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Ismailov RM, Aceña Á, Khasanova ZD. Shared Decision-Making and Cardiovascular Complications of Androgen Deprivation Therapy: an Educational Initiative for Oncology Team Members in Colorado, USA. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:391-397. [PMID: 38488958 DOI: 10.1007/s13187-024-02422-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 03/17/2024]
Abstract
Patients with prostate cancer may experience side effects of androgen deprivation therapy (ADT) such as cardiovascular (CV) complications. Oncology team members should actively communicate with patients about these complications. On the other hand, shared decision-making (SDM) has been shown to improve patient-physician communication. We developed brochures focused on CV complications of ADT and SDM. We proceeded to deliver these brochures to participating oncology offices and then carried out a survey of team members in these offices. We obtained responses from 31 oncology team members. Our survey revealed that about half of the participants (48%) rarely applied SDM in their oncology practice, and only about one-third (32%) sometimes applied SDM. After reading our brochures, the majority of respondents could correctly answer questions about SDM and CV complications of ADT. Improvement in scores after reading our materials was significant for both CV complications of ADT and SDM (e.g., CV complications of ADT: z = 6.153, p-value < 0.001, and SDM z = 6.456, p-value < 0.001). Implementation of SDM and an improved awareness of the CV complications of ADT can lead to significant benefits. It is therefore important to take steps to further raise such implementation and awareness among oncology team members in other geographic locations and clinical settings.
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Affiliation(s)
- Rovshan M Ismailov
- Complex Mechanisms of Disease, Aging and Trauma (CMDAT) Research Foundation, Denver, CO, USA.
| | - Álvaro Aceña
- Cardiology Department, Fundación Jiménez Díaz, Madrid, Spain
| | - Zaytuna D Khasanova
- Complex Mechanisms of Disease, Aging and Trauma (CMDAT) Research Foundation, Denver, CO, USA
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MacNevin W, Ilie G, Rendon R, Mason R, Spooner J, Chedrawe E, Patil N, Bowes D, Bailly G, Bell D, Wilke D, Zahavich JBL, MacDonald C, Rutledge RDH. PC-PEP, a Comprehensive Daily Six-Month Home-Based Patient Empowerment Program Leads to Weight Loss in Men with Prostate Cancer: A Secondary Analysis of a Clinical Trial. Curr Oncol 2024; 31:1667-1688. [PMID: 38534960 PMCID: PMC10969418 DOI: 10.3390/curroncol31030127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/14/2024] [Accepted: 03/20/2024] [Indexed: 05/26/2024] Open
Abstract
Background: The Prostate Cancer-Patient Empowerment Program (PC-PEP) is a six-month daily home-based program shown to improve mental health and urinary function. This secondary analysis explores weight loss in male PC-PEP participants. Methods: In a randomized clinical trial with 128 men undergoing curative prostate cancer (PC) treatment, 66 received 'early' PC-PEP, while 62 were assigned to the 'late' waitlist-control group, receiving 6 months of standard-of-care treatment followed by 6 months of PC-PEP. PC-PEP comprised 182 daily emails with video-based exercise and dietary (predominantly plant-based) education, live online events, and 30 min strength training routines (using body weight and elastic bands). Weight and height data were collected via online surveys (baseline, 6 months, and 12 months) including medical chart reviews. Adherence was tracked weekly. Results: No attrition or adverse events were reported. At 6 months, the early PC-PEP group experienced significant weight loss, averaging 2.7 kg (p < 0.001) compared to the waitlist-control group. Weight loss was noted in the late intervention group of PC-PEP, albeit less pronounced than in the early group. Early PC-PEP surgery patients lost on average 1.4 kg (SE = 0.65) from the trial's start to surgery day. High adherence to exercise and dietary recommendations was noted. Conclusions: PC-PEP led to significant weight loss in men undergoing curative prostate cancer treatment compared to standard-of-care.
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Affiliation(s)
- Wyatt MacNevin
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Gabriela Ilie
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Radiation Oncology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Ricardo Rendon
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Ross Mason
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Jesse Spooner
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Emily Chedrawe
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Nikhilesh Patil
- Department of Radiation Oncology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - David Bowes
- Department of Radiation Oncology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Greg Bailly
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - David Bell
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Derek Wilke
- Department of Radiation Oncology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | | | - Cody MacDonald
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 4R2, Canada
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Mahalingam D, Hanni S, Serritella AV, Fountzilas C, Michalek J, Hernandez B, Sarantopoulos J, Datta P, Romero O, Pillai SMA, Kuhn J, Pollak M, Thompson IM. Utilizing metformin to prevent metabolic syndrome due to androgen deprivation therapy (ADT): a randomized phase II study of metformin in non-diabetic men initiating ADT for advanced prostate cancer. Oncotarget 2023; 14:622-636. [PMID: 37335291 PMCID: PMC10278660 DOI: 10.18632/oncotarget.28458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Androgen deprivation therapy (ADT) can lead to metabolic syndrome (MS) and is implicated in ADT-resistance. Metformin showed antineoplastic activity through mTOR inhibition secondary AMPK-activation. MATERIALS AND METHODS To investigate whether metformin mitigated ADT-related MS, we conducted a randomized double-blind phase II trial of metformin 500 mg TID or placebo in non-diabetic patients with biochemically-relapsed or advanced PC due for ADT. Fasting serum glucose, insulin, PSA, metformin, weight and waist circumference (WC) were measured at baseline, week 12 and 28. The primary endpoint was a group of MS metrics. Secondary endpoints include PSA response, safety, serum metformin concentrations and analysis of downstream an mTOR target, phospho-S6-kinase. RESULTS 36 men were randomized to either metformin or placebo. Mean age was 68.4. Mean weight, WC and insulin levels increased in both arms. At week 12 and 28, no statistical differences in weight, WC or insulin were observed in either arm. No significant difference in percentage of patients with PSA <0.2 at week 28 between metformin (45.5%) vs. placebo (46.7%). Analysis in the metformin-arm showed variable down-regulation of phospho-S6 kinase. CONCLUSIONS In our small study, metformin added to ADT did not show a reduced risk of ADT-related MS or differences in PSA response.
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Affiliation(s)
- Devalingam Mahalingam
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
- Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA
| | - Salih Hanni
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
| | - Anthony V. Serritella
- Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA
| | - Christos Fountzilas
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
- Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Joel Michalek
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
| | - Brian Hernandez
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
| | - John Sarantopoulos
- Institute for Drug Development, Mays Cancer Center at University of Texas Health, San Antonio, TX 78229, USA
| | | | - Ofelia Romero
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
| | | | - John Kuhn
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
| | - Michael Pollak
- Division of Experimental Medicine, Lady Davis Institute of Medical Research, Jewish General Hospital, McGill University, Montreal, Canada
| | - Ian M. Thompson
- Division of Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX 77030, USA
- Christus Health, San Antonio, TX 78229, USA
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Alexander S, Oelfke U, McNair H, Tree A. GI factors, potential to predict prostate motion during radiotherapy; a scoping review. Clin Transl Radiat Oncol 2023; 40:100604. [PMID: 36936470 PMCID: PMC10020110 DOI: 10.1016/j.ctro.2023.100604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/16/2023] [Accepted: 02/19/2023] [Indexed: 02/27/2023] Open
Abstract
Purpose A scoping literature review was conducted to identify gastrointestinal (GI) factors most likely to influence prostate motion during radiotherapy. We proffer that patient specific measurement of these GI factors could predict motion uncertainty during radiotherapy, facilitating personalised care by optimising treatment technique e.g., daily adaption or via bespoke patient pre-habilitation and preparation. Methods The scoping review was undertaken as per JBI guidelines. Searches were conducted across four databases: Ovid Medline®, EMBASE, CINAHL and EBSCO discovery. Articles written in English from 2010-present were included. Those pertaining to paediatrics, biological women exclusively, infectious and post-treatment GI morbidity and diet were excluded.Common GI factors impacting men were identified and related symptoms, incidence and measurement tools examined. Prevalence among persons with prostate cancer was explored and suitable assessment tools discussed. Results A preliminary search identified four prominent GI-factors: mental health, co-morbidity and medication, physical activity, and pelvic floor disorder. The scoping search found 3644 articles; 1646 were removed as duplicates. A further 1249 were excluded after title and abstract screening, 162 remained subsequent to full text review: 42 mental health, 53 co-morbidity and medication, 39 physical activity and 28 pelvic floor disorder.Six GI factors prevalent in the prostate cancer population and estimated most likely to influence prostate motion were identified: depression, anxiety, diabetes, obesity, low physical activity, and pelvic floor disorder. Reliable, quick, and easy to use tools are available to quantify these factors. Conclusion A comprehensive GI factor assessment package suitable to implement into the radiotherapy clinic has been created. Unveiling these GI factors upfront will guide improved personalisation of radiotherapy.
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Affiliation(s)
- S.E. Alexander
- The Royal Marsden NHS Foundation Trust, United Kingdom and The Institute of Cancer Research, United Kingdom
| | - U. Oelfke
- The Joint Department of Physics, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, United Kingdom
| | - H.A. McNair
- The Royal Marsden NHS Foundation Trust, United Kingdom and The Institute of Cancer Research, United Kingdom
| | - A.C. Tree
- The Royal Marsden NHS Foundation Trust, United Kingdom and The Institute of Cancer Research, United Kingdom
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Zhang H, Zhang L, Xu Y, Chen S, Ma Z, Yao M, Li F, Li B, Yuan Y. Simulating androgen receptor selection in designer yeast. Synth Syst Biotechnol 2022; 7:1108-1116. [PMID: 36017332 PMCID: PMC9386396 DOI: 10.1016/j.synbio.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/08/2022] [Accepted: 07/20/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Haoran Zhang
- Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (Ministry of Education), Tianjin University, Tianjin, 300072, PR China
- School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300072, PR China
| | - Lu Zhang
- Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (Ministry of Education), Tianjin University, Tianjin, 300072, PR China
- School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300072, PR China
| | - Yipeng Xu
- Department of Urology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - Shaoyong Chen
- Hematology-Oncology Division, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Zhenyi Ma
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin, 300070, PR China
| | - Mingdong Yao
- Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (Ministry of Education), Tianjin University, Tianjin, 300072, PR China
- School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300072, PR China
| | - Fangyin Li
- Department of Urology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - Bo Li
- Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (Ministry of Education), Tianjin University, Tianjin, 300072, PR China
- School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300072, PR China
| | - Yingjin Yuan
- Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (Ministry of Education), Tianjin University, Tianjin, 300072, PR China
- School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300072, PR China
- Corresponding author. Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (Ministry of Education), Tianjin University, Tianjin, 300072, PR China.
