19 research outputs found
From society to study: process of institutionalization of medical education in Osijek
U realizaciji utemeljenja visokoÅ”kolske medicinske izobrazbe na podruÄju Hrvatske presudnu ulogu odigralo je jaÄanje lijeÄniÄkoga staleža. Osnutak Sbora lieÄnika kr. Hrvatske i Slavonije u Zagrebu i Družtva slavonskih lieÄnika u Osijeku poÄetkom 1874. godine poÄetak je sustavne i intenzivne kampanje za Medicinski fakultet, istovremeno nedjeljiv od borbe za održanje samobitnosti hrvatskoga naroda. Ovaj je proces usko povezan s razvojem zdravstva te njegovom institucionalizacijom, procesima koji se intenziviraju tijekom 19. i poÄetkom 20. stoljeÄa. U ovom se radu na, temelju postojeÄih dokumenata, novinskih Älanaka i objavljene literature, rekonstruiraju kljuÄne faze druÅ”tvenopolitiÄkoga i zdravstvenoga razvoja te njihov upliv na realizaciju nastojanja da se osnuje Medicinski fakultet SveuÄiliÅ”ta J. J. Strossmayer u Osijeku. U okviru tog cilja analizirane su pojedine odrednice institucionalizacije i profesionalizacije zdravstva, presudne u razvoju visokoÅ”kolskoga medicinskoga obrazovanja slavonske regije.In realization of establishing the higher medical education in Croatia the crucial role was played by strengthening of medical doctor social class .The foundation of Medical Association of the Kingdom of Croatia and Slavonia in Zagreb and Society of Slavonian Physicians in Osijek at the beginning of the year 1874 is the start of systematic and intense campaign for the Faculty of Medicine, at the same time inseparable from the battle for survival of the Croatian national identity. This process is closely connected with the development of health care as well as its institutionalization, processes which had been intensified during the 19th and at the beginning of the 20th century. Based on existing documents, newspaper articles and published literature, this paper reconstructs key phases of social, political and health care development, as well as their influence on realization of the pursuit to found Josip Juraj Strossmayer University of Osijek, Faculty of Medicine. Specific determinants of health care institutionalization and professionalization crucial for the development of higher medical education of the region of Slavonia are being analyzed as a part of that goal
On the occasion of the 135th anniversary of the foundation of Družtvo slavonskih lieÄnika (The Slavonian medical association)
Osnutak Sbora lieÄnika kr. Hrvatske i Slavonije sa sjediÅ”tem u Zagrebu i Družtva slavonskih lieÄnika sa sjediÅ”tem u Osijeku 874. godine rezultat je složenih druÅ”tveno - politiÄkih procesa, ali i zamaha na razini hrvatske kulturne integracije. Oblikovanje strukovnoga identiteta podrazumijevalo je sazrijevanje lijeÄnika u kontekstu druÅ”tvene uloge bez obzira na njihovu regionalnu rasporeÄenost. Osijek u to vrijeme jaÄa, ne samo kao kao civilno i vojno srediÅ”te veÄ i kao zdravstveni centar Slavonije. Borba za oživotvorenje samostalnoga strukovnoga udruženja pozicionirala gaje stoga kao ravnopravnoga partnera Zagrebu i kao sredinu sa snažnim potencijalom borbe za reformu zdravstva uvjetovanu angažiranom ulogom lijeÄniÄke profesije.Establishing of Sbor lieÄnika kr. Hrvatske i Slavonije (The Medical Association of the Kingdom of Croatia and Slavonia) with headquarters in Zagreb and Družtvo slavonskih lieÄnika (Slavonian Medical Association) with headquarters in Osijek in 1874 was a result of complex social and political processes, but also efforts taken for Croatian cultural integration. Forming a professional identity included maturing of medical doctors in the context of their social role, regardless of their regional position. Osijek was becoming stronger at the time, not only as a civil and military centre, but also as a health centre of Slavonia. With efforts for establishing an independent professional association, Osijek became an equal partner to Zagreb and a place with a strong potential for fighting for a health reform, which mostly depended on doctorsā efforts
