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Hajibandeh S, Gilham I, Tam W, Kirby E, Babs-Osibodu AO, Jones W, Rose GA, Bailey DM, Morris C, Hargest R, Clayton A, Davies RG. Association between psoas major muscle mass and CPET performance and long-term survival following major colorectal surgery: A retrospective cohort study. Surgeon 2024:S1479-666X(24)00037-4. [PMID: 38653641 DOI: 10.1016/j.surge.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 04/07/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES To evaluate whether computed tomography (CT)-derived psoas major muscle measurements could predict preoperative cardiopulmonary exercise testing (CPET) performance and long-term mortality in patients undergoing major colorectal surgery and to compare predictive performance of psoas muscle measurements using 2D approach and 3D approach. METHODS A retrospective cohort study compliant with STROCSS standards was conducted. Consecutive patients undergoing major colorectal surgery between January 2011 and January 2017 following CPET as part of their preoperative assessment were included. Regression analyses were modelled to investigate association between the CT-derived psoas major muscle mass variables [total psoas muscle area (TPMA), total psoas muscle volume (TPMV) and psoas muscle index (PMI)] and CPET performance and mortality (1-year and 5-year). Discriminative performances of the variables were evaluated using Receiver Operating Characteristic (ROC) curve analysis. RESULTS A total of 457 eligible patients were included. The median TPMA and TPMV were 21 cm2 (IQR: 15-27) and 274 cm3 (IQR: 201-362), respectively. The median PMI measured via 2D and 3D approaches were 7 cm2/m2 (IQR: 6-9) and 99 cm3/m2 (IQR: 76-120), respectively. The risks of 1-year and 5-year mortality were 7.4% and 27.1%, respectively. Regression analyses showed TPMA, TPMV, and PMI can predict preoperative CPET performance and long-term mortality. However, ROC curve analyses showed no significant difference in predictive performance amongst TPMA, TPMV, and PMI. CONCLUSION Radiologically-measured psoas muscle mass variables may predict preoperative CPET performance and may be helpful with informing more objective selection of patients for preoperative CPET and prehabilitation.
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Affiliation(s)
- Shahab Hajibandeh
- Department of General Surgery, University Hospital of Wales, Cardiff, UK.
| | - Iain Gilham
- Department of Radiology, University Hospital of Wales, Cardiff, UK
| | - Winnie Tam
- Department of Radiology, University Hospital of Wales, Cardiff, UK
| | - Emma Kirby
- Department of Radiology, University Hospital of Wales, Cardiff, UK
| | | | - William Jones
- Department of Radiology, University Hospital of Wales, Cardiff, UK
| | - George A Rose
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Damian M Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Christopher Morris
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - Rachel Hargest
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - Amy Clayton
- Department of Radiology, University Hospital of Wales, Cardiff, UK
| | - Richard G Davies
- Department of Anaesthetics, University Hospital of Wales, Cardiff, UK
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Hajibandeh S, Hajibandeh S, Hughes I, Mitra K, Puthiyakunnel Saji A, Clayton A, Alessandri G, Duncan T, Cornish J, Morris C, O'Reilly D, Kumar N. Development and Validation of HAS (Hajibandeh Index, ASA Status, Sarcopenia) - A Novel Model for Predicting Mortality After Emergency Laparotomy. Ann Surg 2024; 279:501-509. [PMID: 37139796 DOI: 10.1097/sla.0000000000005897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To develop and validate a predictive model to predict the risk of postoperative mortality after emergency laparotomy taking into account the following variables: age, age ≥ 80, ASA status, clinical frailty score, sarcopenia, Hajibandeh Index (HI), bowel resection, and intraperitoneal contamination. SUMMARY BACKGROUND DATA The discriminative powers of the currently available predictive tools range between adequate and strong; none has demonstrated excellent discrimination yet. METHODS The TRIPOD and STROCSS statement standards were followed to protocol and conduct a retrospective cohort study of adult patients who underwent emergency laparotomy due to non-traumatic acute abdominal pathology between 2017 and 2022. Multivariable binary logistic regression analysis was used to develop and validate the model via two protocols (Protocol A and B). The model performance was evaluated in terms of discrimination (ROC curve analysis), calibration (calibration diagram and Hosmer-Lemeshow test), and classification (classification table). RESULTS One thousand forty-three patients were included (statistical power = 94%). Multivariable analysis kept HI (Protocol-A: P =0.0004; Protocol-B: P =0.0017), ASA status (Protocol-A: P =0.0068; Protocol-B: P =0.0007), and sarcopenia (Protocol-A: P <0.0001; Protocol-B: P <0.0001) as final predictors of 30-day postoperative mortality in both protocols; hence the model was called HAS (HI, ASA status, sarcopenia). The HAS demonstrated excellent discrimination (AUC: 0.96, P <0.0001), excellent calibration ( P <0.0001), and excellent classification (95%) via both protocols. CONCLUSIONS The HAS is the first model demonstrating excellent discrimination, calibration, and classification in predicting the risk of 30-day mortality following emergency laparotomy. The HAS model seems promising and is worth attention for external validation using the calculator provided. HAS mortality risk calculator https://app.airrange.io/#/element/xr3b_E6yLor9R2c8KXViSAeOSK .
