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Nerlander L, Champezou L, Gomes Dias J, Aspelund G, Berlot L, Constantinou E, Díaz A, Epštein J, Fogarassy E, Hernando V, Hoffmann P, Igoe D, Klavs I, Pinto Leite P, Liitsola K, McIntyre A, Molnár Z, Olsen AO, Pires-Afonso Y, Putniņa R, Rudaitis K, Siakallis G, de Stoppelaar S, Suligoi B, Hannila-Handelberg T, Velicko I, Cabral Veríssimo V, Visser M, Wessman M, Mårdh O. Sharp increase in gonorrhoea notifications among young people, EU/EEA, July 2022 to June 2023. Euro Surveill 2024; 29:2400113. [PMID: 38456219 PMCID: PMC10986672 DOI: 10.2807/1560-7917.es.2024.29.10.2400113] [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: 02/20/2024] [Accepted: 03/06/2024] [Indexed: 03/09/2024] Open
Abstract
Gonorrhoea cases increased steeply in women aged 20 to 24 years across 15 EU/EEA countries in July to December 2022 and January to June 2023 with, respectively, 73% and 89% more cases reported than expected, based on historical data from 2015 to 2019. Smaller increases among men due to heterosexual transmission were observed in nine EU/EEA countries. Interventions to raise awareness among young people about sexually transmitted infection risks are needed, emphasising the benefit of safe sexual practices and testing.
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Affiliation(s)
- Lina Nerlander
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Lydia Champezou
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Joana Gomes Dias
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Gudrun Aspelund
- Centre for Health Security and Communicable Disease Control, Directorate of Health, Reykjavik, Iceland
| | - Lina Berlot
- Communicable Diseases Centre, National Institute of Public Health, Ljubljana, Slovenia
| | | | - Asunción Díaz
- National Centre of Epidemiology, CIBER in Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
| | - Jevgenia Epštein
- Department of Communicable Diseases Epidemiology Health Board, Tallinn, Estonia
| | - Erika Fogarassy
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Victoria Hernando
- National Centre of Epidemiology, CIBER in Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
| | - Patrick Hoffmann
- Health Directorate Luxembourg, Division de l'inspection sanitaire, Luxembourg, Luxembourg
| | - Derval Igoe
- HSE Public Health: National Health Protection Office, Dublin, Ireland
| | - Irena Klavs
- Communicable Diseases Centre, National Institute of Public Health, Ljubljana, Slovenia
| | - Pedro Pinto Leite
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | - Kirsi Liitsola
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Angeline McIntyre
- HSE Public Health: National Health Protection Office, Dublin, Ireland
| | - Zsuzsanna Molnár
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Anne Olaug Olsen
- Department of Infection Control and Vaccine, Norwegian Institute of Public Health, Oslo, Norway
| | - Yolanda Pires-Afonso
- Health Directorate Luxembourg, Division de l'inspection sanitaire, Luxembourg, Luxembourg
| | - Renāte Putniņa
- The Centre for Disease Prevention and Control, Riga, Latvia
| | | | | | | | - Barbara Suligoi
- National AIDS Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Inga Velicko
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Vítor Cabral Veríssimo
- Public Health Unit Cascais, Western Lisbon Local Health Unit, Lisbon, Portugal
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | - Maartje Visser
- Rijksinstituut voor Volksgezondheid en Milieu, Bilthoven, the Netherlands
| | - Maria Wessman
- Department of Infectious Disease Epidemiology and Prevention Statens Serum Institut, Copenhagen, Denmark
| | - Otilia Mårdh
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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O'Malley A, McIntyre A, McGilloway A, Doherty A, Hallahan B. The impact of the COVID-19 pandemic on presentations of self-harm over an 18-month period to a tertiary hospital. Ir J Psychol Med 2023; 40:418-423. [PMID: 36794350 DOI: 10.1017/ipm.2023.9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVES To examine and compare rates and methods of self-harm presenting to a tertiary referral hospital during an 18-month period since the onset of the COVID-19 pandemic with a similar period immediately prior to the pandemic onset. METHODS Data from an anonymized database compared rates of self-harm presentations and methods employed between 1st March 2020 and 31st August 2021 to a similar time-frame prior to the onset of the COVID-19 pandemic. RESULTS A 9.1% increase in presentations with self-harm was noted since the onset of the COVID-19 pandemic. Periods of more stringent restrictions were associated with higher levels of self-harm (daily rate of 2.10 v 0.77). A higher lethality of attempt was demonstrated post-COVID-19 onset (χ2 = 15.38, p < 0.001). Fewer individuals presenting with self-harm were diagnosed with an adjustment disorder since the onset of the COVID-19 pandemic (n = 84, 11.1%, v. n = 112, 16.2%, χ2 = 7.898, p = 0.005), with no other differences pertaining to psychiatric diagnosis noted. More patients actively engaged with mental health services (MHS) presented with self-harm (n = 239 (31.7%) v. n = 137, (19.8%), χ2 = 40.798, p ≤ 0.001) since the onset of the COVID-19 pandemic. CONCLUSIONS Despite an initial reduction, an increase in rates of self-harm has occurred since the onset of the COVID-19 pandemic with higher rates evident during periods of higher government mandated restrictions. An increase in active patients of MHS presenting with self-harm potentially relates to reduced availability of supports and particularly group activities. The recommencement of group therapeutic interventions for individuals attending MHS in particular is warranted.
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Affiliation(s)
- A O'Malley
- School of Medicine, University of Galway, Galway, Ireland
| | - A McIntyre
- School of Medicine, University of Galway, Galway, Ireland
| | - A McGilloway
- School of Medicine, University of Galway, Galway, Ireland
| | - A Doherty
- Department of Psychiatry, University College Dublin, Dublin, Ireland
- Department of Psychiatry, Mater Hospital, Dublin, Ireland
| | - B Hallahan
- School of Medicine, University of Galway, Galway, Ireland
- Galway-Roscommon Mental Health Services, University Hospital Galway, Galway, Ireland
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Murphy PT, Clogher L, van Laar A, O'Regan R, McManus S, McIntyre A, O'Connell A, Geraghty M, Henry G, Hallahan B. The impact of service user's suicide on mental health professionals. Ir J Psychol Med 2022; 39:74-84. [PMID: 30777583 DOI: 10.1017/ipm.2019.4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Our principle objective was to examine the personal and professional impact of service user (SU) suicide on mental health professionals (MHPs). We also wished to explore putative demographic or clinical factors relating to SUs or MPHs that could influence the impact of SU suicide for MHPs and explore factors MHPs report as helpful in reducing distress following SU suicide. METHODS A mixed-method questionnaire with quantitative and thematic analysis was utilised. RESULTS Quantitative data indicated SU suicide was associated with personal and professional distress with sadness (79.5%), shock (74.5%) and surprise (68.7%) particularly evident with these phenomena lasting less than a year for more than 90% of MHPs. MHPs also reported guilt, reduced self-confidence and a fear of negative publicity. Thematic analysis indicated that some MHPs had greater expertise when addressing SU suicidal ideation and in supporting colleagues after experiencing a SU suicide. Only 17.7% of MHPs were offered formal support following SU suicide. CONCLUSION SU suicide impacts MHPs personally and professionally in both a positive and negative fashion. A culture and clear pathway of formal support for MHPs to ascertain the most appropriate individualised support dependent on the distress they experience following SU suicide would be optimal.
