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Brown N, Bhatt H, Salunke A, Chinnakotla S, Qureshi AM, Aggarwal V. Stenting of ductus venosus as a palliation for portal hypertension because of neonatal cirrhosis. Liver Int 2022; 42:879-883. [PMID: 35129262 DOI: 10.1111/liv.15190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/04/2022] [Accepted: 01/24/2022] [Indexed: 02/13/2023]
Abstract
Portal hypertension because of liver cirrhosis is a significant cause of morbidity and mortality. Treatment options in these patients include liver transplant, symptomatic treatment of oesophageal varices via endoscopic treatment and symptomatic management of ascites. Portosystemic shunt creation can be challenging in newborns and infants. We present a newborn with Trisomy 21, severe portal hypertension secondary to neonatal cirrhosis, oesophageal varices and upper GI bleeding, severe ascites refractory to medical management who underwent ductus venosus stenting as a palliative procedure. He demonstrated remarkable clinical improvement with no subsequent upper GI bleed and resolution of ascites till his last follow-up at 12 months of age. To the best of our knowledge, stenting of the patent ductus venosus to create a portosystemic shunt to relieve portal hypertension has not been reported in English literature.
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Affiliation(s)
- Nicholas Brown
- Division of Pediatric Critical Care, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Heli Bhatt
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Amrita Salunke
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Srinath Chinnakotla
- Division of Transplant Surgery, Department of Surgery, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Athar M Qureshi
- Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Varun Aggarwal
- Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
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Alagarasu K, Patil PS, Shil P, Seervi M, Kakade MB, Tillu H, Salunke A. In-vitro effect of human cathelicidin antimicrobial peptide LL-37 on dengue virus type 2. Peptides 2017; 92:23-30. [PMID: 28400226 DOI: 10.1016/j.peptides.2017.04.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/30/2017] [Accepted: 04/07/2017] [Indexed: 12/17/2022]
Abstract
Human Cathelicidin antimicrobial peptide LL-37 is known to have antiviral activity against many viruses. In the present study, we investigated the in-vitro effect of LL-37 on dengue virus type 2 (DENV-2) infection and replication in Vero E6 cells. To study the effect of pretreatment of virus or cells with LL-37, the virus was pretreated with different concentrations of LL-37 (2.5μM-15μM) or scrambled (Scr) LL-37(5μM-15μM) and used for infection or the cells were first treated with LL-37 and infected. To study the effect of LL-37 post infection (PI), the cells were infected first followed by addition of LL-37 to the culture medium 24h after infection. In all conditions, after the incubation, the culture supernatant was assessed for viral RNA copy number by real time RT-PCR, infectious virus particles by focus forming unit assay (FFU) and non structural protein 1 (NS1) antigen levels by ELISA. Percentage of infection was assessed using immunoflourescence assay (IFA). The results revealed that pretreatment of virus with 10-15μM LL-37 significantly reduced its infectivity as compared to virus control (P<0.0001). Moreover, pretreatment of virus with 10-15μM LL-37 significantly reduced the levels of viral genomic RNA and NS1 antigen (P<0.0001). Treatment of virus with 10-15μM LL-37 resulted in two to three log reduction of mean log10 FFU/ml as compared to virus control (P<0.0001). Treatment of the virus with scrambled LL-37 had no effect on percentage of infection and viral load as compared to virus control cultures (P>0.05). Pretreatment of cells before infection or addition of LL-37 to the culture 24h PI had no effect on viral load. Molecular docking studies revealed possible binding of LL-37 to both the units of DENV envelope (E) protein dimer. Together, the in-vitro experiments and in-silico analyses suggest that LL-37 inhibits DENV-2 at the stage of entry into the cells by binding to the E protein. The results might have implications for prophylaxis against DENV infections and need further in-vivo studies.
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Affiliation(s)
- K Alagarasu
- Dengue/Chikungunya Group, ICMR-National Institute of Virology, 20A, Dr. Ambedkar Road, Pune 411001, Maharashtra, India.
| | - P S Patil
- Dengue/Chikungunya Group, ICMR-National Institute of Virology, 20A, Dr. Ambedkar Road, Pune 411001, Maharashtra, India
| | - P Shil
- Bioinformatics Group, Microbial Containment Complex, ICMR-National Institute of Virology, Sus Road, Pashan, Pune 411021, Maharashtra, India
| | - M Seervi
- Dengue/Chikungunya Group, ICMR-National Institute of Virology, 20A, Dr. Ambedkar Road, Pune 411001, Maharashtra, India
| | - M B Kakade
- Dengue/Chikungunya Group, ICMR-National Institute of Virology, 20A, Dr. Ambedkar Road, Pune 411001, Maharashtra, India
| | - H Tillu
- Dengue/Chikungunya Group, ICMR-National Institute of Virology, 20A, Dr. Ambedkar Road, Pune 411001, Maharashtra, India
| | - A Salunke
- Dengue/Chikungunya Group, ICMR-National Institute of Virology, 20A, Dr. Ambedkar Road, Pune 411001, Maharashtra, India
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Ufer M, Tisserant A, Dodman A, Voltz E, Salunke A, Woessner R, Sagkriotis A, Jordaan P, Legangneux E. PP244—Therapeutic and supra-therapeutic intravenous doses of mavoglurant (AFQ056) do not prolong the QTc interval in healthy subjects. Clin Ther 2013. [DOI: 10.1016/j.clinthera.2013.07.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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