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Peri AM, Rafiei N, O'Callaghan K, Brischetto A, Graves B, Sinclair H, Eustace M, Lim K, Parkes-Smith J, Stewart A, Davidson N, Tabah A, Bergh H, Chatfield MD, Harris PNA, Paterson DL. Host response signature trends in persistent bacteraemia and metastatic infection due to Staphylococcus aureus and Gram-negative bacilli: a prospective multicentre observational study. Infect Dis (Lond) 2024; 56:268-276. [PMID: 38093600 DOI: 10.1080/23744235.2023.2294122] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/06/2023] [Indexed: 03/16/2024] Open
Abstract
BACKGROUND A prompt diagnosis of bacteraemia and sepsis is essential. Markers to predict the risk of persistent bacteraemia and metastatic infection are lacking. SeptiCyte RAPID is a host response assay stratifying patients according to the risk of infectious vs sterile inflammation through a scoring system (SeptiScore). In this study we explore the association between SeptiScore and persistent bacteraemia as well as metastatic and persistent infection in the context of a proven bacteraemia episode. METHODS This is a prospective multicentre observational 14-month study on patients with proven bacteraemia caused by Staphylococcus aureus or Gram-negative bacilli. Samples for assessment by SeptiCyte were collected with paired blood cultures for 4 consecutive days after the index blood culture. RESULTS We included 86 patients in the study, 40 with S. aureus and 46 with Gram-negative bacilli bacteraemia. SeptiScores over the follow-up were higher in patients with Gram-negative compared to S. aureus bacteraemia (median 6.4, IQR 5.5-7.4 vs 5.6 IQR 5.1-6.2, p = 0.002). Higher SeptiScores were found to be associated with positive blood cultures at follow-up (AUC = 0.86, 95%CI 0.68-1.00) and with a diagnosis of metastatic infection at day 1 and 2 of follow-up (AUC = 0.79, 95%CI 0.57-1.00 and AUC = 0.82, 95%CI 0.63-1.00 respectively) in the context of Gram-negative bacteraemia while no association between SeptiScore and the outcomes of interest was observed in S. aureus bacteraemia. Mixed models confirmed the association of SeptiScore with positive blood cultures at follow-up (p = 0.04) and metastatic infection (p = 0.03) in the context of Gram-negative bacteraemia but not S. aureus bacteraemia after adjusting for confounders. CONCLUSIONS SeptiScores differ in the follow-up of S. aureus and Gram-negative bacteraemia. In the setting of Gram-negative bacteraemia SeptiScore demonstrated a good negative predictive value for the outcomes of interest and might help rule out the persistence of infection defined as metastatic spread, lack of source control or persistent bacteraemia.
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Affiliation(s)
- Anna Maria Peri
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, Queensland, Australia
| | - Nastaran Rafiei
- Infectious Diseases Unit, Caboolture Hospital, Caboolture, Queensland, Australia
| | - Kevin O'Callaghan
- Infectious Diseases Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Anna Brischetto
- Infectious Diseases Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Bianca Graves
- Herston Infectious Diseases Institute, Herston, Brisbane, Queensland, Australia
| | - Holly Sinclair
- Infectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Matthew Eustace
- Infectious Diseases Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Karen Lim
- Infectious Diseases Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Jill Parkes-Smith
- Infectious Diseases Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Adam Stewart
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, Queensland, Australia
- Central Microbiology, Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Natalie Davidson
- Infectious Diseases Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Alexis Tabah
- Intensive Care Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Haakon Bergh
- Central Microbiology, Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Mark D Chatfield
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, Queensland, Australia
| | - Patrick N A Harris
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, Queensland, Australia
- Herston Infectious Diseases Institute, Herston, Brisbane, Queensland, Australia
- Central Microbiology, Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - David L Paterson
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, Queensland, Australia
- Infectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- ADVANCE-ID, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Infectious Diseases Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Peri AM, O’Callaghan K, Rafiei N, Graves B, Sinclair H, Brischetto A, Lim K, Parkes-Smith J, Eustace M, Davidson N, Tabah A, Stewart A, Chatfield MD, Harris PNA, Paterson DL. Persistence of Detectable Pathogens by Culture-Independent Systems (T2 Magnetic Resonance) in Patients With Bloodstream Infection: Prognostic Role and Possible Clinical Implications. Clin Infect Dis 2024; 78:283-291. [PMID: 37890109 PMCID: PMC10874273 DOI: 10.1093/cid/ciad663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/13/2023] [Accepted: 10/25/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Persistent Staphylococcus aureus bacteremia is associated with metastatic infection and adverse outcomes, whereas gram-negative bacteremia is normally transient and shorter course therapy is increasingly advocated for affected patients. Whether the prolonged detection of pathogen DNA in blood by culture-independent systems could have prognostic value and guide management decisions is unknown. METHODS We performed a multicenter, prospective, observational study on 102 patients with bloodstream infection (BSI) to compare time to bloodstream clearance according to T2 magnetic resonance and blood cultures over a 4-day follow-up. We also explored the association between duration of detectable pathogens according to T2 magnetic resonance (magnetic resonance-DNAemia [MR-DNAemia]) and clinical outcomes. RESULTS Time to bloodstream clearance according to T2 magnetic resonance was significantly longer than blood culture clearance (HR, .54; 95% CI, .39-.75) and did not differ according to the causative pathogen (P = .5). Each additional day of MR-DNAemia increased the odds of persistent infection (defined as metastatic infection or delayed source control) both in the overall population (OR, 1.98; 95% CI, 1.45-2.70) and in S. aureus (OR, 1.92; 95% CI, 1.12-3.29) and gram-negative bacteremia (OR, 2.21; 95% CI, 1.35-3.60). MR-DNAemia duration was also associated with no improvement in Sequential Organ Failure Assessment score at day 7 from infection onset (OR, 1.76; 95% CI, 1.21-2.56). CONCLUSIONS T2 magnetic resonance may help diagnose BSI in patients on antimicrobials with negative blood cultures as well as to identify patients with metastatic infection, source control failure, or adverse short-term outcome. Future studies may inform its usefulness within the setting of antimicrobial stewardship programs.
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Affiliation(s)
- Anna Maria Peri
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Kevin O’Callaghan
- Infectious Diseases Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Nastaran Rafiei
- Infectious Diseases Unit, Caboolture Hospital, Caboolture, Queensland, Australia
| | - Bianca Graves
- Herston Infectious Diseases Institute, Herston, Brisbane, Queensland, Australia
| | - Holly Sinclair
- Infectious Diseases Unit, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
| | - Anna Brischetto
- Infectious Diseases Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Karen Lim
- Infectious Diseases Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Jill Parkes-Smith
- Infectious Diseases Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Matthew Eustace
- Infectious Diseases Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Natalie Davidson
- Infectious Diseases Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Alexis Tabah
- Intensive Care Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Adam Stewart
- Central Microbiology, Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Mark D Chatfield
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Patrick N A Harris
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
- Herston Infectious Diseases Institute, Herston, Brisbane, Queensland, Australia
- Central Microbiology, Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - David L Paterson
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
- Infectious Diseases Unit, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
- ADVANCE-ID, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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3
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Keleher E, Iftikhar H, Schulz LF, McCanny P, Austin D, Stewart A, O'Regan W, Hallbäck M, Wallin M, Aneman A. Capnodynamic monitoring of lung volume and pulmonary blood flow during alveolar recruitment: a prospective observational study in postoperative cardiac patients. J Clin Monit Comput 2023; 37:1463-1472. [PMID: 37243954 DOI: 10.1007/s10877-023-01033-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/08/2023] [Indexed: 05/29/2023]
Abstract
Alveolar recruitment manoeuvres may mitigate ventilation and perfusion mismatch after cardiac surgery. Monitoring the efficacy of recruitment manoeuvres should provide concurrent information on pulmonary and cardiac changes. This study in postoperative cardiac patients applied capnodynamic monitoring of changes in end-expiratory lung volume and effective pulmonary blood flow. Alveolar recruitment was performed by incremental increases in positive end-expiratory pressure (PEEP) to a maximum of 15 cmH2O from a baseline of 5 cmH2O over 30 min. The change in systemic oxygen delivery index after the recruitment manoeuvre was used to identify responders (> 10% increase) with all other changes (≤ 10%) denoting non-responders. Mixed factor ANOVA using Bonferroni correction for multiple comparisons was used to denote significant changes (p < 0.05) reported as mean differences and 95% CI. Changes in end-expiratory lung volume and effective pulmonary blood flow were correlated using Pearson's regression. Twenty-seven (42%) of 64 patients were responders increasing oxygen delivery index by 172 (95% CI 61-2984) mL min-1 m-2 (p < 0.001). End-expiratory lung volume increased by 549 (95% CI 220-1116) mL (p = 0.042) in responders associated with an increase in effective pulmonary blood flow of 1140 (95% CI 435-2146) mL min-1 (p = 0.012) compared to non-responders. A positive correlation (r = 0.79, 95% CI 0.5-0.90, p < 0.001) between increased end-expiratory lung volume and effective pulmonary blood flow was only observed in responders. Changes in oxygen delivery index after lung recruitment were correlated to changes in end-expiratory lung volume (r = 0.39, 95% CI 0.16-0.59, p = 0.002) and effective pulmonary blood flow (r = 0.60, 95% CI 0.41-0.74, p < 0.001). Capnodynamic monitoring of end-expiratory lung volume and effective pulmonary blood flow early in postoperative cardiac patients identified a characteristic parallel increase in both lung volume and perfusion after the recruitment manoeuvre in patients with a significant increase in oxygen delivery.Trial registration This study was registered on ClinicalTrials.gov (NCT05082168, 18th of October 2021).
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Affiliation(s)
- E Keleher
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - H Iftikhar
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - L F Schulz
- Intensive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - P McCanny
- Intensive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - D Austin
- Intensive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - A Stewart
- Intensive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - W O'Regan
- Intensive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, Sydney, NSW, Australia
| | | | - M Wallin
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - A Aneman
- Intensive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, Sydney, NSW, Australia.
- Southwestern Clinical School, University of New South Wales, Sydney, NSW, Australia.
- Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.
- Intensive Care Unit, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia.
