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Schnell F, Donoghue C, Dworzak J, Charleston J, Frank D, Wilton S, Fletcher S, Lewis S, Mendell J, Rodino-Klapac L, Sahenk Z. Development of a validated Western blot method for quantification of human dystrophin protein used in phase 2 and 3 clinical trials of eteplirsen for the treatment of Duchenne muscular dystrophy. Neuromuscul Disord 2017. [DOI: 10.1016/s0960-8966(17)30264-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Fletcher S, Bellgard MI, Price L, Akkari AP, Wilton SD. Translational development of splice-modifying antisense oligomers. Expert Opin Biol Ther 2016; 17:15-30. [PMID: 27805416 DOI: 10.1080/14712598.2017.1250880] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Antisense nucleic acid analogues can interact with pre-mRNA motifs and influence exon or splice site selection and thereby alter gene expression. Design of antisense molecules to target specific motifs can result in either exon exclusion or exon inclusion during splicing. Novel drugs exploiting the antisense concept are targeting rare, life-limiting diseases; however, the potential exists to treat a wide range of conditions by antisense-mediated splice intervention. Areas covered: In this review, the authors discuss the clinical translation of novel molecular therapeutics to address the fatal neuromuscular disorders Duchenne muscular dystrophy and spinal muscular atrophy. The review also highlights difficulties posed by issues pertaining to restricted participant numbers, variable phenotype and disease progression, and the identification and validation of study endpoints. Expert opinion: Translation of novel therapeutics for Duchenne muscular dystrophy and spinal muscular atrophy has been greatly advanced by multidisciplinary research, academic-industry partnerships and in particular, the engagement and support of the patient community. Sponsors, supporters and regulators are cooperating to deliver new drugs and identify and define meaningful outcome measures. Non-conventional and adaptive trial design could be particularly suited to clinical evaluation of novel therapeutics and strategies to treat serious, rare diseases that may be problematic to study using more conventional clinical trial structures.
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Khavari R, Karmonik C, Shy M, Fletcher S, Boone T. Functional Magnetic Resonance Imaging with Concurrent Urodynamic Testing Identifies Brain Structures Involved in Micturition Cycle in Patients with Multiple Sclerosis. J Urol 2016; 197:438-444. [PMID: 27664581 DOI: 10.1016/j.juro.2016.09.077] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 01/05/2023]
Abstract
PURPOSE Neurogenic lower urinary tract dysfunction, which is common in patients with multiple sclerosis, has a significant impact on quality of life. In this study we sought to determine brain activity processes during the micturition cycle in female patients with multiple sclerosis and neurogenic lower urinary tract dysfunction. MATERIALS AND METHODS We report brain activity on functional magnetic resonance imaging and simultaneous urodynamic testing in 23 ambulatory female patients with multiple sclerosis. Individual functional magnetic resonance imaging activation maps at strong desire to void and at initiation of voiding were calculated and averaged at Montreal Neuroimaging Institute. Areas of significant activation were identified in these average maps. Subgroup analysis was performed in patients with elicitable neurogenic detrusor overactivity or detrusor-sphincter dyssynergia. RESULTS Group analysis of all patients at strong desire to void yielded areas of activation in regions associated with executive function (frontal gyrus), emotional regulation (cingulate gyrus) and motor control (putamen, cerebellum and precuneus). Comparison of the average change in activation between previously reported healthy controls and patients with multiple sclerosis showed predominantly stronger, more focal activation in the former and lower, more diffused activation in the latter. Patients with multiple sclerosis who had demonstrable neurogenic detrusor overactivity and detrusor-sphincter dyssynergia showed a trend toward distinct brain activation at full urge and at initiation of voiding respectively. CONCLUSIONS We successfully studied brain activation during the entire micturition cycle in female patients with neurogenic lower urinary tract dysfunction and multiple sclerosis using a concurrent functional magnetic resonance imaging/urodynamic testing platform. Understanding the central neural processes involved in specific parts of micturition in patients with neurogenic lower urinary tract dysfunction may identify areas of interest for future intervention.
