Journal of investigative medicine : the official publication of the American Federation for Clinical Research
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Acetaminophen is a dose-dependent toxin. Prognosis in severe acute liver injury is related presumably in part to the dose ingested. We sought to assess the value of acetaminophen dosing information in patients with acute liver failure (ALF) due to acetaminophen toxicity to determine the role of dose as a prognostic indicator. ⋯ Dose of acetaminophen ingested did not seem to play a role in prognosis. The most important prognostic factor was coma grade on admission to study. Acetaminophen dosing information is not always obtainable. When it is, it adds little to the clinical assessment. Severity of encephalopathy is a more reliable indicator of prognosis in these critically ill patients.
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T helper 17 (TH17) cells are beginning to be implicated in the pathogenesis of systemic lupus erythematosus (SLE). Recent studies have shown that interleukin 27 (IL-27) controls the development of TH17. However, whether IL-27 plays a role in the development of SLE is still unclear. ⋯ However, there was no significant difference between less active and more active SLE (P > 0.05). Correlation analysis between serum IL-27 levels and SLE disease activity index showed no association (P > 0.05). In summary, a decrease in serum IL-27 level in patients with SLE suggested that this cytokine might be implicated in the pathomechanism of this disease.
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Mucin 5AC (MUC5AC) is one of the main airway mucins implicated in pulmonary diseases with mucous hypersecretion. Neutrophil elastase (NE), a serine protease released by neutrophils, is known to induce MUC5AC synthesis by increasing reactive oxygen species (ROS) generation. Nuclear factor erythroid-2 related factor 2 (Nrf2), a basic-region leucine-zipper transcription factor, is believed to protect against ROS damage by activating a series of antioxidant enzymes; Nrf2 is also reported to reduce NE activity. ⋯ The results showed that NCI-H292 epithelial cells, in which the Nrf2 gene expression repressed, were highly predisposed to NE stimulation, with marked exacerbation of ROS generation and reduced secretory leukocyte protease inhibitor production, resulting in high MUC5AC expression. Pretreatment with the potent Nrf2 activator sulforaphane had the reverse effect. These results demonstrate that Nrf2 is a novel nuclear factor involved in down-regulating MUC5AC synthesis by inhibiting ROS generation and augmenting proteinase inhibitor production.