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Lau R, Yu L, Roumeliotis TI, Stewart A, Pickard L, Riisanes R, Gurel B, de Bono JS, Choudhary JS, Banerji U. Unbiased differential proteomic profiling between cancer-associated fibroblasts and cancer cell lines. J Proteomics 2023; 288:104973. [PMID: 37481068 DOI: 10.1016/j.jprot.2023.104973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/03/2023] [Accepted: 07/04/2023] [Indexed: 07/24/2023]
Abstract
Cancer-associated fibroblasts (CAFs) are a key component of tumors. We aimed to profile the proteome of cancer cell lines representing three common cancer types (lung, colorectal and pancreatic) and a representative CAF cell line from each tumor type to gain insight into CAF function and novel CAF biomarkers. We used isobaric labeling, liquid chromatography and mass spectrometry to evaluate the proteome of 9 cancer and 3 CAF cell lines. Of the 9460 proteins evaluated, functional enrichment analysis revealed an upregulation of N-glycan biosynthesis and extracellular matrix proteins in CAFs. 85 proteins had 16-fold higher expression in CAFs compared to cancer cells, including previously known CAF markers like fibroblast activation protein (FAP). Novel overexpressed CAF biomarkers included heat shock protein β-6 (HSPB6/HSP20) and cyclooxygenase 1 (PTGS1/COX1). SiRNA knockdown of the genes encoding these proteins did not reduce contractility in lung CAFs, suggesting they were not crucial to this function. Immunohistochemical analysis of 30 tumor samples (10 lung, 10 colorectal and 10 pancreatic) showed restricted HSPB6 and PTGS1 expression in the stroma. Therefore, we describe an unbiased differential proteome analysis of CAFs compared to cancer cells, which revealed higher expression of HSPB6 and PTGS1 in CAFs. Data are available via ProteomeXchange (PXD040360). SIGNIFICANCE: Cancer-associated fibroblasts (CAFs) are highly abundant stromal cells present in tumors. CAFs are known to influence tumor progression and drug resistance. Characterizing the proteome of CAFs could give potential insights into new stromal drug targets and biomarkers. Mass spectrometry-based analysis comparing proteomic profiles of CAFs and cancers characterized 9460 proteins of which 85 proteins had 16-fold higher expression in CAFs compared to cancer cells. Further interrogation of this rich resource could provide insight into the function of CAFs and could reveal putative stromal targets. We describe for the first time that heat shock protein β-6 (HSPB6/HSP20) and cyclooxygenase 1 (PTGS1/COX1) are overexpressed in CAFs compared to cancer cells.
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Affiliation(s)
- Rachel Lau
- Clinical Pharmacology and Adaptive Therapy Group, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 15 Cotswold Road, London SM2 5NG, United Kingdom.
| | - Lu Yu
- Functional Proteomics group, Chester Beatty Laboratories, The Institute of Cancer Research, 237 Fulham Road, London SW3 6JB, United Kingdom
| | - Theodoros I Roumeliotis
- Functional Proteomics group, Chester Beatty Laboratories, The Institute of Cancer Research, 237 Fulham Road, London SW3 6JB, United Kingdom
| | - Adam Stewart
- Clinical Pharmacology and Adaptive Therapy Group, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 15 Cotswold Road, London SM2 5NG, United Kingdom
| | - Lisa Pickard
- Clinical Pharmacology and Adaptive Therapy Group, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 15 Cotswold Road, London SM2 5NG, United Kingdom
| | - Ruth Riisanes
- Cancer Biomarkers Group, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 15 Cotswold Road, London SM2 5NG, United Kingdom
| | - Bora Gurel
- Cancer Biomarkers Group, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 15 Cotswold Road, London SM2 5NG, United Kingdom
| | - Johann S de Bono
- Cancer Biomarkers Group, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 15 Cotswold Road, London SM2 5NG, United Kingdom
| | - Jyoti S Choudhary
- Functional Proteomics group, Chester Beatty Laboratories, The Institute of Cancer Research, 237 Fulham Road, London SW3 6JB, United Kingdom.
| | - Udai Banerji
- Clinical Pharmacology and Adaptive Therapy Group, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 15 Cotswold Road, London SM2 5NG, United Kingdom.
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5
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Divithotewala C, Sweeney EL, Burke A, Graves B, Stewart A, Whiley D, Heney C, Hopkins PM, Chambers DC. Mycoplasma hominis and Ureaplasma urealyticum infections in the immediate post-lung transplant period: A case series and literature review. Transpl Infect Dis 2023:e14058. [PMID: 36974436 DOI: 10.1111/tid.14058] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/19/2023] [Accepted: 03/09/2023] [Indexed: 03/29/2023]
Abstract
Mycoplasma hominis and Ureaplasma species infections in the post-transplant setting are believed to be donor-derived and can be associated with poor outcomes. Difficulty in culturing and identifying these organisms is a significant barrier to diagnosis and early intervention. Tetracyclines, macrolides and fluoroquinolones are the mainstay treatments to cure these infections; however, there are increasing reports of antibiotic resistance. In this case series, we report our single-centre experience with M. hominis and U. urealyticum infection after lung transplantation (9 recipients, all men, mean age 56 years). Delayed diagnosis was common. Young donor age (mean age 23 yrs) and high-risk donor social history (67%) were repeatedly noted in these cases, and all infections were associated with significant morbidity (anastomosis and sternal wound infection, empyema, mediastinitis, pericarditis). Two patients died; with one directly related to Ureaplasma urealyticum infection. In conclusion post lung transplant M. hominis, and U. urealyticum infections are challenging and carry high morbidity. More prospective studies are required to assess the true prevalence, full spectrum of complications and utility of molecular diagnostics to aid early diagnosis and identify antibiotic susceptibility of Mycoplasma and Ureaplasma infections in the post-lung transplant setting.
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Affiliation(s)
| | - Emma L Sweeney
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Andrew Burke
- Queensland Lung Transplant Service, The Prince Charles Hospital, Brisbane, Australia
| | - Bianca Graves
- Central Microbiology Laboratory, Pathology Queensland, Brisbane, Australia
| | - Adam Stewart
- Central Microbiology Laboratory, Pathology Queensland, Brisbane, Australia
| | - David Whiley
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Claire Heney
- Central Microbiology Laboratory, Pathology Queensland, Brisbane, Australia
| | - Peter M Hopkins
- Queensland Lung Transplant Service, The Prince Charles Hospital, Brisbane, Australia
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Daniel C Chambers
- Queensland Lung Transplant Service, The Prince Charles Hospital, Brisbane, Australia
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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6
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Stewart A, Schlebusch S, Vlack S, McMahon J, Sullivan M, Pyke A, Hajkowicz K. First case of mpox diagnosed in Queensland, Australia: clinical and molecular aspects. Med J Aust 2023; 218:157-159. [PMID: 36739109 DOI: 10.5694/mja2.51842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 02/06/2023]
Affiliation(s)
- Adam Stewart
- Centre for Clinical Research, University of Queensland, Brisbane, QLD.,Pathology Queensland, Brisbane, QLD
| | - Sanmarie Schlebusch
- Centre for Clinical Research, University of Queensland, Brisbane, QLD.,Queensland Public Health and Infectious Diseases Reference Genomics, Public and Environmental Health, Forensic and Scientific Services, Queensland, Health Brisbane, QLD
| | - Susan Vlack
- Metro North Hospital and Health Service, Brisbane, QLD.,University of Queensland, Brisbane, QLD
| | - Jamie McMahon
- Queensland Public Health and Infectious Diseases Reference Genomics, Public and Environmental Health, Forensic and Scientific Services, Queensland, Health Brisbane, QLD
| | - Mitchell Sullivan
- Queensland Public Health and Infectious Diseases Reference Genomics, Public and Environmental Health, Forensic and Scientific Services, Queensland, Health Brisbane, QLD
| | - Alyssa Pyke
- Queensland Public Health and Infectious Diseases Reference Genomics, Public and Environmental Health, Forensic and Scientific Services, Queensland, Health Brisbane, QLD
| | - Krispin Hajkowicz
- Centre for Clinical Research, University of Queensland, Brisbane, QLD.,Royal Brisbane and Women's Hospital, Brisbane, QLD
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7
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Sun Myint A, Dhadda A, Stewart A, Mills J, Sripadam R, Rao C, Hunter A, Hershman M, Franklin A, Chadwick E, Banerjee A, Rockall T, Pritchard D, Gerard J. The Role of Contact X-Ray Brachytherapy in Early Rectal Cancer – Who, when and How? Clin Oncol (R Coll Radiol) 2022. [DOI: 10.1016/j.clon.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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8
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Ingles Russo Garces A, Milite S, Oliveira E, Fernandez-Mateos J, Chen B, Pickard L, Stewart A, Lau R, De Haven Brandon A, Paranjape E, Sottoriva A, Banerjee S, Banerji U. 1697P Drug-induced evolutionary dynamics in BRCA-mutant/non-mutant ovarian cancer models. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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9
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Heeke S, Gay C, Estecio M, Stewart A, Tran H, Zhang B, Tang X, Raso M, Concannon K, De Sousa LG, Lewis W, Kondo K, Nilsson M, Xi Y, Diao L, Wang Q, Zhang J, Wang J, Wistuba I, Byers L, Heymach J. MA01.03 Exploiting DNA Methylation for Classification of SCLC Subtypes from Liquid Biopsies Using a Robust Machine Learning Approach. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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10
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Lau R, Yu L, Roumeliotis T, Pickard L, Stewart A, Choudhary J, Banerji U. Abstract 3187: Understanding the role of cancer-associated fibroblasts (CAFs) on pathogenesis of KRAS mutated cancers by defining differences in the basal state proteome and secretome. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: KRAS is commonly mutated in solid tumors. Cancer-associated fibroblasts (CAFs) are a key tumor stroma component, which can affect cancer progression and drug response. We hypothesized that defining the differential secreted proteins between CAFs and KRAS mutant-cancer cells could reveal potential mechanisms by which CAFs influence cancer progression and drug resistance.
Methods: We studied 12 cell lines: 3 KRAS mutant-colorectal cancer cell lines (H747, LIM2099 and SW620), 3 KRAS mutant-lung cancer cell lines (H1792, H2030 and H23), 3 KRAS mutant-pancreatic cancer cell lines (CAPAN1, DANG, MIAPACA2) and 3 CAF cell line models (colorectal and lung CAF and pancreatic stellate cells). We quantified proteins in cell lines and serum-free media after 24 hour incubation in cells using mass spectrometry in a multiplexed manner (12plex) in triplicates to characterize the proteome and the profile of secreted proteins (secretome), respectively. Prediction software (signalP, secretomeP, TMHMM) and databases (surfaceome and cell surface protein atlas) were used to annotate secreted or transmembrane proteins.
Results: Our proteome analysis quantified 9307 proteins. T-test between the cell types (CAF vs cancer) identified 1770 differentially expressed proteins, where 712 proteins were CAF-enriched. This included known CAF markers (e.g α smooth muscle actin) but also proteins not known to be CAF markers such as heat shock protein beta-5/6 (HSPB5/6). The secretome analysis identified 2330 secreted or transmembrane proteins where 202 were differentially expressed between cancer cells and CAFs. 190 proteins were CAF-enriched with the highest ranking being syndecan-2 (SDC2), collagen α-28(I) chain (COL28A1), decorin (DCN) and wnt family member 5B (WNT5B). Interestingly, basal proteome analysis of KRAS mutant-cancer cells showed expression of receptors corresponding to the CAF-enriched ligands, such as receptor tyrosine kinase-like orphan receptor 1/2 (ROR1/2) which respond to WNT5B. This suggests that CAF-enriched ligands may activate certain downstream pathways, including non-canonical WNT signaling, in KRAS mutant-cancer cells.