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Fletcher S, Jones MG, Spinks K, Sgalla G, Marshall BG, Limbrey R, Richeldi L. The safety of new drug treatments for idiopathic pulmonary fibrosis. Expert Opin Drug Saf 2016; 15:1483-1489. [DOI: 10.1080/14740338.2016.1218470] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Khavari R, Karmonik C, Potter T, Shy M, Fletcher S, Boone T. MP17-09 TRENDS IN SUPRASPINAL VARIATION IN PATIENTS WITH MULTIPLE SCLEROSIS AND DETRUSOR SPHINCTER DYSSENERGIA. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.2677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Glover G, Fletcher S, Esquinas A. Prediction of Non-invasive Mechanical Ventilation Response. Moving from Art to Science? Methods Inf Med 2016; 55:200-1. [PMID: 26928232 DOI: 10.3414/me15-04-0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 01/19/2016] [Indexed: 11/09/2022]
Abstract
Predicting the outcome from NIV is important and the study by Martin-Gonzalez and colleagues applies data mining techniques to improve our understanding of the field. Nevertheless, the predictor variables must be robust and reliably available before NIV is applied. A predictive model must be generalisable in other clinical settings. Until models such as this are extremely robust in their predictive ability and have been shown to positively influence patient centered outcomes, they may be able to assist decision making but cannot replace clinical judgement by an experienced bedside clinician.
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Papanna R, Moise KJ, Mann LK, Fletcher S, Schniederjan R, Bhattacharjee MB, Stewart RJ, Kaur S, Prabhu SP, Tseng SCG. Cryopreserved human umbilical cord patch for in-utero spina bifida repair. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2016; 47:168-176. [PMID: 26489897 DOI: 10.1002/uog.15790] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To identify a patch system to repair surgically created spina bifida in a sheep model for its efficacy in healing the skin defect, protecting the underlying spinal cord and reducing the Chiari II malformation. METHODS Spina bifida was created surgically in 16 fetuses from eight timed-pregnant sheep at gestational age of 75 days. Two fetuses did not survive the procedure. Repeat hysterotomy was performed at 95 days' gestation to cover the defect with either biocellulose film with underwater adhesive (BCF-adhesive) (n = 7) or human umbilical cord with suture (HUC-suture) (n = 7). Three fetuses without formation of the defect served as reference controls. The skin healing was examined by direct visualization after a planned Cesarean section at term, followed by histological analysis using hematoxylin and eosin and Masson's trichrome stains. Mid-sagittal sections of the fetal cranium and upper cervical spine were analyzed by a pediatric neuroradiologist who was blinded to the type of patch received. RESULTS Three fetuses that received the BCF-adhesive and six fetuses that received the HUC-suture survived to term for final analysis. As a result of dislodgment of the BCF-adhesive, all spina bifida defects repaired using BCF-adhesive were not healed and showed exposed spinal cord with leakage of cerebrospinal fluid. In contrast, all spinal defects repaired by HUC-suture were healed with complete regrowth of epidermal, dermal and subdermal tissue components, with no exposed spinal cord. The maximal skin wound width was 21 ± 3.6 mm in the BCF-adhesive group but 3 ± 0.8 mm in the HUC-suture group (P < 0.001). The spinal cord area (P = 0.001) and the number of anterior horn cells (P = 0.03) was preserved to a greater degree in the HUC-suture group than in the BCF-adhesive group, whilst psammoma bodies, signifying neuronal degeneration, were only observed in the BCF-adhesive group. Anatomic changes, indicative of Chiari II malformation, were seen in all three fetuses of the BCF-adhesive group but in none of the HUC-suture group (P < 0.01). CONCLUSION Cryopreserved umbilical cord graft is a promising regenerative patch for intrauterine repair of spina bifida.
