tertiary healthcare center. Methods: Eightynine
individuals were selected and divided into three groups: G1 - 36 healthy
subjects (control group); G2 - 26 non-refractory schizophrenia patients; G3 - 27
refractory schizophrenia patients. All patients met the criteria for Schizophrenia
diagnosis, as proposed by DSM-IV (Diagnostic and Statistical Manual of Mental
Disorders). The Kane et al. criteria and IPAP algorithms (International
Psychopharmacology Algorithm Project) were also used to determine the presence
of clinically refractory Schizophrenia. Clinical and sociodemographic data of groups
were collected, analyzed and compared. For the clinical assessment of the
patient’s psychopathological state, the PANSS (Positive and Negative Syndrome
Scale) tool was used. The patients had peripheral blood drawn for the
measurements of oxidative stress biomarkers: malondialdehyde (MDA), total antioxidant capacity (TEAC), catalase (CAT) and glutathione peroxidase (GSH-Px),
using the methodology of high performance liquid chromatography resolution and
spectrophotometry. The Chi-Square test (χ2), Fisher’s exact test and Mann-
Whitney non-paired test were used for statistical analysis. Results: There was
MDA and CAT increase in the patient groups (G2 and G3) as compared to the
control group (G1). The enzymatic activity of GSH-Px was reduced in G2 and G3
as compared to the control group. TEAC plasma levels remained similar among all
groups. There was no statistic relevant difference among the patient groups
concerning the analysis of all the studied biomarkers (MDA, TEAC, CAT and GSHPx).
The scores obtained by the PANSS scale also showed no differences
between the two groups of patients. The patient groups were similar on
sociodemographic and lifestyle habits. Conclusion: Serum MDA, CAT and GSHPx
were positively associated to Schizophrenia, unlike TEAC, which was not
associated to this condition. Regarding clinical refractority, none of the studied
biomarkers was associated to this schizophrenia characteristic, as well as the
scores obtained by the PANSS, sociodemographic data and lifestyle habits. / Introdução: A Esquizofrenia é uma doença neuropsiquiátrica complexa, cuja
etiologia permanece incompletamente desvendada. Cerca de 30% dos pacientes
mostram-se resistentes ao tratamento com medicamentos antipsicóticos, sendo
considerados esquizofrênicos refratários. Diversas linhas de pesquisa têm sido
desenvolvidas em busca da compreensão dos mecanismos envolvidos na
fisiopatologia da Esquizofrenia, com destaque para o papel do estresse oxidativo.
Objetivo: Avaliar biomarcadores de estresse oxidativo associados a pacientes
com Esquizofrenia, refratários e não refratários ao tratamento antipsicótico e
comparar sintomas positivos e negativos em pacientes esquizofrênicos
acompanhados em um serviço terciário. Casuística e Método: Foram
selecionados 89 indivíduos, divididos em três grupos: G1 - 36 indivíduos
saudáveis (grupo controle); G2 - 26 pacientes com Esquizofrenia não refratária;
G3 - 27 pacientes com Esquizofrenia refratária. Todos os pacientes preencheram
critérios para o diagnóstico de Esquizofrenia, firmado de acordo com o DSM-IV
(Manual Diagnóstico e Estatístico de Transtornos Mentais). Os critérios de Kane et
al. e os algoritmos do IPAP (International Psychopharmacology Algorithm Project)
foram usados para determinar a refratariedade clínica da Esquizofrenia. Os dados
clínicos e sociodemográficos dos grupos foram coletados, analisados e
comparados. Para a avaliação clínica do estado psicopatológico dos pacientes, foi
aplicada a PANSS (Escala das Síndromes Positiva e Negativa). Os pacientes
foram submetidos à coleta de sangue periférico para dosagens dos biomarcadores de estresse oxidativo: malondialdeído (MDA), capacidade antioxidante total
(TEAC), catalase (CAT) e glutationa peroxidase (GSH-Px), realizados por
cromatografia líquida de alta resolução e espectrofotometria. As análises
estatísticas compreenderam os testes Qui-quadrado (χ2), teste exato de Fisher e
teste não pareado de Mann-Whitney. Resultados: Foi observada elevação de
MDA e CAT nos grupos de pacientes (G2 e G3) em relação ao grupo controle
(G1). A atividade enzimática de GSH-Px mostrou-se reduzida nos grupos G2 e
G3, quando comparada ao grupo controle. Os níveis plasmáticos de TEAC
permaneceram semelhantes entre todos os grupos estudados. Não houve
diferença estatisticamente significativa entre os grupos de pacientes (G2 e G3) em
relação à análise de todos os biomarcadores estudados (MDA, TEAC, CAT e
GSH-Px). Os escores obtidos por meio da escala PANSS não evidenciaram
diferenças entre os dois grupos de pacientes (G2 e G3). Os grupos de pacientes
mostraram-se semelhantes em relação aos dados sociodemográficos e hábitos de
vida estudados. Conclusão: Níveis séricos de MDA, CAT e GSH-Px estão
associados à Esquizofrenia, diferentemente de TEAC, que não se associou a essa
patologia. Em relação à refratariedade clínica, nenhum dos biomarcadores
estudados mostrou associação a essa característica da Esquizofrenia, assim
como os escores obtidos pela PANSS, dados sociodemográficos e hábitos de
vida.
