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Brown GE, Han YD, Michell AR, Ly OT, Vanoye CG, Spanghero E, George AL, Darbar D, Khetani SR. Engineered cocultures of iPSC-derived atrial cardiomyocytes and atrial fibroblasts for modeling atrial fibrillation. SCIENCE ADVANCES 2024; 10:eadg1222. [PMID: 38241367 PMCID: PMC10798559 DOI: 10.1126/sciadv.adg1222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 12/21/2023] [Indexed: 01/21/2024]
Abstract
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia treatable with antiarrhythmic drugs; however, patient responses remain highly variable. Human induced pluripotent stem cell-derived atrial cardiomyocytes (iPSC-aCMs) are useful for discovering precision therapeutics, but current platforms yield phenotypically immature cells and are not easily scalable for high-throughput screening. Here, primary adult atrial, but not ventricular, fibroblasts induced greater functional iPSC-aCM maturation, partly through connexin-40 and ephrin-B1 signaling. We developed a protein patterning process within multiwell plates to engineer patterned iPSC-aCM and atrial fibroblast coculture (PC) that significantly enhanced iPSC-aCM structural, electrical, contractile, and metabolic maturation for 6+ weeks compared to conventional mono-/coculture. PC displayed greater sensitivity for detecting drug efficacy than monoculture and enabled the modeling and pharmacological or gene editing treatment of an AF-like electrophysiological phenotype due to a mutated sodium channel. Overall, PC is useful for elucidating cell signaling in the atria, drug screening, and modeling AF.
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Affiliation(s)
- Grace E. Brown
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Yong Duk Han
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Ashlin R. Michell
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Olivia T. Ly
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA
- Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Carlos G. Vanoye
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emanuele Spanghero
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Alfred L. George
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Dawood Darbar
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA
- Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
- Department of Physiology and Biophysics, University of Illinois at Chicago, Chicago, IL, USA
- Department of Pharmacology and Regenerative Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Salman R. Khetani
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA
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Wang X, Zhang S, Wu L, Feng B, Shen H, Gu Y, Zhang Q, Fang F, Yang R, Guo H. Diagnostic performance of an immunoassay based on urine exfoliated cell enrichment nanotechnology for upper tract urothelial carcinoma: a retrospective, monocentric study. BMC Urol 2022; 22:194. [PMID: 36434570 PMCID: PMC9700989 DOI: 10.1186/s12894-022-01122-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/12/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Noninvasively urine-based diagnostic modalities for upper urinary tract urothelial carcinoma (UTUC) were still lacking. We evaluated the diagnostic value of our previously developed urine-based assay (UTC assay) in UTUC. METHODS We retrospectively analyzed 90 patients with suspected UTUC and 40 donors without UTUC. Voided urine specimens were analyzed by UTC assay and fluorescence in situ hybridization (FISH). The performance of UTC assay and FISH was compared among the 60 histologically proven UTUC patients and the 40 donors with benign disease. RESULTS Of the 60 UTUCs, there were 8 low-grade and 52 high-grade cases. Overall sensitivity for UTC assay and FISH were 85% and 73.3%, respectively (P = 0.116). Specificities for UTC assay and FISH were 92.5% and 95%, respectively (P = ns.). By grade, sensitivities of UTC assay and FISH were 87.5% vs. 37.5% for low-grade (P = 0.119), and 84.6% vs. 78.8% for high- grade UTUC (P = 0.446), respectively. By stage, UTC assay showed significantly higher sensitivity than FISH for detecting non-muscle-invasive UTUC, which were 88.5% vs. 61.5%, respectively (P = 0.025). CONCLUSION UTC assay has good performance for the non-invasive diagnosis of UTUC. UTC assay may improve the diagnosis and surveillance of low-grade or superficial UTUC.
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Affiliation(s)
- Xin Wang
- Department of Urology, Institute of Urology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing University, 321 Zhongshan Rd, 210008, Nanjing, Jiangsu, China
| | - Shiwei Zhang
- Department of Urology, Institute of Urology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing University, 321 Zhongshan Rd, 210008, Nanjing, Jiangsu, China
| | - Lang Wu
- PerMed Biomedicine Institute, 201321, Shanghai, China
| | - Baofu Feng
- Department of Urology, Institute of Urology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing University, 321 Zhongshan Rd, 210008, Nanjing, Jiangsu, China
| | - Hongwei Shen
- Department of Urology, Institute of Urology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing University, 321 Zhongshan Rd, 210008, Nanjing, Jiangsu, China
| | - Yuanyuan Gu
- PerMed Biomedicine Institute, 201321, Shanghai, China
| | - Qun Zhang
- PerMed Biomedicine Institute, 201321, Shanghai, China
| | - Feng Fang
- Department of Pharmacology, Nanjing Medical University, 210000, Nanjing, Jiangsu, China
| | - Rong Yang
- Department of Urology, Institute of Urology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing University, 321 Zhongshan Rd, 210008, Nanjing, Jiangsu, China.
| | - Hongqian Guo
- Department of Urology, Institute of Urology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing University, 321 Zhongshan Rd, 210008, Nanjing, Jiangsu, China.