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Fay-Watt V, O'Connor S, Roshan D, Romeo AC, Longo VD, Sullivan FJ. The impact of a fasting mimicking diet on the metabolic health of a prospective cohort of patients with prostate cancer: a pilot implementation study. Prostate Cancer Prostatic Dis 2022:10.1038/s41391-022-00528-3. [PMID: 35314788 DOI: 10.1038/s41391-022-00528-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND This pilot prospective study investigated the effect of a periodic fasting mimicking diet (FMD) on metabolic health factors in patients with Prostate Cancer (PC). There is a well-documented association between PC and metabolic health. Impaired metabolic health is a significant risk factor for the development of PC, and a metabolic syndrome can be induced by hormonal therapies commonly required for its management. (ClinicalTrials.gov Identifier: NCT04292041). METHODS We introduced a periodic 5-day FMD -low in calories, sugars, and proteins but high in unsaturated fats -to a cohort of PC patients and features of metabolic syndrome. 29/35 patients completed 3-monthly cycles of the 5-consecutive day packaged FMD. We compared the subjects' baseline weight, abdominal circumference (AC), blood pressure (BP) and selected laboratory results to the same measurements 3-months after completing the FMD cycles. RESULTS Several important metabolic factors showed improvements post-intervention. On average patients' weights dropped by 3.79 kg (95% CI: -5.61, -1.97, p = 0.0002). AC was reduced on average by 4.57 cm, (95% CI: -2.27, -6.87, p = 0.0003). There was also a decrease in systolic and diastolic BP by 9.52 mmHg (95% CI: -16.16, -2.88, p = 0.0066) and 4.48 mmHg (95% CI: -8.85, -0.43, p = 0.0316) respectively. A sub-analysis indicates that FMD had more relevant effects in 'at-risk' patients than those with normal values of risk factors for metabolic syndrome. For example, subjects with baseline levels of systolic BP > 130 mmHg experienced a greater reduction in BP(-16.04 mmHg, p = 0.0001) than those with baseline systolic BP < 130 mmHg (-0.78 mmHg, p = 0.89). CONCLUSIONS The FMD cycles were safely introduced to this small cohort of PC patients with little or no observed toxicity, and a high overall compliance of 83%. Analysis of the metabolic variables showed an overall decrease in weight, AC, and BP. Larger clinical trials focused on metabolic risk factors, PC quality of life and progression free survival are needed to assess the effect of the FMD on prostate cancer patients.
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Affiliation(s)
- V Fay-Watt
- School of Medicine, National University of Ireland, Galway, Ireland
| | - S O'Connor
- Department of Radiation Oncology, Galway Clinic, Doughiske, Galway, Ireland
| | - D Roshan
- School of Mathematical and Statistical Sciences, National University of Ireland, Galway, Ireland.,CURAM, SFI Research Centre for Medical Devices, National University of Ireland, Galway, Ireland
| | - A C Romeo
- Department of Internal Medicine and Medical Specialties, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - V D Longo
- IFOM, FIRC Institute of Molecular Oncology, Via Adamello 16, 20139, Milano, Italy.,Longevity Institute, School of Gerontology, Department of Biological Sciences, University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089-0191, USA
| | - F J Sullivan
- Department of Radiation Oncology, Galway Clinic, Doughiske, Galway, Ireland. .,Department of Radiation Oncology, Galway Clinic, Prostate Cancer Institute, National University of Ireland, Galway, Ireland.
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Faithfull S, Lemanska A, Poole K, Aning J, Manders R, Marshall J, Saxton J, Turner L, Griffin B. Obesity and low levels of physical activity impact on cardiopulmonary fitness in older men after treatment for prostate cancer. Eur J Cancer Care (Engl) 2021; 30:e13476. [PMID: 34143537 DOI: 10.1111/ecc.13476] [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: 11/18/2020] [Revised: 03/21/2021] [Accepted: 05/13/2021] [Indexed: 12/24/2022]
Abstract
The purpose of this study was to compare fitness parameters and cardiovascular disease risk of older and younger men with prostate cancer (PCa) and explore how men's fitness scores compared to normative age values. 83 men were recruited post-treatment and undertook a cardiopulmonary exercise test (CPET), sit-to-stand, step-and-grip strength tests and provided blood samples for serum lipids and HbA1c. We calculated waist-to-hip ratio, cardiovascular risk (QRISK2), Charlson comorbidity index (CCI) and Godin leisure-time exercise questionnaire [GLTEQ]. Age-group comparisons were made using normative data. Men > 75 years, had lower cardiopulmonary fitness, as measured by VO2 Peak (ml/kg/min) 15.8 + 3.8 p < 0.001, and lower grip strength(28.6+5.2 kg p < 0.001) than younger men. BMI ≥30kg/m2 and higher blood pressure all contributed to a QRisk2 score indicative of 20% chance of cardiovascular risk within 10 years (mean: 36.9-6.1) p < 0.001. Age, BMI and perceived physical activity were significantly associated with lower cardiopulmonary fitness. Men with PCa > 75 years had more cardiovascular risk factors compared to normative standards for men of their age. Although ADT was more frequent in older men, this was not found to be associated with cardiopulmonary fitness, but obesity and low levels of physical activity were. Secondary prevention should be addressed in men with PCa to improve men's overall health.
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Affiliation(s)
- Sara Faithfull
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - Agnieszka Lemanska
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - Karen Poole
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - Jonathan Aning
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - Ralph Manders
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - John Marshall
- PPI Representative, Prostate Cancer UK Charity, London, UK
| | - John Saxton
- Department of Sport Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Lauren Turner
- Frimley Health NHS Foundation Trust, Frimley, Surrey, UK
| | - Bruce Griffin
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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Qi R, Han X, Wang J, Qiu X, Wang Q, Yang F. MicroRNA-489-3p promotes adipogenesis by targeting the Postn gene in 3T3-L1 preadipocytes. Life Sci 2021; 278:119620. [PMID: 34004251 DOI: 10.1016/j.lfs.2021.119620] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 12/11/2022]
Abstract
AIMS Accumulating evidence indicates that a number of microRNAs (miRNAs) serve as essential regulators during adipogenesis and adipolysis in humans and animals and play critical roles in the development of fat tissue. In this study, we aimed to determine the functional role and underlying regulatory mechanism of microRNA-489-3p (miR-489) in adipocytes. MATERIALS AND METHODS The expression patterns of miR-489 in mice were measured by qRT-PCR. Overexpression and knockdown of miR-489 by mimic and inhibitor transfections in 3T3-L1 preadipocytes revealed the regulatory effect of miR-489 on cellular proliferation and differentiation and energy turnover. Furthermore, RNA-seq, bioinformatics prediction, and dual luciferase reporter assays were used to identify the direct target of miR-489. KEY FINDINGS The results showed that miR-489 was highly expressed in the visceral fat tissue of adult mice, and obese mice exhibited higher levels of miR-489 than normal mice. Overexpression of miR-489 suppressed proliferation but promoted adipogenic differentiation and lipid accumulation in the cells. Mitochondrial oxidation also fluctuated in the cells due to the high expression of miR-489. Notably, knockdown of miR-489 did not have a strong opposing effect on the cells. Periostin (Postn) was identified as a direct target gene for miR-489, and silencing the Postn gene similarly stimulated adipogenesis and differentiation of adipocytes. SIGNIFICANCE miR-489 provides a strong driving force for adipogenesis metabolism and adipocyte differentiation by targeting the Postn gene. This result may contribute to the treatment of obesity.
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Affiliation(s)
- Renli Qi
- Chongqing Academy of Animal Science, Rongchang 402460, China; Chongqing Key Laboratory of Pig Industry Sciences, Rongchang 402460, China
| | - Xu Han
- ChaoYang Teachers College, Liaoning 122000, China
| | - Jing Wang
- Chongqing Academy of Animal Science, Rongchang 402460, China
| | - Xiaoyu Qiu
- Chongqing Academy of Animal Science, Rongchang 402460, China
| | - Qi Wang
- Chongqing Academy of Animal Science, Rongchang 402460, China
| | - Feiyun Yang
- Chongqing Academy of Animal Science, Rongchang 402460, China; Chongqing Key Laboratory of Pig Industry Sciences, Rongchang 402460, China.
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Stringer EJ, Sidhu S, Austin K, Cosby C. Nutrition Education Seminars for Prostate Cancer-Diet and Prostate Program: Evaluation and Recommendations (DAPPER Study). CAN J DIET PRACT RES 2021; 82:27-31. [PMID: 33320768 DOI: 10.3148/cjdpr-2020-028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Nutrition is important for prostate cancer (PCa) care as it may influence PCa progression and risk of comorbid diseases. The aim of this pilot study was to assess changes in knowledge and satisfaction in men with PCa following attendance at a nutrition education seminar. Fifty-two men with PCa attended nutrition education seminars instructed by a Registered Dietitian. Participants completed the Revised General Nutrition Knowledge Questionnaire (GNKQ-R) preseminar and 2 weeks postseminar, along with a satisfaction survey. Increased nutrition knowledge was observed through a significant (P = 0.023) improvement in mean scores of 71.6% (P < 0.005) preseminar compared with 79.3% (P < 0.005) postseminar on the GNKQ-R. Participants reported the seminar as a satisfactory method for meeting their diet information needs. Using thematic analysis 3 themes emerged: importance of diet information, desire for an integrative approach, and the value of group learning. This pilot study found that a group nutrition education seminar may be an effective and satisfactory approach to fulfilling the dietary information needs of this population. Group education may be an economically sustainable approach with potential application in other tumour sites or health conditions.
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Affiliation(s)
| | - Satnam Sidhu
- Oncology Nutrition, BC Cancer-Victoria, Victoria, BC
| | - Karina Austin
- Oncology Nutrition, BC Cancer-Victoria, Victoria, BC
| | - Cheri Cosby
- Oncology Nutrition, BC Cancer-Victoria, Victoria, BC
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10
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Surgical versus Medical Castration for Metastatic Prostate Cancer: Use and Overall Survival in a National Cohort. J Urol 2020; 203:933-939. [PMID: 31746656 DOI: 10.1097/ju.0000000000000684] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Surgical castration for metastatic prostate cancer is used less frequently than medical castration yet costs less, requires less followup and may be associated with fewer adverse effects. We evaluated temporal trends and factors associated with the use of surgical castration. MATERIALS AND METHODS This retrospective cohort study sampled 24,805 men with newly diagnosed (de novo) metastatic prostate cancer from a national cancer registry in the United States (2004 to 2016). Multivariable logistic regression assessed the association between sociodemographic factors and surgery. Multivariable Cox regression evaluated the association between castration type and overall survival. RESULTS Overall 5.4% of men underwent surgical castration. This figure decreased from 8.5% in 2004 to 3.5% in 2016 (per year later OR 0.89, 95% CI 0.87-0.91, p <0.001). Compared to Medicare, private insurance was associated with less surgery (OR 0.73, 95% CI 0.61-0.87, p <0.001) while Medicaid or no insurance was associated with more surgery (OR 1.68, 95% CI 1.34-2.11, p <0.001 and OR 2.12, 95% CI 1.58-2.85, p <0.001, respectively). Regional median income greater than $63,000 was associated with less surgery (vs income less than $38,000 OR 0.61, 95% CI 0.43-0.85, p=0.004). After a median followup of 30 months castration type was not associated with differences in survival (surgical vs medical HR 1.02, 95% CI 0.95-1.09, p=0.6). CONCLUSIONS In a contemporary, real-world cohort surgical castration use is low and decreasing despite its potential advantages and similar survival rate compared to medical castration. Men with potentially limited health care access undergo more surgery, perhaps reflecting a provider bias toward the perceived benefit of permanent castration.
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CPT1A Over-Expression Increases Reactive Oxygen Species in the Mitochondria and Promotes Antioxidant Defenses in Prostate Cancer. Cancers (Basel) 2020; 12:cancers12113431. [PMID: 33218188 PMCID: PMC7709014 DOI: 10.3390/cancers12113431] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/03/2020] [Accepted: 11/09/2020] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Prostate cancer (PCa) is the most common cancer in men and the second highest contributor to cancer deaths. Targeting lipid catabolism enzymes in PCa may offer new avenues for therapeutic approaches. During the last decade, carnitine palmitoyl transferase I (CPT1A) has been identified as a potential therapeutic target for a growing list of cancers. In this study, we have tested the hypothesis that excess CPT1A plays a key role in supporting adaptation to stress and antioxidant defense production in PCa cells. Specifically, we have studied molecular differences between CPT1A gain and loss of function models, revealing genetic and metabolic vulnerabilities that could be targeted to avoid progression to neuroendocrine differentiation, a lethal form of the disease. Examining public datasets, we have also found that excess CPT1A expression leads to worse progression-free survival in PCa patients. Abstract Cancers reprogram their metabolism to adapt to environmental changes. In this study, we examined the consequences of altered expression of the mitochondrial enzyme carnitine palmitoyl transferase I (CPT1A) in prostate cancer (PCa) cell models. Using transcriptomic and metabolomic analyses, we compared LNCaP-C4-2 cell lines with depleted (knockdown (KD)) or increased (overexpression (OE)) CPT1A expression. Mitochondrial reactive oxygen species (ROS) were also measured. Transcriptomic analysis identified ER stress, serine biosynthesis and lipid catabolism as significantly upregulated pathways in the OE versus KD cells. On the other hand, androgen response was significantly downregulated in OE cells. These changes associated with increased acyl-carnitines, serine synthesis and glutathione precursors in OE cells. Unexpectedly, OE cells showed increased mitochondrial ROS but when challenged with fatty acids and no androgens, the Superoxide dismutase 2 (SOD2) enzyme increased in the OE cells, suggesting better antioxidant defenses with excess CPT1A expression. Public databases also showed decreased androgen response correlation with increased serine-related metabolism in advanced PCa. Lastly, worse progression free survival was observed with increased lipid catabolism and decreased androgen response. Excess CPT1A is associated with a ROS-mediated stress phenotype that can support PCa disease progression. This study provides a rationale for targeting lipid catabolic pathways for therapy in hormonal cancers.