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Avaliação eletrocardiográfica ambulatorial de cães com ehrliquiose monocítica crônica / Ambulatory electrocardiographic evaluation of dogs with chronic monocytic ehrlichiosisFilippi, Maurício Gianfrancesco [UNESP] 12 December 2016 (has links)
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Previous issue date: 2016-12-12 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A monitorização eletrocardiográfica ambulatorial, ou método Holter, vem se mostrando como uma ferramenta eficaz na Medicina Veterinária para detectar lesões cardíacas precoces, não só por monitorar a atividade elétrica do coração, como também o controle do sistema nervoso autônomo desse órgão. Sabe-se também que as principais enfermidades infecciosas de cães, como a cinomose e a erliquiose monocítica canina (EMC) provocam lesões consideráveis no coração, comprovadas por exame histopatológico. Já está comprovada a ocorrência de miocardite na EMC, levando a frequente presença de alterações na geração e condução do impulso elétrico cardíaco. O presente estudo analisou a atividade elétrica do coração durante 24 horas, com enfoque na prevalência de arritmias, estudo da variabilidade da frequência cardíaca e na concentração de biomarcadores de cães com EMC crônica (grupo doente) em comparação à animais saudáveis (grupo controle). Quarenta e cinco por cento dos animais do grupo doente possuíram alta frequência de arritmias durante o estudo. A média da concentração de troponina cardíaca I e de creatinokinase MB (CK-MB) foi significativa (0,24 ng/mL ± 0,5; 229 ± 205 UI/mL) em comparação ao grupo controle (0,042 ± 0,07 ng/mL; 126 ± 46,12 UI/mL). O desvio padrão da média de todos os intervalos NN (SDNN) e a porcentagem de intervalos RR adjacentes com diferença de duração superior a 50 milissegundos (pnn50%) também foram extremamente singificativos (83 ± 65 e 14,56 ± 20) quando comparado aos animais saudáveis (268 ± 74,6 e 55,87 ± 12,8), respectivamente. Podemos concluir que a EMC crônica possui caráter arritmôgenico, onde há persistente lesão miocárdica e intensa estimulação do sistema nervoso autônomo simpático no coração. / Ambulatorial electrocardiographic monitoring, or Holter method, has been shown to be an effective tool in veterinary medicine to detect early heart lesions, not only to monitor the electrical activity of the heart, but also to control the autonomic nervous system of this organ. It is also known that the main infectious diseases of dogs, such as canine distemper and canine monocytic ehrlichiosis (CME) cause considerable lesions in the heart, proven by histopathological examination. It has already been proven the occurrence of myocarditis in the CME, leading to frequent presence of changes in the generation and conduction of the cardiac electrical impulse. The present study analyzed the electrical activity of the heart during 24 hours, focusing on the prevalence of arrhythmias, heart rate variability study and the biomarkers concentration of dogs with chronic CME (sick group) compared to healthy animals (control group). Forty-five percent of the animals in the diseased group had a high frequency of arrhythmias during the study. The mean concentration of cardiac troponin I and creatinokinase MB (CK-MB) was significant (0.24 ng / mL ± 0.5; 229 ± 205 IU / mL) compared to the control group (0.042 ± 0.07 ng / ML, 126 ± 46.12 IU / mL). The standard deviation of the mean of all NN (SDNN) intervals and the percentage of adjacent RR intervals with a duration difference greater than 50 milliseconds (pnn50%) were also extremely significant (83 ± 65 and 14.56 ± 20) when compared to Healthy animals (268 ± 74.6, 55.87 ± 12.8), respectively. It can be concluded that chronic CME has an arrhythmogenic character, where there is persistent myocardial injury and intense stimulation of the sympathetic autonomic nervous system of the heart. / FAPESP: 2014/11219-6
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Calibre vasculaire rétinien et biomarqueurs cardiovasculaires et métaboliques. Approche clinique et épidémiologique. / Retinal vascular caliber and cardiovascular biomarkers and metabolic biomarkers. Clinical and epidemiological approach.Daien, Vincent 31 January 2014 (has links)
