Dissertations / Theses on the topic 'Thyroid hormones Therapeutic use'

Pregnancy is a condition leading to an important strain on thyroid morphology and function.A normal functioning of the thyroid gland in the mother is essential for the early fetal development, since the fetal thyroid does not produce thyroid hormones until the end of the first trimester (approximately 12 to 14 weeks).The impact of thyroid dysfunction (and especially hypothyroidism) during pregnancy is well documented and has been associated with a number of obstetrical complications, such as premature delivery, low birth weight and even fetal death. In view of all changes in thyroid physiology during pregnancy the ATA (American Thyroid Association) guidelines recommend using trimester- and population-specific normality ranges, to define thyroid dysfunction. It is proposed to determine them in pregnant women without thyroid antibodies (TPO) and without severe iodine deficiency. Due to the few numbers of randomized clinical trials, there is still no consensus whether all pregnant women should be screened or only women at risk for the development of thyroid dysfunction during pregnancy.Thyroid dysfunction during pregnancy is caused in most cases by the presence of thyroid autoimmunity (TAI) and also the altered pregnancy outcomes in most studies are associated with the presence of TAI.Besides the presence of TAI, other factors might also change, influence and/or modify thyroid function. When we started our research, there were only few studies that investigated the impact of other variables, such as iron, BMI, smoking habit and/or the background of the pregnant women on the prevalence of thyroid dysfunction during the first trimester of pregnancy.The aims of the thesis were therefore, to investigate: • the association between the iron reserve status (ferritin levels), thyroid (dys)function and autoimmunity, corrected for confounders such as age, BMI, smoking habit and the time of blood sampling;• the impact of the ethnic background of the pregnant woman on thyroid function and autoimmunity, corrected for confounders such as age, BMI, smoking habit, and the time of blood sampling. Furthermore, to determine ethnic-specific reference ranges and investigate their impact on the diagnosis of thyroid dysfunction;• the impact of changes in thyroid function within the normal reference range in women free of thyroid autoimmunity on pregnancy outcomes, corrected for established covariates (age, BMI, smoking) and iron reserve as candidate new variable.• whether targeted high-risk screening for thyroid dysfunction during pregnancy could be improved with the inclusion of iron status and ethnicity to the actual risk factors defined in the ATA-GL.The results can be summarized as follows:Thyroid function during pregnancy can be influenced by variables others than thyroid antibodies such as the iron status and the ethnical background of the women. However, their impact on thyroid function is less important compared to that of thyroid antibodies. No significant impact of well-known variables (BMI, age, smoking) and others such as iron has been shown on clinical pregnancy outcomes when thyroid function remained within the normal range and no thyroid antibodies were present.We have shown that adding variables such as iron deficiency, ethnic background and obesity to the currently provided list of factors leading to a high-risk for the development of thyroid dysfunction during pregnancy, might improve the detection rate of subclinical hypothyroidism to comparable rates obtained in case of universal screening.
Doctorat en Sciences médicales (Médecine)
info:eu-repo/semantics/nonPublished

Thesis (MSc)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: This study describes: 1. Substrate binding assays investigating the effects of methanolic extracts of unfermented and fermented Rooibos on the binding of natural substrates to ovine adrenal microsomal and mitochondrial P450 enzymes, demonstrating the interference of substrate binding in the presence of the Rooibos extracts. 2. The effects of selected flavonoids (quercetin, rutin and aspalathin) on the binding of natural substrates to ovine adrenal microsomal and mitochondrial P450 enzymes, demonstrating interference of substrate binding in the presence of the flavonoid compounds. 3. Substrate conversion assays in non-steroidogenic COS-1 cells to investigate the effects of methanolic extracts of unfermented and fermented Rooibos on the activity of key steroidogenic P450 enzymes (CYP17A1, CYP21A2, CYP11B1, and CYP11B2), demonstrating inhibition of the catalytic activity in the presence of Rooibos extracts. 4. The effects of selected flavonoids on the substrate conversion of the aforementioned key steroidogenic enzymes expressed in COS-1 cells. 5. An investigation of the effect of methanolic extracts of unfermented and fermented Rooibos on steroid hormone production in human adrenal H295R cells under basal and stimulated conditions, demonstrating the modulating effects of unfermented and fermented Rooibos extracts. Basal and stimulated steroid hormone production was decreased in the presence of unfermented and fermented Rooibos.
AFRIKAANSE OPSOMMING: Hierdie studie beskryf: 1. Die gebruik van substraatbindings-essais om die effek van metanoliese ekstrakte, van gefermenteerde- en ongefermenteerde Rooibos, op die binding van die natuurlike substrate aan skaap adrenale mikrosomale en -mitochondriale P450 ensieme te bepaal. Daar is getoon dat die ekstrakte 'n beduidende inhiberende effek op ensiemsubstraatinteraksie gehad het. 2. Die die inhiberende effek van geselekteerde flavonoïede (kwersetien, rutien and aspalatien) op die binding van die natuurlike substrate aan skaap adrenale mikrosomale en -mitochondriale P450 ensieme. 3. Die gebruik van substraatomsettings-essais in nie-steroïedogeniese COS-1 selle, om die effek van gefermenteerde- en ongefermenteerde Rooibos ekstrakte op die aktiwiteit van die steroïedogeniese P450 ensieme (CYP17A1, CYP21A2, CYP11B1, and CYP11B2) se katalitiese aktiwiteit te bepaal. Daar kon aangetoon word dat die katalitise aktiwiteite van bg. ensieme beduidend beïnvloed word deur die Rooibos ekstrakte. 4. Die gebruik van substraatomsettings-essais in nie-steroïedogeniese COS-1 selle, om die effek van geselekteerde flavonoïede op die aktiwiteit van bogenoemde steroïedogeniese P450 ensieme te bepaal. 5. 'n Ondersoek na die invloed van metanoliese ekstrakte van gefermenteerde- en ongefermenteerde Rooibos op steroïedhormoon biosintese in die menslike adrenale H295R-selmodel. Die ondersoek, onder basale en gestimuleerde toestande, het getoon dat beide Rooibosekstrakte in bogenoemde toestande steroïedhormoon produksie geinhibeer het.