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Ren Y, Song S, Liu X, Yang M. Phenotypic changes in the metabolic profile and adiponectin activity during seasonal fattening and hibernation in female Daurian ground squirrels (Spermophilus dauricus). Integr Zool 2020; 17:297-310. [PMID: 33190391 DOI: 10.1111/1749-4877.12504] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Seasonal hibernation has provided an opportunity to study animals' phenotypic plasticity in adaptation to changing environment. In the present study focusing on the female Daurian ground squirrel (Spermophilus dauricus)-a well demonstrated seasonal hibernator-we examined their behavioral, morphological, and metabolic changes during fattening, hibernation, and emergence. Our data indicated high levels of food intake, fat deposition, and body mass increases during fattening compared to hibernation. The levels of serum glucose and triglycerides were also higher during fattening than during hibernation and emergence. Interestingly, although squirrels showed signs of obesity and elevated triglycerides in serum during fattening, triglyceride levels in the liver and skeletal muscles remained unchanged. Our data also indicated that adiponectin levels in serum and cerebrospinal fluid were different between fattening and hibernation. Levels of adiponectin receptor 1 in the skeletal muscle remained low during fattening but peaked in late hibernation. In contrast, adiponectin receptor 2 in the liver showed a steady increase during fattening, which was followed by a significant decrease at early hibernation. Our data indicate that adiponectin may play an important role in preventing heterotopic fat accumulation in a receptor- and organ-specific manner, as well as in facilitating the switch from glucose metabolism to lipid metabolism during fattening and hibernation in female Daurian ground squirrels.
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Affiliation(s)
- Yue Ren
- College of life Sciences, Shenyang Normal University, Shenyang, China
| | - Shiyi Song
- College of life Sciences, Shenyang Normal University, Shenyang, China
| | - Xinyu Liu
- College of life Sciences, Shenyang Normal University, Shenyang, China
| | - Ming Yang
- College of life Sciences, Shenyang Normal University, Shenyang, China
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13
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Long-term follow-up 3 years after a randomized rehabilitation study among radiated prostate cancer survivors. J Cancer Surviv 2020; 15:668-676. [DOI: 10.1007/s11764-020-00958-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/10/2020] [Indexed: 12/15/2022]
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Milluzzo A, Vigneri P, Martorana F, Vigneri R, Sciacca L. Type 2 diabetes and cancer: problems and suggestions for best patient management. EXPLORATION OF MEDICINE 2020. [DOI: 10.37349/emed.2020.00013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Diabetes and cancer are widespread worldwide and the number of subjects presenting both diseases increased over the years. The management of cancer patients having diabetes represents a challenge not only because of the complexity and heterogeneity of these pathologies but also for the lack of standardised clinical guidelines. The diagnosis of cancer is traumatizing and monopolizes the attention of both patients and caregivers. Thus, pre-existent or new-onset diabetes can be overshadowed thus increasing the risk for short- and long-term adverse events. Moreover, drugs used for each disease can interfere with the clinical course of the concomitant disease, making challenging the management of these patients. Over the years, this issue has become more relevant because of the increased patients’ life expectancy due to the improved efficacy of diabetes and cancer therapies.
The purpose of this review is to highlight what is known and what should be taken into consideration to optimise the clinical management of patients with diabetes and cancer. Due to the complexity of these diseases, a multidisciplinary, shared approach, including all the protagonists involved, is necessary to improve patients’ quality of life and lifespan.
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Affiliation(s)
- Agostino Milluzzo
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Catania Medical School, 95122 Catania, Italy
| | - Paolo Vigneri
- Center of Experimental Oncology and Hematology, Department of Clinical and Experimental Medicine, University of Catania, A.O.U. Policlinico-Vittorio Emanuele, 95124 Catania, Italy
| | - Federica Martorana
- Center of Experimental Oncology and Hematology, Department of Clinical and Experimental Medicine, University of Catania, A.O.U. Policlinico-Vittorio Emanuele, 95124 Catania, Italy
| | - Riccardo Vigneri
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Catania Medical School, 95122 Catania, Italy; Institute of Crystallography, Catania Section, National Research Council, CNR, 95126 Catania, Italy
| | - Laura Sciacca
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Catania Medical School, 95122 Catania, Italy
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Kirlangic OF, Yilmaz-Oral D, Kaya-Sezginer E, Toktanis G, Tezgelen AS, Sen E, Khanam A, Oztekin CV, Gur S. The Effects of Androgens on Cardiometabolic Syndrome: Current Therapeutic Concepts. Sex Med 2020; 8:132-155. [PMID: 32201216 PMCID: PMC7261691 DOI: 10.1016/j.esxm.2020.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 01/31/2020] [Accepted: 02/11/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Cardiometabolic syndrome (CMS), as a bunch of metabolic disorders mainly characterized by type 2 diabetes mellitus (T2DM), hypertension, atherosclerosis, central adiposity, and abdominal obesity triggering androgen deficiency, is one of the most critical threats to men. Although many significant preclinical and clinical findings explain CMS, new approaches toward common pathophysiological mechanisms and reasonable therapeutic targets are lacking. AIM To gain a further understanding of the role of androgen levels in various facets of CMS such as the constellation of cardiometabolic risk factors including central adiposity, dyslipidemia, insulin resistance, diabetes, and arterial hypertension and to define future directions for development of effective therapeutic modalities. METHODS Clinical and experimental data were searched through scientific literature databases (PubMed) from 2009 to October 2019. MAIN OUTCOME MEASURE Evidence from basic and clinical research was gathered with regard to the causal impact and therapeutic roles of androgens on CMS. RESULTS There are important mechanisms implicated in androgen levels and the risk of CMS. Low testosterone levels have many signs and symptoms on cardiometabolic and glycometabolic risks as well as abdominal obesity in men. CLINICAL IMPLICATIONS The implications of the findings can shed light on future improvements in androgen levels and add potentially predictive risk for CMS, as well as T2DM, abdominal obesity to guide clinical management in the early stage. STRENGTHS & LIMITATIONS This comprehensive review refers to the association between androgens and cardiovascular health. A limitation of this study is the lack of large, prospective population-based studies that analyze the effects of testosterone treatment on CMS or mortality. CONCLUSION Low testosterone levels have several common features with metabolic syndrome. Thus, testosterone may have preventive role in the progress of metabolic syndrome and subsequent T2DM, abdominal obesity, and cardiovascular disease and likely affect aging men's health mainly through endocrine and vascular mechanisms. Further studies are necessary to evaluate the therapeutic interventions directed at preventing CMS in men. Kirlangic OF, Yilmaz-Oral D, Kaya-Sezginer E, et al. The Effects of Androgens on Cardiometabolic Syndrome: Current Therapeutic Concepts. Sex Med 2020;8:132-155.
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Affiliation(s)
- Omer Faruk Kirlangic
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Medical Biochemistry, Ankara, Turkey
| | - Didem Yilmaz-Oral
- Cukurova University, Faculty of Pharmacy, Department of Pharmacology, Adana, Turkey
| | - Ecem Kaya-Sezginer
- Ankara University, Faculty of Pharmacy, Department of Biochemistry, Ankara, Turkey
| | - Gamze Toktanis
- Ankara University, Faculty of Pharmacy, Department of Pharmacology, Ankara, Turkey
| | | | - Ekrem Sen
- Ankara University, Faculty of Pharmacy, Department of Pharmacology, Ankara, Turkey
| | - Armagan Khanam
- Ankara University, Faculty of Pharmacy, Department of Pharmacology, Ankara, Turkey
| | - Cetin Volkan Oztekin
- Department of Urology, Faculty of Medicine, University of Kyrenia, Girne, Turkish Republic of North Cyprus, Mersin 10, Turkey
| | - Serap Gur
- Ankara University, Faculty of Pharmacy, Department of Pharmacology, Ankara, Turkey.
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Youn JC, Chung WB, Ezekowitz JA, Hong JH, Nam H, Kyoung DS, Kim IC, Lyon AR, Kang SM, Jung HO, Chang K, Oh YS, Youn HJ, Baek SH, Kim HC. Cardiovascular disease burden in adult patients with cancer: An 11-year nationwide population-based cohort study. Int J Cardiol 2020; 317:167-173. [PMID: 32360647 DOI: 10.1016/j.ijcard.2020.04.080] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/19/2020] [Accepted: 04/27/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is an important cause of morbidity and mortality in patients with cancer. However, the real-world CVD burden of adult cancer patients has not been well established. This study aimed to evaluate the prevalence and mortality of pre-existing and new-onset CVD in patients with cancers. METHODS We analysed the prevalence and mortality of pre-existing and new-onset CVD in 41,034 adult patients with ten common solid cancers in a single payer system using data from the Korean National Health Insurance Service-National Sample Cohort from 2002 to 2013. RESULTS When all types of cancer were included, 11.3% (n = 4647) of patients had pre-existing CVD when they were diagnosed with cancer. After excluding patients with pre-existing CVD, 15.7% of cancer patients (n = 5703) were newly diagnosed with CVD during the follow-up period (median 68 months). Both pre-existing and new-onset CVD were associated with increased risk of overall mortality and 5-year mortality. Multivariate analysis to predict all-cause mortality indicated both pre-existing and new-onset CVD, male sex, old age, prior history of diabetes or chronic kidney disease, suburban residential area, and low-income status as significant factors. CONCLUSIONS Eleven percent of cancer patients had pre-existing CVD at the time of cancer diagnosis, and about 16% of cancer patients without pre-existing CVD were newly diagnosed with CVD, mostly within 5 years after the cancer diagnosis. Proper management of pre-existing CVD is necessary and pre-emptive prevention of new-onset CVD may alter treatment options and outcomes.