On the occasion of the 135th anniversary of the foundation of Družtvo slavonskih lieÄnika (The Slavonian medical association)
Osnutak Sbora lieÄnika kr. Hrvatske i Slavonije sa sjediÅ”tem u Zagrebu i Družtva slavonskih lieÄnika sa sjediÅ”tem u Osijeku 874. godine rezultat je složenih druÅ”tveno - politiÄkih procesa, ali i zamaha na razini hrvatske kulturne integracije. Oblikovanje strukovnoga identiteta podrazumijevalo je sazrijevanje lijeÄnika u kontekstu druÅ”tvene uloge bez obzira na njihovu regionalnu rasporeÄenost. Osijek u to vrijeme jaÄa, ne samo kao kao civilno i vojno srediÅ”te veÄ i kao zdravstveni centar Slavonije. Borba za oživotvorenje samostalnoga strukovnoga udruženja pozicionirala gaje stoga kao ravnopravnoga partnera Zagrebu i kao sredinu sa snažnim potencijalom borbe za reformu zdravstva uvjetovanu angažiranom ulogom lijeÄniÄke profesije.Establishing of Sbor lieÄnika kr. Hrvatske i Slavonije (The Medical Association of the Kingdom of Croatia and Slavonia) with headquarters in Zagreb and Družtvo slavonskih lieÄnika (Slavonian Medical Association) with headquarters in Osijek in 1874 was a result of complex social and political processes, but also efforts taken for Croatian cultural integration. Forming a professional identity included maturing of medical doctors in the context of their social role, regardless of their regional position. Osijek was becoming stronger at the time, not only as a civil and military centre, but also as a health centre of Slavonia. With efforts for establishing an independent professional association, Osijek became an equal partner to Zagreb and a place with a strong potential for fighting for a health reform, which mostly depended on doctorsā efforts
SUDDEN UNEXPECTED DEATH IN EPILEPSY
Pojam āiznenadna smrt u epilepsijiā (engl. Sudden Unexpected Death in Epilepsy ā SUDEP) oznaÄava iznenadnu, neoÄekivanu (bez obzira na postojanje evidentiranog napadaja), neposvjedoÄenu ili posvjedoÄenu smrt u bolesnika s epilepsijom, koja nije nastupila kao izravna posljedica neke traume. BuduÄi da je iz definicije jasno da uzrok smrti nije oÄit, ne Äudi Å”to ovaj entitet u modernoj forenzici dobiva sve veÄu važnost. Naime, struÄnjak sudske medicine u stvaranju svojih zakljuÄaka rukovodi se uglavnom heteroanamnestiÄkim podacima, nekim tipiÄnim ozljedama i toksikoloÅ”kom analizom. U sudskomedicinskoj praksi smrt pacijenta koji boluje od epilepsije može nastupiti tijekom izvoÄenja neke od svakodnevnih aktivnosti (poput vožnje ili ronjenja), Å”to naglaÅ”ava ulogu struÄnjaka sudske medicine u utvrÄivanju prirode smrti. Stoga smo pregledali literaturu o iznenadnoj i neoÄekivanoj smrti u epilepsiji, definirali termine, prikazali dosadaÅ”nje hipoteze o mehanizmu nastupanja smrti te ulogu suvremenih terapijskih pristupa. Epilepsija može biti povezana s mnogim patoloÅ”kim stanjima, Å”to na obdukciji treba prepoznati. S obzirom na to da se dijagnoza smrti zbog epilepsije temelji na metodi iskljuÄivanja, postoji moguÄnost zanemarivanja prave incidencije takvih uzroka smrti.The term sudden unexpected death in epilepsy, regardless of the existing recorded attacks, represents a sudden, unexpected, witnessed or unwitnessed death in patients with epilepsy, which did not occur as a direct result of some trauma or drowning. As it is clear by definition that the cause of death is not obvious, it is not surprising that this entity is becoming increasingly important in modern forensics. In the creation of this conclusions a forensic expert mainly uses heteroanamnestic data, some typical injuries and toxicological examination. In forensic practice, the death of a patient suffering from epilepsy can occur during daily activities (such as driving or diving), which emphasizes the role of forensic medicine Āexperts in such cases. Therefore, we conducted a literature review on the topic of sudden and unexpected death in epilepsy, defined terms, and showed the current hypotheses about the mechanism of death, and the role of modern therapeutic Āapproaches. In particular, we review the possible forensic implications and the importance of conducting autopsies
