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Huang S, de Jong D, Das JP, Widemon RS, Braumuller B, Paily J, Deng A, Liou C, Roa T, Huang A, Ma H, D'Souza B, Leb J, L'Hereaux J, Nguyen P, Luk L, Francescone M, Yeh R, Maccarrone V, Dercle L, Salvatore MM, Capaccione KM. Imaging the Side Effects of CAR T Cell Therapy: A Primer for the Practicing Radiologist. Acad Radiol 2023; 30:2712-2727. [PMID: 37394411 DOI: 10.1016/j.acra.2023.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 07/04/2023]
Abstract
Chimeric antigen receptor (CAR) T cell therapy is a revolutionary form of immunotherapy that has proven to be efficacious in the treatment of many hematologic cancers. CARs are modified T lymphocytes that express an artificial receptor specific to a tumor-associated antigen. These engineered cells are then reintroduced to upregulate the host immune responses and eradicate malignant cells. While the use of CAR T cell therapy is rapidly expanding, little is known about how common side effects such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity (ICANS) present radiographically. Here we provide a comprehensive review of how side effects present in different organ systems and how they can be optimally imaged. Early and accurate recognition of the radiographic presentation of these side effects is critical to the practicing radiologist and their patients so that these side effects can be promptly identified and treated.
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Affiliation(s)
- Sophia Huang
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Dorine de Jong
- Department of Immunology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065 (D.J.)
| | - Jeeban P Das
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065 (J.D., R.Y.)
| | - Reginald Scott Widemon
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Brian Braumuller
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Jacienta Paily
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Aileen Deng
- Department of Hematology and Oncology, Novant Health, 170 Medical Park Road, Mooresville, North Carolina 28117 (A.D.)
| | - Connie Liou
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Tina Roa
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Alice Huang
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Hong Ma
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Belinda D'Souza
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Jay Leb
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Jade L'Hereaux
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Pamela Nguyen
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Lyndon Luk
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Mark Francescone
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Randy Yeh
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065 (J.D., R.Y.)
| | - Valerie Maccarrone
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Laurent Dercle
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Mary M Salvatore
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.)
| | - Kathleen M Capaccione
- Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, New York 10032 (S.H., R.S.W., B.B., J.P., C.L., T.R., A.H., H.M., B.D.S., J.L., J.L.H., P.N., L.L., M.F., V.M., L.D., M.S., K.M.C.).
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de Jong D, Desperito E, Al Feghali KA, Dercle L, Seban RD, Das JP, Ma H, Sajan A, Braumuller B, Prendergast C, Liou C, Deng A, Roa T, Yeh R, Girard A, Salvatore MM, Capaccione KM. Advances in PET/CT Imaging for Breast Cancer. J Clin Med 2023; 12:4537. [PMID: 37445572 PMCID: PMC10342839 DOI: 10.3390/jcm12134537] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/26/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
One out of eight women will be affected by breast cancer during her lifetime. Imaging plays a key role in breast cancer detection and management, providing physicians with information about tumor location, heterogeneity, and dissemination. In this review, we describe the latest advances in PET/CT imaging of breast cancer, including novel applications of 18F-FDG PET/CT and the development and testing of new agents for primary and metastatic breast tumor imaging and therapy. Ultimately, these radiopharmaceuticals may guide personalized approaches to optimize treatment based on the patient's specific tumor profile, and may become a new standard of care. In addition, they may enhance the assessment of treatment efficacy and lead to improved outcomes for patients with a breast cancer diagnosis.
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Affiliation(s)
- Dorine de Jong
- Center for Cell Engineering, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - Elise Desperito
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (E.D.); (L.D.); (H.M.); (A.S.); (B.B.); (C.P.); (C.L.); (T.R.); (M.M.S.)
| | | | - Laurent Dercle
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (E.D.); (L.D.); (H.M.); (A.S.); (B.B.); (C.P.); (C.L.); (T.R.); (M.M.S.)
| | - Romain-David Seban
- Department of Nuclear Medicine and Endocrine Oncology, Institut Curie, 92210 Saint-Cloud, France;
- Laboratory of Translational Imaging in Oncology, Paris Sciences et Lettres (PSL) Research University, Institut Curie, 91401 Orsay, France
| | - Jeeban P. Das
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (J.P.D.); (R.Y.)
| | - Hong Ma
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (E.D.); (L.D.); (H.M.); (A.S.); (B.B.); (C.P.); (C.L.); (T.R.); (M.M.S.)
| | - Abin Sajan
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (E.D.); (L.D.); (H.M.); (A.S.); (B.B.); (C.P.); (C.L.); (T.R.); (M.M.S.)
| | - Brian Braumuller
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (E.D.); (L.D.); (H.M.); (A.S.); (B.B.); (C.P.); (C.L.); (T.R.); (M.M.S.)
| | - Conor Prendergast
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (E.D.); (L.D.); (H.M.); (A.S.); (B.B.); (C.P.); (C.L.); (T.R.); (M.M.S.)
| | - Connie Liou
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (E.D.); (L.D.); (H.M.); (A.S.); (B.B.); (C.P.); (C.L.); (T.R.); (M.M.S.)
| | - Aileen Deng
- Department of Hematology and Oncology, Novant Health, 170 Medical Park Road, Mooresville, NC 28117, USA;
| | - Tina Roa
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (E.D.); (L.D.); (H.M.); (A.S.); (B.B.); (C.P.); (C.L.); (T.R.); (M.M.S.)
| | - Randy Yeh
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (J.P.D.); (R.Y.)
| | - Antoine Girard
- Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, 35000 Rennes, France;
| | - Mary M. Salvatore
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (E.D.); (L.D.); (H.M.); (A.S.); (B.B.); (C.P.); (C.L.); (T.R.); (M.M.S.)
| | - Kathleen M. Capaccione
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (E.D.); (L.D.); (H.M.); (A.S.); (B.B.); (C.P.); (C.L.); (T.R.); (M.M.S.)
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de Jong D, Das JP, Ma H, Pailey Valiplackal J, Prendergast C, Roa T, Braumuller B, Deng A, Dercle L, Yeh R, Salvatore MM, Capaccione KM. Novel Targets, Novel Treatments: The Changing Landscape of Non-Small Cell Lung Cancer. Cancers (Basel) 2023; 15:2855. [PMID: 37345192 PMCID: PMC10216085 DOI: 10.3390/cancers15102855] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/11/2023] [Accepted: 05/19/2023] [Indexed: 06/23/2023] Open
Abstract
Treatment of non-small cell lung cancer (NSCLC) has undergone a paradigm shift. Once a disease with limited potential therapies, treatment options for patients have exploded with the availability of molecular testing to direct management and targeted therapies to treat tumors with specific driver mutations. New in vitro diagnostics allow for the early and non-invasive detection of disease, and emerging in vivo imaging techniques allow for better detection and monitoring. The development of checkpoint inhibitor immunotherapy has arguably been the biggest advance in lung cancer treatment, given that the vast majority of NSCLC tumors can be treated with these therapies. Specific targeted therapies, including those against KRAS, EGFR, RTK, and others have also improved the outcomes for those individuals bearing an actionable mutation. New and emerging therapies, such as bispecific antibodies, CAR T cell therapy, and molecular targeted radiotherapy, offer promise to patients for whom none of the existing therapies have proved effective. In this review, we provide the most up-to-date survey to our knowledge regarding emerging diagnostic and therapeutic strategies for lung cancer to provide clinicians with a comprehensive reference of the options for treatment available now and those which are soon to come.
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Affiliation(s)
- Dorine de Jong
- Center for Cell Engineering, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA;
| | - Jeeban P. Das
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; (J.P.D.); (R.Y.)
| | - Hong Ma
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (H.M.); (J.P.V.); (C.P.); (T.R.); (B.B.); (L.D.); (M.M.S.)
| | - Jacienta Pailey Valiplackal
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (H.M.); (J.P.V.); (C.P.); (T.R.); (B.B.); (L.D.); (M.M.S.)
| | - Conor Prendergast
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (H.M.); (J.P.V.); (C.P.); (T.R.); (B.B.); (L.D.); (M.M.S.)
| | - Tina Roa
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (H.M.); (J.P.V.); (C.P.); (T.R.); (B.B.); (L.D.); (M.M.S.)
| | - Brian Braumuller
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (H.M.); (J.P.V.); (C.P.); (T.R.); (B.B.); (L.D.); (M.M.S.)
| | - Aileen Deng
- Department of Hematology and Oncology, Novant Health, 170 Medical Park Road, Mooresville, NC 28117, USA;
| | - Laurent Dercle
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (H.M.); (J.P.V.); (C.P.); (T.R.); (B.B.); (L.D.); (M.M.S.)
| | - Randy Yeh
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; (J.P.D.); (R.Y.)
| | - Mary M. Salvatore
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (H.M.); (J.P.V.); (C.P.); (T.R.); (B.B.); (L.D.); (M.M.S.)
| | - Kathleen M. Capaccione
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA; (H.M.); (J.P.V.); (C.P.); (T.R.); (B.B.); (L.D.); (M.M.S.)
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Som A, Shaikh P, Deng A, Deych E, Zhang K. Coronary calcification is independently associated with major adverse cardiovascular events in men with recurrent prostate cancer while aortic calcification is not. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiovascular disease is an important cause of morbidity and mortality in men with prostate cancer. Coronary and aortic calcification have been associated with major adverse cardiovascular events (MACE) in the general population, and are readily seen on staging cancer positron emission tomography (PET)/computed tomography (CT) scans. The utility of vascular calcification on non-gated CT for cardiovascular risk assessment in men with prostate cancer is not known.
Purpose
We determined the association between coronary and aortic calcification on non-gated CT imaging and MACE in men with prostate cancer.
Methods
We studied 354 men who underwent indium-111 capromab pendetide PET/CT for recurrent prostate cancer at our institution between 2012–2016. Clinical data were obtained from the medical record. Coronary and aortic calcification were qualitatively assessed using a standardized scoring system. The primary outcome of MACE included myocardial infarction, stroke, coronary and/or peripheral revascularization, heart failure hospitalization, and all-cause mortality.
Results
Over 5 years of follow-up, 63 patients (18%) met the primary outcome. Vascular calcification was common in this cohort (median 68 years of age), with 214 patients (60%) having coronary calcification and 296 patients (84%) having aortic calcification. Older patients had greater coronary and aortic calcification, and also higher rate of MACE. In adjusted models for age and diabetes, coronary calcification was associated with higher rate of MACE (hazard ratio [HR] 2.1, interquartile range [IQR] 1.1–4.0, p=0.02) while aortic calcification was not (HR 2.7, IQR 0.8–9.0, p=0.12). Undifferentiated vascular calcification was not associated with MACE (p=0.24).
Conclusions
Coronary calcification on non-gated CT scan is independently associated with MACE in men with recurrent prostate cancer while aortic calcification is not. The presence of coronary calcification should be included in staging PET/CT reports, and this information should prompt implementation of cardiovascular risk modification strategies.
Funding Acknowledgement
Type of funding sources: Private hospital(s). Main funding source(s): This study was supported by the Mentors in Medicine Program, Department of Internal Medicine, Washington University School of Medicine.
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Affiliation(s)
- A Som
- Washington University School of Medicine, Internal Medicine , St. Louis , United States of America
| | - P Shaikh
- Washington University School of Medicine, Internal Medicine , St. Louis , United States of America
| | - A Deng
- Washington University School of Medicine, Internal Medicine , St. Louis , United States of America
| | - E Deych
- Washington University School of Medicine, Internal Medicine , St. Louis , United States of America
| | - K Zhang
- University of Texas Southwestern Medical Center, Cardiology , Dallas , United States of America
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al 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Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Capaccione KM, Huang S, D'souza B, Leb J, Luk L, Goldstein J, May B, Deng A, Salvatore MM. Radiographic features of pneumonitis in patients treated with immunotherapy compared to traditional chemotherapy for non-small cell lung cancer. Clin Imaging 2022; 93:106-112. [DOI: 10.1016/j.clinimag.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 11/25/2022]
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Capaccione KM, Huang S, Toor Z, May B, Deng A, Salvatore MM. Immunotherapy related pericardial effusion on chest CT. Clin Imaging 2021; 82:204-209. [PMID: 34890964 DOI: 10.1016/j.clinimag.2021.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 11/03/2021] [Accepted: 11/22/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Immunotherapy has become a critical class of anticancer therapy in recent years, functioning by releasing brakes on the immune system that ultimately results in immune cell activation which eliminates cancer cells. Immune related adverse events (IRAEs) are a specific type of adverse event described in patients taking checkpoint inhibitor immunotherapy which results from unrestrained immune activation. Immune related pericardial effusion has been described however has not been comprehensively characterized. Here, we present the most extensive report to date detailing this adverse event. METHODS We queried our medical record system to retrospectively identify patients on checkpoint inhibitor therapy for lung cancer who subsequently developed pericardial effusion. We analyzed the clinical and radiographic characteristics, prior therapies, treatment for the effusion, and outcomes in patients with immune related pericardial effusion and compared them to similar patients with pericardial effusion not attributable to checkpoint inhibitor therapy. RESULTS Our data demonstrate that most of these pericardial effusions were small and not clinically significant. The majority were successfully treated with steroids or resolved spontaneously. Anti-PD-1 inhibitors were the most common checkpoint inhibitor preceding pericardial effusion, and a significant number of patients who went on to develop IRAE pericardial effusion previously had treatment with carboplatin for their cancer. CONCLUSIONS These data suggest that IRAE pericardial effusion is not a clinically significant adverse event however it sometimes leads to permanent discontinuation of checkpoint inhibitor therapy which is not necessary.