Numerous experiments in recent years have indicated differences in the bioavailability of corticosteroids from seemingly identical topical dosage forms. The human blanching assay was utilized in this study to assess the comparative blanching activities of various locally manufactured proprietary corticosteroid preparations. The first experiment was performed to assess the relative blanching activities of six semi - solid preparations containing the same concentration of betamethasone 17-valerate. The preparations used were Betnovate cream and ointment, Persivate cream and ointment and Celestoderm-V cream and ointment. This was followed, in the second experiment, by the investigation of the blanching activities of two lotions containing betamethasone 17-valerate (Betnovate and Celestoderm-V) and a lotion containing betamethasone 17,21- dipropionate (Diprosone). The third experiment involved a study of six semi-solid proprietary corticosteroid-containing formulations, viz. Dermovate (clobetasol propionate) cream and ointment, Betnovate (betamethasone 17-valerate) cream and ointment and Eumovate (clobetasone butyrate) cream and ointment. This investigation was prompted by claims in advertisements in the medical media that Dermovate is therapeutically more efficacious than Betnovate which is more efficacious than Eumovate. The penultimate experiment in this study served the purpose of finding a corticosteroid-containing preparation that falls into the moderately potent group of corticosteroid formulations, as described in the United Kingdom MIMS. This preparation was used in the final experiment which was undertaken to ascertain the potency category of Florone (diflorasone diacetate) cream and ointment.

Two possible variables of the McKenzie/Stoughton blanching assay, namely amount applied to the test site and occlusion time have been investigated. Subsequently, two topical steroid preparations, Synalar cream (0,025% fluocinolone acetonide) and Betnovate cream (0,1% betamethasone 17-valer ate) were extemporaneously diluted with five and six placebo bases respectively. Taking cognizance of the two possible variables, these diluted preparations were assessed in vivo using a modified version of the McKenzie/Stoughton blanching assay for blanching activity over a 14 month period. It was found that the base E45, which is slightly alkali, had the greatest effect on both preparations. In the case of betamethasone 17-valerate this base c aused the conversion to the less active isomer, betamethasone 21-valerate whereas at the end of the 14 month test period it was found that the Synalar/E45 dilution contained no fluocinolone acetonide. Quantitative analysis of all the diluted preparations by high performance liquid chromatography using a reverse-phase system was performed. The data obtained f r om the systematic stUdies of the effects of varying concentrations and occlusion times were presented at the Eleventh National Congress of the South African Pharmacological Society.
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Thesis (M.Tech.)(Nuclear Medicine) -- Central University of Technology, free State, 2007
In the South African Health Services (SAHS) it is each health worker’s responsibility to find ways to reduce health care cost and improve health service to the public. The measurement of radioactive iodine uptake (RAIU) by the thyroid gland for diagnostic purposes has been used as early as the 1940s. The 24-hour (hr) iodine-131 (131I) uptake measurement is traditionally used for the calculation of the 131I administered activity for therapy dosage. This entails that the patient’s hospitalisation is prolonged, which increases the costs. The literature also indicates that the 24-hr 131I uptake value can be discarded and only the 6-hr 131I uptake measurement is needed to calculate administered activity for therapeutic dosages for Graves’ patients. Therefore, if it can be confirmed that the 6-hr 131I uptake measurement alone is needed, the SAHS could decrease hospitalisation costs. The overall goal of the investigation was to analyse the 6-hr and 24-hr 131I uptake measurements of patients with Graves’ disease at the Universitas Hospital. The aim was to determine the relationship between the 6-hr and 24- hr RAIU values to establish the therapeutic dosage for Graves’ disease. To achieve the aim, three objectives were set. First, to serve as a background to the investigation, a literature survey relating to the RAIU measurements of patients with Graves’ disease was made. Second, a retrospective analysis was performed by collecting the 6-hr and 24-hr 131I uptake measurements of patients with proven Graves’ disease at the Universitas Nuclear Medicine Department (UNMD). Finally, the data obtained from the retrospective analysis was analysed, summarised and compared to answer the investigation questions. The investigation group included patients with confirmed Graves’ disease who had undergone both the 6- and 24-hr 131I RAIU at the Universitas Hospital from the beginning of 2004 to the end of 2005. Graves’ disease is confirmed by the following factors at the UNMD, namely: Suppressed TSH, elevated T4 and T3 values, an increased uptake on the 99mTc-pertechnetate scan and increased 6- and 24-hr 131I RAIU values. The UNMD statistics show that 178 patients were diagnosed with Graves’ disease during this period. The patients of the investigation group included both male and female patients from different races, ranging from 15-75 years. In order to increase the validity of the investigation, all factors that could influence the accuracy of the 131I thyroid uptake test were excluded. After the exclusion and inclusion criteria had been applied, the final investigation group was made up of 124 Graves’ disease patients. The data obtained from the patient files was noted on the different data sheets (see Appendix A) for further analysis. The information from these data sheets was then used to obtain the investigation results. The Department of Biostatistics of the University of the Free State (UFS) was consulted for recommendations regarding the management of data and the processing of results. All values were summarised by means and Standard Deviations (SD) or percentiles. Mean or median differences were calculated with a 95% Confidence Interval (CI). A regression analysis was made between the 6-hr and 24-hr 131I RAIU values. The highest RAIU value is the best to calculate the therapeutic dosage, as this gives a true reflection of the thyroid function of a Graves’ disease patient. In the investigation group the median of the 24-hr 131I RAIU values was higher than the 6-hr 131I RAIU values. The findings showed that the 24-hr 131I RAIU in most of the investigation group was the highest value and most effective to calculate the 131I therapeutic dosage. At a time when research-based practice is taking on an increasingly important role, it is essential for nuclear medicine departments to make evidence-based recommendations. This investigation found that the correlation between the 6-hr and 24-hr RAIU clearly justified the cost spent on Graves’ disease patients who must stay overnight for the 24-hr 131I RAIU procedure.