SUDDEN UNEXPECTED DEATH IN EPILEPSY
Pojam āiznenadna smrt u epilepsijiā (engl. Sudden Unexpected Death in Epilepsy ā SUDEP) oznaÄava iznenadnu, neoÄekivanu (bez obzira na postojanje evidentiranog napadaja), neposvjedoÄenu ili posvjedoÄenu smrt u bolesnika s epilepsijom, koja nije nastupila kao izravna posljedica neke traume. BuduÄi da je iz definicije jasno da uzrok smrti nije oÄit, ne Äudi Å”to ovaj entitet u modernoj forenzici dobiva sve veÄu važnost. Naime, struÄnjak sudske medicine u stvaranju svojih zakljuÄaka rukovodi se uglavnom heteroanamnestiÄkim podacima, nekim tipiÄnim ozljedama i toksikoloÅ”kom analizom. U sudskomedicinskoj praksi smrt pacijenta koji boluje od epilepsije može nastupiti tijekom izvoÄenja neke od svakodnevnih aktivnosti (poput vožnje ili ronjenja), Å”to naglaÅ”ava ulogu struÄnjaka sudske medicine u utvrÄivanju prirode smrti. Stoga smo pregledali literaturu o iznenadnoj i neoÄekivanoj smrti u epilepsiji, definirali termine, prikazali dosadaÅ”nje hipoteze o mehanizmu nastupanja smrti te ulogu suvremenih terapijskih pristupa. Epilepsija može biti povezana s mnogim patoloÅ”kim stanjima, Å”to na obdukciji treba prepoznati. S obzirom na to da se dijagnoza smrti zbog epilepsije temelji na metodi iskljuÄivanja, postoji moguÄnost zanemarivanja prave incidencije takvih uzroka smrti.The term sudden unexpected death in epilepsy, regardless of the existing recorded attacks, represents a sudden, unexpected, witnessed or unwitnessed death in patients with epilepsy, which did not occur as a direct result of some trauma or drowning. As it is clear by definition that the cause of death is not obvious, it is not surprising that this entity is becoming increasingly important in modern forensics. In the creation of this conclusions a forensic expert mainly uses heteroanamnestic data, some typical injuries and toxicological examination. In forensic practice, the death of a patient suffering from epilepsy can occur during daily activities (such as driving or diving), which emphasizes the role of forensic medicine Āexperts in such cases. Therefore, we conducted a literature review on the topic of sudden and unexpected death in epilepsy, defined terms, and showed the current hypotheses about the mechanism of death, and the role of modern therapeutic Āapproaches. In particular, we review the possible forensic implications and the importance of conducting autopsies
Drowning in forensic medicine ā an overview and incidence during the 30 years period at the Department of Forensic Medicine and Criminalistics in Rijeka
Prikazom smrti do koje se dolazi utapanjem, Äestom nesreÄom u Äijoj je podlozi asfiksija, pružamo jedinstven pogled na noviju literaturu, te se nadamo kako Äemo Äitateljima približiti podruÄje Äije je prouÄavanje na hrvatskom jeziku gotovo nemoguÄe. Interes za ovu temu možemo objasniti s jedne strane epidemioloÅ”kim kretanjima; naime, utapanjem godiÅ”nje u svijetu strada velik broj ljudi, naroÄito djece; a, s druge strane, umiranje utapanjem Äesto obuhvaÄa spektar najrazliÄitijih tema iz sudske medicine. Pri pisanju Älanka trudili smo se raditi jasnu razliku izmeÄu utopljenika i tijela preminulih koji su izvaÄeni iz vode, razjasniti slijed patofizioloÅ”kih zbivanja kod smrti utapanjem, te predstaviti tipiÄne sudskomedicinske nalaze. Uz pregled podruÄja āklasiÄnog utapanjaā prikazujemo i neke rjeÄe a jednako interesantne smrti do kojih dolazi utapanjem. Uz Äinjenice navedene u meÄunarodnoj literaturi donosimo i podatke do kojih smo doÅ”li analizom dokumentacije prikupljene na Zavodu za sudsku medicinu i kriminalistiku u Rijeci.With an overview of deaths by drowning - a common