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Affiliation(s)
- Kathleen M Capaccione
- Division of Cardiothoracic Imaging, Department of Radiology, Columbia University Irving Medical Center, NY, New York, United States of America.
| | - Sophia Huang
- Division of Cardiothoracic Imaging, Department of Radiology, Columbia University Irving Medical Center, NY, New York, United States of America
| | - Zeeshan Toor
- Division of Cardiothoracic Imaging, Department of Radiology, Columbia University Irving Medical Center, NY, New York, United States of America
| | - Benjamin May
- Division of Cardiothoracic Imaging, Department of Radiology, Columbia University Irving Medical Center, NY, New York, United States of America
| | - Aileen Deng
- Department of Hematology/Oncology, Novant Health Cancer Institute, Novant Health, Mooresville, NC, United States of America
| | - Mary M Salvatore
- Division of Cardiothoracic Imaging, Department of Radiology, Columbia University Irving Medical Center, NY, New York, United States of America
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Capaccione KM, Huang S, West E, Deng A, Salvatore MM, Desperito E. Differential effects of the 2015 American Cancer Society guidelines on screening mammography exams based on socioeconomic status. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.10539] [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: 11/20/2022] Open
Abstract
10539 Background: Guidelines for screening mammography have changed several times since initiation of regular screening mammography in the 1970’s. Most recently, in 2015, the American Cancer Society (ACS) revised their screening guidelines, recommending that a patient discuss screening mammography with her primary care doctor (PCP) between the ages of 40-44 and should begin yearly screening at age 45; after age 54, ACS recommended screening every other year. Prior to this, from 2003-2015, ACS had recommended screening mammography every year beginning at the age of 40. We hypothesized that these guidelines were adopted to varying degrees in different patient populations and may have disproportionately reduced screening mammography utilization in socioeconomically disadvantaged populations. Methods: Here, we analyzed monthly screening mammography rates over time in two large New York City hospitals, one in a socioeconomically advantaged area and the other in a socioeconomically disadvantaged area. Using our radiology records query system, we searched for monthly screening mammography numbers for women by decade from 2012 to 2018. We performed statistical analysis to evaluate changes in number of exams over time. Student’s t-tests were used to evaluate for significant differences. Results: In both groups of 40-49 year old patients, monthly mammograms increased from 2012-2016. In the socioeconomically advantaged group, this increase continued until 2018 resulting in an overall 400% increase in screening mammograms over time. The change in ACS screening guidelines had no effect on the rate of screening mammography in this group. Conversely, after the revision of the ACS guidelines in 2015, there was a marked decline in screening mammography in the 40-49 year old group in the socioeconomically disadvantaged population. By 2018, there was a statistically significant difference in women screened in all age groups (40-49, p<.0001; 50-59, p<.0001; 60-69, p<.01; 70-79, p<.0001; 80+, p<.0001) between these two patient populations. Conclusions: These data suggest that implementation of the 2015 ACS screening guidelines had a disproportionate effect on patients from socioeconomically disadvantaged areas and that these effects have led to significant disparities in screening mammography trends over time. We postulate that lower levels of health literacy may have contributed to misunderstanding of the screening guidelines. More research is needed to elucidate the underlying etiology of these disparities and ensure that women from all socioeconomic backgrounds receive appropriate screening mammography. Over time, this may result in disproportionate breast cancer morbidity and mortality in populations not receiving appropriate screening.
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Affiliation(s)
| | - Sophia Huang
- Columbia University Irving Medical Center, New York, NY
| | | | - Aileen Deng
- Novant Health Cancer Institute, Mooresville, NC
| | - Mary M. Salvatore
- Department of Radiology, Columbia University Irving Medical Center, New York, NY
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Deng A, Wang C, Cohen SJ, Winter JM, Posey J, Yeo C, Basu Mallick A. Multi-agent neoadjuvant chemotherapy improves survival in early-stage pancreatic cancer: A National Cancer Database analysis. Eur J Cancer 2021; 147:17-28. [PMID: 33607382 DOI: 10.1016/j.ejca.2021.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 04/21/2020] [Revised: 12/31/2020] [Accepted: 01/11/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To compare overall survival (OS) in patients who underwent surgery for early-stage pancreatic adenocarcinoma (rPca) based on sequence (NAT, neoadjuvant therapy and/or AT, adjuvant therapy) and type (SA, single-agent or MA, multi-agent) of chemotherapy received. METHODS Using the National Cancer Database, patients with clinical stage I/II rPca diagnosed between 2010 and 2014 were identified and five comparison matches (1: NAT vs. upfront resection (UR); 2: multi-agent neoadjuvant (MA NAT) vs. single-agent adjuvant therapy (SA AT), single-agent neoadjuvant therapy (SA NAT), multi-agent adjuvant therapy (MA AT); 3: MA NAT vs. MA AT; 4: NAT + AT vs NAT; 5: NAT + AT vs AT) were constructed using minimum distance matching strategy. Median OS (mOS) was analysed using Kaplan-Meier method, log-rank test and Cox proportional hazard model. RESULTS A total of 18,470 patients with stage I/II rPca were eligible for analysis. NAT showed a 5 month (mo.) improved OS compared with UR (3271 patients/group, 28.1 vs 23.2 mo. P < 0.0001 hazard ratio [HR]: 0.79). MA-NAT was shown to be superior to other chemotherapy approaches SA AT, SA NAT, and MA AT (1349 patients/group: 30 vs. 25.9 mo., P = 0.0001 [HR: 0.82]). MA NAT showed a survival advantage over MA-AT (1349 patients/group, 30 vs 26.1 mo., P = 0.0008 [HR: 0.86]). The combination of NAT and AT showed a better outcome when compared with NAT alone (1128 patients/group, 31.6 vs 27.4 mo., P = 0.0011 [HR: 0.81]) or AT alone (1128 patients/group, 31.6 vs. 25.2 mo., P < 0.0001 [HR: 0.76]). CONCLUSIONS In patients with stage I/II rPca, MA NAT showed improved mOS compared to UR and all other chemotherapy sequences except both NAT plus AT. These findings support the use of MA NAT in stage I/II rPca patients and warrant prospective trials evaluating MA NAT and post-resection maintenance therapies.
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Affiliation(s)
- Aileen Deng
- Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Chun Wang
- Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Jordan M Winter
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - James Posey
- Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Charles Yeo
- Thomas Jefferson University Hospital, Philadelphia, PA, USA; Thomas Jefferson University, Philadelphia, PA, USA
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Cheng B, Hu J, Zuo X, Chen J, Li X, Chen Y, Yang G, Shi X, Deng A. Predictors of progression from moderate to severe coronavirus disease 2019: a retrospective cohort. Clin Microbiol Infect 2020; 26:1400-1405. [PMID: 32622952 PMCID: PMC7331556 DOI: 10.1016/j.cmi.2020.06.033] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Most cases of coronavirus disease 2019 (COVID-19) are identified as moderate, which is defined as having a fever or dry cough and lung imaging with ground-glass opacities. The risk factors and predictors of prognosis in such cohorts remain uncertain. METHODS All adults with COVID-19 of moderate severity diagnosed using quantitative RT-PCR and hospitalized at the Central Hospital of Wuhan, China, from 1 January to 20 March 2020 were enrolled in this retrospective study. The main outcomes were progression from moderate to severe or critical condition or death. RESULTS Among the 456 enrolled patients with moderate COVID-19, 251/456 (55.0%) had poor prognosis. Multivariate logistic regression analysis identified higher neutrophil count: lymphocyte count ratio (NLR) on admission (OR 1.032, 95% CI 1.042-1.230, p 0.004) and higher C-reactive protein (CRP) on admission (OR 3.017, 95% CI 1.941-4.690, p < 0.001) were associated with increased OR of poor prognosis. The area under the receiver operating characteristic curve (AUC) for NLR and CRP in predicting progression to critical condition was 0.77 (95% CI 0.694-0.846, p < 0.001) and 0.84 (95% CI 0.780-0.905, p < 0.001), with a cut-off value of 2.79 and 25.95 mg/L, respectively. The AUC of NLR and CRP in predicting death was 0.81 (95% CI 0.732-0.878, p < 0.001) and 0.89 (95% CI 0.825-0.946, p < 0.001), with a cut-off value of 3.19 and 33.4 mg/L, respectively. CONCLUSIONS Higher levels of NLR and CRP at admission were associated with poor prognosis of individuals with moderate COVID-19. NLR and CRP were good predictors of progression to critical condition and death.
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Affiliation(s)
- B Cheng
- Department of Pharmacy, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - J Hu
- Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - X Zuo
- Information Centre, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - J Chen
- Information Centre, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - X Li
- Department of Research, Wuhan Hospital of Traditional Chinese and Western Medicine, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Y Chen
- Tongji School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - G Yang
- Information Centre, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - X Shi
- Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - A Deng
- Department of Pharmacy, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Roussel R, Andonian G, Lynn W, Sanwalka K, Robles R, Hansel C, Deng A, Lawler G, Rosenzweig JB, Ha G, Seok J, Power JG, Conde M, Wisniewski E, Doran DS, Whiteford CE. Single Shot Characterization of High Transformer Ratio Wakefields in Nonlinear Plasma Acceleration. Phys Rev Lett 2020; 124:044802. [PMID: 32058730 DOI: 10.1103/physrevlett.124.044802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/12/2019] [Indexed: 06/10/2023]
Abstract
Plasma wakefields can enable very high accelerating gradients for frontier high energy particle accelerators, in excess of 10 GeV/m. To overcome limits on single stage acceleration, specially shaped drive beams can be used in both linear and nonlinear plasma wakefield accelerators (PWFA), to increase the transformer ratio, implying that the drive beam deceleration is minimized relative to acceleration obtained in the wake. In this Letter, we report the results of a nonlinear PWFA, high transformer ratio experiment using high-charge, longitudinally asymmetric drive beams in a plasma cell. An emittance exchange process is used to generate variable drive current profiles, in conjunction with a long (multiple plasma wavelength) witness beam. The witness beam is energy modulated by the wakefield, yielding a response that contains detailed spectral information in a single-shot measurement. Using these methods, we generate a variety of beam profiles and characterize the wakefields, directly observing transformer ratios up to R=7.8. Furthermore, a spectrally based reconstruction technique, validated by 3D particle-in-cell simulations, is introduced to obtain the drive beam current profile from the decelerating wake data.
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Affiliation(s)
- R Roussel
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - G Andonian
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - W Lynn
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - K Sanwalka
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - R Robles
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - C Hansel
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - A Deng
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - G Lawler
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - J B Rosenzweig
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - G Ha
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - J Seok
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - J G Power
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M Conde
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - E Wisniewski
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - D S Doran
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - C E Whiteford
- Argonne National Laboratory, Argonne, Illinois 60439, USA
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Deng A, Pattanaik S, Bhattacharya A, Yin J, Ross L, Liu C, Zhang J. Fish consumption is associated with a decreased risk of death among adults with diabetes: 18-year follow-up of a national cohort. Nutr Metab Cardiovasc Dis 2018; 28:1012-1020. [PMID: 30017435 DOI: 10.1016/j.numecd.2018.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 01/21/2018] [Revised: 05/22/2018] [Accepted: 05/22/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND There is a paucity of studies examining the beneficial effects of fish consumption on cardiovascular diseases (CVDs) among adults with diabetes, who experience a substantially high risk of CVDs. METHODS AND RESULTS We analyzed the data of 1136 adults with diabetes mellitus aged 18 years and older who participated in the National Health and Nutrition Examination Survey, 1988-1994, and were followed up through December 31, 2010. We used Cox regression to estimate the adjusted hazard ratios (HRs) for the relative risk across the levels of fish consumption. A total of 698 deaths were recorded at the end of 11,465 person-years follow-up with a mortality rate of 60.88 per 1000 person-years. CVDs were listed as a contributing cause for 326 deaths, thus accounting for 46.4% of total deaths. Stroke-specific mortality rate among patients who ate fish less than once a week was more than twice as high as that among patients who ate fish more than twice a week, 6.23 vs. 2.36 per 1000 person-years, respectively. The corresponding CVD-specific rate was 34.38 vs. 22.99 per 1000 person-years, respectively. The adjusted HRs of death due to stroke were 1.00 (reference), 0.55 (95% confidence interval = 0.28-1.07), and 0.30 (0.11-0.80) among patients who ate fish <1, 1-2, and 2 + times a week, and the corresponding HRs of death due to CVDs were 1.00 (reference), 0.78 (0.60-1.02), and 0.69 (0.50-0.96), respectively. CONCLUSIONS A high consumption of fish was associated with a low risk of death due to CVDs, especially stroke, among adults with diabetes.
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Affiliation(s)
- A Deng
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - S Pattanaik
- Department of Health Education and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - A Bhattacharya
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - J Yin
- Department of Biostatistics, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - L Ross
- The University of Alabama, Health Science, 461 Russell Hall, Box 870311, Tuscaloosa, AL, 35487, USA
| | - C Liu
- Department of Biostatistics, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - J Zhang
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA.
