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Roy S, Aung MS, Paul SK, Nasreen SA, Haque N, Mazid R, Khan MS, Barman TK, Arafa P, Sathi FA, Nila SS, Jahan A, Urushibara N, Kawaguchiya M, Ohashi N, Kobayashi N. Genetic characterization of methicillin-resistant / susceptible Staphylococcus aureus (MRSA/MSSA) and Staphylococcus argenteus clinical isolates in Bangladesh: Dominance of ST6-MRSA-IV/t304 and detection of cfr/ fexA in ST8-MSSA/t008. IJID Reg 2024; 10:132-139. [PMID: 38283056 PMCID: PMC10819717 DOI: 10.1016/j.ijregi.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/30/2024]
Abstract
Objectives Coagulase-positive staphylococcus (CoPS), represented by Staphylococcus aureus, is a major cause of infections in humans. This study aimed to investigate molecular epidemiological characteristics, antimicrobial resistance, and their trends of CoPS in Bangladesh. Methods Clinical isolates of CoPS were collected from two medical institutions in Bangladesh for a 2-year period and analyzed for their species, genotypes, virulence factors, antimicrobial susceptibility, and resistance determinants. Results 172 CoPS isolates collected were identified as S. aureus or S. argenteus (170 and two, respectively). Methicillin-resistant S. aureus (MRSA) accounted for 36% (n = 61), having Staphylococcal cassette chromosome mec (SCCmec)-IV (82%) or V (18%). Panton-Valentine leukocidin (PVL) genes were detected at higher rate in methicillin-susceptible S. aureus (MSSA) (62%) than MRSA (26%). MRSA comprised 11 STs, including a dominant type ST6 (46%) associated with mostly SCCmec-IVa/spa-t304, and one isolate had genetic features of the USA300 clone (ST8/SCCmec-IVa/coa-IIIa/spa-t008/ACME-I/ΦSa2USA). STs of CC1, CC88, and CC398 were common in MSSA, with CC88 showing the highest PVL-positive rate. One MSSA isolate (ST8/spa-t008) harbored fexA and cfr showing susceptibility to linezolid. S. argenteus was methicillin-susceptible and belonged to ST2250/coa-XId. Conclusions Genetic characteristics of current MRSA/MSSA in Bangladesh were revealed, with first identification of S. argenteus at low prevalence.
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Affiliation(s)
- Sangjukta Roy
- Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh
| | - Meiji Soe Aung
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | | | | | - Nazia Haque
- Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh
| | - Rummana Mazid
- Department of Microbiology, Bangladesh Institute of Health Sciences (BIHS) General Hospital, Dhaka, Bangladesh
| | - Md. Shahed Khan
- Department of Oral Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh
| | | | - Parvez Arafa
- Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh
| | | | | | - Afsana Jahan
- Microbiology Department, Pabna Medical College, Pabna, Bangladesh
| | - Noriko Urushibara
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Mitsuyo Kawaguchiya
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobuhide Ohashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobumichi Kobayashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
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Islam SMM, Gaihre YK, Islam MN, Jahan A, Sarkar MAR, Singh U, Islam A, Al Mahmud A, Akter M, Islam MR. Effects of integrated nutrient management and urea deep placement on rice yield, nitrogen use efficiency, farm profits and greenhouse gas emissions in saline soils of Bangladesh. Sci Total Environ 2024; 909:168660. [PMID: 37979873 DOI: 10.1016/j.scitotenv.2023.168660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 11/20/2023]
Abstract
Soil salinity is one of the major yield-limiting factors in the coastal ecosystems of Bangladesh. An efficient fertilizer management practice and selection of appropriate crop cultivars could play a crucial role in improving yield and promoting low-carbon agriculture across saline soils. A two-year multi-location field experiment was conducted during the Boro (dry) season (December-April) to investigate the effects of fertilizer management and rice cultivar selection on rice yield, economic viability, and global warming potential (GWP) in coastal saline soils of Bangladesh. The study included seven fertilizer treatments with varying nitrogen rates and sources, as well as two rice cultivars (BRRI dhan67 and BRRI dhan88). The results showed that integrated nutrient management-2 (INM-2) significantly (p < 0.05) increased rice yield and nitrogen use efficiency compared to other treatments for both BRRI dhan67 and BRRI dhan88. Similarly, INM-2 gave a higher return on fertilizer investment and marginal benefit-cost ratio than other treatments in both locations and under both cultivars. BRRI dhan67 significantly (p < 0.05) increased rice yield relative to BRRI dhan88 by 21 % and 52 % at the BRRI farm and Kaliganj in Satkhira, respectively. The cost-dominant analysis excluded BRRI dhan88 and all fertilizer treatments, except urea deep placement (UDP) and INM-2, from consideration in both locations. Consequently, INM-2 and UDP proved to be economically viable in both locations, with INM showing a higher marginal rate of return than UDP in BRRI dhan67. In terms of environmental sustainability, UDP significantly (p < 0.05) reduced GWP and yield-scaled emissions of CH4 by 31 % and 38 % without causing yield loss compared to INM-2. Similarly, BRRI dhan67 significantly (p < 0.05) reduced GWP and yield-scaled emissions of CH4 by 5 and 22 % compared to BRRI dhan88. These findings suggest that selecting salt-tolerant rice cultivars and implementing appropriate fertilizer management practices can enhance economic profitability, ensure food security, and mitigate the adverse effects of climate change in coastal saline soils.
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Affiliation(s)
- S M Mofijul Islam
- Soil Science Division, Bangladesh Rice Research Institute, Gazipur, Bangladesh.
| | - Yam Kanta Gaihre
- International Fertilizer Development Center, Muscle Shoals, AL, USA
| | | | - Afsana Jahan
- Soil Science Division, Bangladesh Rice Research Institute, Gazipur, Bangladesh
| | - Md Abdur Rouf Sarkar
- Agricultural Economics Division, Bangladesh Rice Research Institute, Gazipur, Bangladesh; School of Economics, Zhongnan University of Economics and Law, Wuhan, China
| | - Upendra Singh
- International Fertilizer Development Center, Muscle Shoals, AL, USA
| | - Aminul Islam
- Soil Science Division, Bangladesh Rice Research Institute, Gazipur, Bangladesh
| | | | - Mahmuda Akter
- Department of Soil Science, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur, Bangladesh
| | - Md Rafiqul Islam
- Soil Science Division, Bangladesh Rice Research Institute, Gazipur, Bangladesh
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Jahan A, Paul SK, Nasreen SA, Haque N, Roy S, Sultana M, Hossain T, Nila SS, Ahmad FU, Ahmed S, Aung MS, Kobayashi N. Genetic Characterization of the Dengue Virus Type 3 Genotype I Prevailing in Dhaka, Bangladesh, 2021. Vector Borne Zoonotic Dis 2023; 23:634-638. [PMID: 37603293 DOI: 10.1089/vbz.2023.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Abstract
Background: In Bangladesh, dengue has been prevalent since its resurgence in 2018, and the dominant causative virus in 2019 was considered dengue virus serotype 3 (DENV-3). However, limited information is available for DENV serotype/genotype circulating after 2020. Materials and Methods: Viral RNA was extracted from NS1 antigen-positive blood samples of febrile patients in Dhaka, in 2021. DENV gene was detected by semi-nested RT-PCR, and sequences of envelope (E) gene and C-prM gene were determined by direct sequencing of RT-PCR products for genetic analysis. Results: Among 172 NS1-positive samples collected, 91 samples were assigned to DENV-3 and DENV-2 (88 and 3 samples, respectively) by RT-PCR targeting the C-prM gene. Phylogenetic analysis of the E gene for the 17 representative DENV-3 samples showed that all the viruses belonged to genotype I, forming a cluster (B-cluster) with those of DENV-3 reported in Bangladesh in 2017. Analysis of the deduced amino acid sequences of E protein revealed 16 amino acid substitutions, including two novel ones (G221W, L285P), and a substitution T223I that was specifically found in DENV-3 B-cluster. Conclusion: This study showed the persistent predominance of DENV-3 genotype I in Bangladesh having unique genetic traits in the E gene. (Approval number: MMC/IRB/2022/468).
