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Walker SL, Noble J, Thomson A, Moran CM, Mellis D, Lee I, White LJ, Forbes S. Ultrasound-guided hepatic portal vein injection is not a reproducible technique for delivery of cell therapies to the liver in mice. Diabet Med 2023; 40:e15192. [PMID: 37531444 PMCID: PMC10947537 DOI: 10.1111/dme.15192] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/04/2023]
Abstract
AIMS Our aim was to determine if ultrasound-guided HPV injection in mice would provide reproducible and reliable results, as is currently obtained via open laparotomy techniques, and offer a surgical refinement to emulate islet transplantation in humans. METHODS Fluorescent-polymer microparticles (20 μm) were injected (27G-needle) into the HPV via open laparotomy (n = 4) or under ultrasound-guidance (n = 4) using an MX550D-transducer with a Vevo3100-scanner (FUJIFILM VisualSonics, Inc.). Mice were culled 24-h post injection; organs were frozen, step sectioned (10 μm-slices) and 10 sections/mouse (50 μm-spacing) were quantified for microparticles in the liver and other organs by fluorescent microscopy. RESULTS Murine HPV injection, via open laparotomy-route, resulted in widespread distribution of microparticles in the liver, lungs and spleen; ultrasound-guided injection resulted in reduced microparticle delivery (p < 0.0001) and microparticle clustering in distinct areas of the liver at the site of needle penetration, with very few/no microparticles being seen in lung and spleen tissues, hypothesised to be due to flow into the body cavity: liver median (interquartile range) 4.15 (0.00-4.15) versus 0.00 (0.00-0.00) particle-count mm-2 , respectively. CONCLUSIONS Ultrasound-guided injection results in microparticle clustering in the liver, with an overall reduction in microparticle number when compared to open laparotomy HPV injection, and high variability in microparticle-counts detected between mice. Ultrasound-guided injection is not currently a technique that can replace open laparotomy HPV of islet transplantation in mice.
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Affiliation(s)
- Sophie L. Walker
- BHF Centre for Cardiovascular Science, Queens Medical Research InstituteUniversity of EdinburghEdinburghUK
| | - June Noble
- BHF Centre for Cardiovascular Science, Queens Medical Research InstituteUniversity of EdinburghEdinburghUK
| | - Adrian Thomson
- BHF Centre for Cardiovascular Science, Queens Medical Research InstituteUniversity of EdinburghEdinburghUK
| | - Carmel M. Moran
- BHF Centre for Cardiovascular Science, Queens Medical Research InstituteUniversity of EdinburghEdinburghUK
| | - David Mellis
- BHF Centre for Cardiovascular Science, Queens Medical Research InstituteUniversity of EdinburghEdinburghUK
| | - I‐Ning Lee
- School of Pharmacy, Biodiscovery InstituteUniversity of Nottingham, University ParkNottinghamUK
| | - Lisa J. White
- School of Pharmacy, Biodiscovery InstituteUniversity of Nottingham, University ParkNottinghamUK
| | - Shareen Forbes
- BHF Centre for Cardiovascular Science, Queens Medical Research InstituteUniversity of EdinburghEdinburghUK
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Berman DM, Lee AY, Lesurf R, Patel PG, Ebrahimizadeh W, Bayani J, Lee LA, Boufaied N, Selvarajah S, Jamaspishvili T, Guérard KP, Dion D, Kawashima A, Clarke GM, How N, Jackson CL, Scarlata E, Siddiqui K, Okello JBA, Aprikian AG, Moussa M, Finelli A, Chin J, Brimo F, Bauman G, Loblaw A, Venkateswaran V, Buttyan R, Chevalier S, Thomson A, Park PC, Siemens DR, Lapointe J, Boutros PC, Bartlett JMS. Multimodal Biomarkers That Predict the Presence of Gleason Pattern 4: Potential Impact for Active Surveillance. J Urol 2023; 210:257-271. [PMID: 37126232 DOI: 10.1097/ju.0000000000003507] [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: 04/19/2022] [Accepted: 04/20/2023] [Indexed: 05/02/2023]
Abstract
PURPOSE Latent grade group ≥2 prostate cancer can impact the performance of active surveillance protocols. To date, molecular biomarkers for active surveillance have relied solely on RNA or protein. We trained and independently validated multimodal (mRNA abundance, DNA methylation, and/or DNA copy number) biomarkers that more accurately separate grade group 1 from grade group ≥2 cancers. MATERIALS AND METHODS Low- and intermediate-risk prostate cancer patients were assigned to training (n=333) and validation (n=202) cohorts. We profiled the abundance of 342 mRNAs, 100 DNA copy number alteration loci, and 14 hypermethylation sites at 2 locations per tumor. Using the training cohort with cross-validation, we evaluated methods for training classifiers of pathological grade group ≥2 in centrally reviewed radical prostatectomies. We trained 2 distinct classifiers, PRONTO-e and PRONTO-m, and validated them in an independent radical prostatectomy cohort. RESULTS PRONTO-e comprises 353 mRNA and copy number alteration features. PRONTO-m includes 94 clinical, mRNAs, copy number alterations, and methylation features at 14 and 12 loci, respectively. In independent validation, PRONTO-e and PRONTO-m predicted grade group ≥2 with respective true-positive rates of 0.81 and 0.76, and false-positive rates of 0.43 and 0.26. Both classifiers were resistant to sampling error and identified more upgrading cases than a well-validated presurgical risk calculator, CAPRA (Cancer of the Prostate Risk Assessment; P < .001). CONCLUSIONS Two grade group classifiers with superior accuracy were developed by incorporating RNA and DNA features and validated in an independent cohort. Upon further validation in biopsy samples, classifiers with these performance characteristics could refine selection of men for active surveillance, extending their treatment-free survival and intervals between surveillance.
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Affiliation(s)
- D M Berman
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - A Y Lee
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - R Lesurf
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Now with Hospital for Sick Children, Toronto, Ontario, Canada
| | - P G Patel
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
- Now with Hospital for Sick Children, Toronto, Ontario, Canada
| | - W Ebrahimizadeh
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Now with IMV Inc, Dartmouth, Nova Scotia, Canada
| | - J Bayani
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathology, University of Toronto, Toronto, Ontario, Canada
| | - L A Lee
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - N Boufaied
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - S Selvarajah
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
- Now with University Health Network, Toronto, Ontario, Canada
| | - T Jamaspishvili
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - K-P Guérard
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - D Dion
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - A Kawashima
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
- Now with Osaka University, Osaka, Japan
| | - G M Clarke
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - N How
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
- Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - C L Jackson
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - E Scarlata
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - K Siddiqui
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Now with Sultan Qaboos University Hospital, Seeb, Oman
| | - J B A Okello
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - A G Aprikian
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - M Moussa
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
| | - A Finelli
- Princess Margaret Cancer Centre. Toronto, Ontario, Canada
- Departments of Surgery and Oncology, University of Toronto, Toronto, Ontario, Canada
| | - J Chin
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
| | - F Brimo
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Department of Pathology, McGill University, Montreal, Quebec, Canada
| | - G Bauman
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
| | - A Loblaw
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Departments of Radiation Oncology and Health Policy Management and Evaluation, University of Toronto, Toronto
| | - V Venkateswaran
- Departments of Surgery and Oncology, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - R Buttyan
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada
- Departments of Experimental Medicine and Interdisciplinary Oncology, Vancouver, British Columbia, Canada
| | - S Chevalier
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - A Thomson
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Now with College of Science and Engineering Biology, University of Edinburgh, Edinburgh, United Kingdom
| | - P C Park
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
- Now with Department of Pathology, Shared Health, Winnipeg, Manitoba, Canada
| | - D R Siemens
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Departments of Urology, Oncology and Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - J Lapointe
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - P C Boutros
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Now with University of California, Los Angeles, Los Angeles, California, United States
| | - J M S Bartlett
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathology, University of Toronto, Toronto, Ontario, Canada
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, United Kingdom
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Hall P, Howell S, Venkitaraman R, Thomson A, Raja F, King J, Michie C, Khan S, Brunt A, Gahir D, McAdam K, Cooner J, Kane N. P084 Socioeconomic Outcomes With Ribociclib in Patients With HR+, HER2– Advanced Breast Cancer (ABC) in UK Real-world Settings. Breast 2023. [DOI: 10.1016/s0960-9776(23)00201-1] [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: 03/18/2023] Open
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Alberto M, Thomson A, Jack G. Minimally invasive pyeloplasty in adults: A systematic review on stent vs. stentless technique. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01047-3] [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: 02/12/2023]
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5
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Lim KH, Dorris C, Thomson A, Ardis M, Devlin B, Gray G. 715 Implementation of Enhanced Recovery After Surgery (ERAS) in Total Laryngectomies. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.195] [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: 11/07/2022]
Abstract
Abstract
Aim
The Enhanced Recovery After Surgery (ERAS) protocol for total laryngectomies was first implemented in our tertiary head and neck centre from November 2019. It includes pre-operative carbohydrate loading and an early swallow test which facilitates recommencement of oral intake to improve outcomes. Protocol adherence rate and patient outcomes were measured to determine the effectiveness and benefits of ERAS in laryngectomy patients.
Method
22 total laryngectomy patients from November 2019 to September 2021 were enrolled onto the ERAS protocol, 18 primary and 3 salvage cases. An analysis of the respective patient cohorts was performed to determine adherence to the ERAS protocol and outcomes such as complications and length of inpatient stay were measured.
Results
19 patients (86%) received pre-operative carbohydrate loading successfully, while 3 patients were contraindicated due to background of diabetes. Early swallow test was performed in 59% of patients. Potential reasons for delay were stoma dehiscence or clinical suspicion of neo-pharyngeal leak. 59% of primary cases were deemed medically fit for discharge within the target timeframe of 12–14 days whereas no target was set for salvage cases due to expected poor healing. Main complication in primary cases was neo-pharyngeal leak followed by stoma dehiscence with 28% and 11% respectively.