Conclusion: We undertook deep quantitative proteomics where we identified potential novel CAF markers HSPB5/6. We have also found proteins in the CAF secretome, such as WNT5B, which may drive drug resistance in KRAS mutant-cancer cells.
Citation Format: Rachel Lau, Lu Yu, Theodoros Roumeliotis, Lisa Pickard, Adam Stewart, Jyoti Choudhary, Udai Banerji. Understanding the role of cancer-associated fibroblasts (CAFs) on pathogenesis of KRAS mutated cancers by defining differences in the basal state proteome and secretome [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3187.
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Affiliation(s)
- Rachel Lau
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Lu Yu
- 2The Institute of Cancer Research, Chelsea, United Kingdom
| | | | - Lisa Pickard
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Adam Stewart
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | | | - Udai Banerji
- 1The Institute of Cancer Research, Sutton, United Kingdom
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11
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Isler B, Vatansever C, Özer B, Çınar G, Aslan AT, Stewart A, Simos P, Falconer C, Bauer MJ, Forde B, Harris P, Şimşek F, Tülek N, Demirkaya H, Menekşe Ş, Akalin H, Balkan İİ, Aydın M, Tigen ET, Demir SK, Kapmaz M, Keske Ş, Doğan Ö, Arabacı Ç, Yağcı S, Hazırolan G, Bakır VO, Gönen M, Saltoğlu N, Azap A, Azap Ö, Akova M, Ergönül Ö, Paterson DL, Can F. Comparison of ceftazidime-avibactam susceptibility testing methods against OXA-48-like carrying Klebsiella blood stream isolates. Diagn Microbiol Infect Dis 2022; 104:115745. [DOI: 10.1016/j.diagmicrobio.2022.115745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/25/2022] [Accepted: 06/10/2022] [Indexed: 11/03/2022]
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12
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Coker EA, Stewart A, Ozer B, Minchom A, Pickard L, Ruddle R, Carreira S, Popat S, O'Brien M, Raynaud F, de Bono J, Al-Lazikani B, Banerji U. Individualized Prediction of Drug Response and Rational Combination Therapy in NSCLC Using Artificial Intelligence-Enabled Studies of Acute Phosphoproteomic Changes. Mol Cancer Ther 2022; 21:1020-1029. [PMID: 35368084 PMCID: PMC9381105 DOI: 10.1158/1535-7163.mct-21-0442] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/15/2021] [Accepted: 03/11/2022] [Indexed: 01/07/2023]
Abstract
We hypothesize that the study of acute protein perturbation in signal transduction by targeted anticancer drugs can predict drug sensitivity of these agents used as single agents and rational combination therapy. We assayed dynamic changes in 52 phosphoproteins caused by an acute exposure (1 hour) to clinically relevant concentrations of seven targeted anticancer drugs in 35 non-small cell lung cancer (NSCLC) cell lines and 16 samples of NSCLC cells isolated from pleural effusions. We studied drug sensitivities across 35 cell lines and synergy of combinations of all drugs in six cell lines (252 combinations). We developed orthogonal machine-learning approaches to predict drug response and rational combination therapy. Our methods predicted the most and least sensitive quartiles of drug sensitivity with an AUC of 0.79 and 0.78, respectively, whereas predictions based on mutations in three genes commonly known to predict response to the drug studied, for example, EGFR, PIK3CA, and KRAS, did not predict sensitivity (AUC of 0.5 across all quartiles). The machine-learning predictions of combinations that were compared with experimentally generated data showed a bias to the highest quartile of Bliss synergy scores (P = 0.0243). We confirmed feasibility of running such assays on 16 patient samples of freshly isolated NSCLC cells from pleural effusions. We have provided proof of concept for novel methods of using acute ex vivo exposure of cancer cells to targeted anticancer drugs to predict response as single agents or combinations. These approaches could complement current approaches using gene mutations/amplifications/rearrangements as biomarkers and demonstrate the utility of proteomics data to inform treatment selection in the clinic.
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Affiliation(s)
- Elizabeth A. Coker
- Department of Data Science, The Institute of Cancer Research, London, United Kingdom
- Wellcome Sanger Institute, Hinxton, United Kingdom
- Healx Ltd., Cambridge, United Kingdom
| | - Adam Stewart
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Bugra Ozer
- Department of Data Science, The Institute of Cancer Research, London, United Kingdom
- Healx Ltd., Cambridge, United Kingdom
| | - Anna Minchom
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Lisa Pickard
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Ruth Ruddle
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Suzanne Carreira
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Sanjay Popat
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Mary O'Brien
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Florence Raynaud
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Johann de Bono
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Bissan Al-Lazikani
- Department of Data Science, The Institute of Cancer Research, London, United Kingdom
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Udai Banerji
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
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13
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Shelley C, Bolt M, Hollingdale R, Rashid M, Reinlo S, Fazel N, Adams E, Stewart A, South C. PO-1697 Assessment of the impact of CBCT-guided online adaptation on dose distribution in cervical cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03661-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Simos PA, Holland DJ, Stewart A, Isler B, Hughes I, Price N, Henderson A, Alcorn K. Clinical prediction scores and the utility of time to blood culture positivity in stratifying the risk of infective endocarditis in Staphylococcus aureus bacteraemia. J Antimicrob Chemother 2022; 77:2003-2010. [DOI: 10.1093/jac/dkac129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/31/2022] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
Infective endocarditis (IE) complicates up to a quarter of Staphylococcus aureus bacteraemia (SAB) cases. Risk scores predict IE complicating SAB but have undergone limited external validation, especially in community-acquired infections and those who use IV drugs. Addition of the time to positive culture (TTP) may provide incremental risk prognostication.
Objectives
To externally validate risk scores for predicting IE in SAB and assess the incremental value of TTP.
Methods
The modified Duke score was calculated for adults hospitalized with SAB at a major tertiary institution. All patients underwent echocardiography. Sensitivity and specificity of the risk scores for predicting IE were calculated, and the incremental value of TTP was assessed.
Results
One hundred and six cases were analysed and 18 (17%) met definite IE criteria. The optimal TTP to predict IE was 11.5 h (sensitivity 88.9%; specificity 71.6%). The sensitivity of VIRSTA and PREDICT (Predicting risk of endocarditis using a clinical tool) were similar (94.4% for both) and higher than POSITIVE (Prediction Of Staphylococcus aureus Infective endocarditis Time to positivity, IV drug use, Vascular phenomena, pre-Existing heart condition; 77.8%). The receiver-operator characteristic AUCs were VIRSTA 0.83, PREDICT 0.75, POSITIVE 0.89 and TTP 0.85. Adding TTP to VIRSTA (i.e. VIRSTA+) resulted in the highest AUC (0.90), sensitivity (100%) and negative predictive value (100%), albeit with a low specificity (33%).
Conclusions
The VIRSTA and POSITIVE scores were the strongest predictors for IE complicating SAB. The addition of TTP to VIRSTA (VIRSTA+) significantly improved discriminatory value and may be safely used to rationalize echocardiography strategies.
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Affiliation(s)
- Peter A. Simos
- Infection Management Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Infectious Disease Department, Gold Coast University Hospital, Southport, Queensland, Australia
| | - David J. Holland
- Department of Cardiology, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
- School of Human Movement and Nutrition Studies, The University of Queensland, Brisbane, Queensland, Australia
- School of Medicine, Griffith University, Birtinya, Queensland, Australia
| | - Adam Stewart
- Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane and Women’s Hospital Campus, Brisbane, Australia
- Department of Infectious Diseases, Royal Brisbane and Women’s Hospital, Brisbane, Australia
- Central Microbiology, Pathology Queensland, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - Burcu Isler
- Infection Management Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane and Women’s Hospital Campus, Brisbane, Australia
| | - Ian Hughes
- Office for Research Governance and Development, Gold Coast Health, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Nathan Price
- Infection Management Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Andrew Henderson
- Infection Management Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Kylie Alcorn
- Infectious Disease Department, Gold Coast University Hospital, Southport, Queensland, Australia
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15
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Butt N, Chaus A, Ratnani P, Stewart A. Smoky heart: cardiovascular manifestations of carbon monoxide poisoning. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Carbon monoxide (CO) poisoning is one of the most critical health concerns worldwide due to severe clinical effects with high morbidity and mortality. Tissue hypoxia and cellular damage from CO poisoning results in oxidative stress. Organs and tissues with high O2 demand including central nervous system (CNS) and cardiovascular (CV) system are the most susceptible to this oxidative stress. We investigate and describe the cardiovascular manifestations in 350 patients who were admitted for moderate to severe CO poisoning and treated with hyperbaric oxygen (HBO2) therapy.
Purpose
This study was conducted to identify the common cardiovascular manifestations of carbon monoxide poisoning.
Methods
We retrospectively collected data on 350 consecutive adult patients treated for CO poisoning between January 2011 to April 2018. Cardiac biomarkers, EKG and carboxyhemoglobin (COHb) levels were obtained from pre-hospital sources including EMS (emergency medical services) and from outside hospital records at the time of transfer. Glasgow Coma Scale (GCS) measurements were obtained at initial pre-hospital evaluation and upon arrival to the emergency room. Patient demographics, CV, CNS history and cardiac risk factors including hypertension, hyperlipidemia, diabetes, smoking history were obtained from electronic medical record. Myocardial injury was defined by cardiac troponin I level of ≥0.05 ng/mL.
Results
There were 350 patients admitted for CO poisoning from 2011 to 2018. 72% of the patients received HBO treatment due to severity of their symptoms. The mean age was 47.3 years with 60% men, 89% of the admissions were accidental exposure. Cardiac biomarkers were elevated in 40% of the patients and with 21% having sinus tachycardia. 6% had ischemic EKG changes with 23% having regional wall motion abnormalities on echocardiogram. In terms of intervention, 83% of the patients with elevated cardiac biomarkers received HBO treatment, 9% underwent coronary angiogram out of which 50% were candidate for either percutaneous intervention (PCI) or coronary artery bypass graft (CABG). In hospital mortality amongst this population was 2%.