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Affiliation(s)
- Afsana Jahan
- Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh
- Pabna Medical College, Pabna, Bangladesh
| | - Shyamal Kumar Paul
- Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh
- Netrokona Medical College, Netrokona, Bangladesh
| | | | - Nazia Haque
- Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh
| | - Sangjukta Roy
- Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh
| | - Monira Sultana
- Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh
- Nilphamari Medical College, Nilphamari, Bangladesh
| | - Tasmia Hossain
- Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh
| | | | | | - Salma Ahmed
- Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh
- Mugda Medical College, Dhaka, Bangladesh
| | - Meiji Soe Aung
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobumichi Kobayashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
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Sinha R, Pradhan S, Banerjee S, Jahan A, Akhtar S, Pahari A, Raut S, Parakh P, Basu S, Srivastava P, Nayak S, Thenral SG, Ramprasad V, Ashton E, Bockenhauer D, Mandal K. Whole-exome sequencing and variant spectrum in children with suspected inherited renal tubular disorder: the East India Tubulopathy Gene Study. Pediatr Nephrol 2022; 37:1811-1836. [PMID: 35006361 DOI: 10.1007/s00467-021-05388-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/29/2021] [Accepted: 11/10/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Inherited tubulopathies are a heterogeneous group of genetic disorders making whole-exome sequencing (WES) the preferred diagnostic methodology. METHODS This was a multicenter descriptive study wherein children (< 18 years) with clinically suspected tubular disorders were recruited for molecular testing through WES. Multiplex ligation-dependent probe amplification (MLPA) and Sanger sequencing were done when required. Variants were classified as per American College of Medical Genetics 2015 guidelines and pathogenic (P)/likely pathogenic (LP) variants were considered causative. RESULTS There were 77 index cases (male =73%). Median age at diagnosis was 48 months (IQR 18.5 to 108 months). At recruitment, the number of children in each clinical group was as follows: distal renal tubular acidosis (dRTA) = 25; Bartter syndrome = 18; isolated hypophosphatemic rickets (HP) = 6; proximal tubular dysfunction (pTD) = 12; nephrogenic diabetes insipidus (NDI) = 6; kidney stone/nephrocalcinosis (NC) = 6; others = 4. We detected 55 (24 novel) P/LP variants, providing genetic diagnoses in 54 children (70%). The diagnostic yield of WES was highest for NDI (100%), followed by HP (83%; all X-linked HP), Bartter syndrome (78%), pTD (75%), dRTA (64%), and NC (33%). Molecular testing had a definite impact on clinical management in 24 (31%) children. This included revising clinical diagnosis among 14 children (26% of those with a confirmed genetic diagnosis and 18% of the overall cohort), detection of previously unrecognized co-morbidities among 8 children (sensorineural deafness n = 5, hemolytic anemia n = 2, and dental changes n = 1) and facilitating specific medical treatment for 7 children (primary hyperoxaluria n = 1, cystinosis n = 4, tyrosinemia n = 2). CONCLUSION WES is a powerful tool in the diagnosis and management of children with inherited tubulopathies in the Indian population. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Rajiv Sinha
- Institute of Child Health, Kolkata, India
- Apollo Hospital, Kolkata, India
| | | | - Sushmita Banerjee
- Institute of Child Health, Kolkata, India
- Calcutta Medical and Research Institute, Kolkata, India
| | - Afsana Jahan
- Renowell Clinic and Pratiksha Hospital, Gauhati, India
| | | | | | | | | | | | - Priyanka Srivastava
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | - Emma Ashton
- Rare & Inherited Disease Laboratory, NHS North Thames Genomic Laboratory Hub, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Detlef Bockenhauer
- UCL Department of Renal Medicine and Renal Unit, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Kausik Mandal
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India.
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5
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Jahan A, Islam MN, Akhter M, Khan RH, Akhtaruzzaman M, Sharmin M, Zaman K, Tusnim I. Treacher Collins Syndrome: A Case Report. Mymensingh Med J 2021; 30:555-558. [PMID: 33830142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Treacher collins syndrome (TCS) or Franceschetti syndrome is an autosomal dominant inherited disorder with variable expressivity. It affects mainly craniofacial structure that derives from 1st and 2nd branchial arches approximately between the 20th day and 12th week of intrauterine life. This syndrome has different clinical types. Most common features are antimongoloid slanting of the palpebral fissures, hypoplasia of zygoma, maxilla & mandible with various eye and ear abnormalities. Here we present a case of an 11 days old female neonate, who was ill looking, dyspnoeic having significant facial profile, multiple congenital anomalies and dolicocephaly; admitted in the department of Neonatology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh on 7th August 2020. After taking all the diagnostic assistance of the multidisciplinary approach mainly on the basis of clinical features and radiology we diagnosed the case as TCS. We managed the patient by maintaining temperature, giving nutritional support and injectable antibiotic, took consultation from Otolaryngology department then we discharged the baby with proper counseling, advised regarding further follow up and to consult with paediatric surgeon and cardiologist.
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Affiliation(s)
- A Jahan
- Dr Aziza Jahan, Resident, MD Paediatrics, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Naher UA, Biswas JC, Maniruzzaman M, Khan FH, Sarkar MIU, Jahan A, Hera MHR, Hossain MB, Islam A, Islam MR, Kabir MS. Bio-Organic Fertilizer: A Green Technology to Reduce Synthetic N and P Fertilizer for Rice Production. Front Plant Sci 2021; 12:602052. [PMID: 33833767 PMCID: PMC8023392 DOI: 10.3389/fpls.2021.602052] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/21/2021] [Indexed: 05/14/2023]
Abstract
Decomposed organic materials, in combination with plant growth-promoting bacteria (PGPB), are environmentally friendly and reduce synthetic fertilizer use in rice production. A bio-organic fertilizer (BoF) was prepared using kitchen waste (79%), chita-dhan (unfilled rice grain) biochar (15%), rock phosphate (5%), and a consortium of 10 PGPB (1%) to supplement 30% nitrogen and to replace triple superphosphate (TSP) fertilizer in rice production with an improvement of soil health. PGPB were local isolates and identified using 16S ribosomal RNA partial gene sequences as Bacillus mycoides, Proteus sp., Bacillus cereus, Bacillus subtilis, Bacillus pumilus, Paenibacillus polymyxa, and Paenibacillus spp. Isolates could fix N2 by 0.7-1.4 g kg-1, solubilize 0.1-1.2 g kg-1 phosphate, and produce 0.1-40 g kg-1 indoleacetic acid. The performance of BoF was evaluated by 16 field experiments and 18 farmers' field demonstration trials during the year 2017-2020 in different parts of Bangladesh. Performances of BoF were evaluated based on control (T1), full synthetic fertilizer dose of N, P, and K (T2), BoF (2 t ha-1) + 70% N as urea + 100% K as muriate of potash (T3), 70% N as urea + 100% P as TSP + 100% K as muriate of potash (T4), and 2 t ha-1 BoF (T5) treatments. At the research station, average grain yield improved by 10-13% in T3 compared with T2 treatment. Depending on seasons, higher agronomic N use efficiency (19-30%), physiological N use efficiency (8-18%), partial factor productivity (PFP)N (114-150%), recovery efficiency (RE)N (3-31%), N harvest index (HIN) (14-24%), agronomic P use efficiency (22-25%), partial factor productivity of P (9-12%), AREP (15-23%), and HIP (3-6%) were obtained in T3 compared with T2 treatment. Research results were reflected in farmers' field, and significant (P < 0.05) higher plant height, tiller, panicle, grain yield, partial factor productivity of N and P were obtained in the same treatment. Application of BoF improved soil organic carbon by 6-13%, along with an increased number of PGPB as compared with full synthetic fertilizer dose. In conclusion, tested BoF can be considered as a green technology to reduce 30% synthetic N and 100% TSP requirements in rice production with improved soil health.
