The elucidation of the 3D structure of DNA revolutionized modern science and created the basis for the field of molecular biology. The advent of DNA sequencing, and further refinement with Next‐Generation Sequencing (NGS) techniques, has made possible the enormous accumulation of data, which are useful for understanding the molecular mechanisms associated to various complex and rare diseases. Thanks to these advances, today it is known that several mechanisms regulate gene expression without the occurrence of mutations in the genome, a phenomenom known as Epigenetics and Epigenomics. The main mechanisms involved are DNA methylation, histone modifications, and non‐coding RNA transcription. The knowledge of these mechanisms applied to biomedicine has enabled the emergence of several fields, especially precision medicine, which is based on the genetic and epigenetic profiles of patients applied to personalized diagnostics and treatments. In this review, the history of the scientific advances that have enabled the development of precision medicine will be discussed, with a focus in epigenetics. Moreover, several molecules that have been approved for use or have the potential in epigenetic therapies (epidrugs) will also be discussed here, those of which act on targets responsible for maintaining the correct epigenetic pattern or correcting wrong patterns in diseases.
Introduction:
Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) are potentially pathogenic organisms commonly found in the urogenital tract, with colonisation rates up to 80% and 40% worldwide, respectively. The aim of this study was to estimate antimicrobial resistance by UU and MH, and identify the antimicrobial agents involved in bacterial resistance.MethodsA cross-sectional study, with data obtained retrospectively through medical records review. We analysed 140 patients whose women’s endocervical samples and men’s urine tested positive for MH and UU. The test used for the diagnosis and evaluation of antimicrobial resistance was the MYCOFAST Screening EvolutioN 3 kit.ResultsThe majority of patients were female (90.7%), 57.9% of the patients had >29 years of age and 84.3% did not have a stable union. About 70.0% of the patients tested positive for UU, 3.0% for MH, and 27.0% for both. HIV co-infection was seen in 32.1% and HPV in 30.0%. Absence of current history of Chlamydia trachomatis was a protective factor for the acquisition of azithromycin resistance (p=0.04). As for the antimicrobials, doxycycline showed sensitivity rates higher than 96% for both infections, while azithromycin showed 86.8% of sensitivity for UU, but resistance of 75% for MH. Ciprofloxacin showed sensitivity rates lower than 15% for both infections, while less than 35% were strains sensible to ofloxacin. Erythromycin resistance rates ranged over 65% for the UU-MH coinfection, while over 90% of sample was sensible to tetracycline and clarithromycin resistance rates ranged from 7.1% for UU to 100% for MH.ConclusionThe use of ciprofloxacin and ofloxacin is highly debatable considering the high rates of total and intermediate resistance. In our population, doxycycline showed high efficiency and is therefore recommended for the treatment of UU and MH infections. Monitoring antimicrobial resistance is ?fundamental for the adequacy of the therapeutic recommendations.
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