Conclusion
Myocardial injury is common and widely seen with CO poisoning as seen by elevated cardiac biomarkers in 40% of the tested population. Initial work up for patients with CO poisoning should include evaluation with an EKG and serial biomarkers. If an abnormality is detected, patient should undergo an echocardiogram. Further evaluation with coronary angiography may be warranted in patients with new left ventricular dysfunction or wall motion abnormalities, especially in patients with risk factors.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Butt
- Advocate Lutheran General Hospital, Cardiology, Park Ridge, United States of America
| | - A Chaus
- Advocate Lutheran General Hospital, Cardiology, Park Ridge, United States of America
| | - P Ratnani
- Advocate Lutheran General Hospital, Internal Medicine, Park Ridge, United States of America
| | - A Stewart
- Advocate Lutheran General Hospital, Trauma Surgery, Park Ridge, United States of America
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16
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Georgiou A, Stewart A, Vlachogiannis G, Pickard L, Valeri N, Cunningham D, Whittaker SR, Banerji U. A phospho-proteomic study of cetuximab resistance in KRAS/NRAS/BRAF V600 wild-type colorectal cancer. Cell Oncol (Dordr) 2021; 44:1197-1206. [PMID: 34462871 PMCID: PMC8516765 DOI: 10.1007/s13402-021-00628-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 12/02/2022] Open
Abstract
PURPOSE We hypothesised that plasticity in signal transduction may be a mechanism of drug resistance and tested this hypothesis in the setting of cetuximab resistance in patients with KRAS/NRAS/BRAFV600 wild-type colorectal cancer (CRC). METHODS A multiplex antibody-based platform was used to study simultaneous changes in signal transduction of 55 phospho-proteins in 12 KRAS/NRAS/BRAFV600 wild-type CRC cell lines (6 cetuximab sensitive versus 6 cetuximab resistant) following 1 and 4 h in vitro cetuximab exposure. We validated our results in CRC patient samples (n = 4) using ex vivo exposure to cetuximab in KRAS/NRAS/BRAFV600 cells that were immunomagnetically separated from the serous effusions of patients with known cetuximab resistance. RESULTS Differences in levels of phospho-proteins in cetuximab sensitive and resistant cell lines included reductions in phospho-RPS6 and phospho-PRAS40 in cetuximab sensitive, but not cetuximab resistant cell lines at 1 and 4 h, respectively. In addition, phospho-AKT levels were found to be elevated in 3/4 patient samples following ex vivo incubation with cetuximab for 1 h. We further explored these findings by studying the effects of combinations of cetuximab and two PI3K pathway inhibitors in 3 cetuximab resistant cell lines. The addition of PI3K pathway inhibitors to cetuximab led to a significantly higher reduction in colony formation capacity compared to cetuximab alone. CONCLUSION Our findings suggest activation of the PI3K pathway as a mechanism of cetuximab resistance in KRAS/NRAS/BRAFV600 wild-type CRC.
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Affiliation(s)
- Alexandros Georgiou
- Division of Cancer Therapeutics, The Institute of Cancer Research, Sycamore House, Downs Road, London, SM2 5PT, UK.
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Sycamore House, Downs Road, London, SM2 5PT, UK.
| | - Adam Stewart
- Division of Cancer Therapeutics, The Institute of Cancer Research, Sycamore House, Downs Road, London, SM2 5PT, UK
| | - Georgios Vlachogiannis
- Division of Molecular Pathology, The Institute of Cancer Research, Sycamore House, Downs Road, London, SM2 5PT, UK
| | - Lisa Pickard
- Division of Cancer Therapeutics, The Institute of Cancer Research, Sycamore House, Downs Road, London, SM2 5PT, UK
| | - Nicola Valeri
- Division of Molecular Pathology, The Institute of Cancer Research, Sycamore House, Downs Road, London, SM2 5PT, UK
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Sycamore House, Downs Road, London, SM2 5PT, UK
| | - David Cunningham
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Sycamore House, Downs Road, London, SM2 5PT, UK
| | - Steven R Whittaker
- Division of Cancer Therapeutics, The Institute of Cancer Research, Sycamore House, Downs Road, London, SM2 5PT, UK
| | - Udai Banerji
- Division of Cancer Therapeutics, The Institute of Cancer Research, Sycamore House, Downs Road, London, SM2 5PT, UK.
- Division of Clinical Studies, The Institute of Cancer Research, Sycamore House, Downs Road, London, SM2 5PT, UK.
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Coma S, Chowdhury S, Musteanu M, Stewart A, Pickard L, Krebs M, Minchom A, Banerji U, Barbacid M, Pachter J. P52.05 Dual RAF/MEK Inhibitor VS-6766 for Treatment of KRAS Mutant NSCLC: Novel Combinations Targeting G12C or G12V Variants. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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18
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Affiliation(s)
- S Otter
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK.
| | - A Stewart
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK
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19
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Bolt M, Shelley C, Hollingdale R, Chadwick S, Barnard A, Leverton A, Stewart A, Adams E, South C. PO-1574 Evaluation of automated plan quality for cervical cancer using the Ethos TPS. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08025-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Shelley C, Bolt M, Hollingdale R, South C, Adams E, Stewart A. PO-1313 Evaluation of CBCT-based auto-segmentation for online adaptive radiotherapy in cervical cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07764-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Stewart A, Pickard L, Hallsworth AE, Sauvaigo S, Muggiolu G, Raynaud F, BANERJI UDAI. Abstract 1010: A study of combinatorial growth inhibition, cell death and DNA damage repair caused by CHK1 inhibitor SRA737 and WEE1 inhibitor adavosertib in TP53 mutated cell lines. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-1010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose of study: CHK1 and WEE1 are critical determinants of the G2/M cell cycle checkpoint. The G2/M checkpoint is crucial to enable DNA repair caused by endogenous and exogenous stress. We hypothesised that simultaneous inhibition of CHK1 and WEE1 would cause cell death in TP53 mutated cell lines because of the associated replication stress due to an abrogated G1/S checkpoint.
Experimental procedures: The potentiation index of the combination of SRA737 and adavosertib was calculated in six cancer cell lines harbouring TP53 mutations (OVCAR3, COV505, BT20, MDA-MB-436 and CAPAN1, MIAPaCa2) using Cell Titre Blue assays. Cell death and DNA damage was quantified using c-PARP, p-CHK1 Ser345 and gamma H2AX using western blot analysis. In-vivo studies evaluated the efficacy of vehicle control, SRA737, adavosertib and the combination in OVCAR3 and MDA-MB-436 xenograft models. We further explored the mechanisms of DNA damage repair caused by the single agents and the combination using two functional fluorescent multiplex DNA repair assay platforms in OVCAR3 and MDA-MB-436 cells; Exy-SPOT (base excision repair/nucleotide excision repair) and Next-SPOT (double strand break repair).
Results: The potentiation index of the addition of SRA737 to adavosertib were 19, 8.6, 8.8, 9.7, 27.2 and 5.7 for COV504, OVCAR3, BT20, MDA-MB-436, CAPAN1 and MIAPaCa2 respectively. The combination of both drugs at single agent GI50 concentrations caused increase in c-PARP, p-CHK1 Ser345 and gamma H2AX in all cell lines studied. We chose to explore the combination in the TP53 mutated OVCAR3 and the TP53 and BRCA1 mutated MDA-MB-436 cell lines. In the OVCAR3 xenograft model, the combination of SRA737 and adavosertib caused tumour regressions and tumour volumes were significantly smaller than controls, p<0001. The combination caused a lesser but significant degree of reduction in the tumour volume in the MDA-MB-436 xenograft model compared to control p=0.003. There was less than a 20% loss of mouse body weight in treatment arms of both xenograft models. Functional DNA damage repair analysis showed the combination of SRA737 and adavosertib caused a significantly greater reduction in oxidative stress related base excision repair (Etheno and 8oxoG lesions) as well as double stranded break repair via alternative end joining in the OVCAR3 cell lines compared to MDA-MB-436 cells, p=0.009, p=0.014 and p=0.005 respectively.
Conclusions: The combination of SRA737 and adavosertib caused cell death in TP53 mutated cell lines. There were differences in the DNA damage repair mechanisms in across cell lines and the combination showed significant activity in the xenograft models studied. The combination of SRA737 and adavosertib warrants further evaluation for the treatment of selected TP53 mutated cancers.
Citation Format: Adam Stewart, Lisa Pickard, Albert E. Hallsworth, Sylvie Sauvaigo, Giovanna Muggiolu, Florence Raynaud, UDAI BANERJI. A study of combinatorial growth inhibition, cell death and DNA damage repair caused by CHK1 inhibitor SRA737 and WEE1 inhibitor adavosertib in TP53 mutated cell lines [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1010.
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Affiliation(s)
- Adam Stewart
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | - Lisa Pickard
- 1The Institute of Cancer Research, Sutton, United Kingdom
| | | | | | | | | | - UDAI BANERJI
- 1The Institute of Cancer Research, Sutton, United Kingdom
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22
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Whitehouse D, Piffer F, Becker T, Gravett K, Stewart A, Basi K, Inmand S, Bush A, Jarritt P, Stranks A, Newcombe V. Challenges, approaches and opportunities for Patient and Public Involvement (PPI) in Traumatic Brain Injury (TBI) research. Br J Neurosurg 2021; 35:651-652. [PMID: 33944645 DOI: 10.1080/02688697.2021.1922605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- D Whitehouse
- Emergency Department, Addenbrooke's Hospital, Cambridge, UK
| | - F Piffer
- NIHR Brain Injury MedTech Co-operative, Department of Clinical Neurosciences, University of Cambridge, UK
| | - T Becker
- NIHR Cambridge BRC Communications and PPI/E Department, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - K Gravett
- Panel Member, Cambridge TBI PPI Group, Cambridge, UK
| | - A Stewart
- Panel Member, Cambridge TBI PPI Group, Cambridge, UK
| | - K Basi
- Panel Member, Cambridge TBI PPI Group, Cambridge, UK
| | - S Inmand
- Panel Member, Cambridge TBI PPI Group, Cambridge, UK
| | - A Bush
- Panel Member, Cambridge TBI PPI Group, Cambridge, UK
| | - P Jarritt
- NIHR Brain Injury MedTech Co-operative, Department of Clinical Neurosciences, University of Cambridge, UK
| | - A Stranks
- NIHR Cambridge BRC Communications and PPI/E Department, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - V Newcombe
- Emergency Department, Addenbrooke's Hospital, Cambridge, UK
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23
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Henderson A, Bursle E, Stewart A, Harris PNA, Paterson D, Chatfield MD, Paul M, Dickstein Y, Rodriguez-Baño J, Turnidge JD, Kahlmeter G. A systematic review of antimicrobial susceptibility testing as a tool in clinical trials assessing antimicrobials against infections due to gram-negative pathogens. Clin Microbiol Infect 2021; 27:1746-1753. [PMID: 33813125 DOI: 10.1016/j.cmi.2021.03.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/03/2021] [Accepted: 03/06/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Antimicrobial susceptibility testing (AST) is the standard of care for treating bacterial infections. In randomized clinical trials of new antimicrobials, AST might not be performed or reported in real time. OBJECTIVES To determine local, real-time laboratory AST performance, its usage in the trial flow, quality control (QC) of the local testing, central AST performance and the effect of using AST categorization on the trials' primary outcomes. DATA SOURCES We systematically searched PubMed, Embase, PsychINFO and Web of Science. ELIGIBILITY CRITERIA We included registered randomized controlled trials published in journals between January 2015 and December 2019. PARTICIPANTS AND INTERVENTIONS We included trials comparing different antibiotics for the treatment of infections caused predominantly by Gram-negative bacteria. METHODS Primary outcomes for different trial populations were extracted and differences between trial arms were compared for patients with infections caused by susceptible versus non-susceptible bacteria. Results are described narratively. RESULTS Of 32 randomized trials, 25 trials reported that local AST was performed, 1312 reported the local laboratory AST methods, no trial reported QC, but post-hoc referral for AST at a reference laboratory was common. Patients' outcomes were superior when patients with infections due to susceptible and non-susceptible pathogens were compared post hoc (median difference 14%, interquartile range 8%-24%) in trials allowing this comparison (seven antimicrobials), except for colistin, where 14-day mortality was 9% higher when patients were treated with colistin for colistin-susceptible versus colistin-resistant carbapenem-resistant Acinetobacter baumannii. When excluding patients with pathogens that were non-susceptible to either antimicrobial in the trials, the difference in the primary outcome between the trial arms was reduced in five out of six trials. CONCLUSIONS Trials should perform AST to guide patient inclusion or exclusion from the study and consider the impact of the central laboratory susceptibility results on the study outcomes when using post-hoc reference testing.