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Deng A, Wang C, Cohen SJ, Winter JM, Basu Mallick A. Prognosis of resectable pancreatic cancer based on systemic therapy sequence and regimen: An NCDB analysis. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.4120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Aileen Deng
- Thomas Jefferson University Hospital, Philadelphia, PA
| | - Chun Wang
- Thomas Jefferson University, Philadelphia, PA
| | - Steven J. Cohen
- Jefferson Health System/ Abington Memorial Hospital, Abington, PA
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Abstract
361 Background: In 2009, adults had 4.7 million cancer-related hospitalizations. Adult hospital stays with cancer identified as the principal diagnosis cost $20.1 billion and accounted for 6% of adult inpatient hospital costs. GI cancer-related healthcare utilization has not been well-defined. The aim of this study was to evaluate the trends in the incidence and costs of GI cancer-related hospital admissions in the U.S. Methods: We reviewed the National Inpatient Sample Database (NIS) from 1997-2014. All patients with principle discharge diagnoses of esophageal, stomach, colon, rectum and anus, liver and intrahepatic bile duct and pancreas cancer were analyzed. Temporal trends in the number of hospital admissions, length of stay, hospitalization cost and mortality rates were obtained by HCUPnet. Results: GI cancer-related hospital admissions decreased from 230,537 in 1997 to 221,220 in 2014. Although the number of hospital admissions decreased for esophageal (12,157 to 11,885), stomach (23,528 to 21,800), colon (110,939 to 90,135), rectum and anus cancer (43,807 to 40,160), it has increased for liver and intrahepatic bile duct (11,243 to 21,775, p < 0.001) and pancreas cancer (28,862 to 35,465, p < 0.001). While the mean length of stay decreased from 9.6 days in 1997 to 7.6 days in 2014, the mean hospital charges per patient (adjusted for inflation) increased 127% from $34,747 in 1997 to $78,742 in 2014. The highest increase in mean hospital charges per patient were in liver and intrahepatic bile duct ($27,128 to $74,619 (175%), p < 0.001), rectum and anus ($32,566 to $80,789 (148%), p < 0.001) and pancreas cancer ($33,562 to $75,981 (126%), p < 0.001). Conclusions: GI cancer-related hospital admissions decreased from 1997 to 2014. Despite decrease in the mean length of hospital stay, the costs of hospitalizations have increased substantially, especially in liver and intrahepatic bile duct, rectum and anus and pancreas cancer. Our study suggests that shorter length of stay alone has not reduced costs of hospitalizations in GI cancers. There remains a growing need to understand healthcare costs and to develop effective value-based interventions in GI cancer-related hospital admissions.
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Affiliation(s)
- Aileen Deng
- Thomas Jefferson University Hospital, Philadelphia, PA
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15
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Deng A, Basu Mallick A. Suicide risk in persons with colorectal cancer: A population-based study. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.31_suppl.196] [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: 11/20/2022] Open
Abstract
196 Background: Patients with cancer have nearly twice the incidence of suicide compared to the general population. To date, identifying patients at risk for suicide remains challenging. Colorectal cancer (CRC) is the third most common cancer in the US. The purpose of this study was to identify risk factors associated with higher suicide rates (SR) among patients with CRC. Methods: A retrospective analysis was completed using Surveillance, Epidemiology, and End Results data from 1973 to 2014. Comparisons with the general US population were based on US mortality data collected by the National Center for Health Statistics. Suicide incidence, rates and standardized mortality ratio (SMR) were obtained by SEER*Stat 8.3.4. Results: Among 414788 patients with CRC observed for 2785811 person-years, 747 suicides were identified, for an adjusted SR of 26.7/100,000 person-years (SMR 1.40 [95% CI 1.30-1.50]). Higher SRs were associated with male sex, non-white or non-black race, being unmarried and having advanced disease at diagnosis (Table 1). SR was highest in the first year after diagnosis (SMR 2.00 [95% CI 1.68-2.37]) and with increasing age at diagnosis among unmarried patients. In patients 60 to 64 years at diagnosis, SR was highest in unmarried men (SMR 3.72 [95% CI 2.61-5.15]) and lowest in married women (SMR 0.61 [95% CI 0.17-1.57]). Conclusions: CRC is one of the most common cancers in the US. Patients with CRC have a 1.5-fold increase in SR compared to the general population. Suicide screening should especially target those in their first year after diagnosis, particularly older, unmarried patients. [Table: see text]
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Affiliation(s)
- Aileen Deng
- Thomas Jefferson University Hospital, Philadelphia, PA
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16
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Deng A, Basu Mallick A. Risk of suicide in persons with gastrointestinal cancer: A population-based study. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.31_suppl.197] [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: 11/20/2022] Open
Abstract
197 Background: Patients with cancer have nearly twice the incidence of suicide compared to the general population(1). To date, identifying patients at risk for suicide remains challenging. The purpose of this study was to identify risk factors of suicide among patients with GI cancer. Methods: A retrospective analysis was completed using Surveillance, Epidemiology, and End Results data from 1973 to 2014. Comparisons with the general US population were based on US mortality data collected by the National Center for Health Statistics. Suicide incidence, rates and standardized mortality ratio (SMR) were obtained by SEER*Stat 8.3.4. Results: Among 711859 patients with GI cancer observed for 3373014 person-years, 1116 suicides were identified, for an adjusted suicide rate of 33.1/100,000 person-years (SMR 1.74 [95% CI 1.64-1.85]). The highest suicide risks (SR) were in esophageal (SMR 5.42 [95% CI 4.30-6.75]), pancreatic (SMR 4.91 [95% CI 3.83-6.19]) and liver or intrahepatic biliary cancer (SMR 3.36 [95% CI 2.35-4.65]). Higher SRs were associated with unmarried status, age 40 years and older at diagnosis and the first 5 years after diagnosis. In esophageal (EC) and pancreatic (PC) cancer, SR was 8 folds higher in unmarried patients compared to the general population with a SMR of 8.31 [95% CI 5.68-11.73] and 7.68 [95% CI 5.18-10.97], respectively. In EC and PC, SR was highest in patients > 80 years (SMR 7.09 [95% CI 3.40-13.03]) and 40-59 years at diagnosis (SMR 7.10 [95% CI 1.93-18.18]), respectively. Patients have especially high SR the first year after diagnosis in EC (SMR 10.25 [95% CI 7.65-13.44]) and PC (SMR 7.72 [95% CI 5.83-10.03]). Conclusions: While overall, patients with GI cancer have nearly twice the SR, those with certain cancer subtypes have up to 5 times the SR when compared to the general population. SRs are highest in esophageal, pancreatic and liver or intrahepatic biliary cancer. Suicide screening should especially target patients with EC and PC who are unmarried or lack a support system and within the first year after cancer diagnosis.
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Affiliation(s)
- Aileen Deng
- Thomas Jefferson University Hospital, Philadelphia, PA
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17
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Deng A, Leiby BE, Schilder RJ, Kelly WK, Deshmukh S, Sama AR. Assessing solid tumor response with and without RECIST. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e18157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Aileen Deng
- Thomas Jefferson University Hospital, Philadelphia, PA
| | - Benjamin E Leiby
- Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA
| | | | - William Kevin Kelly
- The Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA
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18
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Deng A, Leiby BE, Schilder RJ, Kelly WK, Deshmukh S, Sama AR. Assessing solid tumor response with and without RECIST. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.4_suppl.504] [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: 11/20/2022] Open
Abstract
504 Background: Response Evaluation Criteria in Solid Tumors (RECIST) has become widely accepted as gold standard for response evaluation in clinical trials. It remains underutilized in routine clinical practice. We compared tumor response assessment made with and without RECIST. Methods: This study included patients with solid tumors who underwent imaging from January 2013 to December 2014 at a single academic center. Tumor response was assessed by a radiologist using RECIST and by an oncologist (Onc) and resident (Res) without using RECIST (standard report). Tumor response was classified as progressive disease (PD), stable disease (SD), partial response (PR) and complete response (CR). Agreement in assessment between RECIST and standard report was determined by percent agreement and Kappa statistic. Results: 292 imaging studies were included. Concordance between RECIST and Onc-interpreted standard report is presented in Table 1. Overall agreement between RECIST and Onc-interpreted standard report was 56% (95% CI: 46-65%) and Kappa was 0.31 (95% CI: 0.19-0.44). Similar results were seen between RECIST and Res-interpreted standard report (Table 1). Overall agreement between RECIST and Res-interpreted report was 54% (95% CI: 44%-63%) and Kappa was 0.26 (95% CI: 0.13-0.40). Conclusions: Our study found variability in tumor response assessment between clinicians and radiologists. RECIST-classified PD was often interpreted as SD and vice versa, a distinction that affect treatment decisions. Our study highlights the need to standardize tumor response assessment. [Table: see text]
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Affiliation(s)
- Aileen Deng
- Thomas Jefferson University Hospital, Philadelphia, PA
| | - Benjamin E Leiby
- Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA
| | | | - William Kevin Kelly
- The Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA
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19
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Xia R, Chen S, Zhang W, Chen Y, Zhu R, Deng A. A 39-gene signature is associated with early occurrence of distant metastasis in primary lymph-node negative breast cancers. Neoplasma 2015; 62:821-6. [PMID: 26278156 DOI: 10.4149/neo_2015_099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Risk factors of the development of distant metastasis in primary node-negative breast cancer patients are heterogeneous. Identification of patients at high risk of early distant metastasis is of important clinical significance. In the current study, using the already published datasets, we develop a gene signature that can robustly predict early distant metastasis for patients with primary node-negative breast cancer. We identified a 39-gene signature, which were associated with distant metastasis and shorter distant metastasis free survival (DMFS) in node-negative breast cancers. Using the survival prediction analysis method in BRB-Array tools, this signature can stratify patients into early- and late- distant metastasis subgroups with different DMFS in VDX training dataset (AUC=0.734, P < 0.01). And we further validated the reliability of the prognostic value of this 39-gene signature in another two independent breast cancer cohorts (NKI dataset, AUC=0.642, P<0.0167; TRANSBIG dataset, AUC=0.711, P<0.0167). Furthermore, the early distant metastasis subgroups defined by the 39-gene signature exhibited a significant association with ER negative status and more aggressive molecular subtypes in all three datasets, and with poor differentiation status in two datasets. In summary, we developed a novel distant metastasis-related gene signature for predicting early occurrence of distant metastasis in node-negative breast cancers, what might be useful in making treatment decisions for these early metastasis patients.
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20
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Chen Q, Chong T, Yin J, Luo P, Deng A. Molecular events are associated with resistance to vinblastine in bladder cancer. Cell Mol Biol (Noisy-le-grand) 2015; 61:33-38. [PMID: 26025399] [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: 04/02/2015] [Accepted: 04/17/2015] [Indexed: 06/04/2023]
Abstract
Bladder cancer occurs in the majority of cases in males, which represents the fourth highest incident cancer in men and tenth in women. It is associated with a high rate of recurrence, and prognosis is poor once the cancer metastasizes to distant sites. Transitional cell cancer (TCC) is the most predominant histological type. Bladder cancer is highly chemosensitive. However, the presence of acquired drug resistance is one of the primary impediments to the success of chemotherapy. To differentiate and delineate the molecular events, we developed drug resistant human transitional bladder cancer T24 cells (DRC) by treating cells with the increasing concentration of vinblastine. We found that DRC was resistant to vinblastine in comparison to parental T24 cells. We analyzed the contributory factors that may be involved in the development of resistance. As expected, expression of permeability glycoprotein (P—gp) was up—regulated in DRC. In addition, levels of Caveolin—1 (Cav—1), Fatty acid synthase (FASN) and Cytochrome P450 (CYP450) were elevated in DRC. Downregulation of these proteins by respective specific pharmacological inhibitors and/or by siRNAs resensitized cells to vinblastine. These results suggested that differential levels of P—gp, Cav—1 and FASN except CYP450 play a major role in acquired resistant phenotype in bladder cancer.