Conclusion
Limitations of our study include small sample size due to the COVID-19 pandemic. Despite its infancy, the ERAS protocol has achieved good outcomes in early recommencement of oral intake post-laryngectomy and encouraging early safe discharge from hospital. Future plans include establishment of Prehab Clinic and application of ERAS to neck dissection patients.
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Affiliation(s)
- KH Lim
- Royal Victoria Hospital , Belfast , United Kingdom
| | - C Dorris
- Royal Victoria Hospital , Belfast , United Kingdom
| | - A Thomson
- Royal Victoria Hospital , Belfast , United Kingdom
| | - M Ardis
- Royal Victoria Hospital , Belfast , United Kingdom
| | - B Devlin
- Royal Victoria Hospital , Belfast , United Kingdom
| | - G Gray
- Royal Victoria Hospital , Belfast , United Kingdom
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Sjostrand S, Bacou M, Thomson A, Kaczmarek K, Evertsson M, Svensson I, Farrington SM, Moug S, Jansson T, Moran CM, Mulvana H. Contrast enhanced magneto-motive ultrasound in lymph nodes - modelling and pre-clinical imaging using magnetic microbubbles. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:194-197. [PMID: 36086230 DOI: 10.1109/embc48229.2022.9871876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Despite advances in MRI, the detection and characterisation of lymph nodes in rectal cancer remains complex, especially when assessing the response to neo-adjuvant treatment. An alternative approach is functional imaging, previously shown to aid characterization of cancer tissues. We report proof-of-concept of the novel technique Contrast-Enhanced Magneto-Motive Ultrasound (CE-MMUS) to recover information relating to local perfusion and lymphatic drainage, and interrogate tissue mechanical properties through magnetically induced tissue deformations. The feasibility of the proposed application was explored using a combination of pre-clinical ultrasound imaging and finite element analysis. First, contrast enhanced ultrasound imaging on one wild type mouse recorded lymphatic drainage of magnetic microbubbles after bolus injection. Second, preliminary CE-MMUS data were acquired as a proof of concept. Third, the magneto-mechanical interactions of a magnetic microbubble with an elastic solid were simulated using finite element software. Accumulation of magnetic microbubbles in the inguinal lymph node was verified using contrast enhanced ultrasound, with peak enhancement occurring 3.7 s post-injection. Preliminary CE-MMUS indicates the presence of magnetic contrast agent in the lymph node. The finite element analysis explores how the magnetic force is transferred to motion of the solid, which depends on elasticity and bubble radius, indicating an inverse relation with displacement. Combining magnetic microbubbles with MMUS could harness the advantages of both techniques, to provide perfusion information, robust lymph node delineation and characterisation based on mechanical properties. Clinical Relevance- Robust detection and characterisation of lymph nodes could be aided by visualising lymphatic drainage of magnetic microbubbles using contrast enhanced ultrasound imaging and magneto-motion, which is dependent on tissue mechanical properties.
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7
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Spiroski AM, McCracken IR, Thomson A, Magalhaes-Pinto M, Lalwani MK, Newton KJ, Miller E, Bénézech C, Hadoke P, Brittan M, Mountford JC, Beqqali A, Gray GA, Baker AH. Human embryonic stem cell-derived endothelial cell product injection attenuates cardiac remodeling in myocardial infarction. Front Cardiovasc Med 2022; 9:953211. [PMID: 36299872 PMCID: PMC9588936 DOI: 10.3389/fcvm.2022.953211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/16/2022] [Indexed: 11/25/2022] Open
Abstract
Background Mechanisms contributing to tissue remodeling of the infarcted heart following cell-based therapy remain elusive. While cell-based interventions have the potential to influence the cardiac healing process, there is little direct evidence of preservation of functional myocardium. Aim The aim of the study was to investigate tissue remodeling in the infarcted heart following human embryonic stem cell-derived endothelial cell product (hESC-ECP) therapy. Materials and methods Following coronary artery ligation (CAL) to induce cardiac ischemia, we investigated infarct size at 1 day post-injection in media-injected controls (CALM, n = 11), hESC-ECP-injected mice (CALC, n = 10), and dead hESC-ECP-injected mice (CALD, n = 6); echocardiography-based functional outcomes 14 days post-injection in experimental (CALM, n = 13; CALC, n = 17) and SHAM surgical mice (n = 4); and mature infarct size (CALM and CALC, both n = 6). We investigated ligand-receptor interactions (LRIs) in hESC-ECP cell populations, incorporating a publicly available C57BL/6J mouse cardiomyocyte-free scRNAseq dataset with naive, 1 day, and 3 days post-CAL hearts. Results Human embryonic stem cell-derived endothelial cell product injection reduces the infarct area (CALM: 54.5 ± 5.0%, CALC: 21.3 ± 4.9%), and end-diastolic (CALM: 87.8 ± 8.9 uL, CALC: 63.3 ± 2.7 uL) and end-systolic ventricular volume (CALM: 56.4 ± 9.3 uL, CALC: 33.7 ± 2.6 uL). LRI analyses indicate an alternative immunomodulatory effect mediated via viable hESC-ECP-resident signaling. Conclusion Delivery of the live hESC-ECP following CAL modulates the wound healing response during acute pathological remodeling, reducing infarct area, and preserving functional myocardium in this relatively acute model. Potential intrinsic myocardial cellular/hESC-ECP interactions indicate that discreet immunomodulation could provide novel therapeutic avenues to improve cardiac outcomes following myocardial infarction.
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Affiliation(s)
- Ana-Mishel Spiroski
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
- BHF Centre for Vascular Regeneration, University of Edinburgh, Edinburgh, United Kingdom
| | - Ian R. McCracken
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Adrian Thomson
- Edinburgh Preclinical Imaging, University of Edinburgh, Edinburgh, United Kingdom
| | - Marlene Magalhaes-Pinto
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
- BHF Centre for Vascular Regeneration, University of Edinburgh, Edinburgh, United Kingdom
| | - Mukesh K. Lalwani
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Kathryn J. Newton
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Eileen Miller
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Cecile Bénézech
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Patrick Hadoke
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Mairi Brittan
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
- BHF Centre for Vascular Regeneration, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Abdelaziz Beqqali
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Gillian A. Gray
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew H. Baker
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
- BHF Centre for Vascular Regeneration, University of Edinburgh, Edinburgh, United Kingdom
- *Correspondence: Andrew H. Baker,
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8
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Morgan E, Thomson A, Kolmajer K, Murch S, Upton J, Williams T. An Examination of Inpatient Care of Heart Failure Patients: A Nursing-Led Review. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.060] [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: 11/27/2022]
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9
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Monteiro JP, Rodor J, Caudrillier A, Scanlon JP, Spiroski AM, Dudnakova T, Pflüger-Müller B, Shmakova A, von Kriegsheim A, Deng L, Taylor RS, Wilson-Kanamori JR, Chen SH, Stewart K, Thomson A, Mitić T, McClure JD, Iynikkel J, Hadoke PW, Denby L, Bradshaw AC, Caruso P, Morrell NW, Kovacic JC, Ulitsky I, Henderson NC, Caporali A, Leisegang MS, Brandes RP, Baker AH. MIR503HG Loss Promotes Endothelial-to-Mesenchymal Transition in Vascular Disease. Circ Res 2021; 128:1173-1190. [PMID: 33703914 PMCID: PMC7610629 DOI: 10.1161/circresaha.120.318124] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/09/2021] [Indexed: 12/13/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- João P. Monteiro
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Julie Rodor
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Axelle Caudrillier
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Jessica P. Scanlon
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Ana-Mishel Spiroski
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Tatiana Dudnakova
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Beatrice Pflüger-Müller
- Institute for Cardiovascular Physiology, Goethe University
- German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt, Germany
| | - Alena Shmakova
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Alex von Kriegsheim
- Edinburgh Cancer Research UK Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh
| | - Lin Deng
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Richard S. Taylor
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh
| | - John R. Wilson-Kanamori
- The Queen’s Medical Research Institute, Centre for Inflammation Research, University of Edinburgh
| | - Shiau-Haln Chen
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Kevin Stewart
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Adrian Thomson
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Tijana Mitić
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - John D. McClure
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Centre, University of Glasgow
| | - Jean Iynikkel
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Patrick W.F. Hadoke
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Laura Denby
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Angela C. Bradshaw
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Centre, University of Glasgow
| | | | | | - Jason C. Kovacic
- The Zena and Michael A. Wiener Cardiovascular Institute, School of Medicine at Mount Sinai, New York
- Victor Chang Cardiac Research Institute, Darlinghurst, Australia
| | | | - Neil C. Henderson
- The Queen’s Medical Research Institute, Centre for Inflammation Research, University of Edinburgh
| | - Andrea Caporali
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
| | - Matthias S. Leisegang
- Institute for Cardiovascular Physiology, Goethe University
- German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt, Germany
| | - Ralf P. Brandes
- Institute for Cardiovascular Physiology, Goethe University
- German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt, Germany
| | - Andrew H. Baker
- The Queen’s Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh
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Spiroski AM, Sanders R, Meloni M, McCracken IR, Thomson A, Brittan M, Gray GA, Baker AH. The Influence of the LINC00961/SPAAR Locus Loss on Murine Development, Myocardial Dynamics, and Cardiac Response to Myocardial Infarction. Int J Mol Sci 2021; 22:ijms22020969. [PMID: 33478078 PMCID: PMC7835744 DOI: 10.3390/ijms22020969] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/07/2021] [Accepted: 01/14/2021] [Indexed: 01/14/2023] Open
Abstract
Long non-coding RNAs (lncRNAs) have structural and functional roles in development and disease. We have previously shown that the LINC00961/SPAAR (small regulatory polypeptide of amino acid response) locus regulates endothelial cell function, and that both the lncRNA and micropeptide counter-regulate angiogenesis. To assess human cardiac cell SPAAR expression, we mined a publicly available scRNSeq dataset and confirmed LINC00961 locus expression and hypoxic response in a murine endothelial cell line. We investigated post-natal growth and development, basal cardiac function, the cardiac functional response, and tissue-specific response to myocardial infarction. To investigate the influence of the LINC00961/SPAAR locus on longitudinal growth, cardiac function, and response to myocardial infarction, we used a novel CRISPR/Cas9 locus knockout mouse line. Data mining suggested that SPAAR is predominantly expressed in human cardiac endothelial cells and fibroblasts, while murine LINC00961 expression is hypoxia-responsive in mouse endothelial cells. LINC00961–/– mice displayed a sex-specific delay in longitudinal growth and development, smaller left ventricular systolic and diastolic areas and volumes, and greater risk area following myocardial infarction compared with wildtype littermates. These data suggest the LINC00961/SPAAR locus contributes to cardiac endothelial cell and fibroblast function and hypoxic response, growth and development, and basal cardiovascular function in adulthood.