Thesis (PhD)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: This study describes: • the influence of a methanolic extract of unfermented Rooibos and five major Rooibos flavonoids, aspalathin, nothofagin, rutin, orientin and vitexin, on the activities of key adrenal steroidogenic enzymes - cytochrome P450 17β- hydroxylase/17,20-lyase (CYP17A1), 3β-hydroxysteroid dehydrogenase • the development of a novel UPLC-MS/MS method for the separation and quantification of 21 adrenal steroid metabolites; • the influence of Rooibos and aforementioned flavonoids on adrenal steroid hormone production in H295R cells - a human adrenal carcinoma cell line expressing the enzymes catalysing the production of mineralocorticoids, glucocorticoids and adrenal androgens, assayed under both basal (normal) and forskolin-stimulated (stressed) conditions; • the influence of Rooibos on the inter-conversion between cortisol and cortisone by 11βHSD1 and 11βHSD2 expressed in CHO-K1 cells; • the influence of Rooibos consumption on circulating steroid hormone levels and ratios in male Wistar rats; • the influence of Rooibos consumption on circulating steroid hormone levels and ratios in male and female human test subjects at risk for developing cardiovascular disease. (3βHSD2), cytochrome P450 21-hydroxylase (CYP21A2) and cytochrome P450 11β-hydroxylase (CYP11B1), expressed in non-steroidogenic COS-1 cells;
AFRIKAANSE OPSOMMING: Hierdie studie beskryf: • die invloed van metanoliese ekstrakte van ongefermenteerde Rooibos en vyf van die hoof flavonoïedverbindings in Rooibos, aspalatien, notofagien, rutien, oriëntien en viteksien, op die aktiwiteite van ensieme wat steroïedbiosintese in die bynier kataliseer – sitochroom P450 17α-hidroksilase/17,20-liase (CYP17A1), 3β-hidroksisteroïed dehidrogenase (3βHSD2), sitochroom P450 21-hidroksilase (CYP21A2) en sitochroom P450 11β-hidroksilase (CYP11B1), uitgedruk in nie-steroïed produserende COS-1 selle; • die ontwikkeling van ‘n geskikte UPLC-MS/MS metode vir die skeiding en kwantifisering van 21 steroïedmetaboliete in die bynier; • die invloed van Rooibos en die bg. flavonoïede op steroïedproduksie in H295R selle – ‘n menslike bynier kanker sellyn gekenmerk deur die ekspressie van die steroidogeniese ensieme wat die produksie van mineralokortikoïede, glukokortikoïede en bynierandrogene kataliseer, geanaliseer onder beide basale (normale) en forskoliengestimuleerde (gestresde) kondisies; • die invloed van Rooibos op die omeenskakeling tussen kortisol en kortisoon deur 11βHSD1 and 11βHSD2 in CHO-K1 selle; • die invloed van Rooibosinname op vlakke van sirkulerende steroïed hormone en relatiewe verhoudings in die bloed van manlike Wistarrotte; • die invloed van Rooibosinname op sirkulerende steroïed hormoon vlakke en relatiewe verhoudings in die bloed van mans en vrouens met ‘n hoë risiko vir die ontwikkeling van kardiovaskulêre siektes.

Em 32 pacientes com Distrofia Muscular de Duchenne, em corticoterapia, avaliou-se a evolução da força muscular, ao longo de 14 meses, mensalmente no primeiro semestre e a cada dois meses no segundo e terceiro semestre. Testes empregados: escala "Medical Research Council", Hammersmith "motor ability score", levantamento de peso cronometragem do tempo para manobra de Gowers e para percorrer 9 metros. O estudo revelou tendência de estabilidade da força muscular durante o acompanhamento e que para avaliar objetivamente a força muscular são suficientes intervalos de três meses no primeiro semestre de corticoterapia e, posteriormente, de seis meses enquanto durar o tratamento
In 32 patients with Duchenne muscular dystrophy and receiving steroid therapy we assessed muscle strength along a follow-up of 14 months using Medical Research Council scale, Hammersmith functional motor scale, timed testing for rising from the floor and walking 9 meters, as well as rising weights. The tests were repeated monthly along the first 6 months and every two months by the rest of the follow-up. The study revealed a trend to functional stability and that the muscle strength can be evaluated at 3 and 6 months of treatment and then every 6 months while the steroid therapy is maintained

Dehydroepiandrosterone, a C-19 steroid, is found endogenously with the highest circulating serum levels. It is converted to important steroids such as the sex hormones oestrogen and testosterone. DHEA has come under the spotlight as a purported “fountain of youth” due to its well-characterised age-related decline. The supplementation of DHEA in both the elderly and those with a pathophysiological deficiency has been shown to be of benefit, particularly with regard to wellbeing and depression. The role of DHEA in the periphery has not been elucidated beyond its role as a precursor hormone in sex steroid biosynthesis, though it has been established as a neuroactive neurosteroid, capable of exerting neuroprotective effects in the brain. Since the importance of free radicals in aging and neurodegeneration is well established, investigations were conducted on the ability of DHEA to inhibit free radical generation or scavenge existing free radicals. DHEA was able to significantly inhibit quinolinic acid-induced lipid peroxidation, a measure of membrane damage, over a range of concentrations, although the reduction did not appear to be dose-dependent. This was observed in both in vitro and in vivo studies. Thus, the ability of a compound to reduce the degree of lipid peroxidation may indicate its value as a neuroprotectant. However, DHEA did not significantly reduce cyanide induced generation of the superoxide free radical, suggesting that DHEA is not an effective free radical scavenger of the superoxide anion and that the reduction in lipid peroxidation does not occur through a scavenging mechanism. Apoptosis is a physiological process which is necessary for development and homeostasis. However, this form of programmed cell death can be initiated through various mechanisms and too much apoptotic cell death results in deleterious effects in the body. DHEA was shown not to induce apoptosis. Even the lowest concentration of DHEA investigated in this thesis shows a remarkable decrease in the degree of apoptosis caused by intrahippocampal chemical insult by the neurotoxin quinolinic acid. Cresyl violet was used to visualise tissue for histological examination which revealed that DHEA is able to preserve the normal healthy morphology of hippocampal cells which have been exposed to quinolinic acid. Cells maintained their integrity and showed little evidence of swelling associated with necrosis. Organ culture studies were performed by assessing the impact of DHEA on several pineal metabolites. The study revealed that DHEA exerted an effect on the metabolism of indoleamines in the pineal gland. Melatonin, the chief pineal hormone, did not appear to be affected while the concentrations of N-acetylserotonin, serotonin and methoxytryptamine showed significant alterations. Thus, the neuroprotective mechanism of DHEA does not appear to be mediated by an increase in the presence of melatonin. The biological importance of metal ions in neurodegeneration is also well established and thus the potential interaction between DHEA and metal ions was considered as a mechanism of action. Spectroscopic and electrochemical analyses were performed to determine whether DHEA is able to interact with metal ions as a ligand. These reveal that DHEA does not form a strong bond with the metals investigated, namely copper (II) and iron (III), but that a weak interaction is evident. These investigations were conducted in a rodent model, which has neither large amounts of endogenous DHEA, nor the enzymatic infrastructure present in humans. Thus, the theory that DHEA exerts its effects through downstream metabolic products is unlikely. However, these investigations reveal that there is merit in the statement that DHEA itself is a neuroprotective molecule, and confirm that the further investigation of DHEA is an advisable strategy in the war against neurodegeneration and aging.

