Review

Authors: Gianlorenzo Dionigi, Matteo Lavazza, Chei-Wei Wu...

Transoral thyroidectomy (TOT) represents reasonably the desirable minimally invasive approach to the gland due to the scarless non-visible incisions, the limited distance between the gland and the access that minimize tissue dissection and respect of the surgical anatomical planes. Patients are routinely selected according to an extensive inclusion criteria: (I) ultrasonographically (US) estimated thyroid diameter not larger than 10 cm; (II) US gland volume ≤45 mL; (III) nodule size ≤50 mm; (IV) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter; (V) follicular neoplasm; (VI) papillary microcarcinoma without lymph node metastasis. The operation is realized through median, central approach which allows bilateral exploration of the thyroid gland and central compartment. TOT is succeed both endoscopically adopting ordinary endoscopic equipments or robotically. In detail three ports are placed at the inferior oral vestibule: one 10-mm port for 30° endoscope and two 5-mm ports for dissecting, coagulating and neuromonitoring instruments. Low CO insufflation pressure is set at 6 mmHg. An anterior cervical subplatysmal space is created from the oral vestibule down to the sternal notch, laterally to the sterncleidomuscles similar to that of conventional thyroidectomy. TOT is now reproducible in selective high volume endocrine centers.

PubMed: 28713699
DOI: 10.21037/gs.2017.03.21

Authors: Yan Ye, Wenzhen Zhong, Ruifeng Luo...

BACKGROUND

The complex etiology and pathogenesis underlying Chronic Non-Bacterial Prostatitis (CNP), coupled with the existence of a Blood Prostate Barrier (BPB), contribute to a lack of specificity and poor penetration of most drugs. Emodin (EMO), a potential natural compound for CNP treatment, exhibits commendable anti-inflammatory, anti-oxidant, and anti-fibrosis properties but suffers from the same problems as other drugs.

METHODS

By exploiting the recognition properties of lactoferrin (LF) receptors that target intestinal epithelial cells (NCM-460) and prostate epithelial cells (RWPE-1), a pathway is established for the transrectal absorption of EMO to effectively reach the prostate. Additionally, hyaluronic acid (HA) is employed, recognizing CD44 receptors which target macrophages within the inflamed prostate. This interaction facilitates the intraprostatic delivery of EMO, leading to its pronounced anti-inflammatory effects. A thermosensitive hydrogel (CS-Gel) prepared from chitosan (CS) and β-glycerophosphate disodium salt (β-GP) was used for rectal drug delivery with strong adhesion to achieve effective drug retention and sustained slow release. Thus, we developed a triple-targeted nanoparticle (NPs)/thermosensitive hydrogel (Gel) rectal drug delivery system. In this process, LF, with its positive charge, was utilized to load EMO through dialysis, producing LF@EMO-NPs. Subsequently, HA was employed to encapsulate EMO-loaded LF nanoparticles via electrostatic adsorption, yielding HA/LF@EMO-NPs. Finally, HA/LF@EMO-NPs lyophilized powder was added to CS-Gel (HA/LF@EMO-NPs Gel).

RESULTS

Cellular assays indicated that NCM-460 and RWPE-1 cells showed high uptake of both LF@EMO-NPs and HA/LF@EMO-NPs, while Raw 264.7 cells exhibited substantial uptake of HA/LF@EMO-NPs. For LPS-induced Raw 264.7 cells, HA/LF@EMO-NPs can reduce the inflammatory responses by modulating TLR4/NF-κB signaling pathways. Tissue imaging corroborated the capacity of HA/LF-modified formulations to breach the BPB, accumulating within the gland's lumen. Animal experiments showed that rectal administration of HA/LF@EMO-NPs Gel significantly reduced inflammatory cytokine expression, oxidative stress levels and fibrosis in the CNP rats, in addition to exerting anti-inflammatory effects by inhibiting the NF-κB signaling pathway without obvious toxicity.

CONCLUSION

This triple-targeted NPs/Gel rectal delivery system with slow-release anti-inflammatory, anti-oxidant, and anti-fibrosis properties shows great potential for the effective treatment of CNP.

Topics: Humans; Male; Rats; Animals; Hydrogels; Emodin; Prostatitis; Antioxidants; NF-kappa B; Drug Delivery Systems; Nanoparticles; Anti-Inflammatory Agents; Drug Carriers; Chitosan

PubMed: 38238760
DOI: 10.1186/s12951-023-02282-7

Review

Authors: Geoffrey Burnstock

There is widespread involvement of purinergic signalling in endocrine biology. Pituitary cells express P1, P2X and P2Y receptor subtypes to mediate hormone release. Adenosine 5'-triphosphate (ATP) regulates insulin release in the pancreas and is involved in the secretion of thyroid hormones. ATP plays a major role in the synthesis, storage and release of catecholamines from the adrenal gland. In the ovary purinoceptors mediate gonadotrophin-induced progesterone secretion, while in the testes, both Sertoli and Leydig cells express purinoceptors that mediate secretion of oestradiol and testosterone, respectively. ATP released as a cotransmitter with noradrenaline is involved in activities of the pineal gland and in the neuroendocrine control of the thymus. In the hypothalamus, ATP and adenosine stimulate or modulate the release of luteinising hormone-releasing hormone, as well as arginine-vasopressin and oxytocin. Functionally active P2X and P2Y receptors have been identified on human placental syncytiotrophoblast cells and on neuroendocrine cells in the lung, skin, prostate and intestine. Adipocytes have been recognised recently to have endocrine function involving purinoceptors.

