RESUMEN
We herein report two cases of primary ciliary dyskinesia (PCD) with different responses to macrolides. Case 1: a 17-year-old Japanese man with Pseudomonas aeruginosa infection and combined defect of both inner and outer dynein arms in the cilia was unsuccessfully treated with long-term macrolides (clarithromycin, erythromycin, and azithromycin). Case 2: a 70-year-old Japanese man with deficiency of only the inner dynein arm was successfully treated with clarithromycin. Though the reasons for the different responses to macrolides are unclear, differences of ultrastructural abnormalities of the cilia might be one of the predictive factors in PCD just as in Pseudomonas aeruginosa infection.
Asunto(s)
Antibacterianos/uso terapéutico , Síndrome de Kartagener/diagnóstico , Síndrome de Kartagener/tratamiento farmacológico , Macrólidos/uso terapéutico , Adolescente , Anciano , Claritromicina/uso terapéutico , Humanos , Masculino , Infecciones por Pseudomonas/diagnóstico , Infecciones por Pseudomonas/tratamiento farmacológico , Resultado del TratamientoRESUMEN
The effects of intraperitoneal (i.p.) administration of 2-buten-4-olide (2-B4O), an endogenous sugar acid, on the hypothalamo-neurohypophyseal system were examined in rats. Plasma oxytocin (OXT) levels were significantly increased 15-60 min after i.p. administration of 2-B4O (100 mg/kg), whereas plasma arginine vasopressin (AVP) did not change. Dual immunostaining revealed that Fos-like immunoreactivity (LI) was predominantly observed in OXT-secreting neurons in the paraventricular (PVN) and the supraoptic nuclei (SON) 120 min after i.p. administration of 2-B4O. In addition, many Fos-LI neurons were observed in the nucleus of the tractus solitarius (NTS) after i.p. administration of 2-B4O. These results suggest that a peripherally administered high dose of 2-B4O activates OXT-secreting neurons in the hypothalamus through activation of NTS neurons, possibly as a result of a stress response.