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Ren MY, Shi YJ, Ding Y, Lu W, Fan SS, Tao XH. Current status and research progress of nanoparticle application in superficial fungal infection. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2023; 27:5257-5263. [PMID: 37318500 DOI: 10.26355/eurrev_202306_32645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Superficial fungal infections (SFIs) are characterized by diverse etiologies, complex pathogenesis, and marked geographical differences in patient symptoms. Conventional management of SFIs is associated with complications such as hepatotoxicity, skin problems, severe headaches, and clinical difficulties including intractable relapses and drug-drug interactions in patients with chronic diseases remain to be addressed. Moreover, in topical treatment, low penetration of antifungal drugs in hard tissues such as finger (toe) nails and drug-resistant fungi are emerging concerns in current antifungal therapy. Nanotechnology has been a leading research topic in recent years for new dosing forms of antifungal drugs, chemical modification of traditional drugs, and pharmacokinetic improvement, providing potential opportunities for the effective treatment of SFIs. The present study reviewed the direct use of nanoparticles in SFIs and the use of nanoparticles as carriers in SFIs and discussed their future medicinal applications. Graphical Abstract https://www.europeanreview.org/wp/wp-content/uploads/01-12915-PM-29863.jpg.
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Liu Q, Dai Y, Yu H, Shen Y, Deng J, Lu W, Jin J. [NKD1 promotes glucose uptake in colon cancer cells by activating YWHAE transcription]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2023; 43:585-589. [PMID: 37202194 DOI: 10.12122/j.issn.1673-4254.2023.04.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVE Bo investigate the regulatory relationship between NKD1 and YWHAE and the mechanism of NKD1 for promoting tumor cell proliferation. METHODS HCT116 cells transfected with pcDNA3.0-NKD1 plasmid, SW620 cells transfected with NKD1 siRNA, HCT116 cells with stable NKD1 overexpression (HCT116-NKD1 cells), SW620 cells with nkd1knockout (SW620-nkd1-/- cells), and SW620-nkd1-/- cells transfected with pcDNA3.0-YWHAE plasmid were examined for changes in mRNA and protein expression levels of YWHAE using qRT-PCR and Western blotting. Chromatin immunoprecipitation (ChIP) assay was used to detect the binding of NKD1 to the promoter region of YWHAE gene. The regulatory effect of NKD1 on YWHAE gene promoter activity was analyzed by dual-luciferase reporter gene assay, and the interaction between NKD1 and YWHAE was analyzed with immunofluorescence assay. The regulatory effect of NKD1 on glucose uptake was examined in the tumor cells. RESULTS In HCT116 cells, overexpression of NKD1 significantly enhanced the expression of YWHAE at both the mRNA and protein levels, while NKD1 knockout decreased its expression in SW620 cells (P < 0.001). ChIP assay showed that NKD1 protein was capable of binding to the YWHAE promoter sequence; dual luciferase reporter gene assay showed that NKD1 overexpression (or knockdown) in the colon cancer cells significantly enhanced (or reduced) the transcriptional activity of YWHAE promoter (P < 0.05). Immunofluorescence assay demonstrated the binding of NKD1 and YWHAE proteins in colon cancer cells. NKD1 knockout significantly reduced glucose uptake in colon cancer cells (P < 0.01), while YWHAE overexpression restored the glucose uptake in NKD1-knockout cells (P < 0.05). CONCLUSION NKD1 protein activates the transcriptional activity of YWHAE gene to promote glucose uptake in colon cancer cells.
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Chu J, Lu W, Yang S. Targeted Optimal Treatment Regime Learning Using Summary Statistics. Biometrika 2023. [DOI: 10.1093/biomet/asad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
SUMMARY
Personalized decision-making, aiming to derive optimal treatment regimes based on individual characteristics, has recently attracted increasing attention in many fields, such as medicine, social services, and economics. Current literature mainly focuses on estimating treatment regimes from a single source population. In real-world applications, the distribution of a target population can be different from that of the source population. Therefore, treatment regimes learned by existing methods may not generalize well to the target population. Due to privacy concerns and other practical issues, individual-level data from the target population is often not available, which makes treatment regime learning more challenging. We consider the problem of treatment regime estimation when the source and target populations may be heterogeneous, individual-level data is available from the source population, and only the summary information of covariates, such as moments, is accessible from the target population. We develop a weighting framework that tailors a treatment regime for a given target population by leveraging the available summary statistics. Specifically, we propose a calibrated augmented inverse probability weighted estimator of the value function for the target population and estimate an optimal treatment regime by maximizing this estimator within a class of pre-specified regimes. We show that the proposed calibrated estimator is consistent and asymptotically normal even with flexible semi/nonparametric models for nuisance function approximation, and the variance of the value estimator can be consistently estimated. We demonstrate the empirical performance of the proposed method using simulation studies and a real application to an eICU dataset as the source sample and a MIMIC-III dataset as the target sample.
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Wang Z, Wang WJ, Ding XY, Lu P, Zhu LM, Liu Q, Lu W. [Progress in research of prophylactic therapy in contacts of rifampicin-resistant tuberculosis patients]. ZHONGHUA LIU XING BING XUE ZA ZHI = ZHONGHUA LIUXINGBINGXUE ZAZHI 2023; 44:470-476. [PMID: 36942344 DOI: 10.3760/cma.j.cn112338-20220729-00673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Tuberculosis (TB) prophylactic therapy for latent infection, which can reduce the risk for the development of active TB, is an important measure in TB control. China recommends prophylactic therapy for latent tuberculosis infection (LTBI) in some key populations to reduce the risk for TB. Contacts of patients with multi-drug and rifampicin-resistant TB (MDR/RR-TB) are at high risk for the infection with drug-resistant pathogen, however, no unified prophylactic therapy regimen has been recommended for LTBI due to exposure to MDR/RR-TB patients. This paper summarizes the current MDR/RR-TB prophylactic therapy regimen and its protection effect based on the results of the retrieval of literature, guidelines, expert consensus and technical specifications to provide reference for the prevention and control of LTBI.
