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Pull-down Heller myotomy improves the clinical outcome of advanced sigmoid achalasia
(Springer Science and Business Media LLC, 2025)
Méndez-Hernández, Dulce Paola
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Moreno-Fuentes, Miguel
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Barron-Cervantes, Natalia Maria
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Stenner-Escalante, Andres
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Morales-Herrera, Carlos Alejandro
Introduction: Esophagectomy was considered the first line for advanced sigmoid (aSg) achalasia (esophageal angulation < 90°), while laparoscopic Heller myotomy (LHM) has a lower percentage of success. The pull-down LHM (PD-LHM) technique has emerged as a promising and more effective rescue therapy to avoid esophagectomy for aSg achalasia. However, the long-term functional results of PD-LHM are inconclusive. Objective: To compare the outcome of aSg achalasia (< 90°) who underwent the PD-LHM technique with those of non-advanced (naSg) achalasia (≥ 90°) and LHM. Patients and methods: This ambispective nested cohort study evaluated 34 achalasia patients with megaesophagus divided into two groups: (a) aSg (< 90°; n = 20; 59%) PD-LHM treated, and (b) naSg (≥ 90°; n = 14; 41%) LHM treated. The assessments included esophageal angulation and symptom questionnaires. All patients were clinically and manometrically evaluated before and at 1- and 12-month post-surgery intervals. Clinical outcomes focused on achieving esophageal angulation ≥ 90° and an Eckardt score < 3. Results: 65% of patients were men, and 65% had achalasia type I. The mean esophageal angulation in aSg was 79.6 ± 8.8°, and in naSg was 116.3 ± 16.3°. aSg improved to 99.5 ± 15.2°, and 17/20 patients (85%) shifted to the naSg group. aSg significantly improved in Eckard symptom score at 1 month (1.2 ± 1.3) vs. preoperative score (8.9 ± 1.6). The three aSg patients who experienced PD-LHM failure were male, type I achalasia, had higher preoperative IRP and LES pressure, were older, and had longer disease duration vs. success. A good clinical and manometric outcome was obtained in 85% of aSg. Conclusion: Our findings suggest that PD-LHM is an effective treatment for aSg with a success rate of 85%. ©The authors ©Surgical Endoscopy ©Springer Science and Business Media LLC.
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Polymerized Type I Collagen Downregulates STAT-1 Phosphorylation Through Engagement with LAIR-1 in Circulating Monocytes, Avoiding Long COVID
(MDPI, 2025)
Olivares-Martínez, Elizabeth
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Hernández-Ramírez, Diego Francisco
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Núñez-Álvarez, Carlos Alberto
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Meza-Sánchez, David Eduardo
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Chapa, Mónica
The intramuscular administration of polymerized type I collagen (PTIC) for adult symptomatic COVID-19 outpatients downregulated hyperinflammation and improved symptoms. We inferred that LAIR1 is a potential receptor for PTIC. Thus, a binding assay and surface plasmon resonance binding assay were performed to estimate the affinity of the interaction between LAIR1 and PTIC. M1 macrophages derived from THP-1 cells were cultured with 2–10% PTIC for 24 h. Lysates from PTIC-treated THP-1 cells, macrophage-like cells (MLCs), M1, M1 + IFN-γ, and M1 + LPS were analyzed by Western blot for NF-κB (p65), p38, STAT1, and pSTAT1 (tyrosine701). Serum cytokine levels and monocyte LAIR1 expressions (Mo1 and Mo2) were analyzed by luminometry and flow cytometry in symptomatic COVID-19 outpatients on PTIC treatment. PTIC-bound LAIR1 had a similar affinity to collagen in M1 macrophages. It downregulated pSTAT1 in IFN-γ-induced M1. COVID-19 patients under PTIC treatment showed a significant decrease in Mo1 percentages and cytokines (IP-10/MIF/eotaxin/IL-8/IL-1RA/M-CSF) associated with STAT1 and an increase in the Mo2 subset. The inflammatory mediators and Mo1 downregulation were related to better oxygen saturation and decreased dyspnea, chest pain, cough, and chronic fatigue syndrome in the acute and long-term phase of infection. PTIC is an agonist of LAIR1 and downregulates STAT-1 phosphorylation. PTIC could be relevant for treating STAT1-mediated inflammatory diseases, including COVID-19 and long COVID. ©The authors ©MDPI.