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Affiliation(s)
- Shahab Hajibandeh
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - Shahin Hajibandeh
- Department of General Surgery, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Ioan Hughes
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - Kalyan Mitra
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | | | - Amy Clayton
- Department of Radiology, University Hospital of Wales, Cardiff, UK
| | - Giorgio Alessandri
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - Trish Duncan
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - Julie Cornish
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - Chris Morris
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - David O'Reilly
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
| | - Nagappan Kumar
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
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Hajibandeh S, Hajibandeh S, Brown C, Harper ER, Saji AP, Hughes I, Mitra K, Rashwany H, Clayton A, Patel N, Abdelrahman T, Foliaki A, Kumar N. Sarcopenia versus clinical frailty scale in predicting the risk of postoperative mortality after emergency laparotomy: a retrospective cohort study. Langenbecks Arch Surg 2024; 409:59. [PMID: 38351404 DOI: 10.1007/s00423-024-03252-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/04/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES To compare predictive significance of sarcopenia and clinical frailty scale (CFS) in terms of postoperative mortality in patients undergoing emergency laparotomy METHODS: In compliance with STROCSS statement standards, a retrospective cohort study with prospective data collection approach was conducted. The study period was between January 2017 and January 2022. All adult patients with non-traumatic acute abdominal pathology who underwent emergency laparotomy in our centre were included. The primary outcome was 30-day mortality and secondary outcomes were in-hospital mortality and 90-day mortality. The predictive value of sarcopenia and CFS were compared using the receiver operating characteristic (ROC) curve analysis and multivariable binary logistic regression analysis. RESULTS A total of 1043 eligible patients were included. The risk of 30-day mortality, in-hospital mortality, and 90-day mortality were 8%, 10%, and 11%, respectively. ROC curve analysis suggested that sarcopenia is a significantly stronger predictor of 30-day mortality (AUC: 0.87 vs. 0.70, P<0.0001), in-hospital mortality (AUC: 0.79 vs. 0.67, P=0.0011), and 90-day mortality (AUC: 0.79 vs. 0.67, P=0.0009) compared with CFS. Moreover, multivariable binary logistic regression analysis identified sarcopenia as an independent predictor of mortality [coefficient: 4.333, OR: 76.16 (95% CI 37.06-156.52), P<0.0001] but not the CFS [coefficient: 0.096, OR: 1.10 (95% CI 0.88-1.38), P=0.4047]. CONCLUSIONS Sarcopenia is a stronger predictor of postoperative mortality compared with CFS in patients undergoing emergency laparotomy. It cancels out the predictive value of clinical frailty scale in multivariable analyses; hence among the two variables, sarcopenia deserves to be included in preoperative predictive tools.
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Affiliation(s)
- Shahab Hajibandeh
- Department of General Surgery, University Hospital of Wales, Cardiff, CF14 4XW, UK.
| | - Shahin Hajibandeh
- Department of General Surgery, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Christopher Brown
- Department of General Surgery, University Hospital of Wales, Cardiff, CF14 4XW, UK
| | | | | | - Ioan Hughes
- Department of General Surgery, University Hospital of Wales, Cardiff, CF14 4XW, UK
| | - Kalyan Mitra
- Department of General Surgery, University Hospital of Wales, Cardiff, CF14 4XW, UK
| | - Hind Rashwany
- Department of General Surgery, University Hospital of Wales, Cardiff, CF14 4XW, UK
| | - Amy Clayton
- Department of Radiology, University Hospital of Wales, Cardiff, UK
| | - Neil Patel
- Department of General Surgery, University Hospital of Wales, Cardiff, CF14 4XW, UK
| | - Tarig Abdelrahman
- Department of General Surgery, University Hospital of Wales, Cardiff, CF14 4XW, UK
| | - Antonio Foliaki
- Department of General Surgery, University Hospital of Wales, Cardiff, CF14 4XW, UK
| | - Nagappan Kumar
- Department of General Surgery, University Hospital of Wales, Cardiff, CF14 4XW, UK
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Clayton A, Cutler A, Deligiannidis K, Lasser R, Sankoh A, Doherty J, Kotecha M. Clinical Efficacy of a 2-Week Treatment Course of Zuranolone for the Treatment of Major Depressive Disorder and Postpartum Depression: Outcomes From the Clinical Development Program. Eur Psychiatry 2022. [PMCID: PMC9567193 DOI: 10.1192/j.eurpsy.2022.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Antidepressants that offer a rapid onset of action without requiring chronic use are greatly needed in both major depressive disorder (MDD) and postpartum depression (PPD). Zuranolone is an investigational, oral, neuroactive steroid and GABAA receptor positive allosteric modulator in clinical development as a 2-week treatment course for MDD and PPD. Objectives To present the efficacy and safety of zuranolone vs placebo in Phase 2 and 3 trials. Methods In the studies presented (Table 1), improvements in depressive symptoms were assessed by least-squares mean (LSM) using a mixed-effects model for repeated measures on the change from baseline (CFB) at Day 15 in the 17-item Hamilton Rating Scale for Depression total score (HAMD-17; primary endpoint for all trials) and the Montgomery–Åsberg Depression Rating Scale (MADRS; secondary endpoint) following a 14-day treatment course of once-daily zuranolone. ![]()
Results Compared with placebo, zuranolone treatment led to rapid improvements in depressive symptoms across clinical trials, with significant improvements (LSM treatment difference [SE] in CFB) in HAMD-17 and MADRS scores at Day 15 in 3 of the 4 trials (Table 2). Common treatment-emergent adverse events (≥5% in zuranolone treatment arms) were headache, somnolence, dizziness, nausea, sedation, diarrhea, upper respiratory tract infection, and fatigue (Table 3). No incidences of loss of consciousness or excessive sedation were observed. ![]()
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Conclusions Across the completed studies in the zuranolone clinical trial program, patients receiving zuranolone consistently experienced improvement in depressive symptoms following a 2-week treatment course. Treatment with zuranolone was generally well tolerated with a consistent safety and tolerability profile. Disclosure The MDD-201B, MOUNTAIN, and ROBIN studies were sponsored by Sage Therapeutics, Inc; the WATERFALL study was sponsored by Sage Therapeutics, Inc, and Biogen. Medical writing and editorial support were provided by MediTech Media, Ltd, and funded by Biogen.
