13 research outputs found

    Az invazív urothelsejtes carcinoma morfológiai variánsai

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    Az urothelsejtes carcinoma a húgyutak leggyakoribb rosszindulatú daganata, amely a vesemedencében, a húgyvezetékben, a húgyhólyagban és ritkán a húgycsőben alakul ki. Szövetileg az urothelsejtes carcinomát nem invazív, illetve invazív kategóriába soroljuk. Az előbbi papillaris növekedésű, általában jól differenciált és kedvező kimenetelű, míg az utóbbi infiltratívan szűri be a kiindulási szerveket, jellemzően rosszul differenciált, és gyakran rossz prognózissal társul. Invazív urothelsejtes carcinoma esetén a kórlefolyást elsődlegesen az invázió mélysége határozza meg, az újabb adatok szerint viszont az urothelsejtes carcinoma morfológiai variánsai eltérően reagálnak az onkológiai kezelésekre, továbbá ezek biológiai viselkedése is különböző. Ezek az altípusok és variánsok hazánkban, illetve nemzetközileg is jelentősen aluldiagnosztizáltak, ugyanis a szövettani kórisme kritériumai sok esetben nem egyértelműek. A húgyúti daganatok legfrissebb, 2022. évi WHO-klasszifikációja jelentősen pontosította az egyes altípusok és variánsok definícióit. Ebben a dolgozatban az aktuális klasszifikációból kiindulva áttekintjük ezen altípusok, illetve variánsok morfológiai, immunhisztokémiai, differenciáldiagnosztikai, prognosztikai és prediktív jellemzőit azzal a céllal, hogy ezek minél inkább megjelenjenek a mindennapi diagnosztikában. A munka célja továbbá az urothelsejtes carcinoma egyes altípusainak és variánsainak bemutatása a hazai patológus-, onkológus- és urológusközösségnek azért, hogy az eddigi magas szintű uroonkológiai ellátás még inkább személyre szabottá válhasson. Orv Hetil. 2023; 164(40): 1567–1582

    Damage-mediated macrophage polarization in sterile inflammation

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    Most of the leading causes of death, such as cardiovascular diseases, cancer, dementia, neurodegenerative diseases, and many more, are associated with sterile inflammation, either as a cause or a consequence of these conditions. The ability to control the progression of inflammation toward tissue resolution before it becomes chronic holds significant clinical potential. During sterile inflammation, the initiation of inflammation occurs through damage-associated molecular patterns (DAMPs) in the absence of pathogen-associated molecules. Macrophages, which are primarily localized in the tissue, play a pivotal role in sensing DAMPs. Furthermore, macrophages can also detect and respond to resolution-associated molecular patterns (RAMPs) and specific pro-resolving mediators (SPMs) during sterile inflammation. Macrophages, being highly adaptable cells, are particularly influenced by changes in the microenvironment. In response to the tissue environment, monocytes, pro-inflammatory macrophages, and pro-resolution macrophages can modulate their differentiation state. Ultimately, DAMP and RAMP-primed macrophages, depending on the predominant subpopulation, regulate the balance between inflammatory and resolving processes. While sterile injury and pathogen-induced reactions may have distinct effects on macrophages, most studies have focused on macrophage responses induced by pathogens. In this review, which emphasizes available human data, we illustrate how macrophages sense these mediators by examining the expression of receptors for DAMPs, RAMPs, and SPMs. We also delve into the signaling pathways induced by DAMPs, RAMPs, and SPMs, which primarily contribute to the regulation of macrophage differentiation from a pro-inflammatory to a pro-resolution phenotype. Understanding the regulatory mechanisms behind the transition between macrophage subtypes can offer insights into manipulating the transition from inflammation to resolution in sterile inflammatory diseases

    Renal cell carcinoma in end-stage renal disease: A retrospective study in patients from Hungary

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    Introduction: End-stage renal disease (ESRD) and acquired cystic kidney disease (ACKD) are known risk factors for renal cell carcinoma (RCC). Hereby, the clinicopathological features of RCCs developed in ESRD were investigated. Methods: A database consisting of 34 tumors from 31 patients with ESRD among 2 566 nephrectomy samples of RCC was built. The demographic, clinical, and follow-up data along with pathological parameters were analyzed. The RCCs were diagnosed according to the current WHO Classification of Urinary and Male Genital Tumors. Results: Twenty-two tumors developed in men and 12 in women, with a median age of 56 years (range: 27-75 years). The causes of ESRD were glomerulonephritis (n=7), hypertensive kidney disease (n=6), autosomal dominant polycystic kidney disease (n=6), chronic pyelonephritis (n=4), diabetic nephropathy (n=3), chemotherapy-induced nephropathy (n=1), and undetermined (n=4). ACKD complicated ESRD in 12 patients. The following histological subtypes were identified: clear cell RCC (n=19), papillary RCC (n=5), clear cell papillary tumor (n=5), ACKD RCC (n=3), and eosinophilic solid and cystic RCC (n=2). The median tumor size was 31 mm (range: 10-80 mm), and 32 tumors were confined to the kidney (pT1-pT2). There was no tumor-specific death during the period of this study. Progression was registered in one patient.Conclusion: In our cohort, the most common RCC subtype was clear cell RCC (55%), with a frequency that exceeded international data appreciably (14-25%). The incidence of clear cell papillary tumor and ACKD RCC (14.7% and 8.5%) was lower than data reported in the literature (30% and 40%). Our results indicate a favorable prognosis of RCC in ESRD

    A kaszpáz-9 szerepe nekroptózisban

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    Kutatómunkánk során azt vizsgáltuk, hogy milyen hatással van a kaszpáz-9 a nekroptózis jelátviteli útvonalára. Vizsgálataink azt mutatták, hogy a nekroptózis intenzitása csökkent vagy megszűnt kaszpáz-9 hiányos kísérleti körülmények között. Nem ismert, hogy a kaszpáz-9 mely része, részei töltenek be nélkülözhetetlen szerepet a nekroptózis jelátvitele során. Ennek vizsgálatához in vitro mutagenezis segítségével számos pontmutációs, valamint több fragment konstruktot kívántunk létrehozni, majd ezeket JA3 Jurkat (humán T-limfocita), JA3-C9 (kaszpáz-9 negatív Jurkat) sejtvonalakba transzfektálni.BSc/BABiológia Bsc

    Resolution Potential of Necrotic Cell Death Pathways

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    During tissue damage caused by infection or sterile inflammation, not only damage-associated molecular patterns (DAMPs), but also resolution-associated molecular patterns (RAMPs) can be activated. These dying cell-associated factors stimulate immune cells localized in the tissue environment and induce the production of inflammatory mediators or specialized proresolving mediators (SPMs). Within the current prospect of science, apoptotic cell death is considered the main initiator of resolution. However, more RAMPs are likely to be released during necrotic cell death than during apoptosis, similar to what has been observed for DAMPs. The inflammatory potential of many regulated forms of necrotic cell death modalities, such as pyroptosis, necroptosis, ferroptosis, netosis, and parthanatos, have been widely studied in necroinflammation, but their possible role in resolution is less considered. In this review, we aim to summarize the relationship between necrotic cell death and resolution, as well as present the current available data regarding the involvement of certain forms of regulated necrotic cell death in necroresolution
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