Vascular endothelial growth factor A

血管内皮生长因子 A
  • 文章类型: Journal Article
    无效的子宫内膜基质重塑,不孕症的一个关键因素,阻碍胚胎植入子宫壁。我们的研究揭示了人类胶原酶-1在小鼠子宫中的细胞和分子影响,证明胚胎植入率提高。胶原酶-1促进子宫内膜ECM的重塑,降解胶原纤维和蛋白聚糖。这个过程释放基质结合的生物活性因子(例如,VEGF,decorin),促进血管通透性和血管生成。胶原酶-1提高胚胎植入调节剂,包括NK细胞浸润和关键细胞因子LIF。值得注意的是,尽管子宫内膜胶原纤维张力降低,子宫组织仍保持结构完整性。子宫内胶原酶-1的应用挽救了热应激和胚胎移植模型的着床,众所周知的低植入率。重要的是,人子宫组织离体暴露于胶原酶-1诱导胶原蛋白去张和VEGF释放,在小鼠中观察到的镜像重塑。我们的研究强调了胶原酶诱导和协调细胞和分子过程的潜力,以增强子宫对有效胚胎植入的容受性。这种创新方法强调了对胚胎植入至关重要的ECM重塑机制。
    Ineffective endometrial matrix remodeling, a key factor in infertility, impedes embryo implantation in the uterine wall. Our study reveals the cellular and molecular impact of human collagenase-1 administration in mouse uteri, demonstrating enhanced embryo implantation rates. Collagenase-1 promotes remodeling of the endometrial ECM, degrading collagen fibers and proteoglycans. This process releases matrix-bound bioactive factors (e.g., VEGF, decorin), facilitating vascular permeability and angiogenesis. Collagenase-1 elevates embryo implantation regulators, including NK cell infiltration and the key cytokine LIF. Remarkably, uterine tissue maintains structural integrity despite reduced endometrial collagen fiber tension. In-utero collagenase-1 application rescues implantation in heat stress and embryo transfer models, known for low implantation rates. Importantly, ex vivo exposure of human uterine tissue to collagenase-1 induces collagen de-tensioning and VEGF release, mirroring remodeling observed in mice. Our research highlights the potential of collagenases to induce and orchestrate cellular and molecular processes enhancing uterine receptivity for effective embryo implantation. This innovative approach underscores ECM remodeling mechanisms critical for embryo implantation.
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  • 文章类型: Journal Article
    使用非侵入性方法很难研究脑型疟疾对脑组织转录谱的影响。我们从脑型疟疾和社区对照患者中分离了血浆细胞外囊泡(EV),并对其mRNA含量进行了测序。去卷积分析显示,来自脑型疟疾的电动汽车富含脑源性转录本。我们根据从横截面收集的样本中的EV转录谱和推断的疾病轨迹,同时使用健康的社区对照作为起点,对患有脑型疟疾的患者进行了排序。我们发现血浆EV中的神经元转录本随着疾病轨迹而减少,而来自神经胶质的转录本,内皮,免疫细胞增加。疾病轨迹与死亡等严重程度指标呈正相关,并与VEGFA-VEGFR和谷氨酸能信号的增加相关。以及血小板和中性粒细胞活化。这些数据表明,脑型疟疾的脑组织反应可以使用外周血中循环的电动汽车进行非侵入性研究。
    The impact of cerebral malaria on the transcriptional profiles of cerebral tissues is difficult to study using noninvasive approaches. We isolated plasma extracellular vesicles (EVs) from patients with cerebral malaria and community controls and sequenced their mRNA content. Deconvolution analysis revealed that EVs from cerebral malaria are enriched in transcripts of brain origin. We ordered the patients with cerebral malaria based on their EV-transcriptional profiles from cross-sectionally collected samples and inferred disease trajectory while using healthy community controls as a starting point. We found that neuronal transcripts in plasma EVs decreased with disease trajectory, whereas transcripts from glial, endothelial, and immune cells increased. Disease trajectory correlated positively with severity indicators like death and was associated with increased VEGFA-VEGFR and glutamatergic signaling, as well as platelet and neutrophil activation. These data suggest that brain tissue responses in cerebral malaria can be studied noninvasively using EVs circulating in peripheral blood.