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Protective role of ABCC drug subfamily resistance transporters (ABCC1-7) in intestinal inflammation
(Springer Nature, 2025)
Fonseca-Camarillo, Gabriela
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Furuzawa-Carballeda, Janette
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Miguel-Cruz, Erika
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Barreto-Zuñiga, Rafel
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Martínez-Benítez, Braulio
The ABCC subfamily contains thirteen members. Nine of these transporters are called multidrug resistance proteins (MRPs). The MRPs have been associated with developing ulcerative colitis (UC). This study aimed to evaluate the ABCC expression in UC patients and its role in a dextran sulfate sodium (DSS)-induced colitis mice model under 5-aminosalicylates or methylprednisolone treatment and compared with control without inflammation. DSS-induced colitis mice were treated with 5-aminosalicylates (50 mg/kg 24 h) or methylprednisolone (2 mg/kg 24 h). Human rectal biopsies were obtained from UC patients. The abcc-relative mRNA levels and protein expression were determined by RT-PCR and immunohistochemistry. abcc4, abcc5, and abcc6 mRNA levels were significantly increased in DSS-induced colitis compared to the other groups. The 5-aminosalicylate treatment dramatically increased the abcc2 and abcc3 mRNA levels vs. control. Methylprednisolone treatment increased abcc1 vs. DSS-induced colitis and colitis treated with 5-aminosalicylate. Immunohistochemical analysis revealed down-regulation of ABCC1/ABCC2/ABCC5/ABCC7 in mice colitis vs. control. Treatment with 5-aminosalicylate restored ABCC5 levels, while methylprednisolone restored ABCC2/ABCC5/ABCC7 in colitis mice at similar control levels. Relative mRNA levels of mrp1-5 were increased in active UC patients vs. control. ABCC2/ABCC4/ABCC7 were conspicuously expressed in the mucosa of 5-aminosalicylate and/or methylprednisolone-treated UC patients, while ABCC2/ABCC4/ABCC5/ABCC7 in submucosa, ABCC1/ABCC5/ABCC7 in muscular, and ABCC1/ABCC4/ABCC5/ABCC7 in serosa were expressed vs. controls. This is the first report about the differential up-regulation of the ABCC subfamily gene and protein expression in DSS-induced colitis under aminosalicylates or methylprednisolone treatment. ©The authors ©Springer.
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Protective Role of Selenium-Binding Protein 1 (SELENBP1) in Patients with Ulcerative Colitis
(MDPI, 2024)
Fonseca-Camarillo, Gabriela
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Furuzawa-Carballeda, Janette
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Priego-Ranero, Ángel A.
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Barreto-Zúñiga, Rafael
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Martínez-Benítez, Braulio
Background: The expression of selenium-binding protein 1 (SELENBP1), a molecule responsible for the absorption of selenium in the colon, is crucial for its immunoregulatory effect, but this phenomenon has not been studied in patients with UC. The present study aimed to determine the clinical outcome of SELENBP1 expression in colonic tissue from patients with UC. Methods: The relative mRNA expression of SELENBP1 was analyzed in 34 patients with UC and 20 controls. Statistical analyses were performed with SPSS 19. Results: SELENBP1 gene expression was significantly lower in patients with active UC than those with UC in remission (p = 0.003) and within the controls (p = 0.04). Overexpression of the SELENBP1 gene was associated with a more benign clinical course characterized by initial activity and more than two years of prolonged remission (OR 23.7, p = 0.003) and an intermittent clinical course (OR 47.5, p = 0.001), mild histological activity (OR 0.11; 95% CI: 1.00–1.41, p = 0.05) and severe histological activity (OR 0.08, 95% CI: 0.008–0.866, p = 0.02). SELENBP1-positive cells were found mainly in the submucosa’s inflammatory infiltrate and muscular and adventitia’s internal layers from patients with active UC compared to those in the control group (p ≤ 0.001). Conclusions: The upregulation of SELENBP1 was associated with a benign clinical course of UC. This is the first report suggesting the immunoregulatory role of SELENBP1 in patients with UC. ©The authors ©MDPI