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Affiliation(s)
- P T Murphy
- Galway Mental Health Service, HSE West, Health Centre, Brackernagh, Ballinasloe, Galway, Ireland
- Department of Psychology, HSE West, Merlin Park University Hospital, Galway, Ireland
- Department of Psychiatry, University Hospital Galway, Galway, Ireland
| | - L Clogher
- Department of Psychology, HSE West, Merlin Park University Hospital, Galway, Ireland
| | - A van Laar
- Department of Liaison Psychiatry, University Hospital Galway, Galway, Ireland
| | - R O'Regan
- Child and Adolescent Mental Health Services, Inpatient Unit, Merlin Park Hospital Galway, Galway, Ireland
| | - S McManus
- Department of Psychology, HSE West, Merlin Park University Hospital, Galway, Ireland
| | - A McIntyre
- Department of Psychiatry, University Hospital Galway, Galway, Ireland
| | - A O'Connell
- Department of Psychology, HSE West, Merlin Park University Hospital, Galway, Ireland
| | - M Geraghty
- Department of Psychiatry, University Hospital Galway, Galway, Ireland
| | - G Henry
- Department of Psychiatry, University Hospital Galway, Galway, Ireland
| | - B Hallahan
- Department of Psychiatry, University Hospital Galway, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
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McIntyre A, Singh A. M247 KWASHIORKOR AND ORAL AVERSION SECONDARY TO FOOD ALLERGY TESTING PERFORMED FOR ATOPIC DERMATITIS. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.376] [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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Nanayakkara K, Piccorelli A, McIntyre A, Shamloo N, Nick J. 170: Cystic fibrosis–specific FEV1 to classify pulmonary function severity crossover. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01595-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lazarte J, Wang J, Robinson J, Dron J, McIntyre A, Cao H, Laksman Z, Hegele R, Roberts J. RARE LOSS-OF-FUNCTION VARIANT ANALYSIS IN LONE ATRIAL FIBRILLATION. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.304] [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: 11/30/2022] Open
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Alfardus H, de los Angeles Estevez Cebrero M, Rawlinson J, Lourdusamy A, Grundy R, McIntyre A, Smith S. P04.09 MicroRNA analysis of the invasive margin of Glioblastoma reveals druggable therapeutic targets in lipid metabolism pathways. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.243] [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: 11/13/2022] Open
Affiliation(s)
- H Alfardus
- University of Nottingham, Nottingham, United Kingdom
| | | | - J Rawlinson
- University of Nottingham, Nottingham, United Kingdom
| | - A Lourdusamy
- University of Nottingham, Nottingham, United Kingdom
| | - R Grundy
- University of Nottingham, Nottingham, United Kingdom
| | - A McIntyre
- University of Nottingham, Nottingham, United Kingdom
| | - S Smith
- University of Nottingham, Nottingham, United Kingdom
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Iacocca M, Wang J, Dron J, Cao H, Robinson J, McIntyre A, Hegele R. DNA copy number variation screening in familial hypercholesterolemia-related genes. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lisboa da Motta L, Ledaki I, Haider S, De Bastiani M, Baban D, Stefan K, Klamt F, Heery D, Harris A, McIntyre A. PO-276 Histone acetylation readers BET in hypoxia adaptation in triple negative breast cancer (TNBC). ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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10
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Bhat S, Polos PG, Gupta D, Akel O, Akhtar S, McIntyre A, Ming S, DeBari VA. 0538 CPAP TREATMENT IMPROVES LAPSE COUNT ON PSYCHOMOTOR VIGILANCE TASK TESTING IN PATIENTS WITH OSA: RESULTS OF A PILOT STUDY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sharpe SA, White AD, Sibley L, Gleeson F, Hall GA, Basaraba RJ, McIntyre A, Clark SO, Gooch K, Marsh PD, Williams A, Dennis MJ. An aerosol challenge model of tuberculosis in Mauritian cynomolgus macaques. PLoS One 2017; 12:e0171906. [PMID: 28273087 PMCID: PMC5342172 DOI: 10.1371/journal.pone.0171906] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/27/2017] [Indexed: 11/21/2022] Open
Abstract
Background New interventions for tuberculosis are urgently needed. Non-human primate (NHP) models provide the most relevant pre-clinical models of human disease and play a critical role in vaccine development. Models utilising Asian cynomolgus macaque populations are well established but the restricted genetic diversity of the Mauritian cynomolgus macaques may be of added value. Methods Mauritian cynomolgus macaques were exposed to a range of doses of M. tuberculosis delivered by aerosol, and the outcome was assessed using clinical, imaging and pathology-based measures. Results All macaques developed characteristic clinical signs and disease features of tuberculosis (TB). Disease burden and the ability to control disease were dependent on exposure dose. Mauritian cynomolgus macaques showed less variation in pulmonary disease burden and total gross pathology scores within exposure dose groups than either Indian rhesus macaques or Chinese cynomolgus macaques Conclusions The genetic homogeneity of Mauritian cynomolgus macaques makes them a potentially useful model of human tuberculosis.
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Affiliation(s)
- S. A. Sharpe
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
- * E-mail:
| | - A. D. White
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - L. Sibley
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - F. Gleeson
- The Churchill Hospital, Headington, Oxford, United Kingdom
| | - G. A. Hall
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - R. J. Basaraba
- Department of Microbiology Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
| | - A. McIntyre
- The Churchill Hospital, Headington, Oxford, United Kingdom
| | - S. O. Clark
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - K. Gooch
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - P. D. Marsh
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - A. Williams
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - M. J. Dennis
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
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da Motta LL, Ledaki I, Purshouse K, Haider S, De Bastiani MA, Baban D, Morotti M, Steers G, Wigfield S, Bridges E, Li JL, Knapp S, Ebner D, Klamt F, Harris AL, McIntyre A. The BET inhibitor JQ1 selectively impairs tumour response to hypoxia and downregulates CA9 and angiogenesis in triple negative breast cancer. Oncogene 2017; 36:122-132. [PMID: 27292261 PMCID: PMC5061082 DOI: 10.1038/onc.2016.184] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 03/22/2016] [Accepted: 04/15/2016] [Indexed: 12/16/2022]
Abstract
The availability of bromodomain and extra-terminal inhibitors (BETi) has enabled translational epigenetic studies in cancer. BET proteins regulate transcription by selectively recognizing acetylated lysine residues on chromatin. BETi compete with this process leading to both downregulation and upregulation of gene expression. Hypoxia enables progression of triple negative breast cancer (TNBC), the most aggressive form of breast cancer, partly by driving metabolic adaptation, angiogenesis and metastasis through upregulation of hypoxia-regulated genes (for example, carbonic anhydrase 9 (CA9) and vascular endothelial growth factor A (VEGF-A). Responses to hypoxia can be mediated epigenetically, thus we investigated whether BETi JQ1 could impair the TNBC response induced by hypoxia and exert anti-tumour effects. JQ1 significantly modulated 44% of hypoxia-induced genes, of which two-thirds were downregulated including CA9 and VEGF-A. JQ1 prevented HIF binding to the hypoxia response element in CA9 promoter, but did not alter HIF expression or activity, suggesting some HIF targets are BET-dependent. JQ1 reduced TNBC growth in vitro and in vivo and inhibited xenograft vascularization. These findings identify that BETi dually targets angiogenesis and the hypoxic response, an effective combination at reducing tumour growth in preclinical studies.
