Int J Clin Exp Patho
-
Int J Clin Exp Patho · Jan 2008
Gut hyperpermiability after ischemia and reperfusion: attenuation with adrenomedullin and its binding protein treatment.
Ischemia bowel remains a critical problem resulting in up to 80% mortality. The loss of gut barrier function plays an important role. Our previous studies have shown that administration of adrenomedullin (AM), a novel vasoactive peptide, and its binding protein (AMBP-1), reduces the systemic inflammatory response and organ injury after systemic ischemia induced by hemorrhagic shock. ⋯ Treatment with AM/AMBP-1 dramatically improved I/R-induced intestinal mucosal damages, attenuated remote organ injury, and downregulated gene expression and protein levels of TNF-alpha in the small intestine. In conclusion, AM/AMBP-1 attenuates structural and functional damages to the intestinal mucosa, and it appears to be a novel treatment for reperfusion injury after gut ischemia. The beneficial effect of AM/AMBP-1 on gut barrier function after I/R is associated with downregulation of TNF-alpha.
-
Int J Clin Exp Patho · Jan 2008
Nomenclature, molecular genetics and clinical significance of the precursor lesions in the serrated polyp pathway of colorectal carcinoma.
Serrated adenomas (SAs) are part of the distinct serrated polyp pathway of colorectal carcinogenesis characterized by microsatellite instability and deficiency in DNA mismatch repair. Sessile SA is a recently recognized lesion that typically presents as a large sessile polyp, but lacks the conventional dysplasia. It is more frequently found on the right side than on the left side of the colon, and is thought to represent an intermediate form in the hyperplastic polyp to sessile SA, traditional SA, and colon cancer sequence. Many terms have been used and are still in use in the literature to describe this lesion, such as "hyperplastic polyposis", "giant hyperplastic polyposis," "large hyperplastic polyps," "hyperplastic-adenomatous polyposis syndrome," "giant hyperplastic polyp," and "mixed epithelial polyp." The purpose of this paper is to review and clarify the confusing nomenclature, and to provide a framework for understanding the genetic alterations and clinical significance of these precursor lesions in the serrated polyp pathway of colorectal caner.