Cervikalna endometrioza – prikaz primera in pregled literature Pečovnik, Aleksandra; Šramek Zatler, Prim. asist. Simona; Salobir Gajšek, Prim. Uršula ...
Zdravniški vestnik (Ljubljana, Slovenia : 1992),
02/2022, Volume:
91, Issue:
1-2
Journal Article
Peer reviewed
Open access
Endometrioza je bolezen, pri kateri so endometrijske žlezne celice in stroma prisotni zunaj maternične votline. Kadar se endometrijske žleze in stroma nahajajo v materničnem vratu, govorimo o ...cervikalni endometriozi. Klinično se cervikalna endometrioza najpogosteje kaže kot krvav vaginalni izcedek ali izvenciklična krvavitev. Na brisih materničnega vratu (BMV) lahko endometrioza izgleda, kot da bi šlo za normalne endometrijske žlezne celice ali kot atipične neopredeljene žlezne celice (AŽC-N), vključno z adenokarcinomom in situ (AIS). Članek predstavi primer 32-letne ženske, ki je bila sprejeta na oddelek za ginekologijo zaradi kontaktnih krvavitev in patološkega izvida kolposkopije.
Leta 1962 je Gurdon odkril, da je specializacija celic reverzibilna; jedro v jajčni celici žabe je nadomestil z jedrom iz črevesne celice. Iz spremenjene jajčne celice se je razvil paglavec. Leta ...2006 je Yamanaka odkril, kako je mogoče z uporabo le nekaj genov reprogramirati odrasle mišje celice v stanje, ki je podobno embrionalnim celicam. Tako pridobljene celice so poimenovali inducirane pluripotentne matične celice, ki se lahko razvijejo v vse vrste celic v telesu, zato so obetavno orodje za različne pristope zdravljenja, ki temeljijo na celični terapiji. Gurdon in Yamanaka sta za odkritje, da je mogoče dozorele celice reprogramirati v pluripotentno stanje, leta 2012 prejela Nobelovo nagrado za fiziologijo. V tem prispevku bomo prikazali kratek pregled dognanj na tem področju, pri čemer bomo poudarili področje skupine redkih dednih bolezni krhkosti kože.
Haematopoietic stem and progenitor cells have been successfully used for autologous and al- logeneic transplantations for many years. Quantitative and qualitative laboratory assays allow controlling ...di erent cellular products during collection, concentration and preservation. The in- formation about cell number, viability, functionality and purity of the gra ensure safe applica- tion and help predict the likelihood of successful engra ment. Almost 50 years of research have disclosed the great heterogeneity of cells that exhibit a haematopoietic di erentiation potential. This will enable the identification of subpopulations within the population of CD34-positive ha- ematopoietic stem cells.
Gigantocelični arteritis (GCA) je najpogostejši primarni sistemski vaskulitis pri odraslih po 50. letu starosti v Evropi. Prizadene velike in srednje velike arterije in vnetni proces, ki zožuje ali ...popolnoma zapre svetlino žile, lahko dovede do hudih/trajnih ishemičnih zapletov kot so oslepitev, možganska kap ali miokardni infarkt. V zadnjem desetletju se je z vključitvijo slikovnih preiskav v diagnostični postopek pomembno skrajšal čas do prepoznave bolezni (t.i. zgodnji GCA). Pospešena obravnava bolnikov (ang. “fast track clinic”) je vodila v zmanjšanje pojavnosti najresnejših ishemičnih zapletov bolezni in znižanje stroškov zdravljenja. Vendar pa bolezen praviloma poteka kronično, s poslabšanji, kar skupaj s kroničnim glukokortikoidnem zdravljenjem vodi v kopičenje okvar organov in tkiv. Prav zato se intenzivno preučuje patogeneza bolezni, z možnostjo implementacije izsledkov kot so sodobne molekularno in celično usmerjene tarčne terapije. Glavni cilji našega preglednega članka so bili: a) analiza raziskav z navedenim časom trajanja od začetka simptomov do postavitve diagnoze, b) raziskava obetavnih molekularnih tarč za zdravljenje GCA in c) prepoznava klinično pomembnih celičnih podtipov. Najbolj obetavne tarčne molekule za tarčno zdravljenje so IL-6, IL-12/IL-23 in citototoksični z limfociti T povezan protein 4, medtem ko terapija z zaviralci TNF-α ni bila uspešna. Kliničnih raziskav z učinkovinami, usmerjenimi proti IL-17, še ni. V prispevku pa smo se dotaknili tudi drugih potencialnih terapevtskih tarč, vključno z molekulami, ki sodelujejujo v signalnih poteh.
