Valine

缬氨酸
  • 文章类型: Journal Article
    为了批准一种药物,稳定性数据必须提交给监管机构。这种分析通常是耗时且成本密集的。强制降解研究主要在溶解状态的苛刻条件下进行,通常导致固体药物的外来降解。氧化机械化学降解提供了产生现实降解曲线的可能性。在这项研究中,提出了一种可持续的机械化学程序,用于降解来自沙坦家族的五种活性药物成分(API):氯沙坦钾,厄贝沙坦,缬沙坦,奥美沙坦酯,还有替米沙坦.高分辨率质谱能够检测未经处理的API中已经存在的杂质,并能够阐明降解产物。在球磨时间15-60分钟后,已经可以获得明显的降解曲线。许多鉴定的降解产物在文献和药典中有描述,强调我们的结果的重要性和该方法预测药物在固态降解曲线的适用性。
    For the approval of a drug, the stability data must be submitted to regulatory authorities. Such analyses are often time-consuming and cost-intensive. Forced degradation studies are mainly carried out under harsh conditions in the dissolved state, often leading to extraneous degradation profiles for a solid drug. Oxidative mechanochemical degradation offers the possibility of generating realistic degradation profiles. In this study, a sustainable mechanochemical procedure is presented for the degradation of five active pharmaceutical ingredients (APIs) from the sartan family: losartan potassium, irbesartan, valsartan, olmesartan medoxomil, and telmisartan. High-resolution mass spectrometry enabled the detection of impurities already present in untreated APIs and allowed the elucidation of degradation products. Significant degradation profiles could already be obtained after 15-60 min of ball milling time. Many of the identified degradation products are described in the literature and pharmacopoeias, emphasizing the significance of our results and the applicability of this approach to predict degradation profiles for drugs in the solid state.
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  • 文章类型: Journal Article
    本研究研究了饲粮添加L-缬氨酸(Val)和卫生条件下注射脂多糖对生长性能的影响。免疫反应,断奶猪的肠道细菌谱和代谢产物。根据饮食Val水平和卫生条件(低或高),以2×2阶乘排列将32头断奶猪(6.98±0.47kg)随机分配到治疗组。给猪饲喂含(NRC)建议的标准Val水平的基础饮食,(2012)或补充0.1%L-Val的基础饮食。一个被指定为高卫生室的房间每周清洗一次,而指定的低卫生室在整个实验过程中都没有清洗,并且在第1天,从苗圃猪谷仓中的5公斤粪便散布在围栏地板上。所有数据都使用SAS的混合程序进行分析,以个人笔为实验单元。在低卫生条件下饲养的猪表现出较低(p<0.05)的平均日增重,平均日采食量,在14天的实验期间,与高卫生条件下的腹泻相比,增加了增食比的腹泻发生率(p<0.05)。与高卫生组相比,低卫生组的猪空肠中丁酸酯浓度较低(p<0.05),结肠中NH3-N浓度较高(p<0.05)。膳食补充Val降低(p<0.05)血浆白细胞介素(IL)-1β和IL-1受体拮抗剂浓度以及结肠中的异戊酸和NH3-N浓度,无论卫生条件如何。在mRNA编码β-防御素113、125和129的丰度中观察到膳食Val补充与卫生条件之间的相互作用(p<0.05)。总之,膳食Val补充有益地调节炎症反应和微生物代谢物,而不管卫生条件如何,而β-防御素的转录水平通过膳食Val补充以依赖于住房卫生条件的方式来调节。
    This study investigated the effects of dietary L-valine (Val) supplementation and sanitary conditions with lipopolysaccharide injection on growth performance, immune response, and intestinal bacterial profiles and metabolites in weaned pigs. Thirty-two weaned pigs (6.98 ± 0.47 kg) were randomly assigned to treatments in a 2 × 2 factorial arrangement based on dietary Val levels and sanitary conditions (low or high). The pigs were fed either a basal diet containing the standard levels of Val suggested by (NRC), (2012) or a basal diet supplemented with 0.1% L-Val. A room designated as a high sanitary room was washed weekly, whereas the designated low sanitary room was not washed throughout the experiment and 5 kg of manure from the nursery pig barn was spread on the pen floors on day 1. All data were analysed using a mixed procedure of SAS, with the individual pen as the experimental unit. The pigs raised in low sanitary conditions exhibited a lower (p < 0.05) average daily gain, average daily feed intake, and gain-to-feed ratio and a higher (p < 0.05) incidence of