O carcinoma diferenciado de tireóide (CDT) abrange 95% de todas as doenças malignas da tireóide. Nos EUA, aumentou em 2,4 vezes nos últimos anos (1973-2002). O seu tratamento inclui tireoidectomia total, seguido por terapia com radioiodo e supressão do TSH com L-tiroxina. A doença pode recidivar em ~20% dos casos, sendo necessária avaliação periódica através de exames de imagens e dosagem de tireoglobulina sérica (TGs). Os Anticorpos (Acs) anti-TG podem ser detectados em 15 a 25% dos pacientes, comprometendo, parcialmente, o uso da TGs como marcador de recidiva do câncer. Um método alternativo proposto para monitorar os pacientes é a detecção de células tireoidianas em sangue periférico, através da mensuração do RNA mensageiro de TG (RNAm-TG) pela técnica de RTPCR em tempo real. Esta nova metodologia aumenta a sensibilidade da detecção desta molécula. O objetivo deste estudo é verificar a significância da quantificação do RNAm-TG, como método diagnóstico complementar no acompanhamento a longo prazo de pacientes com CDT. Amostras de sangue de 45 pacientes (25 sem metástase, 14 com metástase ganglionar e 6 com metástase à distância) foram coletadas nos tempos: antes e 24, 48, 72 horas, 7 dias, 1, 3, 6, 9 meses, 1, 2, 4, 5, 6 e 7 anos após a dose ablativa de radioiodo. Foi realizada extensiva padronização da técnica com a finalidade de excluir interferências metodológicas, empregando dois genes controles interno (GAPDH e HPRT1) para o cálculo da concentração do RNAm-TG. Concomitantemente foi realizada a mensuração de TGs, perfil hormonal e de anticorpos anti-TG. A pesquisa de corpo inteiro, realizada 7 dias após a dose terapêutica, estabeleceu o estadio clínico inicial dos pacientes. Não foi possível estabelecer um valor de corte para o RNAm-TG. O RNAm-TG não diferenciou os estadios clínicos da doença ao longo do tempo, independente do gene controle interno utilizado, e tampouco quando analisaram-se os dados na presença de Acs anti-TG e TSH30ng/mL. A TGs diferenciou os estadios clínicos ao longo do tempo. Concluiu-se que, o RNAm-TG não é um bom marcador de recidiva do CDT, mesmo quando considerou-se critérios de padronização da técnica, avaliação em longo prazo e presença de Acs anti-TG, sendo assim não poderia ser utilizado como método diagnóstico complementar no acompanhamento de pacientes com CDT. Este estudo demonstra que a técnica de RT-PCR em tempo real é muito sensível perdendo especificidade, inviabilizando sua utilização no acompanhamento dos pacientes com CDT
The differentiated thyroid carcinoma (DTC) encloses 95% of all thyroid malignant disease. In USA, it increased 2,4 times in recent years (1973- 2002). The treatment includes total thyroidectomy, ablation with radioiodine (RAI) followed by TSH suppression with L-Thyroxine. The cancer recurrence occurs in 20% of the cases. Periodic evaluation through imaging examinations and serum thyroglobulin (TG) measurements by imunoassays method is recommended for careful follow-up of these patients. The anti-TG antibodies prevalence is 15-25% and would impair, partially, the serum TG use as a tumor marker. An alternative method to identify the recurrence of the tumor is the thyroid cells detection in peripheral blood, through the TG messenger RNA quantification (mRNA-TG) by real time RT-PCR. This new methodology increases the sensitivity detection for this molecule. The objective of this study was to verify the mRNA-TG peripheral blood quantification significance, as a complementary diagnostic method in the long term follow up of patients with DTC. Fourty five blood samples from patients with DTC have been collected before and 24, 48, 72 hours, 7 days, 1, 3, 6, 9 months, 1, 2, 4, 5, 6 and 7 years after the ablation therapy. Extensive technique standardization for mRNA-TG measurements was carried out to exclude methodological interventions and two housekeeping genes (GAPDH and HPRT1) were used to calculate the mRNA-TG concentrations. Concomitantly, serum TG measurements, hormonal profile and antibodies anti-TG assays were performed. The whole body scan was performed 7 days after RAI ablation to determine the stage of the disease. It was not possible to establish a cut-point value for mRNA-TG. The mRNA-TG did not differentiated the clinical stage of the disease in the long term follow-up and neither in the presence of anti-TG antibodies and TSH30ng/mL. Serum TG was able to differentiate the clinical stage of the patients during the follow-up. In conclusion mRNA-TG is not a good marker for the DCT recurrence, even when technical standardization, long term evaluation and the presence of antibodies anti-TG were considered. Thus it could not be used as a complementary diagnostic method in the DTC patients follow-up. This study confirmed the high sensivity of the real time RT-PCR whereas with very low specificity, consequently is unviable to be used in the DTC patients follow-up

Embora a utilização do corticóide oral não seja indicada no tratamento de manutenção na doença pulmonar obstrutiva crônica, identificamos em nosso ambulatório, um grupo de pacientes que fazem uso desta medicação de forma continuada e, nos quais, todas as tentativas anteriores de retirada da medicação, havia resultado em exacerbação dos sintomas. O objetivo deste estudo foi o de analisar os fenômenos inflamatórios associados à tentativa de redução progressiva do corticóide oral nesses doentes. Avaliamos o escarro induzido de 14 pacientes usuários crônicos de corticóide. Após a avaliação basal, realizada enquanto os pacientes faziam uso de sua dose habitual da medicação (V0), procedemos ao aumento da prednisona a 40 mg por dia, por duas semanas (V1). A seguir, reduzimos progressivamente a dose até que ocorresse uma exacerbação (EXAC), quando a dose de 40 mg de prednisona foi re-introduzida por duas semanas (APÓS). Comparamos os resultados deste grupo aos