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Tröndle M, Stritter W, Odone V, Peron K, Ghelman R, Seifert G. Beyond the Standard of Care: An Exploratory Qualitative Study of an Implemented Integrative Therapeutic Care Program in a Brazilian Pediatric Oncology Unit. J Altern Complement Med 2021; 27:1002-1010. [PMID: 34668735 DOI: 10.1089/acm.2021.0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: This article examines the feedback of health care providers within the implementation of an integrative care project in a clinic for pediatric oncology in São Paulo, Brazil. Since 2017, the project has implemented external anthroposophic therapies in the activities of daily nursing. The objective is to evaluate how the project evolved and what impact it had on the daily operation of the hospital. A special focus emphasizes the perspective of study nurses. Materials and Methods: Twelve qualitative semistructured interviews were conducted. Audio files were transcribed, translated to German, and underwent a MAXQDA software-assisted analysis. Using a thematic approach, coherent cross-case topics were defined. Results: Three main topics emerged from analysis of the data. (1) The implementation and its effects on daily patient care demonstrated positive outcomes in patients and were well accepted with minimal changes in daily activities. (2) The perspective of study nurses showed a large motivation due to beneficial and stress-relieving effects of the application and a growing patient-health care provider relationship. (3) Problems and aspirations for improvement were the lack of time and the urge to make the project grow in the future. Conclusion: Not only patients but also health care providers seem to benefit from integrative methods. They have the potential to improve the working atmosphere and to strengthen relations between patients, caregivers, and family members. General feedback was positive and acceptance in the team arose over time when beneficial effects became visible.
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Affiliation(s)
- Marc Tröndle
- Department of Pediatric Oncology/Hematology, Otto-Heubner Centre for Pediatric and Adolescent Medicine (OHC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Wiebke Stritter
- Department of Pediatric Oncology/Hematology, Otto-Heubner Centre for Pediatric and Adolescent Medicine (OHC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Vicente Odone
- Departamento de Pediatria, Faculdade de Medicina, Instituto de Tratamento do Câncer Infantil (ITACI), Universidade de São Paulo, São Paulo, Brazil
| | - Karina Peron
- Departamento de Pediatria, Faculdade de Medicina, Instituto de Tratamento do Câncer Infantil (ITACI), Universidade de São Paulo, São Paulo, Brazil
| | - Ricardo Ghelman
- Departamento de Pediatria, Faculdade de Medicina, Instituto de Tratamento do Câncer Infantil (ITACI), Universidade de São Paulo, São Paulo, Brazil
| | - Georg Seifert
- Department of Pediatric Oncology/Hematology, Otto-Heubner Centre for Pediatric and Adolescent Medicine (OHC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Departamento de Pediatria, Faculdade de Medicina, Instituto de Tratamento do Câncer Infantil (ITACI), Universidade de São Paulo, São Paulo, Brazil
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Relationship between depression and fatigue in children with cancer undergoing chemotherapy. ENFERMERIA CLINICA 2021. [DOI: 10.1016/j.enfcli.2020.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Nakajima S, Sato I, Soejima T, Koh K, Kato M, Okamoto Y, Imamura T, Maeda M, Ishida Y, Manabe A, Kamibeppu K. Comparison of child and family reports of health-related quality of life in pediatric acute lymphoblastic leukemia patients after induction therapy. BMC Pediatr 2020; 20:390. [PMID: 32814552 PMCID: PMC7437003 DOI: 10.1186/s12887-020-02287-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/11/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND This study aims at determining the health-related quality of life (HRQOL) of children with acute lymphoblastic leukemia (ALL) after the induction therapy, assessing the agreement between child self-reports and family proxy-reports HRQOL, and determining the factors related to this agreement, especially child age, family attendance, and children's social relationships beyond the family. METHODS We analyzed questionnaire data (2012-2017) from the Japanese Pediatric Leukemia/Lymphoma Study Group's clinical study (ALL-B12). Participants were children with B-cell precursor ALL aged 5-18 and their family members, who mostly took care of the child during hospitalization. Participants answered the Pediatric Quality of Life Inventory™ (PedsQL™) Generic Core Scales (PedsQL-G), and Cancer Module (PedsQL-C) to measure pediatric HRQOL. We calculated the differences between child self-reported and family proxy-reported subscale scores along with intraclass correlation coefficients (ICC). We conducted multiple regression analyses according to all participant pairs and age groups (young children, school age, and adolescents), with ICCs for all PedsQL-G subscales (ICC-G) and all PedsQL-C subscales (ICC-C) as the outcome variables. RESULTS Five hundred twenty-two pairs of children and their families were analyzed. We observed a moderate level of agreement on most PedsQL subscales between child self-reports and family proxy-reports; however, worry had the weakest agreement for all PedsQL subscales (ICC = .32, 95% confidence interval = .24-.40). The agreement of ICC-C was positively related to family attendance in the hospitalization, only for the young children group (B = .185, p = .003). CONCLUSIONS We observed some differences between child self-reports and family proxy-reports of HRQOL of children with ALL. Both child self-reports and family proxy-reports captured HRQOL in the induction therapy. We suggest that attending to young children's hospitalization affects the level of agreement between reports on their HRQOL.