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Affiliation(s)
- L L da Motta
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- Department of Biochemistry/UFRGS, Porto Alegre, Brazil
- CAPES Foundation, Ministry of Education of Brazil, Brasilia, Brazil
| | - I Ledaki
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - K Purshouse
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - S Haider
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | | | - D Baban
- High Throughput Genomics, Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - M Morotti
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - G Steers
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - S Wigfield
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - E Bridges
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - J-L Li
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- Institute of Translational and Stratified Medicine, Plymouth University, Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - S Knapp
- Nuffield Department of Clinical Medicine, Structural Genomics Consortium, University of Oxford, Oxford, UK
- Goethe University Frankfurt, Institute for Pharmaceutical Chemistry and Buchmann Institute for Life Sciences, Campus Riedberg, Frankfurt, Germany
| | - D Ebner
- Nuffield Department of Medicine, Target Discovery Institute (TDI), University of Oxford, Oxford, UK
| | - F Klamt
- Department of Biochemistry/UFRGS, Porto Alegre, Brazil
| | - A L Harris
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - A McIntyre
- Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- Cancer Biology, Division of Cancer and Stem Cells, The University of Nottingham, Nottingham, UK
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Sharpe S, White A, Sarfas C, Sibley L, Gleeson F, McIntyre A, Basaraba R, Clark S, Hall G, Rayner E, Williams A, Marsh PD, Dennis M. Alternative BCG delivery strategies improve protection against Mycobacterium tuberculosis in non-human primates: Protection associated with mycobacterial antigen-specific CD4 effector memory T-cell populations. Tuberculosis (Edinb) 2016; 101:174-190. [PMID: 27865390 PMCID: PMC5120991 DOI: 10.1016/j.tube.2016.09.004] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/11/2016] [Indexed: 12/01/2022]
Abstract
Intradermal (ID) BCG injection provides incomplete protection against TB in humans and experimental models. Alternative BCG vaccination strategies may improve protection in model species, including rhesus macaques. This study compares the immunogenicity and efficacy of BCG administered by ID and intravenous (IV) injection, or as an intratracheal mucosal boost (ID + IT), against aerosol challenge with Mycobacterium tuberculosis Erdman strain. Disease pathology was significantly reduced, and survival improved, by each BCG vaccination strategy, relative to unvaccinated animals. However, IV induced protection surpassed that achieved by all other routes, providing an opportunity to explore protective immunological mechanisms using antigen-specific IFN-γ ELISpot and polychromatic flow cytometry assays. IFN-γ spot forming units and multifunctional CD4 T-cell frequencies increased significantly following each vaccination regimen and were greatest following IV immunisation. Vaccine-induced multifunctional CD4 T-cells producing IFN-γ and TNF-α were associated with reduced disease pathology following subsequent M.tb challenge; however, high frequencies of this population following M.tb infection correlated with increased pathology. Cytokine producing T-cells primarily occupied the CD4 transitional effector memory phenotype, implicating this population as central to the mycobacterial response, potentially contributing to the stringent control observed in IV vaccinated animals. This study demonstrates the protective efficacy of IV BCG vaccination in rhesus macaques, offering a valuable tool for the interrogation of immunological mechanisms and potential correlates of protection.
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Affiliation(s)
- S Sharpe
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK.
| | - A White
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - C Sarfas
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - L Sibley
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - F Gleeson
- Churchill Hospital, Headington, Oxford, UK
| | - A McIntyre
- Churchill Hospital, Headington, Oxford, UK
| | - R Basaraba
- Colorado State University, Fort Collins, CO, USA
| | - S Clark
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - G Hall
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - E Rayner
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - A Williams
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - P D Marsh
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - M Dennis
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
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14
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Ballingall K, McIntyre A, Lin Z, McInnes CJ. P6054 Limited MHC diversity and an exotic virus may have contributed to the decline of red squirrels in the United Kingdom. J Anim Sci 2016. [DOI: 10.2527/jas2016.94supplement4175a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gilhooly KJ, Gilhooly MLM, Sullivan MP, McIntyre A, Wilson L, Harding E, Woodbridge R, Crutch S. A meta-review of stress, coping and interventions in dementia and dementia caregiving. BMC Geriatr 2016; 16:106. [PMID: 27193287 PMCID: PMC4872341 DOI: 10.1186/s12877-016-0280-8] [Citation(s) in RCA: 212] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 05/09/2016] [Indexed: 01/08/2023] Open
Abstract
Background There has been a substantial number of systematic reviews of stress, coping and interventions for people with dementia and their caregivers. This paper provides a meta-review of this literature 1988-2014. Method A meta-review was carried out of systematic reviews of stress, coping and interventions for people with dementia and their caregivers, using SCOPUS, Google Scholar and CINAHL Plus databases and manual searches. Results The meta-review identified 45 systematic reviews, of which 15 were meta-analyses. Thirty one reviews addressed the effects of interventions and 14 addressed the results of correlational studies of factors associated with stress and coping. Of the 31 systematic reviews dealing with intervention studies, 22 focused on caregivers, 6 focused on people with dementia and 3 addressed both groups. Overall, benefits in terms of psychological measures of mental health and depression were generally found for the use of problem focused coping strategies and acceptance and social-emotional support coping strategies. Poor outcomes were associated with wishful thinking, denial, and avoidance coping strategies. The interventions addressed in the systematic reviews were extremely varied and encompassed Psychosocial, Psychoeducational, Technical, Therapy, Support Groups and Multicomponent interventions. Specific outcome measures used in the primary sources covered by the systematic reviews were also extremely varied but could be grouped into three dimensions, viz., a broad dimension of “Psychological Well-Being v. Psychological Morbidity” and two narrower dimensions of “Knowledge and Coping” and of “Institutionalisation Delay”. Conclusions This meta-review supports the conclusion that being a caregiver for people with dementia is associated with psychological stress and physical ill-health. Benefits in terms of mental health and depression were generally found for caregiver coping strategies involving problem focus, acceptance and social-emotional support. Negative outcomes for caregivers were associated with wishful thinking, denial and avoidance coping strategies. Psychosocial and Psychoeducational interventions were beneficial for caregivers and for people with dementia. Support groups, Multicomponent interventions and Joint Engagements by both caregivers and people with dementia were generally found to be beneficial. It was notable that virtually all reviews addressed very general coping strategies for stress broadly considered, rather than in terms of specific remedies for specific sources of stress. Investigation of specific stressors and remedies would seem to be a useful area for future research. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0280-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- K J Gilhooly
- Department of Clinical Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.
| | - M L M Gilhooly
- Department of Clinical Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - M P Sullivan
- Department of Clinical Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - A McIntyre
- Department of Clinical Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - L Wilson
- Department of Clinical Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - E Harding
- Department of Clinical Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.,Dementia Research Centre, Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - R Woodbridge
- Department of Clinical Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - S Crutch
- Dementia Research Centre, Institute of Neurology, University College London, London, WC1N 3BG, UK
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Ballingall KT, McIntyre A, Lin Z, Timmerman N, Matthysen E, Lurz PW, Melville L, Wallace A, Meredith AL, Romeo C, Wauters LA, Sainsbury AW, McInnes CJ. Limited diversity associated with duplicated class II MHC-DRB genes in the red squirrel population in the United Kingdom compared with continental Europe. CONSERV GENET 2016. [DOI: 10.1007/s10592-016-0852-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Affiliation(s)
- C. Kwok
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
| | - A. McIntyre
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
| | - S. Janzen
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
| | - R. Mays
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
| | - R. Teasell
- Aging, Rehabilitation and Geriatric Care; Lawson Health Research Institute; St. Joseph's Parkwood Hospital; London ON Canada
- Department of Physical Medicine and Rehabilitation; Schulich School of Medicine and Dentistry; Western University; London ON Canada
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Harris AL, Buffa FM, Haider S, Bensaad K, McIntyre A, Lord S, Mehta S, Choudhry H, Favaro E, Ledaki I, Singleton D. Abstract BS02-1: Hypoxia metabolism in breast cancer – How to overcome resistance to anti-angiogenic therapy. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-bs02-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. Hypoxia is recognised to induce a multigene programme mainly via HIF1a and also HIF2a transcription factors. Bioinformatics analysis of multiple gene array data sets in breast cancer showed a core hypoxia response programme of approximately 90 genes associated with poor outcome independently of other factors. This core response was significantly over-expressed in triple receptor negative cancers. Additionally, microRNAs associated with hypoxia were shown to give additional worse prognosis associations (mir-210). mir-210 targeted the mitochondrial iron chaperone responsible for regulation of key enzymes in the Krebs cycle and showed an adaptive response to hypoxia involving switching off the mitochondrial metabolism.