Les vaisseaux rétiniens sont accessibles par la visualisation du fond d'œil grâce notamment aux rétinophotographies. Cette visualisation donne donc un accès direct à l'étude de la microcirculation humaine. Depuis 1999, le logiciel IVAN® permet une analyse «semi-automatique» du calibre vasculaire rétinien. L'analyse de la littérature retrouve que les variations du calibre vasculaire rétinien sont le reflet cumulatif du poids de naissance, de facteurs génétiques, de l'âge, des facteurs de risques cardiovasculaires, de la fonction rénale et de l'inflammation. Les méta-analyses d'études épidémiologiques suggèrent un rôle prédictif des calibres vasculaires rétiniens sur les évènements cardiovasculaires : un calibre artériel rétinien étroit serait prédictif de maladie coronaire chez les femmes et augmenterait la mortalité cardiovasculaire globale ; un large calibre veineux serait prédictif d'accident vasculaire cérébral. Cette thèse a pour objectif d'approfondir les connaissances sur les déterminants des calibres vasculaires rétiniens chez les sujets indemnes d'athérosclérose clinique (antécédent de maladie coronaire, d'accident vasculaire cérébral, d'artériopathie des membres inférieurs). Depuis 2007, en partenariat avec l'université de Melbourne, nous avons acquis le logiciel IVAN® et l'agrément permettant son utilisation en recherche clinique et épidémiologique a été obtenu en 2008. Dans un premier article, nous avons mis en évidence une relation linéaire entre calibre artériel et veineux et fonction rénale mesurée par des méthodes gold standard (filtration glomérulaire mesurée par la clairance de 99mTc-DTPA et ratio albuminurie/créatinurie) sur 80 sujets de la cohorte de médecine interne-hypertension artérielle de l'hôpital Lapeyronie, suggérant des déterminants communs de ces lésions précoces d'organes cibles. Dans un deuxième article, nous avons tout d'abord confirmé le lien entre dilatation veineuse rétinienne et inflammation systémique, puis observé une relation entre calibre artériel étroit et stress oxydatif sur les participants de la cohorte POLA (pathologies oculaires liées à l'âge). Cela est d'une importance particulière car cela suggère que la microcirculation rétinienne, dont des associations avec la macrocirculation carotidienne et cardiaque ont été retrouvées, serait particulièrement sensible au stress oxydatif et à l'inflammation, de façon indépendante des facteurs de risques cardiovasculaires. Dans un troisième article, nous avons retrouvé une relation entre malnutrition biologique et dilatation veineuse rétinienne sur les participants de la cohorte POLA. Cela suggère que des remaniements microcirculatoires précoces pourraient être un mécanisme associé à l'augmentation du risque cardiovasculaire observé chez les sujets âgés souffrants de malnutrition. Les caractéristiques techniques du logiciel IVAN® limitent sa généralisation en médecine, mais son utilisation permet d'approfondir les connaissances sur les déterminants des variations de calibre des vaisseaux de la rétine. Le futur challenge des études sur la vascularisation rétinienne utilisera probablement l'étude de la géométrie vasculaire rétinienne afin d'améliorer la compréhension de microcirculation humaine. / Retinal photography, by allowing a direct observation of retinal vessels, may thus constitute a practical and noninvasive method for the examination of early changes in human microcirculation. Since 1999-2000, IVAN ® software allows for a "semi-automatic" retinal vascular caliber analysis. In the literature, changes in the caliber of retinal vessels have been shown to reflect the cumulative effects of birth weight, genetic factors, aging process, cardiovascular risk factors, renal function, and inflammation. In meta analyses from epidemiological studies, wider retinal venules and narrower arterioles were associated with an increased risk of coronary heart disease in women and an increased risk of global cardiovascular mortality, while wider retinal venular caliber predicted stroke. The aim of the current research is thus to improve the knowledge of retinal vascular calibers determinants in subjects free of clinical evidence of atherosclerosis (either stroke or coronary and peripheral artery disease). In 2007, Melbourne University provided us IVAN ® software and the agreement for its use in clinical and epidemiological research was obtained in 2008. In a first article, an inverse linear relationship between retinal arterial and venous caliber and renal function measured with gold standard methods (glomerular filtration rate from urinary