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Russell MD, Dey M, Flint J, Davie P, Allen A, Crossley A, Frishman M, Gayed M, Hodson K, Khamashta M, Moore L, Panchal S, Piper M, Reid C, Saxby K, Schreiber K, Senvar N, Tosounidou S, van de Venne M, Warburton L, Williams D, Yee CS, Gordon C, Giles I, Roddy E, Armon K, Astell L, Cotton C, Davidson A, Fordham S, Jones C, Joyce C, Kuttikat A, McLaren Z, Merrison K, Mewar D, Mootoo A, Williams E. British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids. Rheumatology (Oxford) 2022; 62:e48-e88. [PMID: 36318966 PMCID: PMC10070073 DOI: 10.1093/rheumatology/keac551] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Mark D Russell
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Mrinalini Dey
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Julia Flint
- Department of Rheumatology, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Shropshire, UK
| | - Philippa Davie
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Alexander Allen
- Clinical Affairs, British Society for Rheumatology, London, UK
| | | | - Margreta Frishman
- Rheumatology, North Middlesex University Hospital NHS Trust, London, UK
| | - Mary Gayed
- Rheumatology, Sandwell and West Birmingham Hospitals, Birmingham, UK
| | | | - Munther Khamashta
- Lupus Research Unit, Division of Women's Health, King's College London, London, UK
| | - Louise Moore
- Rheumatic and Musculoskeletal Disease Unit, Our Lady's Hospice and Care Service, Dublin, Ireland
| | - Sonia Panchal
- Department of Rheumatology, South Warwickshire NHS Foundation Trust, Warwickshire, UK
| | - Madeleine Piper
- Royal National Hospital for Rheumatic Diseases, Royal United Hospital, Bath, UK
| | | | - Katherine Saxby
- Pharmacy, University College London Hospitals NHS Foundation Trust, London, UK
| | - Karen Schreiber
- Thrombosis and Haemostasis, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Rheumatology, Danish Hospital for Rheumatic Diseases, Sonderborg, Denmark.,Department of Regional Health Research (IRS), University of Southern Denmark, Odense, Denmark
| | - Naz Senvar
- Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Sofia Tosounidou
- Lupus UK Centre of Excellence, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | | | | | - David Williams
- Obstetrics, University College London Hospitals NHS Foundation Trust, London, UK
| | - Chee-Seng Yee
- Department of Rheumatology, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Caroline Gordon
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Ian Giles
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
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The DevTox Germ Layer Reporter Platform: An Assay Adaptation of the Human Pluripotent Stem Cell Test. TOXICS 2022; 10:toxics10070392. [PMID: 35878297 PMCID: PMC9321663 DOI: 10.3390/toxics10070392] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/14/2022] [Accepted: 06/30/2022] [Indexed: 11/16/2022]
Abstract
Environmental chemical exposures are a contributing factor to birth defects affecting infant morbidity and mortality. The USA EPA is committed to developing new approach methods (NAMs) to detect chemical risks to susceptible populations, including pregnant women. NAM-based coverage for cellular mechanisms associated with early human development could enhance identification of potential developmental toxicants (DevTox) for new and existing data-poor chemicals. The human pluripotent stem cell test (hPST) is an in vitro test method for rapidly identifying potential human developmental toxicants that employs directed differentiation of embryonic stem cells to measure reductions in SOX17 biomarker expression and nuclear localization. The objective of this study was to expand on the hPST principles to develop a model platform (DevTox GLR) that utilizes the transgenic RUES2-GLR cell line expressing fluorescent reporter fusion protein biomarkers for SOX17 (endoderm marker), BRA (mesoderm marker), and SOX2 (ectoderm and pluripotency marker). Initial assay adaption to definitive endoderm (DevTox GLR-Endo) was performed to emulate the hPST SOX17 endpoint and enable comparative evaluation of concordant chemical effects. Assay duration was reduced to two days and screening throughput scaled to 384-well format for enhanced speed and efficiency. Assay performance for 66 chemicals derived from reference and training set data resulted in a balanced accuracy of 72% (79% sensitivity and 65% specificity). The DevTox GLR-Endo assay demonstrates successful adaptation of the hPST concept with increased throughput, shorter assay duration, and minimal endpoint processing. The DevTox GLR model platform expands the in vitro NAM toolbox to rapidly identify potential developmental hazards and mechanistically characterize toxicant effects on pathways and processes associated with early human development.