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Affiliation(s)
- Ana-Mishel Spiroski
- Centre for Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK; (A.-M.S.); (R.S.); (M.M.); (I.R.M.); (M.B.); (G.A.G.)
| | - Rachel Sanders
- Centre for Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK; (A.-M.S.); (R.S.); (M.M.); (I.R.M.); (M.B.); (G.A.G.)
| | - Marco Meloni
- Centre for Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK; (A.-M.S.); (R.S.); (M.M.); (I.R.M.); (M.B.); (G.A.G.)
| | - Ian R. McCracken
- Centre for Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK; (A.-M.S.); (R.S.); (M.M.); (I.R.M.); (M.B.); (G.A.G.)
| | - Adrian Thomson
- Edinburgh Preclinical Imaging, Edinburgh Preclinical Imaging, BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4TJ, UK;
| | - Mairi Brittan
- Centre for Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK; (A.-M.S.); (R.S.); (M.M.); (I.R.M.); (M.B.); (G.A.G.)
| | - Gillian A. Gray
- Centre for Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK; (A.-M.S.); (R.S.); (M.M.); (I.R.M.); (M.B.); (G.A.G.)
| | - Andrew H. Baker
- Centre for Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK; (A.-M.S.); (R.S.); (M.M.); (I.R.M.); (M.B.); (G.A.G.)
- Correspondence: ; Tel.: +44-0131-24-26728
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Castellan RF, Vitiello M, Vidmar M, Johnstone S, Iacobazzi D, Mellis D, Cathcart B, Thomson A, Ruhrberg C, Caputo M, Newby DE, Gray GA, Baker AH, Caporali A, Meloni M. miR-96 and miR-183 differentially regulate neonatal and adult postinfarct neovascularization. JCI Insight 2020; 5:134888. [PMID: 32544097 PMCID: PMC7453899 DOI: 10.1172/jci.insight.134888] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 11/08/2019] [Accepted: 06/10/2020] [Indexed: 12/18/2022] Open
Abstract
Following myocardial infarction (MI), the adult heart has minimal regenerative potential. Conversely, the neonatal heart can undergo extensive regeneration, and neovascularization capacity was hypothesized to contribute to this difference. Here, we demonstrate the higher angiogenic potential of neonatal compared with adult mouse cardiac endothelial cells (MCECs) in vitro and use this difference to identify candidate microRNAs (miRs) regulating cardiac angiogenesis after MI. miR expression profiling revealed miR-96 and miR-183 upregulation in adult compared with neonatal MCECs. Their overexpression decreased the angiogenic potential of neonatal MCECs in vitro and prevented scar resolution and neovascularization in neonatal mice after MI. Inversely, their inhibition improved the angiogenic potential of adult MCECs, and miR-96/miR-183–KO mice had increased peri-infarct neovascularization. In silico analyses identified anillin (ANLN) as a direct target of miR-96 and miR-183. In agreement, Anln expression declined following their overexpression and increased after their inhibition in vitro. Moreover, ANLN expression inversely correlated with miR-96 expression and age in cardiac ECs of cardiovascular patients. In vivo, ANLN+ vessels were enriched in the peri-infarct area of miR-96/miR-183–KO mice. These findings identify miR-96 and miR-183 as regulators of neovascularization following MI and miR-regulated genes, such as anillin, as potential therapeutic targets for cardiovascular disease. MiR-96 and miR-183 act as molecular switches to regulate endothelial cells angiogenic potential and differentially regulate neovascularization following myocardial infarction in neonatal and adult mice.
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Affiliation(s)
- Raphael Fp Castellan
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.,UCL Institute of Ophthalmology, London, United Kingdom
| | - Milena Vitiello
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Martina Vidmar
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Steven Johnstone
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Dominga Iacobazzi
- Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - David Mellis
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Benjamin Cathcart
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Adrian Thomson
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Massimo Caputo
- Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - David E Newby
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Gillian A Gray
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew H Baker
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrea Caporali
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Marco Meloni
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
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Toor IS, Rückerl D, Mair I, Ainsworth R, Meloni M, Spiroski AM, Benezech C, Felton JM, Thomson A, Caporali A, Keeble T, Tang KH, Rossi AG, Newby DE, Allen JE, Gray GA. Eosinophil Deficiency Promotes Aberrant Repair and Adverse Remodeling Following Acute Myocardial Infarction. JACC Basic Transl Sci 2020; 5:665-681. [PMID: 32760855 PMCID: PMC7393409 DOI: 10.1016/j.jacbts.2020.05.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 01/24/2023]
Abstract
In ST-segment elevation myocardial infarction of both patients and mice, there was a decline in blood eosinophil count, with activated eosinophils recruited to the infarct zone. Eosinophil deficiency resulted in attenuated anti-inflammatory macrophage polarization, enhanced myocardial inflammation, increased scar size, and deterioration of myocardial structure and function. Adverse cardiac remodeling in the setting of eosinophil deficiency was prevented by interleukin-4 therapy.
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Affiliation(s)
- Iqbal S. Toor
- British Heart Foundation/University Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Dominik Rückerl
- Faculty of Biology, Medicine and Health, School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - Iris Mair
- MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Rob Ainsworth
- Division of Pathology, Deanery of Molecular, Genetic and Population Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Marco Meloni
- British Heart Foundation/University Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Ana-Mishel Spiroski
- British Heart Foundation/University Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Cecile Benezech
- British Heart Foundation/University Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Jennifer M. Felton
- MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Adrian Thomson
- British Heart Foundation/University Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrea Caporali
- British Heart Foundation/University Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Thomas Keeble
- Essex Cardiothoracic Centre, Basildon and Thurrock Hospitals NHS Foundation Trust, Essex, United Kingdom
- School of Medicine, Anglia Ruskin University, Cambridge, United Kingdom
| | - Kare H. Tang
- Essex Cardiothoracic Centre, Basildon and Thurrock Hospitals NHS Foundation Trust, Essex, United Kingdom
| | - Adriano G. Rossi
- MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - David E. Newby
- British Heart Foundation/University Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Judith E. Allen
- Faculty of Biology, Medicine and Health, School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - Gillian A. Gray
- British Heart Foundation/University Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
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Katz T, Oh R, Thomson A, Widger J. ePS4.10 The principles of the Toyota Production System (TPS) applied to an inpatient food service model can improve nutritional outcomes for children with cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30319-2] [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: 11/25/2022]
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Jones NK, Stewart K, Czopek A, Menzies RI, Thomson A, Moran CM, Cairns C, Conway BR, Denby L, Livingstone DEW, Wiseman J, Hadoke PW, Webb DJ, Dhaun N, Dear JW, Mullins JJ, Bailey MA. Endothelin-1 Mediates the Systemic and Renal Hemodynamic Effects of GPR81 Activation. Hypertension 2020; 75:1213-1222. [PMID: 32200679 PMCID: PMC7176350 DOI: 10.1161/hypertensionaha.119.14308] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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] [Indexed: 02/07/2023]
Abstract
Supplemental Digital Content is available in the text. GPR81 (G-protein-coupled receptor 81) is highly expressed in adipocytes, and activation by the endogenous ligand lactate inhibits lipolysis. GPR81 is also expressed in the heart, liver, and kidney, but roles in nonadipose tissues are poorly defined. GPR81 agonists, developed to improve blood lipid profile, might also provide insights into GPR81 physiology. Here, we assessed the blood pressure and renal hemodynamic responses to the GPR81 agonist, AZ′5538. In male wild-type mice, intravenous AZ′5538 infusion caused a rapid and sustained increase in systolic and diastolic blood pressure. Renal artery blood flow, intrarenal tissue perfusion, and glomerular filtration rate were all significantly reduced. AZ′5538 had no effect on blood pressure or renal hemodynamics in Gpr81−/− mice. Gpr81 mRNA was expressed in renal artery vascular smooth muscle, in the afferent arteriole, in glomerular and medullary perivascular cells, and in pericyte-like cells isolated from kidney. Intravenous AZ′5538 increased plasma ET-1 (endothelin 1), and pretreatment with BQ123 (endothelin-A receptor antagonist) prevented the pressor effects of GPR81 activation, whereas BQ788 (endothelin-B receptor antagonist) did not. Renal ischemia-reperfusion injury, which increases renal extracellular lactate, increased the renal expression of genes encoding ET-1, KIM-1 (Kidney Injury Molecule 1), collagen type 1-α1, TNF-α (tumor necrosis factor-α), and F4/80 in wild-type mice but not in Gpr81−/− mice. In summary, activation of GPR81 in vascular smooth muscle and perivascular cells regulates renal hemodynamics, mediated by release of the potent vasoconstrictor ET-1. This suggests that lactate may be a paracrine regulator of renal blood flow, particularly relevant when extracellular lactate is high as occurs during ischemic renal disease.