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7
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Hansen CL, McCormick BJJ, Azam SI, Ahmed K, Baker JM, Hussain E, Jahan A, Jamison AF, Knobler SL, Samji N, Shah WH, Spiro DJ, Thomas ED, Viboud C, Rasmussen ZA. Substantial and sustained reduction in under-5 mortality, diarrhea, and pneumonia in Oshikhandass, Pakistan: evidence from two longitudinal cohort studies 15 years apart. BMC Public Health 2020; 20:759. [PMID: 32448276 PMCID: PMC7245818 DOI: 10.1186/s12889-020-08847-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 05/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oshikhandass is a rural village in northern Pakistan where a 1989-1991 verbal autopsy study showed that diarrhea and pneumonia were the top causes of under-5 mortality. Intensive surveillance, active community health education and child health interventions were delivered in 1989-1996; here we assess improvements in under-5 mortality, diarrhea, and pneumonia over this period and 15 years later. METHODS Two prospective open-cohort studies in Oshikhandass from 1989 to 1996 (Study 1) and 2011-2014 (Study 2) enrolled all children under age 60 months. Study staff trained using WHO guidelines, conducted weekly household surveillance and promoted knowledge on causes and management of diarrhea and pneumonia. Information about household characteristics and socioeconomic status was collected. Hurdle models were constructed to examine putative risk factors for diarrhea and pneumonia. RESULTS Against a backdrop of considerable change in the socioeconomic status of the community, under-5 mortality, which declined over the course of Study 1 (from 114.3 to 79.5 deaths/1000 live births (LB) between 1989 and 1996), exceeded Sustainable Development Goal 3 by Study 2 (19.8 deaths/ 1000 LB). Reductions in diarrhea prevalence (20.3 to 2.2 days/ Child Year [CY]), incidence (2.1 to 0.5 episodes/ CY), and number of bloody diarrhea episodes (18.6 to 5.2%) seen during Study 1, were sustained in Study 2. Pneumonia incidence was 0.5 episodes /CY in Study 1 and 0.2/CY in Study 2; only 5% of episodes were categorized as severe or very severe in both studies. While no individual factors predicted a statistically significant difference in diarrhea or pneumonia episodes, the combined effect of water, toilet and housing materials was associated with a significant decrease in diarrhea; higher household income was the most protective factor for pneumonia in Study 1. CONCLUSIONS We report a 4-fold decrease in overall childhood mortality, and a 2-fold decrease in childhood morbidity from diarrhea and pneumonia in a remote rural village in Pakistan between 1989 and 2014. We conclude that significant, sustainable improvements in child health may be achieved through improved socioeconomic status and promoting interactions between locally engaged health workers and the community, but that continued efforts are needed to improve health worker training, supervision, and the rational use of medications. TRIAL REGISTRATION Not Applicable.
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Affiliation(s)
- C L Hansen
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - B J J McCormick
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - S I Azam
- Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - K Ahmed
- Karakoram International University, University Road, Gilgit, Pakistan
| | - J M Baker
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - E Hussain
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - A Jahan
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - A F Jamison
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - S L Knobler
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - N Samji
- Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - W H Shah
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - D J Spiro
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - E D Thomas
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - C Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Z A Rasmussen
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA.
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Naher UA, Sarker IU, Jahan A, Maniruzzaman M, Choudhury AK, Kalra N, Biswas JC. Nutrient Mineralization and Soil Biology as Influenced by Temperature and Fertilizer Management Practices. SAINS MALAYS 2019. [DOI: 10.17576/jsm-2019-4804-05] [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: 11/17/2022]
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Jahan A, Iranfar S. Transcranial Near Infra Red Light Improves Naming Performance. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.308] [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: 10/27/2022] Open
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Gee J, Coleman RE, Cheung KL, Evans A, Holcombe C, Skene A, Rea D, Ahmed S, Jahan A, Horgan K, Rauchhaus P, Littleford R, Finlay P, Cheung A, Cullberg M, de Bruin E, Foxley A, Koulai L, Pass M, Schiavon G, Rugman P, Deb R, Robertson JFR. Abstract P2-12-01: Dose- and exposure-response relationship and biomarker correlation analysis in breast tumors from patients treated with capivasertib, an AKT inhibitor, in the STAKT randomized, placebo controlled pre-surgical study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-12-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Capivasertib (AZD5363), an AKT1,2,3 inhibitor, significantly improved progression-free and overall survival when added to paclitaxel in triple negative breast cancer (BC) patients (Schmid et al. ASCO 2018). We have previously reported in STAKT, robust target inhibition at 480mg BD versus placebo, including significant decreases in the primary biomarkers (PBs) - Ki67, pPRAS40 & pGSK3β - in primary BCs (Robertson et al. SABCS 2017). We now report the dose- and exposure-response relationship of capivasertib and the correlation between primary and secondary (pAKT, pS6, nuclear FOXO3a) tumor biomarkers.
Design: STAKT was a two-stage, double blind, randomized, placebo controlled 'window-of-opportunity' trial in newly diagnosed ER+ BC patients. Stage 1 assessed capivasertib at a dose of 480mg BD p.o. versus placebo. Stage 2 assessed capivasertib at two lower doses 360mg and 240mg BD. Tumor biopsies were taken prior to 1st dose and after 4.5 days of dosing. Evaluable patients (who required pre-defined minimum baseline PD values for PBs) included placebo (n=11), capivasertib at 480mg (n=17), 360mg (n=5) and 240mg (n=6). Blood samples for pharmacokinetic (PK) studies were scheduled at pre-dose; 2, 4, optional 6 & 8 hrs post first dose on Day 1; ˜2-4 h post last dose on Day 5 (before biopsy). The % change from baseline for PBs were evaluated against the following exposure variables (placebo=0): i) Dose, ii) Observed Cmax Day 1 (˜2h post-dose), iii) Observed plasma concentration on Day 5, iv) Model-predicted plasma concentration Day 5 at time of biopsy, and v) Model-predicted AUC on Day 5. Spearman correlation coefficient measured the strength and direction of association between biomarkers.
