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Ates I, Yılmaz AD, Buttari B, Arese M, Saso L, Suzen S. A Review of the Potential of Nuclear Factor [Erythroid-Derived 2]-like 2 Activation in Autoimmune Diseases. Brain Sci 2023; 13:1532. [PMID: 38002492 PMCID: PMC10669303 DOI: 10.3390/brainsci13111532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 11/26/2023] Open
Abstract
An autoimmune disease is the consequence of the immune system attacking healthy cells, tissues, and organs by mistake instead of protecting them. Inflammation and oxidative stress (OS) are well-recognized processes occurring in association with acute or chronic impairment of cell homeostasis. The transcription factor Nrf2 (nuclear factor [erythroid-derived 2]-like 2) is of major importance as the defense instrument against OS and alters anti-inflammatory activities related to different pathological states. Researchers have described Nrf2 as a significant regulator of innate immunity. Growing indications suggest that the Nrf2 signaling pathway is deregulated in numerous diseases, including autoimmune disorders. The advantageous outcome of the pharmacological activation of Nrf2 is an essential part of Nrf2-based chemoprevention and intervention in other chronic illnesses, such as neurodegeneration, cardiovascular disease, autoimmune diseases, and chronic kidney and liver disease. Nevertheless, a growing number of investigations have indicated that Nrf2 is already elevated in specific cancer and disease steps, suggesting that the pharmacological agents developed to mitigate the potentially destructive or transformative results associated with the protracted activation of Nrf2 should also be evaluated. The activators of Nrf2 have revealed an improvement in the progress of OS-associated diseases, resulting in immunoregulatory and anti-inflammatory activities; by contrast, the depletion of Nrf2 worsens disease progression. These data strengthen the growing attention to the biological properties of Nrf2 and its possible healing power on diseases. The evidence supporting a correlation between Nrf2 signaling and the most common autoimmune diseases is reviewed here. We focus on the aspects related to the possible effect of Nrf2 activation in ameliorating pathologic conditions based on the role of this regulator of antioxidant genes in the control of inflammation and OS, which are processes related to the progression of autoimmune diseases. Finally, the possibility of Nrf2 activation as a new drug development strategy to target pathogenesis is proposed.
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Affiliation(s)
- Ilker Ates
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Ankara University, Degol Str. No. 4, 06560 Ankara, Turkey
| | - Ayşe Didem Yılmaz
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Ankara University, Degol Str. No. 4, 06560 Ankara, Turkey; (A.D.Y.); (S.S.)
| | - Brigitta Buttari
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, 00161 Rome, Italy;
| | - Marzia Arese
- Department of Biochemical Sciences “A. Rossi Fanelli”, Sapienza University of Rome, Piazzae Aldo Moro 5, 00185 Rome, Italy;
| | - Luciano Saso
- Department of Physiology and Pharmacology ‘‘Vittorio Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Sibel Suzen
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Ankara University, Degol Str. No. 4, 06560 Ankara, Turkey; (A.D.Y.); (S.S.)
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de Assis IM, Callegari B, de Sousa MS. Physiotherapy Methods Applied in the Prevention of Functional Loss Associated with Human T-Lymphotropic Virus 1 Infection: An Overview. Infect Dis Rep 2023; 15:478-493. [PMID: 37736995 PMCID: PMC10514819 DOI: 10.3390/idr15050048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/15/2023] [Accepted: 08/02/2023] [Indexed: 09/23/2023] Open
Abstract
To achieve the objective of this study, we conducted a narrative review on physical therapeutic modalities applied to prevent functional losses associated with human T-lymphotropic virus 1 (HTLV-1) infections to promote health education and viable and accessible alternatives in the development of health education technology adapted to the home environment. This study comprised a qualitative stage of theoretical development to construct a digital booklet with an observational basis based on studies that reiterate themes about educational technologies as tools to conduct a home protocol of guided exercises without the direct supervision of professional physical therapists. Results indicate a lack of research on the development of health education technologies to assist patients with HTLV-1 without tropical spastic paraparesis or HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). We believe that this narrative review can initiate a theoretical framework to conduct a home exercise program aimed at people with HTLV-1 who have subtle symptoms, and also at people without the clinical definition of HAM/TSP, helping to train human resources for care and research on the subject and increase scientific production in physical therapy.
