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Gupta N, Verma N, Patel B. Efficacy and Safety of Metronomic Capecitabine in Hepatocellular Carcinoma: A Systematic Review and Meta-analysis. J Gastrointest Cancer 2024:10.1007/s12029-024-01103-w. [PMID: 39160369 DOI: 10.1007/s12029-024-01103-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND AND OBJECTIVE Metronomic capecitabine has been found to be useful in several types of cancers such as pancreatic cancer, breast cancer, gastrointestinal cancers, nasopharyngeal carcinoma, and metastatic colorectal cancer. This unique systematic literature review and meta-analysis was undertaken to assess the effectiveness and safety of metronomic capecitabine as a treatment regimen for hepatocellular carcinoma. METHOD A systematic search of major databases was performed. Eight studies that dealt with the use of metronomic capecitabine for hepatocellular carcinoma (HCC) were selected, seven were non-randomized control trials (n-RCTs), and one was a randomized control trial (RCT). Meta-analysis of these studies was performed using Review Manager v5.3 and STATA 15.1 software. The pooled prevalence of overall survival (OS), progression-free survival (PFS), overall response rate (ORR), grade 1-2 adverse events (grade 1-2 AEs), grade 3-4 adverse events (grade 3-4 AEs) was determined, including publication bias and sensitivity analysis. RESULT Eight studies met the inclusion criteria, combining the pooled data of 476 patients from safety and efficacy studies. The pooled prevalence of disease control rate (DCR) and overall response rate (ORR) achieved with metronomic capecitabine was 36% (95% CI 32-41) and 7% (95% CI 5-9) respectively. The median progression-free survival (PFS) and median overall survival (OS) were 3.57 months (95% CI 3.29-3.85) and 11.75 months (95% CI 10.56-12.95) respectively. The incidence of grade 3-4 adverse events (grade 3-4 AEs) and grade 1-2 adverse events (grade 1-2 AEs) was 38% (95% CI 32-44) and 73% (95% CI 67-79) respectively. CONCLUSION This meta-analysis highlights metronomic capecitabine as a potential treatment for hepatocellular carcinoma (HCC) in the advanced stage. However, effective management of capecitabine's side effects is essential.
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Affiliation(s)
- Nandini Gupta
- School of Medico-Legal Studies, National Forensic Sciences University, Sector 9, Gandhinagar, Gujarat, 382007, India
| | - Neelkant Verma
- School of Forensic Science, National Forensic Sciences University, Sector 9, Gandhinagar, Gujarat, 382007, India
| | - Bhoomika Patel
- School of Medico-Legal Studies, National Forensic Sciences University, Sector 9, Gandhinagar, Gujarat, 382007, India.
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Rana P, Singh C, Kaushik A, Saleem S, Kumar A. Recent advances in stimuli-responsive tailored nanogels for cancer therapy; from bench to personalized treatment. J Mater Chem B 2024; 12:382-412. [PMID: 38095136 DOI: 10.1039/d3tb02650g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
To improve the quality of health in a personalized manner, better control over pharmacologically relevant cargo formulation, organ-specific targeted delivery, and on-demand release of therapeutic agents is crucial. Significant work has been put into designing and developing revolutionary nanotherapeutics approaches for the effective monitoring and personalized treatment of disease. Nanogel (NG) has attracted significant interest because of its tremendous potential in cancer therapy and its environmental stimuli responsiveness. NG is considered a next-generation delivery technology due to its benefits like as size tunability, high loading, stimuli responsiveness, prolonged drug release via in situ gelling mechanisms, stability, and its potential to provide personalized therapy from the investigation of human genes and the genes in various types of cancers and its association with a selective anticancer drug. Stimuli-responsive NGs can be used as smart nanomedicines to detect and treat cancer and can be tuned as personalized medicine as well. This comprehensive review article's major objectives include the challenges of NGs' clinical translation for cancer treatment as well as its early preclinical successes and prospects.
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Affiliation(s)
- Prinsy Rana
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
- M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala-133207, Haryana, India
| | - Charan Singh
- Department of Pharmaceutical Sciences, School of Sciences, Hemvati Nandan Bahuguna Garhwal University (A Central University), Srinagar, Uttarakhand-246174, India
| | - Ajeet Kaushik
- NanoBiotech Lab, Department of Environmental Engineering, Florida Polytechnic University (FPU), Lakeland, FL, 33805-8531, USA
- School of Engineering, University of Petroleum and Energy Studies, Dehradun 248007, India
| | - Shakir Saleem
- Department of Public Health, College of Health Sciences, Saudi Electronic University, P. O. Box 93499, Riyadh 11673, Saudi Arabia
| | - Arun Kumar
- Department of Pharmacy, School of Health Sciences, Central University of South Bihar, Gaya-824209, India.
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Oh J, Han BK, Ko EY, Ko ES, Choi JS, Kim H, Park YH, Kim JY. Ring Enhancement in Non-Neoplastic Breast Tissue on MRI During Neoadjuvant Chemotherapy for Breast Cancer: Incidence and Clinical Implications. Acad Radiol 2023; 30:2931-2939. [PMID: 37045651 DOI: 10.1016/j.acra.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 04/14/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to describe new lesions called ring enhancement in non-neoplastic breast tissue on breast magnetic resonance imaging (MRI) after neoadjuvant chemotherapy (NAC) in breast cancer patients, and to investigate the factors influencing their occurrence. MATERIALS AND METHODS We retrospectively reviewed 811 consecutive patients (mean age; 50.0 [range, 24-81] years) with breast cancer who had undergone NAC between January 2020 and December 2021, identifying cases with new ring enhancement on post-NAC MRI. We analyzed the MRI findings and identified factors that were potentially associated with ring enhancement through statistical analyses using the chi-square test, univariate and multivariate logistic regression analysis. RESULTS Forty-seven (5.8%) patients developed new ring enhancement on post-NAC MRI. The variables associated with ring enhancement were premenopausal status (p = 0.0007), younger age (p = 0.0011), high mammographic density (p = 0.0076), and high background parenchymal enhancement (BPE) on baseline MRI (p = 0.0001). Among these, high BPE was independently associated with the occurrence of ring enhancement (p = 0.0294, OR = 2.08; CI: 1.08-4.03). In a subset of high BPE patients, an association between HER2-positive cancers and ring enhancement was observed (odds ratio = 5.51 vs. 2.54). New lesion development exhibited no association with any specific NAC drug (p = 0.1676-0.7583 per drug). CONCLUSION Ring enhancement often occurs on post-NAC MRI and mostly disappears on subsequent MRI scans. High BPE on MRI was associated with this finding and HER2-positive cancers potentiated it. Knowledge of this finding can prevent unnecessary biopsies.
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Affiliation(s)
- Jiyun Oh
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea; Department of Radiology, Chung-Ang University Gwangmyeong Hospital, 110 Deokan-ro, Gwangmyeong-si, Gyeonggi-do, Korea
| | - Boo-Kyung Han
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
| | - Eun Y Ko
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Eun S Ko
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Ji S Choi
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Haejung Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Yeon H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Yeon Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Suresh D, Srinivas AN, Prashant A, Harikumar KB, Kumar DP. Therapeutic options in hepatocellular carcinoma: a comprehensive review. Clin Exp Med 2023; 23:1901-1916. [PMID: 36780119 DOI: 10.1007/s10238-023-01014-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/27/2023] [Indexed: 02/14/2023]
Abstract
Hepatocellular carcinoma (HCC) is a chronic liver disease that is highly fatal if not detected and treated early. The incidence and death rate of HCC have been increasing in recent decades despite the measures taken for preventive screening and effective diagnostic and treatment strategies. The pathophysiology of HCC is multifactorial and highly complex owing to its molecular and immune heterogeneity, and thus the gap in knowledge still precludes making choices between viable therapeutic options and also the development of effective regimens. The treatment of HCC demands multidisciplinary approaches and primarily depends on tumor stage, hepatic functional reserve, and response to treatment by patients. Although curative treatments are limited but critical in the early stages of cancer, there are numerous palliative treatments available for patients with intermediate and advanced-stage HCC. In recent times, the use of combination therapy has succeeded over the use of monotherapy in the treatment of HCC by achieving effective tumor suppression, increasing survival rate, decreasing toxicity, and also aiding in overcoming drug resistance. This work focuses on reviewing the current and emerging treatment strategies for HCC.
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Affiliation(s)
- Diwakar Suresh
- Department of Biochemistry, CEMR, JSS Medical College, JSS Academy of Higher Education and Research, SS Nagar, Mysuru, 570015, India
| | - Akshatha N Srinivas
- Department of Biochemistry, CEMR, JSS Medical College, JSS Academy of Higher Education and Research, SS Nagar, Mysuru, 570015, India
| | - Akila Prashant
- Department of Biochemistry, CEMR, JSS Medical College, JSS Academy of Higher Education and Research, SS Nagar, Mysuru, 570015, India
| | - Kuzhuvelil B Harikumar
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology (RGCB), Thiruvananthapuram, 695014, India
| | - Divya P Kumar
- Department of Biochemistry, CEMR, JSS Medical College, JSS Academy of Higher Education and Research, SS Nagar, Mysuru, 570015, India.
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Pope MC, Olson MC, Flicek KT, Patel NJ, Bolan CW, Menias CO, Wang Z, Venkatesh SK. Chemotherapy-associated liver morphological changes in hepatic metastases (CALMCHeM). Diagn Interv Radiol 2023; 29:571-578. [PMID: 37310196 PMCID: PMC10679643 DOI: 10.4274/dir.2023.232299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE To review imaging findings in chemotherapy-associated liver morphological changes in hepatic metastases (CALMCHeM) on computed tomography (CT)/magnetic resonance imaging (MRI) and its association with tumor burden. METHODS We performed a retrospective chart review to identify patients with hepatic metastases who received chemotherapy and subsequent follow-up imaging where CT or MRI showed morphological changes in the liver. The morphological changes searched for were nodularity, capsular retraction, hypodense fibrotic bands, lobulated outline, atrophy or hypertrophy of segments or lobes, widened fissures, and one or more features of portal hypertension (splenomegaly/venous collaterals/ascites). The inclusion criteria were as follows: a) no known chronic liver disease; b) availability of CT or MRI images before chemotherapy that showed no morphological signs of chronic liver disease; c) at least one follow-up CT or MRI image demonstrating CALMCHeM after chemotherapy. Two radiologists in consensus graded the initial hepatic metastases tumor burden according to number (≤10 and >10), lobe distribution (single or both lobes), and liver parenchyma volume affected (<50%, or ≥50%). Imaging features after treatment were graded according to a pre-defined qualitative assessment scale of "normal," "mild," "moderate," or "severe." Descriptive statistics were performed with binary groups based on the number, lobar distribution, type, and volume of the liver affected. Chi-square and t-tests were used for comparative statistics. The Cox proportional hazard model was used to determine the association between severe CALMCHeM changes and age, sex, tumor burden, and primary carcinoma type. RESULTS A total of 219 patients met the inclusion criteria. The most common primaries were from breast (58.4%), colorectal (14.2%), and neuroendocrine (11.0%) carcinomas. Hepatic metastases were discrete in 54.8% of cases, confluent in 38.8%, and diffuse in 6.4%. The number of metastases was >10 in 64.4% of patients. The volume of liver involved was <50% in 79.8% and ≥50% in 20.2% of cases. The severity of CALMCHeM at the first imaging follow-up was associated with a larger number of metastases (P = 0.002) and volume of the liver affected (P = 0.015). The severity of CALMCHeM had progressed to moderate to severe changes in 85.9% of patients, and 72.5% of patients had one or more features of portal hypertension at the last follow-up. The most common features at the final follow-up were nodularity (95.0%), capsular retraction (93.4%), atrophy (66.2%), and ascites (65.7%). The Cox proportional hazard model showed metastases affected ≥50% of the liver (P = 0.033), and the female gender (P = 0.004) was independently associated with severe CALMCHeM. CONCLUSION CALMCHeM can be observed with a wide variety of malignancies, is progressive in severity, and the severity correlates with the initial metastatic liver disease burden.