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Huo HM, Yao X, Lai YJ, Lu W, Liu CL, Huang ZH, Wei ZZ, Xie Y. [Analysis of success rate of organoid construction of nasopharyngeal carcinoma by first-day suspension method]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2023; 58:250-255. [PMID: 36878504 DOI: 10.3760/cma.j.cn115330-20220801-00473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Objective: To investigate the efficacy of the first-day suspension method for improving the success rate of construction of nasopharyngeal carcinoma-patient derived organoids (NPC-PDO). Methods: The tumor samples of 14 nasopharyngeal carcinoma(NPC) patients, i.e.,13 males and 1 female, with a mean age of 43.0±12.0 years old, were collected from the Affiliated Tumor Hospital of Guangxi Medical University and the First Affiliated Hospital of Guangxi Medical University from January 2022 to July 2022. The tumor samples of 3 patients were digested into single cell suspension and divided into 2 groups, for comparing the efficacy of NPC-PDO construction by the direct inoculation method and the first-day suspension method. The remaining 11 patients were randomized to receive either the direct inoculation method or the first-day suspension method for NPC-PDO construction. The diameter and the number of spheres of NPC-PDO constructed by the two methods were compared by optical microscope; the 3D cell viability detection kit was used to compare the cell viability; the survival rates were compared by trypan blue staining; the success rates of the two construction methods were compared; the number of cases which could be successfully passaged for more than 5 generations and were consistent with the original tissue by pathological examination was counted; and the dynamic changes of cells in suspension overnight were observed by live cell workstation. The independent sample t-test was applied to compare the measurement data of the two groups, and the chi-square test was used to compare the classification data. Results: Compared with the direct inoculation, the diameter and the number of spheres of NPC-PDO constructed by the first-day suspension method were increased, with a higher cell activity, and the success rate of construction was obviously improved (80.0% vs 16.7%, χ2=4.41, P<0.05). In the suspension state, some of the cells aggregated and increased their ability to proliferate. Conclusion: The first-day suspension method can improve the success rate of NPC-PDO construction, especially for those whose original tumor sample size is small.
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Xu H, Zheng H, Zhang Q, Song H, Wang Q, Xiao J, Dong Y, Shen Z, Wang S, Wu S, Wei Y, Lu W, Zhu Y, Niu X. A Multicentre Clinical Study of Sarcoma Personalised Treatment Using Patient-Derived Tumour Xenografts. Clin Oncol (R Coll Radiol) 2023; 35:e48-e59. [PMID: 35781406 DOI: 10.1016/j.clon.2022.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/21/2022] [Accepted: 06/09/2022] [Indexed: 01/04/2023]
Abstract
AIMS Medication for advanced sarcomas has not improved for three decades. Patient-derived tumour xenografts (PDTX) are a promising solution for developing new therapies and real-time personalised medicine because of their highly effective prediction of drug efficacy. However, there is a dearth of PDTX models for sarcomas due to the scarcity and heterogeneity of the disease. MATERIALS AND METHODS A multicentre clinical collaborative study (ChiCTR-OOC-17013617) was carried out. Fresh patient tumour tissues via resection or biopsy were used for the PDTX set-up. The standard medical care chosen by the physician was given to the patient, in parallel with testing on multiple regimens. The outcomes of patients' responses and PDTX tests were compared. Comprehensive analyses were carried out to assess the clinical value of PDTX for the treatment of sarcomas. Living tissues from successfully engrafted cases were deposited into a repository. RESULTS Forty-two cases, including 36 bone sarcomas and six soft-tissue sarcomas, were enrolled; the overall engraftment rate was 73.8%. Histopathological examination showed a 100% consistency between primary tumours and tumour grafts. The engraftment rate was independent of age, gender and sampling methods, but was associated with subtypes of tumour. The outgrowth time of tumour grafts could be associated with prognosis. Major somatic mutations in tumour grafts occurred primarily in common tumour driver genes. Poor prognosis was associated with the KMT2C mutation. A drug efficacy test showed complete concordance between the PDTX model and patients' responses in 17 regimens. CONCLUSION PDTX is an ideal preclinical model for sarcomas because of its faithful preservation of the heterogeneity of the disease, a satisfactory engraftment rate and high accuracy in its prediction of drug efficacy.