de um grupo de pacientes portadores de DPOC não-usuários de corticóide oral. Esses pacientes foram avaliados na condição basal (V0), quando exacerbaram (EXAC) e após o tratamento com 40 mg de prednisona, por duas semanas (APÓS). As variáveis analisadas no escarro foram: % de neutrófilos, % de eosinófilos, % de macrófagos, número total de células, interleucinas 4, 6 e 8. Constatamos que o grupo corticóide apresentou um aumento significativo na porcentagem de eosinófilos na exacerbação em relação a V0, e uma redução significativa em APÓS, em relação a EXAC. Isto não ocorreu no grupo não-corticóide. Ao compararmos os dois grupos, observamos que a concentração das interleucinas 4, 6 e 8, foi significativamente mais alta no grupo corticóide em V0 e na exacerbação em relação ao grupo não-corticóide. Quando analisamos o comportamento das interleucinas nas avaliações seqüenciais, dentro de cada grupo, observamos que a interleucina 4 tendeu à elevação na exacerbação, no grupo corticóide, sem atingir, entretanto, significância estatística. As interleucinas 6 e 8 aumentaram significativamente no grupo corticóide na visita APÓS. Concluímos que a retirada progressiva de corticóide oral induz a exacerbação em pacientes com DPOC corticóide-dependentes com um processo inflamatório eosinofílico, que tende à reversão após o aumento da dose do corticóide
Although in chronic obstructive lung disease the use of oral corticoid is not indicated in the maintenance treatment, we identified a group of patients that make use of this medication continuously. The objective of this study was to analyze the inflammatory phenomena associated to the attempt of progressive reduction of oral corticoids in these patients. We evaluated induced sputum of 14 patients on long-term use of oral corticoids. After the basal evaluation, accomplished while the patients made use of their habitual dose of the medication (V0), we increased the dose of prednisone to 40 mg daily for two weeks (V1). To proceed we reduced the dose progressively until an exacerbation occurred (EXAC), when the dose of prednisone 40 mg daily was reintroduced for two weeks (AFTER). We compared the results to a group of patients with COPD not on use of oral corticoids, that were appraised in the basal condition (V0), when they exacerbated (EXAC) and after the treatment with prednisone 40 mg daily for two weeks (AFTER). The variables analyzed in the sputum were:, % of neutrophils, % of eosinophils, % of macrophages, total number of cells, interleukins 4, 6 and 8. We verified that the corticoid group presented a significant increase in the percentage of eosinophils at the exacerbation in relation to V0, and a significant reduction in AFTER in relation to EXAC. This didn\'t happen in the non corticoid group. When we compared the two groups we observed that the concentration of the interleukins was significantly higher in corticoid group in V0 and at the exacerbation in relation to the non corticoid group. When we analyzed the behavior of the interleukins along the evaluations in each group we observed that interleukin 4 tended to an elevation at the exacerbation in the corticoid group, without reaching statistical significance. Interleukins 6 and 8 increased significantly in the corticoid group in the visit AFTER. We concluded that the progressive reduction of oral corticoid induces exacerbation in patients with COPD on long-term use of prednisone with an eosinophilic inflammatory process that tends to reverse after the increase of the dose of the corticoid

This reseach firstly investigated iodine-induced apoptotic effects and the underlying mechanism in thyroid cancer cells. Results indicated that apoptosis induced by iodine, especially at high dose of iodine (100 muM), was mitochondrial-mediated, with the loss of mitochondrial membrane potential, Bak up-regulation, caspase 3 activation and cytochrome C release from mitochondria. Iodine treatment decreased the level of mutant p53 including the R273H mutant that possesses anti-apoptotic features while increased the p21 level. The block of p21 significantly prevented iodine-induced apoptosis. High doses of iodine also stimulated the transient activation of the subfamily members of MAPKs (ERK1/2, p38 and JNK1/2). The results showed the three subfamily members of MAPKs all worked as anti-apoptotic factors. Surprisingly, high doses of iodine promoted instead of suppressed the expression of anti-apoptotic protein Bcl-xL expression. The increase of Bc1-xL was likely to compensate the damage induced by iodine since the inhibition of Bc1-xL accelerated iodine-mediated apoptosis. Collectively, iodine induced mitochondrial-mediated apoptosis in thyroid cancer cells. This apoptotic pathway was involved in the activation of MAPKs pathways, which may subsequently up-regulate p21, Bc1-xL, and down-regulate anti-apoptotic mutant p53 expression. The findings provide solid molecular evidence to explain the epidemiological observation that iodine insufficiency promotes the thyroid tumor development. It may also reveal some novel molecular targets for the treatment of thyroid cancer.
Thyroid cancer is the most common endocrine malignancy and exhibits the full range of malignant behaviors from the relatively indolent occult differentiated thyroid cancer to uniformly aggressive and lethal anaplastic thyroid cancer. Iodine is a well known key element in thyroid normal function maintenance and thyroid cancer development. However, the mechanisms of iodine in thyroid cancer cells development are limited. Recent researches have indicated that iodine could induce cancer cells apoptosis, staying clear from the dysfunction of iodide-specific transportation systems in thyroid cancer cells. Thus, iodine-induced apoptosis may be an effective pathway for iodine to affect thyroid cancer development, but we know little about them.