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Wang ML, Wang HX, Zhao MM, Ma YY, Zhao LM. Redefining the age-specific therapeutic ranges of lamotrigine for patients with epilepsy: A step towards optimizing treatment and increasing cost-effectiveness. Epilepsy Res 2021; 176:106728. [PMID: 34339940 DOI: 10.1016/j.eplepsyres.2021.106728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/10/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The pharmacokinetics of lamotrigine exhibits age-related characteristics. Nevertheless, current evidence regarding the therapeutic range of lamotrigine has been derived almost exclusively from studies in adult patients, and the applicability of this therapeutic range to the pediatric population remains unclear. The purpose of this study was to establish the appropriate age-specific therapeutic ranges of lamotrigine corresponding to adequate clinical responses for patients with epilepsy. METHODS This prospective cohort study of therapeutic drug monitoring included 582 Chinese epilepsy patients receiving lamotrigine monotherapy. Patients were divided into three age-related subgroups: (1) toddler and school-age group (2-12 years old, n = 168), (2) adolescent group (12-18 years old, n = 171), and (3) adult group (>18 years old, n = 243). Patients with a reduction in seizure frequency of 50 % or greater than baseline were defined as responders, and the remaining patients were non-responders. The relationship between lamotrigine serum concentrations and clinical response was assessed using multivariate logistic regression analysis. A receiver operating characteristic curve was generated to determine the representative cut-off values of lamotrigine trough levels, to distinguish responders from non-responders. The upper margin of the therapeutic range of lamotrigine was determined by developing concentration-effect curves for the three age-related subgroups. RESULTS The median trough levels of lamotrigine were significantly higher in responders than in non-responders from all three age-related groups (P < 0.0001). Results of logistic regression analysis revealed that higher serum concentrations of lamotrigine predicted a higher probability that seizure frequency would be reduced by more than 50 % compared to baseline (adjusted odds ratio: 1.228, 95 % CI: 1.137-1.327; P < 0.0001), and younger children were less likely to be responders (adjusted odds ratio: 1.027, 95 % CI: 1.012-1.043; P = 0.001). Based on a trade-off between sensitivity and specificity, the optimal cut-off values for lamotrigine trough concentrations corresponding to clinical response were 3.29 mg/L, 2.06 mg/L, and 1.61 mg/L in the toddler and school-age group, adolescent group, and adult group, respectively. By reducing interpatient variability, the results of the concentration-effect curves suggested no additional clinical benefit from a continued increase of doses for lamotrigine concentrations exceeding 9.08 mg/L, 8.43 mg/L, and 10.38 mg/L in the toddler and school-age group, adolescent group, and adult group, respectively. In conclusion, the therapeutic ranges of lamotrigine trough concentrations corresponding to adequate clinical response were 3.29-9.08 mg/L in the toddler and school-age group, 2.06-8.43 mg/L in the adolescent group, and 1.61-10.38 mg/L in the adult group. CONCLUSIONS The study determined age-specific therapeutic ranges corresponding to optimal clinical efficacy for lamotrigine. Our findings lay the foundation for catalyzing novel opportunities to optimize treatment and reduce therapeutic costs. Based on the age-specific therapeutic ranges identified in this study, individualized and cost-effective algorithms for lamotrigine treatment of epilepsy patients may be developed and validated in larger cohort studies of therapeutic drug monitoring.
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Affiliation(s)
- Ming-Lu Wang
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, PR China
| | - Huan-Xin Wang
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, PR China
| | - Ming-Ming Zhao
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, PR China
| | - Yi-Yi Ma
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, PR China
| | - Li-Mei Zhao
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, PR China.