Results:
· Significant mean reductions in % change from baseline were observed for the PBs pGSK3β (-39%; p<0.006), pPRAS40 (-50%; p<0.0001) and Ki67 (-23%; p=0.052) at 480mg versus placebo. At 360mg and 240mg, mean % changes from baseline in pGSK3β were -27% and -9%, respectively; in pPRAS40 -45% and -28%, respectively; and in Ki67 0% and +22%, respectively.
· Dose-response relationships for individual % change from baseline could be described by an Emax model for all PBs. Overall, the correlation to PK exposure (observed or predicted) was similar to the correlation to dose.
· Correlation coefficient analyses between biomarkers at capivasertib 480mg BD identified- i) Positive correlations for pGSK3β with Ki67 (ρ = 0.52, p-value < 0.05) & with pS6 (ρ = 0.54, p-value<0.05); ii) Negative correlations between FOXO3a and Ki67 (ρ = -0.75, p-value<0.001) pGSK3β (ρ = -0.71, p-value<0.001) & also pS6 (ρ = -0.61, p-value<0.001).Correlation coefficients for lower doses are not robust due to small sample size in these groups.
Conclusions
· Capivasertib caused dose- and concentration- dependent effects on biomarkers after only 4.5 days.
· Significant changes in the PBs were demonstrated at 480 mg BD. Biomarker changes was observed at 360mg and 240mg BD, but statistical analysis was limited by the small sample size at lower doses.
· Correlation between a number of tumor biomarkers (relative changes) were identified for capivasertib 480mg BD.
Citation Format: Gee J, Coleman RE, Cheung KL, Evans A, Holcombe C, Skene A, Rea D, Ahmed S, Jahan A, Horgan K, Rauchhaus P, Littleford R, Finlay P, Cheung A, Cullberg M, de Bruin E, Foxley A, Koulai L, Pass M, Schiavon G, Rugman P, Deb R, Robertson JFR. Dose- and exposure-response relationship and biomarker correlation analysis in breast tumors from patients treated with capivasertib, an AKT inhibitor, in the STAKT randomized, placebo controlled pre-surgical study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-12-01.
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Affiliation(s)
- J Gee
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - RE Coleman
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - KL Cheung
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - A Evans
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - C Holcombe
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - A Skene
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - D Rea
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - S Ahmed
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - A Jahan
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - K Horgan
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - P Rauchhaus
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - R Littleford
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - P Finlay
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - A Cheung
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - M Cullberg
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - E de Bruin
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - A Foxley
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - L Koulai
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - M Pass
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - G Schiavon
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - P Rugman
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - R Deb
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
| | - JFR Robertson
- Cardiff University, Cardiff, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; Royal Bournemouth Hospital, Bournemouth, United Kingdom; University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Leicester Royal Infirmary, Leicester, Leicestershire, United Kingdom; Kings Mill Hospital, Mansfield, Nottinghamshire, United Kingdom; Leeds Teaching Hospitals NHS Trust, Leeds, Yorkshire, United Kingdom; University of Dundee, Dundee, United Kingdom; AstraZeneca, Pepparedsleden 1, Sweden; AstraZeneca, Melbourn, Hertfordshire, United Kingdom; Royal Derby Hospital, Derby, Derbyshire, United Kingdom; University of Nottingham, Nottingham, Nottinghamshire, United Kingdom
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Robertson JFR, Coleman RE, Cheung KL, Evans A, Holcombe C, Skene A, Rea D, Ahmed S, Jahan A, Kelly S, Horgan K, Rauchhaus P, Littleford R, Foxley A, Lindemann JPO, Pass M, Rugman P, Deb R, Finlay P, Gee JMW. Abstract P4-04-06: AZD5363, an AKT inhibitor, significantly inhibits key biomarkers of the AKT pathway and Ki67, in a randomized, placebo, controlled study (STAKT) in human breast cancers. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-04-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: AKT is an important intracellular control point through which Type 1 growth factors and IGFR signal. Mutations in PIK3CA, AKT and PTEN are prevalent in estrogen receptor positive (ER+) breast cancer (BC) and have been implicated in resistance to endocrine therapies. AZD5363 is an inhibitor of AKT 1, 2 and 3 currently in Phase 2 trials for BC and other solid cancers.
Design: The study examined whether AZD5363 impacts on key biomarkers within the AKT pathway and their subsequent effects on Ki67, a marker of tumor proliferation. STAKT is a multi-center, two-stage, double blind, randomized, placebo controlled, biomarker 'window-of-opportunity' trial in women with newly diagnosed, previously untreated ER+ BC who were deemed would require chemotherapy as part of their primary treatment regimen. Stage 1 assessed AZD5363 at a dose of 480mg bd p.o. versus matching placebo. Up to 30 patients per arm were permitted, to allow 12 subjects per arm with evaluable paired biopsies - obtained at baseline, and after 4.5 days of AZD5363 / placebo. Primary endpoint markers were pPRAS40, pGSK3β and Ki67 assessed by immunohistochemistry. pPRAS40 and pGSK3β were assessed by H-scores and measured separately for cytoplasmic (cyto), nuclear (nuc) and total (cyto+nuc) staining. Ki67 was assessed as % positive staining of 500 tumor nuclei. Laboratory staff were blinded to treatment arm and whether the biopsies were taken before or after AZD5363/placebo. Changes in marker expression (both absolute and %) between biopsies were calculated, and compared between the two groups. An ANOVA test was applied for normally distributed data and Wilcoxon Mann-Whitney used if not normally distributed.
Results: 28/36 patients were evaluable with patient & tumor characteristics as follows: 17 received AZD5363 and 11 placebo; the median ages were 48 & 49 years respectively. 27 patients were Caucasian and 1 African-American. Tumors were all ER+. For HER2 status 8 were positive & 9 negative in the AZD5363 treated group compared to 2 & 9 respectively in the placebo group.
For pPRAS40 and pGSK3β cyto was the predominant staining while for Ki67 staining was nuclear. Changes in each marker with associated p-values are shown in the table.
MarkerType of change vs baselineDegree of change in AZD5363 arm (n=17)p-value versus placebo arm (n=11)pPRAS40 (H-score)TotalAbsolute-83.8<0.0001Total%-50.2<0.0001CytoAbsolute-90.0<0.0001Cyto%-55.8<0.0001NucAbsolute+6.90.42Nuc%+8.90.94pGSK3β (H-score)TotalAbsolute-55.30.006Total%-39.00.006CytoAbsolute-53.60.006Cyto%-39.20.006NucAbsolute-2.80.065Nuc%-36.50.058Ki67 (% cells+)Absolute-9.60.031%-29.40.052
Conclusions• AZD5363 for 4.5 days caused highly significant falls in pGSK3β and pPRAS40, key markers of AKT pathway activation
• AZD53643 also caused a significant decline in Ki67 even after only 4.5 days of drug. This is one of the shortest 'window'-studies to report such an early effect on proliferation.
• Placebo controlled 'window' studies of this short duration can provide important evidence of the therapeutic potential early in a drug's development.
Citation Format: Robertson JFR, Coleman RE, Cheung KL, Evans A, Holcombe C, Skene A, Rea D, Ahmed S, Jahan A, Kelly S, Horgan K, Rauchhaus P, Littleford R, Foxley A, Lindemann JPO, Pass M, Rugman P, Deb R, Finlay P, Gee JMW. AZD5363, an AKT inhibitor, significantly inhibits key biomarkers of the AKT pathway and Ki67, in a randomized, placebo, controlled study (STAKT) in human breast cancers [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-04-06.