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Affiliation(s)
- Natalie K Jones
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - Kevin Stewart
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - Alicja Czopek
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - Robert I Menzies
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - Adrian Thomson
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - Carmel M Moran
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - Carolynn Cairns
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - Bryan R Conway
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - Laura Denby
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - Dawn E W Livingstone
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - John Wiseman
- Discovery Sciences, IMED Biotech Unit, AstraZeneca R&D Gothenburg, Sweden (J.W.)
| | - Patrick W Hadoke
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - David J Webb
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - Neeraj Dhaun
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - James W Dear
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - John J Mullins
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
| | - Matthew A Bailey
- From the University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Scotland, United Kingdom (N.K.J., K.S., A.C., R.I.M., A.T., C.M.M., C.C., B.R.C., L.D., D.E.W.L., P.W.H., D.J.W., N.D., J.W.D., J.J.M., M.A.B.)
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Castellan RFP, Thomson A, Moran CM, Gray GA. Electrocardiogram-gated Kilohertz Visualisation (EKV) Ultrasound Allows Assessment of Neonatal Cardiac Structural and Functional Maturation and Longitudinal Evaluation of Regeneration After Injury. Ultrasound Med Biol 2020; 46:167-179. [PMID: 31699549 PMCID: PMC6900752 DOI: 10.1016/j.ultrasmedbio.2019.09.012] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/16/2019] [Accepted: 09/18/2019] [Indexed: 06/10/2023]
Abstract
The small size and high heart rate of the neonatal mouse heart makes structural and functional characterisation particularly challenging. Here, we describe application of electrocardiogram-gated kilohertz visualisation (EKV) ultrasound imaging with high spatio-temporal resolution to non-invasively characterise the post-natal mouse heart during normal growth and regeneration after injury. The 2-D images of the left ventricle (LV) acquired across the cardiac cycle from post-natal day 1 (P1) to P42 revealed significant changes in LV mass from P8 that coincided with a switch from hyperplastic to hypertrophic growth and correlated with ex vivo LV weight. Remodelling of the LV was indicated between P8 and P21 when LV mass and cardiomyocyte size increased with no accompanying change in LV wall thickness. Whereas Doppler imaging showed the expected switch from LV filling driven by atrial contraction to filling by LV relaxation during post-natal week 1, systolic function was retained at the same level from P1 to P42. EKV ultrasound imaging also revealed loss of systolic function after induction of myocardial infarction at P1 and regain of function associated with regeneration of the myocardium by P21. EKV ultrasound imaging thus offers a rapid and convenient method for routine non-invasive characterisation of the neonatal mouse heart.
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Affiliation(s)
- Raphael F P Castellan
- Centre for Cardiovascular Science, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK.
| | - Adrian Thomson
- Centre for Cardiovascular Science, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK; Edinburgh Imaging, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Carmel M Moran
- Centre for Cardiovascular Science, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK; Edinburgh Imaging, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Gillian A Gray
- Centre for Cardiovascular Science, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
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McDicken N, Thomson A, White A, Toor I, Gray G, Moran C, Watson RJ, Anderson T. 3D angle-independent Doppler and speckle tracking for the myocardium and blood flow. Echo Res Pract 2019; 6:105-114. [PMID: 31729209 PMCID: PMC8111307 DOI: 10.1530/erp-19-0040] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
A technology based on velocity ratio indices is described for application in the myocardium. Angle-independent Doppler indices, such as the pulsatility index, which employ velocity ratios, can be measured even if the ultrasound beam vector at the moving target and the motion vector are not in a known plane. The unknown plane situation is often encountered when an ultrasound beam interrogates sites in the myocardium. The velocities employed in an index calculation must be close to the same or opposite directions. The Doppler velocity ratio indices are independent of angle in 3D space as are ratio indices based on 1D strain and 1D speckle tracking. Angle-independent results with spectral Doppler methods are discussed. Possible future imaging techniques based on velocity ratios are presented. By using indices that involve ratios, several other sources of error cancel in addition to that of angular dependence for example errors due to less than optimum gain settings and beam distortion. This makes the indices reliable as research or clinical tools. Ratio techniques can be readily implemented with current commercial blood flow pulsed wave duplex Doppler equipment or with pulsed wave tissue Doppler equipment. In 70 patients where the quality of the real-time B-mode looked suitable for the Doppler velocity ratio technique, there was only one case where clear spectra could not be obtained for both the LV wall and the septum. A reproducibility study of spectra from the septum of the heart shows a 12% difference in velocity ratios in the repeat measurements.
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Affiliation(s)
- Norman McDicken
- Centre for Cardiovascular Research, School of Clinical Sciences and Community Health, The University of Edinburgh, Edinburgh, UK
| | - Adrian Thomson
- Centre for Cardiovascular Research, School of Clinical Sciences and Community Health, The University of Edinburgh, Edinburgh, UK
| | - Audrey White
- Centre for Cardiovascular Research, School of Clinical Sciences and Community Health, The University of Edinburgh, Edinburgh, UK
| | - Iqbal Toor
- Centre for Cardiovascular Research, School of Clinical Sciences and Community Health, The University of Edinburgh, Edinburgh, UK
| | - Gillian Gray
- Centre for Cardiovascular Research, School of Clinical Sciences and Community Health, The University of Edinburgh, Edinburgh, UK
| | - Carmel Moran
- Centre for Cardiovascular Research, School of Clinical Sciences and Community Health, The University of Edinburgh, Edinburgh, UK
| | - Robin J Watson
- Centre for Cardiovascular Research, School of Clinical Sciences and Community Health, The University of Edinburgh, Edinburgh, UK
| | - Tom Anderson
- Centre for Cardiovascular Research, School of Clinical Sciences and Community Health, The University of Edinburgh, Edinburgh, UK
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O'Sullivan J, Finnie SL, Teenan O, Cairns C, Boyd A, Bailey MA, Thomson A, Hughes J, Bénézech C, Conway BR, Denby L. Refining the Mouse Subtotal Nephrectomy in Male 129S2/SV Mice for Consistent Modeling of Progressive Kidney Disease With Renal Inflammation and Cardiac Dysfunction. Front Physiol 2019; 10:1365. [PMID: 31803059 PMCID: PMC6872545 DOI: 10.3389/fphys.2019.01365] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 07/24/2019] [Accepted: 10/14/2019] [Indexed: 12/25/2022] Open
Abstract
Chronic kidney disease (CKD) is prevalent worldwide and is associated with significant co-morbidities including cardiovascular disease (CVD). Traditionally, the subtotal nephrectomy (remnant kidney) experimental model has been performed in rats to model progressive renal disease. The model experimentally mimics CKD by reducing nephron number, resulting in renal insufficiency. Presently, there is a lack of translation of pre-clinical findings into successful clinical results. The pre-clinical nephrology field would benefit from reproducible progressive renal disease models in mice in order to avail of more widely available transgenics and experimental tools to dissect mechanisms of disease. Here we evaluate if a simplified single step subtotal nephrectomy (STNx) model performed in the 129S2/SV mouse can recapitulate the renal and cardiac changes observed in patients with CKD in a reproducible and robust way. The single step STNx surgery was well-tolerated and resulted in clinically relevant outcomes including hypertension, increased urinary albumin:creatinine ratio, and significantly increased serum creatinine, phosphate and urea. STNx mice developed significant left ventricular hypertrophy without reduced ejection fraction or cardiac fibrosis. Analysis of intra-renal inflammation revealed persistent recruitment of Ly6Chi monocytes transitioning to pro-fibrotic inflammatory macrophages in STNx kidneys. Unlike 129S2/SV mice, C57BL/6 mice exhibited renal fibrosis without proteinuria, renal dysfunction, or cardiac pathology. Therefore, the 129S2/SV genetic background is susceptible to induction of progressive proteinuric renal disease and cardiac hypertrophy using our refined, single-step flank STNx method. This reproducible model could be used to study the systemic pathophysiological changes induced by CKD in the kidney and the heart, intra-renal inflammation and for testing new therapies for CKD.