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Affiliation(s)
- Q Chen
- The Second Affiliated Hospital of Xi'an Jiaotong University Department of Urology Xi'an China
| | - T Chong
- The Second Affiliated Hospital of Xi'an Jiaotong University Department of Urology Xi'an China
| | - J Yin
- Xinhua hospital, Shanghai Jiao Tong University Shanghai Key Laboratory of Children's Environmental Health Shanghai China
| | - P Luo
- Shanghai Topgen Bio—pharm Co.Ltd Shanghai China
| | - A Deng
- Changhai Hospital Affiliated to the Second Military Medical University Department of Laboratory Diagnosis Shanghai China denganmei@yeah.net
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21
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Abstract
OBJECTIVE Venous thromboembolism (VTE) is a common complication in cancer patients. This review summarizes some of the most current knowledge of the epidemiology, risk factors, risk models, prophylaxis, and treatment of VTE in cancer patients. METHODS A literature search was conducted using PubMed; the search terms were venous thromboembolism, anticoagulation, and cancer. The bibliographies of pertinent studies and review articles were reviewed for additional references. RESULTS Venous thromboembolism is the second leading cause of death in patients with cancer. Cancer patients with VTE have poorer outcomes compared with noncancer patients with VTE. Many risk factors have been identified for VTE in patients with cancer that are patient-related, cancer-related, or treatment-related. Several biomarkers have been identified as potentially predictive of VTE risk. Risk assessment models such as the Khorana Risk Score stratify cancer patients with low, intermediate, and high risk of developing VTE based on baseline clinical and laboratory variables. Currently, enoxaparin is the preferred anticoagulant for initial VTE treatment in cancer patients. Low molecular weight heparin (LMWH) is recommended for both initial and long-term management of cancer-related VTE. Because the optimal duration of anticoagulation in cancer patients with VTE is unknown, the decision to extend anticoagulation requires weighing the risk of recurrent thrombosis against the risk of major bleeding. Patients with recurrent VTE can be bridged with LMWH, transitioned to full-dose LMWH or treated with LMWH dose escalation. While there is insufficient data to determine whether anticoagulation should be held in the setting of thrombocytopenia, full-dose anticoagulation is typically considered unsafe when platelets are < 50 000/μL. Inferior vena cava filters are currently recommended only for patients with acute VTE and contraindications to anticoagulation. Although management of catheter-associated thrombosis has not been well studied in cancer patients, it is recommended that cancer patients with catheter-associated thrombosis be treated with therapeutic anticoagulation for ≥ 3 months. Venous thromboembolism prophylaxis with UFH, LMWH, or fondaparinux is recommended in all hospitalized nonsurgical cancer patients and cancer patients undergoing major cancer surgery. Primary thromboprophylaxis is only currently recommended in high-risk ambulatory cancer patients such as multiple myeloma patients receiving thalidomide- or lenalidomide- based therapy. CONCLUSION Cancer-associated thrombosis is a common problem. As we begin to better understand the risk factors and biomarkers for cancer-associated VTE, we can further refine and develop risk-assessment models to determine those patients who would most likely benefit from anticoagulation. While LMWH products are generally preferred in cancer-related VTE, more research will continue to evolve our understanding of treatment and thrombopprophylaxis in cancer-associated VTE.
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Affiliation(s)
- Aileen Deng
- Department of Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.
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22
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Abstract
OBJECTIVE Venous thromboembolism (VTE) is a common complication in cancer patients. This review summarizes some of the most current knowledge of the epidemiology, risk factors, risk models, prophylaxis, and treatment of VTE in cancer patients. METHODS A literature search was conducted using PubMed; the search terms were venous thromboembolism, anticoagulation, and cancer. The bibliographies of pertinent studies and review articles were reviewed for additional references. RESULTS Venous thromboembolism is the second leading cause of death in patients with cancer. Cancer patients with VTE have poorer outcomes compared with noncancer patients with VTE. Many risk factors have been identified for VTE in patients with cancer that are patient-related, cancer-related, or treatment-related. Several biomarkers have been identified as potentially predictive of VTE risk. Risk assessment models such as the Khorana Risk Score stratify cancer patients with low, intermediate, and high risk of developing VTE based on baseline clinical and laboratory variables. Currently, enoxaparin is the preferred anticoagulant for initial VTE treatment in cancer patients. Low molecular weight heparin (LMWH) is recommended for both initial and long-term management of cancer-related VTE. Because the optimal duration of anticoagulation in cancer patients with VTE is unknown, the decision to extend anticoagulation requires weighing the risk of recurrent thrombosis against the risk of major bleeding. Patients with recurrent VTE can be bridged with LMWH, transitioned to full-dose LMWH or treated with LMWH dose escalation. While there is insufficient data to determine whether anticoagulation should be held in the setting of thrombocytopenia, full-dose anticoagulation is typically considered unsafe when platelets are < 50 000/μL. Inferior vena cava filters are currently recommended only for patients with acute VTE and contraindications to anticoagulation. Although management of catheter-associated thrombosis has not been well studied in cancer patients, it is recommended that cancer patients with catheter-associated thrombosis be treated with therapeutic anticoagulation for ≥ 3 months. Venous thromboembolism prophylaxis with UFH, LMWH, or fondaparinux is recommended in all hospitalized nonsurgical cancer patients and cancer patients undergoing major cancer surgery. Primary thromboprophylaxis is only currently recommended in high-risk ambulatory cancer patients such as multiple myeloma patients receiving thalidomide- or lenalidomide- based therapy. CONCLUSION Cancer-associated thrombosis is a common problem. As we begin to better understand the risk factors and biomarkers for cancer-associated VTE, we can further refine and develop risk-assessment models to determine those patients who would most likely benefit from anticoagulation. While LMWH products are generally preferred in cancer-related VTE, more research will continue to evolve our understanding of treatment and thrombopprophylaxis in cancer-associated VTE.
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Affiliation(s)
- Aileen Deng
- Department of Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA.
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23
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Bao Y, Gu D, Feng W, Sun X, Wang X, Zhang X, Shi Q, Cui G, Yu H, Tang C, Deng A. COUP-TFII regulates metastasis of colorectal adenocarcinoma cells by modulating Snail1. Br J Cancer 2014; 111:933-43. [PMID: 25032732 PMCID: PMC4150277 DOI: 10.1038/bjc.2014.373] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/26/2014] [Accepted: 05/29/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Chicken ovalbumin upstream promoter-transcription factor II (COUP-TFII, also known as NR2F2) promotes metastasis by functioning in the tumour microenvironment; however, the role of COUP-TFII in colorectal cancer remains unknown. METHODS Human colon adenocarcinoma tissues were collected to test COUP-TFII expression. Wound-healing and cell invasion assay were used to evaluate migration and invasion of cells. Chicken ovalbumin upstream promoter-transcription factor II and related protein expression was assessed by immunostaining, immunoblotting and real-time PCR assay. Tamoxifen-inducible COUP-TFII knockout mice were employed to test COUP-TFII functions on colon cancer metastasis in vivo. RESULTS Elevated expression of COUP-TFII in colorectal adenocarcinoma tissue correlated with overexpression of the Snail1 transcription factor. High COUP-TFII expression correlated with metastasis and shorter patient survival. Chicken ovalbumin upstream promoter-transcription factor II regulated the migration and invasion of cancer cells. With Snail1, COUP-TFII inhibited expression of adherence molecules such as ZO-1, E-cadherin and β-catenin in colorectal cancer cells. Overexpression of COUP-TFII was required for cancer cells to metastasise in vivo. Chicken ovalbumin upstream promoter-transcription factor II regulated the transcription and expression of Snail1 by directly targeting the Snail1 promoter and regulated associated genes. CONCLUSIONS Chicken ovalbumin upstream promoter-transcription factor II was crucial for colorectal cancer metastasis and regulated cell migration and metastasis in conjunction with Snail1. Chicken ovalbumin upstream promoter-transcription factor II was found to be a biomarker associated with patient survival and colorectal cancer metastasis.
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Affiliation(s)
- Y Bao
- First Affiliated Hospital, Huzhou Teachers College, the First People's Hospital of Huzhou, Huzhou 313000, China
| | - D Gu
- Huzhou Central Hospital, Huzhou 313000, China
| | - W Feng
- First Affiliated Hospital, Huzhou Teachers College, the First People's Hospital of Huzhou, Huzhou 313000, China
| | - X Sun
- First Affiliated Hospital, Huzhou Teachers College, the First People's Hospital of Huzhou, Huzhou 313000, China
| | - X Wang
- First Affiliated Hospital, Huzhou Teachers College, the First People's Hospital of Huzhou, Huzhou 313000, China
| | - X Zhang
- First Affiliated Hospital, Huzhou Teachers College, the First People's Hospital of Huzhou, Huzhou 313000, China
| | - Q Shi
- First Affiliated Hospital, Huzhou Teachers College, the First People's Hospital of Huzhou, Huzhou 313000, China
| | - G Cui
- First Affiliated Hospital, Huzhou Teachers College, the First People's Hospital of Huzhou, Huzhou 313000, China
| | - H Yu
- First Affiliated Hospital, Huzhou Teachers College, the First People's Hospital of Huzhou, Huzhou 313000, China
| | - C Tang
- First Affiliated Hospital, Huzhou Teachers College, the First People's Hospital of Huzhou, Huzhou 313000, China
| | - A Deng
- Department of Laboratory Diagnostic, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
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24
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Levin NA, Rivard J, Yasuda M, McMullen K, Deng A. Follicular papules and pustules of the central face in a 40-year-old man. Clin Exp Dermatol 2014; 39:259-61. [PMID: 24450807 DOI: 10.1111/ced.12263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2013] [Indexed: 11/26/2022]
Affiliation(s)
- N A Levin
- UMass Memorial Health Care, Worcester, MA, USA; Division of Dermatology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
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25
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Liu J, Wang F, Wu D, Wang Y, Deng A. Effects of Anthopleurin-Q on the Intracellular Free Ca2+ Concentration in Cultured Rat Cortical Neurons. Drug Res (Stuttg) 2014; 64:436-41. [PMID: 24421072 DOI: 10.1055/s-0033-1361125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- J. Liu
- Department of Pharmacy, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - F. Wang
- Department of Pharmacology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - D. Wu
- Department of Urinary Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Y. Wang
- Department of Pharmacy, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - A. Deng
- Department of Pharmacy, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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26
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Zhang J, Yuan WH, Deng K, Deng A, Xu ZT, Qin CB, Lu ZH, Luo J. A long-term frequency stabilized deep ultraviolet laser for Mg+ ions trapping experiments. Rev Sci Instrum 2013; 84:123109. [PMID: 24387422 DOI: 10.1063/1.4847135] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
As many precision laser spectroscopy experiments require frequency stabilized lasers, development of long-term stabilized lasers is of great interest. In this work, we report long-term frequency stabilization of a 280 nm deep ultraviolet laser to a high precision wavemeter with digital servo control such that the long-term drift of the laser frequency was greatly reduced. Long-term laser frequency drift was measured with a fiber frequency comb system over 8 h. After locking, the maximum drift rate of the 280 nm laser was lowered from 576 MHz/h to 6.4 MHz/h. With proper environment control of the wavemeter, the maximum drift rate of the 280 nm laser was further lowered to less than 480 kHz/h. The locked laser system was successfully used in a Mg(+) ions trapping experiment, which was also discussed in this work.
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Affiliation(s)
- J Zhang
- MOE Key Laboratory of Fundamental Quantities Measurement, School of Physics, Huazhong University of Science and Technology, Wuhan 430074, China
| | - W H Yuan
- MOE Key Laboratory of Fundamental Quantities Measurement, School of Physics, Huazhong University of Science and Technology, Wuhan 430074, China
| | - K Deng
- MOE Key Laboratory of Fundamental Quantities Measurement, School of Physics, Huazhong University of Science and Technology, Wuhan 430074, China
| | - A Deng
- MOE Key Laboratory of Fundamental Quantities Measurement, School of Physics, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Z T Xu
- MOE Key Laboratory of Fundamental Quantities Measurement, School of Physics, Huazhong University of Science and Technology, Wuhan 430074, China
| | - C B Qin
- MOE Key Laboratory of Fundamental Quantities Measurement, School of Physics, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Z H Lu
- MOE Key Laboratory of Fundamental Quantities Measurement, School of Physics, Huazhong University of Science and Technology, Wuhan 430074, China
| | - J Luo
- MOE Key Laboratory of Fundamental Quantities Measurement, School of Physics, Huazhong University of Science and Technology, Wuhan 430074, China
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Albino‐Rodriguez EM, Katsuya T, Deng A, Dutil J. DNA‐nuclear protein interactions around‐224 A/G Single Nucleotide Polymorphism in the Neuropeptide Receptor Y2 (
NPY2R
) Gene in Predisposition to Hypertension. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.975.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - T Katsuya
- Geriatric MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - A Deng
- Molecular Genetics LaboratoryUniversity of Montreal Research Center CHUMMontrealQCCanada
| | - J Dutil
- BiochemistryPonce School of MedicinePoncePR
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Janko M, Ontiveros F, Fitzgerald T, Deng A, DeCicco M, Rock K. IL-1 Generated Subsequent to Radiation-induced Tissue Injury Contributes to the Pathogenesis of Radiodermatitis. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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29
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Qin Q, Sun Y, Fei M, Zhang J, Jia Y, Gu M, Xia R, Chen S, Deng A. Expression of putative stem marker nestin and CD133 in advanced serous ovarian cancer. Neoplasma 2012; 59:310-5. [PMID: 22296500 DOI: 10.4149/neo_2012_040] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
It is hypothesized that "cancer stem cells" are responsible for the resistance to chemotherapy of cancer cells in ovarian cancers. The objective of the studies was to explore if the stem cell biomarkers could be used to predict the tumor chemotherapy-resistance in serous ovarian cancer patients. Expression of two putative stem cell markers CD133 and nestin, and vascular epithelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) were detected in 123 cases of advanced serous ovarian cancer specimens by immunohistochemistry. To estimate intra-tumoral microvessel density (MVD), CD34 immunostaining was also performed. CD133 and nestin were defined to be positive in 35.0% and 32.5% of the serous ovarian carcinoma tissues, respectively. It was observed that overexpression of nestin but not CD133 was associated with the cisplatin-based chemotherapy resistance and shorter overall survival of the patients, and nestin was found to be an independent prognostic factor. Moreover, positive nestin expression also correlated to increased expression of EGFR and VEGF, and elevated MVD in tumors. The results of this study suggest that serous ovarian cancers with high expression level of nestin represent an aggressive malignant phenotype associated with poor prognosis, and treatment targeted the nestin positive cancer cells might be a promising therapeutic strategy for this subgroups.