diarrhoea than those raised in high sanitary conditions during the 14-d experimental period. The pigs in the low sanitary group also had a lower (p < 0.05) concentration of butyrate in the jejunum and a higher (p < 0.05) concentration of NH3-N in the colon than those in the high sanitary group. Dietary Val supplementation was reduced (p < 0.05) plasma interleukin (IL)-1β and IL-1 receptor antagonist concentrations as well as isovalerate and NH3-N concentrations in the colon, regardless of sanitary conditions. Interactions between dietary Val supplementation and sanitary conditions were observed in the abundances of mRNA-encoding β-defensins 113, 125 and 129 (p < 0.05). In conclusion, dietary Val supplementation beneficially modulates inflammatory responses and microbial metabolites regardless of sanitary conditions while transcriptional levels of β-defensins are regulated by dietary Val supplementation in a manner dependent on housing hygiene conditions.
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  • 文章类型: Journal Article
    拟除虫菊酯由于其广泛的杀虫谱而广泛用于防治农业害虫和人类疾病媒介,快速行动,和低哺乳动物毒性。不幸的是,过度使用拟除虫菊酯会导致电压门控钠通道突变引起的敲减抗性(kdr)。在来自拉丁美洲和巴西的许多耐拟除虫菊酯埃及伊蚊种群中反复检测到I1011M突变。此外,首次报道突变G923V与氯菊酯/DDT抗性Ae中的I1011M共存。埃及伊蚊,G923V是否能增强I1011M介导的拟除虫菊酯对钠通道的耐药性尚不清楚.在这项研究中,我们将突变G923V和I1011M单独或联合引入拟除虫菊酯敏感性钠通道AaNav1-1,并检查了这些突变对门控特性和拟除虫菊酯敏感性的影响.我们发现突变I1011M和G923V+I1011M在去极化方向上改变了激活的电压依赖性,并且没有突变影响失活的电压依赖性。G923V和G923V+I1011M突变降低了通道对I型和II型拟除虫菊酯的敏感性。然而,I1011M单独赋予对I型拟除虫菊酯的抗性,不是II型拟除虫菊酯。有趣的是,在突变G923V和I1011M之间观察到对I型拟除虫菊酯的显着协同作用。所有突变对DDT通道敏感性的影响与I型拟除虫菊酯相同。我们的结果证实了由突变G923V和I1011M介导的抗性的分子基础,并可能有助于开发用于监测害虫对拟除虫菊酯抗性的分子标记。
    Pyrethroids are widely used against agricultural pests and human disease vectors due to their broad insecticidal spectrum, fast action, and low mammalian toxicity. Unfortunately, overuse of pyrethroids has led to knockdown resistance (kdr) caused by mutations in voltage-gated sodium channels. Mutation I1011M was repeatedly detected in numerous pyrethroid-resistant Aedes aegypti populations from Latin American and Brazil. In addition, mutation G923V was first reported to coexist with I1011M in permethrin/DDT-resistant Ae. aegypti, whether G923V enhances the I1011M-mediated pyrethroid resistance in sodium channels remains unclear. In this study, we introduced mutations G923V and I1011M alone or in combination into the pyrethroid-sensitive sodium channel AaNav1-1 and examined the effects of these mutations on gating properties and pyrethroid sensitivity. We found mutations I1011M and G923V + I1011M shifted the voltage dependence of activation in the depolarizing direction, and none of mutations affect the voltage-dependence of inactivation. G923V and G923V + I1011M mutations reduced the channel sensitivity to both Type I and Type II pyrethroids. However, I1011M alone conferred resistance to Type I pyrethroids, not to Type II pyrethroids. Interestingly, significant synergism effects on Type I pyrethroids were observed between mutations G923V and I1011M. The effects of all mutations on channel sensitivity to DDT were identical with those to Type I pyrethroids. Our results confirm the molecular basis of resistance mediated by mutations G923V and I1011M and may contribute to develop molecular markers for monitoring pest resistance to pyrethroids.