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Affiliation(s)
- Andrew Henderson
- Princess Alexandra Hospital, Brisbane, QLD, Australia; University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, QLD, Australia.
| | - Evan Bursle
- Princess Alexandra Hospital, Brisbane, QLD, Australia; University of Queensland, QLD, Australia; Sullivan and Nicolaides Pathology, Brisbane, QLD, Australia
| | - Adam Stewart
- University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, QLD, Australia; Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Patrick N A Harris
- University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, QLD, Australia; Pathology Queensland, Brisbane, QLD, Australia
| | - David Paterson
- University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, QLD, Australia
| | - Mark D Chatfield
- University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, QLD, Australia
| | - Mical Paul
- Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Yaakov Dickstein
- Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Jesus Rodriguez-Baño
- Hospital Universitario Virgen Macarena, Sevilla, Spain; Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen Macarena, Sevilla, Spain; Departamento de Medicina, Universidad de Sevilla and Instituto de Biomedicina de Seville, Sevilla, Spain
| | - John D Turnidge
- University of Adelaide, Adelaide, SA, Australia; European Committee on Antimicrobial Susceptibility Testing (EUCAST), Adelaide, Australia
| | - Gunnar Kahlmeter
- European Committee on Antimicrobial Susceptibility Testing (EUCAST), Adelaide, Australia; European Committee on Antimicrobial Susceptibility Testing (EUCAST), Vaxjo, Sweden
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24
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Bourke S, Bertram I, Horne SJ, Wong AKH, Stewart A, Wallett L, Dufty NE. Mutually supporting: a near-peer mentoring system for military junior doctors. BMJ Mil Health 2021; 168:242. [PMID: 33685905 DOI: 10.1136/bmjmilitary-2020-001762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Samuel Bourke
- 3 Medical Regiment, Royal Army Medical Corps, Preston, UK
| | - I Bertram
- AMS HQ, Roberston House, Camberley, England
| | - S-J Horne
- Royal Centre for Defence Medicine, Birmingham, UK
| | - A K H Wong
- Royal Centre for Defence Medicine, Birmingham, UK
| | - A Stewart
- Royal Centre for Defence Medicine, Birmingham, UK
| | - L Wallett
- Royal Centre for Defence Medicine, Birmingham, UK
| | - N E Dufty
- Royal Centre for Defence Medicine, Birmingham, UK.,Department of Sexual Health, Birmingham Heartlands Hospital, Birmingham, England, UK
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25
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Newman L, Brown J, Kerawala C, Patel M, Woodwards B, Lavery K, Courtney D, Stewart A, Herold J, Hyde N. Our specialty. The future. Is the writing on the wall? Br J Oral Maxillofac Surg 2020; 58:1219-1221. [DOI: 10.1016/j.bjoms.2019.10.322] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 10/19/2019] [Indexed: 10/24/2022]
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Fog L, Wirth A, MacManus M, Downes S, Grace M, Moggre A, Mugabe K, Neveri G, Nourbehesht L, Panetieri V, Pope D, Sim L, Stanton C, Steer B, Stewart A, Ungureanu E, Kron T. PO-1464: Total body irradiation practice in Australia and New Zealand: Results of a Survey. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01482-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shinde R, Terbuch A, Little M, Caldwell R, Kurup R, Riisnaes R, Crespo M, Ruddle R, Gurel B, Stewart A, King J, Parmar M, Turner A, Raynaud F, Mahmud M, Yap C, Pachter JA, Mills GB, Minchom A, Lopez J, Banerjee SN, de Bono JS, Krebs M, Banerji U. Abstract CT143: Phase I study of the combination of a RAF-MEK inhibitor CH5126766 and FAK inhibitor defactinib in an intermittent dosing schedule with expansions inKRASmutant cancers. Tumour Biol 2020. [DOI: 10.1158/1538-7445.am2020-ct143] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Antwi AN, Stewart A, Crosbie M. Fighting antibiotic resistance: a narrative review of public knowledge, attitudes, and perceptions of antibiotics use. Perspect Public Health 2020; 140:338-350. [PMID: 32515278 DOI: 10.1177/1757913920921209] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
AIMS The aims of this study were to ascertain the comprehensive knowledge, perceptions, and attitudes of people from varying socioeconomic regions towards antibiotic use; identify the misperceptions and malpractices; and inform health policy and practice. METHOD EBSCO host databases, PubMed, and Google Scholar were searched to obtain relevant primary research papers within the years 2010-2018. Search phrases included the following: 'antibiotics use', 'community perceptions', 'public opinion, knowledge, behaviour, practices, perceptions'. Initially, selected papers were screened using the Preview, Question, Read, Summarize (PQRS) model. RESULTS Review of the 20 articles selected was based on six identified themes. It was found that insufficient knowledge and awareness of antibiotics use; self-medication and the use of leftover antibiotics; treating viral diseases with antibiotics or used as painkillers; expecting antibiotic prescription as a culmination of consultation; and the credibility of information obtained are issues that cut across different countries. CONCLUSION Evidence from this review suggests that misconceptions of antibiotic use are similar in different countries. Therefore, the need for the development and implementation of transferable policies as well as educating the public is necessary for the fight against ABR.
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Affiliation(s)
- A N Antwi
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK.,Parasitology Department, Noguchi Memorial Institute for Medical Research, P.O. Box LG 581, Legon, Accra, Ghana
| | - A Stewart
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Michelle Crosbie
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, UK
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Georgiou A, Stewart A, Cunningham D, Banerji U, Whittaker SR. Inactivation of NF1 Promotes Resistance to EGFR Inhibition in KRAS/NRAS/BRAFV600 -Wild-Type Colorectal Cancer. Mol Cancer Res 2020; 18:835-846. [PMID: 32098826 PMCID: PMC7611272 DOI: 10.1158/1541-7786.mcr-19-1201] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/21/2020] [Accepted: 02/20/2020] [Indexed: 12/26/2022]
Abstract
Through the use of an unbiased, genome-scale CRISPR modifier screen, we identified NF1 suppression as a mechanism of resistance to EGFR inhibition in NRAS/KRAS/BRAFV600 -wild-type colorectal cancer cells. Reduced NF1 expression permitted sustained signaling through the MAPK pathway to promote cell proliferation in the presence of EGFR inhibition. Targeting of MEK in combination with EGFR inhibition leads to synergistic antiproliferative activity. Human KRAS/NRAS/BRAFV600 -wild-type colorectal cancer cell lines with NF1 mutations displayed reduced NF1 mRNA or protein expression and were resistant to EGFR blockade by gefitinib or cetuximab. Cooccurring loss-of-function mutations in PTEN were associated with resistance to dual EGFR/MEK inhibition but cotreatment with a PI3K inhibitor further suppressed proliferation. Loss of NF1 may be a useful biomarker to identify patients that are less likely to benefit from single-agent anti-EGFR therapy in colorectal cancer and may direct potential combination strategies. IMPLICATIONS: This study suggests that further clinical validation of NF1 status as predictor of response to anti-EGFR targeting antibodies in patients with colorectal cancer with KRAS/NRAS/BRAFV600 -wild-type tumors is warranted.
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Affiliation(s)
- Alexandros Georgiou
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Adam Stewart
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - David Cunningham
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Udai Banerji
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom.
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Steven R Whittaker
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom.
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Reed AD, Nethery MA, Stewart A, Barrangou R, Theriot CM. Strain-Dependent Inhibition of Clostridioides difficile by Commensal Clostridia Carrying the Bile Acid-Inducible ( bai) Operon. J Bacteriol 2020; 202:e00039-20. [PMID: 32179626 PMCID: PMC7221253 DOI: 10.1128/jb.00039-20] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/06/2020] [Indexed: 12/18/2022] Open
Abstract
Clostridioides difficile is one of the leading causes of antibiotic-associated diarrhea. Gut microbiota-derived secondary bile acids and commensal Clostridia that carry the bile acid-inducible (bai) operon are associated with protection from C. difficile infection (CDI), although the mechanism is not known. In this study, we hypothesized that commensal Clostridia are important for providing colonization resistance against C. difficile due to their ability to produce secondary bile acids, as well as potentially competing against C. difficile for similar nutrients. To test this hypothesis, we examined the abilities of four commensal Clostridia carrying the bai operon (Clostridium scindens VPI 12708, C. scindens ATCC 35704, Clostridium hiranonis, and Clostridium hylemonae) to convert cholate (CA) to deoxycholate (DCA) in vitro, and we determined whether the amount of DCA produced was sufficient to inhibit the growth of a clinically relevant C. difficile strain. We also investigated the competitive relationships between these commensals and C. difficile using an in vitro coculture system. We found that inhibition of C. difficile growth by commensal Clostridia supplemented with CA was strain dependent, correlated with the production of ∼2 mM DCA, and increased the expression of bai operon genes. We also found that C. difficile was able to outcompete all four commensal Clostridia in an in vitro coculture system. These studies are instrumental in understanding the relationship between commensal Clostridia and C. difficile in the gut, which is vital for designing targeted bacterial therapeutics. Future studies dissecting the regulation of the bai operon in vitro and in vivo and how this affects CDI will be important.IMPORTANCE Commensal Clostridia carrying the bai operon, such as C. scindens, have been associated with protection against CDI; however, the mechanism for this protection is unknown. Herein, we show four commensal Clostridia that carry the bai operon and affect C. difficile growth in a strain-dependent manner, with and without the addition of cholate. Inhibition of C. difficile by commensals correlated with the efficient conversion of cholate to deoxycholate, a secondary bile acid that inhibits C. difficile germination, growth, and toxin production. Competition studies also revealed that C. difficile was able to outcompete the commensals in an in vitro coculture system. These studies are instrumental in understanding the relationship between commensal Clostridia and C. difficile in the gut, which is vital for designing targeted bacterial therapeutics.