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Ibrahim MA, Yasui M, Saha LK, Sasanuma H, Honma M, Takeda S. Enhancing the sensitivity of the thymidine kinase assay by using DNA repair-deficient human TK6 cells. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2020; 61:602-610. [PMID: 32243652 PMCID: PMC7384079 DOI: 10.1002/em.22371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 05/17/2023]
Abstract
The OECD guidelines define the bioassays of identifying mutagenic chemicals, including the thymidine kinase (TK) assay, which specifically detects the mutations that inactivate the TK gene in the human TK6 lymphoid line. However, the sensitivity of this assay is limited because it detects mutations occurring only in the TK gene but not any other genes. Moreover, the limited sensitivity of the conventional TK assay is caused by the usage of DNA repair-proficient wild-type cells, which are capable of accurately repairing DNA damage induced by chemicals. Mutagenic chemicals produce a variety of DNA lesions, including base lesions, sugar damage, crosslinks, and strand breaks. Base damage causes point mutations and is repaired by the base excision repair (BER) and nucleotide excision repair (NER) pathways. To increase the sensitivity of TK assay, we simultaneously disrupted two genes encoding XRCC1, an important BER factor, and XPA, which is essential for NER, generating XRCC1 -/- /XPA -/- cells from TK6 cells. We measured the mutation frequency induced by four typical mutagenic agents, methyl methane sulfonate (MMS), cis-diamminedichloro-platinum(II) (cisplatin, CDDP), mitomycin-C (MMC), and cyclophosphamide (CP) by the conventional TK assay using wild-type TK6 cells and also by the TK assay using XRCC1 -/- /XPA -/- cells. The usage of XRCC1 -/- /XPA -/- cells increased the sensitivity of detecting the mutagenicity by 8.6 times for MMC, 8.5 times for CDDP, and 2.6 times for MMS in comparison with the conventional TK assay. In conclusion, the usage of XRCC1 -/- /XPA -/- cells will significantly improve TK assay.
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Affiliation(s)
| | - Manabu Yasui
- Division of Genetics and MutagenesisNational Institute of Health SciencesKawasakiKanagawaJapan
| | - Liton Kumar Saha
- Department of Radiation GeneticsKyoto University, Graduate School of MedicineKyotoJapan
- Developmental Therapeutics Branch, Center for Cancer ResearchNational Cancer Institute, NIHBethesdaMarylandUSA
| | - Hiroyuki Sasanuma
- Department of Radiation GeneticsKyoto University, Graduate School of MedicineKyotoJapan
| | - Masamitsu Honma
- Division of Genetics and MutagenesisNational Institute of Health SciencesKawasakiKanagawaJapan
| | - Shunichi Takeda
- Department of Radiation GeneticsKyoto University, Graduate School of MedicineKyotoJapan
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Simsek M, Lambalk CB, Wilschut JA, Mulder CJJ, de Boer NKH. The associations of thiopurines with male fertility and paternally exposed offspring: a systematic review and meta-analysis. Hum Reprod Update 2017; 24:192-206. [PMID: 29190351 DOI: 10.1093/humupd/dmx034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/03/2017] [Accepted: 11/13/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Thiopurines are widely used immunosuppressive agents. In high dosages, they inhibit the purine synthesis and are considered to be possibly harmful to spermatogenesis, and subsequently to men's fertility and their offspring. However, the clear association between thiopurine exposure and male fertility and reproduction safety, if any, is still poorly understood. OBJECTIVE AND RATIONALE The aim of this review was to systematically summarize and meta-analyse the available data, derived from animal and human studies, regarding the influence of thiopurine exposure on fertility and conception safety in men and their offspring. SEARCH METHODS A systematic literature search of the MEDLINE and EMBASE databases was performed using a combination of relevant terms related to 'thiopurines', 'fertility', 'conception', 'reproduction', 'semen quality' and 'birth outcome', combined with 'male', 'men', 'father' and 'paternal'. The search was not restricted exclusively to human subjects, neither to a type of disease or