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Waller S, Stockwell J, Tay T, Pamphlett R, Beuzeville S, Huynh W. FKRP-related muscular dystrophy responsive to immunotherapy. Muscle Nerve 2024; 69:735-737. [PMID: 38556796 DOI: 10.1002/mus.28089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/03/2024] [Accepted: 03/10/2024] [Indexed: 04/02/2024]
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Housh AB, Powell G, Scott S, Anstaett A, Gerheart A, Benoit M, Waller S, Powell A, Guthrie JM, Higgins B, Wilder SL, Schueller MJ, Ferrieri RA. Functional mutants of Azospirillum brasilense elicit beneficial physiological and metabolic responses in Zea mays contributing to increased host iron assimilation. THE ISME JOURNAL 2021; 15:1505-1522. [PMID: 33408368 PMCID: PMC8115672 DOI: 10.1038/s41396-020-00866-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 10/28/2020] [Accepted: 12/03/2020] [Indexed: 01/29/2023]
Abstract
Iron (Fe), an essential element for plant growth, is abundant in soil but with low bioavailability. Thus, plants developed specialized mechanisms to sequester the element. Beneficial microbes have recently become a favored method to promote plant growth through increased uptake of essential micronutrients, like Fe, yet little is known of their mechanisms of action. Functional mutants of the epiphytic bacterium Azospirillum brasilense, a prolific grass-root colonizer, were used to examine mechanisms for promoting iron uptake in Zea mays. Mutants included HM053, FP10, and ipdC, which have varying capacities for biological nitrogen fixation and production of the plant hormone auxin. Using radioactive iron-59 tracing and inductively coupled plasma mass spectrometry, we documented significant differences in host uptake of Fe2+/3+ correlating with mutant biological function. Radioactive carbon-11, administered to plants as 11CO2, provided insights into shifts in host usage of 'new' carbon resources in the presence of these beneficial microbes. Of the mutants examined, HM053 exhibited the greatest influence on host Fe uptake with increased plant allocation of 11C-resources to roots where they were transformed and exuded as 11C-acidic substrates to aid in Fe-chelation, and increased C-11 partitioning into citric acid, nicotianamine and histidine to aid in the in situ translocation of Fe once assimilated.
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Ohuma EO, Villar J, Feng Y, Xiao L, Salomon L, Barros FC, Cheikh Ismail L, Stones W, Jaffer Y, Oberto M, Noble JA, Gravett MG, Wu Q, Victora CG, Lambert A, Di Nicola P, Purwar M, Bhutta ZA, Kennedy SH, Papageorghiou AT, Katz M, Bhan M, Garza C, Zaidi S, Langer A, Rothwell P, Weatherall SD, Bhutta Z, Villar J, Kennedy S, Altman D, Barros F, Bertino E, Burton F, Carvalho M, Cheikh Ismail L, Chumlea W, Gravett M, Jaffer Y, Lambert A, Lumbiganon P, Noble J, Pang R, Papageorghiou A, Purwar M, Rivera J, Victora C, Villar J, Altman D, Bhutta Z, Cheikh Ismail L, Kennedy S, Lambert A, Noble J, Papageorghiou A, Villar J, Kennedy S, Cheikh Ismail L, Lambert A, Papageorghiou A, Shorten M, Hoch L, Knight H, Ohuma E, Cosgrove C, Blakey I, Altman D, Ohuma E, Villar J, Altman D, Roseman F, Kunnawar N, Gu S, Wang J, Wu M, Domingues M, Gilli P, Juodvirsiene L, Hoch L, Musee N, Al-Jabri H, Waller S, Cosgrove C, Muninzwa D, Ohuma E, Yellappan D, Carter A, Reade D, Miller R, Papageorghiou A, Salomon L, Leston A, Mitidieri A, Al-Aamri F, Paulsene W, Sande J, Al-Zadjali W, Batiuk C, Bornemeier S, Carvalho M, Dighe M, Gaglioti P, Jacinta N, Jaiswal S, Noble J, Oas K, Oberto M, Olearo E, Owende M, Shah J, Sohoni S, Todros T, Venkataraman M, Vinayak S, Wang L, Wilson D, Wu Q, Zaidi S, Zhang Y, Chamberlain P, Danelon D, Sarris I, Dhami J, Ioannou C, Knight C, Napolitano R, Wanyonyi S, Pace C, Mkrtychyan V, Cheikh Ismail L, Chumlea W, Al-Habsi F, Bhutta Z, Carter A, Alija M, Jimenez-Bustos J, Kizidio J, Puglia F, Kunnawar N, Liu H, Lloyd S, Mota D, Ochieng R, Rossi C, Sanchez Luna M, Shen Y, Knight H, Rocco D, Frederick I, Bhutta Z, Albernaz E, Batra M, Bhat B, Bertino E, Di Nicola P, Giuliani F, Rovelli I, McCormick K, Ochieng R, Pang R, Paul V, Rajan V, Wilkinson A, Varalda A, Eskenazi B, Corra L, Dolk H, Golding J, Matijasevich A, de Wet T, Zhang J, Bradman A, Finkton D, Burnham O, Farhi F, Barros F, Domingues M, Fonseca S, Leston A, Mitidieri A, Mota D, Sclowitz