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  • 文章类型: Journal Article
    伪肽是用于生物应用的新兴的下一代软生物启发材料。因此,已设计并开发了一类新的C2对称L-缬氨酸衍生的伪肽。新开发的假肽在RAW264.7细胞的活细胞荧光研究中表现出细胞内Cu(II)离子检测。我们发现,所需假肽部分中氨基酸侧链的变化会导致其对不同金属离子的选择性发生急剧变化。L-缬氨酸衍生的假肽通过关闭荧光对Cu(II)离子具有选择性,L-苯丙氨酸衍生的假肽通过开启荧光对Zn(II)离子表现出选择性。此外,L-缬氨酸衍生的假肽在超分子纳米组装形成过程中与Cu(II)离子孵育后显示球形结构的增加。相比之下,L-苯丙氨酸衍生的假肽在添加Zn(II)离子后显示出球形结构的减少。审慎设计的L-缬氨酸衍生和L-苯丙氨酸衍生的生物启发假肽有望在高级生物学应用中探索各种肽模拟物中的类似作用。
    Pseudopeptides are emerging next-generation soft bioinspired materials for biological applications. Therefore, a new class of C2-symmetric L-valine-derived pseudopeptides has been designed and developed. The newly developed pseudopeptides exhibit intracellular Cu(II) ion detection in live-cell fluorescence studies on RAW264.7 cells. We find that the changes in the amino acid side chain in desired pseudopeptidic moieties lead to a drastic change in their selectivity towards different metal ions. The L-valine-derived pseudopeptides exhibit selectivity towards Cu(II) ions through turn-off fluorescence, and the L-phenylalanine-derived pseudopeptides exhibit selectivity towards Zn(II) ions through turn-on fluorescence. In addition, the L-valine-derived pseudopeptides show an increase in spherical-shaped structures upon incubation with Cu(II) ions during supramolecular nano-assembly formation. In contrast, the L-phenylalanine-derived pseudopeptides show a decrease in spherical-shaped structures upon adding Zn(II) ions. The judiciously designed L-valine-derived and L-phenylalanine-derived bioinspired pseudopeptides are promising for exploring similar effects in various peptidomimetics in advanced biological applications.