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Affiliation(s)
| | - Bianca Callegari
- Institute of Health Sciences, Federal University of Pará, Belém 66055-240, Brazil;
| | - Maisa Silva de Sousa
- Center for Tropical Medicine, Federal University of Pará, Belém 66055-240, Brazil;
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Postural Adjustments in HTLV-1 Infected Patients during a Self-Initiated Perturbation. Viruses 2022; 14:v14112389. [PMID: 36366487 PMCID: PMC9695886 DOI: 10.3390/v14112389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Human T-cell lymphotropic virus type 1 (HTLV-1) infection can be associated with tropical spastic paraparesis (TSP/HAM), which causes neurological myelopathy and sensory and muscle tone alterations, leading to gait and balance impairments. Once trunk perturbation is predicted, the motor control system uses anticipatory and compensatory mechanisms to maintain balance by recruiting postural muscles and displacement of the body's center of mass. METHODS Twenty-six participants (control or infected) had lower limb muscle onset and center of pressure (COP) displacements assessed prior to perturbation and throughout the entire movement. RESULTS Semitendinosus (ST) showed delayed onset in the infected group compared to the control group. The percentage of trials with detectable anticipatory postural adjustment was also lower in infected groups in the tibialis anterior and ST. In addition, COP displacement in the infected group was delayed, had a smaller amplitude, and took longer to reach the maximum displacement. CONCLUSIONS HTLV-1 infected patients have less efficient anticipatory adjustments and greater difficulty recovering their postural control during the compensatory phase. Clinical assessment of this population should consider postural stability during rehabilitation programs.
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Costa KHA, Santos PSA, da Silva Almeida GC, Caires AS, Vasconcelos BHB, Lima RC, Domingues MM, da Conceição Nascimento Pinheiro M, Sousa RCM, de Athayde Costa e Silva A, Souza GS, Callegari B. Comparison of Static Balance Control in Infected Htlv-1 Subjects with Different Tsp/Ham Diagnosis. Viruses 2022; 14:v14112334. [PMID: 36366437 PMCID: PMC9693226 DOI: 10.3390/v14112334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: Tropical spastic paraparesis (TSP/HAM) associated with the T cell lymphotropic virus in type I humans (HTLV-1) is a slow, chronic, and progressive disease that causes balance changes. TSP/HAM diagnosis can be classified as probable, possible, and definite. We compared the static balance control of HTLV-1-infected patients with different TSP/HAM diagnosis. (2) Methods: Our sample consisted of 13 participants infected with HTLV-1 and 16 healthy participants. The center of pressure was recorded using a force platform with open and closed eyes. We divided the recordings into three intervals, period T1 (corresponds to the first 10 s); period T2 (from 10 to 45 s); period T3 (from 45 to 55 s). (3) Results: Eight participants infected with HTLV-1 were classified as probable TSP/HAM and five participants infected with HTLV-1 were classified as definite TSP/HAM. There was a significant increase in postural instability in patients with definite PET/MAH considering the structural and global variables of body sway compared to the control and the probable TSP/HAM. (4) Conclusions: We concluded that the severity of balance is directly related to the degree of signs and symptoms of TSP/HAM.
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Affiliation(s)
| | | | | | - Andrew Sousa Caires
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | | | - Ramon Costa Lima
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | | | | | | | | | - Givago Silva Souza
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém 66005240, Brazil
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
- Correspondence: ; Tel.:+55-919-8265-3131
| | - Bianca Callegari
- Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém 66005240, Brazil
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Ahmed R, Khan S, Quddus N, Saher T, Fatima N. Physical performance among post-COVID and non-COVID individuals: a comparative study. COMPARATIVE EXERCISE PHYSIOLOGY 2022. [DOI: 10.3920/cep220002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In this comparative cross-sectional study, we compare the physical performance among post-COVID and non-COVID subjects. A sample of 64 subjects recovered from COVID-19 and 64 subjects who were not infected with COVID-19 were recruited for the study. Both groups were tested for physical performance by 30-s sit-to-stand test, 6-min walk test, and HUMAC balance system. The findings of the present study reveal that there was a significant difference in physical performance between both the groups. In conclusion, this study demonstrated that physical performance is impaired in the post-COVID subjects as compared to the matched non-COVID subjects. Therefore, physical therapy exercise program/regimen should be a part of recovery from COVID-19.