I, da Silveira M, Pang R, He Y, Pan Y, Shen Y, Wu M, Wu Q, Wang J, Yuan Y, Zhang Y, Purwar M, Choudhary A, Choudhary S, Deshmukh S, Dongaonkar D, Ketkar M, Khedikar V, Kunnawar N, Mahorkar C, Mulik I, Saboo K, Shembekar C, Singh A, Taori V, Tayade K, Somani A, Bertino E, Di Nicola P, Frigerio M, Gilli G, Gilli P, Giolito M, Giuliani F, Oberto M, Occhi L, Rossi C, Rovelli I, Signorile F, Todros T, Stones W, Carvalho M, Kizidio J, Ochieng R, Shah J, Vinayak S, Musee N, Kisiang’ani C, Muninzwa D, Jaffer Y, Al-Abri J, Al-Abduwani J, Al-Habsi F, Al-Lawatiya H, Al-Rashidiya B, Al-Zadjali W, Juangco F, Venkataraman M, Al-Jabri H, Yellappan D, Kennedy S, Cheikh Ismail L, Papageorghiou A, Roseman F, Lambert A, Ohuma E, Lloyd S, Napolitano R, Ioannou C, Sarris I, Gravett M, Batiuk C, Batra M, Bornemeier S, Dighe M, Oas K, Paulsene W, Wilson D, Frederick I, Andersen H, Abbott S, Carter A, Algren H, Rocco D, Sorensen T, Enquobahrie D, Waller S. Fetal growth velocity standards from the Fetal Growth Longitudinal Study of the INTERGROWTH-21 st Project. Am J Obstet Gynecol 2021; 224:208.e1-208.e18. [PMID: 32768431 PMCID: PMC7858163 DOI: 10.1016/j.ajog.2020.07.054] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/23/2020] [Accepted: 07/29/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Human growth is susceptible to damage from insults, particularly during periods of rapid growth. Identifying those periods and the normative limits that are compatible with adequate growth and development are the first key steps toward preventing impaired growth. OBJECTIVE This study aimed to construct international fetal growth velocity increment and conditional velocity standards from 14 to 40 weeks' gestation based on the same cohort that contributed to the INTERGROWTH-21st Fetal Growth Standards. STUDY DESIGN This study was a prospective, longitudinal study of 4321 low-risk pregnancies from 8 geographically diverse populations in the INTERGROWTH-21st Project with rigorous standardization of all study procedures, equipment, and measurements that were performed by trained ultrasonographers. Gestational age was accurately determined clinically and confirmed by ultrasound measurement of crown-rump length at <14 weeks' gestation. Thereafter, the ultrasonographers, who were masked to the values, measured the fetal head circumference, biparietal diameter, occipitofrontal diameter, abdominal circumference, and femur length in triplicate every 5 weeks (within 1 week either side) using identical ultrasound equipment at each site (4-7 scans per pregnancy). Velocity increments across a range of intervals between measures were modeled using fractional polynomial regression. RESULTS Peak velocity was observed at a similar gestational age: 16 and 17 weeks' gestation for head circumference (12.2 mm/wk), and 16 weeks' gestation for abdominal circumference (11.8 mm/wk) and femur length (3.2 mm/wk). However, velocity growth slowed down rapidly for head circumference, biparietal diameter, occipitofrontal diameter, and femur length, with an almost linear reduction toward term that was more marked for femur length. Conversely, abdominal circumference velocity remained relatively steady throughout pregnancy. The change in velocity with gestational age was more evident for head circumference, biparietal diameter, occipitofrontal diameter, and femur length than for abdominal circumference when the change was expressed as a percentage of fetal size at 40 weeks' gestation. We have also shown how to obtain accurate conditional fetal velocity based on our previous methodological work. CONCLUSION The fetal skeleton and abdomen have different velocity growth patterns during intrauterine life. Accordingly, we have produced international Fetal Growth Velocity Increment Standards to complement the INTERGROWTH-21st Fetal Growth Standards so as to monitor fetal well-being comprehensively worldwide. Fetal growth velocity curves may be valuable if one wants to study the pathophysiology of fetal growth. We provide an application that can be used easily in clinical practice to evaluate changes in fetal size as conditional velocity for a more refined assessment of fetal growth than is possible at present (https://lxiao5.shinyapps.io/fetal_growth/). The application is freely available with the other INTERGROWTH-21st tools at https://intergrowth21.tghn.org/standards-tools/.
