RESUMEN

The objective of this study is to compare game-based digital therapeutic device and other DHI like (smartphone apps, wearable technologies) for ADHD with the current pharmacological and behavior therapy. The FDA has approved a game-based digital therapeutic device - EndeavorRx, for the treatment of ADHD in pediatric patients belonging to the age group of 8-12 years old. This has been primarily recommended for the treatment of inattentive or combined-type ADHD who have demonstrated an attention issue. This is the first game-based therapeutic device to be approved by the FDA for any type of condition. According to the FDA, this has been shown to improve attention which is measured by computer-based testing. Objective: The objective of this study is to compare a game-based digital therapeutic device and other DHI (smartphone apps, wearable technologies) with the current pharmacological and behavior therapy used in the treatment of ADHD.

Asunto(s)

Trastorno por Déficit de Atención con Hiperactividad/terapia , Terapia Conductista/métodos , Aplicaciones Móviles , Dispositivos Electrónicos Vestibles , Adolescente , Niño , Humanos , Programas Informáticos

RESUMEN

The progression of pancreatic oncogenesis requires immune-suppressive inflammation in cooperation with oncogenic mutations. However, the drivers of intratumoral immune tolerance are uncertain. Dectin 1 is an innate immune receptor crucial for anti-fungal immunity, but its role in sterile inflammation and oncogenesis has not been well defined. Furthermore, non-pathogen-derived ligands for dectin 1 have not been characterized. We found that dectin 1 is highly expressed on macrophages in pancreatic ductal adenocarcinoma (PDA). Dectin 1 ligation accelerated the progression of PDA in mice, whereas deletion of Clec7a-the gene encoding dectin 1-or blockade of dectin 1 downstream signaling was protective. We found that dectin 1 can ligate the lectin galectin 9 in mouse and human PDA, which results in tolerogenic macrophage programming and adaptive immune suppression. Upon disruption of the dectin 1-galectin 9 axis, CD4+ and CD8+ T cells, which are dispensable for PDA progression in hosts with an intact signaling axis, become reprogrammed into indispensable mediators of anti-tumor immunity. These data suggest that targeting dectin 1 signaling is an attractive strategy for developing an immunotherapy for PDA.

Asunto(s)

Carcinoma Ductal Pancreático/genética , Galectinas/metabolismo , Lectinas Tipo C/genética , Neoplasias Pancreáticas/genética , Escape del Tumor/genética , Animales , Western Blotting , Carcinogénesis/genética , Carcinoma Ductal Pancreático/inmunología , Carcinoma Ductal Pancreático/metabolismo , Células Epiteliales/metabolismo , Citometría de Flujo , Técnicas de Silenciamiento del Gen , Humanos , Tolerancia Inmunológica/genética , Inmunohistoquímica , Inmunoprecipitación , Lectinas Tipo C/inmunología , Lectinas Tipo C/metabolismo , Espectrometría de Masas , Ratones , Ratones Noqueados , Conductos Pancreáticos/citología , Neoplasias Pancreáticas/inmunología , Neoplasias Pancreáticas/metabolismo , Quinasa Syk/genética , Quinasa Syk/metabolismo , Escape del Tumor/inmunología