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Stevens A, Bonshek C, Whatmore A, Butcher I, Hanson D, De Leonibus C, Shaikh G, Brown M, O'Shea E, Victor S, Powell P, Settle P, Padmakumar B, Tan A, Odeka E, Cooper C, Birch J, Shenoy A, Westwood M, Patel L, Dunn BW, Clayton P. Insights into the pathophysiology of catch-up compared with non-catch-up growth in children born small for gestational age: an integrated analysis of metabolic and transcriptomic data. THE PHARMACOGENOMICS JOURNAL 2014; 14:376-84. [PMID: 24614687 DOI: 10.1038/tpj.2014.4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 12/07/2013] [Accepted: 01/09/2014] [Indexed: 12/11/2022]
Abstract
Small for gestational age (SGA) children exhibiting catch-up (CU) growth have a greater risk of cardiometabolic diseases in later life compared with non-catch-up (NCU) SGA children. The aim of this study was to establish differences in metabolism and gene expression profiles between CU and NCU at age 4-9 years. CU children (n=22) had greater height, weight and body mass index standard deviation scores along with insulin-like growth factor-I (IGF-I) and fasting glucose levels but lower adiponectin values than NCU children (n=11; all P<0.05). Metabolic profiling demonstrated a fourfold decrease of urine myo-inositol in CU compared with NCU (P<0.05). There were 1558 genes differentially expressed in peripheral blood mononuclear cells between the groups (P<0.05). Integrated analysis of data identified myo-inositol related to gene clusters associated with an increase in insulin, growth factor and IGF-I signalling in CU children (P<0.05). Metabolic and transcriptomic profiles in CU SGA children showed changes that may relate to cardiometabolic risk.
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Adare A, Afanasiev S, Aidala C, Ajitanand NN, Akiba Y, Akimoto R, Al-Bataineh H, Al-Ta'ani H, Alexander J, Angerami A, Aoki K, Apadula N, Aphecetche L, Aramaki Y, Armendariz R, Aronson SH, Asai J, Asano H, Aschenauer EC, Atomssa ET, Averbeck R, Awes TC, Azmoun B, Babintsev V, Bai M, Baksay G, Baksay L, Baldisseri A, Bannier B, Barish KN, Barnes PD, Bassalleck B, Basye AT, Bathe S, Batsouli S, Baublis V, Baumann C, Baumgart S, Bazilevsky A, Belikov S, Belmont R, Bennett R, Berdnikov A, Berdnikov Y, Bickley AA, Bing X, Blau DS, Boissevain JG, Bok JS, Borel H, Boyle K, Brooks ML, Buesching H, Bumazhnov V, Bunce G, Butsyk S, Camacho CM, Campbell S, Castera P, Chang BS, Chang WC, Charvet JL, Chen CH, Chernichenko S, Chi CY, Chiba J, Chiu M, Choi IJ, Choi JB, Choi S, Choudhury RK, Christiansen P, Chujo T, Chung P, Churyn A, Chvala O, Cianciolo V, Citron Z, Cleven CR, Cole BA, Comets MP, Connors M, Constantin P, Csanád M, Csörgő T, Dahms T, Dairaku S, Danchev I, Das K, Datta A, Daugherity MS, David G, Deaton MB, Dehmelt K, Delagrange H, Denisov A, d'Enterria D, Deshpande A, Desmond EJ, Dharmawardane KV, Dietzsch O, Ding L, Dion A, Donadelli M, Drapier O, Drees A, Drees KA, Dubey AK, Durham JM, Durum A, Dutta D, Dzhordzhadze V, D'Orazio L, Edwards S, Efremenko YV, Egdemir J, Ellinghaus F, Emam WS, Engelmore T, Enokizono A, En'yo H, Esumi S, Eyser KO, Fadem B, Fields DE, Finger M, Finger M, Fleuret F, Fokin SL, Fraenkel Z, Frantz JE, Franz A, Frawley AD, Fujiwara K, Fukao Y, Fusayasu T, Gadrat S, Gainey K, Gal C, Garishvili A, Garishvili I, Glenn A, Gong H, Gong X, Gonin M, Gosset J, Goto Y, Granier de Cassagnac R, Grau N, Greene SV, Grosse Perdekamp M, Gunji T, Guo L, Gustafsson HÅ, Hachiya T, Hadj Henni A, Haegemann C, Haggerty JS, Hahn KI, Hamagaki H, Hamblen J, Han R, Hanks J, Harada H, Hartouni EP, Haruna K, Hashimoto K, Haslum E, Hayano R, He X, Heffner M, Hemmick TK, Hester T, Hiejima H, Hill JC, Hobbs R, Hohlmann M, Hollis RS, Holzmann W, Homma K, Hong B, Horaguchi T, Hori Y, Hornback D, Huang S, Ichihara T, Ichimiya R, Ide J, Iinuma H, Ikeda Y, Imai K, Imrek J, Inaba M, Inoue Y, Iordanova A, Isenhower D, Isenhower L, Ishihara M, Isobe T, Issah M, Isupov A, Ivanischev D, Jacak BV, Javani M, Jia J, Jiang X, Jin J, Jinnouchi O, Johnson BM, Joo KS, Jouan D, Jumper DS, Kajihara F, Kametani S, Kamihara N, Kamin J, Kaneta M, Kaneti S, Kang BH, Kang JH, Kang JS, Kanou H, Kapustinsky J, Karatsu K, Kasai M, Kawall D, Kawashima M, Kazantsev AV, Kempel T, Khanzadeev A, Kijima KM, Kikuchi J, Kim BI, Kim C, Kim DH, Kim DJ, Kim E, Kim EJ, Kim HJ, Kim KB, Kim SH, Kim YJ, Kim YK, Kinney E, Kiriluk K, Kiss Á, Kistenev E, Kiyomichi A, Klatsky J, Klay