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  • 文章类型: Journal Article
    支链氨基酸(BCAA)与胰岛素抵抗的严重程度相关。部分原因可能是线粒体功能障碍。线粒体功能障碍在胰岛素抵抗期间也很常见,并且部分受到线粒体融合和裂变(线粒体动力学)改变的调节。为了评估BCAA对胰岛素抵抗过程中线粒体动力学的影响,本研究检测了胰岛素抵抗肌管模型中BCAA对线粒体功能和线粒体动力学指标的影响。C2C12肌管用储备DMEM或含有0.2mM额外BCAA的DMEM处理,2mM,或20mM,以在有和没有高胰岛素血症介导的胰岛素抵抗的情况下,达到从生理上可达到的到超生理上(BCAA过载)的连续浓度。qRT-PCR和Westernblot用于测量与线粒体动力学相关的靶标的基因和蛋白质表达。线粒体功能通过耗氧量来评估,使用线粒体特异性染色测量线粒体含量。胰岛素抵抗降低线粒体功能,过氧化物酶体增殖物激活受体γ辅激活因子1-αmRNA,和柠檬酸合成酶mRNA表达,但不是蛋白质表达。20mM的过量BCAA也独立地降低胰岛素敏感细胞中的线粒体功能。BCAA没有改变mRNA或蛋白质水平的线粒体动力学指标,而胰岛素抵抗降低线粒体裂变蛋白1mRNA,但不是蛋白质表达。总的来说,在测试条件下,过高水平的BCAA或与胰岛素抵抗相结合会降低线粒体功能和含量,但似乎不会改变线粒体动力学。
    Branched-chain amino acids (BCAA) are correlated with severity of insulin resistance, which may partially result from mitochondrial dysfunction. Mitochondrial dysfunction is also common during insulin resistance and is regulated in part by altered mitochondrial fusion and fission (mitochondrial dynamics). To assess the effect of BCAA on mitochondrial dynamics during insulin resistance, the present study examined the effect of BCAA on mitochondrial function and indicators of mitochondrial dynamics in a myotube model of insulin resistance. C2C12 myotubes were treated with stock DMEM or DMEM with additional BCAA at 0.2 mM, 2 mM, or 20 mM to achieve a continuum of concentrations ranging from physiologically attainable to supraphysiological (BCAA overload) both with and without hyperinsulinemia-mediated insulin resistance. qRT-PCR and Western blot were used to measure gene and protein expression of targets associated with mitochondrial dynamics. Mitochondrial function was assessed by oxygen consumption, and mitochondrial content was measured using mitochondrial-specific staining. Insulin resistance reduced mitochondrial function, peroxisome proliferator-activated receptor gamma coactivator 1-alpha mRNA, and citrate synthase expression mRNA, but not protein expression. Excess BCAA at 20 mM also independently reduced mitochondrial function in insulin-sensitive cells. BCAA did not alter indicators of mitochondrial dynamics at the mRNA or protein level, while insulin resistance reduced mitochondrial fission protein 1 mRNA, but not protein expression. Collectively, BCAA at excessively high levels or coupled with insulin resistances reduce mitochondrial function and content but do not appear to alter mitochondrial dynamics under the tested conditions.
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  • 文章类型: Journal Article
    肠道菌群及其代谢产物对脓毒症患者肠道损伤的保护作用尚不清楚。
    从被分类为脓毒症和非脓毒症组的患者获得粪便样品,用于通过16SrRNA测序和非靶向代谢组学分析来分析微生物组成。我们评估了脓毒症患者肠道菌群对抗生素治疗小鼠肠道屏障的影响。此外,我们进行了Spearman相关分析,以检查代谢产物与脓毒症严重程度之间的关系。此外,我们进行了动物实验以验证鉴定的代谢物的功能.
    与对照组相比,败血症患者的肠道菌群多样性降低。通过粪便微生物移植实验,研究发现,来自败血症患者的肠道微生物群可以在抗生素治疗的小鼠中引起肠道损伤。微生物群的代谢组学分析揭示了缬氨酸的显著富集,亮氨酸,和异亮氨酸生物合成途径。进一步的分析显示脓毒症患者L-缬氨酸的丰度显著降低,与APACHE-II和SOFA评分呈负相关。在脓毒症小鼠实验中,发现L-缬氨酸可以减轻脓毒症引起的肠道损伤。
    肠道微生物和代谢特征的改变可影响脓毒症的严重程度。此外,L-缬氨酸对脓毒症肠损伤有保护作用。
    UNASSIGNED: The protective role of gut microbiota and its metabolites against intestinal damage in sepsis patients remain unclear.
    UNASSIGNED: Fecal samples were acquired from patients categorized into sepsis and non-sepsis groups for analysis of microbial composition via 16S rRNA sequencing and untargeted metabolomics analysis. We assessed the impact of gut microbiota from sepsis patients on intestinal barriers in antibiotic-treated mice. Furthermore, We conducted spearman\'s correlation analysis to examine the relationship between metabolites and the severity of sepsis. Additionally, we performed animal experiments to validate the functionality of identified metabolites.