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Affiliation(s)
- James O'Sullivan
- Centre for Cardiovascular Science, Queen's Medical Research Centre, The University of Edinburgh, Edinburgh, United Kingdom
| | - Sarah Louise Finnie
- Centre for Cardiovascular Science, Queen's Medical Research Centre, The University of Edinburgh, Edinburgh, United Kingdom
| | - Oliver Teenan
- Centre for Cardiovascular Science, Queen's Medical Research Centre, The University of Edinburgh, Edinburgh, United Kingdom
| | - Carolynn Cairns
- Centre for Cardiovascular Science, Queen's Medical Research Centre, The University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew Boyd
- Centre for Cardiovascular Science, Queen's Medical Research Centre, The University of Edinburgh, Edinburgh, United Kingdom
| | - Matthew A Bailey
- Centre for Cardiovascular Science, Queen's Medical Research Centre, The University of Edinburgh, Edinburgh, United Kingdom
| | - Adrian Thomson
- Centre for Cardiovascular Science, Queen's Medical Research Centre, The University of Edinburgh, Edinburgh, United Kingdom.,Centre for Inflammation, Queen's Medical Research Centre, The University of Edinburgh, Edinburgh, United Kingdom
| | - Jeremy Hughes
- Centre for Inflammation, Queen's Medical Research Centre, The University of Edinburgh, Edinburgh, United Kingdom
| | - Cécile Bénézech
- Centre for Cardiovascular Science, Queen's Medical Research Centre, The University of Edinburgh, Edinburgh, United Kingdom
| | - Bryan Ronald Conway
- Centre for Cardiovascular Science, Queen's Medical Research Centre, The University of Edinburgh, Edinburgh, United Kingdom
| | - Laura Denby
- Centre for Cardiovascular Science, Queen's Medical Research Centre, The University of Edinburgh, Edinburgh, United Kingdom
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Stockler M, Martin A, Dhillon H, Davis I, Chi K, Chowdhury S, Horvath L, Lawrence N, Marx G, Caffrey JM, McDermott R, North S, Parnis F, Pook D, Reaume M, Sandhu S, Tan T, Thomson A, Zielinski R, Sweeney C. Health-related quality of life (HRQL) in a randomized phase III trial of enzalutamide with standard first-line therapy for metastatic, hormone-sensitive prostate cancer (mHSPC): ENZAMET (ANZUP 1304), an ANZUP-led, international, co-operative group trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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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Toor IS, Rückerl D, Mair I, Thomson A, Rossi AG, Newby DE, Allen JE, Gray GA. Enhanced monocyte recruitment and delayed alternative macrophage polarization accompanies impaired repair following myocardial infarction in C57BL/6 compared to BALB/c mice. Clin Exp Immunol 2019; 198:83-93. [PMID: 31119724 PMCID: PMC6718279 DOI: 10.1111/cei.13330] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2019] [Indexed: 12/24/2022] Open
Abstract
Activation of the innate immune response following myocardial infarction (MI) is essential for infarct repair. Preclinical models of MI commonly use C57BL/6 mice, which have a type 1‐dominant immune response, whereas other mouse strains such as BALB/c mice have a type 2‐dominant immune response. We compared C57BL/6 and BALB/c mice to investigate whether predisposition towards a proinflammatory phenotype influences the dynamics of the innate immune response to MI and associated infarct healing and the risk of cardiac rupture. MI was induced by permanent coronary artery ligation in 12–15‐week‐old male wild‐type BALB/c and C57BL/6 mice. Prior to MI, C57BL/6 mice had a lower proportion of CD206+ anti‐inflammatory macrophages in the heart and an expanded blood pool of proinflammatory Ly6Chigh monocytes in comparison to BALB/c mice. The systemic inflammatory response in C57BL/6 mice following MI was more pronounced, with greater peripheral blood Ly6Chigh monocytosis, splenic Ly6Chigh monocyte mobilization and myeloid cell infiltration of pericardial adipose tissue. This led to an increased and prolonged macrophage accumulation, as well as delayed transition towards anti‐inflammatory macrophage polarization in the infarct zone and surrounding tissues of C57BL/6 mice. These findings accompanied a higher rate of mortality due to cardiac rupture in C57BL/6 mice compared with BALB/c mice. We conclude that lower post‐MI survival of C57BL/6 mice over BALB/c mice is mediated in part by a more pronounced and prolonged inflammatory response. Outcomes in BALB/c mice highlight the therapeutic potential of modulating resolution of the innate immune response following MI for the benefit of successful infarct healing.
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Affiliation(s)
- I S Toor
- BHF/University Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - D Rückerl
- Faculty of Biology, Medicine and Health, School of Biological Sciences, University of Manchester, Edinburgh, UK
| | - I Mair
- MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - A Thomson
- BHF/University Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - A G Rossi
- MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - D E Newby
- BHF/University Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - J E Allen
- Faculty of Biology, Medicine and Health, School of Biological Sciences, University of Manchester, Edinburgh, UK
| | - G A Gray
- BHF/University Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
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Thomson A, Mumtaz S, Siddiqi J. Trismus with unilateral facial and neck swelling: an unusual case of Sjogren's Syndrome. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.748] [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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Thomson A, Parrish J, Liggins S. Does the knowledge equate to the competence: a case of an emergency admission following post operative complications after same day implant placement. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.175] [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: 11/16/2022]
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Thomson A, Parrish J, Polina H, Siddiqi J. Diagnosis of acute myeloid Leukaemia from an emergency referral of facial swelling of suspected dental abscess. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.319] [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: 11/27/2022]
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Thomson A, Tielens S, Schuhmann T, De Graaf T, Kenis G, Rutten B, Sack A. The effect of transcranial magnetic stimulation on living human neurons. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Moral-Sanz J, Lewis SA, MacMillan S, Ross FA, Thomson A, Viollet B, Foretz M, Moran C, Hardie DG, Evans AM. The LKB1-AMPK-α1 signaling pathway triggers hypoxic pulmonary vasoconstriction downstream of mitochondria. Sci Signal 2018; 11:11/550/eaau0296. [PMID: 30279167 DOI: 10.1126/scisignal.aau0296] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Hypoxic pulmonary vasoconstriction (HPV), which aids ventilation-perfusion matching in the lungs, is triggered by mechanisms intrinsic to pulmonary arterial smooth muscles. The unique sensitivity of these muscles to hypoxia is conferred by mitochondrial cytochrome c oxidase subunit 4 isoform 2, the inhibition of which has been proposed to trigger HPV through increased generation of mitochondrial reactive oxygen species. Contrary to this model, we have shown that the LKB1-AMPK-α1 signaling pathway is critical to HPV. Spectral Doppler ultrasound revealed that deletion of the AMPK-α1 catalytic subunit blocked HPV in mice during mild (8% O2) and severe (5% O2) hypoxia, whereas AMPK-α2 deletion attenuated HPV only during severe hypoxia. By contrast, neither of these genetic manipulations affected serotonin-induced reductions in pulmonary vascular flow. HPV was also attenuated by reduced expression of LKB1, a kinase that activates AMPK during energy stress, but not after deletion of CaMKK2, a kinase that activates AMPK in response to increases in cytoplasmic Ca2+ Fluorescence imaging of acutely isolated pulmonary arterial myocytes revealed that AMPK-α1 or AMPK-α2 deletion did not affect mitochondrial membrane potential during normoxia or hypoxia. However, deletion of AMPK-α1, but not of AMPK-α2, blocked hypoxia from inhibiting KV1.5, the classical "oxygen-sensing" K+ channel in pulmonary arterial myocytes. We conclude that LKB1-AMPK-α1 signaling pathways downstream of mitochondria are critical for the induction of HPV, in a manner also supported by AMPK-α2 during severe hypoxia.
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Affiliation(s)
- Javier Moral-Sanz
- Centre for Discovery Brain Sciences and Cardiovascular Science, College of Medicine and Veterinary Medicine, Hugh Robson Building, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Sophronia A Lewis
- Centre for Discovery Brain Sciences and Cardiovascular Science, College of Medicine and Veterinary Medicine, Hugh Robson Building, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Sandy MacMillan
- Centre for Discovery Brain Sciences and Cardiovascular Science, College of Medicine and Veterinary Medicine, Hugh Robson Building, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Fiona A Ross
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dow Street, Dundee DD1 5EH, UK
| | - Adrian Thomson
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Benoit Viollet
- Institut Cochin, INSERM U1016, Sorbonne Paris cité, 75014 Paris, France.,CNRS UMR 8104, Sorbonne Paris cité, 75014 Paris, France.,Université Paris Descartes, Sorbonne Paris cité, 75014 Paris, France
| | - Marc Foretz
- Institut Cochin, INSERM U1016, Sorbonne Paris cité, 75014 Paris, France.,CNRS UMR 8104, Sorbonne Paris cité, 75014 Paris, France.,Université Paris Descartes, Sorbonne Paris cité, 75014 Paris, France
| | - Carmel Moran
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - D Grahame Hardie
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dow Street, Dundee DD1 5EH, UK
| | - A Mark Evans
- Centre for Discovery Brain Sciences and Cardiovascular Science, College of Medicine and Veterinary Medicine, Hugh Robson Building, University of Edinburgh, Edinburgh EH8 9XD, UK.
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Ho SF, Thomson A, Kerr A. 52FEEDBACK INTEGRATED REHABILITATION FOR SIT-TO-STAND TRAINING (FIRST): A PILOT RANDOMISED CONTROLLED TRIAL. Age Ageing 2018. [DOI: 10.1093/ageing/afy127.01] [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: 11/14/2022] Open
Affiliation(s)
- S F Ho
- Biomedical Engineering, The University of Strathclyde, Glasgow, Scotland, U.K
| | - A Thomson
- Biomedical Engineering, The University of Strathclyde, Glasgow, Scotland, U.K
| | - A Kerr
- Biomedical Engineering, The University of Strathclyde, Glasgow, Scotland, U.K
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Flores CJ, Quested B, Spigiel T, Thomson A, Saxon B. Junior doctors' perspectives on transfusion education in Australia. Vox Sang 2018; 113:441-448. [PMID: 29740847 DOI: 10.1111/vox.12654] [Citation(s) in RCA: 6] [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] [Received: 10/17/2017] [Revised: 03/19/2018] [Accepted: 03/27/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early postgraduate training is a critical period to develop skills and to influence future clinical practice. Little is known about Australian junior doctors' existing transfusion knowledge and its application in patient care. This study explored their transfusion practice education preferences, developed tools to assist their practice and assessed the usefulness of these tools. METHODS A design-based study was conducted in two phases from April 2016 to March 2017. Phase 1 involved focus group sessions in six hospitals. Transcripts of audio recordings were analysed using thematic analysis. Findings were considered when developing transfusion practice support tools. Phase 2 surveyed junior doctors' response to the tools provided during orientation in five hospitals. Participation was voluntary. RESULTS Fifty-two junior doctors participated in the focus groups. Their priority was to be able to practice safely, appropriately and confidently. Preferred format for transfusion learning included expert-led face-to-face education; printed tools, for example lanyard cards; and for one app that covers essential aspects of transfusion practice. Adverse events management and practical transfusion prescribing were topics of most importance. Thirty-nine survey respondents found the transfusion practice support tools useful and recommended their use to complement practice. CONCLUSION There is a need for improved education to ensure best transfusion practice and patient outcomes. Australian junior doctors want immediate, practical, reliable transfusion information from credible sources to support them in practicing safely and confidently. Their educational needs are driven by real-time patient management. Promotion of the available resources and tools provided by the blood sector is important.