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  • 文章类型: Journal Article
    目的:评价辅酶Q10(CoQ10)对牙槽骨改建和正畸牙齿移动(OTM)的影响。
    方法:将42只雌性Sprague-Dawley大鼠放置正畸矫治器,分为两组:正畸力(OF)组(n=21)和OFCoQ10(CoQ10)治疗组(n=21)。每组分为3个亚组,在第3、7和14天处死大鼠。CoQ10和OF组的大鼠给予100mg/kgb.w./天CoQ10(在1mL/b.w.大豆油中)和1mLb.w./天大豆油,分别,通过口胃灌胃。在实验结束时测量OTM。破骨细胞,成骨细胞和毛细血管数量;血管内皮生长因子(VEGF),受体激活剂核κB配体(RANKL)和组织中的骨保护素(OPG)水平;确定血液中的总抗氧化剂状态(TAS)和总氧化剂状态(TOS)。
    结果:与OF组相比,CoQ10治疗组显示正畸牙齿移动和破骨细胞和毛细血管数量减少。的确,VEGF和RANKL水平下降,而OPG的水平增加,除了第7天。此外,CoQ10治疗组在第7天和第14天表现出更低的TOS和更高的TAS(p<0.05)。组织学结果显示,CoQ10组成骨细胞形态发生改变;各组间成骨细胞数量差异无统计学意义(p>0.05)。
    结论:由于其对氧化应激和炎症的影响,CoQ10通过抑制破骨细胞分化调节骨重建,促进成骨细胞分化和减少OTM的量。
    结论:考虑到OTM可能会随着CoQ10的使用而减慢,诸如正畸治疗持续时间之类的主题,治疗计划中应考虑正畸力激活和预约频率。据预测,CoQ10的使用将支持临床应用中的治疗有效性,例如通过调节骨骼调节和抑制/优化不需要的牙齿移动的锚固方法来预防正畸治疗中的复发。
    OBJECTIVE: To evaluate the effects of coenzyme Q10 (CoQ10) on alveolar bone remodeling and orthodontic tooth movement (OTM).
    METHODS: An orthodontic appliance was placed in 42 female Sprague‒Dawley rats were divided into two groups: the orthodontic force (OF) group (n = 21) and the OF + CoQ10 (CoQ10) treatment group (n = 21). Each group was divided into 3 subgroups, and the rats were sacrificed on days 3, 7 and 14. The rats in CoQ10 and OF groups were administered 100 mg/kg b.w./day CoQ10 (in 1 mL/b.w. soybean oil) and 1 mL b.w./day soybean oil, respectively, by orogastric gavage. The OTM was measured at the end of the experiment. The osteoclast, osteoblast and capillary numbers; vascular endothelial growth factor (VEGF), receptor activator nuclear kappa B ligand (RANKL) and osteoprotegrin (OPG) levels in tissue; and total antioxidant status (TAS) and total oxidant status (TOS) in blood were determined.
    RESULTS: Compared with the OF group, the CoQ10 treatment group exhibited decreased orthodontic tooth movement and osteoclast and capillary numbers. Indeed, the levels of VEGF and RANKL decreased, while the levels of OPG increased except on day 7. Additionally, the CoQ10 treatment group exhibited lower TOS and higher TAS on days 7 and 14 (p < 0.05). Histological findings showed that the morphology of osteoblasts changed in the CoQ10 group; however, there was no significant difference in the number of osteoblasts between the groups (p > 0.05).
    CONCLUSIONS: Due to its effect on oxidative stress and inflammation, CoQ10 regulates bone remodeling by inhibiting osteoclast differentiation, promoting osteoblast differentiation and reducing the amount of OTM.
    CONCLUSIONS: Considering that OTM may be slowed with the use of CoQ10, topics such as orthodontic treatment duration, orthodontic force activation and appointment frequency should be considered in treatment planning. It is predicted that the use of CoQ10 will support the effectiveness of treatment in clinical applications such as preventing relapse in orthodontic treatment by regulating bone modulation and anchorage methods that suppress/optimize unwanted tooth movement.