condition, to gather all available studies with regards to this topic. All published articles on thiopurines and male fertility, written in English and published until May 2017, were screened for eligibility. The GRADE guidelines were used to assess the quality of evidence of the included articles. OUTCOMES A total of 28 studies (including 14 observational studies in humans) were included in this review and six of these were included in the meta-analysis. In various rodents, thiopurines adversely affected the germ cells (in administered doses of 2 to 20 times the human equivalent dose). In human studies, thiopurine therapy was not evidently associated with impaired testicular function or semen quality in 83 men with a variety of underlying diseases. In total, 53 out of 975 offspring with congenital anomalies (5.4%, the background prevalence is 3%), possibly as a result of paternal thiopurine exposure, were described in all studies together. The risk of congenital anomalies was not significantly increased when compared with offspring without paternal thiopurine exposure (4.7%) (pooled odds ratio 1.32, 95% confidence interval 0.75, 2.34). WIDER IMPLICATIONS Thiopurines have spermatotoxic effects in rodents. In humans, overall data are limited and derived from underpowered studies, and therefore not conclusive with regards to the possible effects of thiopurines on spermatogenesis or paternally exposed offspring. Larger, epidemiological trials evaluating the safety of thiopurines to men's fertility and their offspring are mandatory to adequately counsel thiopurine treated men who wish to conceive.
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Affiliation(s)
- Melek Simsek
- Department of Gastroenterology and Hepatology, VU University Medical Centre (VUmc), PO Box 7075, 1081 HZ, Amsterdam, The Netherlands
| | - Cornelis B Lambalk
- Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, VU University medical centre (VUmc), PO Box 7075, 1007 MB, Amsterdam, the Netherlands
| | - Janneke A Wilschut
- Department of Epidemiology and Biostatistics, VU University (VU), Medical Faculty (F-wing), 1081 HV, Amsterdam, The Netherlands
| | - Chris J J Mulder
- Department of Gastroenterology and Hepatology, VU University Medical Centre (VUmc), PO Box 7075, 1081 HZ, Amsterdam, The Netherlands
| | - Nanne K H de Boer
- Department of Gastroenterology and Hepatology, VU University Medical Centre (VUmc), PO Box 7075, 1081 HZ, Amsterdam, The Netherlands
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5
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Deng X, Li X, Luo S, Zheng Y, Luo X, Zhou L. Antitumor activity of Lycium barbarum polysaccharides with different molecular weights: an in vitro and in vivo study. Food Nutr Res 2017; 61:1399770. [PMID: 31139040 PMCID: PMC6516794 DOI: 10.1080/16546628.2017.1399770] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 10/30/2017] [Indexed: 11/25/2022] Open
Abstract
The antitumor activity of Lycium barbarum polysaccharide (LBP) has been reported, but the structure–bioactivity relationship has still not been fully elucidated. In this study, four water-soluble LBP fractions with serial different molecular weights (MWs) were separated from LBP, designated LBP-2, LBP-3, LBP-4, and LBP-5. After a characteristic analysis, the relationship between MW and antitumor activity of LBP was investigated both in vitro using murine hepatoma H22 cells and in vivo using H22 tumor-bearing mice. In vitro, the results showed that all the LBP fractions had significant inhibition on H22 cells, in which LBP-3 had the best activity. LBP-3 could induce apoptosis, mitochondrial membrane potential destruction, and S phase arrest in H22 cells. In vivo, the results showed that LBP-2, LBP-3, LBP-4, and LBP-5 could inhibit the tumor growth in H22 tumor-bearing mice by 18.18%, 37.97%, 9.09%, and 14.44%, respectively. However, only LBP-3 was able to decrease the tumor weight significantly in H22 tumor-bearing mice. Meanwhile, all the LBP fractions did not show significant toxicity to murine splenocytes, thymus, and spleen. Taken together, these results demonstrated that the antitumor activity of LBP was closely related to its MW, and LBP-3 with medium MW (40–350 kDa) was the main active fraction.