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Affiliation(s)
- Q Qin
- Department of Transfusion, Huashan Hospital, Fudan University, Shanghai, China
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Perez-Pomares JM, Ruiz-Villalba A, Ziogas A, Segovia JC, Ehrbar M, Munoz-Chapuli R, De La Rosa A, Dominguez JN, Hove-Madsen L, Sankova B, Sedmera D, Franco D, Aranega Jimenez A, Babaeva G, Chizh N, Galchenko S, Sandomirsky B, Schwarzl M, Seiler S, Steendijk P, Huber S, Maechler H, Truschnig-Wilders M, Pieske B, Post H, Simrick S, Kreutzer R, Rao C, Terracciano CM, Kirchhof P, Fabritz L, Brand T, Theveniau-Ruissy M, Parisot P, Francou A, Saint-Michel E, Mesbah K, Kelly RG, Wu HT, Sie SS, Chen CY, Kuan TC, Lin CS, Ismailoglu Z, Guven M, Yakici A, Ata Y, Ozcan S, Yildirim E, Ongen Z, Miroshnikova V, Demina E, Rodygina T, Kurjanov P, Denisenko A, Schwarzman A, Rubanenko A, Shchukin Y, Germanov A, Goldbergova M, Parenica J, Lipkova J, Pavek N, Kala P, Poloczek M, Vasku A, Parenicova I, Spinar J, Gambacciani C, Chiavacci E, Evangelista M, Vesentini N, Kusmic C, Pitto L, Chernova A, Nikulina SUY, Arvanitis DA, Mourouzis I, Pantos C, Kranias EG, Cokkinos DV, Sanoudou D, Vladimirskaya TE, Shved IA, Kryvorot SG, Schirmer IM, Appukuttan A, Pott L, Jaquet K, Ladilov Y, Archer CR, Bootman MD, Roderick HL, Fusco A, Sorriento D, Santulli G, Trimarco B, Iaccarino G, Hagenmueller M, Riffel J, Gatzoulis MA, Stoupel EG, Garcia R, Merino D, Montalvo C, Hurle MA, Nistal JF, Villar AV, Perez-Moreno A, Gilabert R, Bernhold E, Ros E, Amat-Roldan I, Katus HA, Hardt SE, Maqsood A, Zi M, Prehar S, Neyses L, Ray S, Oceandy D, Khatami N, Wadowski P, Wagh V, Hescheler J, Sachinidis A, Mohl W, Chaudhry B, Burns D, Henderson DJ, Bax NAM, Van Marion MH, Shah B, Goumans MJ, Bouten CVC, Van Der Schaft DWJ, Bax NAM, Van Oorschot AAM, Maas S, Braun J, Van Tuyn J, De Vries AAF, Gittenberger-De Groot AC, Goumans MJ, Bageghni S, Drinkhill MJ, Batten TFC, Ainscough JFX, Onate B, Vilahur G, Ferrer-Lorente R, Ybarra J, Diez-Caballero A, Ballesta-Lopez C, Moscatiello F, Herrero J, Badimon L, Martin-Rendon E, Clifford DM, Fisher SA, Brusnkill SJ, Doree C, Mathur A, Clarke M, Watt SM, Hernandez-Vera R, Badimon L, Kavanagh D, Yemm AI, Frampton J, Kalia N, Terajima Y, Shimizu T, Tsuruyama S, Ishii H, Sekine H, Hagiwara N, Okano T, Vrijsen KR, Chamuleau SAJ, Sluijter JPG, Doevendans PFM, Madonna R, Delli Pizzi S, Di Donato L, Mariotti A, Di Carlo L, D'ugo E, Teberino MA, Merla A, T A, De Caterina R, Kolker L, Ali NN, Maclellan K, Moore M, Wheeler J, Harding SE, Fleck RA, Rowlinson JM, Kraenkel N, Ascione R, Madeddu P, O'sullivan JF, Leblond AL, Kelly G, Kumar AHS, Metharom P, Buneker CK, Alizadeh-Vikali N, Hynes BG, O'connor R, Caplice NM, Noseda M, De Smith AJ, Leja T, Rao PH, Al-Beidh F, Abreu Pavia MS, Blakemore AI, Schneider MD, Stathopoulou K, Cuello F, Ehler E, Haworth RS, Avkiran M, Morawietz H, Eickholt C, Langbein H, Brux M, Goettsch C, Goettsch W, Arsov A, Brunssen C, Mazilu L, Parepa IR, Suceveanu AI, Suceveanu AP, De Man FS, Guignabert C, Tu L, Handoko ML, Schalij I, Fadel E, Postmus PE, Vonk-Noordegraaf A, Humbert M, Eddahibi S, Sorriento D, Santulli G, Del Giudice C, Anastasio A, Trimarco B, Iaccarino G, Fazal L, Azibani F, Bihry N, Merval R, Polidano E, Samuel JL, Delcayre C, Zhang Y, Mi YM, Ren LL, Cheng YP, Guo R, Liu Y, Jiang YN, Mourouzis I, Pantos C, Kokkinos AD, Cokkinos DV, Tretjakovs P, Jurka A, Bormane I, Mikelsone I, Reihmane D, Elksne K, Krievina G, Verbovenko J, Bahs G, Lopez-Andres N, Rousseau A, Calvier L, Akhtar R, Labat C, Cruickshank K, Diez J, Zannad F, Lacolley P, Rossignol P, Hamesch K, Subramanian P, Li X, Thiemann A, Heyll K, Dembowsky K, Chevalier E, Weber C, Schober A, Yang L, Kim G, Gardner B, Earley J, Hofmann-Bowman M, Cheng CF, Lian WS, Lin H, Jinjolia NJ, Abuladze GA, Tvalchrelidze SHT, Khamnagadaev I, Shkolnikova M, Kokov L, Miklashevich I, Drozdov I, Ilyich I, Bingen BO, Askar SFA, Ypey DL, Van Der Laarse A, Schalij MJ, Pijnappels DA, Roney CH, Ng FS, Chowdhury RA, Chang ETY, Patel PM, Lyon AR, Siggers JH, Peters NS, Obergrussberger A, Stoelzle S, Bruggemann A, Haarmann C, George M, Fertig N, Moreira D, Souza A, Valente P, Kornej J, Reihardt C, Kosiuk J, Arya A, Hindricks G, Adams V, Husser D, Bollmann A, Camelliti P, Dudhia J, Dias P, Cartledge J, Connolly DJ, Terracciano CM, Nobles M, Sebastian S, Tinker A, Opel A, Tinker A, Daimi H, Haj Khelil A, Be Chibani J, Barana A, Amoros I, Gonzalez De La Fuente M, Caballero R, Aranega A, Franco D, Kelly A, Bernus O, Kemi OJ, Myles RC, Ghouri IA, Burton FL, Smith GL, Del Lungo M, Sartiani L, Spinelli V, Baruscotti M, Difrancesco D, Mugelli A, Cerbai E, Thomas AM, Aziz Q, Khambra T, Tinker A, Addlestone JMA, Cartwright EJ, Wilkinson R, Song W, Marston S, Jacquet A, Mougenot NM, Lipskaia AJ, Paalberends ER, Stam K, Van Dijk SJ, Van Slegtenhorst M, Dos Remedios C, Ten Cate FJ, Michels M, Niessen HWM, Stienen GJM, Van Der Velden J, Read MI, Andreianova AA, Harrison JC, Goulton CS, Kerr DS, Sammut IA, Schwarzl M, Seiler S, Wallner M, Huber S, Steendijk P, Maechler H, Truschnig-Wilders M, Von Lewinski D, Pieske B, Post H, Kindsvater D, Saes M, Morano I, Muegge A, Jaquet K, Buyandelger B, Kostin S, Gunkel S, Vouffo J, Ng K, Chen J, Eilers M, Isaacson R, Milting H, Knoell R, Cattin ME, Crocini C, Schlossarek S, Maron S, Hansen A, Eschenhagen T, Carrier L, Bonne G, Coppini R, Ferrantini C, Olivotto I, Del Lungo M, Belardinelli L, Poggesi C, Mugelli A, Cerbai E, Leung MC, Messer AE, Copeland O, Marston SB, Mills AM, Collins T, O'gara P, Thum T, Regalla K, Lyon AR, Macleod KT, Harding SE, Rao C, Prodromakis T, Chaudhry U, Darzi A, Yacoub MH, Athanasiou T, Terracciano CM, Bogdanova A, Makhro A, Hoydal M, Stolen TO, Johnssen AB, Alves M, Catalucci D, Condorelli G, Koch LG, Britton SL, Smith GL, Wisloff U, Bito V, Claus P, Vermeulen K, Huysmans C, Ventura-Clapier R, Sipido KR, Seliuk MN, Burlaka AP, Sidorik EP, Khaitovych NV, Kozachok MM, Potaskalova VS, Driesen RB, Galan DT, Vermeulen K, Claus P, Sipido KR, De Paulis D, Arnoux T, Schaller S, Pruss RM, Poitz DM, Augstein A, Braun-Dullaeus RC, Schmeisser A, Strasser RH, Micova P, Balkova P, Hlavackova M, Zurmanova J, Kasparova D, Kolar F, Neckar J, Novak F, Novakova O, Pollard S, Babba M, Hussain A, James R, Maddock H, Alshehri AS, Baxter GF, Dietel B, Altendorf R, Daniel WG, Kollmar R, Garlichs CD, Sirohi R, Roberts N, Lawrence D, Sheikh A, Kolvekar S, Yap J, Arend M, Walkinshaw G, Hausenloy DJ, Yellon DM, Posa A, Szabo R, Szalai Z, Szablics P, Berko MA, Orban K, Murlasits ZS, Balogh L, Varga C, Ku HC, Su MJ, Chreih RM, Ginghina C, Deleanu D, Ferreira ALBJ, Belal A, Ali MA, Fan X, Holt A, Campbell R, Schulz R, Bonanad C, Bodi V, Sanchis J, Morales JM, Marrachelli V, Nunez J, Forteza MJ, Chaustre F, Gomez C, Chorro FJ, Csont T, Fekete V, Murlasits Z, Aypar E, Bencsik P, Sarkozy M, Varga ZV, Ferdinandy P, Duerr GD, Zoerlein M, Dewald D, Mesenholl B, Schneider P, Ghanem A, Rittling S, Welz A, Dewald O, Duerr GD, Dewald D, Becker E, Peigney C, Ghanem A, Welz A, Dewald O, Bouleti C, Galaup A, Monnot C, Ghaleh B, Germain S, Timmermans A, Ginion A, De Meester C, Sakamoto K, Vanoverschelde JL, Horman S, Beauloye C, Bertrand L, Maroz-Vadalazhskaya N, Drozd E, Kukharenko L, Russkich I, Krachak D, Seljun Y, Ostrovski Y, Martin AC, Le Bonniec B, Lecompte T, Dizier B, Emmerich J, Fischer AM, Samama CM, Godier A, Mogensen S, Furchtbauer EM, Aalkjaer C, Choong WL, Jovanovic A, Khan F, Daniel JM, Dutzmann JM, Widmer-Teske R, Guenduez D, Sedding D, Castro MM, Cena JJC, Cho WJC, Goobie GG, Walsh MPW, Schulz RS, Daniel JM, Dutzmann J, Widmer-Teske R, Preissner KT, Sedding D, Aziz Q, Khambra T, Sones W, Thomas AM, Kotlikoff M, Tinker A, Serizawa K, Yogo K, Aizawa K, Hirata M, Tashiro Y, Ishizuka N, Varela A, Katsiboulas M, Tousoulis D, Papaioannou TG, Vaina S, Davos CH, Piperi C, Stefanadis C, Basdra EK, Papavassiliou AG, Hermenegildo C, Lazaro-Franco M, Sobrino A, Bueno-Beti C, Martinez-Gil N, Walther T, Peiro C, Sanchez-Ferrer CF, Novella S, Ciccarelli M, Franco A, Sorriento D, Del Giudice C, Dorn GW, Trimarco B, Iaccarino G, Cseplo P, Torok O, Springo ZS, Vamos Z, Kosa D, Hamar J, Koller A, Bubb KJ, Ahluwalia A, Stepien EL, Gruca A, Grzybowska J, Goralska J, Dembinska-Kiec A, Stepien EL, Stolinski J, Grzybowska J, Goralska J, Partyka L, Gruca A, Dembinska-Kiec A, Zhang H, Sweeney D, Thomas GN, Fish PV, Taggart DP, Watt SM, Martin-Rendon E, Cioffi S, Bilio M, Martucciello S, Illingworth E, Caporali A, Shantikumar S, Marchetti M, Martelli F, Emanueli C, Marchetti M, Meloni M, Caporali A, Al Haj Zen A, Sala-Newby G, Emanueli C, Del Turco S, Saponaro C, Dario B, Sartini S, Menciassi A, Dario P, La Motta C, Basta G, Santiemma V, Bertone C, Rossi F, Michelon E, Bianco MJ, Castelli A, Shin DI, Seung KB, Seo SM, Park HJ, Kim PJ, Baek SH, Shin DI, Seung KB, Seo SM, Park HJ, Choi YS, Her SH, Kim DB, Kim PJ, Lee JM, Park CS, Rocchiccioli S, Cecchettini A, Pelosi G, Kusmic C, Citti L, Parodi O, Trivella MG, Michel-Monigadon D, Burger F, Dunoyer-Geindre S, Pelli G, Cravatt B, Steffens S, Didangelos A, Mayr U, Yin X, Stegemann C, Shalhoub J, Davies AH, Monaco C, Mayr M, Lypovetska S, Grytsenko S, Njerve IU, Pettersen AA, Opstad TB, Bratseth V, Arnesen H, Seljeflot I, Dumitriu IE, Baruah P, Antunes RF, Kaski JC, Forteza MJ, Bodi V, Trapero I, Benet I, Alguero C, Chaustre FJ, Gomez C, Sanchis J, Chorro FJ, Mangold A, Puthenkalam S, Distelmaier K, Adlbrecht C, Preissner KT, Lang IM, Koizumi T, Inoue I, Komiyama N, Nishimura S, Korneeva ON, Drapkina OM, Fornai L, Angelini A, Kiss A, Giskes F, Eijkel G, Fedrigo M, Valente ML, Thiene G, Heeren RMA, Vilahur G, Padro T, Casani L, Suades R, Badimon L, Bertoni B, Carminati R, Carlini V, Pettinari L, Martinelli C, Gagliano N, Noppe G, Buchlin P, Marquet N, Baeyens N, Morel N, Vanoverschelde JL, Bertrand L, Beauloye C, Horman S, Baysa A, Sagave J, Dahl CP, Gullestad L, Carpi A, Di Lisa F, Giorgio M, Vaage J, Valen G, Vafiadaki E, Papalouka V, Arvanitis DA, Terzis G, Spengos K, Kranias EG, Manta P, Sanoudou D, Gales C, Genet G, Dague E, Cazorla O, Payre B, Mias C, Ouille A, Lacampagne A, Pathak A, Senard JM, Abonnenc M, Da Costa Martins P, Srivastava S, Didangelos A, Yin X, Gautel M, De Windt L, Mayr M, Comelli L, Rocchiccioli S, Lande C, Ucciferri N, Trivella MG, Citti L, Cecchettini A, Ikonen L, Vuorenpaa H, Kujala K, Sarkanen JR, Heinonen T, Ylikomi T, Aalto-Setala K, Capros H, Sprincean N, Usurelu N, Egorov V, Stratu N, Matchkov V, Bouzinova E, Moeller-Nielsen N, Wiborg O, Aalkjaer C, Gutierrez PS, Aparecida-Silva R, Borges LF, Moreira LFP, Dias RR, Kalil J, Stolf NAG, Zhou W, Suntharalingam K, Brand N, Vilar Compte R, Ying L, Bicknell K, Dannoura A, Dash P, Brooks G, Tsimafeyeu I, Tishova Y, Wynn N, Oyeyipo IP, Olatunji LA, Maegdefessel L, Azuma J, Toh R, Raaz U, Merk DR, Deng A, Spin JM, Tsao PS, Lande C, Cecchettini A, Tedeschi L, Taranta M, Naldi I, Citti L, Trivella MG, Grimaldi S, Cinti C, Bousquenaud M, Maskali F, Poussier S, Marie PY, Boutley H, Karcher G, Wagner DR, Devaux Y, Torre I, Psilodimitrakopoulos S, Iruretagoiena I, Gonzalez-Tendero A, Artigas D, Loza-Alvarez P, Gratacos E, Amat-Roldan I, Murray L, Carberry DM, Dunton P, Miles MJ, Suleiman MS, Kanesalingam K, Taylor R, Mc Collum CN, Parniczky A, Solymar M, Porpaczy A, Miseta A, Lenkey ZS, Szabados S, Cziraki A, Garai J, Koller A, Myloslavska I, Menazza SM, Canton MC, Di Lisa FDL, Schulz RS, Oliveira SHV, Morais CAS, Miranda MR, Oliveira TT, Lamego MRA, Lima LM, Goncharova NS, Naymushin AV, Kazimli AV, Moiseeva OM, Lima LM, Carvalho MG, Sabino AP, Mota APL, Sousa MO, Niessner A, Richter B, Hohensinner PJ, Rychli K, Zorn G, Berger R, Moertl D, Pacher R, Wojta J, Huelsmann M, Kukharchik G, Nesterova N, Pavlova A, Gaykovaya L, Krapivka N, Konstantinova I, Sichinava L, Prapa S, Mccarthy KP, Kilner PJ, Xu XY, Johnson MR, Ho SY. Poster session 2. Cardiovasc Res 2012. [DOI: 10.1093/cvr/cvr334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wong CM, Peiris JSM, Yang L, Chan KP, Thach TQ, Lai HK, Lim WWL, Hedley AJ, He J, Chen P, Ou C, Deng A, Zhang X, Zhou D, Ma S, Chow A. Effect of influenza on cardiorespiratory and all-cause mortality in Hong Kong, Singapore and Guangzhou. Hong Kong Med J 2012; 18 Suppl 2:8-11. [PMID: 22311353] [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: 05/31/2023] Open