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Feng HF, Xu GE, Chen B, Sun SP, Zeng BP, Tang WX, Lu W. [Branchio-oto-renal syndrome or branchio-oto syndrome: the clinical and genetic analysis in five Chinese families]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2022; 57:1433-1441. [PMID: 36707947 DOI: 10.3760/cma.j.cn115330-20221119-00694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Objective: To screen the causative genes of five families with branchio-oto-renal syndrome (BORS) or branchio-oto syndrome(BOS) and to analyze the phenotypic characteristics and clinical management strategies of patients. Methods: Five families with BORS/BOR from December 2018 to September 2021 were recruited, information of patients, including family history and medical history, was collected, and genealogies were drawn. The examinations concerning audiology, nephrology, and radiology were performed on the affected individuals. Peripheral blood was obtained for DNA extraction, then next-generation sequencing technology was used to screen candidate variants associated with BORS/BOS. Based on patient's clinical results, the appropriate interventions were recommended and implemented. Results: Eight individuals were diagnosed with BOS or BORS. Of the eight patients, all had hearing loss, preauricular pits and ear malformations, and only four presented with branchial cleft fistulae or cysts. Except for two patients(5-I-2, 5-II-2) who did not undergo renal examination, the remaining six lacked renal abnormalities. Genetic analysis identified four likely pathogenic or pathogenic EYA1 variants (c.1715G>T, c.1140+1G>A, c.639G>C, c.1475+1G>C; NM_000503.6), and c.1715G>T was first reported in this study. Middle ear ossicular reconstruction was performed in 1-II-2,2-I-2 and 3-II-2, but did not yield the expected results; then hearing aids and cochlear implantation were recommended and achieved satisfactory results. Conclusions: Next-generation sequencing technology facilitates the diagnosis and genetic counseling of BORS/BOS. Hearing loss, preauricular pits, ear malformations and branchial cleft fistulae or cysts are the most common manifestations of patients in this study. Middle ear surgeries for improving hearing loss may have some limitations in BORS/BOS patients, and hearing aids and cochlear implantation can contribute to hearing gains.
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Alam S, Meyer S, Kuo L, Hu Y, Lu W, Yorke E, Rimner A, Cervino L, Zhang P. Patient-Specific Quality Assurance of Deformable Image Registrations Using Atlas for Adaptive Radiotherapy of Lung Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lin J, Chen M, Lai Y, Trivedi Z, Wu J, Foo T, Gonzalez Y, Lin M, Reynolds R, Park J, Yan Y, Godley A, Pompos A, Jiang S, Jia X, Lu W. Improving Online Adaptive Radiotherapy Quality Assurance with Streamlined Clinical Workflow through In-House Development. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Xie X, Lu W, Qiu J, Cheng Z. Metabolic and Textural Changes in the Brain of Lung Cancer Patients: A Total-Body PET/CT Study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1492] [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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Reyngold M, O'Reilly E, Herrera R, Kaiser A, Zinovoy M, Romesser P, Wu A, Hajj C, Cuaron J, Ucar A, de Zarraga F, Aparo S, Lu W, Mittauer K, McCulloch J, Romaguera T, Alvarez D, Gutierrez A, Crane C, Chuong M. Multi-Institutional Comparison of Ablative Radiation Therapy in 5 Versus 15-25 Fractions for Locally Advanced Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Montalvo S, Bennett A, All S, Lue B, Kakadiaris E, Westover K, Iyengar P, Lu W, Gu X, Munshi N, Zaha V, Dianels J, Link M, Alluri P. Association between Thoracic Radiation and Heart Rhythm Disorders: Toward a Model for Describing Long-Term Cardiac Risk from Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kozela M, Pająk A, Ayuso-Mateo JL, Bobak M, Lu W, Pikhart H, Polak M, Sanchez-Niubo A, Stepaniak U, Haro JM. ATHLOS Healthy Ageing Scale score as the predictor of mortality in Poland and the Czech Republic. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A novel tool to measure healthy ageing was developed by the ATHLOS consortium (Ageing Trajectories of Health-Longitudinal Opportunities and Synergies). ATHLOS Healthy Ageing Scale, constructed using harmonized data from 16 independent ageing cohorts, was designed to contribute to worldwide research on healthy ageing. The aim of the analysis was to assess the relation between ATHLOS Healthy Ageing Scale and all-cause mortality in Central European populations.
Methods
Participants of the Polish and Czech HAPIEE cohorts (baseline age 45-69 years) were followed for 14 years. ATHLOS Healthy Ageing Scale was based on over 40 health indicators related to intrinsic capacity and functional ability. Cox proportional hazards models were used to determine the relationship between the ATHLOS Healthy Ageing Scale scores and all-cause mortality.
Results
As many as 9,922 Polish and 8,518 Czech participants had non-missing data on the ATHLOS Healthy Ageing Scale score and mortality (1828 and 1700 deaths, respectively). After adjustment for age, dose-response associations with mortality in both genders and countries were found (HR for lowest vs. highest quintile of the ATHLOS Healthy Ageing Scale: 2.98 and 1.96 in Czech and Polish women and 2.83 and 2.66 in Czech and Polish men, respectively). Only modest attenuation was observed when additionally adjusted for education, economic activity, smoking and self-rated health.
Conclusions
The ATHLOS Healthy Ageing Scale was found to be a good predictor of all-cause mortality in urban populations of Poland and Czechia. This composite indicator seems to be an important contributor to a better assessment of healthy ageing.