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Chen L, Wilder PT, Drennen B, Tran J, Roth BM, Chesko K, Shapiro P, Fletcher S. Structure-based design of 3-carboxy-substituted 1,2,3,4-tetrahydroquinolines as inhibitors of myeloid cell leukemia-1 (Mcl-1). Org Biomol Chem 2016; 14:5505-10. [DOI: 10.1039/c5ob02063h] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A novel Mcl-1 inhibitor chemotype based on a tetrahydroquinoline carboxylic acid was developed utilizing structure-based design, which was subsequently validated by a fluorescence polarization competition assay and HSQC NMR analysis.
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Lanning ME, Wilder PT, Bailey H, Drennen B, Cavalier M, Chen L, Yap JL, Raje M, Fletcher S. Towards more drug-like proteomimetics: two-faced, synthetic α-helix mimetics based on a purine scaffold. Org Biomol Chem 2015. [PMID: 26204921 DOI: 10.1039/c5ob00478k] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Mimicry of two faces of an α-helix might yield more potent and more selective inhibitors of aberrant, helix-mediated protein-protein interactions (PPI). Herein, we demonstrate that a 2,6,9-tri-substituted purine is capable of disrupting the Mcl-1-Bak-BH3 PPI through effective mimicry of key residues on opposing faces of the Bak-BH3 α-helix.
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Glegg G, Jefferson R, Fletcher S. Marine governance in the English Channel (La Manche): Linking science and management. MARINE POLLUTION BULLETIN 2015; 95:707-718. [PMID: 25819447 DOI: 10.1016/j.marpolbul.2015.02.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 12/14/2014] [Accepted: 02/12/2015] [Indexed: 06/04/2023]
Abstract
The English Channel is one of the world's busiest sea areas with intense shipping and port activity juxtaposed with recreation, communications and important conservation areas. Opportunities for marine renewable energy vie with existing activities for space. The current governance of the English Channel is reviewed and found to lack integration between countries, sectors, legislation and scientific research. Recent developments within the EU's marine management frameworks are significantly altering our approach to marine governance and this paper explores the implications of these new approaches to management of the English Channel. Existing mechanisms for cross-Channel science and potential benefits of an English Channel scale perspective are considered. In conclusion, current management practices are considered against the 12 Malawi Principles of the ecosystem approach resulting in proposals for enhancing governance of the region through science at the scale of the English Channel.
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Wilton SD, Veedu RN, Fletcher S. The emperor's new dystrophin: finding sense in the noise. Trends Mol Med 2015; 21:417-26. [PMID: 26051381 DOI: 10.1016/j.molmed.2015.04.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 01/16/2023]
Abstract
Targeted dystrophin exon removal is a promising therapy for Duchenne muscular dystrophy (DMD); however, dystrophin expression in some reports is not supported by the associated data. As in the account of 'The Emperor's New Clothes', the validity of such claims must be questioned, with critical re-evaluation of available data. Is it appropriate to report clinical benefit and induction of dystrophin as dose dependent when the baseline is unclear? The inability to induce meaningful levels of dystrophin does not mean that dystrophin expression as an end point is irrelevant, nor that induced exon skipping as a strategy is flawed, but demands that drug safety and efficacy, and study parameters be addressed, rather than questioning the strategy or the validity of dystrophin as a biomarker.