Abstract
1. Using a common modelling approach, mortality attributable to influenza was higher in the two subtropical cities Guangzhou and Hong Kong than in the tropical city Singapore. 2. The virus activity appeared more synchronised in subtropical cities, whereas seasonality of influenza tended to be less marked in the tropical city. 3. High temperature was associated with increased mortality after influenza infection in Hong Kong, whereas relative humidity was an effect modifier for influenza in Guangzhou. No effect modification was found for Singapore. 4. Seasonal and environmental factors probably play a more important role than socioeconomic factors in regulating seasonality and disease burden of influenza. Further studies are needed in identifying the mechanism behind the regulatory role of environmental factors.
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Affiliation(s)
- C M Wong
- Department of Community Medicine and School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
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Lu J, Lobarinas E, Deng A, Goodey R, Stolzberg D, Salvi RJ, Sun W. GABAergic neural activity involved in salicylate-induced auditory cortex gain enhancement. Neuroscience 2011; 189:187-98. [PMID: 21664433 DOI: 10.1016/j.neuroscience.2011.04.073] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Revised: 04/12/2011] [Accepted: 04/16/2011] [Indexed: 12/31/2022]
Abstract
Although high doses of sodium salicylate impair cochlear function, it paradoxically enhances sound-evoked activity in the auditory cortex (AC) and augments acoustic startle reflex responses, neural and behavioral metrics associated with hyperexcitability and hyperacusis. To explore the neural mechanisms underlying salicylate (SS)-induced hyperexcitability and "increased central gain," we examined the effects of GABA receptor agonists and antagonists on SS-induced hyperexcitability in the AC and startle reflex responses. Consistent with our previous findings, local or systemic application of SS significantly increased the amplitude of sound-evoked AC neural activity, but generally reduced spontaneous activity in the AC. Systemic injection of SS also significantly increased the acoustic startle reflex. S-baclofen or R-baclofen, GABA-B agonists, which suppressed sound-evoked AC neural firing rate and local field potentials, also suppressed the SS-induced enhancement of the AC field potential and the acoustic startle reflex. Local application of vigabatrin, which enhances GABA concentration in the brain, suppressed the SS-induced enhancement of AC firing rate. Systemic injection of vigabatrin also reduced the SS-induced enhancement of acoustic startle reflex. Collectively, these results suggest that the sound-evoked behavioral and neural hyperactivity induced by SS may arise from a SS-induced suppression of GABAergic inhibition in the AC.
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Affiliation(s)
- J Lu
- Center for Hearing and Deafness, Department of Communicative Disorders and Sciences, State University of New York at Buffalo, 3435 Main Street, NY 14214, USA
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Deng XS, Wang S, Deng A, Liu B, Edgerton SM, Thor AD. Abstract PD03-09: Metformin Induces Apoptosis in Triple Negative Breast Cancer Cells Via Inhibition of Stat3 Activity. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-pd03-09] [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: Metformin inhibits breast cancer cell proliferation and colony formation, with S phase arrest and the induction of apoptosis in triple negative breast cancer cells in vitro. In these cells, metformin down-regulates Cyclin D1 and Cyclin E, as well as EGFR, p-EGFR, p-AKT, p-MAPK, p-Src and p-mTOR, whereas it up-regulates p-AMPK (Liu, et al. Cell Cycle, 2009). Non-triple negative breast cancer cells are resistant to metformin induced apoptosis, although they show similar changes in p-AMPK induction with metformin (Alimova, et al. Cell Cycle, 2009). We hypothesized that there are unique signaling intermediates associated with metformin responsivity in triple negative cells and have identified the signal transducer and activator of transcription 3 (Stat3) as a potential target. Stat3 is constitutively activated in a wide range of tumors, including breast cancer (up to 60%). It reportedly promotes cancer cell proliferation and survival.
Methods: Human triple negative breast cancer cell lines (MDA-468, MDA-231, BT20 and HCC70) were used to evaluate interactions between metformin and Stat3 signaling. Activation of Stat3 was examined by Western blot analysis with phosphorylation-specific antibodies. Cell proliferation was determined by MTS assay. Apoptosis was quantitated by an apoptosis ELISA assay and Western blots for PARP and caspase cleavage. In these 4 cell lines, Stat3-over-expressing clones were obtained via transfection of a constitutive active (CA) construct of Stat3. Specific knock-down of Stat3 expression was achieved by using a lentiviral system containing Stat3 small hairpin RNA.
Results: In a dose and time dependent manner, metformin inhibits Stat3 phosphorylation at sites Tyr705 and Ser727, Cyclin D1 and E protein expression, cleavage of PARP and the pro-caspases 3, 8, and 9. Overexpression of the CA-Stat3 attenuates the aforementioned meformin-associated PARP and caspase cleavage as well as apoptosis, and it suppresses metformin induced cell cycle arrest and changes in cyclin D1 and E. In contrast, specific knock-down of Stat3 expression sensitizes the triple negative breast cancer cells to metformin-mediated apoptosis and cell cycle arrest, enhancing the signaling changes we describe above. Conclusion: These data indicate that Stat3 is a critical intermediary for metformin action in triple negative breast cancer cells. Our studies suggest that targeting Stat3 activation may be a useful strategy to treat breast cancer patients with triple negative phenotype.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD03-09.
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Affiliation(s)
- XS Deng
- University of Colorado at Denver Anschutz Medical Campus, Aurora; Barbara Davis Center UCD, Aurora, CO
| | - S Wang
- University of Colorado at Denver Anschutz Medical Campus, Aurora; Barbara Davis Center UCD, Aurora, CO
| | - A Deng
- University of Colorado at Denver Anschutz Medical Campus, Aurora; Barbara Davis Center UCD, Aurora, CO
| | - B Liu
- University of Colorado at Denver Anschutz Medical Campus, Aurora; Barbara Davis Center UCD, Aurora, CO
| | - SM Edgerton
- University of Colorado at Denver Anschutz Medical Campus, Aurora; Barbara Davis Center UCD, Aurora, CO
| | - AD. Thor
- University of Colorado at Denver Anschutz Medical Campus, Aurora; Barbara Davis Center UCD, Aurora, CO
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Deng A, Martin DB, Spillane A, Chwalek J, St Surin-Lord S, Brooks S, Petrali J, Sina B, Gaspari A, Kao G. Nephrogenic systemic fibrosis with a spectrum of clinical and histopathological presentation: a disorder of aberrant dermal remodeling. J Cutan Pathol 2010; 37:204-10. [PMID: 19341434 DOI: 10.1111/j.1600-0560.2009.01301.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nephrogenic fibrosing dermopathy (NFD) has emerged as a clinicopathologic entity since 1997 and recently renamed as nephrogenic systemic fibrosis (NSF). The etiology and pathogenesis remain uncertain. Characteristic clinical presentation is described as diffuse thickening and hardening of the skin occurring in patients with renal insufficiency. Typical histological features include proliferation of CD34 positive fibrocytes, increased thick collagen bundles and mucin deposition, without significant inflammatory infiltrate. Variations in clinical presentations have been reported, including papular and plaque-like skin lesions, focal lesion only, as well as systemic involvement. Histological changes can be subtle and non-specific, overlapping with other disease processes and harboring features including calcification and osteoclast-like giant cells with osseous metaplasia. METHODS We reviewed patients with NSF that presented to our dermatology clinic by chart review, clinical examination and histological examination. Skin biopsy specimens were obtained from all cases. Histopathology evaluations were carried out by three dermatopathologists (AD, BS and GK) independently and the features were compared among all the cases. Special stains and immunohistochemistry study were also performed to highlight the histological features. RESULTS Seven cases of NSF presented with a spectrum of clinical manifestations, from classic diffuse hardening of the skin to localized linear plaques. On histological examination, proliferation of CD34-positive fibrocytes ranged from sparse to dense, collagen bundles ranged from thin to thick, and the interstitial dermal mucin accumulation ranged from scant-patchy to abundant. In addition, the lesion displayed various degrees of vascular proliferation, inflammatory infiltrates and intensities of CD68 and Factor XIIIa staining. Two cases showed extensive dermal calcification and ossification. CONCLUSION NSF may present with a spectrum of clinical abnormalities, and exhibit overlapping histopathological features resembling cicatrix and other dermal reparative/regenerative processes. NSF may in fact to be a disorder of aberrant extracellular matrix remodeling in patients with renal insufficiency.