    UNASSIGNED: The diversity of intestinal flora is decreased in patients with sepsis compared to the control group. Through fecal microbiota transplantation experiments, it was discovered that the gut microbiota derived from sepsis patients could induce intestinal damage in antibiotic-treated mice. Metabolomics analysis of the microbiota revealed a significant enrichment of the Valine, leucine, and isoleucine biosynthesis pathway. Further analysis showed a significant decrease in the abundance of L-valine in sepsis patients, which was negatively correlated with APACHE-II and SOFA scores. In sepsis mouse experiments, it was found that L-valine could alleviate sepsis-induced intestinal damage.
    UNASSIGNED: Alterations in microbial and metabolic features in the gut can affect the severity of sepsis. Furthermore, L-valine can protect against sepsis-induced intestinal injury.
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  • 文章类型: Journal Article
    代谢重新编程和能量重新布线是癌症的标志,可以促进疾病进展并促进治疗逃避。氧化磷酸化的重塑和增强的脂肪生成先前已被表征为前列腺癌(PCa)的关键代谢特征。最近,琥珀酸依赖的线粒体重编程在高级别前列腺肿瘤中被发现,以及与支链氨基酸(BCAA)分解代谢相关的酶的上调。在这项研究中,我们假设BCAA的退化,特别是缬氨酸,可能在线粒体琥珀酸盐池的麻醉换气中起关键作用,以及维持细胞内脂质代谢。通过抑制BCAA可用性,我们报告脂质含量显着降低,强烈表明BCAA是PCa中重要的生脂燃料。这项工作还揭示了一种新的补偿机制,从而增加脂肪酸摄取以响应细胞外缬氨酸剥夺。通过抑制3-羟基异丁酰辅酶A水解酶(HIBCH)抑制缬氨酸降解导致恶性前列腺细胞增殖的选择性减少,减少细胞内琥珀酸和受损的细胞呼吸。结合结合下一代测序的全面的多体研究,代谢组学,和高含量的定量单细胞成像,我们的工作强调了一种选择性抑制PCa代谢重编程的新型治疗靶点.
    Metabolic reprogramming and energetic rewiring are hallmarks of cancer that fuel disease progression and facilitate therapy evasion. The remodelling of oxidative phosphorylation and enhanced lipogenesis have previously been characterised as key metabolic features of prostate cancer (PCa). Recently, succinate-dependent mitochondrial reprogramming was identified in high-grade prostate tumours, as well as upregulation of the enzymes associated with branched-chain amino acid (BCAA) catabolism. In this study, we hypothesised that the degradation of the BCAAs, particularly valine, may play a critical role in anapleurotic refuelling of the mitochondrial succinate pool, as well as the maintenance of intracellular lipid metabolism. Through the suppression of BCAA availability, we report significantly reduced lipid content, strongly indicating that BCAAs are important lipogenic fuels in PCa. This work also uncovered a novel compensatory mechanism, whereby fatty acid uptake is increased in response to extracellular valine deprivation. Inhibition of valine degradation via suppression of 3-hydroxyisobutyryl-CoA hydrolase (HIBCH) resulted in a selective reduction of malignant prostate cell proliferation, decreased intracellular succinate and impaired cellular respiration. In combination with a comprehensive multi-omic investigation that incorporates next-generation sequencing, metabolomics, and high-content quantitative single-cell imaging, our work highlights a novel therapeutic target for selective inhibition of metabolic reprogramming in PCa.