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Redwood A, Douzgou S, Waller S, Ramsden S, Roberts A, Bonin H, Lloyd IC, Ashworth J, Black GCM, Clayton-Smith J. Congenital cataracts in females caused by BCOR mutations; report of six further families demonstrating clinical variability and diverse genetic mechanisms. Eur J Med Genet 2019; 63:103658. [PMID: 31048080 DOI: 10.1016/j.ejmg.2019.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/26/2019] [Accepted: 04/28/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pathogenic variants in the BCOR gene have been identified in males with X-linked recessive microphthalmia and in females with X-linked dominant oculofaciocardiodental (OFCD) syndrome. This latter condition has previously been regarded as rare but the increased availability of genetic testing in recent years has led to the identification of a greater number of patients. METHODS We report the clinical and molecular findings in a series of 10 patients with pathogenic BCOR variants from 5 families, all seen in a single institution over a two year period. RESULTS We emphasize the phenotypic variability in this cohort and the diverse genetic mechanisms involved which included point mutations and deletions of BCOR as well as the occurrence of gonadal and somatic mosaicism. CONCLUSION In this report we demonstrate the novel findings of four newly identified variants in BCOR associated with an OFCD phenotype, and suggest that the frequency of this condition in females presenting with congenital cataract, including unilateral cataract, is more common than anticipated. We demonstrate the utility of screening for genetic causes of congenital cataract. Although gonadal mosaicism in OFCD had previously been reported, we demonstrate the presence of somatic mosaicism where BCOR mutations may only be detected in DNA from tissues other than blood such as buccal cells.
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Ward B, Reupert A, McCormick F, Waller S, Kidd S. Family-focused practice within a recovery framework: practitioners' qualitative perspectives. BMC Health Serv Res 2017; 17:234. [PMID: 28340614 PMCID: PMC5364722 DOI: 10.1186/s12913-017-2146-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 03/08/2017] [Indexed: 11/27/2022] Open
Abstract
Background Family-focused practice (FFP) is an effective approach to supporting individuals with mental illness. ‘Recovery’ is also central to contemporary mental health care. However, there is a dearth of evidence about how the two concepts are related and subsequently implemented in practice. The aim of this study was to explore practitioners’ understandings and practices of FFP within a recovery framework. Methods Purposive/snowball sampling was used to recruit and conduct qualitative interviews with 11 mental health practitioners in rural Australia. Concurrent sampling and data collection were informed by thematic analysis and continued until data saturation was reached. Results Participants found it difficult to articulate their understandings of FFP within a recovery framework. Nonetheless they were able to describe practices that embodied family-focused recovery. Barriers to such practices included medical models of care, where there are often a shortage of skilled staff and high demands for care. Stigma (self and from others) and confidentiality were also identified as barriers to involving family members in recovery focused care. Conclusions Family-focused recovery care is a priority in many high-income countries. A family-focused recovery framework is needed to assist service planners, practitioners, family members and those with mental health needs and ensure such care is embedded within practice guidelines. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2146-y) contains supplementary material, which is available to authorized users.