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Affiliation(s)
- Jong-Chan Youn
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Woo-Baek Chung
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Justin A Ezekowitz
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Jung Hwa Hong
- Department of Health Insurance Research, NHIS Medical Center, Ilsan Hospital, Goyang, Republic of Korea
| | - Hyewon Nam
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Republic of Korea
| | - Dae-Sung Kyoung
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Republic of Korea
| | - In-Cheol Kim
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Alexander R Lyon
- Cardio-Oncology Service, Royal Brompton & Harefield NHS Foundation Trust and the National Heart & Lung Institute, Imperial College London, London, UK
| | - Seok-Min Kang
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hae Ok Jung
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kiyuk Chang
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-Seog Oh
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho-Joong Youn
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Hong Baek
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeon Chang Kim
- Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Wu SY, Fang SC, Hwang OR, Shih HJ, Shao YHJ. Influence of Baseline Cardiovascular Comorbidities on Mortality after Androgen Deprivation Therapy for Metastatic Prostate Cancer. Cancers (Basel) 2020; 12:cancers12010189. [PMID: 31940958 PMCID: PMC7016583 DOI: 10.3390/cancers12010189] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/07/2020] [Accepted: 01/10/2020] [Indexed: 12/22/2022] Open
Abstract
Few studies have assessed the benefits of androgen deprivation therapy (ADT) in men with metastatic prostate cancer (PC; mPC) at an old age or with major cardiovascular conditions. A retrospective cohort consisted of 3835 men with newly diagnosed mPC from the Taiwan Cancer Registry of 2008–2014. Among them, 2692 patients received only ADT in the first year after the cancer diagnosis, and 1143 patients were on watchful waiting. The inverse probability of treatment-weighted Cox model was used to estimate the effects of ADT on all-cause mortality and PC-specific mortality according to age, and the status of congestive heart failure (CHF), coronary arterial diseases (CADs), and stroke at the baseline. After a median follow-up of 2.65 years, 1650 men had died. ADT was associated with a 17–22% risk reduction in all-cause and PC-specific mortality in men without stroke, CAD, or CHF in the 65–79-year group. The survival benefit diminished in men with any of these preexisting conditions. In contrast, ADT was not found to be associated with any survival benefit in the ≥80-year group, even though they did not present with any major cardiovascular disease at the baseline. Patients who had CHF, CAD, or stroke at the baseline did not show a survival benefit following ADT in any of the age groups. Men who have preexisting major cardiovascular diseases or are ≥80 years do not demonstrate a survival benefit from ADT for mPC. The risk–benefit ratio should be considered when using ADT for mPC in older men especially those with major cardiovascular comorbidities.
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Affiliation(s)
- Szu-Yuan Wu
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan;
- Division of Radiation Oncology, Department of Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
| | - Su-Chen Fang
- Department of Nursing, Mackay Medical College, New Taipei City 252, Taiwan;
| | - Olivia Rachel Hwang
- Department, Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei 110, Taiwan;
| | - Hung-Jen Shih
- Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei 106, Taiwan;
- Department of Urology, School of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Yu-Hsuan Joni Shao
- Department, Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei 110, Taiwan;
- Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan
- Correspondence: ; Tel.: +886-2-6638-2736 (ext. 1502); Fax: +886-2-2739-2914
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Campia U, Moslehi JJ, Amiri-Kordestani L, Barac A, Beckman JA, Chism DD, Cohen P, Groarke JD, Herrmann J, Reilly CM, Weintraub NL. Cardio-Oncology: Vascular and Metabolic Perspectives: A Scientific Statement From the American Heart Association. Circulation 2019; 139:e579-e602. [PMID: 30786722 DOI: 10.1161/cir.0000000000000641] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardio-oncology has organically developed as a new discipline within cardiovascular medicine as a result of the cardiac and vascular adverse sequelae of the major advances in cancer treatment. Patients with cancer and cancer survivors are at increased risk of vascular disease for a number of reasons. First, many new cancer therapies, including several targeted therapies, are associated with vascular and metabolic complications. Second, cancer itself serves as a risk factor for vascular disease, especially by increasing the risk for thromboembolic events. Finally, recent data suggest that common modifiable and genetic risk factors predispose to both malignancies and cardiovascular disease. Vascular complications in patients with cancer represent a new challenge for the clinician and a new frontier for research and investigation. Indeed, vascular sequelae of novel targeted therapies may provide insights into vascular signaling in humans. Clinically, emerging challenges are best addressed by a multidisciplinary approach in which cardiovascular medicine specialists and vascular biologists work closely with oncologists in the care of patients with cancer and cancer survivors. This novel approach realizes the goal of providing superior care through the creation of cardio-oncology consultative services and the training of a new generation of cardiovascular specialists with a broad understanding of cancer treatments.
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Agarwal M, Canan T, Glover G, Thareja N, Akhondi A, Rosenberg J. Cardiovascular Effects of Androgen Deprivation Therapy in Prostate Cancer. Curr Oncol Rep 2019; 21:91. [DOI: 10.1007/s11912-019-0841-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Weiner AB, Nettey OS, Morgans AK. Management of Metastatic Hormone-Sensitive Prostate Cancer (mHSPC): an Evolving Treatment Paradigm. Curr Treat Options Oncol 2019; 20:69. [PMID: 31286275 DOI: 10.1007/s11864-019-0668-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OPINION STATEMENT Combination systemic therapy is now standard of care for all men with metastatic, hormone-sensitive prostate cancer (mHSPC). Patients with mHSPC should be treated with standard androgen deprivation therapy (ADT) and abiraterone acetate with prednisone or docetaxel (chemohormoanl therapy) unless there are contraindications to combination therapy. Based on the Chemohormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer (CHAARTED) study subgroup analysis, chemohormonal therapy may be most beneficial in men with high-volume disease burden, as men with low-volume metastatic disease do not appear to experience a survival benefit with chemohormonal therapy, while abiraterone in combination with ADT appears to be beneficial across both disease volume subgroups. Decisions regarding whether to use chemohormonal therapy or abiraterone and ADT for men with mHSPC should integrate consideration of volume of disease burden, quality of life effects, duration of therapy, and patient preferences for treatment as there is no formally powered prospective head-to-head comparison of these options demonstrating superiority of one approach over the other. Treatment of the primary tumor with radiation should be considered in men with de novo low-volume metastatic disease as radiation is associated with prolonged survival and a tolerable toxicity profile. Men with de novo high-volume metastatic disease do not appear to have improved survival with radiation of the primary tumor. Numerous clinical trials are ongoing to evaluate treatment approaches that may benefit men with mHSPC. Radical prostatectomy in men with mHSPC in combination with optimal systemic therapy is currently being assessed in a clinical trial, but should not be considered outside of a clinical trial. Metastasis-directed therapy with radiotherapy directed at metastatic lesions is still investigational, but can be considered in clinical trials in men with oligometastatic disease. Multiple studies are enrolling worldwide for men with mHSPC, and these should be considered for all interested patients.
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Affiliation(s)
- Adam B Weiner
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Oluwarotimi S Nettey
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alicia K Morgans
- Department of Medicine, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 850, Chicago, IL, 60611, USA.
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Abstract
The cardiovascular system is particularly sensitive to androgens, but some controversies exist regarding the effect of testosterone on the heart. While among anabolic abusers, cases of sudden cardiac death have been described, recently it was reported that low serum level of testosterone was correlated with increased risk of cardiovascular diseases (CVD) and mortality rate. This review aims to evaluate the effect of testosterone on myocardial tissue function, coronary artery disease (CAD), and death. Low testosterone level is associated with increased incidence of CAD and mortality. Testosterone administration in hypogonadal elderly men and women has a positive effect on cardiovascular function and improved clinical outcomes and survival time. Although at supraphysiologic doses, androgen may have a toxic effect, and at physiological levels, testosterone is safe and exerts a beneficial effect on myocardial function including mechanisms at cellular and mitochondrial level. The interaction with free testosterone and estradiol should be considered. Further studies are necessary to better understand the interaction mechanisms for an optimal androgen therapy in CVD.
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Affiliation(s)
- Vittorio Emanuele Bianchi
- Clinical Center Stella Maris, Laboratory of Physiology of Exercise, Strada Rovereta 42, 47891, Falciano, Republic of San Marino.
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DiNicolantonio JJ, McCarty M, OKeefe J. Does elevated bilirubin aid weight control by preventing development of hypothalamic leptin resistance? Open Heart 2019; 6:e000897. [PMID: 30997121 PMCID: PMC6443125 DOI: 10.1136/openhrt-2018-000897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2019] [Indexed: 12/16/2022] Open
Affiliation(s)
| | | | - James OKeefe
- Preventive Cardiology, Mid America Heart Institute, Kansas City, Missouri, USA
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Song D, Zhang J, Wang Y, Hu J, Xu S, Xu Y, Shen H, Wen X, Sun Z. Comparative study of the binding mode between cytochrome P450 17A1 and prostate cancer drugs in the absence of haem iron. J Biomol Struct Dyn 2019; 37:4161-4170. [PMID: 30431391 DOI: 10.1080/07391102.2018.1540360] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
According to the X-ray crystal structures of CYP17A1 (including its complexes with inhibitors), it is shown that a hydrogen bond exists between CYP17A1 and its inhibitors (such as abiraterone and TOK-001). Previous short MD simulations (50 ns) suggested that the binding of abiraterone to CYP17A1 is stronger than that of TOK-001. In this work, by carrying out long atomistic MD simulations (200 ns) of CYP17A1 and its complexes with abiraterone and TOK-001, we observed a binding mode between CYP17A1 and abiraterone, which is different from the binding mode between CYP17A1 and TOK-001. In the case of abiraterone binding, the unfilled volume in the active site cavity increases the freedom of movement of abiraterone within CYP17A1, leading to the collective motions of the helices G and B' as well as the breaking of hydrogen bond existing between the 3β-OH group of abiraterone and N202 of CYP17A1. However, the unfilled volume in the active site cavity can be occupied by the benzimidazole ring of TOK-001, restraining the motion of TOK-001. By pulling the two inhibitors (abiraterone and TOK-001) out of the binding pocket in CYP17A1, we discovered that abiraterone and TOK-001 were moved from their binding sites to the surface of protein similarly through the channels formed by the helices G and B'. In addition, based on the free energy calculations, one can see that it is energetically favorable for the two inhibitors (abiraterone and TOK-001) to enter into the binding pocket in CYP17A1.
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Affiliation(s)
- Dalong Song
- Guizhou University , Guiyang , Guizhou Province , PR China.,Department of Urology, Guizhou Provincial People's Hospital , Guiyang , Guizhou Province , PR China
| | - Jihua Zhang
- Guizhou Provincial Key Laboratory of Computational Nano-Material Science, Guizhou Education University , Guiyang , Guizhou Province , PR China
| | - Yuanlin Wang
- Department of Urology, Guizhou Provincial People's Hospital , Guiyang , Guizhou Province , PR China
| | - Jianxin Hu
- Department of Urology, Guizhou Provincial People's Hospital , Guiyang , Guizhou Province , PR China
| | - Shuxiong Xu
- Department of Urology, Guizhou Provincial People's Hospital , Guiyang , Guizhou Province , PR China
| | - Yuangao Xu
- Department of Urology, Guizhou Provincial People's Hospital , Guiyang , Guizhou Province , PR China
| | - Hujun Shen
- Guizhou Provincial Key Laboratory of Computational Nano-Material Science, Guizhou Education University , Guiyang , Guizhou Province , PR China
| | - Xiaopeng Wen
- Guizhou University , Guiyang , Guizhou Province , PR China
| | - Zhaolin Sun
- Department of Urology, Guizhou Provincial People's Hospital , Guiyang , Guizhou Province , PR China
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Xu YXZ, Mishra S. Obesity-Linked Cancers: Current Knowledge, Challenges and Limitations in Mechanistic Studies and Rodent Models. Cancers (Basel) 2018; 10:E523. [PMID: 30567335 PMCID: PMC6316427 DOI: 10.3390/cancers10120523] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/09/2018] [Accepted: 12/15/2018] [Indexed: 02/07/2023] Open
Abstract
The worldwide prevalence of obesity has doubled during the last 50 years, and according to the World Obesity Federation, one third of the people on Earth will be obese by the year 2025. Obesity is described as a chronic, relapsing and multifactorial disease that causes metabolic, biomechanical, and psychosocial health consequences. Growing evidence suggests that obesity is a risk factor for multiple cancer types and rivals smoking as the leading preventable cause for cancer incidence and mortality. The epidemic of obesity will likely generate a new wave of obesity-related cancers with high aggressiveness and shortened latency. Observational studies have shown that from cancer risk to disease prognosis, an individual with obesity is consistently ranked worse compared to their lean counterpart. Mechanistic studies identified similar sets of abnormalities under obesity that may lead to cancer development, including ectopic fat storage, altered adipokine profiles, hormone fluctuations and meta-inflammation, but could not explain how these common mechanisms produce over 13 different cancer types. A major hurdle in the mechanistic underpinning of obesity-related cancer is the lack of suitable pre-clinical models that spontaneously develop obesity-linked cancers like humans. Current approaches and animal models fall short when discerning the confounders that often coexist in obesity. In this mini-review, we will briefly survey advances in the different obesity-linked cancers and discuss the challenges and limitations in the rodent models employed to study their relationship. We will also provide our perspectives on the future of obesity-linked cancer research.