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Participation of Semaphorin Family and Plexins in the Clinical Course of Patients with Inflammatory Bowel Disease
(2024)
Gabriela Fonseca-Camarillo
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Furuzawa-Carballeda, Janette
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Diana Aguilar-León
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Braulio Martínez-Benítez
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Rafael Barreto-Zúñiga
<jats:p>Semaphorins are an immunoregulatory protein family. Plexins bind semaphorins (SEMAs) and can form receptor complexes that give them chemotactic capacity. The role and expression profile of semaphorins and plexins in inflammatory bowel disease (IBD) is currently unknown. Aim: Characterize the semaphorins and plexins gene and protein expression in intestinal tissue from IBD patients and correlate them with the clinical phenotype. Material and Methods: This comparative and cross-sectional study enrolled 54 diagnosed IBD patients and 20 controls. Gene and protein expression of semaphorins and plexins were determined by RT-PCR and IHQ for the co-localization with neutrophils (myeloperoxidase, MPO) or CD123 plasmacytoid dendritic cells in intestinal tissue from IBD patients. Results: Colonic mucosa from active and remission ulcerative colitis (UC) had a significantly lower SEMA4D and PLXNA1, but higher PLXNB1 gene expression than the control group. The only significant difference between active UC and remission was observed in the higher gene expression of SEMA6D in remission. It was associated with histological remission (p = 0.01, OR = 15, 95% CI: 1.39–16.1). The low expression of PLXNA1 was associated with mild intermittent activity with two relapses per year (p = 0.003, OR = 0.05, CI = 0.006–0.51). Higher SEMA4D+ positive cells were detected in the submucosa, while PLXNC1+/MPO+ in the mucosal and submucosa of active UC patients compared with controls. Conclusions: The increased expression of the semaphorin and plexin family in IBD patients suggests their immunoregulatory function and is associated with remission and clinical phenotype in patients with UC.</jats:p>
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A Higher Manometric Esophageal Length to Height Ratio in Achalasia Explains the Lower Prevalence of Hiatal Hernia
(2023)
Coss-Adame, Enrique
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Furuzawa-Carballeda, Janette
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Valdovinos , Miguel A.
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Sánchez-Gómez, Josué
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Peralta-Figueroa, José
Background/aims: The evidence suggests that a shorter esophageal length (EL) in gastroesophageal reflux disease (GERD) patients is associated with the presence of hiatal hernia (HH). However, there are no reports of this association in patients with achalasia. The aim is to (1) determine the prevalence of hiatal hernia in achalasia patients, (2) compare achalasia EL with GERD patients and healthy volunteers (HV), (3) measure achalasia manometric esophageal length to height (MELH) ratio, and (4) determine if there are differences in symptoms between patients with and without hiatal hernia. Methods: This retrospective and cross-sectional study consist of 87 pre-surgical achalasia patients, 22 GERD patients, and 30 HV. High-resolution manometry (HRM), barium swallow, and upper endoscopy were performed to diagnose HH. The EL and MELH ratio were measured by HRM. Symptoms were assessed with Eckardt, Eating Assessment Tool, and GERD-health-related quality of life questionnaires.