J, Klein-Boesing C, Kleinjan D, Kline P, Kochenda L, Kochetkov V, Komatsu Y, Komkov B, Konno M, Koster J, Kotchetkov D, Kotov D, Kozlov A, Král A, Kravitz A, Krizek F, Kubart J, Kunde GJ, Kurihara N, Kurita K, Kurosawa M, Kweon MJ, Kwon Y, Kyle GS, Lacey R, Lai YS, Lajoie JG, Layton D, Lebedev A, Lee B, Lee DM, Lee J, Lee K, Lee KB, Lee KS, Lee MK, Lee SH, Lee SR, Lee T, Leitch MJ, Leite MAL, Leitgab M, Leitner E, Lenzi B, Lewis B, Li X, Liebing P, Lim SH, Linden Levy LA, Liška T, Litvinenko A, Liu H, Liu MX, Love B, Luechtenborg R, Lynch D, Maguire CF, Makdisi YI, Makek M, Malakhov A, Malik MD, Manion A, Manko VI, Mannel E, Mao Y, Mašek L, Masui H, Masumoto S, Matathias F, McCumber M, McGaughey PL, McGlinchey D, McKinney C, Means N, Mendoza M, Meredith B, Miake Y, Mibe T, Mignerey AC, Mikeš P, Miki K, Miller TE, Milov A, Mioduszewski S, Mishra DK, Mishra M, Mitchell JT, Mitrovski M, Miyachi Y, Miyasaka S, Mohanty AK, Moon HJ, Morino Y, Morreale A, Morrison DP, Motschwiller S, Moukhanova TV, Mukhopadhyay D, Murakami T, Murata J, Nagae T, Nagamiya S, Nagata Y, Nagle JL, Naglis M, Nagy MI, Nakagawa I, Nakamiya Y, Nakamura KR, Nakamura T, Nakano K, Nattrass C, Nederlof A, Newby J, Nguyen M, Nihashi M, Niida T, Norman BE, Nouicer R, Novitzky N, Nyanin AS, O'Brien E, Oda SX, Ogilvie CA, Ohnishi H, Oka M, Okada K, Omiwade OO, Onuki Y, Oskarsson A, Ouchida M, Ozawa K, Pak R, Pal D, Palounek APT, Pantuev V, Papavassiliou V, Park BH, Park IH, Park J, Park SK, Park WJ, Pate SF, Patel L, Pei H, Peng JC, Pereira H, Peresedov V, Peressounko DY, Petti R, Pinkenburg C, Pisani RP, Proissl M, Purschke ML, Purwar AK, Qu H, Rak J, Rakotozafindrabe A, Ravinovich I, Read KF, Rembeczki S, Reuter M, Reygers K, Reynolds R, Riabov V, Riabov Y, Richardson E, Roach D, Roche G, Rolnick SD, Romana A, Rosati M, Rosen CA, Rosendahl SSE, Rosnet P, Rukoyatkin P, Ružička P, Rykov VL, Sahlmueller B, Saito N, Sakaguchi T, Sakai S, Sakashita K, Sakata H, Samsonov V, Sano M, Sano S, Sarsour M, Sato S, Sato T, Sawada S, Sedgwick K, Seele J, Seidl R, Semenov AY, Semenov V, Sen A, Seto R, Sharma D, Shein I, Shevel A, Shibata TA, Shigaki K, Shimomura M, Shoji K, Shukla P, Sickles A, Silva CL, Silvermyr D, Silvestre C, Sim KS, Singh BK, Singh CP, Singh V, Skutnik S, Slunečka M, Soldatov A, Soltz RA, Sondheim WE, Sorensen SP, Soumya M, Sourikova IV, Sparks NA, Staley F, Stankus PW, Stenlund E, Stepanov M, Ster A, Stoll SP, Sugitate T, Suire C, Sukhanov A, Sun J, Sziklai J, Tabaru T, Takagi S, Takagui EM, Takahara A, Taketani A, Tanabe R, Tanaka Y, Taneja S, Tanida K, Tannenbaum MJ, Tarafdar S, Taranenko A, Tarján P, Tennant E, Themann H, Thomas TL, Todoroki T, Togawa M, Toia A, Tojo J, Tomášek L, Tomášek M, Tomita Y, Torii H, Towell RS, Tram VN, Tserruya I, Tsuchimoto Y, Tsuji T, Vale C, Valle H, van Hecke HW, Vargyas M, Vazquez-Zambrano E, Veicht A, Velkovska J, Vértesi R, Vinogradov AA, Virius M, Vossen A, Vrba V, Vznuzdaev E, Wagner M, Walker D, Wang XR, Watanabe D, Watanabe K, Watanabe Y, Watanabe YS, Wei F, Wei R, Wessels J, White SN, Winter D, Wolin S, Wood JP, Woody CL, Wright RM, Wysocki M, Xie W, Yamaguchi YL, Yamaura K, Yang R, Yanovich A, Yasin Z, Ying J, Yokkaichi S, You Z, Young GR, Younus I, Yushmanov IE, Zajc WA, Zaudtke O, Zelenski A, Zhang C, Zhou S, Zimányi J, Zolin L. Medium modification of jet fragmentation in Au+Au collisions at √[s(NN)]=200 GeV measured in direct photon-hadron correlations. PHYSICAL REVIEW LETTERS 2013; 111:032301. [PMID: 23909311 DOI: 10.1103/physrevlett.111.032301] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Indexed: 06/02/2023]
Abstract
The jet fragmentation function is measured with direct photon-hadron correlations in p+p and Au+Au collisions at √[s(NN)]=200 GeV. The p(T) of the photon is an excellent approximation to the initial p(T) of the jet and the ratio z(T)=p(T)(h)/p(T)(γ) is used as a proxy for the jet fragmentation function. A statistical subtraction is used to extract the direct photon-hadron yields in Au+Au collisions while a photon isolation cut is applied in p+p. I(AA), the ratio of hadron yield opposite the photon in Au+Au to that in p+p, indicates modification of the jet fragmentation function. Suppression, most likely due to energy loss in the medium, is seen at high z(T). The associated hadron yield at low z(T) is enhanced at large angles. Such a trend is expected from redistribution of the lost energy into increased production of low-momentum particles.