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Affiliation(s)
- Matthew C. Pope
- Department of Radiology, Division of Abdominal Imaging, Mayo Clinic, Minnesota, USA
| | - Michael C. Olson
- Department of Radiology, Division of Abdominal Imaging, Mayo Clinic, Minnesota, USA
| | - Kristina T. Flicek
- Department of Radiology, Division of Abdominal Imaging, Mayo Clinic, Minnesota, USA
| | - Neema J. Patel
- Department of Radiology, Division of Abdominal Imaging, Mayo Clinic, Florida, USA
| | - Candice W. Bolan
- Department of Radiology, Division of Abdominal Imaging, Mayo Clinic, Florida, USA
| | - Christine O. Menias
- Department of Radiology, Division of Abdominal Imaging, Mayo Clinic, Arizona, USA
| | - Zhen Wang
- Department of Biostatistics, Mayo Clinic, Minnesota, USA
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Serageldin MA, Kassem AB, El-Kerm Y, Helmy MW, El-Mas MM, El-Bassiouny NA. The Effect of Metformin on Chemotherapy-Induced Toxicities in Non-diabetic Breast Cancer Patients: A Randomised Controlled Study. Drug Saf 2023; 46:587-599. [PMID: 37131014 DOI: 10.1007/s40264-023-01305-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Breast cancer patients treated with adriamycin-cyclophosphamide plus paclitaxel (AC-T) are often challenged with serious adverse effects for which no effective therapies are available. Here, we investigated whether metformin, an antidiabetic drug with additional pleiotropic effects could favourably offset AC-T induced toxicities. PATIENTS AND METHODS Seventy non-diabetic breast cancer patients were randomised to receive either AC-T (adriamycin 60 mg/m2 + cyclophosphamide 600 mg/m2 × 4 cycles Q21 days, followed by weekly paclitaxel 80 mg/m2 × 12 cycles) alone or AC-T plus metformin (1700 mg/day). Patients were assessed regularly after each cycle to record the incidence and severity of adverse events based on the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Moreover, baseline echocardiography and ultrasonography were done and repeated after the end of neoadjuvant therapy. RESULTS Addition of metformin to AC-T resulted in significantly less incidence and severity of peripheral neuropathy, oral mucositis, and fatigue (p < 0.05) compared to control arm. Moreover, the left ventricular ejection fraction (LVEF%) in the control arm dropped from a mean of 66.69 ± 4.57 to 62.2 ± 5.22% (p = 0.0004) versus a preserved cardiac function in the metformin arm (64.87 ± 4.84 to 65.94 ± 3.44%, p = 0.2667). Furthermore, fatty liver incidence was significantly lower in metformin compared with control arm (8.33% vs 51.85%, p = 0.001). By contrast, haematological disturbances caused by AC-T were preserved after concurrent metformin administration (p > 0.05). CONCLUSION Metformin offers a therapeutic opportunity for controlling toxicities caused by neoadjuvant chemotherapy in non-diabetic breast cancer patients. TRIAL REGISTRATION This randomised controlled trial was registered on November 20, 2019 in ClinicalTrials.gov under registration number: NCT04170465.
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Affiliation(s)
- Manar A Serageldin
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt.
| | - Amira B Kassem
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
| | - Yasser El-Kerm
- Oncology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Maged W Helmy
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
- Department of Pharmacology and Toxicology, College of Pharmacy, Arab Academy for Science, Technology and Maritime Transport, Alexandria, Egypt
| | - Mahmoud M El-Mas
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
- Department of Pharmacology and Toxicology, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Noha A El-Bassiouny
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
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Yadav V, Krishnan A, Zahiruddin S, Ahmad S, Vohora D. Amelioration of cyclophosphamide-induced DNA damage, oxidative stress, and hepato- and neurotoxicity by Piper longum extract in rats: The role of γH2AX and 8-OHdG. Front Pharmacol 2023; 14:1147823. [PMID: 36969834 PMCID: PMC10036401 DOI: 10.3389/fphar.2023.1147823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
Background: The identification of genoprotectants is a promising strategy for improving human health. Piper longum has drawn scientific attention because of its diverse biological effects and traditional utilization. The current investigation aims to evaluate the genome-stabilizing potential of Piper longum against cyclophosphamide-associated genotoxicity.Methods: We adopted a funnel screening with a three-tier evaluation approach, where Piper longum was investigated in an acellular medium, peripheral blood lymphocytes, and a rodent model. The genoprotective action of the Piper longum extract was initially performed with plasmid pBluescript SK(-) DNA. Furthermore, the extract and various fractions were screened against cyclophosphamide-induced genotoxicity using a cytokinesis-block micronucleus assay and a chromosomal aberration assay in human peripheral blood lymphocytes. The genome-stabilizing action of the extract and potent (hexane) fraction was further confirmed in vivo in Wistar albino rats by evaluating them using mammalian erythrocyte micronucleus tests, DNA fragmentation, oxidative stress markers, 8-hydroxy-2-deoxyguanosine (8-OHdG), γH2AX, and histopathological lesions in the liver and hippocampus. Additionally, acute and sub-acute toxicity studies were conducted following the Organization for Economic Co-operation and Development (OECD) guidelines for rats. Furthermore, the extract was quantified and characterized by high-performance thin-layer chromatography (HPTLC), ultra-high performance liquid chromatography–mass spectroscopy (UPLC-MS), and gas chromatography–mass spectrometry (GC-MS).Results: The Piper longum ethanol extract was shown to protect plasmid pBluescript SK(-) DNA against H2O2-induced strand breaks. In human lymphocytes, the extract and hexane fraction showed a reduction in micronucleus formation (p < 0.001) and chromosomal aberrations (p < 0.01) against cyclophosphamide. Furthermore, the extract and fraction treatment, when administered at 200 mg/kg for 28 days in Wistar rats, restored cyclophosphamide-induced genomic instability by reducing micronucleus formation and DNA fragmentation; restoring redox homeostasis; decreasing 8-OHdG, a hallmark of oxidative DNA damage; reducing γH2AX, a DNA double-strand break (DSB) marker; and preserving the liver and hippocampus against histopathological lesions. The extract and fraction revealed no signs of systemic toxicity at the used doses. Piperine and piperlongumine are the major alkaloids quantified along with the presence of flavonoids in the ethanol extract and the presence of fatty acids and terpenoids in the hexane fraction of Piper longum.Conclusion: Our investigation confirms the genoprotective action of Piper longum by reducing cyclophosphamide-associated cytogenotoxicity, oxidative stress, hepato- and neurotoxicity, oxidative DNA damage, and DNA double-strand breaks. The outcomes are critical for mitigating the genotoxic effects of chemotherapy recipients, requiring further attention.
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Affiliation(s)
- Vaishali Yadav
- Neurobehavioral Pharmacology Laboratory, Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard University, New Delhi, India
| | - Anuja Krishnan
- Department of Molecular Medicine, School of Interdisciplinary Science and Technology, Jamia Hamdard University, New Delhi, India
| | - Sultan Zahiruddin
- Bioactive Natural Product Laboratory, Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard University, New Delhi, India
| | - Sayeed Ahmad
- Bioactive Natural Product Laboratory, Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard University, New Delhi, India
| | - Divya Vohora
- Neurobehavioral Pharmacology Laboratory, Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard University, New Delhi, India
- *Correspondence: Divya Vohora,
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Culcu S, Tamam S, Azili C, Ersoz S, Morkavuk B, Unal AE, Demirci S. Liver Dysfunction After Use of Nathanson Retractor During Laparoscopic Gastrectomy for Gastric Cancer. J Laparoendosc Adv Surg Tech A 2023; 33:205-210. [PMID: 36445740 DOI: 10.1089/lap.2022.0427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Cardiopulmonary complications and liver dysfunction are also specific complications and problems associated with laparoscopic surgery. The main causes of postoperative liver dysfunction, which may often occur after laparoscopic surgery, include carbon dioxide pneumoperitoneum and ligation of the aberrant left hepatic artery. Hepatic steatosis may develop as a natural consequence of neoadjuvant therapy, although rarely, owing to chemotherapy. Nathanson retractor may cause a prolonged elevation in liver enzymes of these patients compared with those who do not receive neoadjuvant therapy. Materials and Methods: The data of 151 patients who underwent laparoscopic radical gastrectomy between January 2017 and January 2022 for histologically proven primary gastric cancer in our clinic were retrospectively reviewed. Results: The mean length of hospital stay was 6.21 days. The mean time normalization of the aspartate aminotransferase (AST) value was 2.45 ± 1.83 (range, 0-12) days postoperatively. The analysis of the correlation between the preoperative and postoperative 1-day values of alanine aminotransferase (ALT) and AST revealed a significant difference between the preoperative and postoperative 1-day median values of both parameters (P < .001). Each one unit increase in ALT led to an increase of 0.338 days in the length of intensive care stay and an increase of 0.345 days in the overall length of hospital stay. As the time to normalization of the AST value increased, the length of both intensive care stay and hospital stay increased. Each one unit increase in AST resulted in an increase of 0.316 days in the length of intensive care stay and an increase of 0.376 days in the overall length of hospital stay. Conclusion: Alternative retraction methods can be used safely in laparoscopic surgery for gastric cancer patients receiving neoadjuvant therapy. We are of the opinion that the Nathanson retractor should be used only during dissection of the relevant regions to shorten the intraoperative intermittent release or the time of use.
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Affiliation(s)
- Serdar Culcu
- Department of Surgical Oncology and Ankara University School of Medicine, Ankara, Turkey
| | - Selim Tamam
- Department of Surgical Oncology and Ankara University School of Medicine, Ankara, Turkey
| | - Cem Azili
- Department of Surgical Oncology and Ankara University School of Medicine, Ankara, Turkey
| | - Siyar Ersoz
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Baris Morkavuk
- Department of Surgical Oncology, University of Health Science Gulhane Training and Research Hospital, Ankara, Turkey
| | - Ali Ekrem Unal
- Department of Surgical Oncology and Ankara University School of Medicine, Ankara, Turkey
| | - Salim Demirci
- Department of Surgical Oncology and Ankara University School of Medicine, Ankara, Turkey
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Alshammari GM, Abdelhalim MA, Al-Ayed MS, Al-Harbi LN, Yahya MA. Concomitant Sub-Chronic Administration of Small-Size Gold Nanoparticles Aggravates Doxorubicin-Induced Liver Oxidative and Inflammatory Damage, Hyperlipidemia, and Hepatic Steatosis. MOLECULES (BASEL, SWITZERLAND) 2023; 28:molecules28020796. [PMID: 36677854 PMCID: PMC9863023 DOI: 10.3390/molecules28020796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/15/2023]
Abstract
This study examined the effect of gold nanoparticles (AuNPs) on doxorubicin (DOX)-induced liver damage and steatosis in rats and tested its effect mechanism. Wistar male rats were divided into four groups (each of eight rats) as control, AuNPs (50 µL of 10 nm), DOX (15 mg/kg; 3 mg/kg/week), and DOX + AuNPs-treated rats. DOX is known to induce fasting hyperglycemia and hyperinsulinemia in treated rats. Individual treatment of both DOX and AuNPs also promoted liver damage, increased circulatory levels of ALT and AST, and stimulated serum and liver levels of TGs, CHOL, LDL-c, and FFAs. They also stimulated MDA, TNF-α, and IL-6, reduced GSH, SOD, HO-1, and CAT, upregulated mRNA levels of Bax and caspases-3 and -8 and downregulated mRNA levels of Bcl2 in the livers of rats. However, while DOX alone reduced hepatic levels of PPARα, both AuNPs and DOX stimulated mRNA levels of SREBP1, reduced the mRNA, cytoplasmic and nuclear levels of Nrf2, and increased mRNA, cytoplasmic, and nuclear levels of NF-κB. The liver damage and the alterations in all these parameters were significantly more profound when both AuNPs and DOX were administered together. In conclusion, AuNPs exaggerate liver damage, hyperlipidemia, and hepatic steatosis in DOX-treated rats by activating SREBP1 and NF-κB and suppressing the Nrf2/antioxidant axis.