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  • 文章类型: Journal Article
    这项研究的目的是使用纵向蛋白质组学和代谢组学分析以及三维病变测量来研究新生血管性年龄相关性黄斑变性(nAMD)中抗血管内皮生长因子(抗VEGF)功效和反应变异性的分子机制。
    在这项前瞻性研究中,54例未接受治疗的nAMD患者接受了“3+prorenata”(3+PRN)抗VEGF方案至少12周。收集治疗前和治疗后的房水,用于蛋白质组学和代谢组学分析。三维光学相干断层扫描(OCT)和OCT血管造影评估了不同类型的nAMD病变体积和面积。
    在房水中鉴定出1350种蛋白质和1268种代谢物,在抗VEGF治疗期间,301种蛋白质和353种代谢物发生了显著改变,富含血管生成途径,能量代谢,信号转导,和神经功能调节。(Δ)分子的67个变化与至少一种ΔnAMD病变显着相关。值得注意的是,蛋白质FGA,治疗期间TALDO1和ASPH显著下降,它们的减少与至少两种病变类型的病变消退更大相关。相反,尽管YIPF3也显示出显着的下调,其减少与总nAMD病变和视网膜下高反射物质的消退较差相关.
    这项研究确定了FGA,TALDO1和ASPH作为抗VEGF治疗疗效的潜在关键分子,而YIPF3可能是反应不佳的关键因素。纵向三维病变分析与多组学的整合为nAMD中抗VEGF治疗的机制和反应变异性提供了有价值的见解。
    UNASSIGNED: The purpose of this study was to investigate the molecular mechanisms underlying anti-vascular endothelial growth factor (anti-VEGF) efficacy and response variability in neovascular age-related macular degeneration (nAMD) using longitudinal proteomic and metabolomic analysis alongside three-dimensional lesion measurements.
    UNASSIGNED: In this prospective study, 54 treatment-naive patients with nAMD underwent \"3+ pro re nata\" (3+PRN) anti-VEGF regimens followed for at least 12 weeks. Aqueous humors were collected pre- and post-treatment for proteomic and metabolomic analysis. Three-dimensional optical coherence tomography (OCT) and OCT angiography assessed different types of nAMD lesion volumes and areas.
    UNASSIGNED: There were 1350 proteins and 1268 metabolites that were identified in aqueous humors, with 301 proteins and 353 metabolites significantly altered during anti-VEGF treatment, enriched in pathways of angiogenesis, energy metabolism, signal transduction, and neurofunctional regulation. Sixty-seven changes of (Δ) molecules significantly correlated with at least one type of ΔnAMD lesion. Notably, proteins FGA, TALDO1, and ASPH significantly decreased during treatment, with their reductions correlating with greater lesion regression in at least two lesion types. Conversely, despite that YIPF3 also showed significant downregulation, its decrease was associated with poorer regression in total nAMD lesion and subretinal hyper-reflective material.
    UNASSIGNED: This study identifies FGA, TALDO1, and ASPH as potential key molecules in the efficacy of anti-VEGF therapy, whereas YIPF3 may be a key factor in poor response. The integration of longitudinal three-dimensional lesion analysis with multi-omics provides valuable insights into the mechanisms and response variability of anti-VEGF treatment in nAMD.
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  • 文章类型: Journal Article
    来自五个生命王国的生物使用矿物质来硬化组织并制造牙齿,贝壳和骨骼,在生物矿化过程中。海胆幼虫骨骼是研究生物矿化及其进化的生物学调控的优秀系统。控制海胆骨骼生成的基因调节网络(GRN)非常详细,与控制脊椎动物血管化的GRN相似,而与驱动脊椎动物骨形成的GRN截然不同。然而,转化生长因子β(TGF-β)信号调节海胆和脊椎动物骨骼形成。这里,我们研究了地中海海胆物种中TGF-β的上游调控和转录目标,Paracentrotuslividus.TGF-βRII在血管内皮生长因子(VEGF)信号下游的骨架细胞中短暂活跃,在P.lividus.TGF-βRII活性的连续扰动显著损害骨骼伸长和关键成骨基因的表达。骨骼启动后TGF-βRII的扰动导致骨骼伸长的延迟和基因表达的微小变化。TGF-β靶标与其在脊椎动物骨形成过程中的转录靶标不同,这表明TGF-β在这两个门的生物矿化中的作用是趋同进化的结果。
    Organisms from the five kingdoms of life use minerals to harden their tissues and make teeth, shells and skeletons, in the process of biomineralization. The sea urchin larval skeleton is an excellent system to study the biological regulation of biomineralization and its evolution. The gene regulatory network (GRN) that controls sea urchin skeletogenesis is known in great details and shows similarity to the GRN that controls vertebrates\' vascularization while it is quite distinct from the GRN that drives vertebrates\' bone formation. Yet, transforming growth factor beta (TGF-β) signaling regulates both sea urchin and vertebrates\' skeletogenesis. Here, we study the upstream regulation and identify transcriptional targets of TGF-β in the Mediterranean Sea urchin species, Paracentrotus lividus. TGF-βRII is transiently active in the skeletogenic cells downstream of vascular endothelial growth factor (VEGF) signaling, in P. lividus. Continuous perturbation of TGF-βRII activity significantly impairs skeletal elongation and the expression of key skeletogenic genes. Perturbation of TGF-βRII after skeletal initiation leads to a delay in skeletal elongation and minor changes in gene expression. TGF-β targets are distinct from its transcriptional targets during vertebrates\' bone formation, suggesting that the role of TGF-β in biomineralization in these two phyla results from convergent evolution.
