6 research outputs found
The validity and applications of the analgesia nociception index: a narrative review
Pain refers to the subjective, unpleasant experience that is related to illness or injury. In contrast to pain, nociception refers to the physiological neural processing of noxious stimuli, such as intra-operative surgical stimuli. One novel device, the Analgesia Nociception Index (ANI), aims to objectively measure intra-operative nociception by analyzing the heart rate variability in patients undergoing surgery. Through this method of nociceptive monitoring, the ANI device aims to provide an objective, continuous evaluation of patient comfort levels and allow anesthesiologists to better manage surgical stress and patient analgesia, perhaps with even better efficacy than current practices used to assess nociception. Additionally, ANI may have clinical application in settings outside of the operating room, such as in the intensive care unit. In this narrative review, we compiled and summarized the findings of many studies that have investigated ANI's validity and applications in different clinical settings. Currently, the literature appears mostly supportive of ANI's ability to detect nociception in both surgical and non-surgical settings. However, the ability for ANI to provide clinical benefits, such as decreased intra-operative opioid use, post-operative opioid use, and post-operative pain compared to standard practices appear controversial. Because of the wide variety of methodology, clinical settings, patient populations, and limitations in these studies, more investigation of ANI is needed before any firm conclusions can be drawn on its clinical benefits
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Elucidating the Role of Tinman-Positive Pericardial Cells in Drosophila Heart Development
With congenital heart disease as the most common birth defect in the world, investigating the genetic basis of heart development is an important endeavor that can be greatly advanced by studying the model organism Drosophila melanogaster. At the end of embryonic fly heart development, there are three types of pericardial cells (PCs) that are distinguished by their gene expression profiles. Among these PCs, those that specifically express the cardiac master regulator tinman (tin) are not well characterized (Tin-PCs). In this study, we use single-cell RNA sequencing, fluorescent staining, and mutational analysis to characterize the role of Tin-PCs in embryonic fly heart development. We have identified and confirmed the expression of several genes—CrzR, Neurotactin, Lachesin, coracle, sinuous, Wnt4, and cut—that were either distinctly expressed or highly enriched in Tin-PCs, but not in other types of PCs. Here, we present that knockdown of sinuous delayed dorsal closure of the heart and epidermis, knockdown of tin reduced expression of the cell adhesion protein Neurotactin, and loss of cut caused abnormal closure of Tin-PCs while ectopic Cut expression in cardioblasts reduced expression of the PC marker even-skipped. From these findings, we conclude that Tin-PCs play some role in dorsal closure, cardiac cell adhesion, and even-skipped expression in PCs of the Drosophila embryo. By elucidating the role of Tin-PCs in Drosophila embryogenesis, we hope to highlight the great potential of single-cell RNA sequencing in identifying novel cell types and provide further understanding of the cellular and genetic mechanisms that underlie Drosophila heart development
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Age-dependent Lamin remodeling induces cardiac dysfunction via dysregulation of cardiac transcriptional programs
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Age-dependent Lamin changes induce cardiac dysfunction via dysregulation of cardiac transcriptional programs
As we age, structural changes contribute to progressive decline in organ function, which in the heart act through poorly characterized mechanisms. Taking advantage of the short lifespan and conserved cardiac proteome of the fruit fly, we found that cardiomyocytes exhibit progressive loss of Lamin C (mammalian Lamin A/C homologue) with age, coincident with decreasing nuclear size and increasing nuclear stiffness. Premature genetic reduction of Lamin C phenocopies aging's effects on the nucleus, and subsequently decreases heart contractility and sarcomere organization. Surprisingly, Lamin C reduction downregulates myogenic transcription factors and cytoskeletal regulators, possibly via reduced chromatin accessibility. Subsequently, we find a role for cardiac transcription factors in regulating adult heart contractility and show that maintenance of Lamin C, and cardiac transcription factor expression, prevents age-dependent cardiac decline. Our findings are conserved in aged non-human primates and mice, demonstrating that age-dependent nuclear remodeling is a major mechanism contributing to cardiac dysfunction