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Affiliation(s)
- Xiangliang Deng
- School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, PR China.,Research and Development Department, Infinitus Chinese Herbal Immunity Research Centre, Guangzhou, PR, China
| | - Xiangling Li
- Research and Development Department, Guangdong Hybribio Co. Ltd, Guangzhou, PR, China
| | - Shuang Luo
- School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Yongyan Zheng
- School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Xia Luo
- School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Lian Zhou
- School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, PR China
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Hayward K, Haaland WL, Hrachovec J, Leu M, Vora S, Clifton H, Rascoff N, Crowell CS. Reliable Pregnancy Testing Before Intravenous Cyclophosphamide: A Quality Improvement Study. Pediatrics 2016; 138:peds.2016-0378. [PMID: 27940668 DOI: 10.1542/peds.2016-0378] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Cyclophosphamide is a teratogenic medication used in the treatment of adolescents with autoimmune disorders. This adolescent population is sexually active, does not receive adequate contraceptive care, and is at risk for unintended pregnancy. We undertook a quality improvement initiative to improve rates of pregnancy screening before intravenous cyclophosphamide administration in our adolescent girl patients. METHODS Data were collected from the electronic medical record. The primary outcome was completion of a urine pregnancy test before intravenous cyclophosphamide infusion in girls aged 12 to 21 years between July 2011 and June 2015. Data were reviewed quarterly and an iterative quality improvement approach was used. Interventions included staff education, electronic order set updates, and a Maintenance of Certification project. Interrupted time series analysis and multivariable mixed effects logistic regression were used to evaluate trends over time and to adjust for potential confounders. RESULTS Thirty girls received 153 cyclophosphamide infusions during the study. Pregnancy testing before medication administration increased from 25% to 100% by study completion. Infusions in the last time period were significantly more likely to be accompanied by a pregnancy test versus those in the first time period (odds ratio: 17.7; 95% confidence interval [CI]: 3.1-101.6) after adjustment for patient age, managing service, infusion setting, and insurance type. CONCLUSIONS Our institution achieved a significant increase in standard pregnancy screening in adolescent girls receiving intravenous cyclophosphamide. The interventions most valuable in increasing screening rates were updating electronic order sets, educating staff, and physician engagement in the Maintenance of Certification program.
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Affiliation(s)
| | - Wren L Haaland
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington; and
| | - Jennifer Hrachovec
- Clinical Effectiveness, Seattle Children's Hospital, Seattle, Washington
| | - Michael Leu
- Departments of Pediatrics, and.,Clinical Effectiveness, Seattle Children's Hospital, Seattle, Washington.,Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington
| | - Surabhi Vora
- Departments of Pediatrics, and.,Clinical Effectiveness, Seattle Children's Hospital, Seattle, Washington
| | - Holly Clifton
- Clinical Effectiveness, Seattle Children's Hospital, Seattle, Washington
| | | | - Claudia S Crowell
- Departments of Pediatrics, and.,Clinical Effectiveness, Seattle Children's Hospital, Seattle, Washington
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Kupsco A, Schlenk D. Oxidative stress, unfolded protein response, and apoptosis in developmental toxicity. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2015; 317:1-66. [PMID: 26008783 DOI: 10.1016/bs.ircmb.2015.02.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Physiological development requires precise spatiotemporal regulation of cellular and molecular processes. Disruption of these key events can generate developmental toxicity in the form of teratogenesis or mortality. The mechanism behind many developmental toxicants remains unknown. While recent work has focused on the unfolded protein response (UPR), oxidative stress, and apoptosis in the pathogenesis of disease, few studies have addressed their relationship in developmental toxicity. Redox regulation, UPR, and apoptosis are essential for physiological development and can be disturbed by a variety of endogenous and exogenous toxicants to generate lethality and diverse malformations. This review examines the current knowledge of the role of oxidative stress, UPR, and apoptosis in physiological development as well as in developmental toxicity, focusing on studies and advances in vertebrates model systems.