accident based on asphyxia, we bring a unique perspective at the newer literature, bearing in mind our students, who we hope to bring closer to this obscure and hardly accessible topic. An interest in this topic can be explained, on the one hand, by epidemiology; namely, each year a large number of people, especially children dies in water; and, on the other hand, deaths by drowning often involve a spectrum of various topics from forensic medicine. While writing this article, we tried to make a clear distinction between drowned and bodies retrieved from water, to clarify the pathophysiological sequence of events of death by drowning, and present typical pathoanatomical findings. In addition to the "classic drowning", we also show some lesser and equally interesting deaths involving submersion in water. Along with the facts listed in the international literature, we also bring the data that we have collected through the thirty-year documentation, which will make our work more interesting and valuable
NONALCOHOLIC FATTY LIVER DISEASE ā A MULTISYSTEM DISEASE?
S porastom incidencije debljine i metaboliÄkog sindroma raste i incidencija nealkoholne masne bolesti jetre (engl. nonalcoholic fatty liver disease ā NAFLD). Osim Å”to ovi bolesnici imaju znatan rizik od progresije u terminalni stadij kroniÄne bolesti jetre, poznato je da imaju i poveÄan rizik od razvoja hepatocelularnog karcinoma. S druge strane, posljednjih godina sve je veÄi broj publikacija koje govore u prilog tomu da NAFLD nije samo bolest ograniÄena na jetru, nego je udružena s nizom izvanjetrenih bolesti i stanja, a najÄeÅ”Äe s kardiovaskularnim bolestima, kroniÄnom bubrežnom bolesti i Å”eÄernom bolesti tipa II. PosljediÄno, NAFLD je postao rastuÄi javnozdravstveni problem. Brojni supspecijalisti, kao i lijeÄnici obiteljske medicine trebali bi biti svjesni navedenih potencijalnih izvanjetrenih manifestacija NAFLD-a s obzirom na dostupnost brojnih metoda za probir u kliniÄkoj praksi. Navedeno je važno kako bi se potencijalne izvanjetrene manifestacije NAFLD-a detektirale u ranim stadijima, a time i prevenirala ili barem usporila progresija pojedinih bolesti.With the increasing incidence of obesity and metabolic syndrome the incidence of nonalcoholic fatty liver Ādisease (NAFLD) is increasing as well. These patients have a significant risk of progression to the end-stage liver disease, but also these patients are at increased risk of developing hepatocellular carcinoma. In recent years there is a growing Ānumber of publications that support the idea that NAFLD is not just a disease that is limited to the liver, but is associated with a number of extrahepatic manifestations. For example, NAFLD increases the risk of type 2 diabetes mellitus, cardiovascular diseases and chronic kidney disease. Consequently NAFLD has become a growing public health problem. A number of sub-specialists as well as primary care physicians should be aware of these potential extrahepatic associations, given the availability of numerous methods for screening in clinical practice. The above approach is important in order to recognize potentially modifiable events in the early stages, and thus manage them and at least prevent the progression of certain diseases
EXPRESSION OF HEAT SHOCK PROTEIN HSP60 AND TLR2 AND TLR4 RECEPTORS IN THE MYOCARD OF THE HEART WITH LEFT VENTRICULAR HYPERTROPHY
Cilj istraživanja: Cilj istraživanja je bio utvrditi dolaze li do pojaÄanog izražaja HSP60, TLR2
i TLR4 kod ljudi s patoloÅ”ki uveÄanom lijevom srÄanom klijetkom i na taj naÄin doprinijeti
rasvjetljavanju molekulskih zbivanja tijekom hipertrofije srÄanog miÅ”iÄa te inicijalnih procesa
ukljuÄenih u patogenezu njenih posljedica. Takvo bi istraživanje dokazalo da je steÄena
hipertrofija lijeve klijetke Äovjeka posredovana humoralnom imunosti, Å”to se do sada samo
pretpostavljalo, buduÄi da su dosadaÅ”nje studije na tu temu raÄene iskljuÄivo na životinjskim
modelima.