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Affiliation(s)
- Shohei Nakajima
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Health Quality and Outcome Research, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Iori Sato
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Health Quality and Outcome Research, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Takafumi Soejima
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Health Quality and Outcome Research, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, 1-2 Shin-toshin, Chuo-ku, Saitama, 330-8777, Japan
| | - Motohiro Kato
- Children's Cancer Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Yasuhiro Okamoto
- Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Miho Maeda
- Department of Pediatrics|, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Yasushi Ishida
- Pediatric Medical Center, Ehime Prefectural Central Hospital, 83 Kasuga-machi, Matsuyama-shi, Ehime, 790-0024, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Kiyoko Kamibeppu
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
- Department of Health Quality and Outcome Research, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
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Hyperuricemia might be an early manifestation of undiagnosed adult leukemia in a population-based cohort study. Biomedicine (Taipei) 2020; 10:40-44. [PMID: 33854912 PMCID: PMC7608843 DOI: 10.37796/2211-8039.1004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/16/2019] [Indexed: 12/30/2022] Open
Abstract
Background/objective No published population-based study investigates the association between hyperuricemia and undiagnosed adult leukemia in Taiwan. The aim of the study was to investigate whether hyperuricemia might be an early manifestation of undiagnosed adult leukemia in Taiwan. Methods A population-based cohort study was conducted to analyze the database of the Taiwan National Health Insurance Program. There were 47708 subjects aged 20 to 84 years with newly diagnosed hyperuricemia as the hyperuricemia group from 2000 to 2013, and 190832 randomly selected subjects without hyperuricemia as the non-hyperuricemia group. The hyperuricemia group and the non-hyperuricemia group were followed for one year to estimate the incidence of new diagnosis of leukemia. Results The overall incidence of leukemia was 1.32-fold higher in the hyperuricemia group than the non-hyperuricemia group (0.74 versus 0.55 per 10000 person-months, 95% confidence interval 1.28-1.37). The incidence rate ratio of leukemia was statistically higher in the first 3 months of hyperuricemia diagnosis (incidence rate ratio 4.05). Conclusion Adults with hyperuricemia have a higher incidence of being diagnosed with leukemia than those without hyperuricemia. Hyperuricemia might be an early manifestation of undiagnosed adult leukemia. Clinicians should check the complete blood count with differential to detect the possibility of leukemia when adults present with hyperuricemia.
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Das AA, Medlock J, Liang H, Nees D, Allsup DJ, Madden LA, Paunov VN. Bioimprint aided cell recognition and depletion of human leukemic HL60 cells from peripheral blood. J Mater Chem B 2019. [DOI: 10.1039/c9tb00679f] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We report a large scale preparation of bioimprints of layers of cultured leukemic HL60 cells which can perform cell shape and size recognition from a mixture with peripheral blood mononuclear cells (PBMCs).