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Affiliation(s)
- A D Reed
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - M A Nethery
- Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - A Stewart
- Molecular Education, Technology and Research Innovation Center, North Carolina State University, Raleigh, North Carolina, USA
| | - R Barrangou
- Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - C M Theriot
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
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Acar A, Nichol D, Fernandez-Mateos J, Cresswell GD, Barozzi I, Hong SP, Trahearn N, Spiteri I, Stubbs M, Burke R, Stewart A, Caravagna G, Werner B, Vlachogiannis G, Maley CC, Magnani L, Valeri N, Banerji U, Sottoriva A. Exploiting evolutionary steering to induce collateral drug sensitivity in cancer. Nat Commun 2020; 11:1923. [PMID: 32317663 PMCID: PMC7174377 DOI: 10.1038/s41467-020-15596-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 03/18/2020] [Indexed: 12/17/2022] Open
Abstract
Drug resistance mediated by clonal evolution is arguably the biggest problem in cancer therapy today. However, evolving resistance to one drug may come at a cost of decreased fecundity or increased sensitivity to another drug. These evolutionary trade-offs can be exploited using 'evolutionary steering' to control the tumour population and delay resistance. However, recapitulating cancer evolutionary dynamics experimentally remains challenging. Here, we present an approach for evolutionary steering based on a combination of single-cell barcoding, large populations of 108-109 cells grown without re-plating, longitudinal non-destructive monitoring of cancer clones, and mathematical modelling of tumour evolution. We demonstrate evolutionary steering in a lung cancer model, showing that it shifts the clonal composition of the tumour in our favour, leading to collateral sensitivity and proliferative costs. Genomic profiling revealed some of the mechanisms that drive evolved sensitivity. This approach allows modelling evolutionary steering strategies that can potentially control treatment resistance.
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Affiliation(s)
- Ahmet Acar
- Evolutionary Genomics and Modelling Lab, Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Department of Biological Sciences, Middle East Technical University, Ankara, Turkey
| | - Daniel Nichol
- Evolutionary Genomics and Modelling Lab, Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
| | - Javier Fernandez-Mateos
- Evolutionary Genomics and Modelling Lab, Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
| | - George D Cresswell
- Evolutionary Genomics and Modelling Lab, Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
| | - Iros Barozzi
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Sung Pil Hong
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Nicholas Trahearn
- Evolutionary Genomics and Modelling Lab, Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
| | - Inmaculada Spiteri
- Evolutionary Genomics and Modelling Lab, Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
| | - Mark Stubbs
- CRUK Cancer Therapeutics Unit, The Institute of Cancer Research, London, UK
| | - Rosemary Burke
- CRUK Cancer Therapeutics Unit, The Institute of Cancer Research, London, UK
| | - Adam Stewart
- Clinical Pharmacology-Adaptive Therapy Group, Division of Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, London, UK
| | - Giulio Caravagna
- Evolutionary Genomics and Modelling Lab, Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
| | - Benjamin Werner
- Evolutionary Genomics and Modelling Lab, Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
| | - Georgios Vlachogiannis
- Gastrointestinal Cancer Biology and Genomics Team, Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
| | - Carlo C Maley
- Arizona Cancer Evolution Center, Biodesign Institute, Arizona State University, Tempe, USA
| | - Luca Magnani
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Nicola Valeri
- Gastrointestinal Cancer Biology and Genomics Team, Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London, UK
| | - Udai Banerji
- CRUK Cancer Therapeutics Unit, The Institute of Cancer Research, London, UK.
- Clinical Pharmacology-Adaptive Therapy Group, Division of Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, London, UK.
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK.
| | - Andrea Sottoriva
- Evolutionary Genomics and Modelling Lab, Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK.
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Stewart A, Sowden D, Sloss A, Broom J. Inflammatory bowel disease masquerading as traveller's diarrhoea. Intern Med J 2020; 49:789-791. [PMID: 31185525 DOI: 10.1111/imj.14311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 11/29/2022]
Abstract
Diarrhoea that occurs during or after recent travel is predominantly infectious in nature; however, in atypical or prolonged cases a broader range of aetiologies for diarrhoea must be considered, and a careful history and examination may reveal clues to more sinister causes of diarrhoea. We report two cases in which a recent travel history and a positive stool culture or polymerase chain reaction testing for bacterial pathogens delayed the diagnosis of ulcerative colitis. As a result of severe inflammatory bowel disease, colectomy was the final result in both cases. Early consideration of causes other than infection for traveller's diarrhoea may prevent unnecessary morbidity in young patients.
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Affiliation(s)
- Adam Stewart
- Infectious Diseases Service, Department of Medicine, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
| | - David Sowden
- Infectious Diseases Service, Department of Medicine, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
| | - Andrew Sloss
- Gastroenterology Department, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
| | - Jennifer Broom
- Infectious Diseases Service, Department of Medicine, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia.,University of Queensland, Brisbane, Queensland, Australia
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McNamara JF, Avent M, Stewart A, Kwan C, Paterson DL. Evaluation of quick sequential organ failure assessment and systemic inflammatory response syndrome in patients with gram negative bloodstream infection. Infect Dis Health 2020; 25:151-157. [PMID: 32005586 DOI: 10.1016/j.idh.2020.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/05/2020] [Accepted: 01/06/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND The quick sequential organ failure assessment (qSOFA) score predicts mortality in patients with suspected infection. We sought to understand how well qSOFA and the Systemic Inflammatory Response Syndrome (SIRS) criteria predict gram negative bacteraemia. METHODS We prospectively evaluated 99 patients with gram negative bloodstream infection from a single tertiary centre. We assessed the utility of SIRS and qSOFA for their rate of positivity and association with early delivery of antibiotics (<3 h). RESULTS The SIRS criteria had the highest positivity rate amongst patients with gram negative bacteraemia (85%) compared to the qSOFA criteria (25%) on the day of first positive culture. Positive SIRS criteria was the only score associated with delivery of antibiotics within 3 h (Relative risk 3.5, 95% Confidence interval 1.3 to 12.5, p = < 0.02). CONCLUSION In patients with gram negative bloodstream infection SIRS criteria was the most common positive risk score and had a higher association with early delivery of antibiotics when compared to qSOFA.
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Affiliation(s)
- John F McNamara
- University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia; The Prince Charles Hospital, Brisbane, Queensland, Australia.
| | - Minyon Avent
- University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia; Queensland Statewide Antimicrobial Stewardship Program, Queensland, Australia
| | - Adam Stewart
- University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
| | - Christopher Kwan
- University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
| | - David L Paterson
- University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia; Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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34
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Sherry AD, Stewart A, Luo G, Kirschner AN. Intensity-Modulated Radiotherapy is Superior to Three-Dimensional Conformal Radiotherapy in the Trimodality Management of Muscle-Invasive Bladder Cancer with Daily Cone Beam Computed Tomography Optimization. ACTA ACUST UNITED AC 2019; 8:395-403. [PMID: 33343830 DOI: 10.1007/s13566-019-00411-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objective Intensity modulated radiation therapy (IMRT) using a volumetric-modulated arc therapy technique may offer dosimetric and clinical benefits compared to the historical standard of care 3D-conformal radiotherapy (3D-CRT) in definitive treatment of bladder cancer. We hypothesized that IMRT with CBCT would reduce dose to the rectum, bowel, and bladder compared to 3D-CRT. Methods We reviewed nineteen patients treated with maximal transurethral resection of bladder tumor followed by concurrent chemotherapy with IMRT. All patients received 45 Gy to the entire empty bladder followed by 19.8 Gy tumor boost treated with full bladder. 3D-CRT treatment plans were created for the same prescription. Paired t-test or Wilcoxon matched-pairs signed rank test analyzed dosimetry and bladder volumes. Results The rectum and bowel V40, V45, V50, V55, and V60 were reduced by over 50% in the IMRT plans compared to 3D-CRT (p<0.0001). IMRT also reduced volume of bladder irradiated compared to 3D-CRT (p<0.01). After CBCT, patients were likely to undergo clinically significant shifts ≥ 0.5 cm before boost delivery (p=0.001). Bladder volumes were significantly lower during boost treatments compared to pre-treatment simulation (p=0.002). There were 4 (21%) grade 3 genitourinary toxicities and 1 (5%) grade 3 gastrointestinal toxicity. Conclusion IMRT is superior to 3D-CRT for bladder cancer and spares dose to bowel, rectum, and bladder with improved acute toxicity compared to published clinical literature. For boost treatment, daily full bladder volume and positioning are not always reproducible, supporting the need for CBCT for optimal localization of the primary bladder tumor.
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Affiliation(s)
| | | | - Guozhen Luo
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN USA
| | - Austin N Kirschner
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN USA
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35
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Court R, Wiesner L, Stewart A, de Vries N, Harding J, Maartens G, Gumbo T, McIlleron H. Steady state pharmacokinetics of cycloserine in patients on terizidone for multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 2019; 22:30-33. [PMID: 29297422 DOI: 10.5588/ijtld.17.0475] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Terizidone/cycloserine (TRD/CS) is included in standard treatment regimens for multidrug-resistant tuberculosis (MDR-TB) in many countries. The steady state pharmacokinetics (PKs) of CS after TRD administration are not known. OBJECTIVES AND DESIGN We recruited in-patients treated with 250-750 mg oral TRD daily as part of standard treatment regimens for pulmonary MDR-TB in Cape Town, South Africa. Plasma CS assays were performed in samples taken pre-dose and at 2, 4, 6, 8 and 10 h post-dose. CS concentrations were measured using a validated liquid chromatography-tandem mass spectrometry method. Non-compartmental PK analyses were performed. RESULTS Of 35 participants enrolled, 22 were males, and 20 (57%) were infected with the human immunodeficiency virus; the median age was 37 years. The median duration on TRD at the time of sampling was 33 days (interquartile range [IQR] 28-39). The area under the concentration-time curve at 0-10 h (AUC0-10) was 319 μg.h/ml (IQR 267.5-378.7), and peak concentration was 38.1 μg/ml (IQR 32.6-47.2). On multiple regression, dose (mg/kg) was the only factor independently associated with AUC0-10. CONCLUSION Steady state concentrations of CS in patients treated with TRD for MDR-TB were higher than those reported with CS formulations. Our findings support once-daily dosing.
