AB0124 EFFECTS OF INHIBITOR K-CARRAGEENAN ON HAECs INFLAMMATORY RESPONSE TO LDLs ISOLATED FROM SLE PATIENTS

Background

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with a high risk of atherosclerosis and cardiovascular events. It was previously reported by our group that low-density lipoprotein (LDL) particles isolated from SLE patients, during an active state of the disease (‘flare’), promoted an exaggerated inflammatory response in human aortic endothelial cells (HAECs). However, the molecular mechanisms underlying this response still remain elusive.

Objectives

The hypothesis of this study is that these SLE-LDLs would be using receptor LOX-1, associated with inflammatory conditions and altered lipoproteins, to generate the proatherogenic response in HAECs.

Methods

LOX-1 pharmacological inhibitor k-carrageenan was used before the stimulation of HAECs with LDLs isolated from healthy controls (10), non-active (13), or active-SLE patients (13). Gene expression, protein, and cell migration assays were performed to evaluate HAECs inflammatory response.

Results

LOX-1 inhibition with k-carrageenan significantly reduced the expression of vascular cell adhesion molecule 1 (VCAM-1) and restored the gene expression of endothelial nitric oxide synthase (eNOS) in HAECs incubated with non-active SLE LDLs.

Conclusion

While VCAM-1 down-regulation was expected, the immediate next step derived from the observed results will be a deeper understanding of how LOX-1 inhibition may restore the endothelial ability to synthetize NO in the presence of altered LDL. This will allow gaining insight not only on the development of atherosclerosis but also on the clue mechanisms involved in the pathogenesis of SLE.

Disclosure of Interests

None declared

Use of an Open-Source Software to Examine Low Skeletal Muscle Mass in Penile Cancer Patients: A Cross-Sectional Study

Purpose

Low skeletal muscle mass determined radiographically has emerged as an important prognostic marker in penile cancer patients but may be unrecognized in obese patients with a high comorbid disease burden. Moreover, publicly available software for image segmentation are limited. Thus, we describe the prevalence of radiographically low skeletal muscle mass in an obese penile cancer cohort, using an open-source software and examine its association with comorbid disease burden.

Methods

This is a cross-sectional study, utilizing retrospective data from patients diagnosed with penile squamous cell carcinoma between October 2009 and December 2019. Available digital files of perioperative computerized tomography were analyzed, using CoreSlicer, an open-source image segmentation software. The correlation between radiographically low skeletal muscle mass, defined as a skeletal muscle index (SMI) less than 55 cm2/m2 and a Charlson Comorbidity Index (CCI) greater than 4 was examined, using logistic and linear regression.

Results

Forty two of 59 patients had available digital files. Median SMI and body mass index (BMI) were 54.6cm2/m2 and 30.2kg/m2 respectively for the entire cohort. Of included patients, 54% had radiographically low skeletal muscle mass and a median BMI of 28.9 kg/m2. Radiographically low skeletal muscle mass was associated with a CCI greater than 4 on univariable and multivariable logistic regression with odds ratios of 4.85 (p = 0.041) and 7.32 (p = 0.033), respectively. When CCI was treated as a continuous variable on linear regression, the association between radiographically low skeletal muscle mass and CCI was positive, but not statistically significant with an estimated effect of 1.29 (p = 0.1) and 1.27 (p = 0.152) on univariable and multivariable analysis, respectively.

Conclusion

Our data demonstrate that low skeletal muscle mass can be readily assessed with CoreSlicer and is associated with a CCI greater than 4 in obese penile cancer patients.

0388 Predictors of Incident Reduced Sleep Efficiency in Community-Dwelling Older Women

Introduction

There is a paucity of longitudinal studies with sleep efficiency (SE) as an outcome measure. Our objective was to examine potential risk factors for incident reduced SE among community-dwelling women in late life.