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Piper DW, Greig M, Landecker KD, Shinners J, Waller S, Canalese J. Analgesic Intake and Chronic Gastric Ulcer. Acute Upper Gastrointestinal Haemorrhage, Personality Traits and Social Class. Proc R Soc Med 2016. [DOI: 10.1177/00359157770700s704] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Musleh M, Hall G, Lloyd IC, Gillespie RL, Waller S, Douzgou S, Clayton-Smith J, Kehdi E, Black GCM, Ashworth J. Diagnosing the cause of bilateral paediatric cataracts: comparison of standard testing with a next-generation sequencing approach. Eye (Lond) 2016; 30:1175-81. [PMID: 27315345 DOI: 10.1038/eye.2016.105] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 04/13/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeIn addition to environmental causes such as TORCH infection, trauma and drug or chemical exposure, childhood cataracts (CC) frequently have a genetic basis. They may be isolated or syndromic and have been associated with mutations in over 110 genes. We have recently demonstrated that next-generation sequencing (NGS), a high throughput sequencing technique that enables the parallel sequencing of multiple genes, is ideally suited to the investigation of bilateral CC. This study assesses the diagnostic outcomes of traditional routine investigations and compares this with outcomes of NGS testing.MethodsA retrospective review of the medical records of 27 consecutive patients with bilateral CC presenting in 2010-2012 was undertaken. The outcomes of routine investigations in these patients, including TORCH screen, urinalysis, karyotyping, and urinary and plasma organic amino acids, were collated. The success of routine genetic investigations undertaken over 10 years (2000-2010) was also assessed.ResultsBy April 2014, the underlying cause of bilateral CC had been identified in just one of 27 patients despite 44% (n=12) receiving a full 'standard' investigative work-up and 22% (n=6) investigations in addition to the standard work-up. Fifteen of these patients underwent NGS testing and nine (60%) of these received a diagnosis for their CC.ConclusionThe frequency of patients receiving a diagnosis for their CC after standard care and the time taken to diagnosis was disappointing. NGS testing improved diagnostic rates and time to diagnosis, as well as changing clinical management. These data serve as a baseline for future evaluation of novel diagnostic modalities.
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Nettle R, Ayre M, Beilin R, Waller S, Turner L, Hall A, Irvine L, Taylor G. Empowering farmers for increased resilience in uncertain times. ANIMAL PRODUCTION SCIENCE 2015. [DOI: 10.1071/an14882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
As farmers continue to face increasingly uncertain and often rapidly changing conditions related to markets, climate or the policy environment, people involved in agricultural research, development and extension (RD&E) are also challenged to consider how their work can contribute to supporting farmer resilience. Research from the social sciences conducted in the past decade has focussed on adaptability or adaptive capacity as a key attribute for individuals and groups to possess for managing resilience. It is, therefore, timely to ask the following: do current ways of doing and organising RD&E in the dairy sector in New Zealand and Australia contribute to supporting farm adaptability? This paper reports on results from an examination of case studies of challenges to resilience in the dairy sector in Australia and New Zealand (i.e. dairy farm conversion, climate-change adaptation, consent to farm) and the contribution of dairy RD&E in enhancing resilience of farmers, their farms and the broader industry. Drawing on concepts from resilience studies and considering an empowerment perspective, the analysis of these cases suggest that, currently, agricultural RD&E supports adaptability in general, but varies in the strength of its presence and level of activity in the areas known to enhance adaptability. This analysis is used to generate principles for dairy scientists and others in the RD&E system to consider in (1) research designs, (2) engaging different farmers in research and (3) presenting research results differently. This represents a significant shift for the science and advisory communities to move to methods that acknowledge uncertainty and facilitate learning.
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Waller S, Raglow Z, Lemons S, Johnson P, Eid A, Schmitt T, Smothers J, O'Neil M, Gilroy R. Microwave ablation of a large renal aspergilloma. Transpl Infect Dis 2014; 16:496-500. [DOI: 10.1111/tid.12221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 12/19/2013] [Accepted: 01/08/2014] [Indexed: 11/28/2022]
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Sinha MD, Turner C, Dalton RN, Rasmussen P, Waller S, Booth CJ, Goldsmith DJ. Investigating FGF-23 concentrations and its relationship with declining renal function in paediatric patients with pre-dialysis CKD Stages 3-5. Nephrol Dial Transplant 2012; 27:4361-8. [DOI: 10.1093/ndt/gfs109] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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Goto S, Fujii H, Kono K, Nakai K, Hamada Y, Yamato H, Shinohara M, Kitazawa R, Kitazawa S, Nishi S, Fukagawa M, Stevens K, Beattie E, Sands W, Delles C, Jardine A, Masai H, Joki N, Kunimasa T, Furuhashi T, Fukuda H, Sugi K, Moroi M, Sinha MD, Turner C, Dalton RN, Rasmussen P, Waller S, Booth CJ, Goldsmith DJ, Van Zuilen A, Blankestijn P, Van Buren M, Ten Dam M, Kaasjager H, Ligtenberg G, Sijpkens Y, Sluiter H, Van de Ven P, Vervoort G, Vleming L, Bots M, Wetzels J. CKD / Mineral bone disease. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Foster JH, Herring R, Waller S, Thom B. The Licensing Act 2003: A step in the right direction? JOURNAL OF SUBSTANCE USE 2009. [DOI: 10.1080/14659890802654532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jeffrey S, Richards J, Ciravegna F, Waller S, Chapman S, Zhang Z. The Archaeotools project: faceted classification and natural language processing in an archaeological context. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2009; 367:2507-2519. [PMID: 19451106 DOI: 10.1098/rsta.2009.0038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This paper describes 'Archaeotools', a major e-Science project in archaeology. The aim of the project is to use faceted classification and natural language processing to create an advanced infrastructure for archaeological research. The project aims to integrate over 1 x 10(6) structured database records referring to archaeological sites and monuments in the UK, with information extracted from semi-structured grey literature reports, and unstructured antiquarian journal accounts, in a single faceted browser interface. The project has illuminated the variable level of vocabulary control and standardization that currently exists within national and local monument inventories. Nonetheless, it has demonstrated that the relatively well-defined ontologies and thesauri that exist in archaeology mean that a high level of success can be achieved using information extraction techniques. This has great potential for unlocking and making accessible the information held in grey literature and antiquarian accounts, and has lessons for allied disciplines.