Aims and methods. To assess in human breast cancer the hypoxia transcriptome we conducted gene microarray studies before and after 2 weeks of bevacizumab 15mg/kg single dose before neoadjuvant chemotherapy. This was correlated with imaging by DCE-MRI Ktrans analysis.
Results. The study showed that high Ktrans was an excellent predictor for the biological affect of VEGF inhibition and extensive gene induction occurred, including many components of the HIF pathway, but also glycogen metabolism and lipid metabolism.
We investigated these further in xenograft models to see which of the adaption pathways may be most important for survival under hypoxic conditions. We showed that induction of CA9, a key enzyme regulating extracellular pH, was critical for survival under anti-angiogenic therapy and blocking CA9 could synergise and also produce radiosensitivity. Reactivating mitochondria under hypoxic conditions induced by angiogenesis also showed additional anti-cancer benefits and is the basis now for a new phase I study in our department.
Additionally, surprisingly, induction of glycogen and lipid storage occurred and this was essential for survival on reoxygenation and for protection against free radical damage, which greatly increased when either pathway was inhibited.
We investigated, by bioinformatic approaches, the expression of 133 key enzymes in metabolism, showed that they were strongly associated with different subtypes of breast cancer, which may help in selection of patients for future intervention studies.
To additionally define the hypoxia transcription, we conducted RNA sequencing of MCF7 cells in normoxia and mild hypoxia. This revealed marked induction of many long non-coding RNAs, suppression of all transfer RNAs and induction of novel antisense RNAs.
Conclusions. Overall, therefore, although anti-angiogenic therapy alone is now withdrawn from clinical utility in breast cancer, the massive induction of hypoxic microenvironment and synergy with many other therapeutics, suggests that as new approach using induced essentiality should be reassessed in breast cancer.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr BS02-1.
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Affiliation(s)
- AL Harris
- Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
| | - FM Buffa
- Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
| | - S Haider
- Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
| | - K Bensaad
- Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
| | - A McIntyre
- Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
| | - S Lord
- Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
| | - S Mehta
- Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
| | - H Choudhry
- Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
| | - E Favaro
- Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
| | - I Ledaki
- Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
| | - D Singleton
- Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
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Abstract
Hypotheses about the relationship between anxiety and affiliation derived from the psychoanalytic, drive, and social comparison models were tested by exposing high anxious (HA) and low anxious (LA)Ss to stress and subsequently to conditions meant to fulfill either nurturance or information needs. Unstressed and non-need fulfilled control groups were included. (N=224 grade school children.) Stress significantly increased the strength of adult affiliating in HA Ss; nurturance reduced it. Peer affiliating was not influenced by stress or information, nor did the conditions affect the affiliation of LASs. Results supported the hypothesis that dependency motives mediate the anxiety-affiliation relationship.
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Rayner E, Pearson G, Hall G, Basaraba R, Gleeson F, McIntyre A, Clark S, Williams A, Dennis M, Sharpe S. Early Lesions Following Aerosol Infection of Rhesus Macaques (Macaca mulatta) with Mycobacterium tuberculosis Strain H37RV. J Comp Pathol 2013; 149:475-85. [DOI: 10.1016/j.jcpa.2013.05.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 04/09/2013] [Accepted: 05/18/2013] [Indexed: 11/15/2022]
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Othman MH, Mcintyre A, Gallagher L. West J Med 2012; 344:e1767-e1767. [DOI: 10.1136/bmj.e1767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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22
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Gilbert DC, Chandler I, Summersgill B, McIntyre A, Missiaglia E, Goddard NC, Huddart RA, Shipley J. Genomic gain and over expression of CCL2 correlate with vascular invasion in stage I non-seminomatous testicular germ-cell tumours. ACTA ACUST UNITED AC 2011; 34:e114-21; discussion e121. [DOI: 10.1111/j.1365-2605.2011.01161.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Sharpe SA, McShane H, Dennis MJ, Basaraba RJ, Gleeson F, Hall G, McIntyre A, Gooch K, Clark S, Beveridge NER, Nuth E, White A, Marriott A, Dowall S, Hill AVS, Williams A, Marsh PD. Establishment of an aerosol challenge model of tuberculosis in rhesus macaques and an evaluation of endpoints for vaccine testing. Clin Vaccine Immunol 2010; 17:1170-82. [PMID: 20534795 PMCID: PMC2916246 DOI: 10.1128/cvi.00079-10] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 04/06/2010] [Accepted: 06/01/2010] [Indexed: 01/19/2023]
Abstract
The establishment of an aerosol challenge model in nonhuman primates (NHPs) for the testing of vaccines against Mycobacterium tuberculosis would assist the global effort to optimize novel vaccination strategies. The endpoints used in preclinical challenge studies to identify measures of disease burden need to be accurate and sensitive enough to distinguish subtle differences and benefits afforded by different tuberculosis (TB) vaccine regimens when group sizes are inevitably small. This study sought to assess clinical and nonclinical endpoints as potentially sensitive measures of disease burden in a challenge study with rhesus macaques by using a new protocol of aerosol administration of M. tuberculosis. Immunological and clinical readouts were assessed for utility in vaccine evaluation studies. This is the first example of TB vaccine evaluation with rhesus macaques where long-term survival was one of the primary endpoints. However, we found that in NHP vaccine efficacy studies with maximum group sizes of six animals, survival did not provide a valuable endpoint. Two approaches used in human clinical trials for the evaluation of the gamma interferon (IFN-gamma) response to vaccination (enzyme-linked immunospot [ELISpot] assay and enzyme-linked immunosorbent assay [ELISA]) were included in this study. The IFN-gamma profiles induced following vaccination were found not to correlate with protection, nor did the level of purified protein derivative (PPD)-specific proliferation. The only readout to reliably distinguish vaccinated and unvaccinated NHPs was the determination of lung lesion burden using magnetic resonance (MR) imaging combined with stereology at the end of the study. Therefore, the currently proposed key markers were not shown to correlate with protection, and only imaging offered a potentially reliable correlate.
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Affiliation(s)
- S A Sharpe
- Health Protection Agency, Centre for Emergency Preparedness and Response, Porton Down, Salisbury, United Kingdom.
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24
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Goddard NC, McIntyre A, Gilbert D, Kitazawa S, Shipley J. No evidence for V600E BRAF mutation in the seminoma cell line TCam-2. Genes Chromosomes Cancer 2010; 49:963-6. [DOI: 10.1002/gcc.20799] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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MacLeod N, McIntyre A, Canney P. What are the minimal standards of radiotherapy planning and dosimetry for “hypofractionated” radiotherapy in breast cancer? Breast 2010; 19:172-5. [DOI: 10.1016/j.breast.2010.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Sharpe SA, Eschelbach E, Basaraba RJ, Gleeson F, Hall GA, McIntyre A, Williams A, Kraft SL, Clark S, Gooch K, Hatch G, Orme IM, Marsh PD, Dennis MJ. Determination of lesion volume by MRI and stereology in a macaque model of tuberculosis. Tuberculosis (Edinb) 2009; 89:405-16. [PMID: 19879805 DOI: 10.1016/j.tube.2009.09.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Revised: 09/03/2009] [Accepted: 09/06/2009] [Indexed: 10/20/2022]
Abstract
Sensitive and reproducible methods are needed to measure the impact on the host following experimental challenge with Mycobacterium tuberculosis, in order to determine the degree of protection conferred by new vaccines. Here we compare how well different clinical and post-mortem measures of disease burden predict the response by the host to increasing doses of M. tuberculosis in rhesus and cynomolgus macaques. The total lung and lesion volume was quantified from magnetic resonance imaging (MRI) digital stacks obtained from lungs of M. tuberculosis infected animals that were formalin fixed and scanned ex-vivo. The total lung lesion volume relative to the fixed whole lung volume was superior at indicating disease burden when compared to thoracic radiography, pathology scores, changes in body weight and temperature, as well as erythrocyte haemoglobin concentrations and sedimentation rate. The total lesion volume accurately reflected differences in challenge doses of M. tuberculosis that ranged from 30 to 500 CFU delivered by aerosol. The determination of total lesion volume from MR images demonstrated a species-dependent difference between rhesus and cynomolgus macaques in susceptibility to M. tuberculosis infection. MR stereology provides an accurate, quantifiable and relatively simple assessment, which can be easily standardized between laboratories and should form an essential component of the clinical assessment of disease progression, or vaccine efficacy.