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  • 文章类型: Journal Article
    丙型肝炎病毒(HCV)的抗性相关替换(RAS)影响直接作用的抗病毒药物(DAA)的功效。在这项研究中,我们旨在阐明非结构(NS)5AQ24K/L28M/R30Q(或R30E)/A92KRAS共存的敏感性,在DAA再治疗失败的患者中观察到,并考虑新的治疗药物。我们使用亚基因组复制子系统,其中HCV基因型1B菌株1B-4被电穿孔到源自HuH-7细胞的OR6c细胞中(野生型[WT])。我们将WT基因转换为NS5AQ24K/L28M/R30Q/A92K或Q24/L28K/R30E/A92K。与WT相比,Q24K/L28M/R30Q/A92KRAS对daclatasvir具有36,000倍的抗性,440,000倍耐ledipasvir,6300倍耐velpatasvir,3100倍耐elbasvir,和1.8倍耐pibrentasvir。与WT相比,Q24K/L28M/R30E/A92KRAS对daclatasvir和ledipasvir的抗性为640,000倍,15万倍耐velpatasvir,44,000倍耐elbasvir,抗pibrentasvir1500倍。Q24K/L28M/R30E/A92KRAS对pibrentasvir的抗性是Q24K/L28M/R30Q/A92KRAS的816.3倍。此外,pibrentasvir和sofosbuvir的组合对这些RAS具有治疗效果.联合方案可以用NS5AQ24K/L28M/R30E/A92KRAS根除HCV。
    Resistance-associated substitutions (RASs) of hepatitis C virus (HCV) affect the efficacy of direct-acting antivirals (DAAs). In this study, we aimed to clarify the susceptibility of the coexistence of nonstructural (NS) 5A Q24K/L28M/R30Q (or R30E)/A92K RASs, which were observed in patients with DAAs re-treatment failure and to consider new therapeutic agents. We used a subgenomic replicon system in which HCV genotype 1B strain 1B-4 was electroporated into OR6c cells derived from HuH-7 cells (Wild-type [WT]). We converted WT genes to NS5A Q24K/L28M/R30Q/A92K or Q24/L28K/R30E/A92K. Compared with the WT, the Q24K/L28M/R30Q/A92K RASs was 36,000-fold resistant to daclatasvir, 440,000-fold resistant to ledipasvir, 6300-fold resistant to velpatasvir, 3100-fold resistant to elbasvir, and 1.8-fold resistant to pibrentasvir. Compared with the WT, the Q24K/L28M/R30E/A92K RASs was 640,000-fold resistant to daclatasvir and ledipasvir, 150,000-fold resistant to velpatasvir, 44,000-fold resistant to elbasvir, and 1500-fold resistant to pibrentasvir. The Q24K/L28M/R30E/A92K RASs was 816.3 times more resistant to pibrentasvir than the Q24K/L28M/R30Q/A92K RASs. Furthermore, a combination of pibrentasvir and sofosbuvir showed therapeutic efficacy against these RASs. Combination regimens may eradicate HCV with NS5A Q24K/L28M/R30E/A92K RASs.
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  • 文章类型: Journal Article
    雷帕霉素复合物(mTORC)的机制靶标调节蛋白质合成,并且可以被支链氨基酸(BCAAs)激活。mTORC还涉及线粒体代谢和BCAA分解代谢的调节。一些人推测BCAA的mTORC过度激活可能导致胰岛素抵抗。本实验使用mTORC激动剂MHY1485评估了mTORC激活对肌管代谢和胰岛素敏感性的影响,该激动剂与BCAA不具有结构相似性。
    方法:C2C12肌管用MHY1485或DMSO对照在有和没有雷帕霉素的情况下处理。使用qRT-PCR评估基因表达,通过蛋白质印迹评估胰岛素敏感性和蛋白质表达。通过细胞外酸化速率和耗氧量来测量糖酵解和线粒体代谢。通过荧光染色分析线粒体和脂质含量。使用液相色谱-质谱来评估细胞外BCAA。
    结果:雷帕霉素降低p-mTORC表达,线粒体含量,和线粒体功能。令人惊讶的是,MHY1485不改变p-mTORC表达或细胞代谢。两种治疗均未改变BCAA代谢或细胞外BCAA含量的指标。
    结论:总的来说,通过雷帕霉素抑制mTORC会降低肌管代谢和线粒体含量,但不会降低BCAA代谢。MHY1485缺乏p-mTORC激活是这些实验的限制,并需要进一步的研究。
    The mechanistic target of rapamycin complex (mTORC) regulates protein synthesis and can be activated by branched-chain amino acids (BCAAs). mTORC has also been implicated in the regulation of mitochondrial metabolism and BCAA catabolism. Some speculate that mTORC overactivation by BCAAs may contribute to insulin resistance. The present experiments assessed the effect of mTORC activation on myotube metabolism and insulin sensitivity using the mTORC agonist MHY1485, which does not share structural similarities with BCAAs.