Methods

We studied 700 women (mean age 82.5 [SD=3.0] years) with a SE ≥70% at the Year 16 (2002-04) visit of the Study of Osteoporotic Fractures with a follow-up measure of SE at the Year 20 (2006-08) visit. SE (percentage of time sleeping while in bed) at both visits was measured using a wrist actigraph with data collected for an average of four 24-hour periods. Women were classified as having incident reduced SE if they had SE <70% at Year 20. Logistic regression was used to estimate the associations between potential risk factors (demographics, lifestyle, use of medications, self-reported medical conditions, functional impairment, frailty, mental and physical health) at Year 16 and reduced SE at Year 20. The association of each candidate risk factor with reduced SE at Year 20 was examined in models adjusted for age, clinical site and continuous SE at Year 16. Candidate risk factors with Benjamin Hochberg false-discovery rate q-values <0.10 were included in a final multivariate model.

Results

Among the 700 eligible women, 62 (8.9%) developed incident reduced SE between the Year 16 and Year 20 visits. After adjusting for age, site and baseline SE, antidepressant use [OR=3.06; 95% CI: 1.50-6.25], benzodiazepine use [OR=2.97; 95% CI: 1.30-6.80] and the presence of hypertension [OR=2.83; 95% CI: 1.47-5.45] at Year 16 were independently associated with a higher odds of having reduced SE at follow-up.

Conclusion

These findings suggest that antidepressant use, benzodiazepine use and hypertension are risk factors or markers for the development of reduced sleep efficiency in older women. Future studies are warranted to examine the underlying mechanisms for these associations.

Support

The Study of Osteoporotic Fractures (SOF) is supported by National Institutes of Health funding. The National Institute on Aging (NIA) provides support under the following grant numbers: R01 AG005407, R01 AR35582, R01 AR35583, R01 AR35584, R01 AG005394, R01 AG027574, and R01 AG027576.

Volumetric laser endomicroscopy and its application to Barrett's esophagus: results from a 1,000 patient registry

Volumetric laser endomicroscopy (VLE) uses optical coherence tomography (OCT) for real-time, microscopic cross-sectional imaging. A US-based multi-center registry was constructed to prospectively collect data on patients undergoing upper endoscopy during which a VLE scan was performed. The objective of this registry was to determine usage patterns of VLE in clinical practice and to estimate quantitative and qualitative performance metrics as they are applied to Barrett's esophagus (BE) management. All procedures utilized the NvisionVLE Imaging System (NinePoint Medical, Bedford, MA) which was used by investigators to identify the tissue types present, along with focal areas of concern. Following the VLE procedure, investigators were asked to answer six key questions regarding how VLE impacted each case. Statistical analyses including neoplasia diagnostic yield improvement using VLE was performed. One thousand patients were enrolled across 18 US trial sites from August 2014 through April 2016. In patients with previously diagnosed or suspected BE (894/1000), investigators used VLE and identified areas of concern not seen on white light endoscopy (WLE) in 59% of the procedures. VLE imaging also guided tissue acquisition and treatment in 71% and 54% of procedures, respectively. VLE as an adjunct modality improved the neoplasia diagnostic yield by 55% beyond the standard of care practice. In patients with no prior history of therapy, and without visual findings from other technologies, VLE-guided tissue acquisition increased neoplasia detection over random biopsies by 700%. Registry investigators reported that VLE improved the BE management process when used as an adjunct tissue acquisition and treatment guidance tool. The ability of VLE to image large segments of the esophagus with microscopic cross-sectional detail may provide additional benefits including higher yield biopsies and more efficient tissue acquisition. Clinicaltrials.gov NCT02215291.

Abstract P5-22-10: Intraoperative ultrasound guided surgery after neoadjuvant treatment in breast cancer improves patient´s quality of life

Background: Intraoperative ultrasound guided surgery (IOUS) has shown not only to improve surgical outcomes by achieving higher rates of negative margins and reducing the need for re-excisions, but also showing better cosmetic results and patient's satisfaction in the adjuvant setting. After neoadjuvant treatments (NAT) we have shown that IOUS lowers the volume of resection in patients with pathologic complete response or minimal microscopic disease after NAT without compromising margins and local recurrences when compared to wire localization techniques (WL) The aim of this study was to determine if IOUS after NAT contributes to improve cosmetic outcomes and quality of life (QOL) when compared with WL.