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Affiliation(s)
- JFR Robertson
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - RE Coleman
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - KL Cheung
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - A Evans
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - C Holcombe
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - A Skene
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - D Rea
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - S Ahmed
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - A Jahan
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - S Kelly
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - K Horgan
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - P Rauchhaus
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - R Littleford
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - A Foxley
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - JPO Lindemann
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - M Pass
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - P Rugman
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - R Deb
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - P Finlay
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
| | - JMW Gee
- University of Nottingham, Nottingham; Univeristy of Dundee, Dundee; University of Sheffield, Sheffield; Royal Liverpool University Hospital, Liverpool; King's Mill Hospital, Nottingham; Leeds General Infirmary, Leeds; Weston Park Hospital, Sheffield; Leicester Royal Infirmary, Leicester; Royal Bournemouth & Christchurch NHS Foundation; Poole Hospital NHS Foundation Trust; University of Birmingham; Royal Derby Hospital; Derriford Hospital; AstraZeneca; Cardiff University
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Pantho AF, Price M, Ashraf AZ, Wajid U, Khansari ME, Jahan A, Afroze SH, Rhaman MM, Johnson CR, Kuehl TJ, Hossain MA, Uddin MN. Synthetic Receptors Induce Anti Angiogenic and Stress Signaling on Human First Trimester Cytotrophoblast Cells. Int J Environ Res Public Health 2017; 14:E517. [PMID: 28492503 PMCID: PMC5451968 DOI: 10.3390/ijerph14050517] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 04/28/2017] [Accepted: 04/28/2017] [Indexed: 01/08/2023]
Abstract
The cytotrophoblast (CTB) cells of the human placenta have membrane receptors that bind certain cardiotonic steroids (CTS) found in blood plasma. One of these, marinobufagenin, is a key factor in the etiology of preeclampsia. Herein, we used synthetic receptors (SR) to study their effectiveness on the angiogenic profile of human first trimester CTB cells. The humanextravillous CTB cells (Sw.71) used in this study were derived from first trimester chorionic villus tissue. Culture media of CTB cells treated with ≥1 nM SR level revealed sFlt-1 (Soluble fms-like tyrosine kinase-1) was significantly increased while VEGF (vascular endothelial growth factor) was significantly decreased in the culture media (* p < 0.05 for each) The AT₂ receptor (Angiotensin II receptor type 2) expression was significantly upregulated in ≥1 nM SR-treated CTB cells as compared to basal; however, the AT₁ (Angiotensin II receptor, type 1) and VEGFR-1 (vascular endothelial growth factor receptor 1) receptor expression was significantly downregulated (* p < 0.05 for each). Our results show that the anti-proliferative and anti-angiogenic effects of SR on CTB cells are similar to the effects of CTS. The observed anti angiogenic activity of SR on CTB cells demonstrates that the functionalized-urea/thiourea molecules may be useful as potent inhibitors to prevent CTS-induced impairment of CTB cells.
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Affiliation(s)
- Ahmed F Pantho
- Department of Biochemistry, University of Texas at Austin, Austin, TX 78712, USA.
| | - Mason Price
- Department of Biology, Angelo State University, San Angelo, TX 76904, USA.
| | - Ahm Zuberi Ashraf
- Department of Obstetrics & Gynecology, Baylor Scott & White Health, Temple/Texas A&M Health Science Center College of Medicine, Temple, TX 76508, USA.
| | - Umaima Wajid
- Department of Obstetrics & Gynecology, Baylor Scott & White Health, Temple/Texas A&M Health Science Center College of Medicine, Temple, TX 76508, USA.
| | - Maryam Emami Khansari
- Department of Chemistry & Biochemistry, Jackson State University, Jackson, MS 39217, USA.
| | - Afsana Jahan
- Department of Chemistry & Biochemistry, Jackson State University, Jackson, MS 39217, USA.
| | - Syeda H Afroze
- Medical Physiology, Texas A&M Health Science Center College of Medicine, Temple, TX 76504, USA.
| | - Md Mhahabubur Rhaman
- Department of Chemistry & Biochemistry, Jackson State University, Jackson, MS 39217, USA.
| | - Corey R Johnson
- Department of Chemistry & Biochemistry, Jackson State University, Jackson, MS 39217, USA.
| | - Thomas J Kuehl
- Department of Obstetrics & Gynecology, Baylor Scott & White Health, Temple/Texas A&M Health Science Center College of Medicine, Temple, TX 76508, USA.
- Department of Pediatrics, Baylor Scott & White Health, Temple/Texas A&M Health Science Center College of Medicine, Temple, TX 76508, USA.
| | - Md Alamgir Hossain
- Department of Chemistry & Biochemistry, Jackson State University, Jackson, MS 39217, USA.
| | - Mohammad Nasir Uddin
- Department of Obstetrics & Gynecology, Baylor Scott & White Health, Temple/Texas A&M Health Science Center College of Medicine, Temple, TX 76508, USA.
- Department of Pediatrics, Baylor Scott & White Health, Temple/Texas A&M Health Science Center College of Medicine, Temple, TX 76508, USA.
- Internal Medicine, Baylor Scott & White Health, Temple/Texas A&M Health Science Center College of Medicine, Temple, TX 76508, USA.
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13
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Roberston JFR, Cheung KL, Ahmed S, Coleman RE, Evans A, Holcombe C, Rea D, Rauchhaus P, Skene A, Littleford R, Jahan A, Kelly S, Lindermann JPO, Horgan K, Foxley A, Rugman P, Pass M. Abstract P3-06-03: The short term effects of an AKT inhibitor (AZD5363) on biomarkers of the AKT pathway and anti-tumour activity in a breast cancer paired biopsy study (STAKT trial). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-06-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- JFR Roberston
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - KL Cheung
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - S Ahmed
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - RE Coleman
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - A Evans
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - C Holcombe
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - D Rea
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - P Rauchhaus
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - A Skene
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - R Littleford
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - A Jahan
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - S Kelly
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - JPO Lindermann
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - K Horgan
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - A Foxley
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - P Rugman
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
| | - M Pass
- University of Nottingham, Nottingham, United Kingdom; Univeristy of Dundee, Dundee, United Kingdom; University of Sheffield, Sheffield, United Kingdom; Royal Liverpool University Hospital, Liverpool, United Kingdom; King's Mill Hospital, Nottingham, United Kingdom; Leeds General Infirmary, Leeds, United Kingdom; Weston Park Hospital, Sheffield, United Kingdom; Leicester Royal Infirmary, Leicester, United Kingdom; Royal Bournemouth & Christchurch NHS Foundation, Bournemouth, United Kingdom; Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Royal Derby Hospital, Derby, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Derriford Hospital, Plymouth, United Kingdom; AstraZeneca, Melbourn, United Kingdom
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14
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Haque SA, Saeed MA, Jahan A, Wang J, Leszczynski J, Hossain MA. Experimental and Theoretical Aspects of Anion Complexes with a Thiophene-Based Cryptand. COMMENT INORG CHEM 2016; 36:305-326. [PMID: 28216803 PMCID: PMC5310392 DOI: 10.1080/02603594.2016.1171216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Selective recognition of anions has received a tremendous attention in recent years because of their significant importance in biology and environment. This article highlights our recent research on a thiophene-based azacryptand that has been shown to effectively bind anions including iodide, bromide, chloride, nitrate and sulfate. Structural studies indicate that the ligand forms inclusion complexes with chloride and iodide. On the other hand, it forms cleft-like complexes with nitrate and sulfate, where three anions are bound between the cyclic arms. The ligand binds each anion with a 1:1 binding mode in water, exhibiting strong selectivity for sulfate; which is further supported by ESI-MS and DFT calculations.