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Affiliation(s)
- R. Ahmed
- Department of Rehabilitation Sciences, Jamia Hamdard University, 110025 New Delhi, India
| | - S.A. Khan
- Department of Rehabilitation Sciences, Jamia Hamdard University, 110025 New Delhi, India
| | - N. Quddus
- Department of Rehabilitation Sciences, Jamia Hamdard University, 110025 New Delhi, India
| | - T. Saher
- Department of Rehabilitation Sciences, Jamia Hamdard University, 110025 New Delhi, India
| | - N. Fatima
- Department of Molecular Medicine, Jamia Hamdard University, 110062 New Delhi, India
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Julca-Copello P, Schwalb A, Cachay R, Tipismana M, Alvarez C, Mejía F, González-Lagos E, Gotuzzo E. Impact of fractures and orthopedic surgeries in patients with HTLV-1 associated myelopathy/tropical spastic paraparesis. Rev Soc Bras Med Trop 2020; 53:e20200101. [PMID: 32935782 PMCID: PMC7491556 DOI: 10.1590/0037-8682-0101-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/17/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In patients with HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) gait disturbance is a predominant feature that leads to falls and fractures, which can further aggravate disability. We sought to evaluate the impact of fractures and orthopedic surgeries in patients with HAM/TSP. METHODS We retrieved the medical records of HAM/TSP patients enrolled in our study center's HTLV-1 clinical cohort between 1989-2018. The selection criteria included: (1) diagnosis of HTLV-1 infection using two enzyme-linked immunosorbent assays and/or a confirmatory test, (2) clinical diagnosis of HAM/TSP by neurological assessment, and (3) fractures associated with HAM/TSP. RESULTS We identified 24 cases of fractures, 70% of which were females. The median age at the time of fracture was 60 years (IQR=24). Six cases reported fractures in patients under 45 years old. Ten patients (42%) had hip/coccyx fractures, seven (29%) were in the lower extremities, and four (17%) in the upper extremities. Half of these patients reported the use of wheelchairs. Five patients who had previously used canes required the use of wheelchairs after the reported fracture. Eight patients underwent corrective orthopedic surgery as a result of the fracture. CONCLUSIONS For HAM/TSP patients, fractures are a complication that can exacerbate their severe impairment.
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Affiliation(s)
| | - Alvaro Schwalb
- Universidad Peruana Cayetano Heredia, Instituto de Medicina Tropical Alexander von Humboldt, Lima, Perú
| | - Rodrigo Cachay
- Universidad Peruana Cayetano Heredia, Instituto de Medicina Tropical Alexander von Humboldt, Lima, Perú
| | - Martín Tipismana
- Universidad Peruana Cayetano Heredia, School of Medicine, Lima, Perú.,Universidad Peruana Cayetano Heredia, Instituto de Medicina Tropical Alexander von Humboldt, Lima, Perú.,Hospital Cayetano Heredia, Neurology Department, Lima, Perú
| | - Carolina Alvarez
- Universidad Peruana Cayetano Heredia, Instituto de Medicina Tropical Alexander von Humboldt, Lima, Perú
| | - Fernando Mejía
- Universidad Peruana Cayetano Heredia, School of Medicine, Lima, Perú.,Universidad Peruana Cayetano Heredia, Instituto de Medicina Tropical Alexander von Humboldt, Lima, Perú
| | - Elsa González-Lagos
- Universidad Peruana Cayetano Heredia, School of Medicine, Lima, Perú.,Universidad Peruana Cayetano Heredia, Instituto de Medicina Tropical Alexander von Humboldt, Lima, Perú
| | - Eduardo Gotuzzo
- Universidad Peruana Cayetano Heredia, School of Medicine, Lima, Perú.,Universidad Peruana Cayetano Heredia, Instituto de Medicina Tropical Alexander von Humboldt, Lima, Perú
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Iwao C, Umekita K, Miyauchi S, Kimura M, Rikitake Y, Iwao K, Rikitake M, Aizawa A, Kawaguchi T, Kariya Y, Matsuda M, Takajo I, Shiomi K, Okayama A. Effective Treatment with Tocilizumab in a Rheumatoid Arthritis Patient Complicated with Human T-cell Leukemia Virus Type 1-associated Myelopathy. Intern Med 2020; 59:1891-1897. [PMID: 32321893 PMCID: PMC7474999 DOI: 10.2169/internalmedicine.4455-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
A 61-year-old woman with human T-cell leukemia virus type 1 (HTLV-1)-associated myelopathy (HAM)/tropical spastic paraparesis (TSP) and interstitial pneumonia (IP) was admitted to our hospital. She complained of sicca symptoms, polyarthralgia, and swollen joints. She was diagnosed with rheumatoid arthritis (RA) and Sjögren's syndrome. Methotrexate and anti-tumor necrosis factor therapy were not utilized because of the inclusion of severe respiratory disorders among the complications and the neurological symptoms of HAM/TSP. Tocilizumab monotherapy improved the RA disease activity without exacerbating HAM/TSP. The present case suggests that tocilizumab might be a suitable treatment option in patients with RA and HAM/TSP.
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Affiliation(s)
- Chihiro Iwao
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
| | - Kunihiko Umekita
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
| | - Shunichi Miyauchi
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
| | - Masatoshi Kimura
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
| | - Yuki Rikitake
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
| | - Koushou Iwao
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
| | - Mao Rikitake
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
| | - Ayako Aizawa
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
| | - Takeshi Kawaguchi
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
| | - Yumi Kariya
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
| | - Motohiro Matsuda
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
| | - Ichiro Takajo
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
| | - Kazutaka Shiomi
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, University of Miyazaki, Japan
| | - Akihiko Okayama
- Department of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Japan
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