Materijali i metode: U tu svrhu izvrŔene su analize imunohistokemijskog izražaja na uzorcima
tkiva srÄanog miÅ”iÄa dobivenima tijekom obdukcija ljudi u kojih je hipertrofija lijeve klijetke
bila jedini patoloÅ”ki nalaz i kod kojih je kao neposredni uzrok smrti odreÄena iznenadna srÄana
smrt. Uzorci iz kontrolne skupine dobiveni su od ispitanika kod kojih histoloÅ”ki nije pronaÄena
srÄana patologija, a koji su umrli nasilnom smrÄu (nesretni sluÄaj ili samoubojstvo). Za
ispitivanje translokacije HSP60 koriŔtena je dvostruka imunoflorescencija, dok je interakcija
HSP60 i TLR2/4 dokazivana testom neposrednog vezivanja (PLA).
Rezultati: Rezultati su pokazali znaÄajno veÄi izražaj HSP60, TLR2 i TLR4 u hipertrofiÄnom
srÄanom miÅ”iÄu u usporedbi s normalnim. Nadalje, u hipertrofiÄnim smo kardiomiocitima
pronaŔli membransku translokaciju HSP60 i znakove interakcija HSP60/TLR. Korelacijska je
analiza pokazala vrlo znaÄajne meÄukorelacije izmeÄu kvantificiranih vrijednosti intenziteta
imunohistokemijskog bojenja HSP60, TLR2 i TLR4 kod ispitanika s hipertrofijom lijeve
klijetke, dok u kontrolnoj skupini rezultati nisu pokazali znaÄajne korelacije. Rezultati dobiveni
PLA analizom jasno su pokazali da se HSP60 u hipertrofiÄnom srÄanom miÅ”iÄu veže za TLR2
i TLR4.
ZakljuÄci: IzmeÄu sekundarno hipertrofiranog i normalnoga srÄanog miÅ”iÄa lijeve srÄane
klijetke Äovjeka postoje razlike u izražaju HSP60, TLR2 i TLR4. Osim toga, dobiveni podatci
ukazuju na važnu potpornu ulogu HSP60 u adaptivnom rastu kardiomiocita, dok istodobna
indukcija TLR2 i TLR4 predlaže interakcije HSP60-TLR kao rana molekulska zbivanja kod
sekundarne hipertrofije lijeve klijetke.Objectives: The study aimed to determine whether HSP60, TLR2 and TLR4 are overexpressed
in people with pathologically enlarged left ventricles and thus contribute to the elucidation of
molecular events during myocardial hypertrophy and the initial processes involved in its
pathogenesis. Such research would prove that acquired left ventricular hypertrophy is mediated
by humoral immunity, which has so far only been hypothesized, given that previous studies on
this topic have been done exclusively on animal models.