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Adare A, Afanasiev S, Aidala C, Ajitanand NN, Akiba Y, Akimoto R, Al-Ta'ani H, Alexander J, Angerami A, Aoki K, Apadula N, Aramaki Y, Asano H, Aschenauer EC, Atomssa ET, Awes TC, Azmoun B, Babintsev V, Bai M, Bannier B, Barish KN, Bassalleck B, Bathe S, Baublis V, Baumgart S, Bazilevsky A, Belmont R, Berdnikov A, Berdnikov Y, Bing X, Blau DS, Boyle K, Brooks ML, Buesching H, Bumazhnov V, Butsyk S, Campbell S, Castera P, Chen CH, Chi CY, Chiu M, Choi IJ, Choi JB, Choi S, Choudhury RK, Christiansen P, Chujo T, Chvala O, Cianciolo V, Citron Z, Cole BA, Connors M, Csanád M, Csörgő T, Dairaku S, Datta A, Daugherity MS, David G, Denisov A, Deshpande A, Desmond EJ, Dharmawardane KV, Dietzsch O, Ding L, Dion A, Donadelli M, Drapier O, Drees A, Drees KA, Durham JM, Durum A, D'Orazio L, Edwards S, Efremenko YV, Engelmore T, Enokizono A, Esumi S, Eyser KO, Fadem B, Fields DE, Finger M, Finger M, Fleuret F, Fokin SL, Frantz JE, Franz A, Frawley AD, Fukao Y, Fusayasu T, Gainey K, Gal C, Garishvili A, Garishvili I, Glenn A, Gong X, Gonin M, Goto Y, Granier de Cassagnac R, Grau N, Greene SV, Grosse Perdekamp M, Gunji T, Guo L, Gustafsson HÅ, Hachiya T, Haggerty JS, Hahn KI, Hamagaki H, Hanks J, Hashimoto K, Haslum E, Hayano R, He X, Hemmick TK, Hester T, Hill JC, Hollis RS, Homma K, Hong B, Horaguchi T, Hori Y, Huang S, Ichihara T, Iinuma H, Ikeda Y, Imrek J, Inaba M, Iordanova A, Isenhower D, Issah M, Isupov A, Ivanischev D, Jacak BV, Javani M, Jia J, Jiang X, Johnson BM, Joo KS, Jouan D, Kamin J, Kaneti S, Kang BH, Kang JH, Kang JS, Kapustinsky J, Karatsu K, Kasai M, Kawall D, Kazantsev AV, Kempel T, Khanzadeev A, Kijima KM, Kim BI, Kim C, Kim DJ, Kim EJ, Kim HJ, Kim KB, Kim YJ, Kim YK, Kinney E, Kiss A, Kistenev E, Klatsky J, Kleinjan D, Kline P, Komatsu Y, Komkov B, Koster J, Kotchetkov D, Kotov D, Král A, Krizek F, Kunde GJ, Kurita K, Kurosawa M, Kwon Y, Kyle GS, Lacey R, Lai YS, Lajoie JG, Lebedev A, Lee B, Lee DM, Lee J, Lee KB, Lee KS, Lee SH, Lee SR, Leitch MJ, Leite MAL, Leitgab M, Lewis B, Lim SH, Linden Levy LA, Litvinenko A, Liu MX, Love B, Maguire CF, Makdisi YI, Makek M, Malakhov A, Manion A, Manko VI, Mannel E, Masumoto S, McCumber M, McGaughey PL, McGlinchey D, McKinney C, Mendoza M, Meredith B, Miake Y, Mibe T, Mignerey AC, Milov A, Mishra DK, Mitchell JT, Miyachi Y, Miyasaka S, Mohanty AK, Moon HJ, Morrison DP, Motschwiller S, Moukhanova TV, Murakami T, Murata J, Nagae T, Nagamiya S, Nagle JL, Nagy MI, Nakagawa I, Nakamiya Y, Nakamura KR, Nakamura T, Nakano K, Nattrass C, Nederlof A, Nihashi M, Nouicer R, Novitzky N, Nyanin AS, O'Brien E, Ogilvie CA, Okada K, Oskarsson A, Ouchida M, Ozawa K, Pak R, Pantuev V, Papavassiliou V, Park BH, Park IH, Park SK, Pate SF, Patel L, Pei H, Peng JC, Pereira H, Peresedov V, Peressounko DY, Petti R, Pinkenburg C, Pisani RP, Proissl M, Purschke ML, Qu H, Rak J, Ravinovich I, Read KF, Reynolds R, Riabov V, Riabov Y, Richardson E, Roach D, Roche G, Rolnick SD, Rosati M, Rukoyatkin P, Sahlmueller B, Saito N, Sakaguchi T, Samsonov V, Sano M, Sarsour M, Sawada S, Sedgwick K, Seidl R, Sen A, Seto R, Sharma D, Shein I, Shibata TA, Shigaki K, Shimomura M, Shoji K, Shukla P, Sickles A, Silva CL, Silvermyr D, Sim KS, Singh BK, Singh CP, Singh V, Slunečka M, Soltz RA, Sondheim WE, Sorensen SP, Soumya M, Sourikova IV, Stankus PW, Stenlund E, Stepanov M, Ster A, Stoll SP, Sugitate T, Sukhanov A, Sun J, Sziklai J, Takagui EM, Takahara A, Taketani A, Tanaka Y, Taneja S, Tanida K, Tannenbaum MJ, Tarafdar S, Taranenko A, Tennant E, Themann H, Todoroki T, Tomášek L, Tomášek M, Torii H, Towell RS, Tserruya I, Tsuchimoto Y, Tsuji T, Vale C, van Hecke HW, Vargyas M, Vazquez-Zambrano E, Veicht A, Velkovska J, Vértesi R, Virius M, Vossen A, Vrba V, Vznuzdaev E, Wang XR, Watanabe D, Watanabe K, Watanabe Y, Watanabe YS, Wei F, Wei R, White SN, Winter D, Wolin S, Woody CL, Wysocki M, Yamaguchi YL, Yang R, Yanovich A, Ying J, Yokkaichi S, You Z, Younus I, Yushmanov IE, Zajc WA, Zelenski A, Zolin L. Evolution of π(0) suppression in Au+Au collisions from √(s(NN))=39 to 200 GeV. PHYSICAL REVIEW LETTERS 2012; 109:152301. [PMID: 23102299 DOI: 10.1103/physrevlett.109.152301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2012] [Indexed: 06/01/2023]