clearance of 99mTc-DTPA and urinary albumin ⁄ creatinine ratio.) was observed in 80 subjects from the cohort of internal medicine-arterial hypertension-Lapeyronie hospital, suggesting common determinants of these preclinical target organ damages. In a second article, we first confirmed the relationship between a wider retinal venular caliber and inflammation, as well as provided evidence for a novel association between wider retinal arteriolar caliber and oxidative stress quantified by GPx-3 activity in the participants of the POLA (Pathologies Oculaires Liées à l'Age) cohort. This finding is of particular importance as it suggests that retinal microvasculature, which has been related to carotid arterial stiffness and cardiac remodeling, may be particularly sensitive to systemic oxidative stress and systemic inflammation, independently of known cardiovascular risk factors. In a third article based on POLA cohort participants, a retinal venular dilatation appears to be strongly associated with malnutrition biomarkers (albumin and transthyretin). This suggests that early microvascular changes may be one of the mechanisms associated with the observed increased risk of cardiovascular disease among elderly subjects with malnutrition. Technical characteristics of IVAN® software limit its generalization in medicine, but its improved our knowledge about the caliber of retinal vessels changes. The future challenge for retinal microcirculation research will probably use parameters of retinal vascular geometry for a better understanding of human microcirculation.
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Identification de biomarqueurs par approche protéomique : application au diagnostic des formes précoces de cancer du sein et à la réaction des tissus sains aux rayonnements ionisants / Identification of biomarkers by proteomic approaches : application to diagnosis of early stage breast cancer and prediction of radiation-induced late side effectsLacombe, Jérôme 24 October 2013 (has links)
Le cancer du sein est un problème de santé public majeur. Avec 500 000 décès dans le monde chaque année, il concentre de nombreux efforts dans la recherche de nouvelles thérapies et de biomarqueurs aussi bien diagnostiques, pronostiques que de suivi thérapeutique. D'un point de vue diagnostique, la mammographie est actuellement la méthode de dépistage de référence. Cependant, elle présente de nombreuses limites, notamment chez les femmes avec une densité mammaire élevée. L'identification de marqueurs permettant de mettre en évidence de petites tumeurs ou pronostiquer l'évolution de ces tumeurs serait une aide précieuse dans la prise en charge de la maladie. D'un point de vue thérapeutique, la radiothérapie est l'un des traitements principaux contre le cancer du sein. Cependant, certaines patientes peuvent développer d'importants effets secondaires tardifs sévères. La prédiction de cette radiotoxicité est un enjeu majeur car elle permettrait d'identifier les patients à risque, de leur proposer un traitement personnalisé et au final d'optimiser leur prise en charge thérapeutique. Malgré de nombreux efforts, il n'existe à l'heure actuelle aucun marqueur prédictif de la radiotoxicité tardive utilisé en routine clinique.Ce travail de thèse a pour objectif d'identifier des marqueurs protéiques, d'une part pour le diagnostic et le pronostic des formes précoces du cancer du sein, et d'autre part pour la prédiction de la réponse à la radiothérapie. Grâce à différentes approches de protéomique, j'ai pu identifier trois signatures protéiques : (1) une signature d'autoanticorps sériques (GAL3, RACK1, PAK2, PHB2 et RUVBL1) pour le diagnostic des carcinomes canalaires in situ (CCIS) et des cancers précoces, (2) une signature d'autoanticorps sériques (CIRBP, ECHDC1, HMGN1, PSRC1 et RBP-Jκ) pronostic de la progression de CCIS en cancer invasif et (3) cinq protéines lymphocytaires (AK2, ANX1, APEX1, HSPA8 et IDH2) prédictives d'une toxicité radio-induite tardive. Au delà de leur intérêt diagnostic, pronostic ou prédictif, ces signatures ont également permis d'identifier de nouveaux partenaires moléculaires susceptibles d'être impliqués dans les mécanismes de carcinogénèse mammaire et de radiotoxicité tardive. / Breast cancer is a major public health problem. With 500,000 deaths every year around the world, it focuses on many efforts in the search for new therapies and for therapeutic