Material and methods: For this reason, immunohistochemical expression analyzes were
performed on myocardial tissue samples acquired during autopsies of people in whom left
ventricular hypertrophy was the only pathological finding and in whom sudden cardiac death
was determined as the immediate cause of death. Samples from the control group were obtained
from subjects who were not found to have cardiac pathology and who died a violent death
(accident or suicide). Double immunofluorescence was used to examine the HSP60
translocation, while the interaction of HSP60 and TLR2/4 was demonstrated by a direct ligation
test (PLA).
Results: The results showed significantly higher expression of HSP60, TLR2, and TLR4 in the
hypertrophic myocardium compared to the normal myocardium. Moreover, we found
HSP60/TLR interactions in hypertrophic cardiomyocytes. Correlation analysis showed very
significant intercorrelations between quantified values of HSP60, TLR2, and TLR4
immunohistochemical intensities in subjects with left ventricular hypertrophy while in the
control group the results showed no significant correlations. The results obtained by PLA
analysis clearly showed that HSP60 in hypertrophic myocardium binds to TLR2 and TLR4.
Conclusion: There are differences in the expression of HSP60, TLR2, and TLR4 between the
secondary hypertrophied myocardium and the normal left ventricular myocardium. In addition,
the data obtained indicate an important supporting role of HSP60 in adaptive cardiomyocyte
growth, while concomitant induction of TLR2 nad TLR4 suggests HSP-TLR interactions as
early molecular events in secondary left ventricular hypertrophy
EXPRESSION OF HEAT SHOCK PROTEIN HSP60 AND TLR2 AND TLR4 RECEPTORS IN THE MYOCARD OF THE HEART WITH LEFT VENTRICULAR HYPERTROPHY
Cilj istraživanja: Cilj istraživanja je bio utvrditi dolaze li do pojaÄanog izražaja HSP60, TLR2
i TLR4 kod ljudi s patoloÅ”ki uveÄanom lijevom srÄanom klijetkom i na taj naÄin doprinijeti
rasvjetljavanju molekulskih zbivanja tijekom hipertrofije srÄanog miÅ”iÄa te inicijalnih procesa
ukljuÄenih u patogenezu njenih posljedica. Takvo bi istraživanje dokazalo da je steÄena
hipertrofija lijeve klijetke Äovjeka posredovana humoralnom imunosti, Å”to se do sada samo
pretpostavljalo, buduÄi da su dosadaÅ”nje studije na tu temu raÄene iskljuÄivo na životinjskim
modelima.
Materijali i metode: U tu svrhu izvrŔene su analize imunohistokemijskog izražaja na uzorcima
tkiva srÄanog miÅ”iÄa dobivenima tijekom obdukcija ljudi u kojih je hipertrofija lijeve klijetke
bila jedini patoloÅ”ki nalaz i kod kojih je kao neposredni uzrok smrti odreÄena iznenadna srÄana
smrt. Uzorci iz kontrolne skupine dobiveni su od ispitanika kod kojih histoloÅ”ki nije pronaÄena
srÄana patologija, a koji su umrli nasilnom smrÄu (nesretni sluÄaj ili samoubojstvo). Za
ispitivanje translokacije HSP60 koriŔtena je dvostruka imunoflorescencija, dok je interakcija
HSP60 i TLR2/4 dokazivana testom neposrednog vezivanja (PLA).
Rezultati: Rezultati su pokazali znaÄajno veÄi izražaj HSP60, TLR2 i TLR4 u hipertrofiÄnom
srÄanom miÅ”iÄu u usporedbi s normalnim. Nadalje, u hipertrofiÄnim smo kardiomiocitima
pronaŔli membransku translokaciju HSP60 i znakove interakcija HSP60/TLR. Korelacijska je
analiza pokazala vrlo znaÄajne meÄukorelacije izmeÄu kvantificiranih vrijednosti intenziteta
imunohistokemijskog bojenja HSP60, TLR2 i TLR4 kod ispitanika s hipertrofijom lijeve
klijetke, dok u kontrolnoj skupini rezultati nisu pokazali znaÄajne korelacije. Rezultati dobiveni
PLA analizom jasno su pokazali da se HSP60 u hipertrofiÄnom srÄanom miÅ”iÄu veže za TLR2
i TLR4.