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Fletcher S. Book review: War, art and surgery – the work of Henry Tonks and Julia Midgley. Br Dent J 2015. [DOI: 10.1038/sj.bdj.2015.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Everitt J, Fletcher S, Caird-Daley A. Task analysis of discrete and continuous skills: a dual methodology approach to human skills capture for automation. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2015. [DOI: 10.1080/1463922x.2015.1028508] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Shy M, Karmonik C, Anderson J, Alkattan A, Boone T, Fung S, Fletcher S, Khavari R. PD10-02 HIGHER NEURAL CORRELATES AT INITIATION OF VOIDING IN PATIENTS WITH MULTIPLE SCLEROSIS WITH NEUROGENIC BLADDER DYSFUNCTION VIA CONCURRENT FUNCTIONAL MAGNETIC RESONANCE IMAGING (FMRI) AND URODYNAMIC STUDIES. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Martin A, Bovill WD, Percy CD, Herde D, Fletcher S, Kelly A, Neate SM, Sutherland MW. Markers for seedling and adult plant crown rot resistance in four partially resistant bread wheat sources. TAG. THEORETICAL AND APPLIED GENETICS. THEORETISCHE UND ANGEWANDTE GENETIK 2015; 128:377-85. [PMID: 25471673 DOI: 10.1007/s00122-014-2437-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 11/21/2014] [Indexed: 05/24/2023]
Abstract
QTL identified for seedling and adult plant crown rot resistance in four partially resistant hexaploid wheat sources. PCR-based markers identified for use in marker-assisted selection. Crown rot, caused by Fusarium pseudograminearum, is an important disease of wheat in many wheat-growing regions globally. Complete resistance to infection by F. pseudograminearum has not been observed in a wheat host, but germplasm with partial resistance to this pathogen has been identified. The partially resistant wheat hexaploid germplasm sources 2-49, Sunco, IRN497 and CPI133817 were investigated in both seedling and adult plant field trials to identify markers associated with the resistance which could be used in marker-assisted selection programs. Thirteen different quantitative trait loci (QTL) conditioning crown rot resistance were identified in the four different sources. Some QTL were only observed in seedling trials whereas others appeared to be adult plant specific. For example while the QTL on chromosomes 1AS, 1BS, and 4BS contributed by 2-49 and on 2BS contributed by Sunco were detected in both seedling and field trials, the QTL on 1DL present in 2-49 and the QTL on 3BL in IRN497 were only detected in seedling trials. Genetic correlations between field trials of the same population were strong, as were correlations between seedling trials of the same population. Low to moderate correlations were observed between seedling and field trials. Flanking markers, most of which are less than 10 cM apart, have now been identified for each of the regions associated with crown rot resistance.
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Fletcher S. SUPER SUPERVISORS. MIDWIVES 2015; 18:27. [PMID: 26665791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Abstract
Recent advancements in the condensation of alcohols with pronucleophiles by the Mitsunobu reaction are described.
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Johnstone V, Viola H, Adams A, Wilton S, Fletcher S, Hool L. Optimising morpholino oligomer therapy in the treatment of mdx cardiomyopathy. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dye J, Scallon A, Qian F, Fletcher S. Musculoskeletal disorder among oral and maxillofacial surgeons and operating position. J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.joms.2014.06.201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Fletcher S, Nosek MA, Rizk DEE. Mobility impairments and pelvic health disorders in women: the need for innovative treatment and research. Int Urogynecol J 2014; 25:1003-4. [PMID: 24928502 DOI: 10.1007/s00192-014-2428-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 04/29/2014] [Indexed: 10/25/2022]
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Longstaff A, Fletcher S, Parkinson S, Myers A. The role of measurement and modelling of machine tools in improving product quality. INTERNATIONAL JOURNAL OF METROLOGY AND QUALITY ENGINEERING 2014. [DOI: 10.1051/ijmqe/2013054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Burghes A, McGovern V, Porensky P, Arnold W, Mitrpant C, Price L, Fletcher S, Wilton S. O10 Development of PMO antisense oligonucleotides for treatment of Spinal muscular atrophy. Neuromuscul Disord 2014. [DOI: 10.1016/s0960-8966(14)70011-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Velthuis J, Page R, Hugtenburg R, Blake S, Crawford D, Fletcher S, Saunders M, Stevens P. 207: An Intensity Modulated Radiotherapy Beam Monitoring System using a Monolithic Active Pixel Sensor. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34228-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Blake S, Fletcher S, Stevens P, Velthuis J, Page R, Hugtenberg R. OC-0509: Early results for a novel IMRT verification system based on an upstream MAPS detector. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30614-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jones MG, Fletcher S, Richeldi L. Idiopathic Pulmonary Fibrosis: Recent Trials and Current Drug Therapy. Respiration 2013; 86:353-63. [DOI: 10.1159/000356958] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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