Sarcolipin (SLN) is an inhibitor of the sarco/endoplasmic reticulum (SR) Ca2+ ATPase (SERCA) and is abnormally elevated in the muscle of Duchenne muscular dystrophy (DMD) patients and animal models. Here we show that reducing SLN levels ameliorates dystrophic pathology in the severe dystrophin/utrophin double mutant (mdx:utr
−/−) mouse model of DMD. Germline inactivation of one allele of the SLN gene normalizes SLN expression, restores SERCA function, mitigates skeletal muscle and cardiac pathology, improves muscle regeneration, and extends the lifespan. To translate our findings into a therapeutic strategy, we knock down SLN expression in 1-month old mdx:utr
−/− mice via adeno-associated virus (AAV) 9-mediated RNA interference. The AAV treatment markedly reduces SLN expression, attenuates muscle pathology and improves diaphragm, skeletal muscle and cardiac function. Taken together, our findings suggest that SLN reduction is a promising therapeutic approach for DMD.
Impaired neuromuscular function by conjoint actions of organophosphorus insecticide metabolites omethoate and cyclohexanol with implications for treatment of respiratory failure, Clinical Toxicology,
Background
Gastrointestinal bleeding (GIB) after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) and coronary artery disease (CAD) is associated with high morbidity and mortality.
Methods
The Nationwide Inpatient Sample (NIS) database from 1998 to 2006 was utilized to identify 1,216,759 PCIs performed for ACS and CAD. We sought to analyze temporal trends in the incidence and in-hospital outcomes of GIB associated with PCI along with its predictors.
Results
The overall incidence of GIB was 1.04% (95% confidence interval (CI), 1.02%–1.06%). The incidence of GIB decreased over the study period (p for trend <0.0001). The overall mortality in the GIB group was 6.0% (95% CI, 5.6%–6.4%). The adjusted odds ratio (OR) for in-hospital mortality and GIB was 4.70 (95% CI, 4.23–5.23; p<0.0001); this remained high and essentially unchanged over the study period. Independent predictors of GIB included rectum/anal cancer (OR, 4.64; 95% CI, 3.20–6.73; p<0.0001), stomach cancer (OR, 2.74; 95% CI, 1.62–4.66; p=0.0002), esophageal cancer (OR, 1.99; 95% CI, 1.08–3.69; p=0.0288), colon cancer (OR, 1.69; 95% CI, 1.43–2.02; p<0.0001), congestive heart failure (OR, 1.43; 95% CI, 1.35–1.52; p<0.0001), and acute myocardial infarction (OR, 1.23; 95% CI, 1.13–1.35; p<0.0001).
Conclusions
Although the incidence of GIB associated with PCI decreased from 1998–2006 in the face of aggressive therapies for ACS and CAD, the risk of GIB-associated death remained high. Underlying GI malignancy is a significant independent predictor of GIB associated with PCI; identifying these patients may reduce the rate of GIB.
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