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Simon J, Clayton A, Kingsberg S, Portman D, Jordan R, Lucas J, Williams L, Krop J. 038 Effect Size of Bremelanotide Treatment in the Phase 3 RECONNECT Studies. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kingsberg S, Portman D, Clayton A, Revicki D, Jordan R, Sadiq A, Williams L, Krop J. 011 Correlation Between Validated Instruments Used in the RECONNECT Studies. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Simon J, Millheiser L, Clayton A, Kingsberg S, Kim N. 084 Improvements in Female Sexual Function Index (FSFI) Domains Over Time after Flibanserin Treatment in Premenopausal Women with Hypoactive Sexual Desire Disorder (HSDD). J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kingsberg S, Clayton A, Portman D, Jordan R, Revicki D, Williams L, Krop J. 012 Bremelanotide Treatment Provided Clinically Meaningful Benefits in Premenopausal Women With Hypoactive Sexual Desire Disorder. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Simon J, Clayton A, Kingsberg S, Portman D, Jordan R, Williams L, Krop J. 194 Effect Size of Bremelanotide Treatment in the Phase 3 RECONNECT Studies. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sicard E, Clayton A, Simon J, Parish S, Kingsberg S, Millheiser L. 103 The Effect of Evening Alcohol Consumption and Bedtime Administration of Flibanserin on the Safety of Flibanserin. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pyke R, Clayton A. 076 Lumping, Splitting, and Treating: Therapies are Needed for Women with Overlapping Sexual Dysfunctions. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sicard E, Clayton A, Simon J, Parish S, Millheiser L, Apfel S. 033 Effects of Alcohol Administered with Flibanserin in Healthy Premenopausal Women: A Randomized, Double-Blind, Single Dose, Seven-Way Crossover Study. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Clayton A, Simon J, Kingsberg S, Jordan R, Lucas J, Williams L, Krop J. 029 Bremelanotide for Hypoactive Sexual Desire Disorders in the RECONNECT Studies: Analysis of Baseline Free Testosterone Level Quartile Subgroups. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sicard E, Clayton A, Simon J, Parish S, Millheiser L, Apfel S. 139 Effects of Alcohol Administered With Flibanserin in Healthy Premenopausal Women: A Randomized, Double-Blind, Single-Dose, Seven-Way Crossover Study. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sicard E, Clayton A, Simon J, Parish S, Kingsberg S, Millheiser L. 140 The Impact of the Timing of Alcohol Consumption on the Safety and Tolerability of Flibanserin. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Clayton A, Kingsberg S, DeRogatis L, Simon J, Jordan R, Lucas J. 138 Bremelanotide for Hypoactive Sexual Desire Disorder in the RECONNECT Study: Analysis of Co-Primary Endpoints According to Baseline FSFI Total Scores. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pyke R, Clayton A. 001 Composite Endpoints for Clinical Trials of Women with HSDD: Content, Responder Values, and Remitter Cutoffs. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kingsberg S, Derogatis L, Yuan J, Barbour K, Kissling R, Clayton A. 021 Flibanserin in Premenopausal Women With Hypoactive Sexual Desire Disorder: Pooled Analysis of Safety From Phase 3, Placebo-Controlled Studies. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Yeung V, Webber JP, Dunlop EA, Morgan H, Hutton J, Gurney M, Jones E, Falcon-Perez J, Tabi Z, Errington R, Clayton A. Rab35-dependent extracellular nanovesicles are required for induction of tumour supporting stroma. Nanoscale 2018; 10:8547-8559. [PMID: 29693684 DOI: 10.1039/c8nr02417k] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Communication between diseased cells and the microenvironment is a complex yet crucial element in progression of varied pathological processes. Recent studies in cancer highlight an important role for small extracellular nanovesicles secreted by cancer cells as modulators of cancer-associated stroma, leading to enhanced angiogenesis and metastatic priming. The intrinsic factors regulating extracellular nanovesicle biogenesis and secretion are therefore relevant in studies of nano-communication in the cancer milieu. We generated prostate cancer cells bearing stable knockdown of several candidate vesicle regulating factors and examined the impact on cell health, vesicle secretion and on communication with fibroblastic stromal cells. We highlight that RAB11B and RAB35 regulate phenotypically distinct nanovesicle populations, each accounting for only around 20% of the total. Depleting RAB35, but not RAB11B leaves a remaining population of vesicles whose phenotype is insufficient for driving fibroblast to myofibroblast differentiation, leading to attenuated motile behaviours in 3D in vitro models. Co-implantation of tumour cells with stromal fibroblasts in xenografts similarly showed that RAB11B knockdown had little effect on growth rates in vivo. In contrast, significant attenuation in growth, and attenuation of myofibroblasts at the tumour site was evident when using RAB35-knockdown cells. The study concludes that a RAB35 regulated nanovesicle sub-population is particularly important for communication between cancer and stromal cells, and is required for generating a tumour-supportive microenvironment.
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Affiliation(s)
- V Yeung
- Division of Cancer & Genetics, School of Medicine, Cardiff University, Heath Park Heath Park, Cardiff CF14 4XN, UK.
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Doherty S, Knight JG, Backhouse T, Bradford A, Saunders F, Bourne RA, Chamberlain TW, Stones R, Clayton A, Lovelock K. Highly efficient aqueous phase reduction of nitroarenes catalyzed by phosphine-decorated polymer immobilized ionic liquid stabilized PdNPs. Catal Sci Technol 2018. [DOI: 10.1039/c7cy02557b] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Phosphino-decorated polymer immobilised ionic liquid-stabilised PdNPs are highly efficient catalysts for the aqueous phase hydrogenation and transfer hydrogenation of aromatic nitro compounds in batch and continuous flow.
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Barr HL, Halliday N, Barrett DA, Williams P, Forrester DL, Peckham D, Williams K, Smyth AR, Honeybourne D, Whitehouse JL, Nash EF, Dewar J, Clayton A, Knox AJ, Cámara M, Fogarty AW. Diagnostic and prognostic significance of systemic alkyl quinolones for P. aeruginosa in cystic fibrosis: A longitudinal study; response to comments. J Cyst Fibros 2017; 16:e21. [PMID: 29079141 DOI: 10.1016/j.jcf.2017.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 09/22/2017] [Indexed: 11/30/2022]
Affiliation(s)
- H L Barr
- Division of Respiratory Medicine, University of Nottingham, City Hospital Campus, Nottingham, UK.
