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Urie RR, Morris A, Farris D, Hughes E, Xiao C, Chen J, Lombard E, Feng J, Li JZ, Goldstein DR, Shea LD. Biomarkers from subcutaneous engineered tissues predict acute rejection of organ allografts. SCIENCE ADVANCES 2024; 10:eadk6178. [PMID: 38748794 PMCID: PMC11095459 DOI: 10.1126/sciadv.adk6178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 04/10/2024] [Indexed: 05/19/2024]
Abstract
Invasive graft biopsies assess the efficacy of immunosuppression through lagging indicators of transplant rejection. We report on a microporous scaffold implant as a minimally invasive immunological niche to assay rejection before graft injury. Adoptive transfer of T cells into Rag2-/- mice with mismatched allografts induced acute cellular allograft rejection (ACAR), with subsequent validation in wild-type animals. Following murine heart or skin transplantation, scaffold implants accumulate predominantly innate immune cells. The scaffold enables frequent biopsy, and gene expression analyses identified biomarkers of ACAR before clinical signs of graft injury. This gene signature distinguishes ACAR and immunodeficient respiratory infection before injury onset, indicating the specificity of the biomarkers to differentiate ACAR from other inflammatory insult. Overall, this implantable scaffold enables remote evaluation of the early risk of rejection, which could potentially be used to reduce the frequency of routine graft biopsy, reduce toxicities by personalizing immunosuppression, and prolong transplant life.
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Affiliation(s)
- Russell R. Urie
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Aaron Morris
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Diana Farris
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Elizabeth Hughes
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Chengchuan Xiao
- Department of Molecular, Cellular, and Developmental Biology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Judy Chen
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
- Program in Immunology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Elizabeth Lombard
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jiane Feng
- Animal Phenotyping Core, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jun Z. Li
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Daniel R. Goldstein
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
- Program in Immunology, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Lonnie D. Shea
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
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Tranchita E, Cafiero G, Giordano U, Palermi S, Gentili F, Guzzo I, Spada M, Morolli F, Drago F, Turchetta A. Differences in Physical Activity Levels between Healthy and Transplanted Children: Who Needs More Tips? Healthcare (Basel) 2023; 11:healthcare11111610. [PMID: 37297751 DOI: 10.3390/healthcare11111610] [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: 04/26/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Advances in the medical-surgical field have significantly increased the life expectancy of patients undergoing solid organ transplantation but this exposes patients to long-term complications due to chronic therapies and changes in lifestyle. It is known that children affected by pathology tend to be more sedentary and inactivity represents a further risk factor for the onset of non-communicable diseases. The aim of the present study was to compare the lifestyle of two groups of young patients: one group of healthy subjects (HG) and one group of kidney or liver transplant recipients (TG). METHODS Patients were asked to complete Physical Activity Questionnaire for Older Children (PAQ-C). RESULTS A total of 104 subjects were recruited (50.9% male, mean age 12.8 ± 3.16 years old). No significant differences were observed in the final score between groups when comparing subjects based on health condition (Healthy 2.69 ± 0.65 vs. Transplant Group 2.42 ± 0.88), the intensity of sports activities (Competitive 2.82 ± 0.59 vs. Not Competitive 2.53 ± 0.7) or type of transplant (Liver 2.51 ± 0.91 vs. Kidney 2.16 ± 0.75). CONCLUSION The results of this study showed a worrying reality: children are engaged in low levels of physical activity regardless of their health status and in general the level of activity does not reach the recommended values even in the absence of contraindications. So, it is necessary to encourage healthy children to practice more PA and to introduce PA prescriptions for transplanted children to prevent their health from deteriorating due to sedentariness.