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Affiliation(s)
- S A Sharpe
- Health Protection Agency, Centre for Emergency Preparedness and Response, Porton Down, Salisbury, SP4 0JG, UK.
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Gilbert DC, Chandler I, McIntyre A, Goddard NC, Gabe R, Huddart RA, Shipley J. Clinical and biological significance of CXCL12 and CXCR4 expression in adult testes and germ cell tumours of adults and adolescents. J Pathol 2009; 217:94-102. [PMID: 18839394 DOI: 10.1002/path.2436] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Interaction between the chemokine CXCL12 (SDF1) and the G-protein coupled receptor CXCR4 is responsible for the maintenance of adult stem cell niches and is known to play an important role in utero in the migration of primordial germ cells. We demonstrate expression of CXCL12 by Sertoli cells and confirm CXCR4 expression by the germ cell population of the adult human testes. CXCR4 is also known to mediate organ-specific patterns of metastases in a range of common cancers. We identify consistent expression of CXCR4 mRNA and protein in testicular germ cell tumours (TGCT) that accounts for their patterns of relapse in sites of known CXCL12 expression. Extragonadal primary germ cell tumours express CXCR4 and their sites of occurrence are coincident with areas of known CXCL12 expression in utero. We show that CXCL12 stimulates the invasive migration of a TGCT cell line in vitro in a CXCR4-dependent fashion and activates ERK. Furthermore, we demonstrate that expression of CXCL12 in stage I non-seminomas is significantly associated with organ-confined disease post-orchidectomy and reduced risk of relapse (p = 0.003). This may be through the loss of CXCL12 gradients that might otherwise attract cells away from the primary tumour. We propose CXCL12 expression as a potential predictor of subsequent relapse that could lead to avoiding unnecessary treatment and associated late toxicities. Our observations support a role for CXCL12/CXCR4 in the adult germ cell population and demonstrate pathological function in germ cell tumour development and metastasis that may have clinical utility.
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Affiliation(s)
- D C Gilbert
- Molecular Cytogenetics, Section of Molecular Carcinogenesis, Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
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Stoop H, Honecker F, van de Geijn GJM, Gillis AJM, Cools MC, de Boer M, Bokemeyer C, Wolffenbuttel KP, Drop SLS, de Krijger RR, Dennis N, Summersgill B, McIntyre A, Shipley J, Oosterhuis JW, Looijenga LHJ. Stem cell factor as a novel diagnostic marker for early malignant germ cells. J Pathol 2008; 216:43-54. [PMID: 18566970 DOI: 10.1002/path.2378] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Carcinoma in situ (CIS) of the testis is the pre-invasive stage of type II testicular germ cell tumours (TGCTs) of adolescents and adults. These tumours are the most frequently diagnosed cancer in Caucasian adolescents and young adults. In dysgenetic gonads, the precursor of type II GCTs can be either CIS or a lesion known as gonadoblastoma (GB). CIS/GB originates from a primordial germ cell (PGC)/gonocyte, ie an embryonic cell. CIS can be cured by local low-dose irradiation, with limited side effects on hormonal function. Therefore, strategies for early diagnosis of CIS are essential. Various markers are informative to diagnose CIS in adult testis by immunohistochemistry, including c-KIT, PLAP, AP-2gamma, NANOG, and POU5F1 (OCT3/4). OCT3/4 is the most informative and consistent in presence and expression level, resulting in intense nuclear staining. In the case of maturational delay of germ cells, frequently present in gonads of individuals at risk for type II (T)GCTs, use of these markers can result in overdiagnosis of malignant germ cells. This demonstrates the need for a more specific diagnostic marker to distinguish malignant germ cells from germ cells showing maturation delay. Here we report the novel finding that immunohistochemical detection of stem cell factor (SCF), the c-KIT ligand, is informative in this context. This was demonstrated in over 400 cases of normal (fetal, neonatal, infantile, and adult) and pathological gonads, as well as TGCT-derived cell lines, specifically in cases of CIS and GB. Both membrane-bound and soluble SCF were expressed, suggestive of an autocrine loop. SCF immunohistochemistry can be a valuable diagnostic tool, in addition to OCT3/4, to screen for precursor lesions of TGCTs, especially in patients with germ cell maturation delay.
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Affiliation(s)
- H Stoop
- Department of Pathology, Erasmus MC-Erasmus University Medical Center, Daniel den Hoed Cancer Center, Josephine Nefkens Institute, Rotterdam, The Netherlands
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O'Toole P, Butt A, Orakzai S, McIntyre A, Callender O, Kingston R, Moore D, Fogarty E, Dowling F. Epidemiology of sporting and recreational injuries in a paediatric orthopaedic outpatients department. Ir Med J 2008; 101:173-174. [PMID: 18700510] [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: 05/26/2023]
Abstract
Knowledge of the number and type of injuries attending the paediatric orthopaedic outpatients is crucial in the future planning of any new paediatric hospital. We prospectively collected data on all new patients attending two paediatric orthopaedic out-patients departments, over a four month period. There were a total of 1,791 completed questionnaires. Sporting and recreational injuries represented 270% and 28% of the total attending, respectively. The new use of heelies represented 11% of the recreational injuries. The upper limb injuries represented 74% of the total, with the lower limb accounting for 25%. Treatment was nonoperative or operative. The number of patients, and the types of injuries presenting demonstrates the workload involved in diagnosing and treating these injuries. A total of 827 casts were applied. With almost half of those attending the clinic requiring a cast, the workload on the plaster technicians is substantial, and has implications for future service planning.
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Affiliation(s)
- P O'Toole
- National Children's Hospital, Tallaght, Dublin.
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Lenehan B, Callender O, McIntyre A, Boran S, Moore D, Fogarty E, Dowling F. Heely injuries: a new epidemic warranting a government health warning! Injury 2007; 38:923-5. [PMID: 17239880 DOI: 10.1016/j.injury.2006.10.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 07/24/2006] [Revised: 10/24/2006] [Accepted: 10/26/2006] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Heelys, the new craze gripping the nation, were first introduced to Ireland in 2005 having been available in the United States since 2000. Designed as "the only shoe with a removable wheel in the sole" and initially marketed among rollerbladers and skateboarders they have been adopted by children as contemporary footwear. MATERIAL AND METHODS From April to June 2006, all patients presenting to trauma orthopaedic services at our institutions with injuries sustained while wearing Heelys were included in this study. RESULTS Thirty-nine patients are included in this study. The mean age was 9.1 years (range 7-13, median 9 years). Of the 39 patients referred to the orthopaedic service, 8 required admissions to hospital. One patient admitted following a head injury, required craniotomy and evacuation of an extradural haematoma. CONCLUSION The significance of the injuries encountered demonstrates the potentially devastating results from the use of Heelys. The public perception of safety is incorrect and manufacturers rightly recommend strongly the use of safety gear.