Abstract
Neutral-pion π(0) spectra were measured at midrapidity (|y|<0.35) in Au+Au collisions at √(s(NN))=39 and 62.4 GeV and compared with earlier measurements at 200 GeV in a transverse-momentum range of 1<p(T)<10 GeV/c. The high-p(T) tail is well described by a power law in all cases, and the powers decrease significantly with decreasing center-of-mass energy. The change of powers is very similar to that observed in the corresponding spectra for p+p collisions. The nuclear modification factors (R(AA)) show significant suppression, with a distinct energy, centrality, and p(T) dependence. Above p(T)=7 GeV/c, R(AA) is similar for √(s(NN))=62.4 and 200 GeV at all centralities. Perturbative-quantum-chromodynamics calculations that describe R(AA) well at 200 GeV fail to describe the 39 GeV data, raising the possibility that, for the same p(T) region, the relative importance of initial-state effects and soft processes increases at lower energies. The p(T) range where π(0) spectra in central Au+Au collisions have the same power as in p+p collisions is ≈5 and 7 GeV/c for √(s(NN))=200 and 62.4 GeV, respectively. For the √(s(NN))=39 GeV data, it is not clear whether such a region is reached, and the x(T) dependence of the x(T)-scaling power-law exponent is very different from that observed in the √(s(NN))=62 and 200 GeV data, providing further evidence that initial-state effects and soft processes mask the in-medium suppression of hard-scattered partons to higher p(T) as the collision energy decreases.
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Basu S, Srinivasan K, Green M, Patel L, Stanback J, George B. Program assessment of the introduction of Multiload-375 in the family welfare program of the Government of India. Contraception 2012. [DOI: 10.1016/j.contraception.2011.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Banerjee I, Skae M, Flanagan SE, Rigby L, Patel L, Didi M, Blair J, Ehtisham S, Ellard S, Cosgrove KE, Dunne MJ, Clayton PE. The contribution of rapid KATP channel gene mutation analysis to the clinical management of children with congenital hyperinsulinism. Eur J Endocrinol 2011; 164:733-40. [PMID: 21378087 DOI: 10.1530/eje-10-1136] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE In children with congenital hyperinsulinism (CHI), K(ATP) channel genes (ABCC8 and KCNJ11) can be screened rapidly for potential pathogenic mutations. We aimed to assess the contribution of rapid genetic testing to the clinical management of CHI. DESIGN Follow-up observational study at two CHI referral hospitals. METHODS Clinical outcomes such as subtotal pancreatectomy, (18)F-Dopa positron emission tomography-computed tomography (PET-CT) scanning, stability on medical treatment and remission were assessed in a cohort of 101 children with CHI. RESULTS In total, 32 (32%) children had pathogenic mutations in K(ATP) channel genes (27 in ABCC8 and five in KCNJ11), of which 11 (34%) were novel. In those negative at initial screening, other mutations (GLUD1, GCK, and HNF4A) were identified in three children. Those with homozygous/compound heterozygous ABCC8/KCNJ11 mutations were more likely to require a subtotal pancreatectomy CHI (7/10, 70%). Those with paternal heterozygous mutations were investigated with (18)F-Dopa PET-CT scanning and 7/13 (54%) had a focal lesionectomy, whereas four (31%) required subtotal pancreatectomy for diffuse CHI. Those with maternal heterozygous mutations were most likely to achieve remission (5/5, 100%). In 66 with no identified mutation, 43 (65%) achieved remission, 22 (33%) were stable on medical treatment and only one child required a subtotal pancreatectomy. CONCLUSIONS Rapid genetic analysis is important in the management pathway of CHI; it provides aetiological confirmation of the diagnosis, indicates the likely need for a subtotal pancreatectomy and identifies those who require (18)F-Dopa PET-CT scanning. In the absence of a mutation, reassurance of a favourable outcome can be given early in the course of CHI.