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Affiliation(s)
- Syed A Haque
- Department of Chemistry and Biochemistry, Jackson State University, Jackson, MS 39217
| | - Musabbir A Saeed
- Department of Chemistry and Biochemistry, Jackson State University, Jackson, MS 39217
| | - Afsana Jahan
- Department of Chemistry and Biochemistry, Jackson State University, Jackson, MS 39217
| | - Jing Wang
- Department of Chemistry and Biochemistry, Jackson State University, Jackson, MS 39217
| | - Jerzy Leszczynski
- Department of Chemistry and Biochemistry, Jackson State University, Jackson, MS 39217
| | - Md Alamgir Hossain
- Department of Chemistry and Biochemistry, Jackson State University, Jackson, MS 39217
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15
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Aghajani Mir M, Taherei Ghazvinei P, Sulaiman NMN, Basri NEA, Saheri S, Mahmood NZ, Jahan A, Begum RA, Aghamohammadi N. Application of TOPSIS and VIKOR improved versions in a multi criteria decision analysis to develop an optimized municipal solid waste management model. J Environ Manage 2016; 166:109-15. [PMID: 26496840 DOI: 10.1016/j.jenvman.2015.09.028] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Revised: 09/14/2015] [Accepted: 09/19/2015] [Indexed: 05/16/2023]
Abstract
Selecting a suitable Multi Criteria Decision Making (MCDM) method is a crucial stage to establish a Solid Waste Management (SWM) system. Main objective of the current study is to demonstrate and evaluate a proposed method using Multiple Criteria Decision Making methods (MCDM). An improved version of Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) applied to obtain the best municipal solid waste management method by comparing and ranking the scenarios. Applying this method in order to rank treatment methods is introduced as one contribution of the study. Besides, Viekriterijumsko Kompromisno Rangiranje (VIKOR) compromise solution method applied for sensitivity analyses. The proposed method can assist urban decision makers in prioritizing and selecting an optimized Municipal Solid Waste (MSW) treatment system. Besides, a logical and systematic scientific method was proposed to guide an appropriate decision-making. A modified TOPSIS methodology as a superior to existing methods for first time was applied for MSW problems. Applying this method in order to rank treatment methods is introduced as one contribution of the study. Next, 11 scenarios of MSW treatment methods are defined and compared environmentally and economically based on the waste management conditions. Results show that integrating a sanitary landfill (18.1%), RDF (3.1%), composting (2%), anaerobic digestion (40.4%), and recycling (36.4%) was an optimized model of integrated waste management. An applied decision-making structure provides the opportunity for optimum decision-making. Therefore, the mix of recycling and anaerobic digestion and a sanitary landfill with Electricity Production (EP) are the preferred options for MSW management.
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Affiliation(s)
- M Aghajani Mir
- Sustainability Informatics Group, Sustainable Science Cluster, University of Malaya, Kuala Lumpur, Malaysia
| | - P Taherei Ghazvinei
- Young Researchers and Elite Club, Parand Branch, Islamic Azad University, Parand, Iran; Civil Engineering Department, Engineering Faculty, University of Malaya, Kuala Lumpur, Malaysia.
| | - N M N Sulaiman
- Sustainability Informatics Group, Sustainable Science Cluster, University of Malaya, Kuala Lumpur, Malaysia
| | - N E A Basri
- Department of Civil and Structural Engineering, University Kebangsaan Malaysia, Bangi, Malaysia
| | - S Saheri
- Department of Civil and Structural Engineering, University Kebangsaan Malaysia, Bangi, Malaysia
| | - N Z Mahmood
- Institute of Biological Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - A Jahan
- Department of Industrial Engineering, Faculty of Engineering, Semnan Brach, Islamic Azad University, Semnan, Iran
| | - R A Begum
- Earth Observation Center, University Kebangsaan Malaysia, Bangi, Malaysia
| | - N Aghamohammadi
- Center for Occupational and Environmental Health, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
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16
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Jahan A, Prabha R, Chaturvedi S, Mathew B, Fleming D, Agarwal I. Clinical efficacy and pharmacokinetics of tacrolimus in children with steroid-resistant nephrotic syndrome. Pediatr Nephrol 2015; 30:1961-7. [PMID: 26135137 DOI: 10.1007/s00467-015-3133-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 05/01/2015] [Accepted: 05/18/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Tacrolimus has gained acceptance in the management of steroid-resistant nephrotic syndrome (SRNS) in children. Due to limited data, therapeutic range is extrapolated from pediatric renal transplant recipients. This study was designed to assess therapeutic efficacy of tacrolimus in children with SRNS and its correlation with inter-dose area under concentration curve (AUC0-12 h) and trough concentration (C0). METHODS Pre dose, 0.5, 1.0, 1.5, 2.0, 2.5, 3, 4, 8, and 12 h after drug administration blood samples were collected in 25 children who were on tacrolimus for a minimum of 3 months and AUC0-12 h was calculated. RESULTS There was an 80% (20/25) response rate with 64% (16/25) children achieving complete remission. Median C0 in remission was higher than in relapse group (2.95 ng/ml, versus 1.20 ng/ml, p = 0.005). Median AUC0-12 h in remission was higher compared to those in relapse group (79.75 versus 35.15 μg × h/l; p = 0.025). Maximum concentration after drug administration (Cmax) among the groups was not significantly different. There was a significant correlation between C0 and AUC0-12 h (r = 0.79); and Cmax and AUC0-12 h (r = 0.84). Five patients had a rise in serum creatinine, of which four were still proteinuric and had lower C0 and AUC0-12 h. No other adverse effect was noted. CONCLUSIONS Tacrolimus had beneficial clinical response in SRNS. Target C0 and AUC0-12 h level for treatment remission was higher than those in relapse in children with SRNS but was lower than required in transplant recipient.
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Affiliation(s)
- Afsana Jahan
- Paediatric Nephrology Unit, Department of Paediatrics, Christian Medical College, Vellore, Tamilnadu, India.