Tekočinska biopsija pri raku Tanja Jesenko; Cvetka Grašič Kuhar; Maja Čemažar
Onkologija,
09/2018, Volume:
22, Issue:
2
Journal Article
Peer reviewed
Open access
V zadnjih letih smo v onkologiji priča hitremu napredku na področju biopsije telesnih tekočin oz. tekočinske biopsije. Tekočinska biopsija predstavlja analizo vzorca odvzete telesne tekočine (v ...onkologiji je to običajno kri), v katerem iščemo znake navzočnosti raka. V krvi lahko analiziramo cirkulirajočo prosto/cirkulirajočo tumorsko DNA (cf/ctDNA) iz tumorskih celic, eksosome, ki jih v kri sproščajo tumorske celice, in tudi cirkulirajoče tumorske celice (CTC). V pregledu predstavljamo najnovejša dognanja in raziskave na področju tekočinske biopsije pri raku in poleg uporabnosti izpostavljamo tudi njihove omejitve, ki jih bo treba natančno opredeliti, če bomo želeli to metodo uporabljati v vsakodnevni obravnavi bolnikov.
Background. For one third of all women urinary incontinence is a health problem. Different strategies of treatment have been used, namely surgical, medical and physiotherapy. To this armamentarium a ...new method – adult stem cells therapy – has been added. Methods. The source of adult autologues multipotent stem cells consists of muscle-derived stem cells, adipose-derived stem cells and mesenchymed bone marrow cells. In facilities for stem cells with processing and in the presence of specific inducing factors, muscle derived stem cells can be differentiated to striated or smooth muscles. Clinical work is based on animal models that with immunohistochemical analysis demonstrated new skeletal-muscle fiber formation at the site of injection of stem cells. In stress urinary incontinence (SUI) autologues bioptic material is obtained by using a musle needle biopsy device. From the biopsy speciment with dissociation muscle-derived stem cells are isolated and injected under local anaesthesia in the middle urethra and/or external urethral sphincter. Initial results of SUI treatment with adult muscle-derived stem cells suggest that perspectives of this method are encouraging. Conclusions. Stem cell therapy is promising to become minimally invasive method for reconstruction of the muscles and connective tissue of urethra and external urethral sphincter.
Background: In different human adult tissues and organs embryonic-like stem cells have already been found. A question is whether they are present also in the adult human ovary. In this study we tried ...to find whether embryonic-like stem cells are present in the ovarian surface epithe- lium of women with premature ovarian failure, and whether these cells can differentiate into oocytes by in vitro culture. Methods: In 10 women with premature ovarian failure the ovarian surface epithelium was laparo- scopically scraped. We tried to immunomagnetically isolate embryonic-like stem cells from the suspension of scraped cells and to confirm their existence immunocytochemically by the expression of the markers c-kit and surface antigen SSEA-4, characteristic of pluripotent stem cells. In the lab, we tried to differentiate stem cells into oocytes in a cell culture medium with added heterologous follicular fluid from the in vitro fertilization programme, which is rich in substances, and important for oocyte growth and maturation. The differentiation of oocyte-like cells was screened. Oocyte-like cells were isolated from the cell culture and im- munocytochemically stained for oocyte-specific markers (c-kit, VASA, ZP2-zona pellucida). Oocyte-like cells were analyzed for the expression of oocyte-specific genes (Oct-4A, ZP3, c-kit, SCP-3) by single-cell PCR. Results: From the ovarian surface epithelium of all patients small yellow coloured cells with diam- eters of 2 to 4 μm and positive for markers of pluripotent stem cells were isolated. In the lab, these cells were cultured into oocyte-like cells with diameter ranging from 60 to 80 μm. Some of oocyte-like cells were positive for oocyte-specific markers and expressed the genes, characteristic of oocytes, including meiotic genes. Conclusions: In patients with premature ovarian failure it is possible to culture oocyte-like cells from ovarian surface epithelium stem cells. Intense research is needed to evaluate the quality of oocyte-like cells developed in vitro and to estimate their potential use for in vitro fertilization in the far future.