ZakljuÄci: IzmeÄu sekundarno hipertrofiranog i normalnoga srÄanog miÅ”iÄa lijeve srÄane
klijetke Äovjeka postoje razlike u izražaju HSP60, TLR2 i TLR4. Osim toga, dobiveni podatci
ukazuju na važnu potpornu ulogu HSP60 u adaptivnom rastu kardiomiocita, dok istodobna
indukcija TLR2 i TLR4 predlaže interakcije HSP60-TLR kao rana molekulska zbivanja kod
sekundarne hipertrofije lijeve klijetke.Objectives: The study aimed to determine whether HSP60, TLR2 and TLR4 are overexpressed
in people with pathologically enlarged left ventricles and thus contribute to the elucidation of
molecular events during myocardial hypertrophy and the initial processes involved in its
pathogenesis. Such research would prove that acquired left ventricular hypertrophy is mediated
by humoral immunity, which has so far only been hypothesized, given that previous studies on
this topic have been done exclusively on animal models.
Material and methods: For this reason, immunohistochemical expression analyzes were
performed on myocardial tissue samples acquired during autopsies of people in whom left
ventricular hypertrophy was the only pathological finding and in whom sudden cardiac death
was determined as the immediate cause of death. Samples from the control group were obtained
from subjects who were not found to have cardiac pathology and who died a violent death
(accident or suicide). Double immunofluorescence was used to examine the HSP60
translocation, while the interaction of HSP60 and TLR2/4 was demonstrated by a direct ligation
test (PLA).
Results: The results showed significantly higher expression of HSP60, TLR2, and TLR4 in the
hypertrophic myocardium compared to the normal myocardium. Moreover, we found
HSP60/TLR interactions in hypertrophic cardiomyocytes. Correlation analysis showed very
significant intercorrelations between quantified values of HSP60, TLR2, and TLR4
immunohistochemical intensities in subjects with left ventricular hypertrophy while in the
control group the results showed no significant correlations. The results obtained by PLA
analysis clearly showed that HSP60 in hypertrophic myocardium binds to TLR2 and TLR4.
Conclusion: There are differences in the expression of HSP60, TLR2, and TLR4 between the
secondary hypertrophied myocardium and the normal left ventricular myocardium. In addition,
the data obtained indicate an important supporting role of HSP60 in adaptive cardiomyocyte
growth, while concomitant induction of TLR2 nad TLR4 suggests HSP-TLR interactions as
early molecular events in secondary left ventricular hypertrophy
EXPRESSION OF HEAT SHOCK PROTEIN HSP60 AND TLR2 AND TLR4 RECEPTORS IN THE MYOCARD OF THE HEART WITH LEFT VENTRICULAR HYPERTROPHY
Cilj istraživanja: Cilj istraživanja je bio utvrditi dolaze li do pojaÄanog izražaja HSP60, TLR2
i TLR4 kod ljudi s patoloÅ”ki uveÄanom lijevom srÄanom klijetkom i na taj naÄin doprinijeti
rasvjetljavanju molekulskih zbivanja tijekom hipertrofije srÄanog miÅ”iÄa te inicijalnih procesa
ukljuÄenih u patogenezu njenih posljedica. Takvo bi istraživanje dokazalo da je steÄena
hipertrofija lijeve klijetke Äovjeka posredovana humoralnom imunosti, Å”to se do sada samo
pretpostavljalo, buduÄi da su dosadaÅ”nje studije na tu temu raÄene iskljuÄivo na životinjskim
modelima.
