MicroRNAs: As Critical Regulators of Tumor- Associated Macrophages
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
Authors: Chatterjee, Bilash; Saha, Priyanka; Bose, Subhankar; Shukla, Devendra; Chatterjee, Nabanita; Kumar, Sanjay; Tripathi, Prem Prakash; Srivastava, Amit Kumar
Abstract
Emerging shreds of evidence suggest that tumor-associated macrophages (TAMs) modulate various hallmarks of cancer during tumor progression. Tumor microenvironment (TME) prime TAMs to execute important roles in cancer development and progression, including angiogenesis, matrix metalloproteinases (MMPs) secretion, and extracellular matrix (ECM) disruption. MicroRNAs (miRNAs) are critical epigenetic regulators, which modulate various functions in diverse types of cells, including macrophages associated with TME. In this review article, we provide an update on miRNAs regulating differentiation, maturation, activation, polarization, and recruitment of macrophages in the TME. Furthermore, extracellular miRNAs are secreted from cancerous cells, which control macrophages phenotypic plasticity to support tumor growth. In return, TAMs also secrete various miRNAs that regulate tumor growth. Herein, we also describe the recent updates on the molecular connection between tumor cells and macrophages. A better understanding of the interaction between miRNAs and TAMs will provide new pharmacological targets to combat cancer.
Early re-laparotomy for patients with high-grade liver injury after damage-control surgery and perihepatic packing
SURGERY TODAY
Authors: Kang, Byung Hee; Jung, Kyoungwon; Choi, Donghwan; Kwon, Junsik
Abstract
Purpose The likelihood of re-bleeding after damage-control surgery (DCS) and perihepatic packing for high-grade liver injuries is a major concern. Thus, although early re-laparotomy tends to be recommended, we conducted this study to evaluate the feasibility of performing definite laparotomy within <= 48 h in this clinical population. Methods The subjects of this retrospective study were 65 patients (n = 24, <= 48-h group; n = 41, > 48-h group) who underwent DCS and perihepatic packing. The primary outcome was the rate of repacking for bleeding during re-laparotomy and the secondary outcomes were mortality and length of stay in the intensive care unit (ICU). Results The <= 48-h group had a higher rate of angioembolization and transfusion of red blood cells (RBCs), fresh frozen plasma, and platelets, but the rates of repacking and mortality were not significantly different between the groups. However, the incidence of pneumonia and ventilation support requirement were significantly lower in the <= 48-h group than in the > 48-h group. Conclusion The re-laparotomy performed within <= 48 h after DCS and perihepatic packing is feasible for patients with high grade liver injury, using angioembolization and aggressive transfusion, as required. Early re-laparotomy reduces the need for prolonged ventilator support and the incidence of ventilator-associated pneumonia.