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Affiliation(s)
- Ghedeir M. Alshammari
- Department of Food Science & Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia
- Correspondence:
| | - Mohamed Anwar Abdelhalim
- Department of Physics and Astronomy, College of Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammed S. Al-Ayed
- Department of Physics and Astronomy, College of Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Laila Naif Al-Harbi
- Department of Food Science & Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammed Abdo Yahya
- Department of Food Science & Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia
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George ES, Sood S, Kiss N, Daly RM, Nicoll AJ, Roberts SK, Baguley BJ. The Evidence Surrounding Non-Alcoholic Fatty Liver Disease in Individuals with Cancer: A Systematic Literature Review. Curr Oncol 2022; 30:48-74. [PMID: 36661654 PMCID: PMC9857873 DOI: 10.3390/curroncol30010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Emerging evidence indicates an association between non-alcoholic fatty liver disease (NAFLD), cancer development and mortality. Cancer treatment-induced metabolic and hepatic dysfunction may be associated with increased rates of NAFLD. The review aims to investigate current evidence surrounding NAFLD in adults (≥18 years) with cancer including prevalence, effect of cancer treatments, metabolic co-morbidities, and mortality. Embase, Scopus, PubMed, and CINAHL were searched from inception to December 2021 including randomized controlled trials and observational studies. Twenty-three articles were included, comprising 142,218 participants. The overall risk of bias for observational studies was determined as low for 10 studies and neutral for 12 studies, and the RCT was determined as some concerns. The prevalence of NAFLD, based on imaging or histology, in adults with cancer ranged from 0.5 to 81.3%, with higher prevalence in breast, colorectal and gynecological cancers. Higher rates of NAFLD were also seen in patients who (i) underwent treatments-including chemotherapy and hormone therapy and/or who (ii) had higher BMI or other metabolic co-morbidities. NAFLD was associated with an increase in all-cause and cancer-related mortality. Based on review results, it is recommended that further assessment is carried out to determine whether liver screening in high-risk patients is cost effective and if interventions can be implemented to improve hepatic and health outcomes in adults with cancer.
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Affiliation(s)
- Elena S. George
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3125, Australia
- Gastroenterology Department, Alfred Health, Prahran, VIC 3004, Australia
| | - Surbhi Sood
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3125, Australia
| | - Nicole Kiss
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3125, Australia
- Allied Health Research, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
| | - Robin M. Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3125, Australia
| | - Amanda J. Nicoll
- Gastroenterology Department, Eastern Health, Box Hill, VIC 3128, Australia
- Central Clinical School, Monash University, Clayton, VIC 3800, Australia
| | - Stuart K. Roberts
- Gastroenterology Department, Alfred Health, Prahran, VIC 3004, Australia
- Central Clinical School, Monash University, Clayton, VIC 3800, Australia
| | - Brenton J. Baguley
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3125, Australia
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11
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Minami Y, Aoki T, Chishina H, Takita M, Hagiwara S, Ida H, Ueshima K, Nishida N, Kudo M. Prognostic Factors for Overall Survival in Patients with HCV-Related HCC Undergoing Molecular Targeted Therapies: Beyond a Sustained Virological Response. Cancers (Basel) 2022; 14:cancers14194850. [PMID: 36230773 PMCID: PMC9562238 DOI: 10.3390/cancers14194850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background: The treatment of the hepatitis C virus (HCV) has reduced the risk of hepatocellular carcinoma (HCC)-related mortality. Many patients with advanced HCC have achieved longer survival through systemic chemotherapy. However, survivors of HCC may develop liver cancer during and after treatment. Therefore, the present study investigated prognostic factors for survival in patients with HCV-related HCC in the new era of molecular targeted therapy. Methods: A total of 359 patients with HCV-related HCC treated with first-line chemotherapy were reviewed. A Cox proportional hazards model and Kaplan−Meier curve were used to identify prognostic factors associated with survival outcomes. Results: The median follow-up duration was 16.0 months (range, 1.0−115.7) and the median duration of first-line systemic therapy was 3.73 months (range, 0.7−86.9). The achievement of a sustained virological response (SVR) (p < 0.001), albumin−bilirubin (ALBI) grade II/III (p < 0.001), Barcelona Clinic Liver Cancer (BCLC) stage C (p = 0.005), extrahepatic spread (p < 0.001), baseline AFP (alpha-fetoprotein) level ≥ 90 (p = 0.038), baseline DCP (des-γ-carboxy prothrombin) level ≥ 500 (p < 0.001), and a fibrosis-4 (FIB-4) index ≥ 4 (p = 0.003) were identified as prognostic factors for overall survival. Conclusions: The achievement of SVR was most strongly associated with overall survival. Other factors, such as the BCLC stage, extrahepatic spread, baseline tumor marker (AFP/DCP) levels, ALBI grade, and FIB-4 index need to be considered in the management of patients with HCV-related HCC.
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Affiliation(s)
- Yasunori Minami
- Correspondence: ; Tel.: +81-72-366-0221 (ext. 3525); Fax: +81-72-367-2880
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12
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Evaluation of liver function tests to identify hepatotoxicity among acute lymphoblastic leukemia patients who are receiving chemotherapy induction. Sci Rep 2022; 12:13215. [PMID: 35918381 PMCID: PMC9346124 DOI: 10.1038/s41598-022-17618-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 07/28/2022] [Indexed: 11/27/2022] Open
Abstract
The effect of induction chemotherapy on liver function in patients with acute lymphoblastic leukemia is not well documented in Ethiopia. This study assessed hepatotoxicity in patients with acute lymphoblastic leukemia who were undergoing induction chemotherapy in Ethiopia. A 1-month cohort study was undertaken in forty patients with acute lymphoblastic leukemia, with measurements taken at the baseline, second, and fourth weeks. A Log 10 transformation was done because of the skewed distribution of liver function tests. Descriptive statistics such as mean and proportion were calculated. A mixed model ANOVA and Bonferroni post hoc test were computed. A p value < 0.05 was declared to determine statistical significance. Clinically significant hepatotoxicity was observed in 15% of patients. Mild liver injury occurred in 5% of patients. The mean of all liver function tests increased significantly from pre-induction to post-induction. ALT levels were significantly higher in patients who received blood transfusions, but not in those who did not. Regardless of other factors, ALP level in children is significantly higher than in adults, although total bilirubin in adults is higher than in children. A significant proportion of patients had hepatotoxicity. During chemotherapy induction, the mean of all liver function tests rose significantly, but this elevation of serum liver function tests may be transient. Chemotherapy drugs should be given without causing a significant alteration in serum liver function tests. Continuous monitoring of patients should be required.
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13
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Cancer Treatment by Laser and Electrochemical Therapy Combined with Magnetic Nanoparticles as Potent Therapy Against Ehrlich Ascites Carcinoma. BIONANOSCIENCE 2022. [DOI: 10.1007/s12668-022-00983-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Faria LLD, Darce GF, Bordini AL, Herman P, Jeismann VB, de Oliveira IS, Ortega CD, Rocha MDS. Liver Surgery: Important Considerations for Pre- and Postoperative Imaging. Radiographics 2022; 42:722-740. [PMID: 35363553 DOI: 10.1148/rg.210124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Liver surgery may be a curative treatment option not only for primary liver neoplasms but also for liver metastases in selected patients. The number of liver surgeries performed worldwide has increased, but surgical morbidity associated with these surgeries remains significant. Therefore, radiologists need to understand the terminology, surgical techniques, resectability and unresectability criteria, and possible postoperative complications as these are part of the decision-making process. Because vascular and biliary variations are common, an adequate preoperative anatomic evaluation determines the best surgical technique, helps identify patients in whom additional surgical steps will be required, and reduces the risk of inadvertent injury. The surgeon must ensure that the future liver remnant is sufficient to maintain adequate function, aided by the radiologist who can provide valuable information such as the presence of steatosis, biliary dilatation, signs of cirrhosis, and portal hypertension, in addition to the volume of the future liver remnant. Postoperative complications must also be understood and evaluated. The most common postoperative complications are vascular (bleeding, thrombosis, and ischemia), biliary (fistulas, bilomas, and strictures), infectious (incisional or deep), those related to liver failure, and even tumor recurrence. An invited commentary by Winslow is available online. Online supplemental material is available for this article. ©RSNA, 2022.
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Affiliation(s)
- Luisa Leitão de Faria
- From the Department of Radiology (L.L.d.F., A.L.B., I.S.d.O., C.D.O., M.d.S.R.) and Liver Surgery Unit, Discipline of Digestive Surgery, Department of Gastroenterology (G.F.D., P.H., V.B.J.), University of São Paulo School of Medicine, Ovídio Pires de Campos 75, São Paulo 05403-010, Brazil
| | - George Felipe Darce
- From the Department of Radiology (L.L.d.F., A.L.B., I.S.d.O., C.D.O., M.d.S.R.) and Liver Surgery Unit, Discipline of Digestive Surgery, Department of Gastroenterology (G.F.D., P.H., V.B.J.), University of São Paulo School of Medicine, Ovídio Pires de Campos 75, São Paulo 05403-010, Brazil
| | - André Leopoldino Bordini
- From the Department of Radiology (L.L.d.F., A.L.B., I.S.d.O., C.D.O., M.d.S.R.) and Liver Surgery Unit, Discipline of Digestive Surgery, Department of Gastroenterology (G.F.D., P.H., V.B.J.), University of São Paulo School of Medicine, Ovídio Pires de Campos 75, São Paulo 05403-010, Brazil
| | - Paulo Herman
- From the Department of Radiology (L.L.d.F., A.L.B., I.S.d.O., C.D.O., M.d.S.R.) and Liver Surgery Unit, Discipline of Digestive Surgery, Department of Gastroenterology (G.F.D., P.H., V.B.J.), University of São Paulo School of Medicine, Ovídio Pires de Campos 75, São Paulo 05403-010, Brazil
| | - Vagner Birk Jeismann
- From the Department of Radiology (L.L.d.F., A.L.B., I.S.d.O., C.D.O., M.d.S.R.) and Liver Surgery Unit, Discipline of Digestive Surgery, Department of Gastroenterology (G.F.D., P.H., V.B.J.), University of São Paulo School of Medicine, Ovídio Pires de Campos 75, São Paulo 05403-010, Brazil
| | - Iraí Santana de Oliveira
- From the Department of Radiology (L.L.d.F., A.L.B., I.S.d.O., C.D.O., M.d.S.R.) and Liver Surgery Unit, Discipline of Digestive Surgery, Department of Gastroenterology (G.F.D., P.H., V.B.J.), University of São Paulo School of Medicine, Ovídio Pires de Campos 75, São Paulo 05403-010, Brazil
| | - Cinthia D Ortega
- From the Department of Radiology (L.L.d.F., A.L.B., I.S.d.O., C.D.O., M.d.S.R.) and Liver Surgery Unit, Discipline of Digestive Surgery, Department of Gastroenterology (G.F.D., P.H., V.B.J.), University of São Paulo School of Medicine, Ovídio Pires de Campos 75, São Paulo 05403-010, Brazil
| | - Manoel de Souza Rocha
- From the Department of Radiology (L.L.d.F., A.L.B., I.S.d.O., C.D.O., M.d.S.R.) and Liver Surgery Unit, Discipline of Digestive Surgery, Department of Gastroenterology (G.F.D., P.H., V.B.J.), University of São Paulo School of Medicine, Ovídio Pires de Campos 75, São Paulo 05403-010, Brazil
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Zeien J, Qiu W, Triay M, Dhaibar HA, Cruz-Topete D, Cornett EM, Urits I, Viswanath O, Kaye AD. Clinical implications of chemotherapeutic agent organ toxicity on perioperative care. Biomed Pharmacother 2022; 146:112503. [PMID: 34922113 PMCID: PMC11118057 DOI: 10.1016/j.biopha.2021.112503] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 01/22/2023] Open
Abstract
Cancer is the second most common cause of death in the United States and is a challenging disease to treat. The treatment options for various cancers include but are not limited to surgery, radiation, and chemotherapy. The mechanism behind chemotherapy is intended to promote cellular damage to cells that are proliferating uncontrollably. Unfortunately for the recipients, most chemotherapeutic agents cannot differentiate between malignant cells and healthy cells and tissues. Thus, chemotherapy-induced toxicities are often observed in once-healthy organs. These effects can be acute and self-limiting or chronic, appearing long after chemotherapy is completed. Cancer survivors can then present for non-cancer related surgeries later in life, due to this toxicity. Furthermore, the administration of chemotherapeutic agents can profoundly impact the anesthetic management of patients who are undergoing surgery. This review discusses how chemotherapy-induced organ toxicity can occur in multiple organ systems and what drugs should be avoided if prior toxicity exists in these organ systems.