| | - N Halliday
- School of Life Sciences, Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - D A Barrett
- Centre for Analytical Bioscience, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - P Williams
- School of Life Sciences, Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - D L Forrester
- Division of Respiratory Medicine, University of Nottingham, City Hospital Campus, Nottingham, UK
| | - D Peckham
- Leeds Adult Cystic Fibrosis Centre, St James's University Hospital, Leeds, UK
| | - K Williams
- Leeds Adult Cystic Fibrosis Centre, St James's University Hospital, Leeds, UK
| | - A R Smyth
- Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, UK
| | - D Honeybourne
- West Midlands Adult CF Centre, Heart of England, NHS Foundation Trust, Birmingham, UK
| | - J L Whitehouse
- West Midlands Adult CF Centre, Heart of England, NHS Foundation Trust, Birmingham, UK
| | - E F Nash
- West Midlands Adult CF Centre, Heart of England, NHS Foundation Trust, Birmingham, UK
| | - J Dewar
- Wolfson Cystic Fibrosis Centre, Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - A Clayton
- Wolfson Cystic Fibrosis Centre, Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - A J Knox
- Division of Respiratory Medicine, University of Nottingham, City Hospital Campus, Nottingham, UK
| | - M Cámara
- School of Life Sciences, Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - A W Fogarty
- Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, University of Nottingham, Nottingham, UK
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Roberts-Dalton HD, Cocks A, Falcon-Perez JM, Sayers EJ, Webber JP, Watson P, Clayton A, Jones AT. Fluorescence labelling of extracellular vesicles using a novel thiol-based strategy for quantitative analysis of cellular delivery and intracellular traffic. Nanoscale 2017; 9:13693-13706. [PMID: 28880029 DOI: 10.1039/c7nr04128d] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Extracellular vesicles, including exosomes, are naturally derived nanovesicles generated in and released by numerous cell types. As extracellular entities they have the capacity to interact with neighbouring cells and distant tissues and affect physiological processes as well as being implicated in numerous diseases including tumorigenesis and neurodegeneration. They are also under intense investigation as delivery vectors for biotherapeutics. The ways in which EVs interact with recipient cells to influence cell physiology and deliver a macromolecular payload are at the early stages of exploration. A significant challenge within these studies is the ability to label EVs directly or indirectly with fluorescent probes to allow visualization without compromising functionality. Here, we present a thiol-based fluorescence labelling method allowing comprehensive analysis of the cellular uptake of prostate cancer derived EVs in live cells using confocal microscopy. Labelling of the EVs in this way did not influence their size and had no effect on their ability to induce differentiation of lung fibroblasts to myofibroblasts. For endocytosis analyses, depletion of key endocytic proteins and the use of chemical inhibitors (Dynasore, EIPA, Rottlerin and IPA-3) indicated that fluid-phase endocytosis and/or macropinocytosis was involved in EV internalisation. Over a period of six hours EVs were observed to increasingly co-localise with lysosomes, indicating a possible termination point following internalisation. Overall this method provides new opportunities for analysing the cellular dynamics of EVs as biological entities affecting cell and whole body physiology as well as investigating their potential as drug delivery vectors.
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Affiliation(s)
- H D Roberts-Dalton
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, CF10 3NB, UK.
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DeRogatis L, Althof S, Clayton A, Jordan R, Lucas J. 016 Changes in Arousal and Desire in the Bremelanotide RECONNECT Study. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Simon J, Portman D, Kingsberg S, Clayton A, Jordan R, Lucas J, Spana C. 017 Bremelanotide (BMT) for Hypoactive Sexual Desire Disorder (HSDD) in the RECONNECT Study: Efficacy Analyses in Study Completers and Responders. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Clayton A. Sentencing for animal cruelty. Vet Rec 2017; 180:256. [DOI: 10.1136/vr.j1173] [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: 11/04/2022]
Affiliation(s)
- Amy Clayton
- Minster Veterinary Centre Southwell; Nottinghamshire
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Clayton A, Haynes F, Cook M. WS05.6 A pilot study of enhanced community support via internet videoconferencing and physiotherapist home visits. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30032-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Willis G, Connolly K, Ladell K, Davies T, Guschina I, Ramji D, Miners K, Price D, Clayton A, James P, Rees D. Young women with polycystic ovary syndrome have raised levels of circulating annexin V-positive platelet microparticles. Hum Reprod 2014; 29:2756-63. [DOI: 10.1093/humrep/deu281] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Saklani AP, Bae SU, Clayton A, Kim NK. Magnetic resonance imaging in rectal cancer: A surgeon’s perspective. World J Gastroenterol 2014; 20:2030-2041. [PMID: 24616572 PMCID: PMC3934473 DOI: 10.3748/wjg.v20.i8.2030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 11/27/2013] [Accepted: 01/15/2014] [Indexed: 02/06/2023] Open
Abstract
Magnetic resonance imaging (MRI) in rectal cancer was first investigated in 1999 and has become almost mandatory in planning rectal cancer treatment. MRI has a high accuracy in predicting circumferential resection margin involvement and is used to plan neoadjuvant therapy. The accuracy of MRI in assessing mesorectal lymph nodes remains moderate, as there are no reliable criteria to assess nodal involvement. MRI seems to be good in assessing peritoneal involvement in upper rectal cancer; this however has been assessed in only a few studies and needs further research. For low rectal cancers, mesorectum is thin at the level of levator ani especially in relation to prostate; so predicting circumferential resection margin involvement is not easy. However high spatial resolution coronal imaging shows levator muscles, sphincter complex and intersphincteric plane accurately. This is used to stage low rectal tumors and plan plane of surgery (standard surgery, intersphincteric resection, Extralevator abdominoperineal resection). While most centres perform MRI post chemoradiotherapy, its role in accurate staging post neoadjuvant therapy remains debatable. THe role of Diffusion weighted MRI post neoadjuvant therapy is being evaluated in research settings.
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Harbinson M, Forrest P, Clayton A, Campbell M, Bell D. TRASTUZUMAB-INDUCED CARDIOTOXICITY: CAN BIOMARKERS AID DIAGNOSIS? Heart 2012. [DOI: 10.1136/heartjnl-2012-303148a.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Jones HG, Hopkins L, Clayton A, McKain E. A perforated duodenal ulcer presenting as inferior lead ST elevation following amphetamine use. Ann R Coll Surg Engl 2012; 94:e144-5. [PMID: 22613281 DOI: 10.1308/003588412x13171221588659] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Typical symptoms of duodenal ulcers include epigastric pain, nausea, vomiting, chest pain and shortness of breath. Here we present the case of a 39-year-old man who had a sudden onset of chest and epigastric pain following the use of recreational amphetamines. There were ST changes in the inferior leads of his electrocardiogram, indicating the possibility of a myocardial infarction. Following double contrast computed tomography of the abdomen and an urgent laparotomy, a diagnosis of a perforated duodenal ulcer was made. We discuss the aetiologies, presentation, investigation and treatment of the disorder, and make recommendations on the management.
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Prescott K, Clayton A. 176 An audit of the diagnosis and treatment of ABPA in a UK adult CF centre. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60346-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Minot DM, Voss J, Rademacher S, Lwin T, Orsulak J, Caron B, Ketterling R, Nassar A, Chen B, Clayton A. Image analysis of HER2 immunohistochemical staining. Reproducibility and concordance with fluorescence in situ hybridization of a laboratory-validated scoring technique. Am J Clin Pathol 2012; 137:270-6. [PMID: 22261453 DOI: 10.1309/ajcp9mknlhqnk2zx] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Image analysis of the HER2 immunohistochemical (IHC) stain can help determine which breast cancer patients may benefit from HER2-targeted therapy. We studied the concordance of HER2 IHC and fluorescence in situ hybridization (FISH) as well as reproducibility of surgical pathologist (SP) and cytotechnologist (CT) interpretations using manual and image analysis methodologies on 154 IHC cases. Concordances with FISH were good for IHC negative (0, 1+) cases (range, 97%-100%) and positive (3+) cases (range, 87%-100%). Image analysis had fewer equivocal (2+) results (10.4%) than CT (14.9%) and SP (16.2%) manual methods, with higher concordances to FISH (31%, 26%, and 20% for image analysis, CT manual, and SP manual, respectively). CT manual (κ = 0.747) and image analysis (κ = 0.779) methods had better interobserver reproducibility than SP manual (κ = 0.697). CT image analysis had better intraobserver reproducibility (κ = 0.882) than CT (κ = 0.828) and SP (κ = 0.766) manual methods. HER2 IHC analysis performed by image analysis can produce accurate results with improved reproducibility.