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Affiliation(s)
- Yang Xin Zi Xu
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 3P4, Canada.
| | - Suresh Mishra
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 3P4, Canada.
- Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 3P4, Canada.
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Xu Y, Du J, Zhang P, Zhao X, Li Q, Jiang A, Jiang D, Tang G, Jiang Y, Wang J, Li X, Zhang S, Zhu L. MicroRNA-125a-5p Mediates 3T3-L1 Preadipocyte Proliferation and Differentiation. Molecules 2018; 23:E317. [PMID: 29393878 PMCID: PMC6017839 DOI: 10.3390/molecules23020317] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 01/26/2018] [Accepted: 01/28/2018] [Indexed: 01/12/2023] Open
Abstract
Excessive accumulation of adipose tissue is a main cause of obesity or overweight, which is significantly involved in increasing the risk of diseases. Recently, numerous studies have proved that microRNAs (miRNAs) play important roles in adipogenesis by negatively regulating gene expression at posttranscriptional levels. In this study, we showed that miR-125a-5p was expressed at lower levels in the adipose tissues of high-fat diet (HFD)-fed mice than the normal chow (NCW)-fed mice. MiR-125a-5p expression were strongly up-regulated by nearly five-fold, when 3T3-L1 preadipocyte were induced and differentiated into mature adipocytes. Functional analysis indicated that overexpression of miR-125a-5p promoted 3T3-L1 preadipocyte proliferation and inhibited its differentiation. By contrast, inhibition of miR-125a-5p repressed 3T3-L1 preadipocyte proliferation and accelerated its differentiation. Furthermore, a dual-luciferase reporter assay demonstrated that signal transducer and activator of transcription 3 (STAT3) is a direct target gene of miR-125a-5p during 3T3-L1 preadipocyte differentiation. Further analysis confirmed that the process of miR-125a-5p inhibiting 3T3-L1 preadipocyte differentiation might be associated with the regulation of fatty acid metabolism related genes. Taken together, our results indicated that miR-125a-5p might promote 3T3-L1 preadipocyte proliferation, whereas inhibiting 3T3-L1 preadipocyte differentiation by negatively regulating STAT3.
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Affiliation(s)
- Yan Xu
- College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China.
| | - Jingjing Du
- College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China.
| | - Peiwen Zhang
- College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China.
| | - Xue Zhao
- College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China.
| | - Qiang Li
- Sichuan Province General Station of Animal Husbandry, Chengdu 611130, China.
| | - Anan Jiang
- College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China.
| | - Dongmei Jiang
- College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China.
| | - Guoqing Tang
- College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China.
| | - Yanzhi Jiang
- College of Life and Science, Sichuan Agricultural University, Chengdu 611130, China.
| | - Jinyong Wang
- Chongqing Academy of Animal Sciences, Chongqing 402460, China.
| | - Xuewei Li
- College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China.
| | - Shunhua Zhang
- College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China.
| | - Li Zhu
- College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China.
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Leow CH, Fischer K, Leow CY, Cheng Q, Chuah C, McCarthy J. Single Domain Antibodies as New Biomarker Detectors. Diagnostics (Basel) 2017; 7:diagnostics7040052. [PMID: 29039819 PMCID: PMC5745390 DOI: 10.3390/diagnostics7040052] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 01/02/2023] Open
Abstract
Biomarkers are defined as indicators of biological processes, pathogenic processes, or pharmacological responses to a therapeutic intervention. Biomarkers have been widely used for early detection, prediction of response after treatment, and for monitoring the progression of diseases. Antibodies represent promising tools for recognition of biomarkers, and are widely deployed as analytical tools in clinical settings. For immunodiagnostics, antibodies are now exploited as binders for antigens of interest across a range of platforms. More recently, the discovery of antibody surface display and combinatorial chemistry techniques has allowed the exploration of new binders from a range of animals, for instance variable domains of new antigen receptors (VNAR) from shark and variable heavy chain domains (VHH) or nanobodies from camelids. These single domain antibodies (sdAbs) have some advantages over conventional murine immunoglobulin owing to the lack of a light chain, making them the smallest natural biomarker binders thus far identified. In this review, we will discuss several biomarkers used as a means to validate diseases progress. The potential functionality of modern singe domain antigen binders derived from phylogenetically early animals as new biomarker detectors for current diagnostic and research platforms development will be described.
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Affiliation(s)
- Chiuan Herng Leow
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang 11800, Malaysia.
| | - Katja Fischer
- Bacterial Pathogenesis and Scabies Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia.
| | - Chiuan Yee Leow
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Kelantan 16150, Malaysia.
| | - Qin Cheng
- Department of Drug Resistance and Diagnostics, Australian Army Malaria Institute, Brisbane 4051, Australia.
| | - Candy Chuah
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan 16150, Malaysia.
| | - James McCarthy
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4029, Australia.
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Effects of resistance exercise in prostate cancer patients: a meta-analysis. Support Care Cancer 2017; 25:2953-2968. [PMID: 28600706 PMCID: PMC5527087 DOI: 10.1007/s00520-017-3771-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 05/30/2017] [Indexed: 01/23/2023]
Abstract
PURPOSE The aim of the present meta-analysis was to quantify effects of resistance exercise (RE) on physical performance and function, body composition, health-related quality of life (HRQoL), and fatigue in patients with prostate cancer. METHODS Trial data were obtained from the databases PubMed, MEDLINE, EMBASE, SCOPUS, and the Cochrane Library as of inception to 31st of December 2016. Thirty-two trials with 1199 patients were included. Results that were measured by using the same assessment method in five or more of the original studies were pooled in a meta-analysis. RESULTS Pooled studies showed significant improvements of muscular strength in the upper and lower body (95% CI [2.52, 7.97] kg; p < 0.001 and 95% CI [10.51, 45.88] kg; p = 0.008, respectively) after RE. Furthermore, significant improvements were seen for body composition (body fat percentage 95% CI [-0.79, -0.53] %; p < 0.001; lean body mass 95% CI [0.15, 1.84] %; p = 0.028; trunk fat mass 95% CI [-0.73, -0.08] kg; p = 0.024). Additionally, the improvement of the 400-m walk time was significant (95% CI [-21.55, -14.65] s; p < 0.001). Concerning fatigue and HRQoL, there were not sufficient data for analysis. CONCLUSIONS RE seems to be a promising approach in order to counteract loss of muscle mass, muscle strength, and physical performance in patients suffering from prostate cancer and its treatment-related side effects. RE should play part in interdisciplinary cancer rehabilitation and care of this patient group. Nevertheless, further research should investigate RE further to determine which protocols are the most pragmatic, yet yielding best patient outcomes.
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Giza DE, Iliescu G, Hassan S, Marmagkiolis K, Iliescu C. Cancer as a Risk Factor for Cardiovascular Disease. Curr Oncol Rep 2017; 19:39. [DOI: 10.1007/s11912-017-0601-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Cormie P, Lamb S, Newton RU, Valentine L, McKiernan S, Spry N, Joseph D, Taaffe DR, Doran CM, Galvão DA. Implementing exercise in cancer care: study protocol to evaluate a community-based exercise program for people with cancer. BMC Cancer 2017; 17:103. [PMID: 28166766 PMCID: PMC5294717 DOI: 10.1186/s12885-017-3092-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/27/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Clinical research has established the efficacy of exercise in reducing treatment-related side-effects and increasing wellbeing in people with cancer. Major oncology organisations have identified the importance of incorporating exercise in comprehensive cancer care but information regarding effective approaches to translating evidence into practice is lacking. This paper describes the implementation of a community-based exercise program for people with cancer and the protocol for program evaluation. METHODS/DESIGN The Life Now Exercise program is a community-based exercise intervention designed to mitigate and rehabilitate the adverse effects of cancer and its treatment and improve physical and psychosocial wellbeing in people with cancer. Involvement in the program is open to people with any diagnosis of cancer who are currently receiving treatment or within 2 years of completing treatment. The 3-month intervention consists of twice weekly group-based exercise sessions administered in community exercise clinics under the supervision of exercise physiologists trained to deliver the program. Evaluation of the program involves measures of uptake, safety, adherence and effectiveness (including cost effectiveness) as assessed at the completion of the program and 6 months follow-up. DISCUSSION To bridge the gap between research and practice, the Life Now Exercise program was designed and implemented to provide people with cancer access to evidence-based exercise medicine. The framework for program implementation and evaluation offers insight into the development of feasible, generalizable and sustainable supportive care services involving exercise. Community-based exercise programs specifically designed for people with cancer are necessary to facilitate adherence to international guidelines advising patients to participate in high-quality exercise. TRIAL REGISTRATION ACTRN12616001669482 (retrospectively registered 5 Dec 2016).
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Affiliation(s)
- Prue Cormie
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA Australia
| | | | - Robert U. Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA Australia
- University of Queensland Centre for Clinical Research, Brisbane, QLD Australia
| | | | | | - Nigel Spry
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA Australia
- Cancer Centre, Sir Charles Gairdner Hospital, Perth, WA Australia
- Faculty of Medicine, University of Western Australia, Perth, WA Australia
| | - David Joseph
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA Australia
- Cancer Centre, Sir Charles Gairdner Hospital, Perth, WA Australia
- Faculty of Medicine, University of Western Australia, Perth, WA Australia
| | - Dennis R. Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA Australia
- School of Medicine, University of Wollongong, Wollongong, NSW Australia
| | - Christopher M. Doran
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA Australia
- School Human Health and Social Sciences, Central Queensland University, Brisbane, QLD Australia
| | - Daniel A. Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA Australia
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Baguley BJ, Skinner TL, Leveritt MD, Wright ORL. Nutrition therapy with high intensity interval training to improve prostate cancer-related fatigue in men on androgen deprivation therapy: a study protocol. BMC Cancer 2017; 17:1. [PMID: 28049525 PMCID: PMC5206780 DOI: 10.1186/s12885-016-3022-6] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 12/17/2016] [Indexed: 12/14/2022] Open
Abstract
Background Cancer-related fatigue is one of the most prevalent, prolonged and distressing side effects of prostate cancer treatment with androgen deprivation therapy. Preliminary evidence suggests natural therapies such as nutrition therapy and structured exercise prescription can reduce symptoms of cancer-related fatigue. Men appear to change their habitual dietary patterns after prostate cancer diagnosis, yet prostate-specific dietary guidelines provide limited support for managing adverse side effects of treatment. The exercise literature has shown high intensity interval training can improve various aspects of health that are typically impaired with androgen deprivation therapy; however exercise at this intensity is yet to be conducted in men with prostate cancer. The purpose of this study is to examine the effects of nutrition therapy beyond the current healthy eating guidelines with high intensity interval training for managing cancer-related fatigue in men with prostate cancer treated with androgen deprivation therapy. Methods/design This is a two-arm randomized control trial of 116 men with prostate cancer and survivors treated with androgen deprivation therapy. Participants will be randomized to either the intervention group i.e. nutrition therapy and high intensity interval training, or usual care. The intervention group will receive 20 weeks of individualized nutrition therapy from an Accredited Practising Dietitian, and high intensity interval training (from weeks 12–20 of the intervention) from an Accredited Exercise Physiologist. The usual care group will maintain their standard treatment regimen over the 20 weeks. Both groups will undertake primary and secondary outcome testing at baseline, week 8, 12, and 20; testing includes questionnaires of fatigue and quality of life, objective measures of body composition, muscular strength, cardiorespiratory fitness, biomarkers for disease progression, as well as dietary analysis. The primary outcomes for this trial are measures of fatigue and quality of life. Discussion This study is the first of its kind to determine the efficacy of nutrition therapy above the healthy eating guidelines and high intensity interval training for alleviating prostate-cancer related fatigue. If successful, nutrition therapy and high intensity interval training may be proposed as an effective therapy for managing cancer-related fatigue and improving quality of life in men during and after prostate cancer treatment. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12615000512527. Trial registered on the 22/5/2015.