Key messages
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Zhang Y, Zhang YP, Zhang RL, Jia LH, Wang QW, Wang Y, Lu W, Wen JG. [Analysis of video-urodynamic and clinical features of non-neuropathic lower urinary tract dysfunction in children]. ZHONGHUA YI XUE ZA ZHI 2022; 102:3001-3006. [PMID: 36229200 DOI: 10.3760/cma.j.cn112137-20220118-00129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To analyze the video-urodynamic(VUDS) and clinical features of non-neuropathic lower urinary tract dysfunction (NNLUTD) in children. Methods: Children diagnosed with NNLUTD in the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2020 were included. Children with neurological, rectal dysfunction and anatomical abnormalities were excluded. VUDS and urinalysis were performed in all children who were divided into 4 groups accordingly: normal group (Normal group), detrusor overactivity group(DO group), detrusor sphincter dyssynergia group (DSD group) and detrusor underactivity group (DU group). VUDS and clinical features, vesicoureteral reflux (VUR) and urinary tract infections (UTI) were analyzed. Results: A total of 173 children were included in this study, including 103 males and 70 females, aged (7.2±3.3) years. VUDS showed that 46 cases (26.6%) were in Normal group, 63 cases (36.4%) in DO group, 39 cases (22.5%) in DSD group and 25 cases (14.5%) in DU group. Compared with Normal group and DO group, the proportion of VUR in DSD group and DU group was significantly higher [18(46.2%) and 11(44.0%) vs 7(15.0%) and 14(22.2%), all P<0.05],and the proportion of male children was significantly higher than that of female children with VUR only in DO group [12(32.4%) vs 2(7.7%), P=0.020 ]; Compared with DO group, the proportion of UTI in DSD group and DU group was significantly higher [16(41.0%) and 12(48.0%) vs 12(19.0%), all P<0.05], and the proportion of female children was significantly higher than that of male children with UTI in normal group, DO group and DU group [9(45.0%) vs 4(15.4%), 8(30.8%) vs 4(10.8%)and 7(87.5%) vs 5(29.4%), all P<0.05]. The maximum detrusor pressure in DSD group was significantly higher than that in Normal group, DO group and DU group [(95±47) vs (43±18), (56±18) and (12±9)cmH2O, all P<0.05, 1 cmH2O=0.098 kPa).Compared with Normal group and DO group, post void residual in DSD group and DU group was significantly increased [(58±38) and (70±62) vs (8±8) and (8±7)ml, all P<0.05], and the proportion of lower bladder compliance was significantly increased [(15(38.5%) and 11(44%) vs 1(2.2%) and 10(15.9%), all P<0.05]. Compared with normal group, the maximum bladder capacity of DO, DSD and DU group were all significantly decreased [(178±61), (184±81) and (194±93) vs (256±92)ml, all P<0.05]. The proportion of urgency had significant difference in the four groups [13(28.3%) in Normal group, 41(65.1%) in DO group, 22(56.4%) in DSD group and 11(44.0%) in DU group, P=0.001], and the proportion of dysuria had significant difference too [5(10.9%) in Normal group, 18(28.6%) in DO group, 20(51.3%) in DSD group and 15(60.0%) in DU group, P<0.001]. Conclusions: Children with 4 different conditions of NNLUTD have distinct video-urodynamic features. The higher ratio of VUR and UTI in DSD and DU children may be associated with reduced bladder compliance and increased post void residual. VUDS is useful for the diagnosis and treatment of refractory children with NNLUTD.
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Hageman SHJ, Lu W, Kaptoge S, Lall K, Bobak M, Pikhart H, Kubinova R, Pajak A, Tamosiunas A, Stang A, Schmidt B, Schramm S, Di Angelantonio E, Visseren FLJ, Dorresteijn JAN. Prediction of lifetime cardiovascular risk and individual lifetime treatment benefit in four European risk regions: geographic recalibration of the LIFE-CVD model. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The life expectancy free of cardiovascular disease (CVD) in individuals without previous CVD can be estimated with the LIFEtime-perspective CardioVascular Disease (LIFE-CVD) model, as recommended by the 2021 ESC CVD prevention guidelines. Our aim was to systematically recalibrate the LIFE-CVD model to four European risk regions using contemporary and representative registry data.
Methods and results
The LIFE-CVD model was systematically recalibrated to four distinct risk regions within Europe, using representative aggregate data on age- and sex-specific expected CVD and non-CVD mortality incidences and risk factor distributions. For external validation, 1,451,077 individuals without previous CVD were included from seven European cohorts, with 53,721 CVD events and 62,902 non-CVD deaths during follow up. After applying the recalibrated risk prediction models to external validation cohorts, C-indices (figure 1) ranged from 0.670 (95% CI 0.650–0.690) to 0.787 (95% CI 0.785–0.789). Predicted risks matched the observed risks in the CPRD data. With the recalibrated LIFE-CVD model, the estimated gain in CVD-free life expectancy from preventive therapy differed per region, for example a 50-year-old smoking women with a systolic blood pressure of 140mm Hg was estimated to gain 0.4 years of CVD-free life from 10 mm Hg SBP reduction in the low risk region, whereas this would be 1.5 years in the very high risk region (figure 2).
Interpretation
By taking into account geographical differences in CVD incidence, the recalibrated LIFE-CVD model provides a more accurate tool for the prediction of lifetime risk and CVD-free life expectancy for individuals without previous CVD, facilitating shared decision-making in cardiovascular prevention options as recommended by the 2021 European Prevention Guidelines.
Funding Acknowledgement
Type of funding sources: None.
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Zhang F, Wang Z, Su H, Zhao H, Lu W, Zhou W, Zhang H. Effect of a home-based resistance exercise program in elderly participants with osteoporosis: a randomized controlled trial. Osteoporos Int 2022; 33:1937-1947. [PMID: 35704055 DOI: 10.1007/s00198-022-06456-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 05/31/2022] [Indexed: 11/30/2022]
Abstract
UNLABELLED The effectiveness of home-based resistance exercise in elder participants with osteoporosis remains unclear. This study demonstrates the beneficial effects of this mode of exercise on improving physical function, increasing confidence in exercise, and reducing fear of falling. INTRODUCTION This study aims to evaluate the effect of a home-based resistance exercise (HBRE) program versus control on physical function, exercise self-efficacy, falling efficacy, and health-related quality of life (HRQOL). METHODS This randomized controlled trial included 72 elderly participants with osteoporosis. Participants in the intervention group received a 12-week HBRE program, and the control group received usual care. The primary outcome was physical function, including muscle strength and balance ability; secondary outcomes were exercise self-efficacy, falling efficacy, and HRQOL. Within-group and between-group changes in outcome were evaluated by t-test and rank-sum test. RESULTS A total of 68 subjects were included in the final analysis. Improvement in physical function was significantly greater in the HBRE group compared with controls. On a psychological level, exercise self-efficacy and falling efficacy improved significantly in the HBRE group; no significant change was observed in the control group. Most of the dimensions of HRQOL demonstrated improvements as well. The adherence was 85.29%, with no adverse events related to the exercise. CONCLUSION A 12-week HBRE program was safe non-pharmacological therapy for elderly participants with osteoporosis, improving physical function, exercise self-efficacy, reduced fear of falling, and improved HRQOL. TRIAL REGISTRATION Chinese Clinical Trial Register: ChiCTR2100051455. Registered 23.09.21. Retrospectively registered.