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  • 文章类型: Journal Article
    子宫内膜异位症是一种常见的疾病,在生育期间会影响5%至10%的女性,尽管病因和病理生理学尚不清楚。本研究旨在建立大鼠子宫内膜异位症模型,以研究天然和合成药物治疗子宫内膜异位症的疗效。使用手术诱导方法和内分泌干扰药物己烯雌酚(DES)建立了体内子宫内膜异位模型。简而言之,实验分为三个不同的组。每组有五只大鼠。第一组没有手术,而在第二组大鼠(n=5)中,两个小组织移植物固定在腹部的左右壁。但在第三组年夜鼠(n=5)中,通过手术和DES治疗将两块小组织移植到右和左腹壁。研究中采用了非侵入性光声成像(PAI)来测量血红蛋白水平等因素。氧饱和度,子宫内膜异位病灶的大小.组织病理学分析使用染色技术,如苏木精和伊红,Masson\'sTrichrome,和高碘酸希夫,以及标记抗体的免疫组织化学。使用Western印迹和实时PCR检查子宫组织中的分子标记。开发的子宫内膜异位症大鼠模型显示抗凋亡Bcl-2,血管生成标志物VEGF和促炎(COX-2和IL-6)蛋白标志物的表达显着增加。与对照组相比,治疗组的Caspase-3表达水平明显降低。光声成像(PAI)数据显示病变大小不断增加,以及氧饱和度的降低。结果表明,体内子宫内膜异位症大鼠模型可以准确评估自然或合成子宫内膜异位症治疗的疗效。该模型可能有助于提高对疾病的认识和靶向治疗药物的开发。
    Endometriosis is a common condition that affects 5% to 10% of women during their reproductive years, although the aetiology and pathophysiology are still unknown. This study aimed to create an endometriosis model in rats to investigate the efficacy of natural and synthetic medications in treating endometriosis. An in vivo endometriotic model was established using a surgical induction method and the endocrine-disrupting drug diethylstilbestrol (DES). In brief, the experiment is categorised into three different groups. Each group contains five rats. The first group had no surgery, while in the in the second group of rats (n = 5), two small tissue grafts were fixed at the right and left walls of the abdomen. But in the in the third group of rats (n = 5), two small pieces of tissue have been grafted on the right and left abdomen walls by surgically along with DES treatments. Noninvasive photoacoustic imaging (PAI) was employed in the study to measure factors such as haemoglobin levels, oxygen saturation, and the size of endometriotic lesions. Histopathological analysis was carried out utilising staining techniques such as Hematoxylin and Eosin, Masson\'s Trichrome, and Periodic Acid Schiff, as well as immunohistochemistry with marker antibodies. Molecular markers in uterine tissue were examined using Western blots and real-time PCR. The developed endometriosis rat model showed a significant increase in the expression of anti-apoptotic Bcl-2, angiogenic marker VEGF and pro-inflammatory (COX-2 and IL-6) protein markers. In contrast to the control group, the treatment group had considerably lower Caspase-3 expression levels. Photoacoustic imaging (PAI) data demonstrated a constant increase in lesion size, as well as a decrease in oxygen saturation levels. The findings suggest that the in vivo endometriosis rat model may accurately assess the efficacy of natural or synthetic endometriosis treatments. This model may help in the improvement of disease understanding and the development of targeted therapeutic drugs.