Materijali i metode: U tu svrhu izvrŔene su analize imunohistokemijskog izražaja na uzorcima
tkiva srÄanog miÅ”iÄa dobivenima tijekom obdukcija ljudi u kojih je hipertrofija lijeve klijetke
bila jedini patoloÅ”ki nalaz i kod kojih je kao neposredni uzrok smrti odreÄena iznenadna srÄana
smrt. Uzorci iz kontrolne skupine dobiveni su od ispitanika kod kojih histoloÅ”ki nije pronaÄena
srÄana patologija, a koji su umrli nasilnom smrÄu (nesretni sluÄaj ili samoubojstvo). Za
ispitivanje translokacije HSP60 koriŔtena je dvostruka imunoflorescencija, dok je interakcija
HSP60 i TLR2/4 dokazivana testom neposrednog vezivanja (PLA).
Rezultati: Rezultati su pokazali znaÄajno veÄi izražaj HSP60, TLR2 i TLR4 u hipertrofiÄnom
srÄanom miÅ”iÄu u usporedbi s normalnim. Nadalje, u hipertrofiÄnim smo kardiomiocitima
pronaŔli membransku translokaciju HSP60 i znakove interakcija HSP60/TLR. Korelacijska je
analiza pokazala vrlo znaÄajne meÄukorelacije izmeÄu kvantificiranih vrijednosti intenziteta
imunohistokemijskog bojenja HSP60, TLR2 i TLR4 kod ispitanika s hipertrofijom lijeve
klijetke, dok u kontrolnoj skupini rezultati nisu pokazali znaÄajne korelacije. Rezultati dobiveni
PLA analizom jasno su pokazali da se HSP60 u hipertrofiÄnom srÄanom miÅ”iÄu veže za TLR2
i TLR4.
ZakljuÄci: IzmeÄu sekundarno hipertrofiranog i normalnoga srÄanog miÅ”iÄa lijeve srÄane
klijetke Äovjeka postoje razlike u izražaju HSP60, TLR2 i TLR4. Osim toga, dobiveni podatci
ukazuju na važnu potpornu ulogu HSP60 u adaptivnom rastu kardiomiocita, dok istodobna
indukcija TLR2 i TLR4 predlaže interakcije HSP60-TLR kao rana molekulska zbivanja kod
sekundarne hipertrofije lijeve klijetke.Objectives: The study aimed to determine whether HSP60, TLR2 and TLR4 are overexpressed
in people with pathologically enlarged left ventricles and thus contribute to the elucidation of
molecular events during myocardial hypertrophy and the initial processes involved in its
pathogenesis. Such research would prove that acquired left ventricular hypertrophy is mediated
by humoral immunity, which has so far only been hypothesized, given that previous studies on
this topic have been done exclusively on animal models.
Material and methods: For this reason, immunohistochemical expression analyzes were
performed on myocardial tissue samples acquired during autopsies of people in whom left
ventricular hypertrophy was the only pathological finding and in whom sudden cardiac death
was determined as the immediate cause of death. Samples from the control group were obtained
from subjects who were not found to have cardiac pathology and who died a violent death
(accident or suicide). Double immunofluorescence was used to examine the HSP60
translocation, while the interaction of HSP60 and TLR2/4 was demonstrated by a direct ligation
test (PLA).
Results: The results showed significantly higher expression of HSP60, TLR2, and TLR4 in the
hypertrophic myocardium compared to the normal myocardium. Moreover, we found
HSP60/TLR interactions in hypertrophic cardiomyocytes. Correlation analysis showed very
significant intercorrelations between quantified values of HSP60, TLR2, and TLR4
immunohistochemical intensities in subjects with left ventricular hypertrophy while in the
control group the results showed no significant correlations. The results obtained by PLA
analysis clearly showed that HSP60 in hypertrophic myocardium binds to TLR2 and TLR4.
Conclusion: There are differences in the expression of HSP60, TLR2, and TLR4 between the
secondary hypertrophied myocardium and the normal left ventricular myocardium. In addition,
the data obtained indicate an important supporting role of HSP60 in adaptive cardiomyocyte
growth, while concomitant induction of TLR2 nad TLR4 suggests HSP-TLR interactions as
early molecular events in secondary left ventricular hypertrophy