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Affiliation(s)
- Eliana Tranchita
- Sports Medicine Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Giulia Cafiero
- Sports Medicine Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Ugo Giordano
- Sports Medicine Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Stefano Palermi
- Public Health Department, University of Naples Federico II, 80131 Naples, Italy
| | - Federica Gentili
- Sports Medicine Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Isabella Guzzo
- Division of Nephrology, Dialysis and Transplantation, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Marco Spada
- Division of Hepato-Bilio-Pancreatic Surgery, Liver and Kidney Transplantation, Bambino Gesù Children's Hospital, ERN Transplant Child, Istituto di Ricovero e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Federica Morolli
- Division of Hepato-Bilio-Pancreatic Surgery, Liver and Kidney Transplantation, Bambino Gesù Children's Hospital, ERN Transplant Child, Istituto di Ricovero e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Fabrizio Drago
- Paediatric Cardiology and Cardiac Arrhythmias Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, 00165 Rome, Italy
| | - Attilio Turchetta
- Sports Medicine Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, 00165 Rome, Italy
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Tranchita E, Cafiero G, Giordano U, Guzzo I, Labbadia R, Palermi S, Cerulli C, Candusso M, Spada M, Ravà L, Gentili F, Drago F, Turchetta A. Preliminary Evaluation of Sedentary Lifestyle in Italian Children after Solid Transplant: What Role Could Physical Activity Play in Health? It Is Time to Move. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:990. [PMID: 36673745 PMCID: PMC9859408 DOI: 10.3390/ijerph20020990] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/04/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Advances in the medical-surgical field have significantly increased survival after solid organ transplantation in the pediatric population. However, these patients are predisposed to the development of long-term complications (e.g., cardiovascular disease). The therapeutic role of physical activity (PA) to counteract these complications is well known. The purpose of the study was to investigate the level of PA in a pediatric population after solid organ transplantation. METHODS In the first 4 weeks at the beginning of the school year, the Physical Activity Questionnaire for Older Children and Adolescents was administered to young patients who had previously undergone solid transplants at our institute. RESULTS Questionnaires of 49 patients (57.1% female, mean age 13.2 ± 3.5 years) were analyzed and 32.7% of subjects did not perform any exercise during school physical education classes. Only 24% practiced a moderate quantity of exercise in the previous week (2-3 times/week) and 72% engaged in sedentary behaviors during weekends. CONCLUSIONS Preliminary data confirmed that young recipients are still far from meeting the minimum indications of the World Health Organization on PA and sedentary behavior. It will be necessary to increase their involvement in PA programs in order not only to increase their life expectancy but also to improve their quality of life.
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Affiliation(s)
- Eliana Tranchita
- Department of Cardiac Surgery, Cardiology and Heart Lung Transplant, Division of Sports Medicine, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Giulia Cafiero
- Department of Cardiac Surgery, Cardiology and Heart Lung Transplant, Division of Sports Medicine, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Ugo Giordano
- Department of Cardiac Surgery, Cardiology and Heart Lung Transplant, Division of Sports Medicine, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Isabella Guzzo
- Kidney Transplant Follow-Up Unit, Division of Nephrology, Department of Pediatrics, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Raffaella Labbadia
- Kidney Transplant Follow-Up Unit, Division of Nephrology, Department of Pediatrics, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Stefano Palermi
- Public Health Department, University of Naples Federico II, 80131 Naples, Italy
| | - Claudia Cerulli
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Manila Candusso
- Hepatology, Gastroenterology, Nutrition and Liver transplantation Unit, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Marco Spada
- Division of Abdominal Transplantation and Hepato-Bilio-Pancreatic Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Lucilla Ravà
- Clinical Epidemiology Unit, Bambino Gesù Children’s Hospital IRCCS, 00165, Rome, Italy
| | - Federica Gentili
- Department of Cardiac Surgery, Cardiology and Heart Lung Transplant, Division of Sports Medicine, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Fabrizio Drago
- Paediatric Cardiology and Cardiac Arrhythmias Unit, Department of Cardiac Surgery, Cardiology and Heart Lung Transplant, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Attilio Turchetta
- Department of Cardiac Surgery, Cardiology and Heart Lung Transplant, Division of Sports Medicine, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
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Ferrigno F, Franceschini A, Kirk R, Amodeo A. Jacobsen Syndrome with Hypoplastic Left Heart Syndrome: Outcome after Cardiac Transplantation. J Cardiovasc Dev Dis 2022; 10:jcdd10010008. [PMID: 36661903 PMCID: PMC9864704 DOI: 10.3390/jcdd10010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Jacobsen syndrome (JS) is a rare syndrome caused by a deletion of chromosome 11q. We report a patient with JS and hypoplastic left heart syndrome (HLHS) who required cardiac transplantation. She had many of the recognized morphological features in addition to immunological (lymphopenia) and hematological (thrombocytopenia) issues. The patient underwent a Norwood procedure with a modified Blalock-Taussig shunt (MBTS) and subsequently a Glenn procedure at six months of age. She developed desaturation, with severe tricuspid regurgitation and right ventricular dysfunction, and underwent heart transplantation at 7 months of age. After the transplant, she was hospitalized several times for severe infections. The diagnosis of Jacobsen syndrome came 2 months after transplant. Now, 5 years post-transplant, she is in relatively good health-her heart is functioning normally, her hospitalization rate is getting lower, and her immunological profile is stable.