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  • 文章类型: Journal Article
    替洛龙二盐酸盐(替洛龙)是一种具有抗癌作用的口服活性干扰素诱导剂。本研究旨在评估替洛酮对乳腺癌的抗癌作用。MTT法检测替洛酮治疗后MCF-7和MDA-MB-231乳腺癌细胞的增殖。通过皮下注射(35mg/kg,0.5mL)的二甲基苯并[a]蒽(DMBA)在SpragueDawley(SD)大鼠的乳腺垫中。使肿瘤生长16周,直到它们的大小达到550-700mm3,然后用10和20mg/kg的替氯酮和标准药物多柔比星(4mg/kg)每周处理两次,持续3周。正常和疾病对照动物接受生理盐水。测量肿瘤体积和体重。分离肿瘤以测量干扰素-β(IFN-β)的水平,血管内皮生长因子-A(VEGF-A),通过酶联免疫吸附实验(ELISA)检测P53和炎症标记物。血清生物化学,通过标准方法测量脂质过氧化(LPO)和抗氧化酶。在肿瘤切片中进行P53的组织病理学和免疫组织化学(IHC)。替罗酮降低MCF-7和MDA-MB-231细胞的增殖,IC50浓度为34.08µM和14.27µM,分别。替洛龙治疗显示肿瘤体积减小,并且在体重没有显著变化的情况下增加存活率。替罗酮治疗还降低了炎症标志物和VEGF-A的水平,并增加了IFN-β和P53水平。Further,替洛龙治疗也降低了LPO和增加了抗氧化剂水平。肿瘤切片的组织病理学显示治疗动物的形态学正常化。肿瘤切片的IHC显示P53水平升高。总之,替洛龙对乳腺癌有潜在的抗癌作用。
    Tilorone dihydrochloride (tilorone) is an orally active interferon inducer with anticancer effects. The present study aimed to evaluate the anticancer effects of tilorone in breast cancer. MTT assay was done to measure the proliferation of MCF-7 and MDA-MB-231 breast cancer cells after treatment with tilorone. Mammary carcinogenesis was induced by subcutaneous injection (35 mg/kg, 0.5 mL) of dimethylbenz[a]anthracene (DMBA) in mammary pads of Sprague Dawley (SD) rats. Tumors were allowed to grow for 16 weeks till their sizes reached to 550-700 mm3, and then treated with 10 and 20 mg/kg of tilorone and standard drug doxorubicin (4 mg/kg) twice a week for 3 weeks. Normal and disease-control animals received normal saline. Tumor volumes and body weights were measured. Tumors were isolated to measure the levels of interferon-β (IFN-β), vascular endothelial growth factor-A (VEGF-A), P53 and inflammatory markers by enzyme-linked immunosorbent assay (ELISA). Serum biochemistry, lipid peroxidation (LPO) and antioxidant enzymes were measured by standard methods. Histopathology and immunohistochemistry (IHC) of P53 was done in tumor sections. Tilorone reduced the proliferation of MCF-7 and MDA-MB-231 cells with IC50 concentrations at 34.08 µM and 14.27 µM, respectively. Tilorone treatment showed reduced tumor volume, and increased survival with no significant changes in the body weights. Tilorone treatment also decreased levels of inflammatory markers and VEGF-A and increased IFN-β and P53 levels. Further, treatment with tilorone also decreased LPO and increased antioxidants levels. Histopathology of tumor sections showed normalizing morphology of treated animals. IHC of tumor sections showed increased levels of P53. In conclusion, tilorone has potential anticancer effects against breast cancer.
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  • 文章类型: Case Reports
    背景:玻璃体腔注射抗血管内皮生长因子被认为是息肉状脉络膜血管病变的一线治疗方法。它对循环系统有潜在的风险,这应该特别仔细评估老年患者。在这个案例研究中,我们旨在讨论该治疗方案对心脏健康的潜在影响.
    方法:本病例报告描述了一位没有心脏病史的老年患者,他表现出意外的心脏扩大和功能障碍。在病人住院期间,调查了各种潜在的原因,产生了这样的假设,即玻璃体内注射抗血管内皮生长因子的10年历史可能与观察到的临床表现有关。病人被建议停止这种治疗,经过2个月的随访,患者的心脏结构和功能逐渐改善。
    结论:这篇手稿强调了在抗血管内皮生长因子治疗前后进行心脏检查的重要性,特别是对于像老年人这样有心脏病风险的人。它强调需要仔细权衡治疗方案的益处和风险,以确保最佳治疗结果。
    BACKGROUND: Intravitreal injection of anti-vascular endothelial growth factor is considered the first-line treatment for polypoidal choroidal vasculopathy. It has potential risks for circulatory system, which should be particularly carefully evaluated in older patients. In this case study, we aim to discuss the potential impact of this treatment regimen on cardiac health.