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Affiliation(s)
- R Court
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town
| | - L Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town
| | - A Stewart
- Clinical Research Centre, Health Sciences Faculty, University of Cape Town, Cape Town
| | | | - J Harding
- D P Marais Hospital, Cape Town, South Africa
| | - G Maartens
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town
| | - T Gumbo
- Center for Infectious Diseases Research and Experimental Therapeutics, Baylor Research Institute, Baylor University Medical Center, Dallas, Texas, USA
| | - H McIlleron
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town
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Park J, Stewart A, Irvine M, Pedersen B, Kefford R, Diefenbach R, Carlino M, Rizos H. Uveal melanoma cell lines depend on multiple signaling pathways for survival. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz238.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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37
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Stewart A, Coker EA, Pölsterl S, Georgiou A, Minchom AR, Carreira S, Cunningham D, O'Brien ME, Raynaud FI, de Bono JS, Al-Lazikani B, Banerji U. Differences in Signaling Patterns on PI3K Inhibition Reveal Context Specificity in KRAS-Mutant Cancers. Mol Cancer Ther 2019; 18:1396-1404. [PMID: 31262731 PMCID: PMC6679718 DOI: 10.1158/1535-7163.mct-18-0727] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/22/2018] [Accepted: 05/10/2019] [Indexed: 02/07/2023]
Abstract
It is increasingly appreciated that drug response to different cancers driven by the same oncogene is different and may relate to differences in rewiring of signal transduction. We aimed to study differences in dynamic signaling changes within mutant KRAS (KRAS MT), non-small cell lung cancer (NSCLC), colorectal cancer, and pancreatic ductal adenocarcinoma (PDAC) cells. We used an antibody-based phosphoproteomic platform to study changes in 50 phosphoproteins caused by seven targeted anticancer drugs in a panel of 30 KRAS MT cell lines and cancer cells isolated from 10 patients with KRAS MT cancers. We report for the first time significant differences in dynamic signaling between colorectal cancer and NSCLC cell lines exposed to clinically relevant equimolar concentrations of the pan-PI3K inhibitor pictilisib including a lack of reduction of p-AKTser473 in colorectal cancer cell lines (P = 0.037) and lack of compensatory increase in p-MEK in NSCLC cell lines (P = 0.036). Differences in rewiring of signal transduction between tumor types driven by KRAS MT cancers exist and influence response to combination therapy using targeted agents.
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Affiliation(s)
- Adam Stewart
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Elizabeth A Coker
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
- Wellcome Sanger Institute, Hinxton, United Kingdom
| | - Sebastian Pölsterl
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Alexandros Georgiou
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Anna R Minchom
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Suzanne Carreira
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - David Cunningham
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Mary Er O'Brien
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Florence I Raynaud
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Johann S de Bono
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Bissan Al-Lazikani
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Udai Banerji
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom.
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
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38
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Reid IR, Horne AM, Mihov B, Stewart A, Garratt E, Wiessing KR, Bolland MJ, Bastin S, Gamble GD. Anti-fracture efficacy of zoledronate in subgroups of osteopenic postmenopausal women: secondary analysis of a randomized controlled trial. J Intern Med 2019; 286:221-229. [PMID: 30887607 DOI: 10.1111/joim.12901] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND We recently reported that the administration of zoledronate every 18 months to osteopenic older women reduces the incidence of fractures. OBJECTIVE Here, we present a more detailed analysis of that trial to determine whether baseline clinical characteristics impact on the anti-fracture efficacy of this intervention. METHODS This is a prospective, randomized, placebo-controlled, double-blind trial in osteopenic postmenopausal women aged ≥ 65 years, to determine the anti-fracture efficacy of zoledronate. 2000 women were recruited using electoral rolls and randomized to receive 4 infusions of either zoledronate 5 mg or normal saline, at 18-month intervals. Each participant was followed for 6 years. Calcium supplements were not supplied. RESULTS Fragility fractures (either vertebral or nonvertebral) occurred in 190 women in the placebo group (227 fractures) and in 122 women in the zoledronate group (131 fractures), odds ratio (OR) 0.59 (95%CI 0.46, 0.76; P < 0.0001). There were no significant interactions between baseline variables (age, anthropometry, BMI, dietary calcium intake, baseline fracture status, recent falls history, bone mineral density, calculated fracture risk) and the treatment effect. In particular, the reduction in fractures appeared to be independent of baseline fracture risk, and numbers needed to treat (NNT) to prevent one woman fracturing were not significantly different across baseline fracture risk tertiles. CONCLUSIONS The present analyses indicate that the decrease in fracture numbers is broadly consistent across this cohort. The lack of relationship between NNTs and baseline fracture risk calls into question the need for BMD measurement and precise fracture risk assessment before initiating treatment in older postmenopausal women.
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Affiliation(s)
- I R Reid
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Auckland District Health Board, Auckland, New Zealand
| | - A M Horne
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - B Mihov
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - A Stewart
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - E Garratt
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - K R Wiessing
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - M J Bolland
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - S Bastin
- Auckland District Health Board, Auckland, New Zealand
| | - G D Gamble
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Georgiou A, Stewart A, Vlachogiannis G, Pickard L, Valeri N, Cunningham D, Whittaker SR, Banerji U. Abstract 2646: Proteomic approaches to study cetuximab resistance in RAS/BRAF wild type colorectal cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-2646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Cetuximab is a licensed anti-EGFR antibody treatment for RAS/BRAF wild type (WT) metastatic colorectal cancer (CRC) but is only effective in a proportion of these patients. Established mechanisms of resistance include primary and secondary activating RAS mutations. However, these cannot explain a proportion of resistant cases.
We investigated the differences in early adaptive signaling in cetuximab sensitive and resistant cells using phospho(p)-proteomics in order to elucidate p-proteomic signatures of response, understand resistance mechanisms and suggest future therapeutic strategies.
Methods: We used a panel of 12 cell lines (6 cetuximab sensitive and 6 resistant cell lines), cells isolated from CRC patients’ ascites (n=4) and patient derived organoids (n=2). All CRC samples used were RAS/BRAF WT. Following 1 and 4h exposure to cetuximab, a multiplex antibody-based platform was used to simultaneously quantify changes in 60 p-proteins. Key results were validated with Western blotting. Proliferation assays and 2-week colony assays were used to test potential cetuximab combinations. Statistical analysis included logistic regression, T tests and Spearman’s correlation
Results: Following 1 and 4h exposure in sensitive cell lines there was downregulation of pHER2 and other intracellular effector p-proteins that function within MAPK, PI3K and JAK-STAT pathways.
In contrast, in resistant cell lines at 1h there was a significantly lower degree of pHER2 downregulation and upregulation of pHER3 (p<0.05). Following 4h exposure, despite comparable pEGFR inhibition, in resistant cells there was statistically significant lack of downregulation/upregulation of known effector p-proteins of the PI3K pathway and also upregulation of other phosphorylated receptor tyrosine kinase (RTKs). When compared to sensitive cell lines, in resistant cells there were also statistically significant increase of pPDGFRα, pTIE2 and pIRS1. Other tyrosine kinases: pVEGFR, pFGFR1 and pSRC were also upregulated in ≥50% of resistant cell lines.
The upregulation/lack of downregulation of the PI3K pathway and upregulation of other pRTKs were confirmed in cetuximab resistant patient derived cells and organoid cultures.
We then investigated the combination of cetuximab with: PI3K inhibitor (i), AKTi, mTORi and IGF1Ri. The combination of cetuximab with PI3Ki pictilisib was able to sensitize to cetuximab in the resistant cell lines and organoid cultures with an effect that ranged from additive to synergistic.
Conclusion: RAS/BRAF WT sensitive and resistant CRC cells have distinct p-proteomic signatures following 1 and 4h cetuximab exposure. In resistant cells, early adaptive signaling involves upregulation of RTKs and the PI3K pathway. The combination of cetuximab and pictilisib showed a modest benefit, however, overlapping toxicity may render this difficult to deliver clinically.
Citation Format: Alexandros Georgiou, Adam Stewart, George Vlachogiannis, Lisa Pickard, Nicola Valeri, David Cunningham, Steven R. Whittaker, Udai Banerji. Proteomic approaches to study cetuximab resistance in RAS/BRAF wild type colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2646.
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Affiliation(s)
- Alexandros Georgiou
- 1The Institute of Cancer Research/ The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Adam Stewart
- 2The Institute of Cancer Research, Sutton, United Kingdom
| | | | - Lisa Pickard
- 2The Institute of Cancer Research, Sutton, United Kingdom
| | - Nicola Valeri
- 1The Institute of Cancer Research/ The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | | | | | - Udai Banerji
- 1The Institute of Cancer Research/ The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
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Brinkler R, Edwards Z, Abid S, Oliver CM, Lo Q, Stewart A, Abayalingam M, Abid S, Afzal S, Aly H, Kasi Anandan T, Ariyanayagam R, Armstrong S, Ashiru G, Barrett S, Baytug B, Black R, Bowman S, Brayshaw S, Brinkler R, Brocklesby S, Cain J, Casey P, Chambers K, Chan C, Chapman R, Cheah C, Cheesman K, Cohen J, Cole A, Combeer A, Cowie V, Dabrowicz A, Desai N, Donovan C, Doraiswami M, El Amin O, Edwards Z, Ellimah T, Evans M, Fawcett E, Fletcher L, Forman E, Fulton L, Gardener K, George R, Gorur P, Gowripalann T, Greenslade T, Hamlyn L, Hawkins R, Herrmann R, Hilton J, Hutchinson J, Kelliher L, Kelly J, King K, Lim S, Mahinthan V, Mahmood N, Major J, Masood N, Matthews L, McHugh B, Milne S, Miltsios K, Monks D, Moores R, Nicklin A, Panesar N, Papageorgiou C, Patel R, Pathmabaskaran S, Perinpanayagam J, Peake M, Pritchard N, Powell K, Qureshi J, Redington K, Richards N, Rintoul E, Robson M, Routley C, Salota V, Samuel M, Sapsford M, Schwartz N, Sellers C, Shareiff I, Sharifi L, Shonfeld A, Stewart A, Story H, Sudunagunta S, Suppiah P, Tamilselvan P, Thompson H, Turner W, Uzkalniene V, Veglio E, Webb A, Waiting J, Wedgewood T, Westcott L, Wickham A, Wilson L, Wimble K, Wong R, Wong S, Wray S, Zafar S. A survey of antenatal and peripartum provision of information on analgesia and anaesthesia. Anaesthesia 2019; 74:1101-1111. [DOI: 10.1111/anae.14745] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2019] [Indexed: 11/30/2022]
Affiliation(s)
- R. Brinkler
- Department of Anaesthesia University College Hospital LondonUK
| | - Z. Edwards
- Department of Anaesthesia Queen Charlotte's and Chelsea Hospital London UK
| | - S. Abid
- Department of Anaesthesia Queen Charlotte's and Chelsea Hospital London UK
| | - C. M. Oliver
- Division of Surgery and Interventional Science University College London UK
| | - Q. Lo
- Department of Anaesthesia Queen Charlotte's and Chelsea Hospital London UK
| | - A. Stewart
- Department of Anaesthesia University College Hospital LondonUK
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Ghebrehewet S, Harries AD, Kliner M, Smith K, Cleary P, Wilkinson E, Stewart A. Adapting the Structured Operational Research Training Initiative (SORT IT) for high-income countries. Public Health Action 2019; 9:69-71. [PMID: 31417856 DOI: 10.5588/pha.18.0103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/20/2019] [Indexed: 11/10/2022] Open
Abstract
SORT IT (Structured Operational Research Training InitiaTive) is a successful capacity building programme started 10 years ago to develop operational research skills in low- and middle-income countries. Public Health England (PHE) aims to embed a culture of research in front-line staff, and SORT IT has been adapted to train frontline health protection professionals at PHE North West (PHE NW) to collate, analyse and interpret routinely collected data for evidence-informed decision-making. Six participants from the PHE NW Health Protection team were selected to attend a two-module course in Liverpool, UK, in May and in November 2018. Five participants finished the course with completed papers on characteristics and burden of influenza-like illness in elderly care homes (two papers), use of dried blood spots for blood-borne virus screening in prisons, uptake of meningococcal ACWY (groups A, C, W-135 and Y) vaccine in schoolchildren and fires in waste management sites. The SORT IT course led to 1) new evidence being produced to inform health protection practice, and 2) agreement within PHE NW to continue SORT IT with two courses per year, and 3) showed how a research capacity building initiative for low- and middle-income countries that combines 'learning with doing' can be adapted and used in a high-income country.