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Affiliation(s)
- Anupam A.K. Das
- Department of Chemistry and Biochemistry
- University of Hull
- Hull
- UK
| | - Jevan Medlock
- Department of Chemistry and Biochemistry
- University of Hull
- Hull
- UK
| | - He Liang
- Department of Chemistry and Biochemistry
- University of Hull
- Hull
- UK
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El Hussein M, Hirst S. Chasing the Mirage: a grounded theory of the clinical reasoning processes that Registered Nurses use to recognize delirium. J Adv Nurs 2015; 72:373-81. [PMID: 26489533 DOI: 10.1111/jan.12837] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to construct a grounded theory that explains the clinical reasoning processes that registered nurses use to recognize delirium in older adults in acute care hospitals. BACKGROUND Delirium is under-recognized in acute hospital settings, this may stem from underdeveloped clinical reasoning processes. Little is known about registered nurses' (RNs) clinical reasoning processes in complex situations such as delirium recognition. DESIGN A grounded theory approach was used to analyse interview data about the clinical reasoning processes of RNs in acute hospital settings. METHOD Seventeen RNs were recruited. Concurrent data collection and comparative analysis and theoretical sampling were conducted in 2013-2014. FINDINGS The core category to emerge from the data was 'chasing the mirage', which describes RNs' clinical reasoning processes to recognize delirium during their interaction with older adults. CONCLUSION Understanding the reasoning that contributes to delirium under-recognition provides a strategy by which, this problem can be brought to the forefront of RNs' awareness and intervention. Delirium recognition will contribute to quality care for older adults.
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Affiliation(s)
- Mohamed El Hussein
- Faculty of Health & Community Studies, School of Nursing, Mount Royal University, Calgary, Alberta, Canada
| | - Sandra Hirst
- Faculty of Nursing, University of Calgary, Alberta, Canada
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Mitchell HR, Lu X, Myers RM, Sung L, Balsamo LM, Carroll WL, Raetz E, Loh ML, Mattano LA, Winick NJ, Devidas M, Hunger SP, Maloney K, Kadan-Lottick NS. Prospective, longitudinal assessment of quality of life in children from diagnosis to 3 months off treatment for standard risk acute lymphoblastic leukemia: Results of Children's Oncology Group study AALL0331. Int J Cancer 2015; 138:332-9. [PMID: 26235006 DOI: 10.1002/ijc.29708] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 06/24/2015] [Indexed: 11/09/2022]
Abstract
Standard risk acute lymphoblastic leukemia (SR-ALL) has high cure rates, but requires 2-3 years of therapy. We aimed to (i) prospectively evaluate health-related quality of life (HRQOL) during and after SR-ALL therapy, and (ii) identify associated predictors. Parents of 160 SR-ALL patients enrolled on Children's Oncology Group (COG) therapeutic trial AALL0331 at 31 sites completed the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales (physical, emotional and social functioning) and Family Assessment Device-General Functioning (FAD-GF) at 1, 6 and 12 months after diagnosis, and 3 months post-therapy. Mean PedsQL scores in physical, emotional and social functioning were impaired 1 month after diagnosis but steadily improved. Three months post-therapy, impaired physical and social functioning was observed in 27.8 and 25.8% of patients, respectively. In repeated-measures analysis, problematic family functioning predicted emotional (OR = 1.85, 95% CI 1.03-3.34) and social (OR = 1.99, 95% CI 1.21-3.27) impairment. Larger household size was associated with social impairment (OR = 1.21, 95% CI 1.02-1.45). Adverse neurological event(s) during therapy predicted post-therapy physical (OR = 5.17, 95% CI 1.61-16.63) and social (OR = 8.17, 95% CI 1.19-56.16) impairment. HRQOL 1 month after diagnosis was not predictive of HRQOL 3 months after therapy completion. In conclusion, children with SR-ALL experience considerable impairment in HRQOL at the end of induction, but rapidly improve. However, many still experience physical and social impairment 3 months post-therapy, suggesting a role for continued family and physical functioning support. Longer follow-up is needed to determine if post-therapy deficits change over time.