Topics: Adenosine Triphosphate; Adipocytes; Adrenal Glands; Animals; Arginine Vasopressin; Endocrine Glands; Humans; Oxytocin; Receptors, Purinergic; Signal Transduction

PubMed: 24265070
DOI: 10.1007/s11302-013-9396-x

Review

Authors: Taichi Noda, Masahito Ikawa

BACKGROUND

A mixture of spermatozoa and accessory gland secretions (from seminal vesicles, prostates, and coagulating glands) is ejaculated into the female reproductive tract at copulation. However, the physiological function of accessory glands on male fecundity remains unclear.

METHODS

Publications regarding the physiological functions of male accessory glands were summarized.

MAIN FINDINGS RESULTS

The functions of accessory glands have been studied using male rodents surgically removed coagulating glands (CG), prostates (PR), or seminal vesicles (SV). CG-removed males are fertile or subfertile, while the fecundity of PR-removed males is controversial. SV-removed males show copulatory plug defects, leading to fewer sperm in the uterus and severe subfertility. TGM4, SVS2, and PATE4 were identified as essential factors for copulatory plug formation. When the sufficient number of epididymal spermatozoa was artificially injected into a uterus (AI method), they could efficiently fertilize oocytes, implicating that accessory gland secretions are not essential. Seminal vesicle secretions (SVSs) improved fertilization rates only when low numbers of spermatozoa were used for AI. The changes of uterine environment by SVSs could not improve the pregnancy rate.

CONCLUSION

Accessory gland factors are critical for copulatory plug formation and support sperm fertilizing ability.

PubMed: 31312102
DOI: 10.1002/rmb2.12282

Authors: Jiaying Qian, Enhang Lu, Haibo Xiang...

Non-healing skin wounds pose significant clinical challenges, with biologic products like exosomes showing promise for wound healing. Saliva and saliva-derived exosomes, known to accelerate wound repair, yet their extraction is difficult due to the complex environment of oral cavity. In this study, as a viable alternative, we established human minor salivary gland organoids (hMSG-ORG) to produce exosomes (MsOrg-Exo). In vitro, MsOrg-Exo significantly enhanced cell proliferation, migration, and angiogenesis. When incorporated into a GelMA-based controlled-release system, MsOrg-Exo demonstrated controlled release, effectively improving wound closure, collagen synthesis, angiogenesis, and cellular proliferation in a murine skin wound model. Further molecular analyses revealed that MsOrg-Exo promotes proliferation, angiogenesis and the secretion of growth factors in wound sites. Proteomic profiling showed that MsOrg-Exo's protein composition is similar to human saliva and enriched in proteins essential for wound repair, immune modulation, and coagulation. Additionally, MsOrg-Exo was found to modulate macrophage polarization, inducing a shift towards M1 and M2 phenotypes in vitro within 48 h and predominantly towards the M2 phenotype in vivo after 15 days. In conclusion, our study successfully extracted MsOrg-Exo from hMSG-ORGs, confirmed the effectiveness of the controlled-release system combining MsOrg-Exo with GelMA in promoting skin wound healing, and explored the potential role of macrophages in this action.

Topics: Exosomes; Wound Healing; Humans; Animals; Macrophages; Organoids; Mice; Cell Proliferation; Hydrogels; Salivary Glands; Saliva; Cell Movement; Skin

PubMed: 39243057
DOI: 10.1186/s12951-024-02811-y

Review

Authors: Graeme R Polglase, Tracey Ong, Noah H Hillman...

The cardiovascular response to asphyxia involves redistribution of cardiac output to maintain oxygen delivery to critical organs such as the adrenal gland, heart, and brain, at the expense of other organs such as the gut, kidneys and skin. This redistribution results in reduced perfusion and localized hypoxia/ischemia in these organs, which, if severe, can result in multiorgan failure. Liver injury, coagulopathy, bleeding, thrombocytopenia, renal dysfunction, and pulmonary and gastrointestinal injury all result from hypoxia, underperfusion, or both. Current clinical therapies need to be considered together with therapeutic hypothermia and cardiovascular recovery.

Topics: Acute Kidney Injury; Asphyxia Neonatorum; Blood Coagulation Disorders; Cardiovascular System; Female; Gastrointestinal Diseases; Hemorrhage; Humans; Hypothermia, Induced; Hypoxia-Ischemia, Brain; Infant, Newborn; Liver Diseases; Lung Diseases; Multiple Organ Failure; Pregnancy; Thrombocytopenia

PubMed: 27524448
DOI: 10.1016/j.clp.2016.04.006

Authors: María Ríos Carrasco, Andrea Gröne, Judith M A van den Brand...

