Because of the high risk of brain metastases from HER2-positive breast cancer, the study of the anticancer activity of drugs used to treat brain tumors, in particular lomustine, is of great importance. In the FVB/N Her-2 transgenic mice bearing HER2-positive breast cancer (BC HER2+), a single oral administration of lomustine at a dose of 50 mg/kg resulted in a significant tumor growth inhibition (up to 96 %, p<0.0001). The tumor growth index (TGI) expressed as a ratio between the areas under the kinetic curves of tumor growth in the study and control groups and amounted to 33 % (p<0.001) indicated the high activity of lomustine. However, the effect of lomustine on intramuscularly transplanted Ehrlich tumor was insignificant (tumor growth inhibition and tumor growth index were <39 % and 68 %, respectively). Lomustine administered orally at a single dose of 50 mg/kg 24 hours after intracranial transplantation of BC HER2+ increased the median survival time up to 30 days in FVB/N mice compared to 21 days in the control group mice (p<0.001). The high therapeutic effect of lomustine in HER2-positive breast cancer mice is likely can be explained by the biological characteristics of this tumor; therefore clinical trials of lomustine for HER2-positive tumors are needed.
To study the mechanisms underlying the effects of intraperitoneal chemoperfusion and to develop the optimal chemoperfusion regimen, an animal model of peritoneal carcinomatosis closely resembles a human model of peritoneal carcinomatosis is required. In our study, the model of peritoneal carcinomatosis in rats with ascitic ovarian cancer was used. material and methods. There were three groups of rats with ascitic ovarian cancer: 1 – the control group (n=15) having no treatment; 2 – rats receiving normothermic intraperitoneal chemoperfusion with cisplatin, 40 mg/kg (n=12); 3 – rats receiving hyperthermic intraperitoneal chemoperfusion with cisplatin, 20 mg/kg (n=14). All animals were euthanized with subsequent autopsy. results. Ascitic ovarian cancer developed in 100 % of the animals injected with the tumor cells. The median overall survival of rats in the control group was 9.5 days. At autopsy, all rats had ascites, and rats surviving 15‒17 days after the tumor cell injection had white tumor nodes measuring 1–3 mm in the greater omentum, intestinal mesentery, parietal and visceral peritoneum. The nodes were histologically verified as metastases of low-differentiated ovarian tumor. In 2 and 5 rats from groups 2 and 3 respectively, metastases in paratracheal lymph nodes and tumor hydrothorax were detected with no evidence of peritoneal carcinomatosis. The median survival of rats in groups 2 and 3 was significantly higher than that in the control group, being 37.5 and 25.5 months, respectively (р=0,256). conclusion. This in vivo study proved that localization of ascitic ovarian tumor, development of the tumor in all animals injected with tumor cells, fast ascites progression and peritoneal carcinomatosis make this ascitic ovarian cancer an adequate preclinical model of peritoneal carcinomatosis to study intraperitoneal chemoperfusion. Further studies are needed to understand the reasons and mechanisms of the tumor hydrothorax development in rats after intraperitoneal chemoperfusion.
По данным ВОЗ (2018), диабет является важной причиной слепоты, почечной недостаточности, ампутации нижних конечностей и других долгосрочных негативных последствий, которые существенно влияют на качество жизни пациентов. На протяжении 10-15 лет у пациентов с сахарным диабетом (СД) появляются признаки диабетической ретинопатии (ДР), ичерез 30 лет более 90% диабетиков приобретают такую патологию зрения. Проведено изучение определения показателей, характеризующих патогенетические механизмы развития сосудистой дисфункции, в частности ДР, и взаимосвязь этих изменений с оксидом азота. Под наблюдением находилось 2114 пациентов с различными хирургическими заболеваниями (из них 1073 пациента с гнойно-септическими заболеваниями мягких тканей), среди которых с СД 2-го типа было 193 пациента, с синдромом диабетической стопы (СДС) 2-5-й стадий по Wagner иДР - 134 пациента основной группы (268 глаз). В группу сравнения вошли 59 пациентов (118 глаз) с СД соответствующего возраста без СДС и ДР. Обе группы были одинаковы по возрасту иполу. Установлена зависимость между ДР и содержанием конечных продуктов метаболизма оксида азота в периферической крови. Повышение их уровня в 1,78 раза (р<0,01). Получено снижение активности супероксиддисмутазы (СОД) у пациентов с ДР в 1,56 раза (р<0,01) по сравнению с группой сравнения. Анализ содержания ТБК-активных продуктов в периферической крови показал повышение показателя в основной группе в 1,58 раза (р<0,01) относительно референтных значений пациентов без ДР. Кроме того, при определении содержания