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Affiliation(s)
- Hannah-Rose Mitchell
- Department of Pediatric Hematology & Oncology, Yale University School of Medicine, New Haven, CT
| | - Xiaomin Lu
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainsville, FL
| | - Regina M Myers
- Department of Pediatrics, Columbia University, New York, NY
| | - Lillian Sung
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Lyn M Balsamo
- Department of Pediatric Hematology & Oncology, Yale University School of Medicine, New Haven, CT
| | - William L Carroll
- Pediatric Oncology, Cancer Institute, New York University Medical Center, New York, NY
| | - Elizabeth Raetz
- Department of Pediatrics, University of Utah, Salt Lake City, NY
| | - Mignon L Loh
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA
| | | | - Naomi J Winick
- Department of Pediatrics, University of Texas, Southwestern Medical Center, Dallas, TX
| | - Meenakshi Devidas
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainsville, FL
| | - Stephen P Hunger
- Division of Oncology and Center for Childhood Cancer Research, The Children's Hospital of Philadelphia (CHOP), Philadelphia, PA
| | - Kelly Maloney
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO
| | - Nina S Kadan-Lottick
- Department of Pediatric Hematology & Oncology, Yale University School of Medicine, New Haven, CT
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Win KT, Hassan NM, Bonney A, Iverson D. Benefits of Online Health Education: Perception from Consumers and Health Professionals. J Med Syst 2015; 39:27. [DOI: 10.1007/s10916-015-0224-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 02/02/2015] [Indexed: 02/07/2023]
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Temtap S, Nilmanat K. Symptom experience and management among people with acute myeloid leukaemia in Thailand. Int J Palliat Nurs 2011; 17:381-6. [DOI: 10.12968/ijpn.2011.17.8.381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Suthisa Temtap
- Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Suthisa Temtap is Advanced Nurse Practitioner, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University
| | - Kittikorn Nilmanat
- Department of Medical Nursing, Faculty of Nursing, Prince of Songkla University, Songkhla 90112, Thailand
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Jabbour E, Thomas D, Cortes J, Kantarjian HM, O'Brien S. Central nervous system prophylaxis in adults with acute lymphoblastic leukemia: current and emerging therapies. Cancer 2010; 116:2290-300. [PMID: 20209620 DOI: 10.1002/cncr.25008] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Central nervous system (CNS) recurrence continues to be a significant complication in the treatment of adult patients with acute lymphoblastic leukemia (ALL). Preventing CNS recurrence has been a therapeutic challenge and has not been addressed critically in many clinical trials. Adult studies modeled on childhood ALL studies have used multiple treatment modalities, including radiation therapy, systemic therapy, intrathecal therapy, and combinations thereof. Cranial irradiation is effective but is offset by substantial toxicity, including neurologic sequelae. Systemic chemotherapy, especially with cytarabine (AraC) and methotrexate, has demonstrated promise in decreasing CNS recurrence, but therapeutic levels of drugs in the cerebrospinal fluid (CSF) are not maintained. Intrathecal chemotherapy with or without high-dose systemic therapy is the most common approach to CNS prophylaxis. Liposomal AraC recently has become available and confers prolonged levels of free AraC in the CSF, a critical requirement for CNS prophylactic therapy. This review discusses the various modalities used for CNS prophylaxis in patients with ALL and the emerging trends, with specific emphasis on the outcome in terms of event-free survival and toxicity.
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Affiliation(s)
- Elias Jabbour
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
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Steis MR, Penrod J, Adkins CS, Hupcey JE. Principle-based concept analysis: recognition in the context of nurse-patient interactions. J Adv Nurs 2009; 65:1965-75. [PMID: 19694860 DOI: 10.1111/j.1365-2648.2009.05083.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM This paper is a report of a principle-based concept analysis of recognition in the context of nurse-patient interactions. BACKGROUND Recognition is a concept employed in practice and research. Since nursing is patient-centred and care is problem-driven, the specificity and accuracy of recognition may have an impact on how nurses label patient phenomena, interventions initiated and patient outcomes. DATA SOURCES The data set included 98 English language articles published from 1997 to 2008 and retrieved through Medline and CINAHL searches. METHODS Principle-based concept analysis was used to examine the state of the science according to major perspectives of the philosophy of science. Conceptual components were integrated into a theoretical definition and the process of recognition was conceptually modelled. FINDINGS The scientific literature dealing with recognition in the context of nurse-patient interactions relies on implied meaning. Recognition is a process marked by an awareness of evidence coupled with the formulation of a conceptual label summarizing the identified pattern of patient phenomena. Contextual features of the nurse, patient and organization are relevant during nurse-patient interactions, resulting in pivotal points in nursing care. These pivotal points are the moments of recognition when the nurse consciously applies a summary label to interpreted evidence. Outcomes of recognition include a choice to act or not to act, each option carrying significant outcomes for nurses, patients, and at times, organizations. CONCLUSION A working definition was produced that will serve as a foundation for future concept-driven research to advance the concept toward greater precision and usefulness in nursing science.