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Affiliation(s)
- Justin Zeien
- University of Arizona College of Medicine - Phoenix, 475 N 5th St, Phoenix, AZ 85004, USA.
| | - Wendy Qiu
- Creighton University School of Medicine, Phoenix Regional Campus at St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
| | - Mason Triay
- School of Medicine, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Hemangini A Dhaibar
- Department of Molecular and Cellular Physiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Diana Cruz-Topete
- Department of Molecular and Cellular Physiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Elyse M Cornett
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Ivan Urits
- Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, 330 Brookline Ave, Boston, MA 02215, USA.
| | - Omar Viswanath
- Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ, USA; University of Arizona College of Medicine - Phoenix, Department of Anesthesiology, Phoenix, AZ, USA; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, USA.
| | - Alan David Kaye
- Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Director Pain Fellowship, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
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16
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Aslani R, Namazi H. Simple fabrication of multifunctional hyperbranched copolymer based on l-lysine and citric acid for co-delivery of anticancer drugs to breast cancer cells. REACT FUNCT POLYM 2022. [DOI: 10.1016/j.reactfunctpolym.2021.105101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Calistri L, Rastrelli V, Nardi C, Maraghelli D, Vidali S, Pietragalla M, Colagrande S. Imaging of the chemotherapy-induced hepatic damage: Yellow liver, blue liver, and pseudocirrhosis. World J Gastroenterol 2021; 27:7866-7893. [PMID: 35046618 PMCID: PMC8678821 DOI: 10.3748/wjg.v27.i46.7866] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/15/2021] [Accepted: 11/29/2021] [Indexed: 02/06/2023] Open
Abstract
The liver is the major drug-metabolizing and drug-detoxifying organ. Many drugs can cause liver damage through various mechanisms; however, the liver response to injury includes a relatively narrow spectrum of alterations that, regardless of the cause, are represented by phlogosis, oxidative stress and necrosis. The combination of these alterations mainly results in three radiological findings: vascular alterations, structural changes and metabolic function reduction. Chemotherapy has changed in recent decades in terms of the drugs, protocols and duration, allowing patients a longer life expectancy. As a consequence, we are currently observing an increase in chemotherapy-associated liver injury patterns once considered unusual. Recognizing this form of damage in an early stage is crucial for reconsidering the therapy regimen and thus avoiding severe complications. In this frontier article, we analyze the role of imaging in detecting some of these pathological patterns, such as pseudocirrhosis, “yellow liver” due to chemotherapy-associated steatosis-steatohepatitis, and “blue liver”, including sinusoidal obstruction syndrome, veno-occlusive disease and peliosis.
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Affiliation(s)
- Linda Calistri
- Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50134, Italy
| | - Vieri Rastrelli
- Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50134, Italy
| | - Cosimo Nardi
- Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50134, Italy
| | - Davide Maraghelli
- Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50134, Italy
| | - Sofia Vidali
- Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50134, Italy
| | - Michele Pietragalla
- Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50134, Italy
| | - Stefano Colagrande
- Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence 50134, Italy
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18
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Shinoda T, Tanahashi T, Sakuratani T, Ota M, Fujibayashi S, Kiriyama S, Matsumoto K, Yawata K, Sasaki Y, Osada S, Yamada M. Pseudocirrhosis after chemotherapy for gastric cancer with diffuse liver metastases: A case report. Mol Clin Oncol 2021; 16:11. [PMID: 34881031 PMCID: PMC8647196 DOI: 10.3892/mco.2021.2441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 09/07/2021] [Indexed: 01/03/2023] Open
Abstract
Pseudocirrhosis is a rare but important complication of metastatic cancer. We herein present the case of a patient with pseudocirrhosis occurring after a complete response to chemotherapy for metastatic gastric cancer was achieved. A 72-year-old man was diagnosed with gastric adenocarcinoma with multiple liver metastases. The patient's general condition was good, with an Eastern Cooperative Oncology Group performance status of 1. Chemotherapy with oxaliplatin and S-1 was initiated and, after four cycles, the patient noticed sudden abdominal distension. Despite the marked regression of the liver metastases, massive ascites, segmental atrophy and esophageal varices developed, findings consistent with pseudocirrhosis. The patient achieved complete response for the primary and metastatic lesions. Following endoscopic ligation of the varices, he underwent subsequent chemotherapy with S-1 only and management of his ascites for 6 months. At 12 months after initial chemotherapy, the patient appeared to be disease-free. In conclusion, clinicians should be aware of the possibility of pseudocirrhosis in cases of cancer metastasis to the liver, including metastatic gastric cancer.
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Affiliation(s)
- Tomohito Shinoda
- Department of Surgery, Gifu Municipal Hospital, Gifu 500-8513, Japan
| | | | - Takuji Sakuratani
- Department of Surgery, Gifu Municipal Hospital, Gifu 500-8513, Japan
| | - Masato Ota
- Department of Surgery, Gifu Municipal Hospital, Gifu 500-8513, Japan
| | - Seito Fujibayashi
- Department of Surgery, Gifu Municipal Hospital, Gifu 500-8513, Japan
| | - Shunya Kiriyama
- Department of Surgery, Gifu Municipal Hospital, Gifu 500-8513, Japan
| | - Keita Matsumoto
- Department of Surgery, Gifu Municipal Hospital, Gifu 500-8513, Japan
| | - Kazunori Yawata
- Department of Surgery, Gifu Municipal Hospital, Gifu 500-8513, Japan
| | - Yoshiyuki Sasaki
- Department of Surgery, Gifu Municipal Hospital, Gifu 500-8513, Japan
| | - Shinji Osada
- Department of Surgery, Gifu Municipal Hospital, Gifu 500-8513, Japan
| | - Makoto Yamada
- Department of Surgery, Gifu Municipal Hospital, Gifu 500-8513, Japan
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19
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Torri GB, Soldatelli MD, Luersen GF, Almeida Ghezzi CL. Imaging of chemotherapy-induced liver toxicity: an illustrated overview. Hepat Oncol 2021; 8:HEP32. [PMID: 34765105 PMCID: PMC8577512 DOI: 10.2217/hep-2020-0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/16/2021] [Indexed: 01/27/2023] Open
Abstract
Chemotherapy is a potential cause of focal and diffuse hepatobiliary lesions. Many of these lesions may be demonstrated on imaging, especially computed tomography and MRI. Some of these lesions, especially those of steatosis and sinusoidal obstruction syndrome, are associated with a worse prognosis and risk of hepatic failure in the context of surgical management. Notably, some chemotherapy-induced hepatic alterations, such as sinusoidal obstruction syndrome, pseudocirrhosis and focal hepatopathies, may be mistakenly interpreted as signs of cancer progression, misguiding the therapeutic planning for patients receiving chemotherapy.
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Affiliation(s)
| | | | - Gustavo Felipe Luersen
- Department of Radiology, Hospital da Cruz Vermelha Portuguesa, Lisboa, 1549008, Portugal.,Department of Radiology, Hospital CUF Tejo, Lisboa, 1350352, Portugal.,Affidea group, Lisboa, Portugal
| | - Caroline Lorenzoni Almeida Ghezzi
- Department of Radiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS 90035903, Brazil.,Department of Radiology, Hospital Moinhos de Vento, Porto Alegre, RS 90035000, Brazil
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20
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Kim J, Randhawa H, Sands D, Lambe S, Puglia M, Serrano PE, Pinthus JH. Muscle-Invasive Bladder Cancer in Patients with Liver Cirrhosis: A Review of Pertinent Considerations. Bladder Cancer 2021; 7:261-278. [PMID: 38993608 PMCID: PMC11181825 DOI: 10.3233/blc-211536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/09/2021] [Indexed: 11/15/2022]
Abstract
The incidence of liver cirrhosis is increasing worldwide. Patients with cirrhosis are generally at a higher risk of harbouring hepatic and non-hepatic malignancies, including bladder cancer, likely due to the presence of related risk factors such as smoking. Cirrhosis can complicate both the operative and non-surgical management of bladder cancer. For example, cirrhotic patients undergoing abdominal surgery generally demonstrate worse postoperative outcomes, and chemotherapy in patients with cirrhosis often requires dose reduction due to its direct hepatotoxic effects and reduced hepatic clearance. Multiple other considerations in the peri-operative management for cirrhosis patients with muscle-invasive bladder cancer must be taken into account to optimize outcomes in these patients. Unfortunately, the current literature specifically related to the treatment of cirrhotic bladder cancer patients remains sparse. We aim to review the literature on treatment considerations for this patient population with respect to perioperative, surgical, and adjuvant management.
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Affiliation(s)
- John Kim
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - David Sands
- Division of Urology, McMaster University, Hamilton, ON, Canada
| | - Shahid Lambe
- Division of Urology, McMaster University, Hamilton, ON, Canada
- McMaster Institute of Urology, St. Joseph’s Hospital, Hamilton, ON, Canada
| | - Marco Puglia
- Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada
| | | | - Jehonathan H. Pinthus
- Division of Urology, McMaster University, Hamilton, ON, Canada
- Juravinski Hospital and Cancer Centre, Hamilton, ON, Canada
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21
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Hermanowicz JM, Kalaska B, Pawlak K, Sieklucka B, Miklosz J, Mojzych M, Pawlak D. Preclinical Toxicity and Safety of MM-129-First-in-Class BTK/PD-L1 Inhibitor as a Potential Candidate against Colon Cancer. Pharmaceutics 2021; 13:pharmaceutics13081222. [PMID: 34452183 PMCID: PMC8400941 DOI: 10.3390/pharmaceutics13081222] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 01/03/2023] Open
Abstract
MM-129 is a novel inhibitor targeting BTK/PI3K/AKT/mTOR and PD-L1, as it possesses antitumor activity against colon cancer. To evaluate the safety profile of MM-129, we conducted a toxicity study using the zebrafish and rodent model. MM-129 was also assessed for pharmacokinetics features through an in vivo study on Wistar rats. The results revealed that MM-129 exhibited favorable pharmacokinetics with quick absorption and 68.6% of bioavailability after intraperitoneal administration. No serious adverse events were reported for the use of MM-129, confirming a favorable safety profile for this compound. It was not fatal and toxic to mice at an anticancer effective dose of 10 μmol/kg. At the end of 14 days of administering hematological and biochemical parameters, liver and renal functions were all at normal levels. No sublethal effects were either detected in zebrafish embryos treated with a concentration of 10 μM. MM-129 has the potential as a safe and well-tolerated anticancer formulation for future treatment of patients with colon cancer.
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Affiliation(s)
- Justyna Magdalena Hermanowicz
- Department of Pharmacodynamics, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland; (B.K.); (B.S.); (J.M.); (D.P.)
- Department of Clinical Pharmacy, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland
- Correspondence: ; Tel./Fax: +48-8574-85601
| | - Bartlomiej Kalaska
- Department of Pharmacodynamics, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland; (B.K.); (B.S.); (J.M.); (D.P.)
| | - Krystyna Pawlak
- Department of Monitored Pharmacotherapy, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland;
| | - Beata Sieklucka
- Department of Pharmacodynamics, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland; (B.K.); (B.S.); (J.M.); (D.P.)
| | - Joanna Miklosz
- Department of Pharmacodynamics, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland; (B.K.); (B.S.); (J.M.); (D.P.)
| | - Mariusz Mojzych
- Department of Chemistry, Siedlce University of Natural Sciences and Humanities, 3 Maja 54, 08-110 Siedlce, Poland;
| | - Dariusz Pawlak
- Department of Pharmacodynamics, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland; (B.K.); (B.S.); (J.M.); (D.P.)
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Prokop A, Zhang Y, Mukhopadhyay P, Khan F, Shameer K. SAEgnal: A Predictive Assessment Framework for Optimizing Safety Profiles in Immuno-Oncology Combination Trials. AMIA JOINT SUMMITS ON TRANSLATIONAL SCIENCE PROCEEDINGS. AMIA JOINT SUMMITS ON TRANSLATIONAL SCIENCE 2021; 2021:535-544. [PMID: 34457169 PMCID: PMC8378624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Combination therapies are an emerging drug development strategy in cancer, particularly in the immunooncology (IO) space. Many combination studies do not meet their safety objectives due to serious adverse events (SAEs). Prediction of SAEs based on evidence from single and combination studies would be highly beneficial. To address the emerging challenge of optimizing the safety and efficacy of combination studies, we have assembled a novel oncology clinical trial data set with 329 trials, 685 arms (279 unique treatment arms), including 200 combinations, 79 mono arms, and 59 curated adverse event categories in the setting of non-small cell lung cancer (NSCLC). We integrated the database with an analytical framework: SAEgnal. Using SAEgnal, we have investigated the difference in the risk of 39 adverse event types between combination and monotherapy arms across a subset of 34 combination trials. We observed different risk profiles between combination and monotherapies; interestingly, while the risk of elevated AST/ALT is lower in combination arms (in 1/8 trials, p-value < 0.05), it is higher for bleeding (7/8 trials, p-value < 0.05). We envisage that the SAEgnal framework would enable rapid predictive analytics of SAEs in oncology and accelerate drug development in oncology.