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Affiliation(s)
- A Deng
- 1Department of Dermatology, University of Maryland, School of Medicine, Baltimore, Maryland, USA.
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McLaughlin T, Deng A, Yee G, Lamendola C, Reaven G, Tsao PS, Cushman SW, Sherman A. Inflammation in subcutaneous adipose tissue: relationship to adipose cell size. Diabetologia 2010; 53:369-77. [PMID: 19816674 PMCID: PMC6290757 DOI: 10.1007/s00125-009-1496-3] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Accepted: 07/16/2009] [Indexed: 11/28/2022]
Abstract
AIMS/HYPOTHESIS Inflammation is associated with increased body mass and purportedly with increased size of adipose cells. We sought to determine whether increased size of adipose cells is associated with localised inflammation in weight-stable, moderately obese humans. METHODS We recruited 49 healthy, moderately obese individuals for quantification of insulin resistance (modified insulin suppression test) and subcutaneous abdominal adipose tissue biopsy. Cell size distribution was analysed with a multisizer device and inflammatory gene expression with real-time PCR. Correlations between inflammatory gene expression and cell size variables, with adjustment for sex and insulin resistance, were calculated. RESULTS Adipose cells were bimodally distributed, with 47% in a 'large' cell population and the remainder in a 'small' cell population. The median diameter of the large adipose cells was not associated with expression of inflammatory genes. Rather, the fraction of small adipose cells was consistently associated with inflammatory gene expression, independently of sex, insulin resistance and BMI. This association was more pronounced in insulin-resistant than insulin-sensitive individuals. Insulin resistance also independently predicted expression of inflammatory genes. CONCLUSIONS/INTERPRETATION This study demonstrates that among moderately obese, weight-stable individuals an increased proportion of small adipose cells is associated with inflammation in subcutaneous adipose tissue, whereas size of mature adipose cells is not. The observed association between small adipose cells and inflammation may reflect impaired adipogenesis and/or terminal differentiation. However, it is unclear whether this is a cause or consequence of inflammation. This question and whether small vs large adipose cells contribute differently to inflammation in adipose tissue are topics for future research. TRIAL REGISTRATION ClinicalTrials.gov NCT00285844.
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Affiliation(s)
- T McLaughlin
- Division of Endocrinology, Stanford University School of Medicine, 300 Pasteur Drive, Rm S025, Stanford, CA 94305-5103, USA.
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Sun W, Lu J, Stolzberg D, Gray L, Deng A, Lobarinas E, Salvi RJ. Salicylate increases the gain of the central auditory system. Neuroscience 2008; 159:325-34. [PMID: 19154777 DOI: 10.1016/j.neuroscience.2008.12.024] [Citation(s) in RCA: 148] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Revised: 12/14/2008] [Accepted: 12/16/2008] [Indexed: 10/21/2022]
Abstract
High doses of salicylate, the anti-inflammatory component of aspirin, induce transient tinnitus and hearing loss. Systemic injection of 250 mg/kg of salicylate, a dose that reliably induces tinnitus in rats, significantly reduced the sound evoked output of the rat cochlea. Paradoxically, salicylate significantly increased the amplitude of the sound-evoked field potential from the auditory cortex (AC) of conscious rats, but not the inferior colliculus (IC). When rats were anesthetized with isoflurane, which increases GABA-mediated inhibition, the salicylate-induced AC amplitude enhancement was abolished, whereas ketamine, which blocks N-methyl-d-aspartate receptors, further increased the salicylate-induced AC amplitude enhancement. Direct application of salicylate to the cochlea, however, reduced the response amplitude of the cochlea, IC and AC, suggesting the AC amplitude enhancement induced by systemic injection of salicylate does not originate from the cochlea. To identify a behavioral correlate of the salicylate-induced AC enhancement, the acoustic startle response was measured before and after salicylate treatment. Salicylate significantly increased the amplitude of the startle response. Collectively, these results suggest that high doses of salicylate increase the gain of the central auditory system, presumably by down-regulating GABA-mediated inhibition, leading to an exaggerated acoustic startle response. The enhanced startle response may be the behavioral correlate of hyperacusis that often accompanies tinnitus and hearing loss.
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Affiliation(s)
- W Sun
- Center for Hearing and Deafness, 137 Cary Hall, State University of New York at Buffalo, 3435 Main Street, Buffalo, NY 14214, USA.
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McLaughlin T, Deng A, Gonzales O, Aillaud M, Yee G, Lamendola C, Abbasi F, Connolly AJ, Sherman A, Cushman SW, Reaven G, Tsao PS. Insulin resistance is associated with a modest increase in inflammation in subcutaneous adipose tissue of moderately obese women. Diabetologia 2008; 51:2303-8. [PMID: 18825363 PMCID: PMC3290914 DOI: 10.1007/s00125-008-1148-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2008] [Accepted: 08/11/2008] [Indexed: 10/21/2022]
Abstract
AIMS/HYPOTHESIS We have previously described differences in adipose cell size distribution and expression of genes related to adipocyte differentiation in subcutaneous abdominal fat obtained from insulin-sensitive (IS) and -resistant (IR) persons, matched for degree of moderate obesity. To determine whether other biological properties also differ between IR and IS obese individuals, we quantified markers of inflammatory activity in adipose tissue from overweight IR and IS individuals. METHODS Subcutaneous abdominal tissue was obtained from moderately obese women, divided into IR (n = 14) and IS (n = 19) subgroups by determining their steady-state plasma glucose (SSPG) concentrations during the insulin suppression test. Inflammatory activity was assessed by comparing expression of nine relevant genes and by immunohistochemical quantification of CD45- and CD68-containing cells. RESULTS SSPG concentrations were approximately threefold higher in IR than in IS individuals. Expression levels of CD68, EMR1, IL8, IL6 and MCP/CCL2 mRNAs were modestly but significantly increased (p < 0.05) in IR compared with IS participants. Results of immunohistochemical staining were consistent with gene expression data, demonstrating modest differences between IR and IS individuals. Crown-like structures, in which macrophages surround single adipocytes, were rarely seen in tissue from either subgroup. CONCLUSIONS/INTERPRETATION A modest increase in inflammatory activity was seen in subcutaneous adipose tissue from IR compared with equally obese IS individuals. Together with previous evidence of impaired adipose cell differentiation in IR vs equally obese individuals, it appears that at least two biological processes in subcutaneous adipose tissue characterize the insulin-resistant state independent of obesity per se.
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Affiliation(s)
- T McLaughlin
- Department of Medicine, Division of Endocrinology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305-5103, USA.
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Abstract
Naevus comedonicus (NC) is a rare developmental anomaly, with < 200 cases reported in the literature. It usually occurs on the face, neck or chest, appearing as groups of closely arranged dilated follicular openings with keratin plugs. Several associations have been made in the literature. We review the current literature, emphasizing the clinical features, associated conditions and therapeutic options.
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Affiliation(s)
- K K Guldbakke
- Department of Dermatology, St. Olav's Hospital, Tronheim University Hospital, Norway
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Blantz RC, Deng A. Coordination of kidney filtration and tubular reabsorption: considerations on the regulation of metabolic demand for tubular reabsorption. ACTA ACUST UNITED AC 2007; 94:83-94. [PMID: 17444277 DOI: 10.1556/aphysiol.94.2007.1-2.8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Kidney blood flow is highly regulated by a combination of myogenic autoregulation, multiple neurohormonal systems and the tubuloglomerular feedback system, the later of which specifically relates tubular reabsorption to the filtered load. Oxygen and substrate requirements of the kidney are dictated by both supply of oxygen and substrates and metabolic demands of the kidney. The tubuloglomerular feedback system utilizes mediators which are intimately linked to cellular metabolism, ATP and adenosine. This system based upon communication transfer between the macular densa and the afferent arteriole stabilizes kidney function and is not static but temporally adapts or resets to new external physiologic conditions. Such temporal adaptation occurs via modulators such as nitric oxide (NO), primarily derived from NOS-1, angiotensin II and COX-2 products. These hormonal influences also exert capacities to modulate cellular demands for oxygen, particularly NO which decreases oxygen consumption via multiple mechanisms. The several mechanisms whereby NO and other hormonal systems and transporter activity can regulate and produce changes in kidney metabolic demands are discussed. Modulators which influence temporal adaptation and resetting of TGF are also significant contributors to the regulation of cellular oxygen consumption in the kidney. These systems may act in concert to preserve the coordination of filtered load and tubular reabsorption and the metabolic demands of kidney function, thereby determining the ischemic threshold for kidney function.
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Affiliation(s)
- R C Blantz
- Division of Nephrology-Hypertension, School of Medicine, University of California, & VASDHS 3350 La Jolla Village Drive (111-H) San Diego, California 92161, USA.
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Scott G, Deng A, Rodriguez-Burford C, Seiberg M, Han R, Babiarz L, Grizzle W, Bell W, Pentland A. Protease-activated receptor 2, a receptor involved in melanosome transfer, is upregulated in human skin by ultraviolet irradiation. J Invest Dermatol 2001; 117:1412-20. [PMID: 11886502 DOI: 10.1046/j.0022-202x.2001.01575.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Previous studies have shown that the protease-activated receptor 2 is involved in skin pigmentation through increased phagocytosis of melanosomes by keratinocytes. Ultraviolet irradiation is a potent stimulus for melanosome transfer. We show that protease-activated receptor 2 expression in human skin is upregulated by ultraviolet irradiation. Subjects with skin type I, II, or III were exposed to two or three minimal erythema doses of irradiation from a solar simulator. Biopsies were taken from nonexposed and irradiated skin 24 and 96 h after irradiation and protease-activated receptor 2 expression was detected using immunohistochemical staining. In nonirradiated skin, protease-activated receptor 2 expression was confined to keratinocytes in the lower one-third of the epidermis. After ultraviolet irradiation protease-activated receptor 2 expression was observed in keratinocytes in the upper two-thirds of the epidermis or the entire epidermis at both time points studied. Subjects with skin type I showed delayed upregulation of protease-activated receptor 2 expression, however, compared with subjects with skin types II and III. Irradiated cultured human keratinocytes showed upregulation in protease-activated receptor 2 expression as determined by immunofluorescence microscopy and Western blotting. Cell culture supernatants from irradiated keratinocytes also exhibited a dose-dependent increase in protease-activated receptor-2 cleavage activity. These results suggest an important role for protease-activated receptor-2 in pigmentation in vivo. Differences in protease-activated receptor 2 regulation in type I skin compared with skin types II and III suggest a potential mechanism for differences in tanning in subjects with different skin types.
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Affiliation(s)
- G Scott
- Department of Dermatology, University of Rochester Medical Center, School of Medicine, Rochester, New York 14642, USA.
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Abstract
A common polymorphism in the cystatin C gene is associated with increased risk of developing Alzheimer's disease (AD). To explore possible neuropathological consequences of this genetic association, we examined expression of cystatin C in brains from 22 AD and 11 control patients by immunohistochemistry. In the temporal cortex of all AD brains, there was strong cystatin C immunostaining of neurons and activated glia, whereas staining was absent or minimal in 7 of the 11 control brains. Neuronal staining of cystatin C in AD brains was primarily limited to pyramidal neurons in cortical layers III and V, which are the neurons most susceptible to cell death in AD. The increase in cystatin C staining in AD was independent of cystatin C genotype. Immunostaining of cystatin C within neurons showed a punctate distribution, which co-localized with the endosomal/lysosomal proteinase, cathepsin B. A primarily glial source for cystatin C was suggested by parallel studies using in situ hybridization of mouse brain. In human AD brain, there was little co-localization of cystatin C with parenchymal Abeta deposits, although a small fraction of cerebral blood vessels and neurofibrillary tangles were cystatin C-positive. The regional distribution of cystatin C neuronal immunostaining also duplicated the pattern of neuronal susceptibility in AD brains: the strongest staining was found in the entorhinal cortex, in the hippocampus, and in the temporal cortex; fewer pyramidal neurons were stained in frontal, parietal, and occipital lobes. These neuropathological observations reinforce the association between cystatin C and AD, and support a model of cystatin C involvement in the process of neuronal death in AD.
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Affiliation(s)
- A Deng
- Memory Disorders Clinic and the Alzheimer's Research Unit, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Berezovska O, Jack C, Deng A, Gastineau N, Rebeck GW, Hyman BT. Notch1 and amyloid precursor protein are competitive substrates for presenilin1-dependent gamma-secretase cleavage. J Biol Chem 2001; 276:30018-23. [PMID: 11408475 DOI: 10.1074/jbc.m008268200] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Proteolytic processing of the amyloid precursor protein (APP) by beta- and gamma-secretases results in the production of a highly amyloidogenic Abeta peptide, which deposits in the brains of Alzheimer's disease patients. Similar gamma-secretase processing occurs in another transmembrane protein, Notch1, releasing a potent signaling molecule, the Notch C-terminal domain. It has been shown that both events are dependent on a presenilin-dependent protease. We now test the hypothesis that activated Notch1 and APP are competitive substrates for the same proteolytic activity in neurons. Treatment of neurons with the native Notch ligand, Delta, induces endogenous Notch1 intramembraneous cleavage and diminishes Abeta production in a dose-dependent manner. Complementary experiments showed that the converse was also true. Overexpressing human APP (APP(695Sw)) in neurons leads to a decrease in endogenous Notch1 signal transduction, as assessed by a CBF1 luciferase transcription assay, by Notch C-terminal domain nuclear translocation in vitro and by analysis of Notch C-terminal domain generation and Notch1 staining in vivo. In summary, two complementary approaches suggest that APP and Notch1 are physiologically relevant competitive substrates for gamma-secretase activity.