| | - Ratna Prabha
- Department of Clinical Pharmacology, Christian Medical College, Vellore, Tamilnadu, India
| | - Swasti Chaturvedi
- Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Binu Mathew
- Department of Clinical Pharmacology, Christian Medical College, Vellore, Tamilnadu, India
| | - Denise Fleming
- Department of Clinical Pharmacology, Christian Medical College, Vellore, Tamilnadu, India
| | - Indira Agarwal
- Paediatric Nephrology Unit, Department of Paediatrics, Christian Medical College, Vellore, Tamilnadu, India
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Abstract
This case-control study was done to identify the correlation between the familial, social and environmental risk factors and autism. This hospital and specialized centre based study done from January 2002 to November, 2004. Thirty two children from the autism group and 14 children from the control group were enrolled. Mean age were 3.75 yrs. and 2.83 yrs. respectively. Significant proportion of children were in the highest birth orders, 68.8% in autism and 78.6% in the control group. Full term children were 96.9% and 92.9% respectively. 53.1% children in the autism and 57.1% in the normal speech delay group were born by cesarean sections. Higher education of parents in autism group was statistically significant (p<0.05). Too much watching TV, inadequate opportunity to mix with peers and inadequate interactive relationship with the family members in the early childhood were significantly (p= 0.001) related to the development of autism.Bangladesh Med Res Counc Bull 2014; 40 (3): 113-117
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18
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Reddy SK, Jahan A, Chaturvedi S, Agarwal I. Plasma exchange for paediatric kidney disease-indications and outcomes: a single-centre experience. Clin Kidney J 2015; 8:702-7. [PMID: 26613028 PMCID: PMC4655793 DOI: 10.1093/ckj/sfv084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 08/03/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Outcome data in paediatrics regarding the use of plasmapheresis for immunological kidney disease are scarce. OBJECTIVES We aimed to evaluate the role of plasmapheresis in children presenting with severe renal impairment secondary to immunological kidney diseases. METHODS A retrospective chart review of children admitted between January 2009 and August 2013 to the Paediatric Nephrology Unit, Christian Medical College, Vellore, India, and requiring plasma exchange was undertaken. Demographic and clinical data were studied and descriptive statistics applied for analysis. RESULTS Sixteen children underwent plasmapheresis with a male:female ratio of 10:6 and a mean age of 10.2 years (range 5-15 years). Twelve children had atypical haemolytic uraemic syndrome, two had anti-glomerular basement disease and one each had lupus nephritis with neurological manifestation and anti-nuclear cytoplasmic antibody-associated vasculitis. The mean serum creatinine at presentation was 6.52 [interquartile range (IQR) 4.96-7.85] mg/dL with a mean eGFR of 43 (IQR 27.54-56.7) mL/min/1.73 m(2). Other presenting features included nephrotic range proteinuria (69%), gross haematuria (27%), hypertension (94%) and seizures (37.5%). All children received 1.5 times plasma volume plasmapheresis (mean 11 sessions, range 5-26), dialysis and immunosuppressive therapy. The mean duration of follow-up was 4 months (range 2-24 months) with a majority of the children (15/16, 93.75%) surviving acute illness. One child died of overwhelming sepsis and another was lost to follow-up. Of the survivors, eight had eGFR >60 mL/min/1.73 m(2), while eGFR was 15-60 mL/min/1.73 m(2) in the remaining six children. Eight children were still requiring antihypertensive medications and two were continuing peritoneal dialysis at the last follow-up. Thus early introduction of plasmapheresis along with other supportive therapy in immunological kidney disease may improve outcome.
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Affiliation(s)
- Sudheer Kumar Reddy
- Department of Paediatric Nephrology, Child Health 2 , Christian Medical College , Vellore , India
| | - Afsana Jahan
- Department of Paediatric Nephrology , Christian Medical College , Vellore , India
| | - Swasti Chaturvedi
- Department of Paediatrics , Khoo Teck Puat-National University Children's Medical Institute, National University Health System , Singapore , Singapore
| | - Indira Agarwal
- Department of Paediatric Nephrology, Child Health 2 , Christian Medical College , Vellore , India
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Nandan D, Jahan A, Dewan V, Singh S, Buxi G. Pure red cell aplasia in a three-months-old infant possibly secondary to cytomegalo virus infection. Indian J Hematol Blood Transfus 2014; 30:30-2. [PMID: 25332527 PMCID: PMC4192248 DOI: 10.1007/s12288-012-0226-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 12/26/2012] [Indexed: 02/07/2023] Open
Abstract
We report a 3 months old child who presented with severe anemia due to pure red cell aplasia (PRCA). After ruling out other known causes of PRCA, congenital cytomegalovirus (CMV) infection was diagnosed to be the cause. The child responded to Ganciclovir and is doing well. CMV infection should be considered as differential diagnosis in PRCA during infancy.
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Affiliation(s)
- Devki Nandan
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India 110001
- D-3/3210, DDA SFS Flat, Vasant Kunj, New Delhi, 110070 India
| | - Afsana Jahan
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India 110001
| | - Vivek Dewan
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India 110001
| | - Sarman Singh
- Division of Clinical Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Gurdeep Buxi
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India 110001
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Satija M, Yadav TP, Sachdev N, Chhabra A, Jahan A, Dewan V. Endothelial function, arterial wall mechanics and intima media thickness in juvenile idiopathic arthritis. Clin Exp Rheumatol 2014; 32:432-439. [PMID: 24564946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 12/02/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease of children which might persist into adulthood. Systemic inflammation seen in adult RA patients has been shown to be associated with alteration in endothelial function, arterial wall mechanics and intima media thickness. Our study was planned to assess similar changes in JIA patients. METHODS Thirty-one newly diagnosed JIA patients and a similar number of age- and sex-matched controls were enrolled in the study. Endothelial function was assessed by measuring flow mediated dilation and glyceryl trinitrate (GTN)-mediated dilation of the brachial artery. To assess arterial stiffness, various arterial wall mechanic parameters such as cross-sectional compliance, cross-sectional distensibility, shear stress and elastic modulus were derived. Intima media thickness of the common carotid artery was measured as a marker of subclinical atherosclerosis. RESULTS The brachial artery diameter at rest was found to be slightly lower in the patients than controls (0.258 ± 0.042 vs. 0.264 ± 0.039; p=0.54). No significant difference was found in flow mediated dilation (17.71 ± 9.26 vs. 16.31 ± 8.23; p=0.53), GTN mediated dilation (25.25 ± 10.02 vs. 23.66 ± 9.79; p=0.53) or FMD: GTN mediated dilation ratio (0.730 ± 0.432 vs. 0.717 ± 0.280; p=0.89) between the cases and controls. There was also no significant difference in carotid artery intima media thickness (0.065 ± 0.0068 vs. 0.068 ± 0.007; p=0.084) between cases and controls. Cases in different subsets of JIA were also analysed separately with regards to FMD, GTN mediated dilation and cIMT but no difference was found between cases in each subset and their controls. Cross-sectional compliance was significantly lower in cases than controls (0.0016 ± 0.0005 vs. 0.002 ± 0.001; p=0.034). Cross-sectional distensibility (0.009 ± 0.003 vs. 0.011 ± 0.006; p=0.14) was also found to be lower whereas diastolic wall shear stress (299.9 ± 47.08 vs. 294.9 ± 59.5; p=0.72) and elastic modulus (1138.5 ± 1085.8 vs. 911 ± 453; p=0.19) were found to be higher in cases as compared to controls. But these differences were not statistically significant. When the subsets were analysed separately for vessel wall indices, cross-sectional compliance was found to be significantly lower in systemic arthritis patients as compared to controls. A high level of intra- and inter-observer agreement was found for all the ultrasonographically evaluated parameters. CONCLUSIONS Arterial wall indices were found altered in JIA patients indicating increased arterial stiffness. Larger studies are required to assess endothelial dysfunction, intima media thickness and arterial stiffness in each subset of JIA patients.
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Affiliation(s)
- M Satija
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India.