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Affiliation(s)
- Andrzej Prokop
- Biometrics, Oncology R&D, AstraZeneca, Warsaw, Poland
- Data Science and Artificial intelligence, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Youyi Zhang
- Data Science and Artificial intelligence, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Pralay Mukhopadhyay
- Late ImmunoOncology Statistics, GMD, AstraZeneca, Gaithersburg, US
- Current Affiliation: Otsuka Biopharmaceuticals, Rockville, MD, USA
| | - Faisal Khan
- Data Science and Artificial intelligence, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Khader Shameer
- Data Science and Artificial intelligence, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
- Corresponding Author
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23
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Brown T, Sykes D, Allen AR. Implications of Breast Cancer Chemotherapy-Induced Inflammation on the Gut, Liver, and Central Nervous System. Biomedicines 2021; 9:biomedicines9020189. [PMID: 33668580 PMCID: PMC7917715 DOI: 10.3390/biomedicines9020189] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 12/18/2022] Open
Abstract
Breast Cancer is still one of the most common cancers today; however, with advancements in diagnostic and treatment methods, the mortality and survivorship of patients continues to decrease and increase, respectively. Commonly used treatments today consist of drug combinations, such as doxorubicin and cyclophosphamide; docetaxel, doxorubicin, and cyclophosphamide; or doxorubicin, cyclophosphamide, and paclitaxel. Although these combinations are effective at destroying cancer cells, there is still much to be understood about the effects that chemotherapy can have on normal organ systems such as the nervous system, gastrointestinal tract, and the liver. Patients can experience symptoms of cognitive impairments or “chemobrain”, such as difficulty in concentrating, memory recollection, and processing speed. They may also experience gastrointestinal (GI) distress symptoms such as diarrhea and vomiting, as well as hepatotoxicity and long term liver damage. Chemotherapy treatment has also been shown to induce peripheral neuropathy resulting in numbing, pain, and tingling sensations in the extremities of patients. Interestingly, researchers have discovered that this array of symptoms that cancer patients experience are interconnected and mediated by the inflammatory response.
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Affiliation(s)
- Taurean Brown
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
- Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Department of Neurobiology & Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - DeLawrence Sykes
- Department of Biology, Pomona College, Claremont, CA 91711, USA;
| | - Antiño R. Allen
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
- Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Department of Neurobiology & Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Correspondence: ; Tel.: +1-501-686-7335
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24
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Devarajan N, Jayaraman S, Mahendra J, Venkatratnam P, Rajagopal P, Palaniappan H, Ganesan SK. Berberine-A potent chemosensitizer and chemoprotector to conventional cancer therapies. Phytother Res 2021; 35:3059-3077. [PMID: 33559280 DOI: 10.1002/ptr.7032] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 12/14/2022]
Abstract
Chemotherapy and radiotherapy are mainstay treatments for cancer patients. However, their clinical outcomes are highly limited by the resistance of malignant tumors to these therapies and the incurrence of serious damages in vital organs. This in turn necessitates the development of adjunct drugs that overcomes chemo/radioresistance in refractory cancers and protects vital organs from the cytotoxic effects of cancer therapies. In recent years, Berberine (BBR), a natural isoquinoline alkaloid has garnered more attention due to its potent chemosensitizing and chemoprotective properties. BBR effectively sensitizes refractory cancers to chemotherapy and radiotherapy by ameliorating the diverse events underlying therapy resistance. Furthermore, it protects the heart, liver, lungs, and kidneys from severe damages caused by these therapies. In this review, we discuss the molecular mechanisms underlying the chemo/radiosensitizing and chemo/radioprotective potential of BBR during cancer treatment. Also, we highlight the limitations that hamper the clinical application of BBR as an adjunct drug and how novel innovations have been made in recent years to circumvent these challenges.
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Affiliation(s)
- Nalini Devarajan
- Central Research Laboratory, Meenakshi Ammal Dental College, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Selvaraj Jayaraman
- Department of Biochemistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College, and Hospital, Chennai, India
| | - Purushothaman Venkatratnam
- Central Research laboratory, Meenakshi Ammal Dental College, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Ponnulakshmi Rajagopal
- Central Research Laboratory, Meenakshi Ammal Dental College, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Hema Palaniappan
- Department of Pharmacology, Coimbatore Medical College, Coimbatore, India
| | - Senthil Kumar Ganesan
- Laboratory of Functional Genomics, Structural Biology & Bioinformatics Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
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25
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Anderson MA, Kurra V, Bradley W, Kilcoyne A, Mojtahed A, Lee SI. Abdominal immune-related adverse events: detection on ultrasonography, CT, MRI and 18F-Fluorodeoxyglucose positron emission tomography. Br J Radiol 2021; 94:20200663. [PMID: 33112648 DOI: 10.1259/bjr.20200663] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Immune checkpoint inhibitor and chimeric antigen receptor T-cell therapies are associated with a unique spectrum of complications termed immune-related adverse events (irAEs). The abdomen is the most frequent site of severe irAEs that require hospitalization with life-threatening consequences. Most abdominal irAEs such as enterocolitis, hepatitis, cholangiopathy, cholecystitis, pancreatitis, adrenalitis, and sarcoid-like reaction are initially detected on imaging such as ultrasonography (US), CT, MRI and fusion 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT during routine surveillance of cancer therapy. Early recognition and diagnosis of irAEs and immediate management with cessation of immune modulator cancer therapy and institution of immunosuppressive therapy are necessary to avert morbidity and mortality. Diagnosis of irAEs is confirmed by tissue sampling or by follow-up imaging demonstrating resolution. Abdominal radiologists reviewing imaging on patients being treated with anti-cancer immunomodulators should be familiar with the imaging manifestations of irAEs.
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Affiliation(s)
- Mark A Anderson
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Vikram Kurra
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - William Bradley
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Amirkasra Mojtahed
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Susanna I Lee
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
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26
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Gunter D, Riaz S, Haider EA, Rebello R, Patlas MN, Alabousi A. Hepatic perfusional changes on CT and MRI: a radiology primer. Abdom Radiol (NY) 2021; 46:179-196. [PMID: 33047227 DOI: 10.1007/s00261-020-02787-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/16/2020] [Accepted: 09/24/2020] [Indexed: 11/29/2022]
Abstract
Hepatic perfusional changes are common in response to, or as a result of, a multitude of pathological processes. These can be neoplastic, inflammatory, fibrotic, or ischemic in origin, to name a few. The liver, having a dual blood supply, is a unique organ to study using contrast-enhanced CT and MRI imaging due to its varied appearance on multiphasic imaging. Knowledge of the CT and MRI appearance of hepatic perfusional changes, in addition to the clinical presentation, can often result in an accurate differential diagnosis. Many of the conditions that cause these changes in hepatic blood flow result in similar appearances on imaging. As a result, it is important that radiologists be aware of common pitfalls when dealing with hepatic perfusional changes to prevent misdiagnosis or delayed diagnosis. As such, this review will focus on some of the various causes of hepatic perfusional changes and how to accurately identify and diagnose them based on their CT and MRI appearance.
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Affiliation(s)
- Dane Gunter
- University College Cork, School of Medicine, Cork, Ireland
| | - Shaista Riaz
- Department of Radiology, McGill University, Montreal, QC, Canada
| | - Ehsan A Haider
- Department of Radiology, McMaster University, St Joseph's Healthcare, Hamilton, ON, L8N 4A6, Canada
| | - Ryan Rebello
- Department of Radiology, McMaster University, St Joseph's Healthcare, Hamilton, ON, L8N 4A6, Canada
| | - Michael N Patlas
- Department of Radiology, McMaster University, Hamilton General Hospital, Hamilton, ON, Canada
| | - Abdullah Alabousi
- Department of Radiology, McMaster University, St Joseph's Healthcare, Hamilton, ON, L8N 4A6, Canada.
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27
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Khan A, Sahu NK. Hydrazone conjugated and DOX loaded PEGylated-Fe 3O 4 mesoporous magnetic nanoclusters (MNCs): hyperthermia and in vitro chemotherapy. NEW J CHEM 2021. [DOI: 10.1039/d1nj03968g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Schematic representation of the functionalization of MNCs and DOX loading.
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Affiliation(s)
- Ahmaduddin Khan
- Centre for Nanotechnology Research, Vellore Institute of Technology, Vellore-632014, TN, India
| | - Niroj Kumar Sahu
- Centre for Nanotechnology Research, Vellore Institute of Technology, Vellore-632014, TN, India
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28
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John J, Kinra M, Mudgal J, Viswanatha GL, Nandakumar K. Animal models of chemotherapy-induced cognitive decline in preclinical drug development. Psychopharmacology (Berl) 2021; 238:3025-3053. [PMID: 34643772 PMCID: PMC8605973 DOI: 10.1007/s00213-021-05977-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 08/31/2021] [Indexed: 12/23/2022]
Abstract
RATIONALE Chemotherapy-induced cognitive impairment (CICI), chemobrain, and chemofog are the common terms for mental dysfunction in a cancer patient/survivor under the influence of chemotherapeutics. CICI is manifested as short/long term memory problems and delayed mental processing, which interferes with a person's day-to-day activities. Understanding CICI mechanisms help in developing therapeutic interventions that may alleviate the disease condition. Animal models facilitate critical evaluation to elucidate the underlying mechanisms and form an integral part of verifying different treatment hypotheses and strategies. OBJECTIVES A methodical evaluation of scientific literature is required to understand cognitive changes associated with the use of chemotherapeutic agents in different preclinical studies. This review mainly emphasizes animal models developed with various chemotherapeutic agents individually and in combination, with their proposed mechanisms contributing to the cognitive dysfunction. This review also points toward the analysis of chemobrain in healthy animals to understand the mechanism of interventions in absence of tumor and in tumor-bearing animals to mimic human cancer conditions to screen potential drug candidates against chemobrain. RESULTS Substantial memory deficit as a result of commonly used chemotherapeutic agents was evidenced in healthy and tumor-bearing animals. Spatial and episodic cognitive impairments, alterations in neurotrophins, oxidative and inflammatory markers, and changes in long-term potentiation were commonly observed changes in different animal models irrespective of the chemotherapeutic agent. CONCLUSION Dyscognition exists as one of the serious side effects of cancer chemotherapy. Due to differing mechanisms of chemotherapeutic agents with differing tendencies to alter behavioral and biochemical parameters, chemotherapy may present a significant risk in resulting memory impairments in healthy as well as tumor-bearing animals.
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Affiliation(s)
- Jeena John
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka India 576104
| | - Manas Kinra
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka India 576104
| | - Jayesh Mudgal
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka India 576104
| | - G. L. Viswanatha
- Independent Researcher, Kengeri, Bangalore, Karnataka India 560060
| | - K. Nandakumar
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka India 576104
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29
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Raslan MA, F. Taher R, Al-Karmalawy AA, El-Ebeedy D, Metwaly AG, Elkateeb NM, Ghanem A, Elghaish RA, Abd El Maksoud AI. Cordyline fruticosa (L.) A. Chev. leaves: isolation, HPLC/MS profiling and evaluation of nephroprotective and hepatoprotective activities supported by molecular docking. NEW J CHEM 2021. [DOI: 10.1039/d1nj02663a] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The metabolites profile of C. fruticosa (L.) A. Chev. leaves, 12 isolates, and its nephroprotective and hepatoprotective activities are described.
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Affiliation(s)
- Mona A. Raslan
- Pharmacognosy Department, National Research Centre, Dokki, 12622 Giza, Egypt
| | - Rehab F. Taher
- Chemistry of Natural Compounds Department, National Research Centre, 12622 Giza, Egypt
| | - Ahmed A. Al-Karmalawy
- Department of Pharmaceutical Medicinal Chemistry, Faculty of Pharmacy, Horus University-Egypt, New Damietta 34518, Egypt
| | - Dalia El-Ebeedy
- Pharmaceutical Biotechnology Department, Faculty of Biotechnology, Misr University for Science and Technology, Giza, Egypt
| | | | | | - Aml Ghanem
- Faculty of biotechnology, Badr university, Cairo, Egypt
| | | | - Ahmed I. Abd El Maksoud
- Industrial Biotechnology Department, Genetic Engineering and Biotechnology Research Institute, University of Sadat City, Sadat City, Egypt
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30
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Leao Filho H, de Oliveira CV, Horvat N. Other types of diffuse liver disease: is there a way to do it? Abdom Radiol (NY) 2020; 45:3425-3443. [PMID: 32306241 DOI: 10.1007/s00261-020-02530-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There are a variety of less common diffuse liver diseases that can be asymptomatic or cause severe liver dysfunction. For the majority of them, the association of clinical, laboratory, and imaging findings are needed to narrow the differential diagnosis. In this article, we will review and describe the rarer diffuse liver diseases including drug-related liver disease, inflammatory and infectious diseases, and deposition disorders such as amyloidosis, glycogen storage disease, Wilson's disease, and alpha-1 antitrypsin deficiency. Abdominal radiologists should be familiar with the imaging features of different types of diffuse liver diseases to help the multidisciplinary team involved in the treatment of these patients. The data related to some of these conditions are scarce and sometimes experimental, but we want to demonstrate to the reader the value of imaging techniques in their analysis and introduce the potential of new imaging methods.