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Affiliation(s)
- C J Flores
- Clinical Services and Research Division, Australian Red Cross Blood Service, Melbourne, VIC, Australia
| | - B Quested
- Clinical Services and Research Division, Australian Red Cross Blood Service, Adelaide, SA, Australia
| | - T Spigiel
- Clinical Services and Research Division, Australian Red Cross Blood Service, Adelaide, SA, Australia
| | - A Thomson
- Clinical Services and Research Division, Australian Red Cross Blood Service, Sydney, NSW, Australia
| | - B Saxon
- Clinical Services and Research Division, Australian Red Cross Blood Service, Adelaide, SA, Australia
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Knazovicky D, Helgeson E, Case B, Thomson A, Gruen M, Maixner W, Lascelles B. Replicate Effects and Test–Retest Reliability of Quantitative Sensory Threshold Testing in Dogs with and without Chronic Pain. Vet Comp Orthop Traumatol 2018. [DOI: 10.1055/s-0038-1660882] [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: 10/28/2022]
Affiliation(s)
- D. Knazovicky
- Comparative Pain Research and Education Centre, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - E. Helgeson
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, United States
| | - B. Case
- Comparative Pain Research and Education Centre, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - A. Thomson
- Comparative Pain Research and Education Centre, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - M. Gruen
- Comparative Pain Research and Education Centre, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - W. Maixner
- Canine Cognition Center, Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, United States
| | - B. Lascelles
- Comparative Pain Research and Education Centre, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
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Dubuisson N, Paterson A, Turner B, Westcott M, Thomson A, Giovannoni G. Self-monitoring visual function via a smartphone application. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Coan PM, Barrier M, Alfazema N, Carter RN, Marion de Procé S, Dopico XC, Garcia Diaz A, Thomson A, Jackson-Jones LH, Moyon B, Webster Z, Ross D, Moss J, Arends MJ, Morton NM, Aitman TJ. Complement Factor B Is a Determinant of Both Metabolic and Cardiovascular Features of Metabolic Syndrome. Hypertension 2017; 70:HYPERTENSIONAHA.117.09242. [PMID: 28739975 PMCID: PMC5548512 DOI: 10.1161/hypertensionaha.117.09242] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 02/22/2017] [Accepted: 06/02/2017] [Indexed: 12/28/2022]
Abstract
CFB (complement factor B) is elevated in adipose tissue and serum from patients with type 2 diabetes mellitus and cardiovascular disease, but the causal relationship to disease pathogenesis is unclear. Cfb is also elevated in adipose tissue and serum of the spontaneously hypertensive rat, a well-characterized model of metabolic syndrome. To establish the role of CFB in metabolic syndrome, we knocked out the Cfb gene in the spontaneously hypertensive rat. Cfb-/- rats showed improved glucose tolerance and insulin sensitivity, redistribution of visceral to subcutaneous fat, increased adipocyte mitochondrial respiration, and marked changes in gene expression. Cfb-/- rats also had lower blood pressure, increased ejection fraction and fractional shortening, and reduced left ventricular mass. These changes in metabolism and gene expression, in adipose tissue and left ventricle, suggest new adipose tissue-intrinsic and blood pressure-independent mechanisms for insulin resistance and cardiac hypertrophy in the spontaneously hypertensive rat. In silico analysis of the human CFB locus revealed 2 cis-regulated expression quantitative trait loci for CFB expression significantly associated with visceral fat, circulating triglycerides and hypertension in genome-wide association studies. Together, these data demonstrate a key role for CFB in the development of spontaneously hypertensive rat metabolic syndrome phenotypes and of related traits in humans and indicate the potential for CFB as a novel target for treatment of cardiometabolic disease.
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Affiliation(s)
- Philip M Coan
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.).
| | - Marjorie Barrier
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Neza Alfazema
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Roderick N Carter
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Sophie Marion de Procé
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Xaquin C Dopico
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Ana Garcia Diaz
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Adrian Thomson
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Lucy H Jackson-Jones
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Ben Moyon
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Zoe Webster
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - David Ross
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Julie Moss
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Mark J Arends
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Nicholas M Morton
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
| | - Timothy J Aitman
- From the Centre for Genomic and Experimental Medicine, MRC Institute for Genetics and Molecular Medicine, Edinburgh, United Kingdom (P.M.C., M.B., N.A., S.M.P., X.C.D., D.R., J.M., T.J.A.); British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute (P.M.C., M.B., N.A., R.N.C., A.T., L.H.J.-J., N.M.M., T.J.A.) and Royal (Dick) School of Veterinary Studies (X.C.D.), University of Edinburgh, United Kingdom; Department of Medicine (A.G.D., T.J.A) and Embryonic Stem Cell and Transgenics Facility, MRC Clinical Sciences Centre (B.M., Z.W.), Imperial College London, United Kingdom; and Division of Pathology, Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, United Kingdom (M.J.A.)
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Toor IS, Rückerl D, Thomson A, Tang K, Newby DE, Rossi AG, Allen JE, Grey GA. E Eosinophils have an essential role in cardiac repair following myocardial infarction. Heart 2017. [DOI: 10.1136/heartjnl-2017-311726.236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Toor I, Ruckerl D, Thomson A, Rossi A, Allen J, Gray G. IL-4/IL-13 SIGNALLING MODULATES THE INFLAMMATORY RESPONSE IN THE INFARCTED ADULT MOUSE HEART TO ENHANCE CARDIAC REPAIR AND REMODELLING. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)35946-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Snowdon VK, Lachlan NJ, Hoy AM, Hadoke PWF, Semple SI, Patel D, Mungall W, Kendall TJ, Thomson A, Lennen RJ, Jansen MA, Moran CM, Pellicoro A, Ramachandran P, Shaw I, Aucott RL, Severin T, Saini R, Pak J, Yates D, Dongre N, Duffield JS, Webb DJ, Iredale JP, Hayes PC, Fallowfield JA. Serelaxin as a potential treatment for renal dysfunction in cirrhosis: Preclinical evaluation and results of a randomized phase 2 trial. PLoS Med 2017; 14:e1002248. [PMID: 28245243 PMCID: PMC5330452 DOI: 10.1371/journal.pmed.1002248] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 02/02/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Chronic liver scarring from any cause leads to cirrhosis, portal hypertension, and a progressive decline in renal blood flow and renal function. Extreme renal vasoconstriction characterizes hepatorenal syndrome, a functional and potentially reversible form of acute kidney injury in patients with advanced cirrhosis, but current therapy with systemic vasoconstrictors is ineffective in a substantial proportion of patients and is limited by ischemic adverse events. Serelaxin (recombinant human relaxin-2) is a peptide molecule with anti-fibrotic and vasoprotective properties that binds to relaxin family peptide receptor-1 (RXFP1) and has been shown to increase renal perfusion in healthy human volunteers. We hypothesized that serelaxin could ameliorate renal vasoconstriction and renal dysfunction in patients with cirrhosis and portal hypertension. METHODS AND FINDINGS To establish preclinical proof of concept, we developed two independent rat models of cirrhosis that were characterized by progressive reduction in renal blood flow and glomerular filtration rate and showed evidence of renal endothelial dysfunction. We then set out to further explore and validate our hypothesis in a phase 2 randomized open-label parallel-group study in male and female patients with alcohol-related cirrhosis and portal hypertension. Forty patients were randomized 1:1 to treatment with serelaxin intravenous (i.v.) infusion (for 60 min at 80 μg/kg/d and then 60 min at 30 μg/kg/d) or terlipressin (single 2-mg i.v. bolus), and the regional hemodynamic effects were quantified by phase contrast magnetic resonance angiography at baseline and after 120 min. The primary endpoint was the change from baseline in total renal artery blood flow. Therapeutic targeting of renal vasoconstriction with serelaxin in the rat models increased kidney perfusion, oxygenation, and function through reduction in renal vascular resistance, reversal of endothelial dysfunction, and increased activation of the AKT/eNOS/NO signaling pathway in the kidney. In the randomized clinical study, infusion of serelaxin for 120 min increased total renal arterial blood flow by 65% (95% CI 40%, 95%; p < 0.001) from baseline. Administration of serelaxin was safe and well tolerated, with no detrimental effect on systemic blood pressure or hepatic perfusion. The clinical study's main limitations were the relatively small sample size and stable, well-compensated population. CONCLUSIONS Our mechanistic findings in rat models and exploratory study in human cirrhosis suggest the therapeutic potential of selective renal vasodilation using serelaxin as a new treatment for renal dysfunction in cirrhosis, although further validation in patients with more advanced cirrhosis and renal dysfunction is required. TRIAL REGISTRATION ClinicalTrials.gov NCT01640964.