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Affiliation(s)
- Federica Ferrigno
- The School of Pediatrics, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Correspondence: ; Tel.: +39-3286426575
| | - Alessio Franceschini
- Department of Cardiosurgery, Cardiology, Heart and Lung Transplant, Bambino Gesù Children’s Hospital, IRCSS, 00165 Rome, Italy
| | - Richard Kirk
- Mechanical Circulatory Support Unit, Department of Cardiosurgery, Cardiology, Heart and Lung Transplant, Bambino Gesù Children’s Hospital, IRCSS, 00165 Rome, Italy
| | - Antonio Amodeo
- Mechanical Circulatory Support Unit, Department of Cardiosurgery, Cardiology, Heart and Lung Transplant, Bambino Gesù Children’s Hospital, IRCSS, 00165 Rome, Italy
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Christian VJ, Sarwar R, Resch JC, Lim S, Somani A, Larson-Nath C, McAllister S, Thielen BK, Adeyi O, Chinnakotla S, Bhatt H. Use of Cidofovir for Safe Transplantation in a Toddler with Acute Liver Failure and Adenovirus Viremia. Case Rep Transplant 2022; 2022:9426175. [PMID: 36405892 PMCID: PMC9668457 DOI: 10.1155/2022/9426175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/21/2022] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Since October 2021, there have been more than 500 cases of severe hepatitis of unknown origin in children reported worldwide, including 180 cases in the U.S. The most frequently detected potential pathogen to date has been adenovirus, typically serotype 41. Adenovirus is known to cause a self-limited infection in the immunocompetent host. However, in immunosuppressed individuals, severe or disseminated infections may occur. METHOD We present the case of a two-year-old female who presented with cholestatic hepatitis and acute liver failure (ALF). Work up for etiologies of ALF was significant for adenovirus viremia, but liver biopsy was consistently negative for the virus. The risk for severe adenoviral infection in the setting of anticipated immunosuppression prompted us to initiate cidofovir to decrease viral load prior to undergoing liver transplantation. RESULT Our patient received a successful liver transplant, cleared the viremia after 5 doses of cidofovir, and continues to maintain allograft function without signs of infection at the time of this report, 5 months posttransplant. CONCLUSION Recent reports of pediatric hepatitis cases may be associated with adenoviral infection although the exact relationship is unclear. There is the possibility of the ongoing SARS-CoV-2 environment, or other immunologic modifying factors. All patients presenting with hepatitis or acute liver failure should be screened for adenovirus and reported to state health departments. Cidofovir may be used to decrease viral load prior to liver transplantation, to decrease risk of severe adenoviral infection.
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Affiliation(s)
- Vikram J. Christian
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Raiya Sarwar
- Department of Medicine, Division of Transplant Hepatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Joseph C. Resch
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Sarah Lim
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Arif Somani
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Catherine Larson-Nath
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Shane McAllister
- Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Beth K. Thielen
- Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Oyedele Adeyi
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Srinath Chinnakotla
- Department of Surgery, Division of Transplant Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Heli Bhatt
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
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Evans-Barns H, Mushtaq I, Michell I, Kausman J, Webb N, Taghavi K. Paediatric kidney transplantation: Towards a framework for pretransplant urological evaluation. Pediatr Transplant 2022; 26:e14299. [PMID: 35587393 DOI: 10.1111/petr.14299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/29/2022] [Accepted: 04/07/2022] [Indexed: 11/27/2022]
Abstract
The role of the urologist in paediatric kidney transplantation has evolved alongside advances in management for the various causes of end-stage kidney disease. Improvements in antenatal intervention and postnatal care have seen children with increasingly complex urological anomalies survive until transplant. Once solely responsible for the oversight of a child's surgical care, the paediatric urologist now works within a multidisciplinary transplant team, alongside transplant surgeons, paediatric nephrologists, transplant coordinators, psychologists, social workers, and transitional care specialists. We sought to identify available pretransplant evaluation frameworks to guide urological preparation and decision-making. Drawing from available evidence and reflecting on multi-institutional experience, we propose a streamlined approach to urologic assessment, which recognises that optimal transplant outcomes in this heterogenous cohort require lower urinary tract dysfunction to be carefully defined preoperatively.