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31
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Borisovsky G, Goldstein DA, Eliakim-Raz N, Tamir SR. Transitional Cell Carcinoma and Pseudocirrhosis— A Case Report and Review of the Literature. JOURNAL OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY 2020. [DOI: 10.1055/s-0040-1713829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
AbstractPseudocirrhosis is the occurrence of capsular retraction in patients with metastatic liver disease, usually of breast origin. It usually appears in these patients following chemotherapy and may result from shrinkage of the tumor, with scarring and nodular regeneration. In this article, we describe the first case of pseudocirrhosis, following treatment of transitional cell carcinoma metastatic to the liver. Portal vein thrombosis, a rare complication in pseudocirrhosis, was also detected in this patient.
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Affiliation(s)
- Gilad Borisovsky
- Radiology Department, Rabin Medical Center, Petah Tikva, Israel, affliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel A. Goldstein
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel, affliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noa Eliakim-Raz
- Internal Medicine E, Rabin Medical Center, Petah Tikva, Israel, affliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shlomit R. Tamir
- Radiology Department, Rabin Medical Center, Petah Tikva, Israel, affliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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32
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Dannen SD, Cornelison L, Durham P, Morley JE, Shahverdi K, Du J, Zhou H, Sudlow LC, Hunter D, Wood MD, Berezin MY, Gerasimchuk N. New in vitro highly cytotoxic platinum and palladium cyanoximates with minimal side effects in vivo. J Inorg Biochem 2020; 208:111082. [PMID: 32413634 PMCID: PMC7518941 DOI: 10.1016/j.jinorgbio.2020.111082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/28/2020] [Accepted: 03/28/2020] [Indexed: 11/26/2022]
Abstract
Several biologically active bivalent Pd and Pt complexes with two structurally similar cyanoxime ligands abbreviated as H(DECO): 2-oximino-2-cyano-N,N'-diethylacetamide, and H(PyrCO): 2-oximino-2-cyan-N-pyrrolidine acetamide were synthesized and characterized using spectroscopic methods, thermal analysis and X-ray crystallography. Structures revealed planar cis-geometry of studied complexes. Freshly obtained Pt(DECO)2, Pd(DECO)2, Pt(PyrCO)2 and Pd(PyrCO)2 complexes were used in for in vitro cytotoxicity assays using two different etiology human cancer cell lines HeLa and WiDr cells. Investigated compounds showed cytotoxicity levels at or above cisplatin. Pt(DECO)2 was also tested in vivo in healthy C57BL/6 mice. The complex was administered at three different dosage (0, 7.5, 15 mg/kg, i.p. once/week), over a total period of 8 weeks. No changes were observed in the animal weight in the treated mice compared to the control dextrose-treated group. The levels of erythrocytes, leukocytes, and hemoglobin were within the normal level suggesting low myelotoxicity. Negligible cardiotoxicity was observed from the histological evaluation of the hearts from the treated animals. Results from the tail nerve conduction velocity (NCV) and nerve histomorphometry suggested no impact of Pt(DECO)2 on peripheral nerves. The complex, however, induced certain hepatotoxicity and lead to the elevation of IL-6, a pro-inflammatory cytokine. Overall, Pt(DECO)2 showed minimal in vivo toxicity, thus presenting a promising candidate for future testing in animal models of cancer.
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Affiliation(s)
- Stephanie D Dannen
- Department of Chemistry, Temple Hall 431, Missouri State University, 901 S. National, Springfield, MO 65897, USA
| | - Lauren Cornelison
- Department of Biology, Missouri State University, MC/Center for Biomedical & Life Sciences, Springfield, MO 65897, USA
| | - Paul Durham
- Department of Biology, Missouri State University, MC/Center for Biomedical & Life Sciences, Springfield, MO 65897, USA
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University, St. Louis, MO 63110, USA
| | - Kiana Shahverdi
- Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Junwei Du
- Institute of Materials Science and Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Haiying Zhou
- Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Leland C Sudlow
- Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Daniel Hunter
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Matthew D Wood
- Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Mikhail Y Berezin
- Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA; Institute of Materials Science and Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA.
| | - Nikolay Gerasimchuk
- Department of Chemistry, Temple Hall 431, Missouri State University, 901 S. National, Springfield, MO 65897, USA.
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Chiarante N, Duhalde Vega M, Valli F, Zotta E, Daghero H, Basika T, Bollati-Fogolin M, García Vior MC, Marino J, Roguin LP. In Vivo Photodynamic Therapy With a Lipophilic Zinc(II) Phthalocyanine Inhibits Colorectal Cancer and Induces a Th1/CD8 Antitumor Immune Response. Lasers Surg Med 2020; 53:344-358. [PMID: 32525252 DOI: 10.1002/lsm.23284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVES Photodynamic therapy (PDT) is an antitumor procedure clinically approved for the treatment of different cancer types. Despite strong efforts and promising results in this field, PDT has not yet been approved by any regulatory authority for the treatment of colorectal cancer, one of the most prevalent gastrointestinal tumors. In the search of novel therapeutic strategies, we examined the in vivo effect of PDT with a lipophilic phthalocyanine (Pc9) encapsulated into polymeric poloxamine micelles (T1107) in a murine colon carcinoma model. STUDY DESIGN/MATERIALS AND METHODS In vivo assays were performed with BALB/c mice challenged with CT26 cells. Pc9 tumor uptake was evaluated with an in vivo imaging system. Immunofluorescence, western blot, and flow cytometry assays were carried out to characterize the activation of apoptosis and an antitumor immune response. RESULTS Pc9-T1107 effectively delayed tumor growth and prolonged mice survival, without generating systemic or tissue-specific toxicity. The induction of an apoptotic response was characterized by a decrease in the expression levels of Bcl-XL , Bcl-2, procaspase 3, full length Bid, a significant increment in the amount of active caspase-3 and the detection of PARP-1 cleavage. Infiltration of CD8+ CD107a+ T cells and higher levels of interferon-γ and tumor necrosis factor-α were also found in PDT-treated tumors. CONCLUSIONS Pc9-T1107 PDT treatment reduced tumor growth, inducing an apoptotic cell death and activating an immune response. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Nicolás Chiarante
- Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, Buenos Aires, C1113AAD, Argentina
| | - Maite Duhalde Vega
- Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, Buenos Aires, C1113AAD, Argentina
| | - Federico Valli
- Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, Buenos Aires, C1113AAD, Argentina
| | - Elsa Zotta
- Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Fisiología y Biofísica Bernardo Houssay (IFIBIO), Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Buenos Aires, C1113AAD, Argentina
| | - Hellen Daghero
- Cell Biology Unit, Institut Pasteur de Montevideo, Mataojo 2020, Montevideo, 11400, Uruguay
| | - Tatiana Basika
- Cell Biology Unit, Institut Pasteur de Montevideo, Mataojo 2020, Montevideo, 11400, Uruguay
| | | | - María C García Vior
- Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, Buenos Aires, C1113AAD, Argentina
| | - Julieta Marino
- Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, Buenos Aires, C1113AAD, Argentina
| | - Leonor P Roguin
- Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Química y Fisicoquímica Biológicas (IQUIFIB), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, Buenos Aires, C1113AAD, Argentina
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34
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Lund M, Nadarevic T, Bjerre TA, Grønbaek H, Mortensen F, Kragh Andersen P. Contrast-enhanced ultrasound compared with computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography for diagnosing liver metastases in people with newly diagnosed colorectal cancer. Hippokratia 2020. [DOI: 10.1002/14651858.cd012388.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Martin Lund
- Department of Radiology; Randers Regional Hospital; Randers Denmark
| | - Tin Nadarevic
- Department of Radiology; Clinical Hospital Centre Rijeka; Rijeka Croatia
| | | | - Henning Grønbaek
- Medical Department V; Aarhus University Hospital; Aarhus Denmark
| | - Frank Mortensen
- Department of Surgery L; Aarhus University Hospital; Aarhus Denmark
| | - Per Kragh Andersen
- Department of Biostatistics; University of Copenhagen, Faculty of Health Sciences, Institute of Public Health; Copenhagen K Denmark
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Effect of Chemotherapy on Fatty Liver Occurrence in Breast and Gastrointestinal Cancer Patients: A Case-Controlled Study. HEPATITIS MONTHLY 2020. [DOI: 10.5812/hepatmon.97986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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36
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Navaei Shoorvarzi S, Shahraki F, Shafaei N, Karimi E, Oskoueian E. Citrus aurantium L. bloom essential oil nanoemulsion: Synthesis, characterization, cytotoxicity, and its potential health impacts on mice. J Food Biochem 2020; 44:e13181. [PMID: 32173879 DOI: 10.1111/jfbc.13181] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 01/13/2020] [Accepted: 02/05/2020] [Indexed: 12/23/2022]
Abstract
This research was performed to synthesize the Citrus aurantium L. bloom essential oil nanoemulsion (CABE-NE) and investigate its cytotoxic and apoptotic impacts on human lung (A549 cells), and further, the effects of CABE-NE on mice health parameters was determined. The obtained results demonstrated that C. aurantium bloom contained 1.2 ± 0.16% of essential oil with linalyl acetate, limonene, and α-terpineol as major compounds. The CABE-NE possessed particle size of 76.9 ± 6.11 nm, PDI of 0.19, and zeta potential of -43.5 mV. The CABE-NE indicated the cytotoxicity against A549 cells with the IC50 value of 152 µg/ml. The CABE-NE induced the overexpression of Cas-3 and triggered the apoptotic cells death. The mice gavaged daily with CABE-NE at the concentrations of 10 and 20 mg/kg body weight for 30 days did not show any remarkable histopathological alteration in the liver and kidney while exhibited enhancement in the jejunum morpho-structural architecture and hepatic antioxidant redox potential. PRACTICAL APPLICATIONS: According to the results, the produced CABE-NE drug delivery system could be considered as a promising alternative to prevent lung cancer progression and it provides a new way to enhance the therapeutic value of the plant phytochemicals.
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Affiliation(s)
| | - Farzaneh Shahraki
- Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Negin Shafaei
- Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Ehsan Karimi
- Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Ehsan Oskoueian
- Mashhad Branch, Agricultural Biotechnology Research Institute of Iran (ABRII), Agricultural Research, Education, and Extension Organization (AREEO), Mashhad, Iran
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Javanshir A, Karimi E, Maragheh AD, Tabrizi MH. The antioxidant and anticancer potential of Ricinus communis L. essential oil nanoemulsions. JOURNAL OF FOOD MEASUREMENT AND CHARACTERIZATION 2020. [DOI: 10.1007/s11694-020-00385-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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38
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Herath NI, Berthault N, Thierry S, Jdey W, Lienafa MC, Bono F, Noguiez-Hellin P, Sun JS, Dutreix M. Preclinical Studies Comparing Efficacy and Toxicity of DNA Repair Inhibitors, Olaparib, and AsiDNA, in the Treatment of Carboplatin-Resistant Tumors. Front Oncol 2019; 9:1097. [PMID: 31781480 PMCID: PMC6861330 DOI: 10.3389/fonc.2019.01097] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/07/2019] [Indexed: 01/12/2023] Open
Abstract
Purpose: Carboplatin is used to treat many cancers, but occurrence of drug resistance and its high toxicity remain a clinical hurdle limiting its efficacy. We compared the efficacy and toxicity of DNA repair inhibitors olaparib or AsiDNA administered alone or in combination with carboplatin. Olaparib acts by inhibiting PARP-dependent repair pathways whereas AsiDNA inhibits double-strand break repair by preventing recruitment of enzymes involved in homologous recombination and non-homologous end joining. Experimental Design: Mice with MDA-MB-231 tumors were treated with carboplatin or/and olaparib or AsiDNA for three treatment cycles. Survival and tumor growth were monitored. Toxicities of treatments were assayed in C57BL/6 immunocompetent mice. Circulating blood hematocrits, bone marrow cells, and organs were analyzed 10 and 21 days after end of treatment using flow cytometry and microscopy analysis. Resistance occurrence was monitored after cycles of treatments with combination of AsiDNA and carboplatin in independent BC227 cell cultures. Results: Olaparib or AsiDNA monotherapies decreased tumor growth and increased mean survival of grafted animals. The combination with carboplatin further increased survival. Carboplatin toxicity resulted in a decrease of most blood cells, platelets, thymus, and spleen lymphocytes. Olaparib or AsiDNA monotherapies had no toxicity, and their combination with carboplatin did not increase toxicity in the bone marrow or thrombocytopenia. All animals receiving carboplatin combined with olaparib developed high liver toxicity with acute hepatitis at 21 days. In vitro, carboplatin resistance occurs after three cycles of treatment in all six tested cultures, whereas only one became resistant (1/5) after five cycles when carboplatin was associated to low doses of AsiDNA. All selected carboplatin-resistant clones retain sensitivity to AsiDNA. Conclusion: DNA repair inhibitor treatments are efficient in the platinum resistant model, MDA-MB-231. The combination with carboplatin improves survival. The association of carboplatin with olaparib is associated with high liver toxicity, which is not observed with AsiDNA. AsiDNA could delay resistance to carboplatin without increasing its toxicity.