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Mehta P, Patel L, Roncaroli F, Pickering MC, Brand A. Painful myositis in the anti-synthetase syndrome with anti-PL12 antibodies. J Transl Med 2010. [PMCID: PMC3007798 DOI: 10.1186/1479-5876-8-s1-p52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Rosenberg LE, Patel L, Lilljeqvist AC. Absence of an intracellular cobalamin-binding protein in cultured fibroblasts from patients with defective synthesis of 5'-deoxyadenosylcobalamin and methylcobalamin. Proc Natl Acad Sci U S A 2010; 72:4617-21. [PMID: 16592285 PMCID: PMC388774 DOI: 10.1073/pnas.72.11.4617] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Three distinct classes of human mutations (cbl A, cbl B, and cbl C) cause defective synthesis of cobalamin (Cbl; vitamin B(12)) coenzymes. Cultured fibroblasts from that unique class (cbl C) deficient in the synthesis of both Cbl coenzymes, 5'-deoxyadenosylcobalamin (AdoCbl) and methylcobalamin (MeCbl), were used to explore the underlying defect. We compared the uptake of transcobalamin II(TC II)-bound cyano[(57)Co]cobalamin (CN-Cbl) by cbl cells with that of other control and mutant cell lines. Although the cbl C cells initially took up CN-[(57)Co]Cbl normally, they were unable to retain it. To characterize this "leak" further, cell extracts were prepared following incubation and chromatographed on Sephadex G-150. After incubations of 1-2 hr, most of the CN-[(57)Co]Cbl accumulated by control cells was still bound to TC II; the remainder was free. Thereafter, an ever-increasing fraction of the labeled Cbl eluted with an intracellular cobalamin-binding protein (ICB); more than 80% of the total was so bound after 76 hr incubations. ICB had an apparent molecular weight similar to that of several Cbl "R" binders (about 120,000), but was distinguished from them by its failure to react with specific anti-"R"binder antiserum. Significantly, no ICB was detected in extracts of three different cbl C lines even aftr prolonged incubations, whereas its appearance in cbl A, cbl B, and mutase apoenzyme mutants was normal. We propose: that ICB is required for retention of cobalamins by cells; and that cbl C cells "leak" cobalamins and show defective synthesis of Cbl coenzymes because they lack this intracellular binder.
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Dyer K, Glasscoe C, Hope H, Patel L, Southern K. The impact of pulmonary exacerbation on the challenge of living with cystic fibrosis. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60388-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Glasscoe C, Quittner A, Patel L, Dale C, Burrows E, Hope H, Lancaster G, Southern K, Nunn A. Components of risk associated with home intravenous antibiotic therapy (H-IVAT) in the UK. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60408-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Puttha R, Cooke D, Subbarayan A, Odeka E, Ariyawansa I, Bone M, Doughty I, Patel L, Amin R. Low dose (0.05 units/kg/h) is comparable with standard dose (0.1 units/kg/h) intravenous insulin infusion for the initial treatment of diabetic ketoacidosis in children with type 1 diabetes-an observational study. Pediatr Diabetes 2010; 11:12-7. [PMID: 19602154 DOI: 10.1111/j.1399-5448.2009.00536.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To compare low dose (0.05 units/kg/h) with standard dose (0.1 units/kg/h) intravenous insulin infusion for the treatment of diabetic ketoacidosis (DKA) in children with type 1 diabetes. STUDY DESIGN Data from five paediatric centres were compared in children who received 0.05 (41 episodes) or 0.1 units/kg/h (52 episodes). RESULTS In the low vs. standard dose group, at 6 h following admission, the fall in blood glucose levels [11.3 (95% confidence interval 8.6 to 13.9) vs. 11.8 (8.4 to 15.2) mmol/L, p = 0.86] and rise in pH [0.13 (0.09 to 0.18) vs. 0.11 (0.07 to 0.15), p = 0.78] were similar. These changes were comparable between doses in relation to: severity of initial acidosis, children newly diagnosed with diabetes or aged less than 5 years. After adjustment for other clinical and biochemical covariates, insulin dose was unrelated to the change in pH and blood glucose levels at 6 h following admission. Comparisons of safety data, particularly in relation to abnormal Glasgow Coma Score, were inconclusive. CONCLUSION In this observational study, low dose was as effective as standard dose intravenous insulin infusion in the initial treatment (less than 6 h) of DKA in children with type 1 diabetes. A randomised controlled trial is required to show true equivalence between doses and to evaluate potential safety benefits.
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Mattock K, Gough P, Humphries J, Burnand K, Patel L, Suckling K, Cuello F, Watts C, Gautel M, Avkiran M, Smith A. Legumain and cathepsin-L expression in human unstable carotid plaque. Atherosclerosis 2010; 208:83-9. [DOI: 10.1016/j.atherosclerosis.2009.07.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Revised: 05/28/2009] [Accepted: 07/03/2009] [Indexed: 12/30/2022]
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Murray PG, Hague C, Fafoula O, Gleeson H, Patel L, Banerjee I, Raabe AL, Hall CM, Wright NB, Amin R, Clayton PE. Likelihood of persistent GH deficiency into late adolescence: relationship to the presence of an ectopic or normally sited posterior pituitary gland. Clin Endocrinol (Oxf) 2009; 71:215-9. [PMID: 19226266 DOI: 10.1111/j.1365-2265.2009.03554.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The presence of an ectopic posterior pituitary gland (EPP) in childhood is associated with isolated GH deficiency (IGHD) and multiple pituitary hormone deficiency. GHD in late adolescence has been defined as a peak GH level <5 microg/l. The aim of this study was to identify the likelihood of persistent GHD in late adolescence in patients with an EPP compared with those with a normally sited posterior pituitary (NPP). METHODS In 18 patients with an EPP and 15 patients with an NPP, clinical, biochemical and radiographic data were collected. RESULTS In the EPP vs. the NPP group, the change in peak GH levels at the end of growth was less (+0.4[95% confidence interval (CI) - 0.8 to 2.7] vs. +4.1[95%CI + 0.4 to +10.5] microg/l, P-value for ancova = 0.03, after adjustment for age and sex). Using a peak GH level of <5 microg/l as a cut-off for GHD, 66% of EPP subjects compared with 40% of NPP subjects had GHD (P = 0.3). Hundred per cent of EPP subjects had a peak GH level on retesting <10 microg/l, compared with 40% of NPP subjects (P < 0.001). CONCLUSION It is important to document GH status at the end of growth, even if there is a structural abnormality of the hypothalamic-pituitary axis. The presence of an EPP compared to an NPP increases the likelihood of persistent GHD by 26%. As all EPP patients had a peak GH level of <10 microg/l, the cut-off for persistent GHD in late adolescence may need to be revised.