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Iqbal S, Voss J, Maldonado F, Jenkins S, Henry M, Clayton A, Halling K. Predicting the Risk of Malignancy in Patients With Indeterminate Peripheral Lung Nodules. Chest 2011. [DOI: 10.1378/chest.1119584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Affiliation(s)
- A Clayton
- Section of Clinical Oncology and Palliative Medicine, School of Medicine, Cardiff University, Velindre Cancer Centre, Cardiff, Wales, U.K.
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Gismondi R, Clayton A, Baker R, Forbes R, Marler S, Berman R. Effect of aripiprazole adjunctive to antidepressants on sexual functioning: A subgroup analysis of a 52-week open-label safety study (CN138–164). Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72337-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IntroductionThis presentation addresses impacts of adjunctive aripiprazole (AA) in major depressive disorder (MDD).ObjectiveAssess impacts of long-term (≤52 weeks) open-label AA to ADT on efficacy, sexual function and weight change in MDD.MethodsData were analyzed post-hoc from de novo patients enrolled in an open-label safety study of AA after inadequate response to one or more ADT. Three ADT classes were included: SSRIs, SNRIs, and a noradrenaline-dopamine reuptake inhibitor, bupropion.Global well-being with AA was assessed (mean change in CGI-S score from baseline by ADT). Sexual functioning was assessed by Sexual Function Inventory (SFI) items: interest in sex, sexual arousal, achievement of orgasm, erection maintenance and sexual satisfaction. Item 6 captured change in the overall improvement score. Weight change at Week 52 (last observation carried forward) was assessed.ResultsOverall mean change in CGI-S (n = 285) by Week 52 was -1.5. Mean changes in CGI-S from baseline scores (4.2-4.4) were: escitalopram (n=64) -1.5, venlafaxine XL (n = 48) -1.4, sertraline (n = 39) -1.7, fluoxetine (n = 41) -1.3, paroxetine or CR (n = 37) -1.5 and bupropion XL or SR (n = 46) -1.4. Improvements on SFI items (n = 155) ranged from -0.2 (sexual satisfaction) to -0.6 (interest in sex and orgasm). Mean overall improvement score (3.8) indicated mild-to-moderate sexual dysfunction. All AA groups experienced a mean weight increase (range +1.8 kg [sertraline] to +3.3 kg [fluoxetine]).ConclusionsAA moderately improved CGI-S scores (to a similar degree) when added to three different classes of ADTs. Sexual functioning in patients on ADT modestly improved after adding aripiprazole to ADT.
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Mullany SA, Moslemi-Kebria M, Rattan R, Khurana A, Clayton A, Ota T, Mariani A, Podratz KC, Chien J, Shridhar V. Expression and functional significance of HtrA1 loss in endometrial cancer. Clin Cancer Res 2011; 17:427-36. [PMID: 21098697 PMCID: PMC3057564 DOI: 10.1158/1078-0432.ccr-09-3069] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to determine if loss of serine protease HtrA1 in endometrial cancer will promote the invasive potential of EC cell lines. EXPERIMENTAL DESIGN Western blot analysis and immunohistochemistry methods were used to determine HtrA1 expression in EC cell lines and primary tumors, respectively. Migration, invasion assays and in vivo xenograft experiment were performed to compare the extent of metastasis between HtrA1 expressing and HtrA1 knocked down clones. RESULTS Western blot analysis of HtrA1 in 13 EC cell lines revealed complete loss of HtrA1 expression in all seven papillary serous EC cell lines. Downregulation of HtrA1 in Hec1A and Hec1B cell lines resulted in a three- to fourfold increase in the invasive potential. Exogenous expression of HtrA1 in Ark1 and Ark2 cells resulted in three- to fourfold decrease in both invasive and migration potential of these cells. There was an increased rate of metastasis to the lungs associated with HtrA1 downregulation in Hec1B cells compared to control cells with endogenous HtrA1 expression. Enhanced expression of HtrA1 in Ark2 cells resulted in significantly less tumor nodules metastasizing to the lungs compared to parental or protease deficient (SA mutant) Ark2 cells. Immunohistochemical analysis showed 57% (105/184) of primary EC tumors had low HtrA1 expression. The association of low HtrA1 expression with high-grade endometrioid tumors was statistically significant (P = 0.016). CONCLUSIONS Collectively, these data indicate loss of HtrA1 may contribute to the aggressiveness and metastatic ability of endometrial tumors.