monitoring, diagnosis or prognosis biomarkers. From a diagnostic point of view, mammography remains gold standard for breast cancer detection. However, it has many limitations, especially in women with significant breast density. The identification of biomarkers for early diagnosis or for prognosis of in situ tumors in this population at risk would be a valuable improvement in the breast cancer management. Considering treatment strategies, radiotherapy has become a major treatment against breast cancer. However, some patients can develop severe radiation-induced late side effects. Their prediction is a main challenge as clinicians will be able to identify patients at risk and develop individualized treatment. Despite all efforts, no biomarkers are validated and used in clinical routine for normal tissues outcomes after irradiation. The aim of my PhD work was to identify protein markers for the diagnosis and prognosis of early-stage breast cancers, and also for the prediction of radiation-induced severe late effects. With different proteomic approaches, I was able to identify three protein signatures: (1) a serum autoantibody signature for the diagnosis of DCIS and node negative early-stage breast cancers (GAL3, RACK1, PAK2, and PHB2 RUVBL1), (2) a serum autoantibody signature of ductal carcinoma in situ progression to invasive breast cancer (CIRBP, ECHDC1, HMGN1, PSRC1 and RBP-Jκ) and (3) five lymphocyte proteins (AK2, ANX1, APEX1, HSPA8 and IDH2 ) that could predict late radiation-induced toxicity. In addition, these signatures allowed to identify new molecular partners likely to be involved in the mechanisms of mammary carcinogenesis and in the late radio-induced toxicity.
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Caracterização fenotípica e o potencial imunomodulador de agonistas de receptores Toll-like na resposta citotóxica de células Natural Killer na Síndrome de Sézary / Phenotypic characterization and the immunomodulatory potential of Tolllike receptor agonists (TLRs) in the cytotoxic response of Natural Killer cells in Sézary syndrome.Kelly Cristina Gomes Manfrere 20 January 2017 (has links)
A Síndrome de Sézary (SS) é um dos tipos mais comuns de linfoma cutâneo de células T (CTCL). Esta síndrome é caracterizada por eritrodermia, linfadenopatia generalizada e presença de células tumorais na pele, linfonodos e sangue periférico. A imunidade do hospedeiro está comprometida nesta síndrome, contudo, estudos relacionados à imunidade inata, particularmente sobre as células Natural Killer (NK) são mais escassos. As células NK exercem um papel essencial na resposta imune antitumoral. A proposta deste estudo é caracterizar o perfil fenotípico associado à ativação e inibição das células NK e a capacidade de secreção de citocinas em resposta aos agonistas de receptores Toll-like (TLR), TLR4, TLR7/TLR8 e TLR9 em pacientes com SS. Foram selecionados 14 pacientes com SS (7 homens, 7 mulheres), com 48-85 anos de idade provenientes do Ambulatório de Linfomas Cutâneos do Hospital das Clínicas da Faculdade de Medicina da USP, e um grupo controle com 22 indivíduos sadios (11 homens, 11 mulheres, idade de 48-75). Os resultados evidenciaram diminuição percentual de células NK CD56dim do sangue periférico dos pacientes SS, bem como baixa expressão de marcadores de ativação, NKG2D e NKG2C. A forma solúvel dos ligantes de NKG2D, MICB e MICA solúvel (sMICA/MICB), foi detectada em níveis séricos elevados para sMICB, e sMICA foi detectado em apenas 2 pacientes. Houve uma correlação negativa entre os níveis de sMICB e o percentual de células NK CD56brightCD16 NKG2D+. O perfil de secreção de citocinas das células NK, mostra, já na condição sem estímulo, um aumento percentual de TNF e CD107a em células NKCD56dim de pacientes com SS. Após o estímulo com os agonistas de TLR7/TLR8 houve um aumento na produção de CD107a e TNF nas células NKCD56bright e de TNF para as células NKCD56dim. Na produção de citocinas induzidas por agonistas de TLRs nos sobrenadantes de células mononucleares, foi observado que os agonistas TLR2 e TLR4 foram capazes de estimular a produção de IL-6, TNF e IL-10 enquanto o agonista de TLR7/8 mostrou um efeito adjuvante para a secreção de IFN-alfa, IFN-y e IL-10. Além disso, foi observado aumento de expressão de RNAm para TLR2 em células mononucleares avaliada por PCR em tempo real, como também para os fatores relacionados à resposta antiviral, como interferon