Influenza A viruses (IAVs) from the H5N1 2.3.4.4b clade are circulating in dairy farms in the USA.; ruminants were presumed not to be hosts for IAVs. Previously, IAV-positive mammalian species were hunters and scavengers, possibly getting infected while feeding on infected birds. It is now recognized that H5N1 viruses that circulate in US dairy cattle transmit through a mammary gland route, in contrast to transmission by aerosols via the respiratory tract. The sialome in the cow mammary and respiratory tract is so far solely defined using plant lectins. Here, we used recombinant HA proteins representing current circulating and classical H5 viruses to determine the distribution of IAV receptors in the respiratory and mammary tract tissues of cows. We complemented our study by mapping the glycan distribution of the upper and lower respiratory tracts of horses and pigs. Most of the sialome of the cow respiratory tract is lined with sialic acid modifications, such as N-glycolyl and O-acetyl, which are not bound by IAV. Interestingly, the H5 protein representing the cow isolates is bound significantly in the mammary gland, whereas classical H5 proteins failed to do so. Furthermore, whereas the 9-O-acetyl modification is prominent in all tissues tested, the 5-N-glycolyl modification is not, resulting in the display of receptors for avian IAV hemagglutinins. This could explain the high levels of virus found in these tissues and milk, adding supporting data to this virus transmission route.IMPORTANCEH5N1 influenza viruses, which usually affect birds, have been found on dairy farms in the USA. Surprisingly, these viruses are spreading among dairy cows, and there is a possibility that they do not spread through the air but through their milk glands. To understand this better, we studied how the virus attaches to tissues in the cow's respiratory tract and mammary glands using specific viral proteins. We found that the cow-associated virus binds strongly to the mammary glands, unlike older versions infecting birds. This might explain why the virus is found in cow's milk, suggesting a new way the virus could be spreading.

Topics: Animals; Cattle; Mammary Glands, Animal; Female; Receptors, Virus; Influenza A Virus, H5N1 Subtype; Hemagglutinin Glycoproteins, Influenza Virus; Orthomyxoviridae Infections; Swine; Horses; Respiratory System; Influenza A virus; Influenza in Birds; Cattle Diseases

PubMed: 39387556
DOI: 10.1128/jvi.01052-24

Review

Authors: Ingrid Pabinger, Dietmar Fries, Herbert Schöchl...

Uncontrolled massive bleeding with subsequent derangement of the coagulation system is a major challenge in the management of both surgical and seriously injured patients. Under physiological conditions activators and inhibitors of coagulation regulate the sensitive balance between clot formation and fibrinolysis. In some cases, excessive and diffuse bleeding is caused by systemic activation of fibrinolysis, i. e. hyperfibrinolysis (HF). Uncontrolled HF is associated with a high mortality. Polytrauma patients and those undergoing surgical procedures involving organs rich in plasminogen proactivators (e. g. liver, kidney, pancreas, uterus and prostate gland) are at a high risk for HF. Antifibrinolytics, such as tranexamic acid (TXA) are used for prophylaxis and treatment of bleeding caused by a local or generalized HF as well as other hemorrhagic conditions. TXA is a synthetic lysine analogue that has been available in Austria since 1966. TXA is of utmost importance in the prevention and treatment of traumatic and perioperative bleeding due to the resulting reduction in perioperative blood loss and blood transfusion requirements. The following article presents the different fields of application of TXA with particular respect to indications and dosages, based on a literature search and on current guidelines.

Topics: Antifibrinolytic Agents; Blood Coagulation; Blood Coagulation Disorders; Dose-Response Relationship, Drug; Fibrinolysis; Hematology; Hemorrhage; Humans; Practice Guidelines as Topic; Tranexamic Acid; Treatment Outcome

PubMed: 28432428
DOI: 10.1007/s00508-017-1194-y

Review

Authors: Azam Hosseinzadeh, Abolfazl Bagherifard, Fereshteh Koosha...

Severe COVID-19 is associated with the dynamic changes in coagulation parameters. Coagulopathy is considered as a major extra-pulmonary risk factor for severity and mortality of COVID-19; patients with elevated levels of coagulation biomarkers have poorer in-hospital outcomes. Oxidative stress, alterations in the activity of cytochrome P450 enzymes, development of the cytokine storm and inflammation, endothelial dysfunction, angiotensin-converting enzyme 2 (ACE2) enzyme malfunction and renin-angiotensin system (RAS) imbalance are among other mechanisms suggested to be involved in the coagulopathy induced by severe acute respiratory syndrome coronavirus (SARS-CoV-2). The activity and function of coagulation factors are reported to have a circadian component. Melatonin, a multipotential neurohormone secreted by the pineal gland exclusively at night, regulates the cytokine system and the coagulation cascade in infections such as those caused by coronaviruses. Herein, we review the mechanisms and beneficial effects of melatonin against coagulopathy induced by SARS-CoV-2 infection.

Topics: Angiotensin-Converting Enzyme 2; Blood Platelets; COVID-19; Cytokines; Humans; Melatonin; Peptidyl-Dipeptidase A; Renin-Angiotensin System; SARS-CoV-2

PubMed: 35944663
DOI: 10.1016/j.lfs.2022.120866