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Murray PG, Hague C, Fafoula O, Patel L, Raabe AL, Cusick C, Hall CM, Wright NB, Amin R, Clayton PE. Associations with multiple pituitary hormone deficiency in patients with an ectopic posterior pituitary gland. Clin Endocrinol (Oxf) 2008; 69:597-602. [PMID: 18331606 DOI: 10.1111/j.1365-2265.2008.03236.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The presence of an ectopic posterior pituitary gland (EPP) on magnetic resonance imaging (MRI) is associated with hypopituitarism with one or more hormone deficiencies. We aimed to identify risk factors for having multiple pituitary hormone deficiency (MPHD) compared to isolated growth hormone deficiency (IGHD) in patients with an EPP. METHODS In 67 patients (45 male) with an EPP on MRI, the site (hypothalamic vs. stalk) and surface area (SA) [ x (maximum diameter/2) x (maximum height/2), mm(2)] of the EPP were recorded and compared in patients with IGHD and MPHD in relation to clinical characteristics. RESULTS In MPHD (n = 32) compared to IGHD (n = 35) patients: age of presentation was younger (1.4 [0.1-10.7]vs. 4.0 [0.1-11.3] years, P = 0.005), major incidents during pregnancy were increased (47%vs. 20%, P = 0.02) as were admissions to a neonatal intensive care unit (NICU) (60%vs. 26%, P = 0.04), whilst EPP SA was lower (12.3 [2.4-34.6]vs. 25.7 [6.9-48.2] mm(2), P < 0.001). In patients with a hypothalamic (n = 56) compared to a stalk sited EPP (n = 11): prevalence of MPHD was greater (55%vs. 9%,P = 0.05) and EPP surface area was smaller (17.3 [2.4-48.2]vs. 25.3 [11.8-38.5] mm(2), P < 0.001). In regression analysis, after adjusting for age, presence of MPHD was associated with: major incidents during pregnancy (RR 6.8 [95%CI 1.2-37.7]), hypothalamic EPP site (RR 10.9 [1.0-123.9]) and small EPP SA (RR 2.5 [1.0-5.0] for tertiles of SA). CONCLUSION In patients with an EPP, adverse antenatal events, size (small) and position (hypothalamic) of the posterior pituitary gland on MRI were associated with MPHD. These findings suggest that adverse factors during pregnancy may be important for the development of an EPP.
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Mattock K, Burnand K, Gough P, Patel L, Watts C, Taylor P, Smith A. Expression and activity of the cysteine protease, legumain, is up-regulated in unstable REGIONS OF human atherosclerotic plaques. Atherosclerosis 2007. [DOI: 10.1016/j.atherosclerosis.2007.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Isaac H, Patel L, Meyer S, Hall CM, Cusick C, Price DA, Clayton PE. Efficacy of a Monthly Compared to 3-Monthly Depot GnRH Analogue (Goserelin) in the Treatment of Children with Central Precocious Puberty. Horm Res Paediatr 2007; 68:157-63. [PMID: 17356292 DOI: 10.1159/000100579] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2006] [Accepted: 01/17/2007] [Indexed: 11/19/2022] Open
Abstract
AIMS To compare the efficacy of goserelin 10.8 mg (Zoladex LA-ZLA) administered 9-12 weekly with 3.6 mg (Zoladex-Z) given monthly in suppressing pubertal development, and effect on body mass index (BMI). METHODS Children with central precocious puberty (CPP) treated with Z (n = 34) or ZLA (n = 28) were studied retrospectively. Pubertal scores and BMI SDS during 24 months' treatment were compared. RESULTS To attain adequate pubertal suppression, more patients on ZLA than Z required increase in injection frequency (p = 0.02) and this was so for 7/8 patients with a structural aetiology for CPP on ZLA and 2/8 on Z. A greater proportion of patients on ZLA had BMI >+2 SDS before (p = 0.05), and at 18 and 24 months (p = 0.02 and 0.04). BMI SDS transiently increased during the first 6 months on ZLA (p = 0.04). CONCLUSION Both Z and ZLA were effective in suppressing puberty. To achieve adequate suppression, increased injection frequency was more likely with ZLA than Z, and particularly in patients with structural defects. Children with CPP had an elevated BMI at the onset of therapy and ZLA had a transient positive influence on BMI.
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Ellison JA, Patel L, Kecojevic T, Foster PJ, David TJ, Clayton PE. Pattern of growth and adiposity from infancy to adulthood in atopic dermatitis. Br J Dermatol 2007; 155:532-8. [PMID: 16911277 DOI: 10.1111/j.1365-2133.2006.07400.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Impaired linear growth has been reported in children with atopic dermatitis (AD) but the pattern of growth in height and weight through childhood and adolescence has not been described. OBJECTIVES To define the pattern of linear growth and adiposity in AD from early childhood through to adult life. PATIENTS AND METHODS Growth measurements of 70 male and 40 female patients with AD followed through childhood and adolescence were studied retrospectively and compared with the 1990 U.K. normal values. Height, weight and body mass index (BMI) were converted to standard deviation scores (SDS). Regression analysis examined whether the mean trend was different from zero. RESULTS While dermatitis was the predominant atopic problem in all 110 patients, 92 had a history of asthma which was mild in 85 of 92. Regression analyses showed that the trends in height, weight and BMI SDS for AD patients were significantly different from zero and also different between males and females. Both sexes were short and relatively overweight from early childhood, a trend that was more pronounced in males than females. At 5 years (school entry), the 50th centile BMI of male (but not female) patients was 0.44 kg m(-2) higher than the reference population but height and weight were lower. The age at adiposity rebound in AD males and females was 0.8 year and 0.7 year later than the U.K. population (6.2 years vs. 5.4 years and 6.2 years vs. 5.3 years, respectively). AD patients attained peak height velocity later than the 1990 U.K. population (males 16.0 years vs. 13.5 years, P = 0.0002; females 13.4 years vs. 11.0 years, P = 0.008). In addition, males had greater mean gain in height during late adolescence (12.2 vs. 8.8 cm, P = 0.03) and were shorter as young adults (170.9 vs. 177.6 cm, P = 0.0005). CONCLUSIONS Our patients with AD were relatively overweight very early but had a later adiposity rebound, were short in childhood and had a delayed adolescent growth spurt. Serial growth measurements should be done on all children with troublesome AD and can be helpful in counselling about the growth prognosis.