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Affiliation(s)
- Victoria K Snowdon
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Neil J Lachlan
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Anna M Hoy
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Patrick W F Hadoke
- British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Scott I Semple
- British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Dilip Patel
- Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Will Mungall
- Biological Services, University of Edinburgh, Edinburgh, United Kingdom
| | - Timothy J Kendall
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Adrian Thomson
- British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Ross J Lennen
- British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Maurits A Jansen
- British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Carmel M Moran
- British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Antonella Pellicoro
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Prakash Ramachandran
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Isaac Shaw
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Rebecca L Aucott
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Rajnish Saini
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States of America
| | - Judy Pak
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States of America
| | - Denise Yates
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, United States of America
| | | | - Jeremy S Duffield
- Division of Nephrology and Lung Biology, University of Washington, Seattle, Washington, United States of America
| | - David J Webb
- British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - John P Iredale
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Peter C Hayes
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Jonathan A Fallowfield
- MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
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Whiteley R, Einarsson E, Thomson A, Hansen C. Is the swing or stance phase more likely to injure the hamstrings during running? An EMG investigation using a reduced bodyweight (Alter-G®) treadmill. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.01.220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Simpson N, Simpson G, Laney R, Thomson A, Wheatley D, Ellis R, Mcgrane J. OC-0558: Automated VMAT planning in prostate cancer patients using a Single Arc SIB Technique. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31808-4] [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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White CI, Jansen MA, McGregor K, Mylonas KJ, Richardson RV, Thomson A, Moran CM, Seckl JR, Walker BR, Chapman KE, Gray GA. Cardiomyocyte and Vascular Smooth Muscle-Independent 11β-Hydroxysteroid Dehydrogenase 1 Amplifies Infarct Expansion, Hypertrophy, and the Development of Heart Failure After Myocardial Infarction in Male Mice. Endocrinology 2016; 157:346-57. [PMID: 26465199 PMCID: PMC4701896 DOI: 10.1210/en.2015-1630] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Global deficiency of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), an enzyme that regenerates glucocorticoids within cells, promotes angiogenesis, and reduces acute infarct expansion after myocardial infarction (MI), suggesting that 11β-HSD1 activity has an adverse influence on wound healing in the heart after MI. The present study investigated whether 11β-HSD1 deficiency could prevent the development of heart failure after MI and examined whether 11β-HSD1 deficiency in cardiomyocytes and vascular smooth muscle cells confers this protection. Male mice with global deficiency in 11β-HSD1, or with Hsd11b1 disruption in cardiac and vascular smooth muscle (via SM22α-Cre recombinase), underwent coronary artery ligation for induction of MI. Acute injury was equivalent in all groups. However, by 8 weeks after induction of MI, relative to C57Bl/6 wild type, globally 11β-HSD1-deficient mice had reduced infarct size (34.7 ± 2.1% left ventricle [LV] vs 44.0 ± 3.3% LV, P = .02), improved function (ejection fraction, 33.5 ± 2.5% vs 24.7 ± 2.5%, P = .03) and reduced ventricular dilation (LV end-diastolic volume, 0.17 ± 0.01 vs 0.21 ± 0.01 mL, P = .01). This was accompanied by a reduction in hypertrophy, pulmonary edema, and in the expression of genes encoding atrial natriuretic peptide and β-myosin heavy chain. None of these outcomes, nor promotion of periinfarct angiogenesis during infarct repair, were recapitulated when 11β-HSD1 deficiency was restricted to cardiac and vascular smooth muscle. 11β-HSD1 expressed in cells other than cardiomyocytes or vascular smooth muscle limits angiogenesis and promotes infarct expansion with adverse ventricular remodeling after MI. Early pharmacological inhibition of 11β-HSD1 may offer a new therapeutic approach to prevent heart failure associated with ischemic heart disease.
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MESH Headings
- 11-beta-Hydroxysteroid Dehydrogenase Type 1/deficiency
- 11-beta-Hydroxysteroid Dehydrogenase Type 1/genetics
- 11-beta-Hydroxysteroid Dehydrogenase Type 1/metabolism
- Animals
- Cardiomegaly/etiology
- Cardiomegaly/prevention & control
- Coronary Circulation
- Crosses, Genetic
- Gene Expression Regulation
- Heart Failure/etiology
- Heart Failure/prevention & control
- Heart Ventricles/metabolism
- Heart Ventricles/pathology
- Heart Ventricles/physiopathology
- Male
- Mice, Inbred C57BL
- Mice, Knockout
- Mice, Transgenic
- Muscle, Smooth, Vascular/enzymology
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocardial Infarction/metabolism
- Myocardial Infarction/pathology
- Myocardial Infarction/physiopathology
- Myocytes, Cardiac/enzymology
- Myocytes, Cardiac/metabolism
- Myocytes, Cardiac/pathology
- Neovascularization, Physiologic
- Organ Size
- Pulmonary Edema/etiology
- Pulmonary Edema/prevention & control
- Stroke Volume
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Affiliation(s)
- Christopher I White
- British Heart Foundation/University Centre for Cardiovascular Science (C.I.W., M.A.J., K.M., K.J.M., R.V.R., C.M.M., J.R.S., B.R.W., K.E.C., G.A.G.), Queens Medical Research Institute, and Edinburgh Preclinical Imaging (M.A.J., A.T., C.M.M.), College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH16 4TJ, Scotland, United Kingdom
| | - Maurits A Jansen
- British Heart Foundation/University Centre for Cardiovascular Science (C.I.W., M.A.J., K.M., K.J.M., R.V.R., C.M.M., J.R.S., B.R.W., K.E.C., G.A.G.), Queens Medical Research Institute, and Edinburgh Preclinical Imaging (M.A.J., A.T., C.M.M.), College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH16 4TJ, Scotland, United Kingdom
| | - Kieran McGregor
- British Heart Foundation/University Centre for Cardiovascular Science (C.I.W., M.A.J., K.M., K.J.M., R.V.R., C.M.M., J.R.S., B.R.W., K.E.C., G.A.G.), Queens Medical Research Institute, and Edinburgh Preclinical Imaging (M.A.J., A.T., C.M.M.), College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH16 4TJ, Scotland, United Kingdom
| | - Katie J Mylonas
- British Heart Foundation/University Centre for Cardiovascular Science (C.I.W., M.A.J., K.M., K.J.M., R.V.R., C.M.M., J.R.S., B.R.W., K.E.C., G.A.G.), Queens Medical Research Institute, and Edinburgh Preclinical Imaging (M.A.J., A.T., C.M.M.), College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH16 4TJ, Scotland, United Kingdom
| | - Rachel V Richardson
- British Heart Foundation/University Centre for Cardiovascular Science (C.I.W., M.A.J., K.M., K.J.M., R.V.R., C.M.M., J.R.S., B.R.W., K.E.C., G.A.G.), Queens Medical Research Institute, and Edinburgh Preclinical Imaging (M.A.J., A.T., C.M.M.), College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH16 4TJ, Scotland, United Kingdom
| | - Adrian Thomson
- British Heart Foundation/University Centre for Cardiovascular Science (C.I.W., M.A.J., K.M., K.J.M., R.V.R., C.M.M., J.R.S., B.R.W., K.E.C., G.A.G.), Queens Medical Research Institute, and Edinburgh Preclinical Imaging (M.A.J., A.T., C.M.M.), College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH16 4TJ, Scotland, United Kingdom
| | - Carmel M Moran
- British Heart Foundation/University Centre for Cardiovascular Science (C.I.W., M.A.J., K.M., K.J.M., R.V.R., C.M.M., J.R.S., B.R.W., K.E.C., G.A.G.), Queens Medical Research Institute, and Edinburgh Preclinical Imaging (M.A.J., A.T., C.M.M.), College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH16 4TJ, Scotland, United Kingdom
| | - Jonathan R Seckl
- British Heart Foundation/University Centre for Cardiovascular Science (C.I.W., M.A.J., K.M., K.J.M., R.V.R., C.M.M., J.R.S., B.R.W., K.E.C., G.A.G.), Queens Medical Research Institute, and Edinburgh Preclinical Imaging (M.A.J., A.T., C.M.M.), College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH16 4TJ, Scotland, United Kingdom
| | - Brian R Walker
- British Heart Foundation/University Centre for Cardiovascular Science (C.I.W., M.A.J., K.M., K.J.M., R.V.R., C.M.M., J.R.S., B.R.W., K.E.C., G.A.G.), Queens Medical Research Institute, and Edinburgh Preclinical Imaging (M.A.J., A.T., C.M.M.), College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH16 4TJ, Scotland, United Kingdom
| | - Karen E Chapman
- British Heart Foundation/University Centre for Cardiovascular Science (C.I.W., M.A.J., K.M., K.J.M., R.V.R., C.M.M., J.R.S., B.R.W., K.E.C., G.A.G.), Queens Medical Research Institute, and Edinburgh Preclinical Imaging (M.A.J., A.T., C.M.M.), College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH16 4TJ, Scotland, United Kingdom
| | - Gillian A Gray
- British Heart Foundation/University Centre for Cardiovascular Science (C.I.W., M.A.J., K.M., K.J.M., R.V.R., C.M.M., J.R.S., B.R.W., K.E.C., G.A.G.), Queens Medical Research Institute, and Edinburgh Preclinical Imaging (M.A.J., A.T., C.M.M.), College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH16 4TJ, Scotland, United Kingdom
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Thomson A, Whiteley R, Bleakley C. Shoe–surface interaction and lower extremity injury in the football codes: A systematic review and meta-analysis. J Sci Med Sport 2015. [DOI: 10.1016/j.jsams.2015.12.460] [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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Ngo L, Ho H, Hunter P, Quinn K, Thomson A, Pearson G. Post-mortem prediction of primal and selected retail cut weights of New Zealand lamb from carcass and animal characteristics. Meat Sci 2015; 112:39-45. [PMID: 26519607 DOI: 10.1016/j.meatsci.2015.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 01/06/2015] [Revised: 10/14/2015] [Accepted: 10/15/2015] [Indexed: 11/24/2022]
Abstract
Post-mortem measurements (cold weight, grade and external carcass linear dimensions) as well as live animal data (age, breed, sex) were used to predict ovine primal and retail cut weights for 792 lamb carcases. Significant levels of variance could be explained using these predictors. The predictive power of those measurements on primal and retail cut weights was studied by using the results from principal component analysis and the absolute value of the t-statistics of the linear regression model. High prediction accuracy for primal cut weight was achieved (adjusted R(2) up to 0.95), as well as moderate accuracy for key retail cut weight: tenderloins (adj-R(2)=0.60), loin (adj-R(2)=0.62), French rack (adj-R(2)=0.76) and rump (adj-R(2)=0.75). The carcass cold weight had the best predictive power, with the accuracy increasing by around 10% after including the next three most significant variables.