To further explore iodine on the apoptotic effects of chemotherapeutic agents in thyroid cancer, anaplastic thyroid cancer cell line ARO was used. Anaplastic thyroid cancer is lethal because of its rapid progression and poor response to chemotherapy and radioiodine therapy. The study examined the effect of moderate dose of iodine (50 muM) on the apoptosis of ARO cells treated with doxorubicin (Dox) and histone deacetylase inhibitor sodium butyrate (NaB). The cytotoxic effect of either Dox or NaB alone was limited, but co-administration of NaB and Dox (NaB-Dox) significantly increased mitochondrial-mediated apoptosis. The effects of iodine to apoptosis-induced by the two agents were diversified. Iodine reduced the apoptosis induced by Dox or NaB-Dox but promoted apoptosis induced by NaB. To explain this diversifying finding, the experiment found that iodine exaggerated NaB-mediated Bcl-xL down-regulation. In contrast, it reduced the effect of Dox on the decrease of Bcl-xL expression. Further experiments showed that iodine regulated the level of Bcl-xL in ERK- or/and p38-related pathways. The balance between ERK and p38 may determine the iodine-modulated Bcl-xL expression. The high ERK/p38 activity ratio up-regulated Bc1-xL and enabled the tumor cells to resist chemotherapy, whereas the low ERK/p38 down-regulated Bc1-xL and sensitized the tumor cells to chemotherapy. Taken together, iodine plays a critical role in apoptosis of thyroid cancer cells induced by chemotherapeutic agents. The balance between ERK and p38 may determine cell survival and death through modulating Bcl-xL expression in thyroid cancer cells. The findings provide some new insights into the roles of iodine in chemotherapeutic agents-induced apoptosis in thyroid cancer cells.
To summarize, iodine-induced apoptotic effects on thyroid cancer cells is a key pathway for iodine to influence thyroid cancer development and chemotherapy. Meanwhile MAPKs-related mutant p53, p21 and Bcl-xL expression are critical in deciding thyroid cancer cells survival and death. Moreover, iodine can influence chemotherapeutic agents-induced apoptosis through ERK/p38-mediated Bcl-xL expression.
Liu, Xiaohong.
"December 2009."
Adviser: Charles Andrew van Hasselt.
Source: Dissertation Abstracts International, Volume: 72-01, Section: B, page: .
Thesis (Ph.D.)--Chinese University of Hong Kong, 2010.
Includes bibliographical references (leaves 111-146).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstract also in Chinese.

The most useful drugs in the management of nephrotic syndrome are the corticosteroids. These drugs are as well known for their adverse effects as they are for their therapeutic advantages. The two most common paediatric side effects are suppression of linear growth and posterior subcapsular cataracts. Both of these untoward effects are insiduous and therefore less easily perceived. Although many workers have studied the growth inhibiting effects of the corticosteroids in the various diseases e.g. asthma, very little work was done to investigate these effects in patients with nephrotic syndrome. Furthermore, the Renal Clinic, King Edward VIII Hospital, Durban continues to use a daily regime of prednisone instead of the alternate day regime which is widely recommended to minimise growth retardation. This study was therefore undertaken to investigate the growth inhibiting effects of repeated courses of daily, high-dose prednisone in African and Indian children with nephrotic syndrome. All children with nephrotic syndrome with relevant data in their records and with no other chronic illness were selected from the Renal Clinic. Of the 125 selected, 87 children had been treated with prednisone for an average of 35,9 weeks and 38 had been treated symptomatically. The heights of those that received prednisone were measured at an averace of 77 weeks after completion of therapy. The mean height standard deviation score (SDS) of the treatment and control groups of Indian children were -1,06 and -0,92 respectively, both being between the 10th and 25th percentile, whilst the mean height SDS of the treatment and control groups of African children were -1,82 (just below the 5th percentile) and -1,77 (between the 5th and 10th percentile) respectively. From the results, it is evident that repeated courses of daily prednisone therapy, even when it exceeds 36 weeks, does not inhibit growth in both African and Indian children. Although there was no significant difference between the races and sexes with respect to growth and corticosteroid therapy, this study does confirm earlier reports that most of the African children with nephrotic syndrome had obvious glomerular lesions whilst most of the Indians had minimal change nephrotic syndrome.
Thesis (M.Med.)-University of Natal, Durban, 1986.

Sam Sze Wing.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2000.
Includes bibliographical references (leaves 156-184).
Abstracts in English and Chinese.
Publications based on work in this thesis --- p.ii
Abstract --- p.iii
Acknowledgements --- p.vii
Chapter 1 --- INTRODUCTION --- p.1
Chapter 1.1 --- Corticosteroids --- p.2
Chapter 1.1.1 --- Chemical Structure of Steroids --- p.3
Chapter 1.1.2 --- Biosynthesis of Endogenous Corticosteroids --- p.3
Chapter 1.1.2.1 --- Regulation of Cortisol synthesis and negative feedback system --- p.4
Chapter 1.1.3 --- Biological Significance of Corticosteroids --- p.5
Chapter 1.1.3.1 --- Involvement of corticosteroids as anti-inflammatory drugs --- p.6
Chapter 1.1.3.2 --- Eicosanoid biosynthesis --- p.7
Chapter 1.1.3.3 --- Lipoxygenase pathway --- p.9
Chapter 1.1.3.4 --- Side-effects of prolonged use of corticosteroids --- p.9
Chapter 1.2 --- Organisation of the Emetic Reflex --- p.11