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Affiliation(s)
- B Lenehan
- National Children's Hospital, Tallaght, Dublin & Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
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Goddard NC, McIntyre A, Summersgill B, Gilbert D, Kitazawa S, Shipley J. KIT and RAS signalling pathways in testicular germ cell tumours: new data and a review of the literature. ACTA ACUST UNITED AC 2007; 30:337-48; discussion 349. [PMID: 17573850 DOI: 10.1111/j.1365-2605.2007.00769.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [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: 01/07/2023]
Abstract
Testicular germ cell tumours (TGCTs) are the leading cause of cancer deaths in young male Caucasians. Identifying changes in DNA copy number can pinpoint genes involved in tumour development. We defined the smallest overlapping regions of imbalance in TGCTs using array comparative genomic hybridization analysis. Novel regions, or regions which refined those previously reported, were identified. The expression profile of genes from 12p, which is invariably gained in TGCTs, and amplicons defined at 12p11.2-12.1 and 4q12, suggest KRAS and KIT involvement in TGCT and seminoma development, respectively. Amplification of these genes was not found in intratubular germ cell neoplasia adjacent to invasive disease showing these changes, suggesting their involvement in tumour progression. Activating mutations of RAS genes (KRAS or NRAS) and overexpression of KRAS were mutually exclusive events. These, correlations between the expression levels of KIT, KRAS and GRB7 (which encodes an adapter molecule known to interact with the KIT tyrosine kinase receptor) and other reported evidence reviewed here, are consistent with a role for activation of KIT and RAS signalling in TGCT development. In order to assess a role for KIT in seminomas, we modulated the level of KIT expression in TCam-2, a seminoma cell line. The likely seminomatous origin of this cell line was supported by demonstrating KIT and OCT3/4 overexpression and gain of 12p material. Reducing the expression of KIT in TCam-2 through RNA inhibition resulted in decreased cell viability. Further understanding of KIT and RAS signalling in TGCTs may lead to novel therapeutic approaches for these tumours.
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Affiliation(s)
- N C Goddard
- Molecular Cytogenetics, Section of Molecular Carcinogenesis, The Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK
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Abstract
Hermaphroditism was diagnosed in three, 6-month-old, male, chimeric mice generated by microinjection of 129/Ola XY recombinant embryonic stem cells into unsexed C57BL/6 blastocysts. Grossly, mice Nos. 1 and 2 had perigenital masses and hydrometra. All mice had unilateral ovaries and cystic endometrial hyperplasia. Mice Nos. 1 and 3 also had contralateral testes and epididymides. Histologically, mice Nos. 1 and 3 were true hermaphrodites with unilateral ovotestes, while mouse No. 2 was a pseudohermaphrodite with ovarian tissue only. The presence of a uterus with cystic endometrial hyperplasia in these mice resembles XY pseudohermaphroditism in miniature schnauzers. The mice were determined to be 95 to 100% chimeric via haircoat color; however, the presence of both male and female sex organs in these phenotypically male mice suggests otherwise. Published reports note incidences for sex chimeras and hermaphroditism in genetically engineered mice of 50% and 20%, respectively. Hermaphroditism is expected to increase as the numbers of chimeric mice rise with technical advances in genetic engineering.
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Affiliation(s)
- A McIntyre
- Tri-Institutional Training Program in Laboratory Animal Medicine and Science, Memorial Sloan-Kettering Cancer Center, Rockefeller University, Weill Medical College of Cornell University, New York, NY, USA
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Thomas S, Cantrill S, Waghorn DJ, McIntyre A. The role of screening and antibiotic prophylaxis in the prevention of percutaneous gastrostomy site infection caused by methicillin-resistant Staphylococcus aureus. Aliment Pharmacol Ther 2007; 25:593-7. [PMID: 17305760 DOI: 10.1111/j.1365-2036.2006.03242.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [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: 12/13/2022]
Abstract
BACKGROUND Peristomal wound infections are common complications of percutaneous endoscopic gastrostomy (PEG), especially in hospitals where methicillin-resistant Staphylococcus aureus (MRSA) is endemic. Evidence suggests that antibiotic prophylaxis at PEG insertion may reduce infection rates. AIM To examine rates of peristomal MRSA infection before and after introduction of a screening, decontamination and antibiotic prophylaxis protocol. METHODS Retrospective case analysis detected new peristomal MRSA infections over a 33-month period. Prospectively from October 2004, patients requiring PEG were screened and, if MRSA positive, received decontamination (5 days) and prophylactic teicoplanin before insertion. Peristomal wound sites were monitored after insertion. RESULTS Peristomal MRSA infection was identified in 5/42 patients (12%) in 2002, 7/35 (20%) in 2003 and 7/24 (29%) in 2004 -- overall infection rate 19%. Of 47 patients undergoing new PEG insertions between October 2004 and August 2006 (four known MRSA and 10 identified by screening), one (2%) developed peristomal MRSA infection 14 days postprocedure. A significant reduction in MRSA peristomal infection has been demonstrated (P < 0.01). CONCLUSIONS Screening for MRSA before PEG insertion identifies MRSA colonization and subsequent decontamination and antibiotic prophylaxis reduces peristomal MRSA infection rates. Where MRSA is endemic, the risk of wound site infection may remain postprocedure unless high standards of wound care are maintained.
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Affiliation(s)
- S Thomas
- Department of Microbiology/Infection Control, Wycombe Hospital, High Wycombe, Buckinghamshire, UK
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Tho LM, McIntyre A, Rosst A, Gallagher C, Yap C, Ritchie DM, Canney PA. Acute Supraclavicular Skin Toxicity in Patients Undergoing Radiotherapy for Breast Cancer: An Evaluation of the ‘T’-Grip Method of Patient Positioning. Clin Oncol (R Coll Radiol) 2006; 18:133-8. [PMID: 16523814 DOI: 10.1016/j.clon.2005.08.011] [Citation(s) in RCA: 1] [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] [Indexed: 10/25/2022]
Abstract
AIMS Supraclavicular fossa (SCF) radiotherapy plays an important part in the adjuvant management of breast cancer but data on acute radiotherapy toxicity are lacking, particularly when differing patient treatment positions are used to allow computed tomography planning or to reduce cardiac doses. MATERIALS AND METHODS We evaluated SCF and breast/chest wall acute skin toxicity in a cohort of 92 women with breast cancer, who were planned in a 'T'-grip (n = 72) or 90 degrees-grip (n = 20) position, while 'on treatment' and at 6 weeks. The modified Radiation Therapy Oncology Group (RTOG) criteria were used to score toxicity. Data on age, body mass index, smoking history, type of breast operation, prior chemotherapy, radiation dose, number of fields and field size were recorded and correlated with outcome. RESULTS Maximum SCF reaction score was RTOG 2a, with no moist desquamation observed. SCF reactions were less severe compared with chest wall reactions and no worse than breast reactions. There was significant resolution of toxicity at 6 weeks. SCF radiotherapy in 'T'-grip patients was well tolerated and no worse than the 90 degees-grip group. Pain scores and sore throat occurrences were minimal. Univariate and multivariate analyses showed that smoking was associated with worsening SCF toxicity (odds ratio [OR] 2.92; P = 0.045) and delayed healing. Incremental SCF dose worsened toxicity (OR 3.65; P = 0.023). Smoking worsened breast but not chest wall toxicity. CONCLUSIONS SCF radiotherapy was at least as well tolerated as breast radiotherapy and better tolerated than chest wall radiotherapy. The 'T'-grip position did not affect toxicity negatively. Smoking and radiation dose affected SCF toxicity.
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Affiliation(s)
- L M Tho
- Department of Clinical Oncology, Beatson Oncology Centre, Glasgow, UK.