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Affiliation(s)
- Sally A. Mullany
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Wake Forest Medical Center, Salem, NC
| | - Mehdi Moslemi-Kebria
- Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, 55905
| | - Ramandeep Rattan
- Department of Laboratory Medicine and Pathology, Division of Experimental Pathology, Mayo Clinic, Rochester, MN, 55905
| | - Ashwani Khurana
- Department of Laboratory Medicine and Pathology, Division of Experimental Pathology, Mayo Clinic, Rochester, MN, 55905
| | - Amy Clayton
- Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, 55905
| | - Takayo Ota
- Department of Laboratory Medicine and Pathology, Division of Experimental Pathology, Mayo Clinic, Rochester, MN, 55905
| | - Andrea Mariani
- Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, 55905
| | - Karl C. Podratz
- Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, 55905
| | - Jeremy Chien
- Department of Laboratory Medicine and Pathology, Division of Experimental Pathology, Mayo Clinic, Rochester, MN, 55905
| | - Viji Shridhar
- Department of Laboratory Medicine and Pathology, Division of Experimental Pathology, Mayo Clinic, Rochester, MN, 55905
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McWeeney D, Chien J, Clayton A, Brost B. 714: Invasive placentation: an investigation into the gene expression profile of pregnancies complicated by placenta previa, accreta, increta and percreta. Am J Obstet Gynecol 2011. [DOI: 10.1016/j.ajog.2010.10.736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Brown Jones M, Neuper C, Clayton A, Mariani A, Konecny G, Thomas MB, Keeney G, Hartmann L, Podratz KC. Rationale for folate receptor alpha targeted therapy in "high risk" endometrial carcinomas. Int J Cancer 2008; 123:1699-703. [PMID: 18646191 DOI: 10.1002/ijc.23686] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Advanced and recurrent endometrial cancers account for the majority of deaths from this disease with limited therapeutic options. High grade, and nonendometrioid histology, pathologically characterize the endometrial tumors associated with adverse outcome and are classified as "high risk". The identification of molecular prognostic factors that might be targeted for therapy among "high risk" endometrial cancers is an active area of investigation. We hypothesize that the FRalpha, highly expressed in endometrial cancer cells, is a potential target for this disease. Our objectives were to determine if FRalpha overexpression is associated with adverse prognostic factors and worse outcome. Three hundred and thirty-two endometrial cancer cores were arrayed onto a tissue microarray and stained using a FRalpha-specific monoclonal antibody. Staining was scored as absent or weak and moderate or strong. Forty-one percent of 310 evaluable cases stained moderate/strong. Moderate/strong FRalpha staining was significantly associated with other poor prognostic factors including: advanced stage, nonendometrioid histology and high grade. An association was observed between moderate/strong FRalpha staining and recurrence (p < 0.0014). These findings support further exploring a role for FRalpha targeted approaches for therapy and diagnostics in endometrial cancer.
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Affiliation(s)
- Monica Brown Jones
- Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
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Moriarty AT, Schwartz MR, Eversole G, Means M, Clayton A, Souers R, Fatheree L, Tench WD, Henry M, Wilbur DC. Human papillomavirus testing and reporting rates: practices of participants in the College of American Pathologists Interlaboratory Comparison Program in Gynecologic Cytology in 2006. Arch Pathol Lab Med 2008; 132:1290-4. [PMID: 18684028 DOI: 10.5858/2008-132-1290-hptarr] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2008] [Indexed: 11/06/2022]
Abstract
CONTEXT Oncogenic, high-risk human papillomavirus (HR-HPV) testing is used to evaluate women who are older than 20 years with atypical squamous cells of undetermined significance (ASC-US) and in conjunction with a screening Papanicolaou test in women older than 30 years. OBJECTIVES To evaluate the 2006 laboratory practice data from laboratories incorporating human papillomavirus (HPV) testing with the Papanicolaou test. DESIGN To use the College of American Pathologists (CAP) Supplemental Questionnaire Survey for 2006 to determine laboratory practices of participants in the CAP Interlaboratory Comparison Program in Cervicovaginal Cytology. RESULTS A total of 679 laboratories responded to the questionnaire. Most (73%) refer HPV testing to reference laboratories. Nine percent perform HPV testing in cytology. Forty-five percent offer low-risk HPV (LR-HPV) testing. The most common reflex is ASC-US, although HR-HPV is also offered with low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), or any other Papanicolaou test result. Digene Hybrid Capture II is the most common method. Human papilloma virus median test volumes are 55 monthly. Frequency distributions of HPV test volumes are significantly different from those found in 2003. Laboratories performing in-house testing reported significantly higher monthly HPV volumes (P < .001). Median rates for HR-HPV positivity are 36.6% for ASC-US, 50.0% for atypical squamous cells, cannot exclude HSIL (ASC-H), and 4% for women 30 years of age and older in conjunction with a screening Papanicolaou test. CONCLUSIONS Reference HPV testing remains the most common pattern. The most common reflex indication is for ASC-US, but HPV testing is modified locally to include a variety of scenarios. LR-HPV testing is commonly offered despite its lack of clinical significance. These data form a baseline for ongoing monitoring of HPV testing practice trends.
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Affiliation(s)
- Ann T Moriarty
- Department of Pathology, AmeriPath Indiana, Indianapolis, Indiana 46219-1739, USA.
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El-Haroun H, Clarke DL, Deacon K, Bradbury D, Clayton A, Sutcliffe A, Knox AJ. IL-1beta, BK, and TGF-beta1 attenuate PGI2-mediated cAMP formation in human pulmonary artery smooth muscle cells by multiple mechanisms involving p38 MAP kinase and PKA. Am J Physiol Lung Cell Mol Physiol 2007; 294:L553-62. [PMID: 18156442 DOI: 10.1152/ajplung.00044.2006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We have previously shown that interleukin (IL)-1beta, transforming growth factor (TGF)-beta1, or bradykinin (BK) impair cAMP generation in response to prostacyclin analogs in human pulmonary artery smooth muscle (PASM), suggesting that inflammation can impair the effects of prostacyclin analogs on PASM in pulmonary hypertension. Here we explored the biochemical mechanisms involved. We found that IL-1beta, BK, and TGF-beta1 reduced adenylyl cyclase isoform 1, 2, and 4 mRNA, increased Galphai protein levels, and reduced prostacyclin receptor (IP receptor) mRNA expression. In contrast, Galphas protein levels were unchanged. Protein kinase A (PKA) (H-89, KT-2750, PKIm) and p38 mitogen-activated protein (MAP) kinase (SB-202190) inhibitors attenuated these effects, but protein kinase C (bisindolylmaleide) or phosphoinositol 3-kinase (LY-294002) inhibitors did not. Fluorescent kemptide assay and Western blotting confirmed that PKA and p38 MAP kinase were activated by IL-1beta, BK, and TGF-beta1. These studies suggest that IL-1beta, BK, and TGF-beta1 impair IP receptor-mediated cAMP accumulation by multiple effects on different components of the signaling pathway and that these effects are PKA and p38 MAP kinase dependent.