Chapter 1.2.1 --- Motor Pathway of Emetic Reflex --- p.12
Chapter 1.2.1.1 --- Retching and vomiting --- p.12
Chapter 1.2.1.2 --- Nausea --- p.13
Chapter 1.2.2 --- Components of the Emetic Reflex --- p.14
Chapter 1.2.2.1 --- The vomiting centre (VC) --- p.15
Chapter 1.2.2.2 --- Area postrema (AP) / Chemoreceptor trigger zone (CTZ) --- p.15
Chapter 1.2.2.3 --- The nucleus tractus solitarius (NTS) --- p.17
Chapter 1.2.2.4 --- Gastrointestinal tract and vagus nerves --- p.17
Chapter 1.2.2.5 --- Neurotransmitter receptors --- p.18
Chapter 1.3 --- Chemotherapy-Induced Emesis --- p.19
Chapter 1.3.1 --- Cancer as a cause of mortality in Man --- p.20
Chapter 1.3.2 --- Chemotherapeutic Agents --- p.20
Chapter 1.3.2.1 --- Different classes --- p.20
Chapter 1.3.2.2 --- Emetogenic potential --- p.21
Chapter 1.3.3 --- Cisplatin-Induced Emesis --- p.23
Chapter 1.3.3.1 --- Unfavourable effects associated with chemotherapy-induced nausea and emesis --- p.24
Chapter 1.3.3.2 --- Anticipatory nausea and vomiting --- p.24
Chapter 1.3.3.3 --- Profile of cisplatin-induced emesis --- p.25
Chapter 1.3.4 --- Animal Models of Cisplatin-Induced Acute and Delayed Emesis --- p.26
Chapter 1.3.5 --- Mechanisms and Pathways Involves in Chemotherapy-Induced Emesis --- p.28
Chapter 1.3.6 --- Anti-Emetic Drugs for the Treatment of Chemotherapy-Induced Emesis --- p.31
Chapter 1.3.6.1 --- 5-HT3 receptor antagonists --- p.31
Chapter 1.3.6.2 --- Dopamine receptor antagonists --- p.33
Chapter 1.3.6.3 --- Benzodiazepines --- p.35
Chapter 1.3.6.4 --- Cannabinoids --- p.35
Chapter 1.3.6.5 --- Antihistamines and anticholinergics --- p.35
Chapter 1.3.6.6 --- NK1 receptor antagonists --- p.37
Chapter 1.3.6.7 --- Corticosteroids --- p.38
Chapter 1.3.6.8 --- Multi-agent anti-emetic regimens --- p.39
Chapter 1.4 --- Motion-Induced Emesis --- p.41
Chapter 1.4.1 --- Incidence --- p.42
Chapter 1.4.2 --- Mechanisms and Pathways Involved in Motion Sickness --- p.43
Chapter 1.4.2.1 --- Importance of the vestibular apparatus --- p.44
Chapter 1.4.2.2 --- Importance of the area postrema --- p.45
Chapter 1.4.2.3 --- The nucleus tractus solitarius --- p.46
Chapter 1.4.2.4 --- Hormone and neurotransmitters --- p.46
Chapter 1.4.3 --- Animal models in Motion-Induced Emesis --- p.47
Chapter 1.4.4 --- Anti-Emetic Drugs for the Treatment of Motion Sickness --- p.48
Chapter 1.4.4.1 --- Anticholinergics --- p.49
Chapter 1.4.4.2 --- Antihistamines --- p.49
Chapter 1.4.4.3 --- Non-selective muscarinic and histamine receptor antagonists --- p.51
Chapter 1.4.4.4 --- Sympathomimetics --- p.51
Chapter 1.4.4.5 --- NK1i receptor antagonists --- p.51
Chapter 1.4.4.6 --- 5-HT1A agonists --- p.52
Chapter 1.4.4.7 --- 5-HT2 receptor agonist --- p.52
Chapter 1.4.4.8 --- Arginine vasopressin (AVP) antagonists --- p.53
Chapter 1.4.4.9 --- Opioid receptor agonists --- p.53
Chapter 1.4.4.10 --- Dexamethasone and hormone levels --- p.54
Chapter 1.4.4.11 --- Other anti-emetic drugs --- p.55
Chapter 1.5 --- Aims of the Studies --- p.56
Chapter 2 --- Methods --- p.59
Chapter 2.1 --- Cisplatin-Induced Emesis Studies --- p.60
Chapter 2.1.1 --- Animals --- p.60
Chapter 2.1.2 --- Induction and Measurement of Emesis --- p.60
Chapter 2.1.3 --- The Effects of Corticosteroids on Cisplatin-Induced Acute and Delayed Retching and Vomiting --- p.63
Chapter 2.1.4 --- "The Effects of Dexamethasone (1 mg/kg, i.p.) Administered as an Intervention Treatment on an Established Delayed Retching and Vomiting Response Induced by Cisplatin" --- p.63
Chapter 2.1.5 --- The Effects of Cortrosyn Depot (Tetracosactrin) on Cisplatin-Induced Acute and Delayed Retching and Vomiting --- p.63
Chapter 2.1.6 --- The Effects of Metyrapone on Cisplatin-Induced Acute and Delayed Retching and Vomiting --- p.64
Chapter 2.1.7 --- The Effects of Indomethacin on Cisplatin-Induced Acute and Delayed Retching and Vomiting --- p.64
Chapter 2.1.8 --- "The Effects of DFU and L-745,337 Administered as an Intervention Treatments on an Established Delayed Retching and Vomiting Response Induced by Cisplatin" --- p.64
Chapter 2.1.9 --- "The Effects of MK-886 (L-663,536) on Cisplatin-Induced Acute and Delayed Retching and Vomiting" --- p.65
Chapter 2.1.10 --- The Effects of a Combination of Indomethacin and MK-886 on Cisplatin- Induced Acute and Delayed Retching and Vomiting --- p.65
Chapter 2.1.11 --- Statistical Analysis --- p.66
Chapter 2.2 --- Motion-Induced Emesis Studies --- p.67
Chapter 2.2.1 --- Animals --- p.67
Chapter 2.2.2 --- Measurement of Emesis --- p.67
Chapter 2.2.3 --- Induction of Emesis in Motion-Naive Suncus murinus: Effects of Glucocorticoids --- p.68
Chapter 2.2.4 --- Induction of Emesis in Motion-Sensitive Suncus murinus: Effects of Dexamethasone --- p.70
Chapter 2.2.5 --- Preparation of Serum --- p.72
Chapter 2.2.6 --- Measurement of Serum Cortisol by Enzyme-Linked Immunoassay (ELISA) --- p.72
Chapter 2.2.6.1 --- Immunoassay kit --- p.72
Chapter 2.2.6.2 --- Assay procedures --- p.73
Chapter 2.2.7 --- Measurement of Serum Adrenocorticotrophin (ACTH) by Radioimmunoassay (RIA) --- p.75
Chapter 2.2.7.1 --- Immunoassay kit --- p.75
Chapter 2.2.7.2 --- Assay procedures --- p.76
Chapter 2.2.8 --- Statistical Analysis --- p.79
Chapter 3 --- Results --- p.81
Chapter 3.1 --- Cisplatin-Induced Emesis --- p.82
Chapter 3.1.1 --- General Profile of Emesis Induced by Cisplatin --- p.82
Chapter 3.1.2 --- Antagonism of Cisplatin-Induced Emesis by Corticosteroids --- p.82
Chapter 3.1.3 --- "The Effect of Dexamethasone (1 mg/kg, i.p.) Administered as an Intervention Treatment on an Established Delayed Retching and Vomiting Response Induced by Cisplatin" --- p.84
Chapter 3.1.4 --- The Effect of Cortrosyn Depot (Tetracosactrin) on Cisplatin-Induced Acute and Delayed Retching and Vomiting --- p.85