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Cheng Immergluck L, Kanungo S, Schwartz A, McIntyre A, Schreckenberger PC, Diaz PS. Prevalence of Streptococcus pneumoniae and Staphylococcus aureus nasopharyngeal colonization in healthy children in the United States. Epidemiol Infect 2004; 132:159-66. [PMID: 15061489 PMCID: PMC2870090 DOI: 10.1017/s0950268803001791] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [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: 11/05/2022] Open
Abstract
This study documents the colonization of Staphylococcus aureus (SA), Streptococcus pneumoniae (SP) and specific resistant forms of these organisms among healthy children and identifies risk factors associated with these pathogens. Prospective point prevalence survey of nasopharyngeal specimens were obtained from 291 healthy children seeking routine well-child care at a university-based ambulatory paediatric clinic in a large urban city in the United States. A total of 291 children less than 5 years were enrolled during a 1-year period. Fifty-four (18.6%) were colonized with SA and 47 (16.2%) were colonized with SP. Among the 54 SA isolates, five (9.2%) were methicillin resistant (MRSA) and among the SP isolates, three (6.4%) were intermediate to penicillin (DRSP). Eighty per cent of all children enrolled reported no underlying medical condition. Care outside their home was more common among colonized (40.8%, 40/98) than non-colonized children (25.4%, 49/193), P=0.007. Healthy children from households of four or more people were also more likely to be colonized. The colonization rate of SA and SP among healthy children is consistent with what has been reported in the literature. The prevalence of MRSA and DRSP among healthy children colonized with SA or SP is low in this population of children attending a university-based ambulatory care centre in the United States.
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Kidwai BJ, Allen JD, Harbinson MT, McIntyre A, Anderson J, Adgey AA. Waveform optimization for internal atrial defibrillation: effects of waveform rounding, phase duration, and voltage swing. Pacing Clin Electrophysiol 2001; 24:1198-207. [PMID: 11523604 DOI: 10.1046/j.1460-9592.2001.01198.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 11/20/2022]
Abstract
The aim of this study was to compare the efficacy of internal atrial defibrillation by conventional truncated exponential biphasic waveforms with and without waveform rounding (1-2 phases) and to determine optimal duration for this novel double rounded waveform. Atrial fibrillation, induced by rapid electrical stimulation, was converted by internal shocks through defibrillation catheters (lateral right atrium and coronary sinus) in anesthetised sheep. Rounding the leading edges of the conventional biphasic waveform (Ventritex HVS-02; settings 100/-50 V, 150/-70 V, and 200/-100 V; n = 8) reduced delivered peak and trough voltages, currents, and energy (by > or = 21 %, P < 0.001; for double (both phases) rounded) without decreasing cardioversion success. At 100/-50 V the efficacy of single (first phase) rounded (53 +/- 13%; mean +/- SEM) and double rounded (59 +/- 11%) shocks was similar to the conventional waveform (56 +/- 14%). Double rounded waveform (phase durations 1-20 ms) efficacy was optimum at 6-10 ms phase duration (100% success at 10-ms phase duration; 1.52 +/- 0.04 J delivered energy; n = 6). Successful cardioversion by conventional, single rounded, and double rounded biphasic waveforms (duration 6 ms each phase), conventional monophasic, rounded monophasic (duration 12 ms), and a damped sine waveform correlated strongly with peak-to-trough voltage swing within the waveform (r = 0.882; P < 0.01; n = 8). For internal atrial defibrillation, rounding both phases of the conventional biphasic waveforms, the double rounded waveform, permits similar efficacy to the conventional truncated exponential biphasic waveform at reduced peak voltage, current, and delivered energy. Optimum phase duration is 6-10 ms (tested range 1-20 ms).
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Affiliation(s)
- B J Kidwai
- Regional Medical Cardiology Center, Royal Victoria Hospital, Belfast, Ireland
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Hall R, Adderley N, MacLaren C, McIntyre A, Barker R, Imrie D, Allen C, Glenn J, Fairhurst K, McLaren R. Does intrathecal morphine alter the stress response following coronary artery bypass grafting surgery? Can J Anaesth 2000; 47:463-6. [PMID: 10831205 DOI: 10.1007/bf03018978] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [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] Open
Abstract
PURPOSE Intrathecal morphine administered prior to coronary artery revascularization (CABG) surgery was studied to determine its effects on the stress response. METHODS In a single centre, open, randomized clinical trial, first time elective CABG surgery patients, < 75 yr, were studied. Control subjects (n=12) received a standardized anesthetic consisting of fentanyl (maximum cumulative dose of 35 microg x kg(-1)), propofol, and pancuronium. In addition, spinal subjects (n=13) received 1.0 mg (age > 60 yr) or 1.5 mg (age < or = 59 yr) intrathecal morphine prior to induction of anesthesia. Control subjects received continuous i.v. morphine at 2 mg x hr(-1) on arrival in the ICU with i.v. bolus morphine supplementation as required while spinal subjects received bolus i.v. morphine as required. Changes in plasma cortisol and catecholamine concentrations were measured preoperatively, poststernotomy, on admission to ICU, following tracheal extubation, at 0800 hr on the first postoperative day, and 24 and 48 hr after ICU admission. RESULTS No differences between groups were detected for demographic variables. The percent change in cortisol concentration relative to preoperative values (control vs spinal; (38 (87) vs -41 (46)%: P < 0.05)) was lower in the spinal group on admission to ICU. The percent change in plasma epinephrine levels (control vs spinal) on admission to ICU (285 (337) vs -10 (37)%) and 0800 hr after surgery (314 (341) vs -4 (37)%) was also significantly different. CONCLUSION Intrathecal morphine only partially attenuated the postsurgical stress response in CABG surgical patients.
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Affiliation(s)
- R Hall
- Department of Anesthesiology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
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Gibson PR, Nov R, Fielding M, McIntyre A, Finch CF, Rosella O, Mariadason JM, Barkla DH, Young GP. Relationship of hydrolase activities to epithelial cell turnover in distal colonic mucosa of normal rats. J Gastroenterol Hepatol 1999; 14:866-72. [PMID: 10535467 DOI: 10.1046/j.1440-1746.1999.01973.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 12/09/2022]
Abstract
BACKGROUND The relationships between changes induced by diet in colonic epithelial kinetics and in the activities of brush border hydrolases are poorly defined. The aims of this study are to define these relationships, as changes in kinetics would be expected to influence differentiation, and to determine whether the type of ingested dietary indigestible carbohydrates influences hydrolase activities. METHODS Groups of eight rats were fed a low fibre diet +/- supplements of different types of indigestible carbohydrates for 4 weeks. Alkaline phosphatase (ALP) and dipeptidyl peptidase IV (DPPIV) activities and epithelial kinetics were measured in distal colonic mucosa. RESULTS Median ALP activities correlated positively and DPPIV activity negatively with the median proportion of cells entering metaphase (r = 0.58 and -0.58, respectively; P < 0.05) and number of metaphase arrests per crypt column across the diets (r = 0.59 and 0.58, respectively; P < 0.05). Stepwise regression analysis showed that both hydrolases independently predicted these kinetic indices (R2 > 63% for each). Mucosal ALP activities were markedly elevated during consumption of raw potato starch, guar gum and methylcellulose, while only potato starch caused a significant elevation of DPPIV activities. CONCLUSIONS The type of indigestible carbohydrate in the diet influences colonic mucosal hydrolase activities. The opposite relationship between kinetics and each of the two hydrolases indicates that these hydrolases do not reflect the same event; dipeptidyl peptidase IV might relate to differentiation status while ALP could also be influenced by epithelial irritation due to changes in luminal conditions.
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Affiliation(s)
- P R Gibson
- University of Melbourne Department of Medicine, The Royal Melbourne Hospital, Victoria, Australia.