    METHODS: C2C12 myotubes were treated with MHY1485 or DMSO control both with and without rapamycin. Gene expression was assessed using qRT-PCR and insulin sensitivity and protein expression by western blot. Glycolytic and mitochondrial metabolism were measured by extracellular acidification rate and oxygen consumption. Mitochondrial and lipid content were analyzed by fluorescent staining. Liquid chromatography-mass spectrometry was used to assess extracellular BCAAs.
    RESULTS: Rapamycin reduced p-mTORC expression, mitochondrial content, and mitochondrial function. Surprisingly, MHY1485 did not alter p-mTORC expression or cell metabolism. Neither treatment altered indicators of BCAA metabolism or extracellular BCAA content.
    CONCLUSIONS: Collectively, inhibition of mTORC via rapamycin reduces myotube metabolism and mitochondrial content but not BCAA metabolism. The lack of p-mTORC activation by MHY1485 is a limitation of these experiments and warrants additional investigation.
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  • 文章类型: Journal Article
    我们介绍了一例30多岁的初产妇,她在妊娠33周时剖腹产双胎双胎。她的产后过程因乳头单纯疱疹病毒(HSV)感染而变得复杂,在她的新生儿被诊断为HSV脑炎后发现。在产后3周时对她进行了评估,并报告说她的新生儿同时因传播的新生儿HSV-1被送入新生儿重症监护病房。患者和她的伴侣处于一夫一妻制关系,没有已知的HSV病史。体格检查显示,她的右乳头脸上有垂直裂痕,左手上有一小群囊泡。病灶的PCR拭子在两个位置均为HSV-1阳性。患者开始口服伐昔洛韦1000mg,每天两次,局部用阿昔洛韦软膏每天应用4-6次,莫匹罗星软膏每天应用3次,以解决她的乳房病变。她能够在泵的帮助下继续表达母乳,然后在感染清除后恢复母乳喂养。她的婴儿经过长时间的肠胃外抗病毒治疗后康复,并在随访时与年龄相适应。
    We present a case of a primigravida in her 30s who had a caesarean delivery of dichorionic diamniotic twins at 33 weeks of gestation. Her postpartum course was complicated by a herpes simplex virus (HSV) infection of her nipple, found after her neonates were diagnosed with HSV encephalitis. She was evaluated at her 3-week postpartum visit and reported that her neonates were concurrently admitted to the neonatal intensive care unit with disseminated neonatal HSV-1. The patient and her partner were in a monogamous relationship with no known history of HSV. Physical examination demonstrated a vertical fissure on the face of her right nipple and a small cluster of vesicles on her left hand. PCR swabs of the lesions were positive for HSV-1 at both locations. The patient was started on oral valacyclovir 1000 mg two times per day, topical acyclovir ointment applied 4-6 times per day and mupirocin ointment applied 3 times per day to her breast with resolution of her breast lesions. She was able to continue expressing her breastmilk with the help of a pump and then resumed breastfeeding once her infection was cleared. Her infants recovered after prolonged parenteral antiviral therapy with age-appropriate development at follow-up.
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