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Affiliation(s)
- Nirmitha I Herath
- Institut Curie, PSL Research University, CNRS, INSERM, UMR 3347, Orsay, France.,Université Paris-Sud, Université Paris-Saclay, CNRS, INSERM, UMR 3347, Orsay, France.,DNA Therapeutics, Evry, France.,Onxeo, Paris, France
| | - Nathalie Berthault
- Institut Curie, PSL Research University, CNRS, INSERM, UMR 3347, Orsay, France.,Université Paris-Sud, Université Paris-Saclay, CNRS, INSERM, UMR 3347, Orsay, France
| | - Sylvain Thierry
- Institut Curie, PSL Research University, CNRS, INSERM, UMR 3347, Orsay, France.,Université Paris-Sud, Université Paris-Saclay, CNRS, INSERM, UMR 3347, Orsay, France
| | - Wael Jdey
- Institut Curie, PSL Research University, CNRS, INSERM, UMR 3347, Orsay, France.,Université Paris-Sud, Université Paris-Saclay, CNRS, INSERM, UMR 3347, Orsay, France.,DNA Therapeutics, Evry, France.,Onxeo, Paris, France
| | | | | | | | | | - Marie Dutreix
- Institut Curie, PSL Research University, CNRS, INSERM, UMR 3347, Orsay, France.,Université Paris-Sud, Université Paris-Saclay, CNRS, INSERM, UMR 3347, Orsay, France
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Kang MK, Lee HJ, Choi JH. Imatinib-induced hepatitis treated by corticosteroids in a patient with metastatic gastrointestinal stromal tumor. Yeungnam Univ J Med 2019; 36:155-158. [PMID: 31620629 PMCID: PMC6784631 DOI: 10.12701/yujm.2019.00115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/14/2019] [Accepted: 01/16/2019] [Indexed: 11/04/2022] Open
Abstract
Imatinib mesylate is currently used as the first-line treatment for metastatic gastrointestinal stromal tumors (GISTs). Imatinib-induced hepatotoxicity in patients with GIST is very rare. Its features vary from subclinical elevation of serum aminotransferase to clinically apparent acute hepatitis, which is associated with immunologic reactions. Imatinib-induced hepatotoxicity with autoimmune-like features can be treated by the discontinuation of imatinib mesylate and the administration of oral steroids. Here, we report a case of late-onset imatinib-induced hepatitis with autoimmune-like features in a patient with metastatic GIST, which was improved by oral corticosteroids.
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Affiliation(s)
- Min Kyu Kang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Heon Ju Lee
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Joon Hyuk Choi
- Department of Pathology, Yeungnam University College of Medicine, Daegu, Korea
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De Clercq K, Xie F, De Wever O, Descamps B, Hoorens A, Vermeulen A, Ceelen W, Vervaet C. Preclinical evaluation of local prolonged release of paclitaxel from gelatin microspheres for the prevention of recurrence of peritoneal carcinomatosis in advanced ovarian cancer. Sci Rep 2019; 9:14881. [PMID: 31619730 PMCID: PMC6795903 DOI: 10.1038/s41598-019-51419-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 09/25/2019] [Indexed: 01/12/2023] Open
Abstract
Patients with advanced ovarian cancer develop recurrence despite initial treatment response to standard treatment of surgery and intravenous/intraperitoneal (IP) chemotherapy, partly due to a limited peritoneal exposure time of chemotherapeutics. Paclitaxel-loaded genipin-crosslinked gelatin microspheres (PTX-GP-MS) are evaluated for the treatment of microscopic peritoneal carcinomatosis and prevention of recurrent disease. The highest drug load (39.2 µg PTX/mg MS) was obtained by immersion of GP-MS in aqueous PTX nanosuspension (PTXnano-GP-MS) instead of ethanolic PTX solution (PTXEtOH-GP-MS). PTX release from PTX-GP-MS was prolonged. PTXnano-GP-MS displayed a more controlled release compared to a biphasic release from PTXEtOH-GP-MS. Anticancer efficacy of IP PTX-GP-MS (PTXEtOH-GP-MS, D = 7.5 mg PTX/kg; PTXnano-GP-MS D = 7.5 and 35 mg PTX/kg), IP nanoparticular albumin-bound PTX (D = 35 mg PTX/kg) and controls (0.9% NaCl, blank GP-MS) was evaluated in a microscopic peritoneal carcinomatosis xenograft mouse model. PTXnano-GP-MS showed superior anticancer efficacy with significant increased survival time, decreased peritoneal carcinomatosis index score and ascites incidence. However, prolonged PTX release over 14 days from PTXnano-GP-MS caused drug-related toxicity in 27% of high-dosed PTXnano-GP-MS-treated mice. Dose simulations for PTXnano-GP-MS demonstrated an optimal survival without drug-induced toxicity in a range of 7.5-15 mg PTX/kg. Low-dosed PTXnano-GP-MS can be a promising IP drug delivery system to prevent recurrent ovarian cancer.
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Affiliation(s)
- Kaat De Clercq
- Laboratory of Pharmaceutical Technology, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Feifan Xie
- Laboratory for Medical Biochemistry and Clinical Analysis, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium
| | - Olivier De Wever
- Laboratory of Experimental Cancer Research, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Benedicte Descamps
- Infinity (IBiTech-MEDISIP), Department of Electronics and Information Systems, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - An Vermeulen
- Department of Gastro-intestinal Surgery, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Wim Ceelen
- Department of Gastro-intestinal Surgery, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Chris Vervaet
- Laboratory of Pharmaceutical Technology, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium.
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Abstract
Chemotherapy-induced hepatopathy includes a wide variety of parenchymal and vascular hepatic changes on imaging, including diffuse or focal hepatopathies (i.e. hepatitis, steatosis, fibrosis, pseudocirrhosis, or sinusoidal obstruction). These changes can profoundly alter the hepatic parenchyma on imaging and result in both false negative and false-positive diagnoses of hepatic metastases and lead to errors in patient management strategies. It is therefore important for radiologists to have a comprehensive knowledge of the imaging patterns that may develop following chemotherapy. The purpose of this review is to explore the broad spectrum of hepatic parenchymal and vascular chemotherapy-induced changes on CT and MR imaging.
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42
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Tenório LP, Miranda MFO, Andrade MQ, Araujo MAN. Hepatic changes after treatment with oxaliplatin. Radiol Bras 2019; 52:343-344. [PMID: 31656355 PMCID: PMC6808605 DOI: 10.1590/0100-3984.2017.0173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Oliai C, Douek ML, Rhoane C, Bhutada A, Ge PS, Runyon BA, Wang X, Hurvitz SA. Clinical features of pseudocirrhosis in metastatic breast cancer. Breast Cancer Res Treat 2019; 177:409-417. [PMID: 31175499 PMCID: PMC6664810 DOI: 10.1007/s10549-019-05311-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 05/31/2019] [Indexed: 01/26/2023]
Abstract
PURPOSE Pseudocirrhosis has been demonstrated to mimic cirrhosis radiographically, but studies evaluating the pathophysiology and clinical features are lacking. To better understand the incidence, risk factors, clinical course, and etiology of pseudocirrhosis, we performed a retrospective analysis of consecutively treated patients with metastatic breast cancer (MBC). METHODS Of 374 patients treated for MBC from 2006 to 2012, 199 had imaging available for review. One radiologist evaluated computed tomography scans for evidence of pseudocirrhosis. Features of groups with and without pseudocirrhosis were compared by Kaplan-Meier product-limit survival estimates and log-rank tests. Wilcoxon Rank-Sum testing evaluated if patients more heavily treated were more likely to develop pseudocirrhosis. Univariate and multivariate Cox proportional hazard models investigated factors associated with mortality. RESULTS Pseudocirrhosis developed in 37 of 199 patients (19%). Of the patients with liver metastases, 55% developed pseudocirrhosis. Liver metastases were demonstrated in 100% of patients with pseudocirrhosis. Survival in the subset with liver metastases favored those without pseudocirrhosis, 189 versus 69 months (p = 0.01). The number of systemic regimens received were higher in patients with pseudocirrhosis (p = 0.01). Ascites was demonstrated in 68%, portal hypertension in 11%, and splenomegaly in 8% of patients with pseudocirrhosis. CONCLUSIONS Pseudocirrhosis does not occur in the absence of liver metastases, can manifest as hepatic decompensation, and appears to be associated with poorer survival amongst patients with hepatic metastases. Higher cumulative exposure to systemic therapy may be causative, instead of the previously held belief of pseudocirrhosis as an adverse effect of a particular systemic agent/class.
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Affiliation(s)
- Caspian Oliai
- Department of Medicine, Division of Hematology-Oncology, University of California, Los Angeles, 10945 Le Conte Ave, PVUB Suite 3360, Los Angeles, CA, 90095, USA
| | - Michael L Douek
- Department of Radiology, University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Caelainn Rhoane
- Department of Medicine, Division of Hematology-Oncology, University of California, Los Angeles, 10945 Le Conte Ave, PVUB Suite 3360, Los Angeles, CA, 90095, USA
| | - Abhishek Bhutada
- Department of Radiology, University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Phillip S Ge
- Department of Gastroenterology, Hepatology, and Nutrition, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1466, Houston, TX, 77004, USA
| | - Bruce A Runyon
- Department of Gastroenterology & Hepatology, University of New Mexico, Albuquerque, NM, 87106, USA
| | - Xiaoyan Wang
- Department of Biostatistics, UCLA, 911 Broxton Ave., 3rd Floor, Los Angeles, CA, 90095, USA
| | - Sara A Hurvitz
- Department of Medicine, Division of Hematology-Oncology, University of California, Los Angeles, 10945 Le Conte Ave, PVUB Suite 3360, Los Angeles, CA, 90095, USA.
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Zhou X, Ling K, Liu M, Zhang X, Ding J, Dong Y, Liang Z, Li J, Zhang J. Targeted Delivery of Cisplatin-Derived Nanoprecursors via a Biomimetic Yeast Microcapsule for Tumor Therapy by the Oral Route. Theranostics 2019; 9:6568-6586. [PMID: 31588236 PMCID: PMC6771252 DOI: 10.7150/thno.35353] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/20/2019] [Indexed: 02/07/2023] Open
Abstract
Targeted therapy via the patient-friendly oral route remains the holy grail of chemotherapy for cancer. Herein we report a yeast-derived platform for targeted oral delivery of cisplatin (CDDP) that is one of the most effective drugs for chemotherapy of various types of cancers. Methods: The optimal conditions were first established to fabricate yeast microcapsules (YCs) with desirable loading capability. Then, CDDP-derived precursor nanoparticles (PreCDDP) were prepared and packaged into YC to produce orally deliverable PreCDDP/YC. The physiochemical properties, in vitro drug release profiles, in vitro antitumor activity, oral targeting capability, in vivo pharmacokinetics, and in vivo efficacy of the YC-based biomimetic delivery system were examined. Results: YCs obtained under the optimized condition showed desirable loading efficiency for quantum dots that were used as a model nanocargo. In vitro experiments demonstrated rapid endocytosis and prolonged retention of YC in macrophages. By electrostatic force-mediated self-deposition, PreCDDP was efficiently loaded into YC. PreCDDP/YC showed potent cytotoxicity in different tumor cells, indicating that PreCDDP loaded in YC maintained its antitumor activity after intracellular release. As compared to CDDP and PreCDDP, orally administered PreCDDP/YC displayed significantly higher bioavailability. Post oral delivery, YC could accumulate in A549 human lung carcinoma xenografts in mice, achieving by monocyte/macrophage-mediated translocation via the lymphatic system. Through this targeting effect, orally administered PreCDDP/YC showed desirable efficacy in A549 xenograft-bearing mice, which was comparable to that of free CDDP administered by intravenous injection. Orally administered free CDDP, however, did not afford antitumor effects. Furthermore, oral treatment with PreCDDP/YC displayed better safety than free CDDP administered via the oral or intravenous route. Conclusions: This biomimetic approach can serve as an effective strategy to develop targeted oral chemotherapies based on CDDP or its derivatives.