Chapter 3.1.5 --- The Effect of Metyrapone on Cisplatin-Induced Acute and Delayed Retching and Vomiting --- p.85
Chapter 3.1.6 --- "The Effect of Indomethacin, DFU and L-745,337 on Cisplatin-Induced Acute and Delayed Retching and Vomiting" --- p.86
Chapter 3.1.7 --- The Effect of MK-886 on Cisplatin-Induced Acute and Delayed Retching and Vomiting --- p.88
Chapter 3.1.8 --- The Effect of Combination of Indomethacin and MK-886 on Cisplatin- Induced Acute and Delayed Retching and Vomiting --- p.89
Chapter 3.2 --- Motion-Induced Emesis --- p.91
Chapter 3.2.1 --- General Effect of Motion on Serum Cortisol and ACTH Levelsin Motion Naive Suncus murinus --- p.91
Chapter 3.2.2 --- The Effect of Glucocorticoids on Motion-Induced Emesis and Cortisol and ACTH Levels in Motion-Naive Male Suncus murinus --- p.92
Chapter 3.2.2.1 --- Effect of dexamethasone --- p.92
Chapter 3.2.2.2 --- Effect of betamethasone --- p.93
Chapter 3.2.2.3 --- Effect of methylprednisolone --- p.93
Chapter 3.2.3 --- The Effect of Glucocorticoids on Motion-Induced Emesis and Cortisol and ACTH Levels in Motion Naive Female Suncus murinus --- p.94
Chapter 3.2.3.1 --- Effect of dexamethasone --- p.94
Chapter 3.2.3.2 --- Effect of betamethasone --- p.95
Chapter 3.2.3.3 --- Effect of methylprednisolone --- p.95
Chapter 3.2.4 --- The Effect of Dexamethasone on Motion-Induced Emesis and Cortisol and ACTH Levels in Motion-Sensitive Suncus murinus --- p.96
Chapter 3.2.4.1 --- Effect of dexamethasone on male motion-sensitive animals --- p.97
Chapter 3.2.4.2 --- Effect of dexamethasone on female motion-sensitive animals --- p.97
Chapter 4 --- Discussion --- p.131
Chapter 4.1 --- "Cisplatin (5 mg/kg, i.p.)-Induced Emesis in Control Animals" --- p.132
Chapter 4.2 --- Anti-Emetic Action of Corticosteroids in the Ferret --- p.133
Chapter 4.3 --- Metyrapone Study --- p.138
Chapter 4.4 --- Cortrosyn Depot Study --- p.139
Chapter 4.5 --- Role of Cycloxygenase --- p.141
Chapter 4.6 --- Role of 5-Lipoxygenase --- p.143
Chapter 4.7 --- Duel Inhibition of Cycloxygenase and 5-Lipoxygenase --- p.144
Chapter 4.8 --- Anti-Emetic Potential of Glucocorticoids in Suncus murinus --- p.145
Chapter 4.9 --- General Summary --- p.149
Appendix I --- p.152
Appendix II --- p.154
References --- p.156

Additionally, cyclosporin A, an inhibitor of the mitochondrial permeability transition (MPT) pore, failed to prevent hIAPP-induced DeltaPsim collapse, cytochrome c and AIF release and caspase-3 activation, indicating that the MPT pore was not involved in hIAPP-induced apoptosis. On the other hand, potential crosstalk between the extrinsic and intrinsic apoptotic pathways was demonstrated by cleavage of Bid by caspase-8 in the apoptotic process triggered by hIAPP.
It is widely accepted that human islet amyloid polypeptide (hIAPP) aggregation plays an important role in the loss of insulin-producing pancreatic beta cells. Insulin secretion impairment and cell apoptosis can be due to mitochondrial dysfunction in pancreatic beta cells. hIAPP-induced cytotoxicity is mediated by the generation of reactive oxygen species (ROS). Phycocyanin (PC) is a natural compound from blue-green algae that is widely used as food supplement. Currently, little information is available about the effect of hIAPP on mitochondrial function of beta cells and protection of PC against hIAPP-induced cytotoxicity. In this thesis, I hypothesize that hIAPP may impair beta cell function with the involvement of mitochrondrial dysfunction, and this effects could be attenuated by PC. Therefore, the aim of this study was to investigate the role of mitochondria in hIAPP-induced apoptosis, the in vitro protective effects of PC and explore the underlying mechanisms.
It was found that hIAPP induced apoptosis in INS-1E cells with the disruption of mitochondrial function, as evidenced by ATP depletion, mitochondrial mass reduction, mitochondrial fragmentation and loss of mitochondrial membrane potential (DeltaPsim). Further molecular analysis showed that hIAPP induced changes in the expression of Bcl-2 family members, release of cytochrome c and apoptosis-inducing factor (AIF) from mitochondria into cytosol, activation of caspases and cleavage of poly (ADP-ribose) polymerase. Interestingly, the hIAPP-induced mitochondrial dysfunction in INS1-E cells was effectively restored by co-treatment with PC.
Our results showed that hIAPP inhibited the INS-1E cell growth in a dose-dependent manner. However, cytotoxicity of hIAPP was significantly attenuated by co-incubation of the cells with PC. hIAPP induced DNA fragmentation and chromatin condensation, which were key characteristics of cell apoptosis. These changes were inhibited by PC as examined by TUNEL assay and DAPI staining. Moreover, PC significantly prevented the hIAPP-induced overproduction of intracellular ROS and malonaldehyde (MDA), as well as changes of activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) enzymes. Furthermore, hIAPP triggered the activation of mitogen-activated protein kinases (MAPKs) such as c-Jun N-terminal kinase (JNK) and p38 kinase, and these effects were effectively suppressed by PC.
Taken together, I have demonstrated for the first time the involvement of mitochondrial dysfunction in hIAPP-induced INS-1E cell apoptosis, which was attenuated by PC through attenuating oxidative stress, modulating JNK and p38 pathways and reducing mitochondrial dysfunction.
Li, Xiaoling.
Adviser: Juliana Chung Ngor Chan.
Source: Dissertation Abstracts International, Volume: 73-01, Section: B, page: .
Thesis (Ph.D.)--Chinese University of Hong Kong, 2010.
Includes bibliographical references (leaves 150-159).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstract also in Chinese.