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Lu W, Huang Z, Wang J, Chen Y, Huang M. 359P Analysis of TMB and tumor microenvironment in Polymerase epsilon (POLE) deficient colorectal cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Kristensen LE, Keiserman M, Papp K, Mccasland L, White D, Lu W, Soliman AM, Eldred A, Barcomb L, Behrens F. POS1024 EFFICACY AND SAFETY OF RISANKIZUMAB (RZB) FOR ACTIVE PSORIATIC ARTHRITIS (PsA): 52-WEEK RESULTS FROM KEEPsAKE 1. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRZB, a humanized immunoglobulin G1 monoclonal antibody that specifically inhibits the p19 subunit of the human cytokine IL-23, is being investigated as a treatment for PsA.ObjectivesTo compare efficacy and safety of RZB vs. placebo (PBO) in patients with PsA who had an inadequate response or intolerance to conventional synthetic disease modifying antirheumatic drug (csDMARD-IR).MethodsKEEPsAKE 1 (NCT03675308) is an ongoing, phase 3 study that includes a screening period; a 24-week double-blinded, placebo-controlled, parallel-group period (period 1); and an open-label extension period (period 2). Eligible patients aged ≥18 years with active PsA (symptom onset ≥6 months prior to screening, meeting the Classification Criteria for PsA [CASPAR], and ≥5 swollen and ≥5 tender joints) and who had an inadequate response or intolerance to ≥1 csDMARD-IR, were randomized 1:1 to receive RZB 150 mg or placebo (PBO) at weeks 0, 4, and 16. The primary endpoint was the proportion of patients achieving ≥20% improvement in American College of Rheumatology (ACR20) response at week 24. Period 2 started at week 24, and patients were switched to receive open-label RZB 150 mg every 12 weeks through week 208. Mixed-effect model repeated measures and nonresponder imputation methods were used to assess continuous and binary variables, respectively. Efficacy and safety were analyzed in all patients who received ≥1 dose of study drug through week 52. Treatment-emergent adverse events (TEAE) were summarized using exposure-adjusted event rates (EAERs, events/100 patient-years [PY]).ResultsAt week 24, a greater proportion of RZB-treated (N=483) vs PBO-treated (N=481) patients achieved ACR20 (55.3% and 32.8%, respectively). At week 52, 70% of patients who were randomized to receive RZB and 63% of patients who were randomized to receive PBO and switch to RZB at week 24 achieved ACR20. In patients with ≥3% of body surface area affected at baseline, 52.7% of RZB-treated patients (N=273) and 9.9% of PBO-treated patients (N=272) achieved ≥90% improvement in Psoriasis Area and Severity Index (PASI 90) at week 24; 67.8% who were randomized to receive RZB and 59.9% who were randomized to receive PBO and switch to RZB at week 24 achieved PASI 90 at week 52. Similar results were observed for other efficacy measures. RZB was well tolerated through 52 weeks of treatment. EAERs of adverse events were stable between weeks 24 and 52. At the week 52 data cut-off (19 April 2021), the total EAER of any TEAE in patients receiving RZB was 143.1/100 PY.ConclusionContinuous RZB treatment provided durable efficacy and a consistent safety profile through 52 weeks of treatment in patients with active PsA who were csDMARD-IR.AcknowledgementsAbbVie, Inc. participated in the study design; study research; collection, analysis, and interpretation of data. AbbVie funded the research for this study. Medical writing assistance, funded by AbbVie, was provided by Jay Parekh, PharmD, of JB Ashtin.Disclosure of InterestsLars Erik Kristensen Speakers bureau: AbbVie, Amgen, Biogen, Bristol Myers Squibb, Gilead, Janssen, Lilly, Merck, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Biogen, Bristol Myers Squibb, Gilead, Janssen, Lilly, Merck, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Biogen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB, MAURO KEISERMAN Speakers bureau: AbbVie, Amgen, Bristol Myers Squibb, Celgene, GlaxoSmithKline, Janssen, Novartis, Pfizer, Roche, and UCB, Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene, GlaxoSmithKline, Janssen, Novartis, Pfizer, Roche, and UCB, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Celgene, GlaxoSmithKline, Janssen, Novartis, Pfizer, Roche, and UCB, Kim Papp Speakers bureau: AbbVie, Amgen, Arcutis, Astellas, Bausch Health, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Dermavant, Dermira, Incyte, Janssen, LEO Pharma, Lilly, Novartis, Pfizer, Sandoz, Sanofi Genzyme, and UCB, Consultant of: AbbVie, Amgen, Arcutis, Astellas, Bausch Health, Baxalta, Baxter, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Coherus, Dermavant, Dermira, EMD Serono, Forward Pharma, Galderma, Genentech, Gilead, Incyte, Janssen, LEO Pharma, Lilly, Meiji Seika Pharma, Merck, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Regeneron, Sandoz, Sanofi Genzyme, Stiefel, Sun Pharma, Takeda, and UCB, Grant/research support from: AbbVie, Amgen, Arcutis, Astellas, Bausch Health, Baxalta, Baxter, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Coherus, Dermavant, Dermira, EMD Serono, Forward Pharma, Galderma, Genentech, Gilead, Incyte, Janssen, LEO Pharma, Lilly, Merck, Novartis, Ortho Dermatologics, Pfizer, Regeneron, Sanofi Genzyme, Sun Pharma, and UCB, Leslie McCasland Consultant of: Lilly, Douglas White Speakers bureau: AbbVie and Novartis, Consultant of: AbbVie and Novartis, Wenjing Lu Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Ahmed M. Soliman Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Ann Eldred Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Lisa Barcomb Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Frank Behrens Speakers bureau: AbbVie, Amgen, Boehringer Ingelheim, Celgene, Chugai, Galapagos, Genzyme, Gilead, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, and Sanofi, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Celgene, Chugai, Galapagos, Genzyme, Gilead, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, and Sanofi, Grant/research support from: AbbVie, Amgen, Boehringer Ingelheim, Celgene, Chugai, Galapagos, Genzyme, Gilead, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, and Sanofi