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Affiliation(s)
- Hannah Evans-Barns
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Imran Mushtaq
- Department of Paediatric Urology, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Ian Michell
- Department of Renal Transplant Surgery, Austin Health, Melbourne, Victoria, Australia.,Department of Nephrology, Royal Children's Hospital, Melbourne, Australia
| | - Joshua Kausman
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of Nephrology, Royal Children's Hospital, Melbourne, Australia
| | - Nathalie Webb
- Department of Paediatric Urology, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Kiarash Taghavi
- Department of Paediatric Urology, Monash Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, Monash University, Clayton, Victoria, Australia
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Elserafy N, Thompson S, Dalkeith T, Stormon M, Thomas G, Shun A, Sawyer J, Balasubramanian S, Bhattacharya K, Badawi N, Ellaway C. Liver transplantation in children with inborn errors of metabolism: 30 years experience in NSW, Australia. JIMD Rep 2021; 60:88-95. [PMID: 34258144 PMCID: PMC8260479 DOI: 10.1002/jmd2.12219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Inborn errors of metabolism (IEM) are a diverse group of genetic disorders that can result in significant morbidity and sometimes death. Metabolic management can be challenging and burdensome for families. Liver transplantation (LT) is increasingly being considered a treatment option for some IEMs. IEMs are now considered the second most common reason for pediatric LT. AIM To review the data of all children with an IEM who had LT at The Children's Hospital at Westmead (CHW), NSW, Australia between January 1986 and January 2019. METHODS Retrospective data collected from the medical records and genetic files included patient demographics, family history, parental consanguinity, method of diagnosis of IEM, hospital and intensive care unit admissions, age at LT, graft type, clinical outcomes and metabolic management pre and post-LT. RESULTS Twenty-four LT were performed for 21 patients. IEM diagnoses were MSUD (n = 4), UCD (n = 8), OA (n = 6), TYR type I (n = 2) and GSD Ia (n = 1). Three patients had repeat transplants due to complications. Median age at transplant was 6.21 years (MSUD), 0.87 years (UCD), 1.64 years (OA) and 2.2 years (TYR I). Two patients died peri-operatively early in the series, one died 3 months after successful LT due to septicemia. Eighteen LTs have been performed since 2008 in comparison to six LT prior to 2008. Dietary management was liberalized post LT for all patients. CONCLUSIONS Referral for LT for IEMs has increased over the last 33 years, with the most referrals in the last 10 years. Early LT has resulted in improved clinical outcomes and patient survival.
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Affiliation(s)
- Noha Elserafy
- Genetic Metabolic Disorders Service, The Children's Hospital at WestmeadSydney Children's Hospital NetworkSydneyNew South WalesAustralia
| | - Sue Thompson
- Genetic Metabolic Disorders Service, The Children's Hospital at WestmeadSydney Children's Hospital NetworkSydneyNew South WalesAustralia
- Paediatric divisonThe University of SydneySydneyNew South WalesAustralia
| | - Troy Dalkeith
- Genetic Metabolic Disorders Service, The Children's Hospital at WestmeadSydney Children's Hospital NetworkSydneyNew South WalesAustralia
- Paediatric divisonThe University of SydneySydneyNew South WalesAustralia
| | - Michael Stormon
- Paediatric divisonThe University of SydneySydneyNew South WalesAustralia
- Department of Gastroenterology, The Children's Hospital at WestmeadSydney Children's Hospital NetworkSydneyNew South WalesAustralia
| | - Gordon Thomas
- Paediatric divisonThe University of SydneySydneyNew South WalesAustralia
- Department of Paediatric Surgery, The Children's Hospital at WestmeadSydney Children's Hospital NetworkSydneyNew South WalesAustralia
| | - Albert Shun
- Paediatric divisonThe University of SydneySydneyNew South WalesAustralia
- Department of Paediatric Surgery, The Children's Hospital at WestmeadSydney Children's Hospital NetworkSydneyNew South WalesAustralia
| | - Janine Sawyer
- Department of Gastroenterology, The Children's Hospital at WestmeadSydney Children's Hospital NetworkSydneyNew South WalesAustralia
| | - Shanti Balasubramanian
- Genetic Metabolic Disorders Service, The Children's Hospital at WestmeadSydney Children's Hospital NetworkSydneyNew South WalesAustralia
- Paediatric divisonThe University of SydneySydneyNew South WalesAustralia
| | - Kaustuv Bhattacharya
- Genetic Metabolic Disorders Service, The Children's Hospital at WestmeadSydney Children's Hospital NetworkSydneyNew South WalesAustralia
- Paediatric divisonThe University of SydneySydneyNew South WalesAustralia
| | - Nadia Badawi
- Paediatric divisonThe University of SydneySydneyNew South WalesAustralia
- Grace Centre for Newborn Care, The Children's Hospital at WestmeadSydney Children's Hospital NetworkSydneyNew South WalesAustralia
| | - Carolyn Ellaway
- Genetic Metabolic Disorders Service, The Children's Hospital at WestmeadSydney Children's Hospital NetworkSydneyNew South WalesAustralia