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Affiliation(s)
- Allison Kupsco
- Environmental Toxicology Program, University of California, Riverside, CA, USA
| | - Daniel Schlenk
- Environmental Toxicology Program, University of California, Riverside, CA, USA; Environmental Sciences, University of California, Riverside, CA, USA
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The need for a disease-specific prospective pregnancy registry for multiple sclerosis (MS). Mult Scler Relat Disord 2015; 4:6-17. [DOI: 10.1016/j.msard.2014.10.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Revised: 10/09/2014] [Accepted: 10/14/2014] [Indexed: 11/22/2022]
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Patti F, Messina S, D'Amico E, Lo Fermo S, Zappia M. Pregnancy outcomes in multiple sclerosis patients previously treated with cyclophosphamide. Acta Neurol Scand 2014; 130:e41-4. [PMID: 24730672 DOI: 10.1111/ane.12255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cyclophosphamide (Cyc) can induce ovarian failure and can have teratogenic effect. Few case reports of successful pregnancies after Cyc treatment in women with autoimmune diseases and malignancies have been described. To date, there are no data about Cyc effect on pregnancy outcomes in MS patients. AIM OF THE STUDY To describe pregnancy outcomes in multiple sclerosis (MS) patients treated with Cyc before conception. METHODS We reviewed retrospectively the medical records of all MS patients who received Cyc from 1st of January 1997 to 31st of March 2012, referring to the MS centre of the University of Catania. All pregnancies, occurred during the follow-up period after Cyc treatment, were recorded according to a computerized and standardized protocol (iMED). RESULTS We found a total of 105 MS women of childbearing age; eleven patients experienced a pregnancy (10.4%); 10 of them had a successful delivery; and one experienced a voluntary abortion. Five women had a preterm delivery. One child was small for gestational age. CONCLUSIONS Although the favourable pregnancy outcomes, Cyc should be avoided in young women planning a pregnancy. However, Cyc might be considered as a possible alternative to licensed therapies in few selected cases of very aggressive MS, including women of childbearing age.
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Affiliation(s)
- F. Patti
- Department G.F. Ingrassia-section of Neurosciences; University of Catania; Catania Italy
| | - S. Messina
- Department G.F. Ingrassia-section of Neurosciences; University of Catania; Catania Italy
| | - E. D'Amico
- Department G.F. Ingrassia-section of Neurosciences; University of Catania; Catania Italy
| | - S. Lo Fermo
- Department G.F. Ingrassia-section of Neurosciences; University of Catania; Catania Italy
| | - M. Zappia
- Department G.F. Ingrassia-section of Neurosciences; University of Catania; Catania Italy
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Induction of cytochrome P450 3A1 expression by diallyl disulfide: Protective effects against cyclophosphamide-induced embryo-fetal developmental toxicity. Food Chem Toxicol 2014; 69:312-9. [DOI: 10.1016/j.fct.2014.04.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 04/02/2014] [Accepted: 04/12/2014] [Indexed: 02/01/2023]
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11
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Alwan S, Sadovnick AD. Multiple sclerosis and pregnancy: maternal considerations. ACTA ACUST UNITED AC 2012; 8:399-414. [PMID: 22757731 DOI: 10.2217/whe.12.33] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Multiple sclerosis (MS) is the most commonly acquired neurological disorder affecting young adults of reproductive age with approximately a 3:1 female-to-male ratio. Pregnancy is not contraindicated in MS but remains to be an issue that raises many questions. Although relapse rates tend to increase in the first 3 months postpartum, pregnancy does not seem to be a detriment to the long-term progression of MS and has a protective effect on reducing relapses, especially during the third trimester. MS does not appear to affect fertility or increase the risk of congenital anomalies or pregnancy complications. There has been some evidence that maternal treatment with β interferons, the most commonly used disease-modifying therapies in MS, may cause adverse reproductive outcomes, prompting the US FDA to issue warnings about their use at conception and during pregnancy.