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Ostor A, Van den Bosch F, Papp K, Asnal C, Blanco R, Aelion J, Lu W, Wang Z, Soliman AM, Eldred A, Padilla B, Kivitz A. POS1036 EFFICACY AND SAFETY OF RISANKIZUMAB (RZB) FOR ACTIVE PSORIATIC ARTHRITIS (PsA): 52-WEEK RESULTS FROM KEEPsAKE 2. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundRZB, a humanized immunoglobulin G1 monoclonal antibody that specifically inhibits the p19 subunit of the human cytokine interleukin-23, is being investigated as a treatment for PsA.ObjectivesEvaluate longer-term safety and efficacy of RZB in patients with active PsA who experienced inadequate response or intolerance to 1 or 2 biologic therapies and/or to at least 1 csDMARD therapy.MethodsKEEPsAKE 2 (NCT03671148) is an ongoing, phase 3, multicenter study that includes a screening period; a 24-week double-blinded, randomized, placebo-controlled, parallel-group period (period 1); and an open-label extension period (period 2). Eligible patients were ≥18 years of age with active PsA (symptom onset ≥6 months before screening, meeting Classification Criteria for PsA [CASPAR], and ≥5 tender and ≥5 swollen joints) and had inadequate response or intolerance to 1 or 2 biologic therapies (Bio-IR) and/or ≥1 conventional synthetic disease modifying antirheumatic drug (csDMARD-IR). Patients received RZB 150 mg or placebo (PBO) at weeks 0, 4, and 16 (1:1). The primary endpoint was the proportion of patients achieving ACR20 response at week 24. Period 2 started at week 24, and patients were switched to receive open-label RZB 150 mg every 12 weeks through week 208. Efficacy and safety were analyzed in patients who received ≥1 dose of study drug through week 52. Mixed-effect model with repeated measures and nonresponder imputation methods were used to assess continuous and binary variables, respectively. Treatment-emergent adverse events (TEAEs) were summarized using exposure-adjusted event rates (EAERs, events/100 patient-years [PY]).ResultsAt week 24, 51,3% of RZB-treated (N=224) and 26.5% of PBO-treated (N=219) patients achieved ACR20. At week 52, 58.5% of patients who were randomized to RZB and 55.7% of patients who were randomized to PBO and then switched to RZB at week 24 achieved ACR20. In patients with ≥3% of body surface area affected at baseline, 55.0% of RZB-treated patients (N=123) and 10.2% of PBO-treated patients (N=119) achieved PASI 90 at week 24. At week 52, 64.2% of patients randomized to RZB and 59.7% of patients who were randomized to PBO and then switched to RZB at week 24 achieved PASI 90. For other efficacy measures, similar trends were observed. RZB was well tolerated through 52 weeks of treatment, and EAERs of adverse events were stable between weeks 24 and 52. At the week 52 data cutoff (19 April 2021), the total EAER of any TEAE in patients receiving RZB was 184.2/100 PY.ConclusionContinuous RZB treatment resulted in maintained efficacy responses with a consistent safety profile through 52 weeks of treatment in patients with active PsA who were Bio-IR and/or csDMARD-IR.AcknowledgementsAbbVie, Inc. participated in the study design; study research; collection, analysis, and interpretation of data. AbbVie funded the research for this study and provided writing support for this abstract. Medical writing assistance, funded by AbbVie, was provided by Jay Parekh, PharmD, of JB Ashtin.Disclosure of InterestsAndrew Ostor Speakers bureau: AbbVie, Celgene, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB., Consultant of: AbbVie, Celgene, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB., Filip van den Bosch Speakers bureau: AbbVie, Celgene, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB., Consultant of: AbbVie, Celgene, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB., Kim Papp Speakers bureau: AbbVie, Amgen, Astellas, Bausch Health (Valeant), Baxalta, Baxter, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Coherus, Dermira, EMD Serono, Forward Pharma, Galderma, Genentech, GlaxoSmithKline, Janssen, Kyowa Kirin, Lilly, LEO Pharma, MedImmune, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi Genzyme, Stiefel, Sun Pharma, Takeda, and UCB, Consultant of: AbbVie, Amgen, Astellas, Bausch Health (Valeant), Baxalta, Baxter, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Coherus, Dermira, EMD Serono, Forward Pharma, Galderma, Genentech, GlaxoSmithKline, Janssen, Kyowa Kirin, Lilly, LEO Pharma, MedImmune, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi Genzyme, Stiefel, Sun Pharma, Takeda, and UCB, Grant/research support from: AbbVie, Amgen, Astellas, Bausch Health (Valeant), Baxalta, Baxter, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Coherus, Dermira, EMD Serono, Forward Pharma, Galderma, Genentech, GlaxoSmithKline, Janssen, Kyowa Kirin, Lilly, LEO Pharma, MedImmune, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi Genzyme, Stiefel, Sun Pharma, Takeda, and UCB, CECILIA ASNAL Speakers bureau: AbbVie, Amgen, Genentech, Janssen, Lilly, Pfizer, Roche, and R-Pharm., Consultant of: AbbVie, Amgen, Genentech, Janssen, Lilly, Pfizer, Roche, and R-Pharm., Grant/research support from: AbbVie, Amgen, Genentech, Janssen, Lilly, Pfizer, Roche, and R-Pharm., Ricardo Blanco Speakers bureau: AbbVie, Bristol Myers Squibb, Janssen, Lilly, Merck, Pfizer, and Roche., Consultant of: AbbVie, Bristol Myers Squibb, Janssen, Lilly, Merck, Pfizer, and Roche., Grant/research support from: AbbVie, Merck, and Roche, Jacob Aelion Grant/research support from: AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb, Galapagos/Gilead, Genentech, GlaxoSmithKline, Lilly, Mallinckrodt, Nektar Therapeutics, Nichi-Iko, Novartis, Pfizer, Regeneron, Roche, Sanofi, Selecta Biosciences, and UCB., Wenjing Lu Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Zailong Wang Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Ahmed M. Soliman Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Ann Eldred Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Byron Padilla Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Alan Kivitz Shareholder of: AbbVie, Boehringer Ingelheim, Celgene, Flexion, Gilead, GlaxoSmithKline, Janssen, Lilly, Merck, Novartis, Pfizer, Regeneron, Sanofi Genzyme, Sun Pharma, and UCB., Speakers bureau: AbbVie, Boehringer Ingelheim, Celgene, Flexion, Gilead, GlaxoSmithKline, Janssen, Lilly, Merck, Novartis, Pfizer, Regeneron, Sanofi Genzyme, Sun Pharma, and UCB., Consultant of: AbbVie, Boehringer Ingelheim, Celgene, Flexion, Gilead, GlaxoSmithKline, Janssen, Lilly, Merck, Novartis, Pfizer, Regeneron, Sanofi Genzyme, Sun Pharma, and UCB.
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Lu W, Kang L, Sheu J, Chen R. T067 Vincristine sulfate inhibits platelet activation via suppressing AKT and MAPK phosphorylation. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Li F, Dalichaouch TN, Pierce JR, Xu X, Tsung FS, Lu W, Joshi C, Mori WB. Ultrabright Electron Bunch Injection in a Plasma Wakefield Driven by a Superluminal Flying Focus Electron Beam. PHYSICAL REVIEW LETTERS 2022; 128:174803. [PMID: 35570446 DOI: 10.1103/physrevlett.128.174803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 02/28/2022] [Accepted: 04/08/2022] [Indexed: 06/15/2023]
Abstract
We propose a new method for self-injection of high-quality electron bunches in the plasma wakefield structure in the blowout regime utilizing a "flying focus" produced by a drive beam with an energy chirp. In a flying focus the speed of the density centroid of the drive bunch can be superluminal or subluminal by utilizing the chromatic dependence of the focusing optics. We first derive the focal velocity and the characteristic length of the focal spot in terms of the focal length and an energy chirp. We then demonstrate using multidimensional particle-in-cell simulations that a wake driven by a superluminally propagating flying focus of an electron beam can generate GeV-level electron bunches with ultralow normalized slice emittance (∼30 nm rad), high current (∼17 kA), low slice energy spread (∼0.1%), and therefore high normalized brightness (>10^{19} A/m^{2}/rad^{2}) in a plasma of density ∼10^{19} cm^{-3}. The injection process is highly controllable and tunable by changing the focal velocity and shaping the drive beam current. Near-term experiments at FACET II where the capabilities to generate tens of kA, <10 fs drivers are planned, could potentially produce beams with brightness near 10^{20} A/m^{2}/rad^{2}.
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Hartley NJ, Grenzer J, Huang L, Inubushi Y, Kamimura N, Katagiri K, Kodama R, Kon A, Lu W, Makita M, Matsuoka T, Nakajima S, Ozaki N, Pikuz T, Rode A, Sagae D, Schuster AK, Tono K, Voigt K, Vorberger J, Yabuuchi T, McBride EE, Kraus D. Erratum: Using Diffuse Scattering to Observe X-Ray-Driven Nonthermal Melting [Phys. Rev. Lett. 126, 015703 (2021)]. PHYSICAL REVIEW LETTERS 2022; 128:169901. [PMID: 35522523 DOI: 10.1103/physrevlett.128.169901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Indexed: 06/14/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.126.015703.
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Chen M, Lin W, Gan J, Lu W, Wang M, Wang X, Yi J, Zhao Z. Transcriptomic Mapping of Human Parotid Gland at Single-Cell Resolution. J Dent Res 2022; 101:972-982. [PMID: 35220796 DOI: 10.1177/00220345221076069] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
As the largest salivary gland in oral cavity, the parotid gland plays an important role in initial digesting and lubricating food. The abnormal secretory function of the parotid gland can lead to dental caries and oral mucosal inflammation. In recent years, single-cell RNA sequencing (scRNA-seq) has been used to explore the heterogeneity and diversity of cells in various organs and tissues. However, the transcription profile of the human parotid gland at single-cell resolution has not been reported yet. In this study, we constructed the cell atlas of human parotid gland using the 10× Genomics platform. Characteristic gene analysis identified the biological functions of serous acinar cell populations in secreting digestive enzymes and antibacterial proteins. We revealed the specificity and similarity of the parotid gland compared to other digestive glands through comparative analyses of other published scRNA-seq data sets. We also identified the cell-specific expression of hub genes for Sjögren syndrome in the human parotid gland by integrating the results of genome-wide association studies and bulk RNA-seq, which highlighted the importance of immune cell dysfunction in parotid Sjögren syndrome pathogenesis.