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Affiliation(s)
- S Ghebrehewet
- Cheshire & Merseyside Health Protection Team, Public Health England, North West Centre, Liverpool, UK
| | - A D Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France.,London School of Hygiene & Tropical Medicine, London, UK
| | - M Kliner
- Greater Manchester Health Protection Team, Public Health England, North West Centre, Manchester, UK
| | - K Smith
- Cheshire & Merseyside Health Protection Team, Public Health England, North West Centre, Liverpool, UK
| | - P Cleary
- Field Service, Public Health England, Liverpool, UK
| | - E Wilkinson
- Institute of Medicine, University of Chester, Chester, UK
| | - A Stewart
- College of Life and Environmental Science, University of Exeter, Exeter, UK
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Otter S, Franklin A, Evans P, Stewart A. EP-1479 The use of CT texture analysis in cervical cancer to predict response to chemoradiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31899-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Primary cutaneous Mycobacterium avium complex (MAC) infection is a rare diagnosis in both immunocompetent and immunocompromised hosts. Disseminated MAC almost always occurs in the setting of advanced HIV infection and typically results from initial pulmonary or gastrointestinal disease. We describe a case of a 70-year-old female with systemic sclerosis and severe tumoral calcinosis that developed disseminated MAC infection secondary to deep cutaneous disease. Treatment was complicated by multiple significant drug interactions, patient comorbidities, as well as an inability to safely and completely surgically resect her infected soft tissue for source control.
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Affiliation(s)
- Adam Stewart
- Department of Infectious Diseases, Sunshine Coast University Hospital, Queensland; Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Royal Brisbane and Women's Hospital Campus, Brisbane, Australia
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Sun Myint A, Stewart A, Mills J, Sripadam R, Whitmarsh K, Roy R, Franklin A, Dhadda A. Treatment: the role of contact X-ray brachytherapy (Papillon) in the management of early rectal cancer. Colorectal Dis 2019; 21 Suppl 1:45-52. [PMID: 30809905 DOI: 10.1111/codi.14507] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 11/26/2018] [Indexed: 12/13/2022]
Affiliation(s)
- A Sun Myint
- Papillon Suite, Clatterbridge Cancer Centre, Bebington, Wirral, UK.,Translational Medicine Department, University of Liverpool, Liverpool, UK
| | - A Stewart
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK.,University of Surrey, Guildford, UK
| | - J Mills
- Nottingham University Hospital, Nottingham, UK
| | - R Sripadam
- Papillon Suite, Clatterbridge Cancer Centre, Bebington, Wirral, UK
| | - K Whitmarsh
- Papillon Suite, Clatterbridge Cancer Centre, Bebington, Wirral, UK
| | - R Roy
- Queen's Centre for Oncology and Haematology, Hull, UK
| | - A Franklin
- St Luke's Cancer Centre, Royal Surrey County Hospital, Guildford, UK
| | - A Dhadda
- Queen's Centre for Oncology and Haematology, Hull, UK
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van den Elsen LWJ, Tims S, Jones AM, Stewart A, Stahl B, Garssen J, Knol J, Forbes-Blom EE, Van't Land B. Prebiotic oligosaccharides in early life alter gut microbiome development in male mice while supporting influenza vaccination responses. Benef Microbes 2019; 10:279-291. [PMID: 30773928 DOI: 10.3920/bm2018.0098] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Beneficial modulation of the gut microbiota is an attractive therapeutic approach to improve the efficacy of vaccine-induced immunity. In this study, mice were supplemented with the prebiotic milk oligosaccharide 2'-fucosyllactose (2'FL) as well as a complex mixture of immune modulatory prebiotic short-chain galacto-oligosaccharides and long-chain fructo-oligosaccharides (scGOS/lcFOS) from different stages in early life. Adult mice were vaccinated with trivalent influenza vaccine (TIV) and both development of the gut microbiota and antibody-mediated vaccine responses were followed over time. Within the control group, female mice demonstrated a larger antibody response to TIV vaccination than male mice, which was accompanied by enhanced cytokine production by splenocytes and a higher percentage of plasma cells in skin draining lymph nodes. In addition, the prebiotic diet improved vaccine-specific antibody responses in male mice. Introduction of prebiotics into the diet modulated the gut microbiota composition and at the genus level several bacterial groups showed a significant interaction effect which potentially contributed to the immunological effects observed. This study provides insight in the effect of scGOS/lcFOS/2'FL in influenza vaccination antibody production.
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Affiliation(s)
- L W J van den Elsen
- 1 Malaghan Institute of Medical Research, Gate 7 Victoria University, Kelburn Parade, Wellington 6012, New Zealand
| | - S Tims
- 1 Malaghan Institute of Medical Research, Gate 7 Victoria University, Kelburn Parade, Wellington 6012, New Zealand
| | - A M Jones
- 1 Malaghan Institute of Medical Research, Gate 7 Victoria University, Kelburn Parade, Wellington 6012, New Zealand
| | - A Stewart
- 1 Malaghan Institute of Medical Research, Gate 7 Victoria University, Kelburn Parade, Wellington 6012, New Zealand
| | - B Stahl
- 2 Danone Nutricia Research, Departments of Immunology/Microbiology/Human Milk Research, Uppsalalaan 12, 3584 CT Utrecht, the Netherlands
| | - J Garssen
- 2 Danone Nutricia Research, Departments of Immunology/Microbiology/Human Milk Research, Uppsalalaan 12, 3584 CT Utrecht, the Netherlands.,3 Utrecht University, Faculty of Science, Department of Pharmaceutical Sciences, Division of Pharmacology, Universiteitsweg 99, 3584 CG Utrecht, the Netherlands
| | - J Knol
- 2 Danone Nutricia Research, Departments of Immunology/Microbiology/Human Milk Research, Uppsalalaan 12, 3584 CT Utrecht, the Netherlands.,4 Wageningen University & Research, 6708 PB Wageningen, the Netherlands
| | - E E Forbes-Blom
- 1 Malaghan Institute of Medical Research, Gate 7 Victoria University, Kelburn Parade, Wellington 6012, New Zealand
| | - B Van't Land
- 2 Danone Nutricia Research, Departments of Immunology/Microbiology/Human Milk Research, Uppsalalaan 12, 3584 CT Utrecht, the Netherlands.,5 University Medical Center Utrecht, The Wilhelmina Children's Hospital, Laboratory of Translational Immunology, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
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Otter S, Whitaker S, Chatterjee J, Stewart A. The Human Papillomavirus as a Common Pathogen in Oropharyngeal, Anal and Cervical Cancers. Clin Oncol (R Coll Radiol) 2019; 31:81-90. [DOI: 10.1016/j.clon.2018.10.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/07/2018] [Accepted: 09/10/2018] [Indexed: 12/21/2022]
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Stewart A, Sowden D, Caffery M, Bint M, Broom J. Rhodococcus equi infection: A diverse spectrum of disease. IDCases 2019; 15:e00487. [PMID: 30656137 PMCID: PMC6329319 DOI: 10.1016/j.idcr.2019.e00487] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 12/11/2022] Open
Abstract
Rhodococcus equi is a gram positive bacterium most commonly presenting clinically as pneumonia, however can disseminate to cause disease in virtually any human tissue. Although it is predominantly an opportunistic pathogen, a number of case series have described infection occurring among individuals with a normal immune system. We describe two cases of Rhodococcus equi infection which highlight the diversity of disease presentations of this rare organism.
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Affiliation(s)
- Adam Stewart
- Infectious Diseases Service, Department of Medicine, Sunshine Coast University Hospital, QLD, Australia
| | - David Sowden
- Infectious Diseases Service, Department of Medicine, Sunshine Coast University Hospital, QLD, Australia.,Microbiology Department, Pathology Queensland, Sunshine Coast University Hospital, QLD, Australia
| | - Michael Caffery
- Microbiology Department, Pathology Queensland, Sunshine Coast University Hospital, QLD, Australia
| | - Michael Bint
- Respiratory Medicine, Department of Medicine, Sunshine Coast University Hospital, QLD, Australia
| | - Jennifer Broom
- Infectious Diseases Service, Department of Medicine, Sunshine Coast University Hospital, QLD, Australia.,University of Queensland, School of Medicine, QLD, Australia
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Abstract
Antimicrobial resistance is a major threat to the delivery of effective care and already causes 700000 excess deaths per year worldwide. International consensus on action to combat antimicrobial resistance was reached in 2015. Australia is implementing a national strategy. The clinical consequences of antimicrobial resistance are seen most acutely in multi-drug resistant Gram-negative bacterial infections, where they cause increased mortality and morbidity and threaten the delivery of once routine medical care. The solution to antimicrobial resistance is complex and multifaceted. Antimicrobial stewardship, that is optimising the use of the antibiotics we currently have, is the most rapidly deployable mitigation. Several novel antibiotics with activity against a range of drug-resistant bacteria are now available clinically, leading to hope that innovative solutions will reduce the impact of resistance. It is critical that these new drugs are protected from inappropriate use.
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del Arroyo A, Sanchez J, Patel S, Phillips S, Reyes A, Cubillos C, Fernando R, David A, Sultan P, Ackland G, Reeve A, Sodha S, Ciechanowicz S, Olearo E, Dick J, Stewart A. Role of leucocyte caspase-1 activity in epidural-related maternal fever: a single-centre, observational, mechanistic cohort study. Br J Anaesth 2019; 122:92-102. [DOI: 10.1016/j.bja.2018.09.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 09/03/2018] [Accepted: 09/24/2018] [Indexed: 01/19/2023] Open
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Johnson J, Stewart A, Anna N, Acree M, Flatt J, Max W, Gregorich S. A CHOIR INTERVENTION TO PROMOTE WELL-BEING AMONG DIVERSE OLDER ADULTS: THE COMMUNITY OF VOICES TRIAL. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J Johnson
- University of California San Francisco
| | - A Stewart
- University of California San Francisco
| | - N Anna
- National Institute on Minority Health and Health Disparities
| | - M Acree
- University of California San Francisco
| | - J Flatt
- University of California-San Francisco
| | - W Max
- University of California San Francisco
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