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Waller S, Thyagarajan S, Kaplan F, Viljoen A. Dramatic resolution of massive retinal hard exudates after correction of extreme dyslipidaemia. Eye (Lond) 2009; 23:738. [DOI: 10.1038/eye.2008.109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Baskin D, Waller S. Implantation of collagen punctal plugs for the reduction of post-keratoplasty ametropia. Nepal J Ophthalmol 2009; 1:72-4. [PMID: 21141024 DOI: 10.3126/nepjoph.v1i1.3676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In 1995, a 46-year-old woman was referred for refractive surgery. Eleven years earlier, she had undergone an uncomplicated penetrating keratoplasty in her right eye to treat a dense corneal opacity caused by contact lens-related microbial keratitis. Due to high myopia in the graft, she was unable to achieve useful vision and declined contact lens use. After extensive counseling, she elected to undergo radial keratotomy (RK) and arcuate keratotomy (AK) in her right eye. We recommended the insertion of collagen punctal plugs into the keratotomy incisions to increase the RK effect. She also decided to have RK in her left eye. Postoperatively, her uncorrected visual acuity was 20/25 OD and 20/30 OS. We were able to contact her and her ophthalmologist eleven years later, and eight of eleven collagen plugs were still present in the incisions, with no signs of rejection or inflammation. Later, we learned that she underwent a repeat penetrating keratoplasty due to corneal graft failure after a phacoemulsification procedure. The pathologic examination of the intact plugs and graft also showed no rejection or inflammation.
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Steward WP, Middleton M, Benghiat A, Loadman PM, Hayward C, Waller S, Ford S, Halbert G, Patterson LH, Talbot D. The use of pharmacokinetic and pharmacodynamic end points to determine the dose of AQ4N, a novel hypoxic cell cytotoxin, given with fractionated radiotherapy in a phase I study. Ann Oncol 2007; 18:1098-103. [PMID: 17442658 DOI: 10.1093/annonc/mdm120] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AQ4N (1,4-bis[[2-(dimethylamino)ethyl] amino]-5,8-dihydroxyanthracene-9, 10-dione bis-N-oxide dihydrochloride) is a prodrug which is selectively activated within hypoxic tissues to AQ4, a topoisomerase II inhibitor and DNA intercalator. PATIENTS AND METHODS In the phase I study, 22 patients with oesophageal carcinoma received an i.v. infusion of AQ4N (22.5-447 mg/m(2)) followed, 2 weeks later, by further infusion and radiotherapy. Pharmacokinetics and lymphocyte AQ4N and AQ4 levels were measured after the first dose. At 447 mg/m(2), biopsies of tumour and normal tissue were taken after AQ4N administration. RESULTS Drug-related adverse events were blue discolouration of skin and urine, grade 2-3 lymphopenia, grade 1-3 fatigue, grade 1-2 anaemia, leucopenia and nausea. There were no drug-related serious adverse events (SAEs). Three patients had reductions in tumour volume >50%, nine had stable disease. Pharmacokinetics indicated predictable clearance. Plasma area under the curve (AUC) at 447 mg/m(2) exceeded AQ4N concentrations in mice at therapeutic doses and tumour biopsies contained concentrations of AQ4 greater than those in normal tissue. Tumour concentrations of AQ4 exceeded in vitro IC(50) values for most cell lines investigated. CONCLUSIONS No dose-limiting toxic effects were observed and a maximum tolerated dose was not established. Tumour AQ4 concentrations and plasma AUC at 447 mg/m(2) exceeded active levels in preclinical models. This dose was chosen for future studies with radiotherapy.