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Affiliation(s)
- Sura Alwan
- Department of Medical Genetics, University of British Columbia, and Vancouver Coastal Health Authority-UBC Hospital, Vancouver, BC, Canada.
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12
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Lazalde B, Grijalva-Flores J, Guerrero-Romero F. Klippel-Feil syndrome in a boy exposed inadvertently to cyclophosphamide during pregnancy: a case report. ACTA ACUST UNITED AC 2012; 94:249-52. [PMID: 22450872 DOI: 10.1002/bdra.23004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 01/27/2012] [Accepted: 01/31/2012] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cyclophosphamide (CPA) is an alkylating agent widely used as an immunosuppressive agent in the treatment of several autoimmune diseases, including systemic lupus erythematosus. Its teratogenic effect has been well studied in different experimental mammalian and non-mammalian animal models. In humans, 11 cases of CPA teratogenesis have been documented. CASE We present a case of a patient with Klippel-Feil syndrome inadvertently exposed to CPA and prednisone in utero during the first trimester. CONCLUSIONS This case of possible cyclophosphamide embryopathy provides evidence of teratogenesis as an etiologic agent in developmental field defects such as Klippel-Feil syndrome.
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Affiliation(s)
- Brissia Lazalde
- Biomedical Research Unit, Mexican Social Security Institute, Durango, Dgo., México.
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13
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Logsdon AL, Herring BJ, Lockard JE, Miller BM, Kim H, Hood RD, Bailey MM. Exposure to green tea extract alters the incidence of specific cyclophosphamide-induced malformations. ACTA ACUST UNITED AC 2012; 95:231-7. [PMID: 22447743 DOI: 10.1002/bdrb.21011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 02/14/2012] [Indexed: 11/07/2022]
Abstract
BACKGROUND Green tea extract (GTE) has been shown to have antioxidative properties due to its high content of polyphenols and catechin gallates. Previous studies indicated that catechin gallates scavenge free radicals and attenuate the effects of reactive oxygen species. Cyclophosphamide (CP) produces reactive oxidative species, which can have adverse effects on development, causing limb, digit, and cranial abnormalities. The current study was performed to determine if exposure to GTE can decrease teratogenic effects induced by CP in CD-1 mice. METHODS From gestation days (GD) 6-13, mated CD-1 mice were dosed with 400 or 800 mg/kg/d GTE; 100, 200, 400, or 800 mg/kg/d GTE + CP; CP alone, or the vehicle. GTE was given by gavage. CP (20 mg/kg) was given by intraperitoneal injection on GD 10. Dams were sacrificed on GD 17, and their litters were examined for adverse effects. RESULTS The highest GTE dose did not effectively attenuate, and in some cases exacerbated the negative effect of CP. GTE alone was also associated with an increased incidence of microblepharia. Conversely, moderate GTE doses (200 and/or 400 mg/kg/d) attenuated the effect of CP on fetal weight and (GTE 200 mg/kg/d) decreased the incidences of certain defects resulting from CP exposure. CONCLUSIONS Exposure of a developing mammal to moderate doses of GTE can modulate the effects of exposure to CP during development, possibly by affecting biotransformation, while a higher GTE dose tended to exacerbate the developmental toxicity of CP. GTE alone appeared to cause an adverse effect on eyelid development.
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Affiliation(s)
- Amanda L Logsdon
- Department of Biological Sciences, Emporia State University, Emporia, Kansas, USA
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14
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Kim SH, Lee IC, Lim JH, Moon C, Bae CS, Kim SH, Shin DH, Park SC, Kim HC, Kim JC. Protective effects of pine bark extract on developmental toxicity of cyclophosphamide in rats. Food Chem Toxicol 2012; 50:109-15. [DOI: 10.1016/j.fct.2011.10.048] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2011] [Revised: 10/11/2011] [Accepted: 10/12/2011] [Indexed: 12/30/2022]
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