    METHODS: This case report describes an elderly patient with no prior history of heart disease who exhibited unexpected heart enlargement and dysfunction. Throughout the patient\'s hospital stay, various potential causes were investigated, leading to the hypothesis that a 10-year history of intravitreal injections of anti-vascular endothelial growth factor could be related to the observed clinical manifestations. The patient was advised to discontinue this treatment, and after a 2-month follow-up period, there was a gradual improvement in the patient\'s cardiac structure and function.
    CONCLUSIONS: This manuscript highlights the importance of conducting cardiac examinations before and after anti-vascular endothelial growth factor treatment, especially for individuals at risk of heart diseases like the elderly. It emphasizes the need to carefully weigh the benefits and risks of treatment regimens to ensure optimal therapeutic outcomes.
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  • 文章类型: Journal Article
    背景:在使用扩张的大皮瓣修复大量组织缺损中,并发症的发生率随着面积的扩大而增加。目前,干细胞疗法在解决这个问题上有局限性。我们假设机械预处理后收集的脂肪来源干细胞(ADSC-CM)的条件培养基可以帮助皮肤扩张。
    方法:用ADSC-CM培养大鼠主动脉内皮细胞和成纤维细胞,10%,12%,和15%的拉伸力。将10毫升圆柱形软组织扩张器皮下植入36只Sprague-Dawley大鼠的背部。0%和10%拉伸组注射在0%和10%拉伸力下收集的ADSC-CM,分别,对照组不注射。经过3、7、14和30天的扩张,收获扩增的皮肤组织用于染色和qPCR分析。
    结果:内皮细胞的管腔形成最好,迁移率最高,在10%拉伸力下收集的ADSC-CM培养后,成纤维细胞分泌的胶原蛋白最多。10%牵张组皮肤扩张率显著增长。经过7天的扩张,扩张区域的血管数量,血管生成相关蛋白血管内皮生长因子的表达,碱性成纤维细胞生长因子,和肝细胞生长因子,10%拉伸组胶原沉积明显增加。
    结论:最佳机械力上调ADSCs中的特定旁分泌蛋白,以增加血管生成和胶原分泌,从而促进皮肤再生和扩张。本研究为扩张大型皮瓣提供了一种新的辅助方法。
    BACKGROUND: In the repair of massive tissue defects using expanded large skin flaps, the incidence of complications increases with the size of the expanded area. Currently, stem cell therapy has limitations to solve this problem. We hypothesized that conditioned medium of adipose-derived stem cells (ADSC-CM) collected following mechanical pretreatment can assist skin expansion.
    METHODS: Rat aortic endothelial cells and fibroblasts were cultured with ADSC-CM collected under 0%, 10%, 12%, and 15% stretching force. Ten-milliliter cylindrical soft tissue expanders were subcutaneously implanted into the backs of 36 Sprague-Dawley rats. The 0% and 10% stretch groups were injected with ADSC-CM collected under 0% and 10% stretching force, respectively, while the control group was not injected. After 3, 7, 14, and 30 days of expansion, expanded skin tissue was harvested for staining and qPCR analyses.
    RESULTS: Endothelial cells had the best lumen formation and highest migration rate, and fibroblasts secreted the most collagen upon culture with ADSC-CM collected under 10% stretching force. The skin expansion rate was significantly increased in the 10% stretch group. After 7 days of expansion, the number of blood vessels in the expanded area, expression of the angiogenesis-associated proteins vascular endothelial growth factor, basic fibroblast growth factor, and hepatocyte growth factor, and collagen deposition were significantly increased in the 10% stretch group.
    CONCLUSIONS: The optimal mechanical force upregulates specific paracrine proteins in ADSCs to increase angiogenesis and collagen secretion, and thereby promote skin regeneration and expansion. This study provides a new auxiliary method to expand large skin flaps.