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Affiliation(s)
- H El-Haroun
- Division of Respiratory Medicine, University of Nottingham, Clinical Science Bldg., City Hospital, Nottingham, NG5 1PB, United Kingdom
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Levy MJ, Clain JE, Clayton A, Halling KC, Kipp BR, Rajan E, Roberts LR, Root RM, Sebo TJ, Topazian MD, Wang KK, Wiersema MJ, Gores GJ. Preliminary experience comparing routine cytology results with the composite results of digital image analysis and fluorescence in situ hybridization in patients undergoing EUS-guided FNA. Gastrointest Endosc 2007; 66:483-90. [PMID: 17725938 DOI: 10.1016/j.gie.2007.03.1053] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Accepted: 03/19/2007] [Indexed: 12/17/2022]
Abstract
BACKGROUND Studies indicate enhanced diagnostic accuracy for digital image analysis (DIA) and fluorescence in situ hybridization (FISH) versus routine cytology examination (RC) when biliary strictures are evaluated. These tumor markers have not been applied to EUS-guided FNA. OBJECTIVE Our purpose was to determine the accuracy of RC versus the composite results of DIA/FISH. DESIGN Patients enrolled with known or suspected malignancy. The final diagnosis was based on strict cytopathologic and imaging criteria and 12-month follow-up. SETTINGS Tertiary referral center. PATIENTS A total of 39 patients were enrolled in whom each diagnostic test was performed on samples from 42 sites to evaluate lymphadenopathy (n=19), pancreatic mass (n=19), esophageal or gastric wall mass (n=3), and thyroid mass (n=1). INTERVENTIONS EUS-guided FNA with RC, DIA, and FISH. MAIN OUTCOME MEASUREMENT Diagnostic accuracy of RC, DIA, and FISH. RESULTS Malignancy was diagnosed in 30 of 42 patients, including esophageal squamous cell carcinoma, esophageal adenocarcinoma, gastric adenocarcinoma, pancreatic adenocarcinoma, pancreatic mucinous cystic neoplasia, intraductal papillary mucinous neoplasia, metastatic forearm sarcoma, small cell and non-small cell lung cancer, thyroid carcinoma, malignant GI stromal tumor, melanoma, adenocarcinoma of unknown primary, and lymphoma. The sensitivity, specificity, and accuracy of DIA/FISH versus RC for detecting malignancy were 97%, 100%, and 98% versus 87%, 100%, and 90%, respectively. LIMITATIONS Single-center pilot study. CONCLUSIONS Our findings suggest that DIA and FISH processing of EUS-guided FNA specimens provides higher diagnostic accuracy than RC does. These data suggest that these tumor markers incorporate generic targets as suggested by the high diagnostic sensitivity in this patient cohort with diverse pathologic conditions.
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Affiliation(s)
- Michael J Levy
- Division of Gastroenterology and Hepatology, Department of Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA
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Navabi H, Croston D, Hobot J, Clayton A, Zitvogel L, Jasani B, Bailey-Wood R, Wilson K, Tabi Z, Mason MD, Adams M. Preparation of human ovarian cancer ascites-derived exosomes for a clinical trial. Blood Cells Mol Dis 2006; 35:149-52. [PMID: 16061407 DOI: 10.1016/j.bcmd.2005.06.008] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2005] [Accepted: 06/27/2005] [Indexed: 01/23/2023]
Abstract
Despite initial response to chemotherapy, at least 50% of ovarian cancer patients will relapse within 18 months. Progression-free survival is related to tumour infiltration with cytotoxic T lymphocytes (CTL). We recently demonstrated that CD8+ T cell responses to recall antigens improve following tumour response to chemotherapy. Vaccination designed to expand CTL, specific for tumour-associated antigens, may be a means of improving outcome. We are planning a clinical trial in advanced ovarian cancer patients undergoing chemotherapy using a combination of a Toll-like receptor 3 (TLR3) agonist and tumour-associated ascites-derived exosomes. Tumour-derived exosomes are a potential source of tumour antigens able to induce CD8+ T cell responses when loaded on mature dendritic cells (DC). DC maturation can be achieved with Toll-like receptor (TLR) agonists, such as the GMP-grade synthetic double stranded RNA, poly[I]:poly[C12U] (Ampligen) which is a TLR-3 agonist. Here, we describe the development of a method suitable for the preparation of GMP-grade exosomes from the ascites fluid of ovarian cancer patients, and the methods used for the molecular and immunological characterisation of these exosomes preceding their use in a clinical trial.
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Affiliation(s)
- H Navabi
- Cancer Services, Velindre NHS Trust, Cardiff, UK
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Clayton A, West S. Combination Therapy in Fibromyalgia. Curr Pharm Des 2006. [DOI: 10.2174/1381612810606010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Summers YJ, Mullin G, Clayton A, Armstrong A, Wilson G, Wardley AM. Experience of weekly paclitaxel therapy in patients with metastatic breast cancer at a single cancer institution. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.855] [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)
- Y. J. Summers
- Northern Ireland Cancer Ctr, Belfast, United Kingdom; Univ of Manchester, Manchester, United Kingdom; Christie Hosp NHS Trust, Manchester, United Kingdom
| | - G. Mullin
- Northern Ireland Cancer Ctr, Belfast, United Kingdom; Univ of Manchester, Manchester, United Kingdom; Christie Hosp NHS Trust, Manchester, United Kingdom
| | - A. Clayton
- Northern Ireland Cancer Ctr, Belfast, United Kingdom; Univ of Manchester, Manchester, United Kingdom; Christie Hosp NHS Trust, Manchester, United Kingdom
| | - A. Armstrong
- Northern Ireland Cancer Ctr, Belfast, United Kingdom; Univ of Manchester, Manchester, United Kingdom; Christie Hosp NHS Trust, Manchester, United Kingdom
| | - G. Wilson
- Northern Ireland Cancer Ctr, Belfast, United Kingdom; Univ of Manchester, Manchester, United Kingdom; Christie Hosp NHS Trust, Manchester, United Kingdom
| | - A. M. Wardley
- Northern Ireland Cancer Ctr, Belfast, United Kingdom; Univ of Manchester, Manchester, United Kingdom; Christie Hosp NHS Trust, Manchester, United Kingdom
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Adams M, Navabi H, Croston D, Coleman S, Tabi Z, Clayton A, Jasani B, Mason MD. The rationale for combined chemo/immunotherapy using a Toll-like receptor 3 (TLR3) agonist and tumour-derived exosomes in advanced ovarian cancer. Vaccine 2005; 23:2374-8. [PMID: 15755631 DOI: 10.1016/j.vaccine.2005.01.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [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: 11/25/2022]
Abstract
A clinical trial employing an immunotherapeutic approach based on the use of a Toll-like receptor 3 (TLR3) agonist and tumour-derived exosomes carrying tumour-associated antigens is planned in advanced ovarian cancer in conjunction with conventional first line chemotherapy. Most patients with ovarian cancer present with advanced disease and despite high initial response rate to chemotherapy the majority will relapse within 2 years with poor overall survival. Tumour antigen-specific T cells are naturally occurring in ovarian cancer patients and T cell infiltration of the tumour is highly prognostic. Novel immunotherapy to expand and activate tumour antigen-specific T cells combined with adjuvant treatment to overcome tumour-induced immunosuppression is considered to be therapeutically beneficial. The rationale for adopting such a combined approach is discussed here.