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Yadav A, Jahan A, Yadav TP, Sachdev N, Chitkara A, Asare R. Effect of glucocorticoids on serum lipid profile and endothelial function and arterial wall mechanics. Indian J Pediatr 2013; 80:1007-14. [PMID: 23696151 DOI: 10.1007/s12098-013-1035-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Accepted: 04/03/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the effect of glucocorticoids on lipid profile, endothelial function and arterial wall mechanics in children. METHODS Thirty patients who had received glucocorticoids for 4 to 8 wk were compared with 30 age and sex matched healthy controls. Baseline evaluation included weight, height, body mass index (BMI), blood pressure (BP), lipid profile and Ultrasonographic evaluation of brachial artery for endothelial dependant as well as endothelial independent vasodilatation and evaluation of common carotid artery for intima media thickness (IMT) and arterial wall mechanics. All of these parameters were evaluated two more times- after 4 wk of steroid therapy and 2 wk after stopping the drug. RESULTS Patients were found to have significant increase in BMI; systolic and diastolic BP; total and LDL cholesterol and carotid IMT and also a decrease in cross sectional compliance (CSC) after 4 wk of steroid therapy (oral prednisolone). However, all these parameters returned towards baseline, 2 wk after stopping the drug. No endothelial dysfunction was observed in these patients. CONCLUSIONS Four to eight wk of glucocorticoids use in children leads to reversible changes in BMI, systolic and diastolic BP, total and LDL cholesterol, carotid IMT and CSC.
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Affiliation(s)
- Anita Yadav
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Zeier MG, Chaturvedi S, Jahan A, Korula A, Agarwal I. A 12-year-old boy with renal failure and haemoptysis. Clin Kidney J 2013; 6:650-2. [PMID: 26069836 PMCID: PMC4438382 DOI: 10.1093/ckj/sft136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 10/11/2013] [Indexed: 11/18/2022] Open
Affiliation(s)
- M G Zeier
- Paediatric Nephrology Unit, Department of Paediatrics , Christian Medical College , Vellore, Tamilnadu , India
| | - Swasti Chaturvedi
- Paediatric Nephrology Unit, Department of Paediatrics , Christian Medical College , Vellore, Tamilnadu , India
| | - Afsana Jahan
- Paediatric Nephrology Unit, Department of Paediatrics , Christian Medical College , Vellore, Tamilnadu , India
| | - Anila Korula
- Department of Pathology , Christian Medical College , Vellore, Tamilnadu , India
| | - Indira Agarwal
- Paediatric Nephrology Unit, Department of Paediatrics , Christian Medical College , Vellore, Tamilnadu , India
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Abstract
Methotrexate, the mainstay of treatment in Juvenile idiopathic arthritis, might not be effective in a few patients of polyarticular and systemic onset juvenile idiopathic arthritis. Use of biologicals like TNF-a blockers, the next line of preferred drugs is constrained by the high cost. We successfully used leflunomide in four patients.
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Affiliation(s)
- Afsana Jahan
- Department of Paediatrics, Post Graduate Institute of Medical Education and Research, Dr Ram Manohar Lohia hospital, New Delhi, India
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Khatoon S, Kolte SW, Kurkure NV, Chopde NA, Jahan A. Detection of tropical bovine theileriosis by polymerase chain reaction in cattle. J Parasit Dis 2013; 39:53-6. [PMID: 25698860 DOI: 10.1007/s12639-013-0270-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 02/05/2013] [Accepted: 02/21/2013] [Indexed: 10/27/2022] Open
Abstract
Tropical bovine theileriosis, a tick borne disease, caused by, Theileria annulata with marked clinical signs of pyrexia (102-105 °F), enlargement of lymphnodes etc., causes heavy economic losses in terms of high mortality and morbidity rates. Diagnosis of theileriosis is mainly based on clinical symptoms and microscopic examination of stained blood smears and lymph node biopsy smears but limitations of these methods against Theileria sp. limits the specificity. Hence, to overcome the limitations, the present study reports the detection of T. annulata in blood samples of cattle by polymerase chain reaction. The study was conducted on 155 cattle having typical clinical symptoms and blood smear after staining with Giemsa stain was examined for the presence of T. annulata in RBC. The Primer sequences were used as per d'Oliveira et al. The assay employs primers specific for the gene encoding the 30-kDa major merozoite surface antigen of T. annulata and the amplification of 721 bp was done. Out of the total 155 animals, 34 were positive for T. annulata by blood smear method whereas 134 samples were positive by PCR. So diagnosis of blood samples by PCR is found to be the most sensitive and specific methodology as compared to cytological blood smear examination. The sensitivity was 23.88 % and specificity was 90.47 % of blood smear method considering PCR as gold standard and it was found that PCR is more sensitive than the conventional method of examination.
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Affiliation(s)
- S Khatoon
- Nagpur Veterinary College, Maharashtra Animal and Fishery Sciences University (MAFSU), Nagpur, 440006 MS India
| | - S W Kolte
- Nagpur Veterinary College, Maharashtra Animal and Fishery Sciences University (MAFSU), Nagpur, 440006 MS India
| | - N V Kurkure
- Nagpur Veterinary College, Maharashtra Animal and Fishery Sciences University (MAFSU), Nagpur, 440006 MS India
| | - N A Chopde
- Nagpur Veterinary College, Maharashtra Animal and Fishery Sciences University (MAFSU), Nagpur, 440006 MS India
| | - A Jahan
- Nagpur Veterinary College, Maharashtra Animal and Fishery Sciences University (MAFSU), Nagpur, 440006 MS India
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Jahan A, Demmy T, Hennon M, Dexter E, Nwogu C, Farooq A, Dy G, Yendamuri S. Perioperative Outcomes of Patients With Less Than Clinical N2 NSCLC Receiving Neoadjuvant Vs. Adjuvant Therapy. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.029] [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: 12/01/2022]
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Bhagwani D, Jahan A, Yadav T, Dey S, Sachdev N. Diagnostic Sensitivity and Specificity of Spectral Color Doppler Ultrasound Indices in Juvenile Idiopathic Arthritis. ACTA ACUST UNITED AC 2012. [DOI: 10.5455/apr.090320121032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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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Robertson J, Dixon J, Sibbering D, Jahan A, Ellis I, Channon E, Nicholson R, Gee J. 18 Biological activity of a combination of fulvestrant 500 mg (F500) plus anastrozole versus F500 alone or anastrozole alone as neoadjuvant treatment for breast cancer. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70050-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Zura A, Jahan A, Hass J. An introduction to digital cameras. Reg Anesth Pain Med 2001; 26:164-8. [PMID: 11251142 DOI: 10.1053/rapm.2001.20771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES People in all walks of life are using digital cameras instead of the traditional film cameras. Reasons include simplicity of use, ease of development, ability to incorporate the pictures into documents, potential to edit the pictures easily, and capability to send them by e-mail. This article will briefly discuss digital cameras, how they work, what they can do, and what you should look for in one. Editor's Note: This is the fourth in a series of articles demonstrating and describing information technology. The articles include nontechnical information and are geared toward the computer novice with interest in regional anesthesia and pain medicine.
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Affiliation(s)
- A Zura
- Department of General Anesthesiology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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Affiliation(s)
- A Jahan
- Dept. Biochem. Med., Ninewells Hospital and Medical School, Dundee, Scotland
| | - M C Browning
- Dept. Biochem. Med., Ninewells Hospital and Medical School, Dundee, Scotland
| | - C G Fraser
- Dept. Biochem. Med., Ninewells Hospital and Medical School, Dundee, Scotland
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Jahan A, Browning MC, Fraser CG. Desirable performance standards for assays of serum water and osmolality. Clin Chem 1988; 34:995. [PMID: 3370813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- A Jahan
- Dept. Biochem. Med., Ninewells Hospital and Medical School, Dundee, Scotland
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Jahan A. Studies on digenetic Trematodes of Vertebrates. I. On four trematode parasites of turtles. Ann Parasitol Hum Comp 1970; 45:793-803. [PMID: 5535151 DOI: 10.1051/parasite/1970456793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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