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Affiliation(s)
- Brenton J Baguley
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Michael D Leveritt
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Olivia R L Wright
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,Mater Research Institute, University of Queensland, Kent Street, Woolloongabba, Brisbane, QLD 4102, Australia
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Bjerre E, Bruun DM, Tolver A, Brasso K, Krustrup P, Johansen C, Christensen R, Rørth M, Midtgaard J. Effectiveness of community-based football compared to usual care in men with prostate cancer: Protocol for a randomised, controlled, parallel group, multicenter superiority trial (The FC Prostate Community Trial). BMC Cancer 2016; 16:767. [PMID: 27716218 PMCID: PMC5048405 DOI: 10.1186/s12885-016-2805-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 09/22/2016] [Indexed: 01/07/2023] Open
Abstract
Background Prostate cancer is the most common non-cutaneous malignancy in men. Today most patients may expect to live years following the diagnosis and may thus experience significant morbidity due to disease progression and treatment toxicity. In order to address some of these problems exercise has been suggested and previously studies have shown improvements of disease specific quality of life and a reduction in treatment-related toxicity. Cohort studies with long term follow up have suggested that physical activity is associated with improved survival in prostate cancer patients. Previously one randomised controlled trial has examined the efficacy of football in prostate cancer patients undergoing androgen deprivation therapy to usual care and reported positive effects on lean body mass and bone markers. Against this background, we wish to examine the effectiveness of community-based football for men diagnosed with prostate cancer. Methods Using a randomised controlled parallel group, multicenter, superiority trial design, two hundred prostate cancer patients will be recruited and randomised (1:1) to either community-based football one hour twice weekly or to a control group. The intervention period will be six months. The primary outcome is quality of life assessed after 12 weeks based on the change from baseline in the Functional Assessment of Cancer Therapy–Prostate questionnaire. Secondary outcomes are change from baseline to six months in quality of life, lean body mass, fat mass, whole body and regional bone markers, as well as physical activity and functional capacity at 12 weeks and six months. Safety outcome variables will be falls resulting in seeking medical assessment and fractures during the six-month period. Discussion Football is viewed as a case for non-professional, supervised community-based team sport for promoting long-term physical activity in men diagnosed with prostate cancer. This randomised trial will provide data on effectiveness and safety for men with prostate cancer when football training is delivered in local football clubs. Trial registration Clinicaltrials.gov identifier: NCT02430792
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Affiliation(s)
- Eik Bjerre
- University Hospitals Centre for Health Research (UCSF), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
| | - Ditte Marie Bruun
- University Hospitals Centre for Health Research (UCSF), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anders Tolver
- Department of Mathematical Sciences, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Brasso
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense M, Denmark.,Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Christoffer Johansen
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Unit of Survivorship, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Robin Christensen
- Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Mikael Rørth
- University Hospitals Centre for Health Research (UCSF), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Julie Midtgaard
- University Hospitals Centre for Health Research (UCSF), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Thomas AA, Pearce A, Sharp L, Gardiner RA, Chambers S, Aitken J, Molcho M, Baade P. Socioeconomic disadvantage but not remoteness affects short-term survival in prostate cancer: A population-based study using competing risks. Asia Pac J Clin Oncol 2016; 13:e31-e40. [DOI: 10.1111/ajco.12570] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 08/24/2015] [Accepted: 11/30/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Audrey A Thomas
- Health Promotion Research Centre; National University of Ireland; Galway Ireland
| | | | - Linda Sharp
- Institute of Health and Society; Newcastle University; United Kingdom
| | | | - Suzanne Chambers
- Menzies Health Institute Queensland; Griffith University; Gold Coast Australia
| | | | - Michal Molcho
- Department of Health Promotion; National University of Ireland; Galway Ireland
| | - Peter Baade
- Cancer Council Queensland; Brisbane Australia
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Mangar S. Radiotherapy versus Prostatectomy: a Question of Survival or Survivorship? Addressing Ongoing Questions and Controversies in the Management of Localised Prostate Cancer in the UK. Clin Oncol (R Coll Radiol) 2016; 28:479-81. [DOI: 10.1016/j.clon.2016.04.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 04/26/2016] [Accepted: 04/27/2016] [Indexed: 01/23/2023]
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Huang CK, Lee SO, Chang E, Pang H, Chang C. Androgen receptor (AR) in cardiovascular diseases. J Endocrinol 2016; 229:R1-R16. [PMID: 26769913 PMCID: PMC4932893 DOI: 10.1530/joe-15-0518] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 01/13/2016] [Indexed: 01/13/2023]
Abstract
Cardiovascular diseases (CVDs) are still the highest leading cause of death worldwide. Several risk factors have been linked to CVDs, including smoking, diabetes, hyperlipidemia, and gender among others. Sex hormones, especially the androgen and its receptor, androgen receptor (AR), have been linked to many diseases with a clear gender difference. Here, we summarize the effects of androgen/AR on CVDs, including hypertension, stroke, atherosclerosis, abdominal aortic aneurysm (AAA), myocardial hypertrophy, and heart failure, as well as the metabolic syndrome/diabetes and their impacts on CVDs. Androgen/AR signaling exacerbates hypertension, and anti-androgens may suppress hypertension. Androgen/AR signaling plays dual roles in strokes, depending on different kinds of factors; however, generally males have a higher incidence of strokes than females. Androgen and AR differentially modulate atherosclerosis. Androgen deficiency causes elevated lipid accumulation to enhance atherosclerosis; however, targeting AR in selective cells without altering serum androgen levels would suppress atherosclerosis progression. Androgen/AR signaling is crucial in AAA development and progression, and targeting androgen/AR profoundly restricts AAA progression. Men have increased cardiac hypertrophy compared with age-matched women that may be due to androgens. Finally, androgen/AR plays important roles in contributing to obesity and insulin/leptin resistance to increase the metabolic syndrome.
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Affiliation(s)
- Chiung-Kuei Huang
- George Whipple Lab for Cancer ResearchDepartments of Pathology, Urology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Soo Ok Lee
- George Whipple Lab for Cancer ResearchDepartments of Pathology, Urology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Eugene Chang
- George Whipple Lab for Cancer ResearchDepartments of Pathology, Urology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA Department of MedicineCase Cardiovascular Institute Research Institute, Case Western Reserve University, Cleveland, OH, USA
| | - Haiyan Pang
- George Whipple Lab for Cancer ResearchDepartments of Pathology, Urology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Chawnshang Chang
- George Whipple Lab for Cancer ResearchDepartments of Pathology, Urology, and The Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA Sex Hormone Research CenterChina Medical University/Hospital, Taichung, Taiwan
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Zhong S, Yan X, Wu Y, Zhang X, Chen L, Tang J, Zhao J. Body mass index and mortality in prostate cancer patients: a dose-response meta-analysis. Prostate Cancer Prostatic Dis 2016; 19:122-31. [PMID: 26754262 DOI: 10.1038/pcan.2015.64] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 10/29/2015] [Accepted: 11/26/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous studies concerning the association between body mass index (BMI) and mortality in prostate cancer yielded mixed results. We investigated the association by performing a meta-analysis of all available studies. METHODS Relevant studies were identified by searching PubMed and EMBASE to August 2015. We calculated the summary hazard ratio (HR) and 95% confidence interval (CI) using random-effects models. We estimated combined HRs associated with defined increments of BMI, using random-effects meta-analysis and dose-response meta-regression models. RESULTS Thirty-seven cohort studies and one case-control study involving 27 38 000 patients of prostate cancer were selected for meta-analysis. The summary results indicated higher prediagnosis BMI but not postdiagnosis BMI was associated with increased risk of death from prostate cancer. An increment of every 5 kg/m(2) in prediagnosis BMI was associated with a 15% higher prostate cancer-specific mortality (HR=1.15, 95% CI: 1.07-1.23, P<0.01). Prediagnosis or postdiagnosis BMI showed no effect on all-cause mortality in prostate cancer patients. CONCLUSIONS In conclusion, higher prediagnosis BMI is associated with a higher risk of death from prostate cancer. Considering the significant heterogeneity among included studies, these findings require confirmation in future studies.
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Affiliation(s)
- S Zhong
- Center of Clinical Laboratory Science, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - X Yan
- Institute of Laboratory Medicine, Jinling Hospital of Nanjing University, Nanjing, China
| | - Y Wu
- Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - X Zhang
- Center of Clinical Laboratory Science, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - L Chen
- Departments of Oncology, Xuzhou Medical College, Xuzhou, China
| | - J Tang
- Department of General Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - J Zhao
- Center of Clinical Laboratory Science, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Nanjing, China
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Wang LH, Liu CK, Chen CH, Kao LT, Lin HC, Huang CY. No increased risk of coronary heart disease for patients receiving androgen deprivation therapy for prostate cancer in Chinese/Taiwanese men. Andrology 2015; 4:128-32. [PMID: 26711703 DOI: 10.1111/andr.12141] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/19/2015] [Accepted: 11/01/2015] [Indexed: 11/28/2022]
Abstract
The relationship between androgen deprivation therapy (ADT) and coronary heart disease (CHD) remains controversial. Furthermore, the majority of such studies focused on Caucasian populations, and there is still a paucity of studies among Asian populations. This population-based study aimed to investigate the relationship between ADT and CHD in an ethnic Chinese (i.e., Taiwanese) population. We used data sourced from the Taiwan 'Longitudinal Health Insurance Database'. This study included 1278 patients with prostate cancer in the study group and 1278 subjects without prostate cancer in the comparison group. Each patient was individually tracked for a 3-year period to identify those who had subsequently received a diagnosis of CHD. The results showed that the incidence rate of CHD during the 3-year follow-up period was 4.69 (95% CI: 2.99-5.48) per 100 person-years and 2.67 (95% CI: 2.15-3.27) per 100 person-years for the study and comparison cohort, respectively. The Cox proportional hazard regression showed that the hazard ratio for CHD during the 3-year follow-up period for prostate cancer patients was 1.65 (95% confidence interval (CI) = 1.25-2.16) compared with comparison subjects after adjusting for patients' geographic location, monthly income, urbanization level, hypertension, diabetes, hyperlipidemia, and stroke. However, we failed to find a significant difference in the adjusted hazard of CHD during the 3-year follow-up period between prostate cancer patients who did and those who did not receive ADT (hazard ratio = 1.12, 95% CI = 0.79-1.59). We concluded that prostate cancer but not ADT was significantly associated with CHD. In addition, a common cause of prostate cancer and coronary heart disease could exist.