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Sanka S, Khan A, Vuppali N, Thornton C, Lloyd E, Dixon M, Vyas J, David T, Patel L. 219 Pulmonary function and growth in children with CF in relation to Pseudomonas aeruoginosa (PA) status and treatment regimen: an observational study. J Cyst Fibros 2006. [DOI: 10.1016/s1569-1993(06)80201-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Harvey RD, Shea T, Walko C, Krasnow C, Patel L, Serody J, Gabriel D, Comeau T, Lindley C. Intravenous busulfan test dose clearance comparison with first and thirteenth dose systemic exposure in allogenic bone marrow transplantation patients. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bessant R, Hingorani A, Patel L, MacGregor A, Isenberg DA, Rahman A. Risk of coronary heart disease and stroke in a large British cohort of patients with systemic lupus erythematosus. Rheumatology (Oxford) 2004; 43:924-9. [PMID: 15150430 DOI: 10.1093/rheumatology/keh213] [Citation(s) in RCA: 147] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Patients with systemic lupus erythematosus (SLE) are at increased risk of myocardial infarction and stroke. We sought to determine how much of this risk was dependent on recognized cardiovascular risk factors. METHODS Initially a software package 'Cardio-Risk-Manager', which utilizes Framingham data, was used to calculate a 10-yr risk of coronary heart disease (CHD) and stroke for 202 patients with SLE (Group 1) in comparison with hypothetical age- and sex-matched comparators. Subsequently 47 patients who had been followed since 1991 (Group 2) were studied to compare their predicted risks in 1991 with the actual number of cardiovascular events that occurred during the subsequent decade. RESULTS Patients in Group 1 had a higher predicted 10-yr risk of stroke (P<0.0001), but not of CHD, than their comparators. However, following age stratification, traditional risk factors predicted a higher risk of CHD (P<0.0001) and of stroke (P<0.0001) in patients under 40 with SLE compared with age-matched comparators. The predicted 10-yr risks of CHD and stroke for patients aged 40 and above were not significantly different from those of their comparators. Predicted risks, however, were lower than the true 10-yr event rate for CHD and stroke in patients in Group 2. In this group, during the 10 yr of follow-up four patients (8.5%) suffered a CHD event and five patients (10.6%) had a stroke, significantly more than were predicted by the presence of conventional risk factors (P<0.001 for CHD and P<0.001 for stroke, respectively). CONCLUSIONS Conventional risk factors predicted an increased risk of stroke and CHD in younger patients. They do not, however, fully explain the high risk of cardiovascular disease in patients with SLE. Although it is important to address the management of orthodox risk factors for cardiovascular disease in patients with SLE, other causes must be sought to explain the increased incidence of CHD and stroke, especially in those aged over 40.
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Papaspyridonos M, Smith A, Cox J, Woollard R, Roberts T, Burnand K, Suckling K, Patel L. W01.1 Differential gene expression in areas of instability in carotid artery plaques. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90001-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Graham T, Palmer C, Patel L. W01.115 GW0742X, a potent and selective PPARδ ligand, inhibits the development of atherosclerosis in LDLR knockout mice. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90114-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Birkebaek NH, Patel L, Wright NB, Grigg JR, Sinha S, Hall CM, Price DA, Lloyd IC, Clayton PE. Endocrine status in patients with optic nerve hypoplasia: relationship to midline central nervous system abnormalities and appearance of the hypothalamic-pituitary axis on magnetic resonance imaging. J Clin Endocrinol Metab 2003; 88:5281-6. [PMID: 14602762 DOI: 10.1210/jc.2003-030527] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
We here: 1) describe the phenotypic spectrum, including magnetic resonance imaging (MRI) appearances of the pituitary stalk and anterior and posterior pituitary [H-P (hypothalamic-pituitary) axis], in children with optic nerve hypoplasia (ONH) with or without an abnormal septum pellucidum (SP); and 2) define endocrine dysfunction according to the MRI findings. Medical records of 55 children with ONH who had been assessed by ophthalmology and endocrine services were reviewed. All had MRI of the brain and H-P axis. Forty-nine percent of the ONH patients had an abnormal SP on MRI, and 64% had a H-P axis abnormality. Twenty-seven patients (49%) had endocrine dysfunction, and 23 of these had H-P axis abnormality. The frequency of endocrinopathy was higher in patients with an abnormal SP (56%) than a normal SP (39%). Patients were divided into four groups based on SP and H-P axis appearance: 1) both normal; 2) abnormal SP and normal H-P axis; 3) normal SP and abnormal H-P axis; and 4) both abnormal. The frequency of multiple pituitary hormone deficiency was highest (56%) in group 4, lower (35%) in group 3, and even lower (22%) in group 2. Precocious puberty was most common in group 2. None of the patients in group 1 had endocrine dysfunction. Thus, SP and H-P axis appearances on MRI can be used to predict the likely spectrum of endocrinopathy.