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Ganguly N, Waller S, Stasik CJ, Skikne BS, Ganguly S. Giant anal condylomatosis after allogeneic bone marrow transplantation: a rare complication of human papilloma virus infection. Transpl Infect Dis 2007; 10:56-8. [PMID: 17511821 DOI: 10.1111/j.1399-3062.2007.00233.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Condyloma acuminata or genital warts are caused by human papilloma virus (HPV). Ongoing proliferation of HPV in patients with congenital or acquired immunodeficiency states leads to the development of rapidly progressive and sometimes locally invasive tumor with or without dysplasia. Aggressive treatment, diagnostic immuno-typing, and follow-up are necessary in patients with ongoing immunosuppression. We report a case of giant ano-genital condylomatosis due to HPV types 6 and 11 in a patient with chronic myeloid leukemia after allogeneic bone marrow transplantation. The tumor was successfully treated with surgical excision and local application of 5% imiquimod cream.
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Jameson MB, Baguley BC, Kestell P, Zhao L, Paxton JW, Thompson PI, Waller S. Pharmacokinetics of 5,6-dimethylxanthenone-4-acetic acid (AS1404), a novel vascular disrupting agent, in phase I clinical trial. Cancer Chemother Pharmacol 2006; 59:681-7. [PMID: 17021822 DOI: 10.1007/s00280-006-0322-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2006] [Accepted: 08/04/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE 5,6-Dimethylxanthenone-4-acetic acid (DMXAA) (AS1404) is a novel antitumour agent that selectively disrupts tumour vasculature and induces cytokines. The purpose of this study was to determine the pharmacokinetics (PK) of DMXAA in cancer patients enrolled in a phase I clinical trial. METHODS DMXAA was administered as a 20-min i.v. infusion every 3 weeks and doses were escalated in cohorts of patients according to a predefined schema. PK samples were taken over the first 24 h of at least the first cycle. RESULTS DMXAA was administered to 63 patients at 19 dose levels from 6 to 4,900 mg m(-2), and 3,700 mg m(-2) was established as the maximum tolerated dose. The PK observed over the dose range showed a non-linear fall in clearance from 16.1 to 1.42 l h(-1) m(-2) and resultant increase in the area under the concentration-time curve (AUC) from 1.29 to 12,400 microM h. In contrast, the increase in peak plasma concentrations from 2.17 to 1,910 microM approximated linearity. DMXAA was highly protein-bound to albumin (>99%) until saturation occurred at higher doses, leading to a rapid increase in the free fraction (up to 20%) and greater concentrations of DMXAA bound to non-albumin proteins. However, the main determinant of the non-linearity of the PK appeared to be sequential saturation of elimination mechanisms, which include hydroxylation, glucuronidation and perhaps hepatic transport proteins. This resulted in an exaggerated non-linear increase in free DMXAA plasma concentrations and AUC compared to total drug. CONCLUSIONS The PK of DMXAA are well-defined, with a consistent degree of non-linearity across a very large dose range.