Scopus© Citations 1 19 1
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Predictive factors associated with the persistence of chest pain in post-laparoscopic myotomy and fundoplication in patients with achalasia
(2022)
Olvera-Prado, Héctor
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Peralta-Figueroa, José
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Narváez-Chávez, Sofía
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Furuzawa-Carballeda, Janette
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Méndez-Flores, Silvia
Background: Episodic angina-like retrosternal pain is a prevalent symptom for achalasia patients pre- and post-treatment. The cause of postoperative chest pain remains poorly understood. Moreover, there are no reports on their predictive value for chest pain in the long-term post-treatment. The effect of laparoscopic Heller myotomy (LHM) and fundoplication techniques (Dor vs. Toupet) is unclear. Methods: We analyzed a cohort of 129 achalasia cases treated with LHM and randomly assigned fundoplication technique. All the patients were diagnosed with achalasia by high-resolution manometry (HRM). Patients were followed up at 1-, 6-, 12-, and 24-month post-treatment. We implemented unadjusted and adjusted logistic regression analyses to evaluate the predictive significance of pre- and post-operative clinical factors. Copyright © 2022 Frontiers in Medicine
Scopus© Citations 1 10 1
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Effect of polymerised type I collagen on hyperinflammation of adult outpatients with symptomatic COVID‐19
(2022)
Méndez‐Flores, Silvia
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Priego‐Ranero, Ángel
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Azamar‐Llamas, Daniel
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Olvera‐Prado, Héctor
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Rivas‐Redonda, Kenia Ilian
Dear Editor: Although dexamethasone is approved for the hyperinflammation treatment of hospitalised COVID-19 patients, non-hospitalised patients do not benefit from this therapy.1 A potential drug for treating COVID-19 patients is polymerised type I collagen (PTIC). A downregulator of pro-inflammatory cytokines, adhesion molecules (ELAM-1, VCAM-1, and ICAM-1), cyclooxygenase (Cox)-1 enzyme and the collagenases expression through the modulation of transcription of factor NF-kB.2-6 The intramuscular or subcutaneous administration of PTIC to patients with active RA (Phase II studies) improved the count of swollen joints and morning stiffness; 57% of patients achieved an ACR score of 50, and 30% had disease remission with this therapeutic combination. PTIC was safe and well-tolerated in long-term treatment, without adverse effects. © Clinical and Translational Medicine
24 2
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Long-Term Effectiveness of Polymerized-Type I Collagen Intra-Articular Injections in Patients with Symptomatic Knee Osteoarthritis: Clinical and Radiographic Evaluation in a Cohort Study
(2020)
Borja-Flores, Adrián
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Macías-Hernández, Salvador I.
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Hernández-Molina, Gabriela
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Reyes-Martínez, Eloy
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Belzazar-Castillo de la Torre, José
Objective. Polymerized-type I collagen (polymerized-collagen) is a downregulator of inflammation and a tissue regenerator. The aim was to evaluate the effect of intra-articular injections (IAIs) of polymerized-collagen among patients with symptomatic knee osteoarthritis (OA) in delaying or preventing joint replacement surgery. Patients and Methods. This was a cohort study of 309 patients with knee OA. Patients with mild-to-moderate disease were treated weekly with IAIs of 2 mL of polymerized-collagen for six weeks (n = 309). Follow-up was for 6-60 months. The primary endpoints included the following determinations: (1) therapeutic effect; (2) survival from total knee replacement surgery (TKR); (3) Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and pain (visual analogue scale, VAS). Clinical improvement was defined as a decrease in pain exceeding 20 mm on the VAS and the achievement of at least 20% improvement from baseline with respect to the WOMAC score. Radiographic analysis was performed at baseline and 60 months. The joint space width in the medial, lateral, and patellofemoral compartments was calculated. Results. Patients who received IAIs of polymerized-collagen had a statistically significant improvement in the primary criteria (p<0.05). Kaplan-Meier survival analysis of the therapeutic effect demonstrated 98.8% survival at 60 months with TKR as the endpoint. There was no significant reduction in joint space in any compartment based on the analyzed radiographs. No serious adverse events were recorded. Conclusion. Polymerized-collagen increased the time to TKR by at least 60 months, modifying the disease course, improving functional disability, and decreasing pain. © 2020 Adrián Borja-Flores et al.
Scopus© Citations 2 19 2
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Long‐term risk of adult overweight and obesity among achalasia patients who underwent Heller Myotomy
(2020)
Narváez-Chávez, Sofía
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Furuzawa-Carballeda, Janette
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Coss‐Adame, Enrique
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Valdovinos‐Díaz, Miguel A.
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Peralta‐Figueroa, José
Background: It is unknown whether surgically treated achalasia cases regain or surpass their usual weight into obesity or overweight in the long-term post-operative period. Here, we aimed to assess the incidence of overweight/obesity (Ob/Ow) and the risk for reoccurrence up to 48 months post-laparoscopic Heller myotomy (LHM). Methods: We performed a cohort of 114 achalasia cases undergoing LHM. All patients had a confirmed diagnosis of achalasia and had no added comorbidities. We followed up the body mass index (BMI) at the immediate post-operative period, and at one-, six-, 12-, 24-, and 48 months after LHM. We measured the incidence of Ob/Ow and its reoccurrence risk with Cox regression. © © 2020 John Wiley & Sons Ltd.
Scopus© Citations 3 45 2

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