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Affiliation(s)
- L H Wang
- School of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Department of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan
| | - C K Liu
- Department of Urology, Taipei City Hospital, Taipei, Taiwan.,College of Medicine, Fu-Jen University, New Taipei, Taiwan
| | - C H Chen
- Department & Institute of Physiology, National Yang-Ming University, Taipei, Taiwan
| | - L T Kao
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
| | - H C Lin
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - C Y Huang
- School of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Urology, National Taiwan University Hospital, College of Medicine National Taiwan University, Taipei, Taiwan
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Seo H, Kong YG, Jin SJ, Chin JH, Kim HY, Lee YK, Hwang JH, Kim YK. Dynamic Arterial Elastance in Predicting Arterial Pressure Increase After Fluid Challenge During Robot-Assisted Laparoscopic Prostatectomy: A Prospective Observational Study. Medicine (Baltimore) 2015; 94:e1794. [PMID: 26469925 PMCID: PMC4616778 DOI: 10.1097/md.0000000000001794] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
During robot-assisted laparoscopic prostatectomy, specific physiological conditions such as carbon dioxide insufflation and the steep Trendelenburg position can alter the cardiac workload and cerebral hemodynamics. Inadequate arterial blood pressure is associated with hypoperfusion, organ damage, and poor outcomes. Dynamic arterial elastance (Ea) has been proposed to be a useful index of fluid management in hypotensive patients. We therefore evaluated whether dynamic Ea can predict a mean arterial pressure (MAP) increase ≥ 15% after fluid challenge during pneumoperitoneum and the steep Trendelenburg position.We enrolled 39 patients receiving robot-assisted laparoscopic prostatectomy. Fluid challenge was performed with 500 mL colloids in the presence of preload-dependent conditions and arterial hypotension. Patients were classified as arterial pressure responders or arterial pressure nonresponders according to whether they showed an MAP increase ≥15% after fluid challenge. Dynamic Ea was defined as the ratio between the pulse pressure variation and stroke volume variation. Receiver operating characteristic curve analysis was performed to assess the arterial pressure responsiveness after fluid challenge during robot-assisted laparoscopic prostatectomy.Of the 39 patients, 17 were arterial pressure responders and 22 were arterial pressure nonresponders. The mean dynamic Ea before fluid challenge was significantly higher in arterial pressure responders than in arterial pressure nonresponders (0.79 vs 0.61, P < 0.001). In receiver operating characteristic curve analysis, dynamic Ea showed an area under the curve of 0.810. The optimal cut-off value of dynamic Ea for predicting an MAP increase of ≥ 15% after fluid challenge was 0.74.Dynamic Ea can predict an MAP increase ≥ 15% after fluid challenge during robot-assisted laparoscopic prostatectomy. This result suggests that evaluation of arterial pressure responsiveness using dynamic Ea helps to maintain an adequate arterial blood pressure and to improve perioperative outcomes in preload-dependent patients receiving robot-assisted laparoscopic prostatectomy under pneumoperitoneum and in the steep Trendelenburg position.
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Affiliation(s)
- Hyungseok Seo
- From the Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea (HS); Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (Y-GK, S-JJ, J-HC, J-HH, Y-KK); and Department of Anesthesiology and Pain Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea (H-YK, Y-KL)
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The Prevalence of Cardiac Risk Factors in Men with Localized Prostate Cancer Undergoing Androgen Deprivation Therapy in British Columbia, Canada. JOURNAL OF ONCOLOGY 2015; 2015:820403. [PMID: 26300918 PMCID: PMC4537764 DOI: 10.1155/2015/820403] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 12/08/2014] [Accepted: 12/09/2014] [Indexed: 02/08/2023]
Abstract
Background. While androgen deprivation therapy (ADT) reduces the risk of prostate cancer-specific mortality in high-risk localized prostate cancer, it adversely affects cardiovascular (CV) risk factor profiles in treated men. Methods. We retrospectively reviewed the charts of 100 consecutive men with intermediate- or high-risk localized prostate cancer referred to the British Columbia Cancer Agency for ADT. Data on CV risk factors and disease were collected and Framingham risk scores were calculated. Results. The median age of the study cohort was 73 years. Established cardiovascular disease was present in 25% of patients. Among patients without established CV disease, calculated Framingham risk was high in 65%, intermediate in 33%, and low in 1%. Baseline hypertension was present in 58% of patients, dyslipidemia in 51%, and diabetes or impaired glucose tolerance in 24%. Hypertension was more prevalent in the study cohort than in an age- and sex-matched population sample (OR 1.74, P = 0.006); diabetes had a similar prevalence (OR 0.93, P = 0.8). Conclusions. Patients receiving ADT have a high prevalence of cardiovascular disease and risk factors and are more likely to be hypertensive than population controls. Low rates of CV risk screening suggest opportunities for improved primary and secondary prevention of CV disease in this population.
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Schmid M, Sammon JD, Reznor G, Kapoor V, Speed JM, Abdollah FA, Sood A, Chun FKH, Kibel AS, Menon M, Fisch M, Sun M, Trinh QD. Dose-dependent effect of androgen deprivation therapy for localized prostate cancer on adverse cardiac events. BJU Int 2015; 118:221-9. [DOI: 10.1111/bju.13203] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Marianne Schmid
- Division of Urologic Surgery and Center for Surgery and Public Health; Brigham and Women's Hospital; Harvard Medical School; Boston MA USA
- Department of Urology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Jesse D. Sammon
- Vattikuti Urology Institute Center for Outcomes Research Analytics and Evaluation; Henry Ford Health System; Detroit MI USA
| | - Gally Reznor
- Division of Urologic Surgery and Center for Surgery and Public Health; Brigham and Women's Hospital; Harvard Medical School; Boston MA USA
| | - Victor Kapoor
- Vattikuti Urology Institute Center for Outcomes Research Analytics and Evaluation; Henry Ford Health System; Detroit MI USA
| | - Jacqueline M. Speed
- Division of Urologic Surgery and Center for Surgery and Public Health; Brigham and Women's Hospital; Harvard Medical School; Boston MA USA
| | - Firas A. Abdollah
- Vattikuti Urology Institute Center for Outcomes Research Analytics and Evaluation; Henry Ford Health System; Detroit MI USA
| | - Akshay Sood
- Vattikuti Urology Institute Center for Outcomes Research Analytics and Evaluation; Henry Ford Health System; Detroit MI USA
| | - Felix K.-H. Chun
- Department of Urology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Adam S. Kibel
- Division of Urologic Surgery and Center for Surgery and Public Health; Brigham and Women's Hospital; Harvard Medical School; Boston MA USA
| | - Mani Menon
- Vattikuti Urology Institute Center for Outcomes Research Analytics and Evaluation; Henry Ford Health System; Detroit MI USA
| | - Margit Fisch
- Department of Urology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Maxine Sun
- Division of Urologic Surgery and Center for Surgery and Public Health; Brigham and Women's Hospital; Harvard Medical School; Boston MA USA
| | - Quoc-Dien Trinh
- Division of Urologic Surgery and Center for Surgery and Public Health; Brigham and Women's Hospital; Harvard Medical School; Boston MA USA
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40
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Katzenwadel A, Wolf P. Androgen deprivation of prostate cancer: Leading to a therapeutic dead end. Cancer Lett 2015; 367:12-7. [PMID: 26185001 DOI: 10.1016/j.canlet.2015.06.021] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 04/16/2015] [Accepted: 06/29/2015] [Indexed: 11/19/2022]
Abstract
Androgen deprivation therapy (ADT) is considered as the standard therapy for men with de novo or recurrent metastatic prostate cancer. ADT commonly leads to initial biochemical and clinical responses. However, several months after the beginning of treatment, tumors become castration-resistant and virtually all patients show disease progression. At this stage, tumors are no longer curable and cancer treatment options are only palliative. In this review, we describe molecular alterations in tumor cells during ADT, which lead to deregulation of different signaling pathways and castration-resistance, and how they might interfere with the clinical outcome of different second-line therapeutics. A recent breakthrough finding that early chemotherapy is associated with a significant survival benefit in metastatic hormone-sensitive disease highlights the fact that there is time for a fundamental paradigm shift in the treatment of advanced prostate cancer. Therapeutic intervention seems to be indicated before a castration-resistant stage is reached to improve therapeutic outcome and to reduce undesirable side effects.
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Affiliation(s)
- Arndt Katzenwadel
- Department of Urology, Medical Center, University of Freiburg, Hugstetter Strasse 55, D-79106 Freiburg, Germany
| | - Philipp Wolf
- Department of Urology, Medical Center, University of Freiburg, Engesser Strasse 4b, D-79108 Freiburg, Germany.
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Xia JW, Tan SJ, Zhang XL, Jun T, Sun XK, Ling W. Correlation of serum testosterone with insulin resistance in elderly male type 2 diabetes mellitus patients with osteoporosis. J Diabetes Investig 2015; 6:548-52. [PMID: 26417412 PMCID: PMC4578494 DOI: 10.1111/jdi.12291] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 08/18/2014] [Accepted: 09/18/2014] [Indexed: 12/26/2022] Open
Abstract
AIMS/INTRODUCTION The present study was designed to investigate the correlations between the serum testosterone level and insulin sensitivity in elderly male type 2 diabetes patients with osteoporosis. MATERIALS AND METHODS A total of 35 elderly male patients with type 2 diabetes (type 2 diabetes group), 30 elderly male type 2 diabetes patients combined with osteoporosis (DO group) and 30 healthy elderly men (normal control group) participated in the present study. The fasting plasma glucose, fasting insulin, testosterone (T) and estradiol (E2) were measured. The insulin sensitivity index (ISI), homeostasis model assessment of insulin resistance (HOMA-IR) and E2/T were calculated. Then, the correlations of serum testosterone level with ISI and HOMA-IR were analyzed by statistical methods. RESULTS The HOMA-IR, E2 and E2/T of the type 2 diabetes group and DO group were significantly increased, whereas the bone mineral density, ISI, T and sex hormone binding globulin were decreased compared with those of the normal control group. Serum testosterone levels of the type 2 diabetes group and DO group were negatively correlated to the HOMA-IR (r = -0.496, -0.506; P < 0.05), whereas they were positively correlated to the fasting insulin (r = 0.281, 0.292; P < 0.05) and ISI (r = 0.364, 0.403; P < 0.05). CONCLUSIONS The reduced level of serum testosterone in elderly male type 2 diabetes patients with osteoporosis might promote insulin resistance.
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Affiliation(s)
- Jin-Wei Xia
- Department of Geriatrics, the First Affiliated Hospital of Suzhou University Suzhou, China
| | - Shi-Jin Tan
- Department of Geriatrics, the Sixth People's Hospital Affiliated to Shanghai Jiaotong University Shanghai, China
| | - Xing-Liang Zhang
- Department of Geriatrics, the Sixth People's Hospital Affiliated to Shanghai Jiaotong University Shanghai, China
| | - Tao Jun
- Department of Geriatrics, the Sixth People's Hospital Affiliated to Shanghai Jiaotong University Shanghai, China
| | - Xiao-Kang Sun
- Department of Geriatrics, the Sixth People's Hospital Affiliated to Shanghai Jiaotong University Shanghai, China
| | - Wang Ling
- Department of Geriatrics, the First Affiliated Hospital of Suzhou University Suzhou, China
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The effects of resistance exercise on physical performance and health-related quality of life in prostate cancer patients: a systematic review. Support Care Cancer 2015; 23:2479-97. [PMID: 26003426 DOI: 10.1007/s00520-015-2782-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 05/17/2015] [Indexed: 02/07/2023]
Abstract
PURPOSE Physical exercise has been shown to be an effective, safe, and quite inexpensive method to reduce cardiovascular and metabolic risk factors and is currently in the process of establishing its relevance for cancer specific morbidity and mortality. The aim of this systematic review was to focus on specific effects of resistance exercise (RE) in the adjuvant therapy and rehabilitation of prostate cancer patients (PCaPs) receiving or having received androgen deprivation therapy (ADT). METHODS A systematic literature search focusing on relevant and peer-reviewed studies published between 1966 and September 2014, using PubMed, EMBASE, MEDLINE, SCOPUS, and Cochrane Library databases, was conducted. RESULTS The majority of studies demonstrated RE as an effective and safe intervention to improve muscular strength and performance, fatigue and quality of life (QoL) in PCaPs, while there is inconclusive evidence concerning cardiovascular performance, body composition, blood lipids, bone mineral density (BMD), and immune response. CONCLUSION Existing evidence leads to the conclusion that RE seems to be a safe intervention in PCaPs with beneficial effects on physical performance capacity and QoL. Nevertheless, further research in this field is urgently needed to increase understanding of exercise interventions in PCaPs.
