http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Xing-xian Luo,Jun-ping Han,Muhammad Usman,Charles D. Sands,Changqing Yang 한국병원약사회 2018 병원약사회지 Vol.35 No.3
Background : Mechanical prophylaxis (MP) and low-molecular-weight heparins (LMWHs) have been widely used after patient undergoing orthopedic surgery. However, their efficacy in preventing venous thrombus remains unclear. Methods : PubMed, Embase and Cochrane library databases were systematically searched for studies that investigated the effectiveness between MP and LMWHs. Predefined outcomes were incidence of deep vein thrombosis (DVT), pulmonary embolism (PE), proximal DVT and major bleeding using random-effects models. Results : A total of 8 randomized controlled trials (RCTs) on 2899 patients were eligible for inclusion. No significant difference was observed between MP and LMWHs for the prevention of DVT (RR 1.37; 95% CI: 0.83-2.26), PE (RR 1.35; 95% CI: 0.41-4.41), or proximal DVT (RR 1.30; 95% CI: 0.55- 3.02). However, there was a significant reduction of major bleeding (RR 0.21; 95% CI: 0.05-0.82). Predefined subgroup analysis suggested that MP might enhance the occurrence of DVT in comparison with fixed-dose LMWHs (RR 1.61; 95% CI: 1.09-2.37), but not in the subgroup with adjusted-weight LMWHs (RR 0.38; 95% CI, 0.11-1.30). Without combining graduated compression stockings (GCS) in both groups, the incidence of DVT was significantly associated with MP (RR 1.88; 95% CI: 1.01-3.21). Conclusions : Results of this meta-analysis suggested, compared to LMWHs, MP might have no significance in the prevention of DVT, although it was associated with lower incidence of major bleeding after patients underwent orthopedic surgery. However, subgroup analyses suggested that fixed-based LMWHs or application one of mechanical types without GCS might have differential effects. Therefore, large-scaled and well-designed RCTs are needed in the future.
Li, Suzhao,Neff, C. Preston,Barber, Kristina,Hong, Jaewoo,Luo, Yuchun,Azam, Tania,Palmer, Brent E.,Fujita, Mayumi,Garlanda, Cecilia,Mantovani, Alberto,Kim, Soohyun,Dinarello, Charles Anthony National Academy of Sciences 2015 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF Vol.112 No.8
<P><B>Significance</B></P><P>Interleukin-1 family members are highly inflammatory but IL-37 member broadly suppresses inflammation and specific immunity. Initially, the mechanism of this suppression was shown to be via translocation to the nucleus following cleavage of the precursor by intracellular caspase-1. We now show that recombinant forms of IL-37 limit inflammation by extracellular binding to surface receptors but require the IL-1 family decoy receptor IL-1R8. Unexpectedly, picomolar concentrations of the IL-37 precursor optimally suppress IL-1β, IL-6, and TNFα production from human blood M1 macrophages, suggesting a unique function for a coreceptor function of IL-1R8. Assessment of IL-37 as well as IL-1R8 levels may provide previously unidentified insights into how the host limits inflammation.</P><P>Similar to IL-1α and IL-33, IL-1 family member IL-37b translocates to the nucleus and is associated with suppression of innate and adaptive immunity. Here we demonstrate an extracellular function of the IL-37 precursor and a processed form. Recombinant IL-37 precursor reduced LPS-induced IL-6 by 50% (<I>P</I> < 0.001) in highly inflammatory human blood-derived M1 differentiated macrophages derived from selective subjects but not M2 macrophages. In contrast, a neutralizing monoclonal anti–IL-37 increased LPS-induced IL-6, TNFα and IL-1β (<I>P</I> < 0.01). The suppression by IL-37 was consistently observed at low picomolar but not nanomolar concentrations. Whereas LPS induced a 12-fold increase in TNFα mRNA, IL-37 pretreatment decreased the expression to only 3-fold over background (<I>P</I> < 0.01). Mechanistically, LPS-induced p38 and pERK were reduced by IL-37. Recombinant IL-37 bound to the immobilized ligand binding α-chain of the IL-18 receptor as well as to the decoy receptor IL-1R8. In M1 macrophages, LPS increased the surface expression of IL-1R8. Compared with human blood monocytes, resting M1 cells express more surface IL-1R8 as well as total IL-1R8; there was a 16-fold increase in IL-1R8 mRNA levels when pretreated with IL-37. IL-37 reduced LPS-induced TNFα and IL-6 by 50–55% in mouse bone marrow-derived dendritic cells, but not in dendritic cells derived from IL-1R8–deficient mice. In mice subjected to systemic LPS-induced inflammation, pretreatment with IL-37 reduced circulating and organ cytokine levels. Thus, in addition to a nuclear function, IL-37 acts as an extracellular cytokine by binding to the IL-18 receptor but using the IL-1R8 for its anti-inflammatory properties.</P>