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Petrov I, Boesenberg U, Bushuev VA, Hallmann J, Kazarian K, Lu W, Möller J, Reiser M, Rodriguez-Fernandez A, Samoylova L, Scholz M, Sinn H, Zozulya A, Madsen A. Performance of a cryo-cooled crystal monochromator illuminated by hard X-rays with MHz repetition rate at the European X-ray Free-Electron Laser. OPTICS EXPRESS 2022; 30:4978-4987. [PMID: 35209469 DOI: 10.1364/oe.451110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/18/2022] [Indexed: 06/14/2023]
Abstract
Due to the high intensity and MHz repetition rate of photon pulses generated by the European X-ray Free-Electron Laser, the heat load on silicon crystal monochromators can become large and prevent ideal transmission in Bragg diffraction geometry due to crystal deformation. Here, we present experimental data illustrating how heat load affects the performance of a cryogenically cooled monochromator under such conditions. The measurements are in good agreement with a depth-uniform model of X-ray dynamical diffraction taking beam absorption and heat deformation of the crystals into account.
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Su J, Qin Z, Fu H, Luo J, Huang Y, Huang P, Zhang S, Liu T, Lu W, Li W, Jiang T, Wei S, Yang S, Shen Y. Association of prenatal renal ultrasound abnormalities with pathogenic copy number variants in a large Chinese cohort. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 59:226-233. [PMID: 34090309 DOI: 10.1002/uog.23702] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 05/12/2021] [Accepted: 05/21/2021] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To assess the clinical utility of prenatal chromosomal microarray analysis (CMA) in fetuses with abnormal renal sonographic findings, and to evaluate the association of pathogenic or likely pathogenic copy number variants (P/LP CNVs) with different types of renal abnormality. METHODS This was a retrospective study of fetuses at 14-36 weeks screened routinely for renal and other structural abnormalities at the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. We retrieved and analyzed data from fetuses with abnormal renal sonographic findings, examined between January 2013 and November 2019, which underwent CMA analysis using tissue obtained from chorionic villus sampling (CVS), amniocentesis or cordocentesis. We evaluated the CMA findings according to type of renal ultrasound anomaly and according to whether renal anomalies were isolated or non-isolated. RESULTS Ten types of renal anomaly were reported on prenatal ultrasound screening, at a mean ± SD gestational age of 24.9 ± 4.8 weeks. The anomalies were diagnosed relatively late in this series, as 64% of cases with an isolated renal anomaly underwent cordocentesis rather than CVS. Fetal pyelectasis was the most common renal ultrasound finding, affecting around one-third (34.32%, 301/877) of fetuses with a renal anomaly, but only 3.65% (n = 11) of these harbored a P/LP CNV (comprising: isolated cases, 2.37% (4/169); non-isolated cases, 5.30% (7/132)). Hyperechogenic kidney was found in 5.47% (n = 48) of fetuses with a renal anomaly, of which 39.58% (n = 19) had a P/LP CNV finding (comprising: isolated cases, 44.44% (16/36); non-isolated cases, 25.00% (3/12)), the highest diagnostic yield among the different types of renal anomaly. Renal agenesis, which accounted for 9.92% (n = 87) of all abnormal renal cases, had a CMA diagnostic yield of 12.64% (n = 11) (comprising: isolated cases, 11.54% (9/78); non-isolated cases, 22.22% (2/9); unilateral cases, 11.39% (9/79); bilateral cases, 25.00% (2/8)), while multicystic dysplastic kidney (n = 110), renal cyst (n = 34), renal dysplasia (n = 27), crossed fused renal ectopia (n = 31), hydronephrosis (n = 98), renal duplication (n = 42) and ectopic kidney (n = 99) had overall diagnostic rates of 11.82%, 11.76%, 7.41%, 6.45%, 6.12%, 4.76% and 3.03%, respectively. Compared with the combined group of CMA-negative fetuses with any other type of renal anomaly, the rate of infant being alive and well at birth was significantly higher in CMA-negative fetuses with isolated fetal pyelectasis or ectopic kidney, whereas the rate was significantly lower in fetuses with isolated renal agenesis, multicystic dysplastic kidney or severe hydronephrosis. The most common pathogenic CNV was 17q12 deletion, which accounted for 30.14% (22/73) of all positive CMA findings, with a rate of 2.51% (22/877) among fetuses with an abnormal renal finding. Fetuses with 17q12 deletion exhibited a wide range of renal phenotypes. Other P/LP CNVs in the recurrent region that were associated with prenatal renal ultrasound abnormalities included 22q11.2, Xp21.1, Xp22.3, 2q13, 16p11.2 and 1q21, which, collectively, accounted for 2.17% (19/877) of the fetuses with prenatal renal anomalies. CONCLUSIONS In this retrospective review of CMA findings in a large cohort of fetuses with different types of renal ultrasound abnormality, the P/LP CNV detection rate varied significantly (3.03-39.58%) among the different types of kidney anomaly. Our data may help in the decision regarding whether to perform prenatal genetic testing in fetuses with renal ultrasound findings. Specifically, prenatal CMA testing should be performed in cases of hyperechogenic kidney, regardless of whether or not the anomaly is isolated, while it should be performed postnatally rather than prenatally in cases of fetal pyelectasis. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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