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  • 文章类型: Journal Article
    背景:新生血管性年龄相关性黄斑变性(nAMD)是老年人视觉障碍和失明的常见原因,全球患病率不断增加。血管内皮生长因子抑制剂(抗VEGF)治疗改善了nAMD的视觉预后,但是持续治疗可能会导致焦虑和压力,尽管视力(VA)的增加也可能对患者的生活质量产生积极影响。由于频繁的治疗和监测,医疗负担是显而易见的,但抗VEGF治疗对患者生活质量的影响尚不完全清楚。我们评估了现实环境中nAMD及其治疗对新诊断患者健康相关生活质量(HRQoL)的总体影响。
    方法:本前瞻性队列研究包括2019-2020年在奥卢大学医院接受抗VEGF注射治疗的新诊断nAMD患者。数据包括全面眼科检查和眼底成像的参数,诊断时的年龄,性别,合并症,视敏度,和抗VEGF注射的频率。在诊断时通过15D问卷评估HRQoL,6个月,和12个月。
    结果:纳入95例nAMD患者。他们是78±8岁,56(59%)是女性,和74(78%)有一个以上的合并症。患者接受8±3次抗VEGF注射。视力(VA)在12个月内从56±18提高到61±24早期治疗糖尿病视网膜病变研究(ETDRS)字母。VA在45个(47%)中改善了>5个ETDRS字母,在30只(32%)眼中保持稳定,在17只(18%)眼中减少>5个字母。反映总体HRQoL的平均总15D评分在12个月内从0.850±0.104降至0.834±0.103。HRQoL降低与基线最佳校正VA(BCVA)≥70个ETDRS字母(p=0.023)和多个合并症(p=0.034)相关。在12个月的随访期间,有关视觉功能的HRQoL从0.765±0.194增加到0.789±0.184。
    结论:在现实世界中,在诊断和治疗开始后的前12个月内,抗VEGF治疗的nAMD患者的视觉功能HRQoL得到改善。良好的基线VA或几种合并症与随访期间整体HRQoL降低相关。尽管抗VEGF治疗对视功能有效,在实施nAMD治疗时,应考虑影响老年患者日常生活的其他几个方面.
    BACKGROUND: Neovascular age-related macular degeneration (nAMD) is a common cause of visual impairment and blindness in the elderly with globally increasing prevalence. Vascular endothelial growth factor inhibitor (anti-VEGF) treatment has improved visual prognosis of nAMD, but continuous treatment may cause anxiety and stress, although increase in visual acuity (VA) may also have positive effects on patients\' quality of life. The health care burden due to frequent treatment and monitoring is apparent, but the effect of anti-VEGF treatment on patients\' quality of life is not fully understood. We evaluated the overall impact of nAMD and its treatment on newly diagnosed patients\' health-related quality of life (HRQoL) in real-world setting.
    METHODS: The present prospective cohort study included newly diagnosed nAMD patients treated with anti-VEGF injections at Oulu University Hospital during 2019-2020. Data included parameters from comprehensive ophthalmic examination and fundus imaging, age at diagnosis, sex, comorbidities, visual acuity, and frequency of anti-VEGF injections. HRQoL was assessed by 15D questionnaire at diagnosis, 6 months, and 12 months.
    RESULTS: 95 nAMD patients were included. They were 78 ± 8 years old, 56 (59%) were female, and 74 (78%) had more than one comorbidity. The patients received 8 ± 3 anti-VEGF-injections. Visual acuity (VA) improved from 56 ± 18 to 61 ± 24 Early treatment diabetic retinopathy study (ETDRS) letters in 12 months. VA improved > 5 ETDRS letters in 45 (47%), remained stable in 30 (32%) and decreased > 5 letters in 17 (18%) eyes. The mean total 15D score reflecting overall HRQoL decreased from 0.850 ± 0.104 to 0.834 ± 0.103 in 12 months. Decreased HRQoL was associated with baseline best-corrected VA (BCVA) ≥ 70 ETDRS letters (p = 0.023) and more than one comorbidity (p = 0.034). HRQoL regarding visual function increased from 0.765 ± 0.194 to 0.789 ± 0.184 during the 12-month follow-up.
    CONCLUSIONS: In real world setting, HRQoL regarding visual function improved in anti-VEGF-treated nAMD patients during the first 12 months after the diagnosis and treatment initiation. Good baseline VA or several comorbidities were associated with decreased overall HRQoL during the follow-up. Despite the effectiveness of anti-VEGF treatment on visual function, several other aspects affecting elderly patients\' everyday life should be considered when nAMD treatment is implemented.
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