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Affiliation(s)
- L Ngo
- Auckland Bioengineering Institute, University of Auckland, New Zealand; Arts et Métiers ParisTech, France
| | - H Ho
- Auckland Bioengineering Institute, University of Auckland, New Zealand.
| | - P Hunter
- Auckland Bioengineering Institute, University of Auckland, New Zealand
| | - K Quinn
- Silver Fern Farms Ltd, New Zealand
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Smith MD, Russell T, Thomson A, MacIntyre E, Devane H, Howe E, Tucker K. 43 Frontal plane knee and pelvis angles during single leg squat and step down tasks do not differ between people with and without chronic ankle instability. Br J Sports Med 2015. [DOI: 10.1136/bjsports-2015-095573.43] [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: 11/03/2022]
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Maitin-Casalis N, Neeman T, Thomson A. Protective effect of advanced age on post-ERCP pancreatitis and unplanned hospitalisation. Intern Med J 2015; 45:1020-5. [DOI: 10.1111/imj.12844] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 06/18/2015] [Indexed: 02/03/2023]
Affiliation(s)
- N. Maitin-Casalis
- Australian National University Medical School; Canberra Australian Capital Territory Australia
| | - T. Neeman
- Statistical Consulting Unit; Australian National University; Canberra Australian Capital Territory Australia
| | - A. Thomson
- Australian National University Medical School; Canberra Australian Capital Territory Australia
- Gastroenterology Unit; The Canberra Hospital; Canberra Australian Capital Territory Australia
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43
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Aldridge T, Thomson A, Ilankovan V. Abnormal anatomy of inferior orbital fissure and herniation of buccal fat pad. Br J Oral Maxillofac Surg 2015; 53:92-3. [DOI: 10.1016/j.bjoms.2014.09.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 09/24/2014] [Indexed: 11/16/2022]
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Wheelock A, Parand A, Rigole B, Thomson A, Miraldo M, Vincent C, Sevdalis N. Personal context and childhood experiences affect adult vaccination behaviour. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku161.034] [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: 11/12/2022] Open
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Wheelock A, Thomson A, Rigole B, Miraldo M, Vincent C, Sevdalis N. Trust and adult vaccination: what matters the most? Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku151.017] [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: 11/13/2022] Open
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Thomson A, Purvis G, McGrane J, Palmer J, Mathew J. The Molecular Profile of Matched Primary Breast Cancer and Resected or Biopsied Brain Metastases. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu329.6] [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: 11/13/2022] Open
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Castellan R, Thomson A, Moran C, Gray G. 195 Ultrasound Characterisation of the Murine Myocardium Reveals Dynamic Modification in the Early Post-natal Period. Heart 2014. [DOI: 10.1136/heartjnl-2014-306118.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
INTRODUCTION The aim of this study was to determine the efficacy and complications of postoperative endoscopic retrograde cholangiopancreatography (ERCP) in confirming and treating choledocholithiasis found at intraoperative cholangiography during laparoscopic cholecystectomy. METHODS Patients who had undergone ERCP following a cholecystectomy between 2008 and 2011 with an indication of intraoperative cholangiography findings consistent with choledocholithiasis were identified from a prospectively collected database of a single endoscopist. Deep biliary access rate, confirmation of choledocholithiasis, clearance rate of bile duct stones, delay between cholecystectomy and postoperative ERCP, and the complication rates following the procedure were analysed. RESULTS The median age of the 41 patients (16 male, 25 female) was 42 years (range: 18–82 years). Sixteen surgeons performed the operations with a median delay of 6 days (range: 1–103 days) between cholecystectomy and postoperative ERCP. Common bile duct access was achieved in 100% of the patients, with ERCP taking a median time of 16 minutes (range: 6–40 minutes). Initial ERCP confirmed the presence of a stone in 30 patients (73%) and successful stone removal occurred in 28 of these 30 patients (93%) during the first ERCP and in the remaining 2 on a subsequent ERCP. Following ERCP, two patients (4.9%) experienced extended hospital stays for four and eight days owing to complications, including one patient (2.4%) with mild acute pancreatitis. CONCLUSIONS This study demonstrates that postoperative ERCP is highly effective in both confirming and treating choledocholithiasis. However, there is a significant risk of short-term complications that must be taken into consideration when deciding management.
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Affiliation(s)
- A P Lynn
- Canberra Hospital, The Australian National University, Australia
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Gruen ME, Griffith E, Thomson A, Simpson W, Lascelles BDX. Detection of clinically relevant pain relief in cats with degenerative joint disease associated pain. J Vet Intern Med 2014; 28:346-50. [PMID: 24512390 PMCID: PMC4064787 DOI: 10.1111/jvim.12312] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [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: 08/26/2013] [Revised: 11/20/2013] [Accepted: 12/26/2013] [Indexed: 11/30/2022] Open
Abstract
Background Detection of clinically relevant pain relief in cats with degenerative joint disease (DJD) is complicated by a lack of validated outcome measures and a placebo effect. Hypothesis/Objectives To evaluate a novel approach for detection of pain relief in cats with DJD. Animals Fifty‐eight client‐owned cats. Methods Prospective, double‐masked, placebo‐controlled, stratified, randomized, clinical study. Enrolled cats were 6–21 years of age, with owner‐observed mobility impairment, evidence of pain in at least 2 joints during orthopedic examination, and overlapping radiographic evidence of DJD, and underwent a 2‐week baseline period, 3‐week treatment period with placebo or meloxicam, and 3‐week masked washout period. Outcome measures were evaluated at days 0, 15, 36, and 57. Results Both groups significantly improved after the treatment period (day 36) on client‐specific outcome measures (CSOM) and feline musculoskeletal pain index (FMPI) (P < .0001 for both); there was no difference between the groups on CSOM or FMPI score improvement. After the masked washout period, more cats that received meloxicam during the treatment period had a clinically relevant decrease in CSOM score (P = .048) and FMPI score (P = .021) than cats that received placebo. Conclusions and Clinical Importance Using both a client‐specific and a general clinical metrology instrument, owners of cats with DJD were able to detect evident recurrence of clinical signs after withdrawal of active medication than after withdrawal of placebo, and that this study design might be a novel and useful way to circumvent the placebo effect and detect the efficacy of pain‐relieving medications.
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Affiliation(s)
- M E Gruen
- Comparative Pain Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, Raleigh, NC
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Nicholson S, Hall E, Harland SJ, Chester JD, Pickering L, Barber J, Elliott T, Thomson A, Burnett S, Cruickshank C, Carrington B, Waters R, Bahl A. Phase II trial of docetaxel, cisplatin and 5FU chemotherapy in locally advanced and metastatic penis cancer (CRUK/09/001). Br J Cancer 2013; 109:2554-9. [PMID: 24169355 PMCID: PMC3833214 DOI: 10.1038/bjc.2013.620] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [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: 06/24/2013] [Revised: 09/11/2013] [Accepted: 09/15/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Penis cancer is rare and clinical trial evidence on which to base treatment decisions is limited. Case reports suggest that the combination of docetaxel, cisplatin and 5-flurouracil (TPF) is highly active in this disease. METHODS Twenty-nine patients with locally advanced or metastatic squamous carcinoma of the penis were recruited into a single-arm phase II trial from nine UK centres. Up to three cycles of chemotherapy were received (docetaxel 75 mg m(-2) day 1, cisplatin 60 mg m(-2) day 1, 5-flurouracil 750 mg m(-2) per day days 1-5, repeated every 3 weeks). Primary outcome was objective response (assessed by RECIST). Fourteen or more responses in 26 evaluable patients were required to confirm a response rate of 60% or higher (Fleming-A'Hern design), warranting further evaluation. Secondary endpoints included toxicity and survival. RESULTS 10/26 evaluable patients (38.5%, 95% CI: 20.2-59.4) achieved an objective response. Two patients with locally advanced disease achieved radiological complete remission. 65.5% of patients experienced at least one grade 3/4 adverse event. CONCLUSION Docetaxel, cisplatin and 5FU did not reach the pre-determined threshold for further research and caused significant toxicity. Our results do not support the routine use of TPF. The observed complete responses support further investigation of combination chemotherapy in the neoadjuvant setting.
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Affiliation(s)
- S Nicholson
- Imperial College Healthcare NHS Trust, Department of Medical Oncology, Charing Cross Hospital, London W6 8RF, UK
| | - E Hall
- The Institute of Cancer Research, Clinical Trials & Statistics Unit, 123 Old Brompton Road, London SW7 3RP, UK
| | - S J Harland
- Department of Oncology, University College London Hospitals NHSFT, 250 Euston Road, London NW1 2PG, UK
| | - J D Chester
- Leeds Institute of Molecular Medicine, University of Leeds and St. James's Institute of Oncology, St James's University Hospital, Leeds LS9 7TF, UK
| | - L Pickering
- Department of Oncology, St. Georges Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK
| | - J Barber
- Velindre Cancer Centre, Velindre Hospital, Velindre Road, Whitchurch, Cardiff CF14 2TL, UK
| | - T Elliott
- Department of Clinical Oncology, The Christie Hospital, Wilmslow Road, Manchester M20 4BX, UK
| | - A Thomson
- Department of Oncology, Royal Cornwall Hospital, London Road, Treliske, Truro TR1 3LJ, UK
| | - S Burnett
- The Institute of Cancer Research, Clinical Trials & Statistics Unit, 123 Old Brompton Road, London SW7 3RP, UK
| | - C Cruickshank
- The Institute of Cancer Research, Clinical Trials & Statistics Unit, 123 Old Brompton Road, London SW7 3RP, UK
| | - B Carrington
- Department of Diagnostic Radiotherapy, The Christie Hospital, Manchester, UK
| | - R Waters
- The Institute of Cancer Research, Clinical Trials & Statistics Unit, 123 Old Brompton Road, London SW7 3RP, UK
| | - A Bahl
- Bristol Haematology and Oncology Centre, Horfield Road, Bristol BS2 8ED, UK
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