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Chen D, Li D, Cui Z, Zhang C, Zhang Z, Yan L. Evaluation of the value of Preoperative Sialic Acid Levels in Diagnosis and Localization of Urothelial Tumors. J Cancer 2021; 12:5066-5075. [PMID: 34234875 PMCID: PMC8247387 DOI: 10.7150/jca.45648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/26/2021] [Indexed: 11/29/2022] Open
Abstract
Objective: To explore SA levels in the serum of urothelial tumor patients and their correlation with clinical pathological features and localization. Materials and Methods: Our research retrospectively collected data from 591 patients with urothelial tumors between July 2014 and April 2018. The SA levels in the serum of urothelial tumor patients and their correlation with clinical pathological features and localization were investigated. Univariate and multivariate logistic regression analyses were further performed to identify independent associations. Results: The levels of SA were significantly associated with the malignant degree (tumor grade and infiltration) of bladder cancer and tumor localization (all p < 0.05). The multivariate logistic regression model showed that SA levels were independently associated with the presence of high-grade urothelial carcinoma (BUC: HR = 1.941, UTUC: HR = 3.820, all p <0.05) and upper urinary tract urothelial carcinoma (HR = 2.047, p < 0.05). Finally, we validated the diagnosis and localization value of SA in an independent cohort from another institutions. Conclusions: Elevated serum SA levels are an independent predictor of high-grade urothelial carcinoma and upper urinary tract urothelial carcinoma, indicating that SA levels may be a potential biomarker for the diagnosis, prognosis and localization of urothelial tumors.
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Affiliation(s)
- Dongshan Chen
- Department of Urology, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan, 250012, P.R. China
| | - Dawei Li
- Department of Urology, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan, 250012, P.R. China
| | - Zhanwu Cui
- Department of Urology, Second Traditional Chinese Medicine Hospital of Dezhou City, Zhongxing Road 245#, Dezhou , 253500, P.R. China
| | - Cong Zhang
- Department of Urology, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan, 250012, P.R. China
| | - Zhao Zhang
- Department of Urology, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan, 250012, P.R. China
| | - Lei Yan
- Department of Urology, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan, 250012, P.R. China
- ✉ Corresponding author: Lei Yan, Department of Urology, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan, 250012, P.R. China. Tel.: +86-531-82166701; Fax: +86-531-82169044; E-mail:
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Wang X, Gu Y, Zhang S, Li G, Liu T, Wang T, Qin H, Jiang B, Zhu L, Li Y, Lei H, Li M, Zhang Q, Yang R, Fang F, Guo H. Unbiased enrichment of urine exfoliated cells on nanostructured substrates for sensitive detection of urothelial tumor cells. Cancer Med 2019; 9:290-301. [PMID: 31709750 PMCID: PMC6943141 DOI: 10.1002/cam4.2655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/14/2019] [Accepted: 10/14/2019] [Indexed: 12/19/2022] Open
Abstract
Background Early detection of urothelial carcinoma (UC) by noninvasive diagnostic methods with high accuracy is still underscored. This study aimed to develop a noninvasive assay incorporating both enrichment of urine exfoliated cells and immunoassays for UC detection. Methods Polystyrene dishes were exposed to oxygen plasma and modified with 3‐aminopropyltriethoxysilane to prepare amine‐functionalized nanostructured substrates (NS). Performance characterization of NS was evaluated by atomic force microscope and X‐ray photoelectron spectroscopy. Urine exfoliated cells were captured by NS and then immunostained to detect urinary tumor cells (UTCs), which was called UTC assay. The receiver operating characteristic (ROC) curve, area under ROC curve (AUC), and Youden index were used to find the cutoff value of UTC assay. ROC analysis and McNemar test were used to compare the diagnostic accuracy of UTC assay with cytology. Kappa test was used to analyze the agreement of UTC assay and cytology with pathological diagnosis. Results Nanostructured substrates had good cell binding yields of nucleated cells and tumor cells. CK20+CD45−CD11b− cells were considered as UTCs. UTC number ≥ 1 per sample could be considered as a positive result. By AUC and Kappa analysis, UTC assay showed good performance in UC detection. McNemar test demonstrated that UTC assay had a superior sensitivity even in low‐grade subgroup and a similar specificity compared to cytology in UC diagnosis. Conclusions Nanostructured substrates could be used to enrich the exfoliated cells from urine samples. UTC assay with NS has the potential to play a role in UC detection. The value of this assay still needs additional validation by large, multi‐center studies.
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Affiliation(s)
- Xin Wang
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Yuanyuan Gu
- PerMed Biomedicine Institute, Shanghai, China
| | - Shiwei Zhang
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Gangqiang Li
- Department of Pathology, Naval Characteristic Medical Center, Shanghai, China
| | - Tianyao Liu
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Tianwei Wang
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Haixiang Qin
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Bo Jiang
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Lin Zhu
- PerMed Biomedicine Institute, Shanghai, China
| | - Yajun Li
- PerMed Biomedicine Institute, Shanghai, China
| | - Haozhi Lei
- PerMed Biomedicine Institute, Shanghai, China
| | - Ming Li
- Department of Pathology, The Affiliated Suzhou Municipal Hospital of Nanjing Medical University, Suzhou, China
| | - Qun Zhang
- PerMed Biomedicine Institute, Shanghai, China
| | - Rong Yang
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
| | - Feng Fang
- Department of Pharmacology, Nanjing Medical University, Nanjing, China
| | - Hongqian Guo
- Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University, Nanjing, China
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