Priority of experimental evidence.

نویسنده

  • Shigeru Nishizawa
چکیده

To the Editor: The authors of a recent article that appeared in Circulation Research1 described that “there is no information available regarding the mechanism by which SAH activates the Rho/Rho kinase or PKC pathways” (page 810). I would like to say that such a description is incorrect. There is a history of experiments to identify the relationship between the roles of protein kinase C (PKC) and the mechanism of vasospasm after subarachnoid hemorrhage (SAH). In particular, we have extensively investigated the roles of PKC in the development and maintenance of vasospasm after SAH, as listed in the References.2–5 Wickman et al1 should have discussed the history of the experiments regarding “the mechanism by which SAH activates PKC pathways.” Since we clarified the roles of PKC in the mechanism of vasospasm, we carefully examined which PKC isoforms are expressed in canine basilar artery and which ones are involved in the development and maintenance of vasospasm with Western blotting analysis, just as the authors did. We detected four PKC isoforms in canine basilar artery (PKC , , , ). Among these four PKC isoforms, PKC is closely related with the initiation and PKC with the maintenance of vasospasm in a “two-hemorrhage” canine model (in situ 1-week study). Because the antibodies for PKC isoforms are derived from a different space (rat brain), we showed the specificity of the bands expressed in Western blotting by elimination of these bands using antibody-specific synthetic peptides. I believe that it is not good enough to show the positive control using rat brain, but rather to show the elimination of bands, just as we did, in order to say it is specific. From these points of view, I think that Wickman et al should have discussed the priority of experimental evidence regarding the role of PKC isoforms in the mechanism of vasospasm after SAH by citing previously published studies. Wickman et al emphasized the roles of PKC and PKC in the mechanism of vasospasm. The authors should also have discussed the reasons why they obtained such different experimental evidence from ours. The authors’ experimental periods were 1.5 hours in the isometric tension study and 60 minutes in cultured smooth muscles cells. The period of clinical vasospasm lasts for 1 or 2 weeks. In addition, it is not deniable that multiple substances could be candidates to induce vasospasm besides oxyhemoglobin. The authors’ explanation based on their evidence for the mechanism of vasospasm might be a mechanism of the initiation of vasospasm, and a property of rabbit basilar artery to only oxyhemoglobin. However, it cannot be relevant for a mechanism of the sustained cerebral arterial contraction like vasospasm after SAH.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Does the Narrative About the Use of Evidence in Priority Setting Vary Across Health Programs Within the Health Sector: A Case Study of 6 Programs in a Low-Income National Healthcare System

Background There is a growing body of literature on evidence-informed priority setting. However, the literature on the use of evidence when setting healthcare priorities in low-income countries (LICs), tends to treat the healthcare system (HCS) as a single unit, despite the existence of multiple programs within the HCS, some of whic...

متن کامل

Evidence-Informed Deliberative Processes for Universal Health Coverage: Broadening the Scope; Comment on “Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness”

Universal health coverage (UHC) is high on the global health agenda, and priority setting is fundamental to the fair and efficient pursuit of this goal. In a recent editorial, Rob Baltussen and colleagues point to the need to go beyond evidence on cost-effectiveness and call for evidence-informed deliberative processes when setting priorities for UHC. Such processes are crucial at every step on...

متن کامل

Don’t Discount Societal Value in Cost-Effectiveness; Comment on “Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness”

As healthcare resources become increasingly scarce due to growing demand and stagnating budgets, the need for effective priority setting and resource allocation will become ever more critical to providing sustainable care to patients. While societal values should certainly play a part in guiding these processes, the methodology used to capture these values need not necessarily be limited to mul...

متن کامل

Disease Control Priorities Third Edition Is Published: A Theory of Change Is Needed for Translating Evidence to Health Policy

How can evidence from economic evaluations of the type the Disease Control Priorities project have synthesized be translated to better priority setting? This evidence provides insights into how investing in health, particularly though priority interventions and expanded access to health insurance and prepaid care, can not only save lives but also help alleviate poverty and provide financial ris...

متن کامل

Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness

Priority setting of health interventions is generally considered as a valuable approach to support low- and middle-income countries (LMICs) in their strive for universal health coverage (UHC). However, present initiatives on priority setting are mainly geared towards the development of more cost-effectiveness information, and this evidence does not sufficiently support countries to make optimal...

متن کامل

Health Technology Assessment: Global Advocacy and Local Realities; Comment on “Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness”

Cost-effectiveness analysis (CEA) can help countries attain and sustain universal health coverage (UHC), as long as it is context-specific and considered within deliberative processes at the country level. Institutionalising robust deliberative processes requires significant time and resources, however, and countries often begin by demanding evidence (including local CEA evidence as well as evi...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Circulation research

دوره 93 3  شماره 

صفحات  -

تاریخ انتشار 2003