S-нитрозотиолов нами установлено повышение этих показателей в основной группе в 2,38 раза (р<0,01). Также у пациентов основной группы с ДР получено повышение концентрации гомоцистеина (ГЦ) в периферической крови в 5,13 раза (р<0,001). Следует помнить, что оксид азота (NO) может иметь как положительные, так и вредные эффекты в зависимости от его концентрации. С одной стороны, NO вызывает расслабление кровеносных сосудов, снижая кровяное давление, предотвращает агрегацию и адгезию тромбоцитов, ограничивает окисления холестерина ЛПНП, подавляет пролиферацию клеток гладких мышц и снижает экспрессию генов провоспалительных цитокинов, которые связаны с атерогенезом. С другой стороны, NO взаимодействует с O2-, приводя к инактивации NO и продукции пероксинитрита, который посттранскрипционно модифицирует белки и негативно влияет на их функцию. Это может способствовать эндотелиальной дисфункции, стимулируя выработку медиаторов воспаления и перекисное окисление липидов и таким образом увеличивая проницаемость клеток. В результате проведенных исследований нами установлено, что у пациентов с СД, осложненным ретинопатией и СДС, определяется значительное повышение содержания оксида азота в периферической крови, причиной которого является гипергликемия. Использование межклеточного посредника (NO), который способствует физиологическому регулированию гемодинамики глаза, защищает эндотелиальные клетки сосудов от патогенных факторов ишемии, поможет клиницистам выбрать действенную фармакологическую терапию, подходящую для конкретного пациента и конкретного глаза. According to WHO (2018), diabetes is an important cause of blindness, renal failure, lower limb amputation and other long-term negative consequences that significantly affect the quality of life of patients. For 10-15 years, patients with diabetes mellitus (DM) show signs of diabetic retinopathy, and after 30 years, more than 90% of diabetics acquire this vision pathology. The study of the determination of indicators characterizing the pathogenetic mechanisms of the development of vascular dysfunction, in particular diabetic retinopathy (DR), and the relationship of these changes with nitric oxide was carried out. The study included 2114 patients with various surgical diseases (of which 1073 patients with purulent-septic diseases of soft tissues), among which there were 193 patients with type 2 diabetes mellitus and with Wagner stage 2-5 diabetic foot syndrome and 134 patients with diabetic retinopathy. Main group (268 eyes). The comparison group included 59 patients (118 eyes) with diabetes of the corresponding age without SDS and DR. Both groups were the same in age and gender. The relationship between DR and the content of end products of nitric oxide metabolism in peripheral blood has been established. An increase in their level by 1.78 times (p<0.01). A decrease in SOD activity was obtained in patients with DR by 1.56 times (p<0.01) compared with the comparison group. Analysis of the content of TBA-active products in peripheral blood showed an increase in the indicator in the main group by 1.58 times (p<0.01) relative to the reference values of patients without diabetic retinopathy. In addition, when determining the content of S-nitrosithiols, we found an increase in these indicators in the main group by 2.38 times (p<0.01). In addition, in patients of the main group with DR, the concentration of homocestine in the peripheral blood increased by 5.13 times (p<0.001). It should be remembered that NO can have both positive and harmful effects depending on its concentration. On the one hand, NO induces relaxation of blood vessels, lowering blood pressure, preventing platelet aggregation and adhesion, restricting oxidation of LDL cholesterol, inhibiting smooth muscle cell proliferation, and decreasing the expression of pro-inflammatory genes that are associated with atherogenesis. On the other hand, NO interacts with O2-, leading to NO inactivation and the production of peroxynitrite, which post-transcriptionally modifies proteins and negatively affects their function. It can contribute to endothelial dysfunction by stimulating the production of inflammatory mediators and lipid peroxidation, and thus increasing cell permeability. As a result, we found that in patients with diabetes mellitus complicated by retinopathy and SDS, a significant increase in the content of nitric oxide in the peripheral blood is determined, the cause of which is hyperglycemia. The use of an intercellular messenger (nitric oxide NO), which contributes to the physiological regulation of eye hemodynamics, protects vascular endothelial cells from pathogenic ischemic factors, will help clinicians choose an effective pharmacological therapy suitable for a specific patient and a specific eye.
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