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Affiliation(s)
- Melinda R Steis
- School of Nursing, The Pennsylvania State University, University Park, PA, USA.
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Quality of life in children with acute lymphoblastic leukaemia: a systematic review. Eur J Oncol Nurs 2008; 13:36-48. [PMID: 19019732 DOI: 10.1016/j.ejon.2008.09.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2008] [Revised: 09/01/2008] [Accepted: 09/06/2008] [Indexed: 11/22/2022]
Abstract
Quality of life (QOL) in children with acute lymphoblastic leukaemia (ALL) is now considered an important outcome measure of treatment for this disease. The aim of this paper is to systematically review studies on QOL in children during treatment for ALL with consideration to methodological details and quality of studies, empirical findings on QOL as reported by children and parents, and whether children and parents differ in their reports on QOL. Searches were conducted in biomedical, psychological and behavioural science databases. Six papers met inclusion criteria for review: 4 cross-sectional studies and 2 qualitative studies. There was little consistency in how QOL was measured or qualitatively assessed across studies. The quality of most studies was limited by small sample sizes and cross-sectional designs. Children's reports on QOL were represented in 3 studies and discrepancies were found between children's and parent's accounts of QOL. There is a need for ongoing research on QOL in children with ALL that use longitudinal designs, large sample sizes, and child reports of QOL. There is a need for theoretical development of the concept of QOL through concept analysis, grounded theory research and empirical validation of developing theory of QOL. Theoretical development of the concept of QOL will contribute to greater clarification of what is meant by QOL than currently exists which in turn has the potential to advance the methodology of measuring this concept in children.
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Schetinger MRC, Morsch VM, Bonan CD, Wyse ATS. NTPDase and 5'-nucleotidase activities in physiological and disease conditions: new perspectives for human health. Biofactors 2007; 31:77-98. [PMID: 18806312 DOI: 10.1002/biof.5520310205] [Citation(s) in RCA: 160] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Extracellular nucleotides and nucleosides act as signaling molecules involved in a wide spectrum of biological effects. Their levels are controlled by a complex cell surface-located group of enzymes called ectonucleotidases. There are four major families of ectonucleotidases, nucleoside triphosphate diphosphohydrolases (NTPDases/CD39), ectonucleotide pyrophosphatase/phosphodiesterases (E-NPPs), alkaline phosphatases and ecto-5'-nucleotidase. In the last few years, substantial progress has been made toward the molecular identification of members of the ectonucleotidase families and their enzyme structures and functions. In this review, there is an emphasis on the involvement of NTPDase and 5'-nucleotidase activities in disease processes in several tissues and cell types. Brief background information is given about the general characteristics of these enzymes, followed by a discussion of their roles in thromboregulatory events in diabetes, hypertension, hypercholesterolemia and cancer, as well as in pathological conditions where platelets are less responsive, such as in chronic renal failure. In addition, immunomodulation and cell-cell interactions involving these enzymes are considered, as well as ATP and ADP hydrolysis under different clinical conditions related with alterations in the immune system, such as acute lymphoblastic leukemia (ALL), B-chronic lymphocytic leukemia (B-CLL) and infections associated with human immunodeficiency virus (HIV). Finally, changes in ATP, ADP and AMP hydrolysis induced by inborn errors of metabolism, seizures and epilepsy are discussed in order to highlight the importance of these enzymes in the control of neuronal activity in pathological conditions. Despite advances made toward understanding the molecular structure of ectonucleotidases, much more investigation will be necessary to entirely grasp their role in physiological and pathological conditions.
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Affiliation(s)
- Maria Rosa C Schetinger
- Laboratório de Enzimologia Toxicológica, Departamento de Química, CCNE, Universidade Federal de Santa Maria, Avenida Roraima, no 1000, Cidade Universitária, Bairro Camobi, Santa Maria-RS, 97105-900, Brazil.
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