Background. Selection of mature sperm for intracytoplasmic sperm injection (ICSI) has recently been made possible by hyaluronan, a naturally occurring substance found in the cumulus cells. Only fully ...mature sperm have the receptors on the head that effectively bind to the oocyte cumulus, or, to be more precise, to hyaluronan. The aim of this study was to evaluate the differences in fertilization rates and in embryo development to the blastocyst stage after ICSI performed either with sperm selected by hyaluronan or by standard morphological sperm appearance. Methods. This retrospective study involved 17 couples undergoing ICSI. One half of sibling oocytes were fertilized with sperm selected by hyaluronan (84 oocytes), and the other half with sperm selected on the basis of morphological appearance (89 oocytes). The comparison between the two groups involved fertilization rates and the percentages of arrested embryos, and delayed (morulae) and advanced blastocysts. Blastocysts were classified as early, developed and expanded. Results. In the group with hyaluronan-selected sperm 65 % of oocytes fertilized, and in the group with sperm selected by morphological appearance 70 % of oocytes. The fertilization rates did not statistically differ between the two groups, and neither did the percentages of arrested embryos (47 % vs. 62 %), morulae (11 % vs. 11 %), and blastocysts (42 % vs. 26 %). In the group with hyaluronan-selected sperm the shares of expanded and early blastocysts were significantly greater (P ≤ 0.04 and P ≤ 0.002, respectively) than in the group with sperm selected according to morphological appearance. Conclusions. The use of hyaluronan for sperm selection in ICSI does not affect fertilization rates. Hyaluronan-selected sperm improves subsequent development of embryos. A larger study sample is required for the assessment of hyaluronan-selected sperm on the achievement of pregnancies.
Izhodišča: Amnijska membrana (AM) je notranja stran posteljice, ki obdaja in ščiti zarodek. AM je večplastna struktura, ki je sestavljena iz amnijskih epitelijskih celic, amnijskih mezenhimskih ...stromalnih celic, bazalne lamine in vezivnega tkiva. Iz njene zgradbe izhajajo tudi lastnosti AM, zaradi katerih se že vrsto let uporablja v terapevtske namene, predvsem v oftalmologiji, saj pospešuje epitelizacijo, deluje kot substrat za celice, zmanjšuje fibrozo in neovaskularizacijo tkiva ter deluje protimikrobno. Zaradi mehanskih lastnosti AM, ki so posledica predvsem molekul zunajceličnega matriksa bazalne lamine in vezivnega tkiva, se AM v zadnjih letih vedno pogosteje uporablja tudi kot biološki nosilec v regenerativni medicini. Zaključki: Regenerativna medicina je interdisciplinarno področje raziskav in kliničnih aplikacij, ki uporablja načela bioloških in inženirskih znanosti za razvoj živih tkivnih ali organskih nadomestkov. V regenerativni medicini ločimo tri pristope: 1) vsaditev funkcionalnih celic, med drugim tudi matičnih celic, v poškodovano ali okvarjeno tkivo, 2) uporaba različnih sintetičnih materialov ali materialov naravnega izvora, ki pomagajo pri ponovnem oblikovanju poškodovanega ali okvarjenega tkiva in 3) tkivno inženirstvo, tj. uporaba ustreznih nosilcev, ki spodbujajo rast tkivno specifičnih celic in oblikovanje novega tkiva. V prispevku predstavljamo tudi uporabo amnijske membrane kot biološkega nosilca v regenerativni medicini v Sloveniji.