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Waller S, Tremelling M, Bredin F, Godfrey L, Howson J, Parkes M. Evidence for association of OCTN genes and IBD5 with ulcerative colitis. Gut 2006; 55:809-14. [PMID: 16361305 PMCID: PMC1856215 DOI: 10.1136/gut.2005.084574] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Genetic association between Crohn's disease (CD) and OCTN1 (SLC22A4) C1672T/OCTN2 (SLC22A5) G-207C variants in IBD5 has recently been reported. These genes encode solute carriers and the association was suggested to be distinct from the background IBD5 risk haplotype. There have been conflicting reports of the association between markers in the IBD5 region and ulcerative colitis (UC) and interaction (epistasis) between this locus and CARD15. Our aim was to ascertain the contribution of OCTN variants to UC and CD in a large independent UK dataset, to seek genetic evidence that the OCTN association is distinct from the IBD5 risk haplotype and to identify interactions between the IBD5 and CARD15 loci. METHODS A total of 1104 unrelated Caucasian subjects with inflammatory bowel disease (IBD) (496 CD, 512 UC, 96 indeterminate) and 750 ethnically matched controls were genotyped for three single nucleotide polymorphisms (SNPs) in the CD associated genes (OCTN1+1672, OCTN2-207, and IGR2230), and two flanking IBD5 tagging SNPs, IGR2096 and IGR3096. Data were analysed by logistic regression methods within STATA. RESULTS OCTN variants were as strongly associated with UC and IBD overall as they were with CD (p = 0.0001; OR 1.3 (95% confidence interval 1.1-1.5)). OCTN variants were in tight linkage disequilibrium with the extended IBD5 risk haplotype D' 0.79 and 0.88, and r2 = 0.62 and 0.72 for IGR2096 and 3096, respectively. There was no deviation from a multiplicative model of interaction between CARD15 and IBD5 on the penetrance scale. CONCLUSIONS The OCTN variants were associated with susceptibility to IBD overall. The effect was equally strong in UC and CD. Although OCTN variants may account for the increased risk of IBD associated with IBD5, a role for other candidate genes within this extended haplotype was not excluded. There was no statistical evidence of interaction between CARD15 and either OCTN or IBD5 variants in susceptibility to IBD.
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Waterston AM, Gumbrell L, Bratt T, Waller S, Gustav-Aspland J, L'hermenier C, Bellenger K, Campbell M, Powles T, Highley M, Bower M, Mouritsen S, Feldmann M, Coombes RC. Phase I study of TNFalpha AutoVaccIne in patients with metastatic cancer. Cancer Immunol Immunother 2005; 54:848-57. [PMID: 15754205 PMCID: PMC11032879 DOI: 10.1007/s00262-005-0661-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2004] [Accepted: 12/18/2004] [Indexed: 11/28/2022]
Abstract
We evaluated the safety and immunogencity of a novel vaccine directed against autologous TNFalpha in a Phase I fixed dose escalation trial. The vaccine consisted of two recombinant TNFalpha proteins, with specific peptides replaced by foreign immunodominant T cell epitopes from tetanus toxoid. The main objectives were to establish a safe dose and evaluate the vaccines ability to raise neutralising TNFalpha antibodies. Secondary objectives were improvements in body weight and tumour response. Thirty-three patients were vaccinated with three doses (20, 100, or 400 mug) of TNFalpha vaccine at 2-weekly intervals adjuvanted with aluminium hydroxide. Anti-TNFalpha antibody titres were measured by both a RIA, using soluble native TNFalpha as the antigen, and by an ELISA using immobilized partly denatured TNFalpha. Eleven patients (33%) had mild grade1/2 injection site reactions at the higher doses. In 10 of 20 patients, serum antibodies recognize denatured TNFalpha in the ELISA, whereas, antibody titres against native TNFalpha in the RIA were undetectable. This suggests that the production process had partly denatured the vaccine preventing the formation of cross-reacting antibodies to native TNFalpha. In conclusion, TNFalpha vaccine was able to elicit vaccine specific antibodies. However, since the antibodies were only able to cross-react with partly denatured TNFalpha, evaluation of safety and tumour responses to the TNFalpha vaccine was compromised.
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Rustin GJS, Bradley C, Galbraith S, Stratford M, Loadman P, Waller S, Bellenger K, Gumbrell L, Folkes L, Halbert G. 5,6-dimethylxanthenone-4-acetic acid (DMXAA), a novel antivascular agent: phase I clinical and pharmacokinetic study. Br J Cancer 2003; 88:1160-7. [PMID: 12698178 PMCID: PMC2747563 DOI: 10.1038/sj.bjc.6600885] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The purpose of this phase I, dose-escalation study was to determine the toxicity, maximum tolerated dose, pharmacokinetics, and pharmacodynamic end points of 5,6-dimethylxanthenone acetic acid (DMXAA). In all, 46 patients received a total of 247 infusions of DMXAA over 15 dose levels ranging from 6 to 4900 mg x m(-2). The maximum tolerated dose was established at 3700 mg x m(-2); dose-limiting toxicities in the form of urinary incontinence, visual disturbance, and anxiety were observed at the highest dose level (4900 mg x m(-2)). The pharmacokinetics of DMXAA were dose dependent. Peak concentrations and area under the curve level increased from 4.8 microM and 3.2 microM h, respectively, at 6 mg x m(-2) to 1290 microM and 7600 microM h at 3700 mg x m(-2), while clearance declined from 7.4 to 1.7 l h(-1) x m(-2) over the same dose range. The terminal half-life was 8.1+/-4.3 h. More than 99% of the drug was protein bound at doses up to 320 mg x m(-2); at higher doses the percent free drug increased to a maximum of 6.9% at 4900 mg x m(-2). Dose-dependent increases in the serotonin metabolite 5-hydroxyindoleacetic acid were observed at dose levels of 650 mg x m(-2) and above. There was one unconfirmed partial response at 1300 mg x m(-2). In conclusion, DMXAA is a novel vascular targeting agent and is well tolerated.