tipo I (IFN- alfa), receptor de IFN-beta e interferon tipo III (IFN- ) em pacientes com SS. Quanto aos níveis séricos de citocinas, foi detectado aumento de IL-5 (citocina Th2), IL-6 (pró-inflamatória) e IL-10 (reguladora) nos SS, não diferindo quanto aos níveis de IL-1beta, IL-2, IL-17a, TNF e TGF-beta em relação ao grupo controle. Os resultados mostram que há uma diminuição percentual de células NK CD56dim, alteração da expressão dos receptores de ativação e elevação de ligantes solúveis que podem bloquear a ativação das células NK nos pacientes com SS. Além disto, as células NK exibem diminuição da produção de IFN-alfa, que contribuem na diminuição da resposta Th1. Há uma baixa responsividade das células NK aos ligantes de TLRs. Contudo, há um efeito adjuvante dos ligantes de TLRs em células mononucleares dos pacientes com SS, sendo que os agonistas de TLR2/4 e TLR7/8 foram capazes de restaurar parcialmente a produção de citocinas. Os resultados evidenciam que nos pacientes com SS, apesar da redução percentual das células NK, essas células são funcionais, mas que podem ser bloqueadas pelos ligantes solúveis de receptores de ativação. O uso de ligantes de TLRs pode ser uma estratégia para potencializar a produção de citocinas na Síndrome de Sézary / Sézary syndrome (SS) is one of the most common types of cutaneous T-cell lymphoma (CTCL). This syndrome is characterized by erythroderma, generalized lymphadenopathy and presence of tumor cells in the skin, lymph nodes and peripheral blood. Immunity of the host is compromised in syndrome, a study has related an innate immunity, particularly in Natural Killer (NK) cells are more scarce. NK cells play an essential role in the antitumor immune response. The aim of this study is to characterize the phenotypic profile associated with the activation and inhibition of NK cells and cytokine secretion capacity in response to the TLR4, TLR7 / TLR8 and TLR9 receptor agonists in SS patients. METHODS: We selected 14 patients with SS (7 men, 7 women, 48-85 years old) from the Cutaneous Lymphoma Outpatient Clinic of the Medical School of USP, and a control group with 22healthy individuals (11 men , 11 women, 48-75 years old). The results showed a decrease in CD56dim NK cells in the peripheral blood of SS patients, as well as low expression of activation markers, NKG2D and NKG2C. The soluble form of NKG2D, MICB and soluble MICA (sMICA/MICB) ligands was detected at high levels in serum for sMICB, and sMICA was detected in only 2 patients. There was a negative correlation between sMICB levels and the percentage of NK cells CD56brightCD16 NKG2D+. The cytokine secretion profile of NK cells, in the unstimulated condition, showed an increase of TNF and CD107a in NKCD56dim cells of SS patients. Upon stimulation of TLR7 / TLR8 agonists, CD107a and TNF production was higher in NKCD56bright cellsandforTNF in CD56dim cells.The agonists TLR2 and TLR4 in NK cells were able to stimulate the production of IL-6, TNF and IL-10,, while TLR7/8 agonist showed an adjuvant effect for secretion of IFN-alfa, IFN-y e IL-10. In addition, increased expression of TLR2 mRNA was observed in mononuclear cells evaluated by real-time PCR, simirlaly for factors related to antiviral response, such as interferon type I (IFN-alfa), IFN-Type III receptor (IFN - ) in patients with SS. Forserum levels of cytokines, IL- 5 (cytokine Th2), IL-6 (proinflammatory) and IL-10 (regulatory) were detectedhigher in SS, not differing in levels of IL-1beta, IL-2 , IL-17a, TNF and TGF-beta in relation to the control group. The results show that, there is a percentage decreased of CD56dim NK cells, alteration in activation receptor expression and elevation of soluble ligands that block theactivation of NK cells in SS patients. In addition, NK cells exhibit decreased IFN-? production, thatcontribute to the decrease in Th1 response. There is low responsiveness of NK cells to TLR ligands. However, there is an adjuvant effect of TLR ligands on mononuclear cells of SS patients, with TLR2/4 and TLR7 / 8 agonists is able to partially restore cytokine production. The results show that patients with SS, despite the percentage reduction of NK cells, these cells are functional, but can be blocked by soluble ligands of activation receptors. The use of TLR ligands may be a strategy to potentiate a production of cytokines in Sézary Syndrome
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