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Das U, Whatmore AJ, Khosravi J, Wales JKH, Butler G, Kibirige MS, Diamandi A, Jones J, Patel L, Hall CM, Price DA, Clayton PE. IGF-I and IGF-binding protein-3 measurements on filter paper blood spots in children and adolescents on GH treatment: use in monitoring and as markers of growth performance. Eur J Endocrinol 2003; 149:179-85. [PMID: 12943519 DOI: 10.1530/eje.0.1490179] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND/AIM In childhood an appropriate response to GH treatment is achieved by titration of growth response against dose administered, with careful observation for side-effects. In order to evaluate the potential use of IGF monitoring in children treated with GH, a cross-sectional study has been carried in 215 children and adolescents (134 with GH deficiency (GHD), 54 with Turner syndrome (TS) and 27 with non-GHD growth disorders) treated with GH for 0.2-13.7 years. METHODS IGF-I and IGF-binding protein-3 (IGFBP-3) were measured in ELISAs, using dried capillary blood collected onto filter papers. Results were expressed as the mean S.D. range (SDS). Values of either analyte < -2 or > +2 SDS were considered abnormal. RESULTS IGF-I and IGFBP-3 SDS were higher in the TS and non-GHD groups (mean +0.01 and +0.1 respectively) than in those with GHD (mean value -0.6). Nineteen per cent of the IGF-I values (13% low, 6% high) and 12% of IGFBP-3 values were abnormal (10% low, 2% high). Abnormalities, either low or high, were most common in the GHD group. There was a weak but significant relationship between change in height SDS over the Year up to the time of sampling in the whole group and IGF-I SDS. Satisfactory growth performance (+0.5>change in height SDS> -0.5) was found in those with high (7.2%), normal (60%) and low (9.3%) IGF-I levels. Overall, it was estimated that 26% of the tests would indicate that an adjustment to GH dose (up in 18% and down in 8%) could be considered. CONCLUSIONS From this cross-sectional study of IGF monitoring across a broad range of diagnoses and ages, it can be concluded that the majority of children on GH have normal levels of IGF-I and IGFBP-3, but 26% of tests could suggest that a change of GH dose should be considered. Regular monitoring of IGF-I and IGFBP-3 should be considered in any child on GH treatment.
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McMillian MK, Li L, Parker JB, Patel L, Zhong Z, Gunnett JW, Powers WJ, Johnson MD. An improved resazurin-based cytotoxicity assay for hepatic cells. Cell Biol Toxicol 2002; 18:157-73. [PMID: 12083422 DOI: 10.1023/a:1015559603643] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A simple resazurin-based cytotoxicity assay is presented for screening of cytotoxicity in hepatocytes and liver cell lines. Human hepatoma (HepG2) cells in 96-well culture plates were exposed to known toxic (cisplatin, 5-fluorouracil, ethionine, flufenamic acid, and diflunisal) and control (transplatin, 5-chlorouracil, methionine, and acetylsalicylic acid) compounds for 1-3 days, and resazurin (5 micromol/L) was added. A conventional short-term (1 h) assay was first performed, where cytotoxicity is indicated by decreased reduction of resazurin to its fluorescent product resorufin. Our improved assay consists of additionally measuring fluorescence 2-4 days later, when cytotoxicity is indicated by a striking increase in the concentration of resorufin, resulting from two distinct processes. First, viable liver-derived cells slowly convert resorufin to nonfluorescent metabolites. Fluorescence of control cell wells decreased to background during a 2- to 4-day exposure to resazurin. This metabolism of resorufin was largely blocked by dicumarol and to lesser extents by disulfiram and SKF525a. Second, dead or dying cells slowly convert resazurin to resorufin but do not further metabolize resorufin; thus this fluorescent metabolite accumulates to high levels in wells with dead cells by 2 to 4 days. A similar increase in fluorescence associated with cytotoxicity was observed in primary cultures of rat hepatocytes using the long-term resazurin-based assay. In addition to an improved signal relative to the short-term assay, the inversion of the fluorescent signal from high = alive short-term to high = dead long-term allows determination of two independent cytotoxicity endpoints after addition of one innocuous vital dye.
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Patel L, Cooper CD, Quinton ND, Butler GE, Gill MS, Jefferson IG, Kibirige MS, Price DA, Shalet SM, Wales JKH, Ross RJM, Clayton PE. Serum leptin and leptin binding activity in children and adolescents with hypothalamic dysfunction. J Pediatr Endocrinol Metab 2002; 15:963-71. [PMID: 12199340 DOI: 10.1515/jpem.2002.15.7.963] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Marked disturbance in eating behaviour and obesity are common sequelae of hypothalamic damage. To investigate whether these were associated with dysfunctional leptin central feedback, we evaluated serum leptin and leptin binding activity in 37 patients (age 3.5-21 yr) with tumour or trauma involving the hypothalamic-pituitary axis compared with 138 healthy children (age 5.0-18.2 yr). Patients were subdivided by BMI <2 SDS or > or = 2 SDS and healthy children and children with simple obesity of comparable age and pubertal status served as controls. Patients had higher BMI (mean 1.9 vs 0.2 SDS; p <0.001), a greater proportion had BMI > or = 2 SDS (54% vs 8%; p <0.001) and higher serum leptin (mean 2.1 vs 0.04 SDS; p <0.001) than healthy children. Serum leptin (mean 1.1 vs -0.1 SDS; p = 0.004) and values adjusted for BMI (median 0.42 vs 0.23 microg/l:kg/m2; p = 0.02) were higher in patients with BMI <2 SDS. However, serum leptin adjusted for BMI was similar in patients with BMI > or = 2 SDS compared to corresponding controls (1.08 vs 0.95; p = 0.6). Log serum leptin correlated with BMI SDS in all subject groups but the relationship in patients with BMI <2 SDS was of higher magnitude (r = 0.65, slope = 0.29, p =0.05 for difference between slopes) than in healthy controls (r = 0.42, slope = 0.19). Serum leptin binding activity (median 7.5 vs 9.3%; p = 0.02) and values adjusted for BMI (median 0.28 vs 0.48 % x m2/kg; p <0.001) were lower in patients than in healthy children. The markedly elevated leptin levels with increasing BMI in non-obese patients with hypothalamic-pituitary damage are suggestive of an unrestrained pattern of leptin secretion. This along with low leptin binding activity and hence higher free leptin levels would be consistent with central leptin insensitivity.
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