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Davies J, Waller S, Zeng Q, Wells S, Murphy D. Further delineation of the sequences required for the expression and physiological regulation of the vasopressin gene in transgenic rat hypothalamic magnocellular neurones. J Neuroendocrinol 2003; 15:42-50. [PMID: 12535168 DOI: 10.1046/j.1365-2826.2003.00865.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We have introduced transgenes into rats with a view to defining genomic regions that mediate the cell-specific and physiological regulation of the vasopressin gene. These transgenes consist of the rat vasopressin structural gene with a reporter inserted into exon III, flanked by different lengths of upstream and downstream sequences. 11-VCAT-3 is flanked by 11 kbp of upstream sequences and 3 kbp of downstream sequences. The previously described 5-VCAT-3 is flanked by 5 kbp of upstream and 3 kbp of downstream sequences. 3-VCAT-3 has 3 kbp of upstream and 3 kbp of downstream sequences, and 3-VCAT-0.2 is flanked by 3 kbp of upstream and 0.2 kbp of downstream sequences. All four transgenes elicit the same expression patterns; low basal expression is seen in the magnocellular supraoptic and paraventricular nuclei, and is negligible in the suprachiasmatic nucleus. Expression increases markedly in vasopressin magnocellular cells following dehydration. The sequences responsible for the cell-specific expression and physiological regulation of our transgenes thus reside within the confines of the smallest construct studied, 3-VCAT-0.2.
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Lipchik GL, Holroyd KA, O'Donnell FJ, Cordingley GE, Waller S, Labus J, Davis MK, French DJ. Exteroceptive suppression periods and pericranial muscle tenderness in chronic tension-type headache: effects of psychopathology, chronicity and disability. Cephalalgia 2000; 20:638-46. [PMID: 11128821 DOI: 10.1111/j.1468-2982.2000.00105.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
We examined pericranial muscle tenderness and abnormalities in the second exteroceptive suppression period (ES2) of the temporalis muscle in chronic tension-type headache (CTTH; n = 245) utilizing a blind design and methods to standardize the elicitation and scoring of these variables. No ES2 variable differed significantly between CTTH sufferers and controls (all tests, P>0.05). We found no evidence that CTTH sufferers with daily or near daily headaches, a mood or an anxiety disorder, or high levels of disability exhibit abnormal ES2 responses (all tests, P>0.05). CTTH sufferers were significantly more likely than controls to exhibit pervasive tenderness in pericranial muscles examined with standardized (500 g force) manual palpation (P<0.005). Female CTTH sufferers exhibited higher levels of pericranial muscle tenderness than male CTTH sufferers at the same level of headache activity (P<0.0001). Elevated pericranial muscle tenderness was associated with a comorbid anxiety disorder. These findings provide further evidence of pericranial hyperalgesia in CTTH and suggest this phenomenon deserves further study. Basic research that better elucidates the biological significance of the ES2 response and the factors that influence ES2 assessments appears necessary before this measure can be of use in clinical research.
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Lipchik GL, Holroyd KA, O'donnell FJ, Cordingley GE, Waller S, Labus J, Davis MK, French DJ. Exteroceptive suppression periods and pericranial muscle tenderness in chronic tension-type headache: effects of psychopathology, chronicity and disability. Cephalalgia 2000. [DOI: 10.1046/j.1468-2982.2000.00105.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Murphy D, Xu J, Waller S. Transgenic studies in rats and mice on the osmotic regulation of vasopressin gene expression. Exp Physiol 2000; 85 Spec No:211S-222S. [PMID: 10795925 DOI: 10.1111/j.1469-445x.2000.tb00026.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Over the past 10-15 years, profoundly important transgenic techniques have been developed that enable new genes to be introduced into whole mammalian organisms. This review describes the ways in which transgenic animals, both rats and mice, have been used to study the mechanisms by which the expression of the vasopressin gene is confined to specific neurones in the hypothalamus, and how the pattern of that expression is altered following an osmotic challenge to the organism.
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