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Affiliation(s)
- Xing Zhou
- Department of Pharmaceutics, College of Pharmacy, Third Military Medical University, Chongqing 400038, China
| | - Kaijian Ling
- Department of Obstetrics and Gynaecology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Mengyu Liu
- Department of Pharmaceutics, College of Pharmacy, Third Military Medical University, Chongqing 400038, China
| | - Xiangjun Zhang
- Department of Pharmaceutics, College of Pharmacy, Third Military Medical University, Chongqing 400038, China
| | - Jun Ding
- Department of Ultrasound, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Yan Dong
- Department of Oncology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Zhiqing Liang
- Department of Obstetrics and Gynaecology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Jianjun Li
- Department of Oncology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Jianxiang Zhang
- Department of Pharmaceutics, College of Pharmacy, Third Military Medical University, Chongqing 400038, China
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An imaging-based review of systemic therapies and associated toxicities in metastatic pancreatic cancer as per the 2018 ASCO guidelines: what every radiologist should know. Abdom Radiol (NY) 2019; 44:2182-2195. [PMID: 30820626 DOI: 10.1007/s00261-019-01954-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To provide an overview of what radiologists should know about systemic agents utilized in the modern treatment of metastatic pancreatic cancer and their associated toxicities. RESULTS The clinical landscape of metastatic pancreatic cancer has significantly evolved in recent years, with the advent of new first- and second-line systemic therapies. As these systemic treatment options continue to expand, knowledge of their clinically relevant features is becoming critical for radiologists. While the issues of surgical resectability and tumor response evaluation of advanced stages of pancreatic cancer have been thoroughly discussed in the radiology literature, the diagnostic importance of systemic therapies has tended to be less well appreciated. In this review, we provide a primer for radiologists outlining the radiologically pertinent features of modern systemic therapies used in the treatment of metastatic pancreatic ductal adenocarcinoma. These systemic agents are discussed from the standpoint of the newly updated 2018 ( https://doi.org/10.1007/s00261-019-01954-z ) guidelines for the treatment of metastatic pancreatic cancer from the American Society of Clinical Oncology (ASCO). Understanding the radiology relevance of these modern therapeutic agents is critical, especially with regard to treatment response and toxicity assessment. CONCLUSION Knowledge of the modern systemic therapies utilized in the treatment of metastatic pancreatic cancer and their associated toxicity profiles is critical in diagnostic imaging interpretation.
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Wang Q, Ye F, Ma P, Chen F, Che Y, Zhao X, Yang L. Quantitative magnetic resonance imaging evaluation of hepatic fat content with iron deposition: will it be disturbed? J Int Med Res 2019; 47:1958-1974. [PMID: 30859893 PMCID: PMC6567757 DOI: 10.1177/0300060519836033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Objective To explore noninvasive assessment of liver fat content with iron deposition using magnetic resonance (MR) quantitative technology. Methods A water–fat phantom with iron deposition containing 63 vials with predetermined fat percentages and iron concentrations was constructed. Thirty-three patients underwent fat quantitative MR examinations. The fat fraction (FF) was determined by three Dixon techniques. Pathological evaluation findings and the steatosis area rate (SAR) were used as the gold standards. Results FFIOP and FFLAVA-Flex significantly differed from FFTEST for iron concentrations of 1 to 30 µg/mL and fat components of 10% to 80%. Using the three Dixon techniques, FFIOP was 15.76% ± 6.98%, FFLAVA-Flex was 16.71% ± 6.77%, and FFIDEAL IQ was 13.18% ± 6.42% in patients without liver cirrhosis; these values in patients with liver cirrhosis were 20.35% ± 6.11%, 20.89% ± 8.49%, and 12.86% ± 4.00%, respectively. The SAR in patients without and with liver cirrhosis was 11.31% ± 5.89% and 9.84% ± 4.17%, respectively. There were significant positive correlations between FFIDEAL IQ and SAR with or without liver cirrhosis. Conclusion Iron deposition must be considered when using quantitative MR techniques to evaluate the hepatic fat content. Compared with the IOP and LAVA-Flex techniques, the IDEAL IQ technique has more stability and accuracy in measurement of the hepatic fat content, free from iron deposition.
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Affiliation(s)
- Qian Wang
- 1 Department of Radiology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, China.,2 Department of Imaging Diagnosis, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Ye
- 2 Department of Imaging Diagnosis, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Peiqing Ma
- 3 Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Chen
- 4 Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiqun Che
- 2 Department of Imaging Diagnosis, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinming Zhao
- 2 Department of Imaging Diagnosis, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Yang
- 1 Department of Radiology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, China
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Eskreis-Winkler S, Corrias G, Monti S, Zheng J, Capanu M, Krebs S, Fung M, Reeder S, Mannelli L. IDEAL-IQ in an oncologic population: meeting the challenge of concomitant liver fat and liver iron. Cancer Imaging 2018; 18:51. [PMID: 30541635 PMCID: PMC6292167 DOI: 10.1186/s40644-018-0167-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/14/2018] [Indexed: 12/14/2022] Open
Abstract
Background Cancer patients often have a history of chemotherapy, putting them at increased risk of liver toxicity and pancytopenia, leading to elevated liver fat and elevated liver iron respectively. T1-in-and-out-of-phase, the conventional MR technique for liver fat assessment, fails to detect elevated liver fat in the presence of concomitantly elevated liver iron. IDEAL-IQ is a more recently introduced MR fat quantification method that corrects for multiple confounding factors, including elevated liver iron. Methods This retrospective study was approved by the institutional review board with a waiver for informed consent. We reviewed the MRI studies of 50 cancer patients (30 males, 20 females, 50–78 years old) whose exams included (1) T1-in-and-out-of-phase, (2) IDEAL-IQ, and (3) T2* mapping. Two readers independently assessed fat and iron content from conventional and IDEAL-IQ MR methods. Intraclass correlation coefficient (ICC) was estimated to evaluate agreement between conventional MRI and IDEAL-IQ in measuring R2* level (a surrogate for iron level), and in measuring fat level. Agreement between the two readers was also assessed. Wilcoxon signed rank test was employed to compare iron level and fat fraction between conventional MRI and IDEAL-IQ. Results Twenty percent of patients had both elevated liver iron and moderate/severe hepatic steatosis. Across all patients, there was high agreement between readers for IDEAL-IQ fat fraction (ICC = 0.957) and IDEAL R2* (ICC = 0.971) measurements, but lower agreement for conventional fat fraction measurements (ICC = 0.626). The fat fractions calculated with IOP were statistically significantly different from those calculated with IDEAL-IQ (reader 1: p < 0.001, reader 2: p < 0.001). Conclusion Fat measurements using IDEAL-IQ and IOP diverged in patients with concomitantly elevated liver fat and liver iron. Given prior work validating IDEAL-IQ, these diverging measurements indicate that IOP is inadequate to screen for hepatic steatosis in our cancer population.
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Affiliation(s)
- Sarah Eskreis-Winkler
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Giuseppe Corrias
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.,Department of Radiology, University of Cagliari, Via Università, 40, 09124, Cagliari, CA, Italy
| | | | - Junting Zheng
- Department of Statistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Marinela Capanu
- Department of Statistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Simone Krebs
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Maggie Fung
- Global MR Applications and Workflow, GE Healthcare, New York, NY, USA
| | - Scott Reeder
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Lorenzo Mannelli
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. .,, 300 East 66th Street, New York, NY, 10021, USA.
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Kuyooro SE, Akintunde JK, Okekearu FC, Maduagwu EN. Toxicokinetics and Biliary Excretion of N-Nitrosodiethylamine in Rat Supplemented with Low and High Dietary Proteins. J Diet Suppl 2018; 16:506-520. [PMID: 30513225 DOI: 10.1080/19390211.2018.1471561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although biliary excretion is one of the biological elimination processes for foreign compounds, intake of high-protein diets was hypothesized to enhance their detoxification rates. Hence, this study investigates the effect of differential dietary protein intake on toxicokinetics and biliary excretion in rats following exposure to N-nitrosodiethylamine (NDEA) and aflatoxin B1 (AFB1). The animals were divided into five groups. Groups I and II were exposed to low and high dietary proteins following a single intraperitoneal dose of 43 µg NDEA/kg body weight, respectively. Groups III and IV were equally treated after a combined single intraperitoneal dose of 43 µg NDEA plus 0.022µg AFBI/kg body weight, respectively. Group V was fed with low-protein diets following a single intraperitoneal dose of 0.022µg AFB1/kg body weight. The experiment lasted 35 days. The bile excreted higher amounts of unchanged NDEA than nitrite. The groups placed on high-protein diets (HPD = 64%) eliminated higher amounts of the unchanged NDEA and nitrite than the lower-protein diet (LPD = 8%) groups. Furthermore, the animals fed with high dietary protein (HPD = 64%) depicted short half-life with corresponding increase in elimination rate constant. The presence of AFB1 heightened the excretion of bound NDEA with AFB1 than NDEA only. Generally, this study advocates that N-nitrosodiethylamine and the corresponding metabolites follow hepatobiliary system potentiated by high intake of dietary proteins.
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Affiliation(s)
- S E Kuyooro
- Department of Chemical Sciences, Biochemistry unit, College of Natural and Applied Sciences, Bells University of Technology , Ota , Nigeria.,Nutritional Biochemistry Research Laboratory, Department of Biochemistry, College of Medicine, University of Ibadan , Ibadan , Nigeria
| | - J K Akintunde
- Applied Biochemistry and Molecular Toxicology Research Group, Department of Biochemistry College of Biological Sciences, Federal University of Agriculture , Abeokuta , Nigeria
| | - F C Okekearu
- Nutritional Biochemistry Research Laboratory, Department of Biochemistry, College of Medicine, University of Ibadan , Ibadan , Nigeria
| | - E N Maduagwu
- Nutritional Biochemistry Research Laboratory, Department of Biochemistry, College of Medicine, University of Ibadan , Ibadan , Nigeria
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Semicarbazide-sensitive amine oxidase activity levels in patients with acute lymphoblastic leukemia after cytotoxic chemotherapy. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2018. [DOI: 10.1016/j.bjbas.2018.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Bordbar M, Shakibazad N, Fattahi M, Haghpanah S, Honar N. Effect of ursodeoxycholic acid and vitamin E in the prevention of liver injury from methotrexate in pediatric leukemia. TURKISH JOURNAL OF GASTROENTEROLOGY 2018; 29:203-209. [PMID: 29749328 DOI: 10.5152/tjg.2018.17521] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND/AIMS Ursodeoxycholic acid (UDCA) and antioxidants such as vitamin E are considered to have a protective role in preventing chemotherapy-induced liver damage. The aim of this study was to assess the efficacy of these agents for hepatoprotection in pediatric patients with B-cell acute lymphoblastic leukemia (ALL), who were treated with methotrexate in their maintenance phase of treatment. MATERIALS AND METHODS Eighty children with B-cell ALL were randomly divided into four groups. Group 1 was administered oral vitamin E (400 mg/day); group 2 was administered oral UDCA (15 mg/kg/day); group 3 was administered a combination of the two drugs; and group 4 served as a control group and was administered no drug except their chemotherapy drugs. Complete blood count, liver function test, liver ultrasonography, and liver fibroscan were requested, and the results were compared. RESULTS Group 1 showed a slight increase in total bilirubin levels compared to baseline levels during the study (P=0.036). Group 2 showed a decline in aspartate aminotransferase and alanine aminotransferase levels during the study and at 6 months after discontinuing the drug; however, these differences were not statistically significant (P=0.051 and 0.083, respectively). None of the patients showed the evidence of significant fibrosis on liver fibroscan. Eight patients showed some evidence of mild-to-moderate fibrosis (F1, F2), but the results were not different between the groups as well as between pre- and post-study periods in each group. CONCLUSION Low-dose methotrexate does not cause significant liver fibrosis in pediatric leukemia. UDCA and vitamin E have minimal roles in hepatoprotection among pediatric patients with ALL.
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Affiliation(s)
| | - Nader Shakibazad
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammadreza Fattahi
- Gastroenterology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naser Honar
- Department of Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran
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