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Hatherill M, McIntyre A, Wattie M, Murdoch IA. Outcome of early hyperlactataemia in critically ill children. Crit Care 1999. [PMCID: PMC3301848 DOI: 10.1186/cc520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Caygill CP, Reed PI, McIntyre A, Hill MJ. The UK National Barrett's Oesophagus Registry: a study between two centres. Eur J Cancer Prev 1998; 7:161-4. [PMID: 9818779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- C P Caygill
- UK National Barrett's Oesophagus Registry and ECP (UK) Headquarters, Lady Sobell Gastrointestinal Unit, Wexham Park Hospital, Slough, Berks
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Lee J, Adams G, Sloper J, McIntyre A. Future of preschool vision screening. Cost effectiveness of screening for amblyopia is a public health issue. BMJ 1998; 316:937-8. [PMID: 9569403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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McIntyre A, Vincent RM, Perkins AC, Spiller RC. Effect of bran, ispaghula, and inert plastic particles on gastric emptying and small bowel transit in humans: the role of physical factors. Gut 1997; 40:223-7. [PMID: 9071936 PMCID: PMC1027053 DOI: 10.1136/gut.40.2.223] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.2] [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: 02/04/2023]
Abstract
BACKGROUND Coarse bran is known to accelerate transit through the whole gut and to increase stool weight. This effect is much reduced by grinding the bran, suggesting that particle size influences gut motor patterns. AIMS To compare the effect of 15 g coarse bran with 15 g inert plastic particles and 7 g of ispaghula on the gastric emptying and small bowel transit of a rice pudding test meal. SUBJECTS 13 healthy volunteers. METHODS Transit of 99mTc labelled rice studied by gamma-scintigraphy measuring gastric emptying and colonic arrival over 10 hours. Small bowel transit was estimated from the difference between time to 50% gastric emptying and 50% colonic arrival. RESULTS Bran delayed gastric emptying by 22 (SEM 8) minutes compared with control values of 88 (SEM 6) minutes p < 0.05. Ispaghula and plastic particles had no significant effect. Small bowel transit was accelerated compared with control values of 322 (SEM 29) minutes, decreasing by 95 (29) minutes and 62 (22) minutes after bran and plastic particles respectively. Ispaghula again showed no significant effect. CONCLUSION Coarse bran delays gastric emptying and accelerates small bowel transit. The marked acceleration of small bowel transit also seen with inert plastic particles may be due to increased upper gut secretions after stimulation of enteric nerves.
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Affiliation(s)
- A McIntyre
- Department of Medicine, University Hospital, Queen's Medical Centre, Nottingham
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Abstract
Abundance cycles of the marine alga Florisphaera profunda centered on a period of 7600 carbon-14 years (8400 calendar years) are present in high-resolution records from the equatorial Atlantic spanning 0 to 45,000 years ago. These cycles correlate with Heinrich events 1 through 5, which document rapid changes in continental ice melting around the subpolar North Atlantic. These variations in F. profunda are a direct response to modulation in zonal wind-driven divergence produced by a precessional component of orbital variation during a time of reduced eccentricity modulation.
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Affiliation(s)
- A McIntyre
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY 10964, USA
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Sirocko F, Garbe-Schonberg D, McIntyre A, Molfino B. Teleconnections Between the Subtropical Monsoons and High-Latitude Climates During the Last Deglaciation. Science 1996. [DOI: 10.1126/science.272.5261.526] [Citation(s) in RCA: 227] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Affiliation(s)
- J Lee
- Strabismus and Paediatric Service, Moorfields Eye Hospital, London, UK
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Young GP, McIntyre A, Albert V, Folino M, Muir JG, Gibson PR. Wheat bran suppresses potato starch--potentiated colorectal tumorigenesis at the aberrant crypt stage in a rat model. Gastroenterology 1996; 110:508-14. [PMID: 8566598 DOI: 10.1053/gast.1996.v110.pm8566598] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.6] [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: 01/31/2023]
Abstract
BACKGROUND & AIMS Starch that escapes digestion in the small intestine (resistant starch [RS]) may act similarly to nonstarch polysaccharides in the colon. The aim of this study was to examine the effect of raw potato starch alone and in combination with wheat bran on tumor development and precancer events in a rat model of colorectal cancer. METHODS Three groups of rats received either a low-RS/low-fiber ("basic") diet, the basic diet containing raw potato starch as 20% of carbohydrate content, or the potato starch diet plus 10% of "wheat bran" fiber. Epithelial proliferation, aberrant crypt foci (ACF), and tumors were measured 6 and 20 weeks after a 10-week course of dimethylhydrazine. RESULTS Rats on the potato starch diet had tumors more frequently and had larger tumors than rats consuming the wheat bran or basic diets. Parallel effects on the density of ACF were found 6 weeks after the carcinogen. Although epithelial proliferation was significantly enhanced by potato starch compared with the basic diet, the addition of wheat bran did not suppress this enhancement. CONCLUSIONS This type-2 RS enhances epithelial proliferation, ACF density, and tumor formation. The addition of wheat bran to an RS-containing diet suppresses tumorigenesis, acting on events responsible for the formation of ACF but not the events controlling the hyperproliferative phase.
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Affiliation(s)
- G P Young
- Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Victoria, Australia
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Jones D, Rushmer J, McIntyre A, Cumpston P. Airway monitoring in the post anaesthetic recovery room. Anaesth Intensive Care 1996; 24:115-6. [PMID: 8669630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Folino M, McIntyre A, Young GP. Dietary fibers differ in their effects on large bowel epithelial proliferation and fecal fermentation-dependent events in rats. J Nutr 1995; 125:1521-8. [PMID: 7782906 DOI: 10.1093/jn/125.6.1521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The effects of different fiber types and processing on putative protective mechanisms for colorectal cancer were evaluated. Rats were fed diets of similar nutrient balance containing either no added fiber or 10% fiber from various sources. The rate of distal colonic epithelial proliferation, measured by the metaphase arrest method, was dependent on fiber type; ranking of fibers from highest to lowest yielded the following order: methylcellulose > coarse wheat bran > fine wheat bran approximately parboiled and extruded rice brans > no fiber (P = 0.012). Effect on stool output ranked identically. Ranking of effect on fecal pH, from most to least acidic was as follows: coarse wheat bran approximately the rice brans > fine wheat bran > no fiber approximately methylcellulose (P = 0.00001). Coarse wheat bran gave significantly higher fecal butyrate concentrations than did the rice brans, which in turn gave higher levels than fine wheat bran, methylcellulose and the no-fiber diet. Proximal colon epithelial proliferation was unaffected by diet although cecal short-chain fatty acid concentrations and pH were affected. Different fibers have different effects on events in the fecal environment and distal colonic epithelium. Putative protective events (increased output, low fecal pH, high butyrate, low proliferation) are not equally affected and are unlikely in themselves to allow prediction of the protective effect of a fiber.
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Affiliation(s)
- M Folino
- University of Melbourne Department of Medicine, Royal Melbourne Hospital, Victoria, Australia
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Abstract
The amount and type of dietary fibre ingested influences colonic luminal characteristics, especially the concentration of carbohydrate fermentation products such as butyrate. This study aimed to assess whether diets supplemented with fibres of differing fermentability (delivering different amounts of butyrate to the colon) influence mucosal activities of urokinase and brush border hydrolases, and epithelial turnover. Groups of five rats were fed one of four diets containing low (2%), highly fermented (guar 10% or oat bran 10%) or slowly fermented fibre (wheat bran 10%) for 4 weeks. Activities of urokinase, alkaline phosphatase, dipeptidyl peptidase IV and maltase were measured in mucosal homogenates of proximal and distal colon and from rectum. Proliferative kinetics were assessed in distal and proximal colon by the metaphase arrest technique. Hydrolase activities were similar across all four dietary groups but a significant difference was found for urokinase (P = 0.014). This was due to a reduction in urokinase activities of > 30% at the three sites in the wheat bran group compared with the other groups. Of proliferative indices, only crypt column height differed across the groups (P = 0.038) and was highest in rats fed wheat bran and lowest in those fed the low fibre diet (P = 0.047). The proportion of mitoses in the top one-fifth of the crypt also differed across groups (P = 0.038) due to the high values in the distal colon of the low fibre group. Thus, addition of a slowly fermented (but not highly fermented) fibre to the diet of rats reduces net urokinase activity in large bowel mucosa and increases the life span of colonic epithelial cells without changing activities of brush border hydrolases.
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Affiliation(s)
- P Gibson
- Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Parkville, Victoria, Australia
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