- Paediatric divisonThe University of SydneySydneyNew South WalesAustralia
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Chiu CF, Chiu SJ, Bai LY, Feng CH, Hu JL, Lin WY, Huang HY, Weng JR. A macrolide from Streptomyces sp. modulates apoptosis and autophagy through Mcl-1 downregulation in human breast cancer cells. ENVIRONMENTAL TOXICOLOGY 2021; 36:1316-1325. [PMID: 33713530 DOI: 10.1002/tox.23128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/08/2021] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
Secondary metabolites in marine organisms exhibit various pharmacological activities against diseases, such as cancer. In this study, the anti-proliferative effect of JBIR-100, a macrolide isolated from Streptomyces sp., was investigated in breast cancer cells. Cell growth was inhibited in response to JBIR-100 treatment concentration- and time-dependently in both MCF-7 and MDA-MB-231 breast cancer cells. JBIR-100 caused apoptosis, as verified by caspase activation and the cleavage of PARP. Western blotting revealed that JBIR-100 modulated the expression of Akt/NF-κB signaling components and Bcl-2 family members. Overexpression of Mcl-1 partially rescued MCF-7 cells from JBIR-100-induced cytotoxicity. In addition, transmission electron microscopy analyses, confocal analysis, and western blot assay indicated that JBIR-100 inhibited autophagy in MCF-7 cells. Exposure to the autophagy inhibitor did not synergize JBIR-100-induced apoptosis. In summary, our results suggested that JBIR-100 may be potentially used for breast cancer therapy.
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Affiliation(s)
- Chang-Fang Chiu
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- Cancer Center, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Shih-Jiuan Chiu
- School of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Li-Yuan Bai
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hsien Feng
- Department of Fragrance and Cosmetic Science, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jing-Lan Hu
- Cancer Center, China Medical University Hospital, Taichung, Taiwan
| | - Wei-Yu Lin
- Department of Pharmacy, Kinmen Hospital, Ministry of Health and Welfare, Kinmen, Taiwan
| | - Hao-Yu Huang
- Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Jing-Ru Weng
- Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, Taiwan
- Doctoral Degree Program in Marine Biotechnology, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
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Pulmonary Manifestations of Immunodeficiency and Immunosuppressive Diseases Other than Human Immunodeficiency Virus. Pediatr Clin North Am 2021; 68:103-130. [PMID: 33228927 DOI: 10.1016/j.pcl.2020.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Immune deficiencies may alter normal lung function and protective mechanisms, resulting in a myriad of pulmonary manifestations. Primary immunodeficiencies involve multiple branches of the immune system, and defects may predispose to recurrent upper and lower respiratory infections by common pathogens; opportunistic infections; and autoimmune, inflammatory, and malignant processes that may result in interstitial pneumonias. Secondary immunodeficiencies may result from neoplasms or their treatment, organ transplant and immunosuppression, and from autoimmune diseases and their treatments. Primary and secondary immunodeficiencies and their pulmonary manifestations may be difficult to diagnose and treat. A multidisciplinary approach to evaluation is essential.
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Abstract
PURPOSE OF REVIEW Long-term survival is now the rule rather than the exception for infants and children who undergo liver transplantation for end-stage liver disease, metabolic liver conditions and a variety of other indications. Pediatricians and primary care providers play vital roles in the care and management of this patient population. The purpose of this review is to highlight key aspects important to the care of the pediatric liver transplant recipient. RECENT FINDINGS Significant advances in immunosuppressive therapies and surgical techniques have contributed to improved graft and patient survival rates, shifting the focus beyond immediate survival to strategies to minimize comorbidities related to long-term immunosuppression during growing years, attend to patient and parent-reported outcomes and enhance quality of life. A multidisciplinary approach allows for monitoring and surveillance of both routine (growth, nutritional rehabilitation, cognitive development, mental and psychosocial health, contraception and daily activities) and transplant-related (adverse effects of immunosuppression, susceptible infections, extra-hepatic systems, transition from childhood to adolescence to adulthood) themes. SUMMARY Effective communication between the primary care physician and the transplant team is imperative for optimizing best outcomes. The primary care provider should be aware of the multifacet nature of posttransplant management, which includes medication regimens, common complications and infections.
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