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Affiliation(s)
- O Berezovska
- Alzheimer's Disease Research Laboratory, Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Charlestown, Massachusetts 02129, USA
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Thomson SC, Deng A, Bao D, Satriano J, Blantz RC, Vallon V. Ornithine decarboxylase, kidney size, and the tubular hypothesis of glomerular hyperfiltration in experimental diabetes. J Clin Invest 2001; 107:217-24. [PMID: 11160138 PMCID: PMC199175 DOI: 10.1172/jci10963] [Citation(s) in RCA: 190] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
In early diabetes, the kidney grows and the glomerular filtration rate (GFR) increases. This growth is linked to ornithine decarboxylase (ODC). The study of hyperfiltration has focused on microvascular abnormalities, but hyperfiltration may actually result from a prior increase in capacity for proximal reabsorption which reduces the signal for tubuloglomerular feedback (TGF). Experiments were performed in Wistar rats after 1 week of streptozotocin diabetes. Kidney weight, ODC activity, and GFR were correlated in diabetic and control rats given difluoromethylornithine (DFMO; Marion Merrell Dow, Cincinnati, Ohio, USA) to inhibit ODC. We assessed proximal reabsorption by micropuncture, using TGF as a tool for manipulating single-nephron GFR (SNGFR), then plotting proximal reabsorption versus SNGFR. ODC activity was elevated 15-fold in diabetic kidneys and normalized by DFMO, which also attenuated hyperfiltration and hypertrophy. Micropuncture data revealed an overall increase in proximal reabsorption in diabetic rats too great to be accounted for by glomerulotubular balance. DFMO prevented the overall increase in proximal reabsorption. These data confirm that ODC is required for the full effect of diabetes on kidney size and proximal reabsorption in early streptozotocin diabetes and are consistent with the hypothesis that diabetic hyperfiltration results from normal physiologic actions of TGF operating in a larger kidney, independent of any primary malfunction of the glomerular microvasculature.
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Affiliation(s)
- S C Thomson
- Department of Medicine, Division of Nephrology/Hypertension, University of California at San Diego and Veterans Affairs Medical Center, 3350 La Jolla Village Drive, San Diego, California 92161-9151, USA.
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Zhu Z, Wang Y, Wang H, Deng A. The study on the relationship between serum vascular endothelial growth factor and proteinuria in adriamycin-induced nephrotic rats. Curr Med Sci 2001; 21:301-3. [PMID: 12539553 DOI: 10.1007/bf02886562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2000] [Indexed: 10/19/2022]
Abstract
To study the relationship between serum vascular endothelial growth factor (VEGF) and proteinuria in adriamycin-induced nephrotic rats, a rat model of adriamycin-induced nephrotitis was developed by injection of adriamycin into a tail vein in a rat. At different time points, 24-h urinary protein excretion was measured by using Coomassie brilliant blue method and the serum VEGF levels detected by using ELISA assay. The interventional effect of VEGF on this model was observed. The results showed that: (1) The adriamycin-induced nephrotic syndrome rat model was developed successfully; (2) Serum VEGF levels and proteinuria were significantly increased at 7th day after intravenous injection of adriamycin. There was a positive correlation between serum VEGF levels and 24-h urinary protein excretion (r = 0.67, P < 0.05). (3) The 24-h urinary protein excretion was significantly increased in the rats receiving administration of VEGF (P < 0.05). It was concluded that VEGF might play an important role in the pathogenesis of proteinuria in adriamycin-induced nephrotic rats.
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Affiliation(s)
- Z Zhu
- Department of Nephrology, Xiehe Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030
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45
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Bertram L, Guénette S, Jones J, Keeney D, Mullin K, Crystal A, Basu S, Yhu S, Deng A, Rebeck GW, Hyman BT, Go R, McInnis M, Blacker D, Tanzi R. No evidence for genetic association or linkage of the cathepsin D (CTSD) exon 2 polymorphism and Alzheimer disease. Ann Neurol 2001; 49:114-6. [PMID: 11198280 DOI: 10.1002/1531-8249(200101)49:1<114::aid-ana18>3.0.co;2-m] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [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
Two recent case-control studies have suggested a strong association of a missense polymorphism in exon 2 of the cathepsin D gene (CTSD) and Alzheimer disease (AD). However, these findings were not confirmed in another independent study. We analyzed this polymorphism in two large and independent AD study populations and did not detect an association between CTSD and AD. The first sample was family-based and included 436 subjects from 134 sibships discordant for AD that were analyzed using the sibship disequilibrium test (SDT, p = 0.68) and the sib transmission/disequilibrium test (Sib-TDT, p = 0.81). The second sample of 200 AD cases and 182 cognitively normal controls also failed to show significant differences in the allele or genotype distribution in cases versus controls (chi2, p = 0.91 and p = 0.88, respectively). In addition, two-point linkage analyses in an enlarged family sample (n = 670) did not show evidence for linkage of the chromosomal region around CTSD. Thus, our analyses on more than 800 subjects suggest that if an association between the CTSD exon 2 polymorphism and AD exists, it is likely to be smaller than previously reported.
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Affiliation(s)
- L Bertram
- Genetics and Aging Unit, Massachusetts General Hospital, Harvard Medical School, Charlestown, USA
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Finckh U, von der Kammer H, Velden J, Michel T, Andresen B, Deng A, Zhang J, Müller-Thomsen T, Zuchowski K, Menzer G, Mann U, Papassotiropoulos A, Heun R, Zurdel J, Holst F, Benussi L, Stoppe G, Reiss J, Miserez AR, Staehelin HB, Rebeck GW, Hyman BT, Binetti G, Hock C, Growdon JH, Nitsch RM. Genetic association of a cystatin C gene polymorphism with late-onset Alzheimer disease. Arch Neurol 2000; 57:1579-83. [PMID: 11074789 DOI: 10.1001/archneur.57.11.1579] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To determine whether the cystatin C gene (CST3) is genetically associated with late-onset Alzheimer disease (AD). DESIGN A case-control study with 2 independent study populations of patients with AD and age-matched, cognitively normal control subjects. SETTING The Alzheimer's Disease Research Unit at the University Hospital Hamburg-Eppendorf, Hamburg, Germany, for the initial study (n = 260). For the independent multicenter study (n = 647), an international consortium that included the Massachusetts Alzheimer's Disease Research Center at the Massachusetts General Hospital, Boston; the Scientific Institute for Research and Patient Care, Brescia, Italy; and Alzheimer's research units at the Universities of Basel and Zurich, Switzerland, and Bonn, Goettingen, and Hamburg, Germany. PARTICIPANTS Five hundred seventeen patients with AD and 390 control subjects. MEASURES Molecular testing of the KspI polymorphisms in the 5' flanking region and exon 1 of CST3 and the apolipoprotein E (APOE) genotype. Mini-Mental State Examination scores for both patients with AD and control subjects. RESULTS Homozygosity for haplotype B of CST3 was significantly associated with late-onset AD in both study populations, with an odds ratio of 3.8 (95% confidence interval, 1.56-9.25) in the combined data set; heterozygosity was not associated with an increased risk. The odds ratios for CST3 B/B increased from 2.6 in those younger than 75 years to 8.8 for those aged 75 years and older. The association of CST3 B/B with AD was independent of APOE epsilon4; both genotypes independently reduced disease-free survival. CONCLUSIONS CST3 is a susceptibility gene for late-onset AD, especially in patients aged 75 years and older. To our knowledge, CST3 B is the first autosomal recessive risk allele in late-onset AD.
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Affiliation(s)
- U Finckh
- Division of Psychiatry Research, University of Zurich, August Forel Str 1, 8008 Zurich, Switzerland
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Abstract
Nephron function is stabilized by tubuloglomerular feedback (TGF). TGF operates within the juxtaglomerular apparatus, sensing changes in tubular flow and eliciting compensatory changes in single nephron GFR (SNGFR). The mediator(s) of TGF remains unconfirmed. One theory is that ATP consumed in active transport by the macula densa leads to formation of adenosine, which causes glomerular vasoconstriction. We performed micropuncture in rats to test this hypothesis. Adenosine activity was manipulated by microperfusing nephrons with adenosine A1 receptor blocker, A1-agonist, or 5'-nucleotidase inhibitor. Effects on TGF were characterized by changes in TGF efficiency (the compensation for small perturbations in tubular flow) and by changes in the maximum range over which TGF can cause SNGFR to change. These data were further applied to generate TGF profiles [SNGFR versus late proximal flow (V(LP))]. TGF efficiency was significantly reduced by blocking A1-receptors. TGF efficiency, TGF range, and the slope of the TGF profile (DeltaSNGFR/DeltaV(LP)) were all significantly reduced by blocking 5'-nucleotidase. When adenosine activity was clamped by combining 5'-nucleotidase inhibitor with A1-agonist to determine whether TGF requires adenosine to be present or to fluctuate, the TGF slope was reduced by 83%, indicating that adenosine activity must fluctuate for normal TGF to occur and that adenosine is a mediator of TGF.
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Affiliation(s)
- S Thomson
- Department of Medicine, University of California San Diego and San Diego Veterans Affairs Medical Center, San Diego, California, USA.
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48
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Rebeck GW, Cheung BS, Growdon WB, Deng A, Akuthota P, Locascio J, Greenberg SM, Hyman BT. Lack of independent associations of apolipoprotein E promoter and intron 1 polymorphisms with Alzheimer's disease. Neurosci Lett 1999; 272:155-8. [PMID: 10505604 DOI: 10.1016/s0304-3940(99)00602-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Several studies have demonstrated genetic associations between Alzheimer's disease (AD) and polymorphisms in the promoter/enhancer regions of the apolipoprotein E (APOE) gene. These studies raise the possibility that APOE transcription control may be involved in altered risks for AD. We evaluated polymorphic sites in the intron-1 enhancer element (IE-1G/C) and in the APOE promoter (-219G/T). For the IE-1 polymorphism, we analyzed 433 individuals (183 AD and 250 controls), and found a strong linkage between the IE-1G allele and APOE-epsilon4. When we controlled for this linkage using log-linear model analysis, we found no independent association between the IE-1 polymorphism and AD. For the -219 polymorphism, we analyzed 475 individuals (168 AD cases, 234 controls, and 73 cases of cerebral amyloid angiopathy (CAA)). We found strong linkages between the -219G allele and APOE-epsilon2 and between the -219 T allele and APOE-epsilon4. Controlling for these linkages, we found no independent association between the -219 polymorphism and AD or CAA. Thus, our studies do not support independent associations between AD and either the IE-1 or the -219 polymorphisms.
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Affiliation(s)
- G W Rebeck
- Alzheimer Research Unit, Massachusetts General Hospital, Charlestown 02129, USA.
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49
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Deng A, Zhong R, Chen S. [Elimination of CD28+ T cell in patients with chronic active hepatitis]. Zhonghua Gan Zang Bing Za Zhi 1999; 7:149-50. [PMID: 10572682] [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] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
OBJECTIVE To study the role of toxicyte T cell in active hepatitis. METHODS We examined CD28+ T cell in patients with chronic active/remission hepatitis by flow cytometry. RESULTS It shows that CD28+, CD8+CD28+ T cell in patients with chronic active hepatitis decreased significantly, compared with normal control or patients with liver cirrhosis and heptoma. CONCLUSION It implies that B7-CD28 costimulation pathway contribute to the tissue injury in hepatitis.
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Affiliation(s)
- A Deng
- Clinical Immunology Center, Changzheng Hospital, Shanghai
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50
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Deng A, Yang X, Wu C, Yao L, Li Y. Experimental study on detached renal tubular epithelial cells in urine of nephropathia epidemic patients. Curr Med Sci 1999; 19:307-9. [PMID: 12938525 DOI: 10.1007/bf02886970] [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] [Received: 08/10/1999] [Indexed: 11/27/2022]
Abstract
To elucidate the pathogenesis of acute renal failure (ARF) with nephropathia epidemic (NE), provide experimental evidence for the new therapy to NE and observe the effects of Arg-Gly-Asp (RGD) peptides on adhesion of renal tubular epithelial cell (RTEC), urine specimens of patients were collected under sterile conditions. Detached RTECs were separated, cultured and identified. Hantan Virus antigen was determined by using indirect immunofluorescence method and effects of RGD on adhesion of RTECs was observed by subgroup counting as well as by flow cytometry. This study showed that: (1) sublethal RTECs existed in the urine of NE-ARF patients, which could be cultured in monolayer form; (2) there was NE antigen in RTECs; and (3) adhesion of RTECs could be inhibited by RGD.
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Affiliation(s)
- A Deng
- Department of Nephrology, Xiehe Hospital, Tongji Medical University, Wuhan 430022
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