Material and Methods. The pilot study enrolled patients treated with NAT who underwent breast-conserving surgery (BCS) between July 2008 and December 2012. On the follow up visit, cosmetic outcomes were assessed by the patient and surgeon on a 4 point Likert scale, by the Breast Cancer Conservative Treatment cosmetic results (BCCT.core) software, and by an independent panel. QOL was assessed using cancer-specific (EORTC QLQ-C30 and EORTC QLQ-B23) questionnaires.

Results. The study investigated 113 patients: 81 (71.6 %) in the IOUS group and 32 (28.3 %) in the WL group. The patient and tumor characteristics were comparable between the two groups. Mean follow up was 64 months (range, 12-90) in the WL group while 41 months (range, 18-107) in the IOUS group.

Cosmetic outcomes reported by the patient showed a tendency (p=0.07) for better results in the IOUS group. Patient reported cosmetic outcomes and the independent panel cosmetic evaluation significantly correlated with lumpectomy volume excised (p= 0.04, p = 0.02 respectively). The BCCT.core did not correlate with volume of tissue excised (p < 0.14). IOUS achieved better cosmetic outcomes compared to WL, with excellent outcomes of 30% and 19% respectively, although poor cosmetic outcomes were 3% and 0% respectively. Correlation between patients and surgeons evaluation regarding cosmetic outcomes and satisfaction was low (0.38 and 0.40 respectively). A comparison of the QOL scores of 113 patients showed a significantly better global health status (p = 0.03), better emotional and role function (p = 0.004), for patients with IOUS compared to WL patients.

Conclusions. This is the first study to show that breast volume excised significantly correlates with cosmetic outcomes in the neoadjuvant setting. These results suggest that IOUS after NAT contributes to a better quality of life and may influence cosmetic outcomes in breast cancer patients. Patient reported outcomes should be included in the quality assessment in breast surgery as the correlation with surgeons' evaluation is low.

Citation Format: Rubio IT, Rodriguez R, Esgueva-Colmenarejo A, Suarez M, Espinosa-Bravo M, Siso C, Cordoba O, Alvarado S, Volders J, Van Den Tol P. Intraoperative ultrasound guided surgery after neoadjuvant treatment in breast cancer improves patient´s quality of life [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-22-10.

Enhancement of Quasistationary Shocks and Heating via Temporal Staging in a Magnetized Laser-Plasma Jet

We investigate the formation of a laser-produced magnetized jet under conditions of a varying mass ejection rate and a varying divergence of the ejected plasma flow. This is done by irradiating a solid target placed in a 20 T magnetic field with, first, a collinear precursor laser pulse (10^{12}  W/cm^{2}) and, then, a main pulse (10^{13}  W/cm^{2}) arriving 9-19 ns later. Varying the time delay between the two pulses is found to control the divergence of the expanding plasma, which is shown to increase the strength of and heating in the conical shock that is responsible for jet collimation. These results show that plasma collimation due to shocks against a strong magnetic field can lead to stable, astrophysically relevant jets that are sustained over time scales 100 times the laser pulse duration (i.e., >70  ns), even in the case of strong variability at the source.

Counterpropagating Radiative Shock Experiments on the Orion Laser

We present new experiments to study the formation of radiative shocks and the interaction between two counterpropagating radiative shocks. The experiments are performed at the Orion laser facility, which is used to drive shocks in xenon inside large aspect ratio gas cells. The collision between the two shocks and their respective radiative precursors, combined with the formation of inherently three-dimensional shocks, provides a novel platform particularly suited for the benchmarking of numerical codes. The dynamics of the shocks before and after the collision are investigated using point-projection x-ray backlighting while, simultaneously, the electron density in the radiative precursor was measured via optical laser interferometry. Modeling of the experiments using the 2D radiation hydrodynamic codes nym and petra shows very good agreement with the experimental results.