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Ariaans G, de Jong S, Gietema J, Lefrandt J, de Vries E, Jalving M. Cancer-drug induced insulin resistance: Innocent bystander or unusual suspect. Cancer Treat Rev 2015; 41:376-84. [DOI: 10.1016/j.ctrv.2015.02.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 02/09/2015] [Accepted: 02/11/2015] [Indexed: 02/08/2023]
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Bosco C, Crawley D, Adolfsson J, Rudman S, Van Hemelrijck M. Quantifying the evidence for the risk of metabolic syndrome and its components following androgen deprivation therapy for prostate cancer: a meta-analysis. PLoS One 2015; 10:e0117344. [PMID: 25794005 PMCID: PMC4368630 DOI: 10.1371/journal.pone.0117344] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 12/23/2014] [Indexed: 11/18/2022] Open
Abstract
Background No meta-analysis is yet available for the risk of metabolic syndrome (MetS) following androgen deprivation therapy (ADT) for men with prostate cancer. To summarize the evidence for the link between ADT and MetS or its components quantitatively with a meta-analysis including all studies published to date. Methods PubMed and Embase were searched using predefined inclusion criteria to perform meta-analyses on the association between metabolic syndrome, hyperglycemia, diabetes, hypertension, dyslipidemia or obesity and androgen deprivation therapy in patients with prostate cancer. Random effects methods were used to estimate pooled relative risks (RRs) and 95% confidence intervals (CI). Results A total of nine studies was included. There was a positive association between ADT and risk of MetS (RR: 1.75 (95% CI: 1.27–2.41)). Diabetes was the only MetS component present in more than 3 studies, and also showed an increased risk following ADT (RR: 1.36 (95% CI: 1.17–1.58)). Conclusion This is the first quantitative summary addressing the potential risk of MetS following ADT in men with PCa. The positive RRs indicate that there is a need to further elucidate how type and duration of ADT affect these increased risks of MetS and diabetes as the number of men with PCa treated with ADT is increasing.
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Affiliation(s)
- Cecilia Bosco
- King’s College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom
| | - Danielle Crawley
- King’s College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom
- Department of Oncology, Guy’s & St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Jan Adolfsson
- Karolinska Institute, CLINTEC Department, Stockholm, Sweden
| | - Sarah Rudman
- Department of Oncology, Guy’s & St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Mieke Van Hemelrijck
- King’s College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom
- * E-mail:
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45
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Abstract
Testosterone levels in men slowly decline with aging and also decline more abruptly due to medical illness or medications. Prescriptions for testosterone have increased dramatically over the past decade, since a testosterone-gel formulation was approved and since numerous studies reported an association between low serum testosterone and increased mortality. However, recent observational studies of testosterone treatment have reported conflicting results with some studies reporting decreased risks for mortality while others reported increased mortality risks with testosterone treatment. This paper will summarize recent studies of low serum testosterone and mortality and testosterone treatment and mortality and what the potential implications of these studies are for the clinician.
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Affiliation(s)
- Molly M Shores
- VA Puget Sound Health Care System, Seattle, WA ; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
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46
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Williams L, Hicks E, Kwan L, Litwin M, Maliski S. Cardiovascular risk profile of veteran men beginning androgen deprivation therapy. JOURNAL OF VASCULAR NURSING 2014; 32:99-104. [PMID: 25131756 DOI: 10.1016/j.jvn.2014.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 01/24/2014] [Accepted: 01/25/2014] [Indexed: 10/24/2022]
Abstract
We sought to describe the cardiovascular profile of veteran men before beginning androgen deprivation therapy (ADT), with the eventual benefit of targeting treatments to manage harmful cardiovascular side effects. We performed a secondary analysis with chi-square and Fisher's exact tests for associations between demographics and cardiovascular comorbidities on 375 veteran men diagnosed with prostate cancer. Those who were overweight and current smokers were more likely to be younger, whereas men with a systolic blood pressure >120 mmHg were more likely to be older (all P < 0.05). Men with total cholesterol 180 mg/dL were more likely to be identified in the Hispanic/other/unknown ethnicity category. Interventions to manage cardiovascular risk should focus on preventive lifestyle changes for younger men, and chronic disease management for older men. Men in the smaller Hispanic/other/unknown category are at risk for marginalization within the Veteran Administration system owing to their low numbers and should be closely monitored for cholesterol levels when receiving ADT.
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Affiliation(s)
| | | | - Lorna Kwan
- Department of Urology, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Mark Litwin
- Department of Urology, UCLA David Geffen School of Medicine, Los Angeles, California
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Aleman BM, Moser EC, Nuver J, Suter TM, Maraldo MV, Specht L, Vrieling C, Darby SC. Cardiovascular disease after cancer therapy. EJC Suppl 2014; 12:18-28. [PMID: 26217163 PMCID: PMC4250533 DOI: 10.1016/j.ejcsup.2014.03.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 03/26/2014] [Indexed: 12/15/2022] Open
Abstract
Improvements in treatment and earlier diagnosis have both contributed to increased survival for many cancer patients. Unfortunately, many treatments carry a risk of late effects including cardiovascular diseases (CVDs), possibly leading to significant morbidity and mortality. In this paper we describe current knowledge of the cardiotoxicity arising from cancer treatments, outline gaps in knowledge, and indicate directions for future research and guideline development, as discussed during the 2014 Cancer Survivorship Summit organised by the European Organisation for Research and Treatment of Cancer (EORTC). Better knowledge is needed of the late effects of modern systemic treatments and of radiotherapy to critical structures of the heart, including the effect of both radiation dose and volume of the heart exposed. Research elucidating the extent to which treatments interact in causing CVD, and the mechanisms involved, as well as the extent to which treatments may increase CVD indirectly by increasing cardiovascular risk factors is also important. Systematic collection of data relating treatment details to late effects is needed, and great care is needed to obtain valid and generalisable results. Better knowledge of these cardiac effects will contribute to both primary and secondary prevention of late complications where exposure to cardiotoxic treatment is unavoidable. Also surrogate markers would help to identify patients at increased risk of cardiotoxicity. Evidence-based screening guidelines for CVD following cancer are also needed. Finally, risk prediction models should be developed to guide primary treatment choice and appropriate follow up after cancer treatment.
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Affiliation(s)
- Berthe M.P. Aleman
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Elizabeth C. Moser
- Department of Radiotherapy and Breast Unit, Champalimaud Foundation, Lisbon, Portugal
| | - Janine Nuver
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - Thomas M. Suter
- Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | - Maja V. Maraldo
- Department of Oncology and Haematology, Rigshospitalet, University of Copenhagen, Denmark
| | - Lena Specht
- Department of Oncology and Haematology, Rigshospitalet, University of Copenhagen, Denmark
| | - Conny Vrieling
- Department of Radiotherapy, Clinique des Grangettes, Geneva, Switzerland
| | - Sarah C. Darby
- Clinical Trial Service Unit, University of Oxford, Oxford, United Kingdom
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Abstract
PURPOSE OF REVIEW Use of testosterone among men is increasing rapidly. Low serum testosterone is positively associated with cardiovascular disease and its risk factors. No large randomized controlled trial (RCT) has assessed the effects of testosterone on cardiovascular outcomes. Here recent evidence accumulating from other sources - pharmacoepidemiology, Mendelian randomization studies and meta-analysis of small RCTs - is reviewed to inform current testosterone usage. RECENT FINDINGS In a large, well conducted pharmacoepidemiology study specifically testosterone prescription was associated with myocardial infarction. Two Mendelian randomization studies did not corroborate beneficial effects of higher endogenous testosterone on cardiovascular risk factors, but suggested higher endogenous testosterone raised LDL cholesterol and lowered HDL cholesterol. A comprehensive meta-analysis of RCTs summarizing 27 trials including 2994 men found increased risk of cardiovascular-related events on testosterone (odds ratio 1.54, 95% confidence interval 1.09-2.18). SUMMARY Contrary to expectations from observational studies, current indications suggest testosterone causes ischemic cardiovascular disease with corresponding implications for practice. A large RCT would undoubtedly settle the issue definitively. Given mounting evidence of harm and the urgency of the situation assembling all the evidence from completed RCTs of testosterone or androgen deprivation therapy and use of Mendelian randomization might generate a definitive answer most quickly.
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Affiliation(s)
- C Mary Schooling
- aCity University New York School of Public Health and Hunter College, New York, USA bSchool of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Freeman BM, Mountain DJH, Brock TC, Chapman JR, Kirkpatrick SS, Freeman MB, Klein FA, Grandas OH. Low testosterone elevates interleukin family cytokines in a rodent model: a possible mechanism for the potentiation of vascular disease in androgen-deficient males. J Surg Res 2014; 190:319-27. [PMID: 24703604 DOI: 10.1016/j.jss.2014.03.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 02/26/2014] [Accepted: 03/05/2014] [Indexed: 01/24/2023]
Abstract
BACKGROUND Androgen deficiency (AD) is associated with increased risk of atherosclerosis, cardiovascular, and peripheral arterial disease. Although the biochemical and molecular mechanisms underlying this risk remain unclear, higher testosterone (TST) levels correlate to significant immunoprotective molecular and cellular responses. Our group has previously demonstrated that female sex hormones influence vascular pathogenesis via inflammatory-modulated matrix metalloproteinase (MMP) regulation. Here we investigated the role of AD and androgen replacement therapy in the modulation of these hormonally responsive pathways that could be playing a role in the development of vascular pathogenesis. METHODS Aged orchiectomized male rats underwent TST supplementation per controlled release pellet implantation (0-150 mg). Young and aged intact groups served as controls. Serum was collected at 0-4 wk and analyzed by enzyme-linked immunosorbent assays, qualitative cytokine screening, and quantitative multiplex analyses. Human aortic smooth muscle cells were treated with 4,5α-dihydrotestosterone (DHT; 0-3000 nM) before or after interleukin 1β (IL-1β; 5 ng/mL) stimulation. Quantitative polymerase chain reaction and in-gel zymography was used to assay the effect on MMP expression and activity. RESULTS Subphysiological, physiological, and supraphysiological levels of TST were achieved with 0.5, 2.5, and 35 mg TST pellet implants in vivo, respectively. Inflammatory arrays indicated that interleukin cytokines, specifically IL-2, IL-6, IL-10, IL-12, and IL-13, were elevated at subphysiological level of TST, whereas TST supplementation decreased interleukins. Supraphysiological TST resulted in a significant increase in MMP-9 and tissue inhibitor of metalloproteinase-1 (TIMP-1) in vivo. Pretreatment with IL-1β slightly increased membrane type 1-MMP (MT1-MMP) and MMP-2 expression at low to mid-level DHT exposure in vitro, although these trends were not statistically significant. CONCLUSIONS Here we demonstrate AD is a proinflammatory modulator and indicate that MMP-independent mechanisms may play a role downstream of AD-induced inflammatory signaling in dysfunctional vascular remodeling. Future in vivo studies will examine AD and TST supplementation in acute inflammatory response to vascular injury and in MMP-modulated vascular disease.
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Affiliation(s)
- Brian M Freeman
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Deidra J H Mountain
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Timothy C Brock
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Jason R Chapman
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Stacy S Kirkpatrick
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Michael B Freeman
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Frederick A Klein
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Oscar H Grandas
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee.
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Garbis SD, Townsend PA. Proteomics of human prostate cancer biospecimens: the global, systems-wide perspective for Protein markers with potential clinical utility. Expert Rev Proteomics 2014; 10:337-54. [DOI: 10.1586/14789450.2013.827408] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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