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Affiliation(s)
- M Adams
- Velindre Hospital, Whitchurch, Cardiff and Cardiff University School of Medicine, Cardiff, UK.
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Valle JW, Lawrance J, Brewer J, Clayton A, Corrie P, Alakhov V, Ranson M. A phase II, window study of SP1049C as first-line therapy in inoperable metastatic adenocarcinoma of the oesophagus. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4195] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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)
- J. W. Valle
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
| | - J. Lawrance
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
| | - J. Brewer
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
| | - A. Clayton
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
| | - P. Corrie
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
| | - V. Alakhov
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
| | - M. Ranson
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
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Clayton A, Danson S, Jolly S, Ryder D, Burt P, Stewart A, Wilkinson P, Magee B, Wilson G, Wardley A. High incidence of cerebral metastases in patients with metastatic breast cancer treated with trastuzumab. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)90847-6] [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: 11/26/2022] Open
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49
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El-Haroun H, Bradbury D, Clayton A, Knox AJ. Interleukin-1beta, transforming growth factor-beta1, and bradykinin attenuate cyclic AMP production by human pulmonary artery smooth muscle cells in response to prostacyclin analogues and prostaglandin E2 by cyclooxygenase-2 induction and downregulation of adenylyl cyclase isoforms 1, 2, and 4. Circ Res 2003; 94:353-61. [PMID: 14670842 DOI: 10.1161/01.res.0000111801.48626.f4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Increased levels of inflammatory cytokines contribute to the pathophysiology of pulmonary hypertension. Prostacyclin (PGI2) analogues, which relax pulmonary vessels mainly through cAMP elevation, have a major therapeutic role. In this study, we show that prolonged incubation with bradykinin (BK), interleukin-1beta (IL-1beta), and transforming growth factor-beta1 (TGF-beta1) markedly impairs cAMP accumulation in human pulmonary artery smooth muscle cells in response to short-term incubation with prostaglandin E2 (PGE2) and the PGI2 analogues iloprost and carbaprostacyclin. A similar reduction in cAMP accumulation in response to a direct adenylyl cyclase activator, forskolin, suggested that the effect was attributable to downregulation of adenylyl cyclase. Reverse transcriptase-polymerase chain reaction studies showed downregulation of adenylyl cyclase isoforms 1, 2, and 4. The effect of IL-1beta, BK, and TGF-beta1 on cAMP levels was abrogated by the selective COX-2 inhibitor NS398. Furthermore, it was mimicked by prolonged incubation with the COX-2 product PGE2 and PGI2 analogues or the COX substrate arachidonic acid, suggesting that it was mediated by endogenous prostanoids produced by COX-2. Consistent with this, IL-1beta, BK, and TGF-beta1 all induced COX-2 and PGE2 release. These results show that BK, IL-1beta, and TGF-beta1 downregulate adenylyl cyclase in human pulmonary artery smooth muscle cells via COX-2 induction and prostanoid release. This suggests a novel mechanism whereby mediators and cytokines produced in pulmonary hypertension may impair the therapeutic effects of prostacyclin analogues such as iloprost and carbaprostacyclin.
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MESH Headings
- Adenylyl Cyclases/genetics
- Adenylyl Cyclases/metabolism
- Adult
- Arachidonic Acid/pharmacology
- Bradykinin/pharmacology
- Cells, Cultured
- Colforsin/pharmacology
- Cyclic AMP/metabolism
- Cyclooxygenase 2
- Dinoprostone/pharmacology
- Dose-Response Relationship, Drug
- Down-Regulation/drug effects
- Enzyme Induction/drug effects
- Epoprostenol/analogs & derivatives
- Epoprostenol/pharmacology
- Gene Expression Regulation, Enzymologic/drug effects
- Growth Substances/pharmacology
- Humans
- Interleukin-1/pharmacology
- Isoenzymes/biosynthesis
- Isoproterenol/pharmacology
- Membrane Proteins
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Nitrobenzenes/pharmacology
- Prostaglandin-Endoperoxide Synthases/biosynthesis
- Prostaglandins/pharmacology
- Pulmonary Artery/cytology
- Pulmonary Artery/drug effects
- Pulmonary Artery/metabolism
- RNA, Messenger/drug effects
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Sulfonamides/pharmacology
- Transforming Growth Factor beta/pharmacology
- Transforming Growth Factor beta1
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Affiliation(s)
- H El-Haroun
- Division of Respiratory Medicine, University of Nottingham, City Hospital, Nottingham, UK
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50
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McGarvey E, Peterson C, Pinkerton R, Keller A, Clayton A. Medical students' perceptions of sexual health issues prior to a curriculum enhancement. Int J Impot Res 2003; 15 Suppl 5:S58-66. [PMID: 14551579 DOI: 10.1038/sj.ijir.3901074] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [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: 11/09/2022]
Abstract
The objectives were to compare first, second and third year medical students on self-perceived sexual health knowledge, comfort in addressing sexual health problems, and attitudes towards the importance of addressing sexual health issues with patients as part of a sexual health medical curriculum enhancement project. A paper-and-pencil questionnaire survey was designed and administered to first and second year medical students at the start of the fall semester, resulting in high participation rates for both years (98% and 86%, respectively). Third year students were surveyed through an on-line version of the questionnaire yielding a lower response rate (52%). Multivariate statistical analyses were used to compare knowledge, comfort and attitudes by year in medical school. Results were as follows: As might be expected, sexual health knowledge and comfort in addressing sexual health problems increased linearly from first to third year (P<0.01) for all questions. Unexpectedly, second year students had significantly higher scores on questions assessing attitudes towards the importance of addressing sexual health issues than either first or third year students (P<0.001). Female medical students reported that addressing sexual health issues with patients was significantly more important than did male medical students; however, male students reported higher levels of self-reported knowledge and comforting related to sexual health issues than did female students in a number of areas. In conclusion, knowledge gained from this survey was used to finalize the design of an enhanced, integrated curriculum on sexual health for medical students. Further investigation of gender differences related to training medical students in this area is suggested.
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Affiliation(s)
- E McGarvey
- Department of Psychiatric Medicine, University of Virginia School of Medicine, Charlottesville,Virginia 22908, USA
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