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Tajima T, Martinez OM, Bernstein D, Boyd SD, Gratzinger D, Lum G, Sasaki K, Tan B, Twist CJ, Weinberg K, Armstrong B, Desai DM, Mazariegos GV, Chin C, Fishbein TM, Tekin A, Venick RS, Krams SM, Esquivel CO. Epstein-Barr virus-associated post-transplant lymphoproliferative disorders in pediatric transplantation: A prospective multicenter study in the United States. Pediatr Transplant 2024; 28:e14763. [PMID: 38682750 DOI: 10.1111/petr.14763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 03/26/2024] [Accepted: 04/08/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Epstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorders (PTLD) is the most common malignancy in children after transplant; however, difficulties for early detection may worsen the prognosis. METHODS The prospective, multicenter, study enrolled 944 children (≤21 years of age). Of these, 872 received liver, heart, kidney, intestinal, or multivisceral transplants in seven US centers between 2014 and 2019 (NCT02182986). In total, 34 pediatric EBV+ PTLD (3.9%) were identified by biopsy. Variables included sex, age, race, ethnicity, transplanted organ, EBV viral load, pre-transplant EBV serology, immunosuppression, response to chemotherapy and rituximab, and histopathological diagnosis. RESULTS The uni-/multivariable competing risk analyses revealed the combination of EBV-seropositive donor and EBV-naïve recipient (D+R-) was a significant risk factor for PTLD development (sub-hazard ratio: 2.79 [1.34-5.78], p = .006) and EBV DNAemia (2.65 [1.72-4.09], p < .001). Patients with D+R- were significantly more associated with monomorphic/polymorphic PTLD than those with the other combinations (p = .02). Patients with monomorphic/polymorphic PTLD (n = 21) had significantly more EBV DNAemia than non-PTLD patients (p < .001) and an earlier clinical presentation of PTLD than patients with hyperplasias (p < .001), within 6-month post-transplant. Among non-liver transplant recipients, monomorphic/polymorphic PTLD were significantly more frequent than hyperplasias in patients ≥5 years of age at transplant (p = .01). CONCLUSIONS D+R- is a risk factor for PTLD and EBV DNAemia and associated with the incidence of monomorphic/polymorphic PTLD. Intensive follow-up of EBV viral load within 6-month post-transplant, especially for patients with D+R- and/or non-liver transplant recipients ≥5 years of age at transplant, may help detect monomorphic/polymorphic PTLD early in pediatric transplant.
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Affiliation(s)
- Tetsuya Tajima
- Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Olivia M Martinez
- Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Daniel Bernstein
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Scott D Boyd
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Dita Gratzinger
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Grant Lum
- Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Kazunari Sasaki
- Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Brent Tan
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Clare J Twist
- Department of Pediatric Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Kenneth Weinberg
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Brian Armstrong
- Rho Federal Systems Division, Rho, Durham, North Carolina, USA
| | - Dev M Desai
- Division of Surgical Transplantation, University of Texas (UT) Southwestern Medical Center, Dallas, Texas, USA
| | - George V Mazariegos
- Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children's Hospital, Pittsburgh, Pennsylvania, USA
| | - Clifford Chin
- Department of Pediatrics and Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio, USA
| | - Thomas M Fishbein
- Department of Surgery and Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Akin Tekin
- Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Robert S Venick
- Department of Pediatric Gastroenterology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Sheri M Krams
- Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Carlos O Esquivel
- Division of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
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Finnegan OL, White JW, Armstrong B, Adams EL, Burkart S, Beets MW, Nelakuditi S, Willis EA, von Klinggraeff L, Parker H, Bastyr M, Zhu X, Zhong Z, Weaver RG. The utility of behavioral biometrics in user authentication and demographic characteristic detection: a scoping review. Syst Rev 2024; 13:61. [PMID: 38331893 PMCID: PMC10851515 DOI: 10.1186/s13643-024-02451-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/03/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Objective measures of screen time are necessary to better understand the complex relationship between screen time and health outcomes. However, current objective measures of screen time (e.g., passive sensing applications) are limited in identifying the user of the mobile device, a critical limitation in children's screen time research where devices are often shared across a family. Behavioral biometrics, a technology that uses embedded sensors on modern mobile devices to continuously authenticate users, could be used to address this limitation. OBJECTIVE The purpose of this scoping review was to summarize the current state of behavioral biometric authentication and synthesize these findings within the scope of applying behavioral biometric technology to screen time measurement. METHODS We systematically searched five databases (Web of Science Core Collection, Inspec in Engineering Village, Applied Science & Technology Source, IEEE Xplore, PubMed), with the last search in September of 2022. Eligible studies were on the authentication of the user or the detection of demographic characteristics (age, gender) using built-in sensors on mobile devices (e.g., smartphone, tablet). Studies were required to use the following methods for authentication: motion behavior, touch, keystroke dynamics, and/or behavior profiling. We extracted study characteristics (sample size, age, gender), data collection methods, data stream, model evaluation metrics, and performance of models, and additionally performed a study quality assessment. Summary characteristics were tabulated and compiled in Excel. We synthesized the extracted information using a narrative approach. RESULTS Of the 14,179 articles screened, 122 were included in this scoping review. Of the 122 included studies, the most highly used biometric methods were touch gestures (n = 76) and movement (n = 63), with 30 studies using keystroke dynamics and 6 studies using behavior profiling. Of the studies that reported age (47), most were performed exclusively in adult populations (n = 34). The overall study quality was low, with an average score of 5.5/14. CONCLUSION The field of behavioral biometrics is limited by the low overall quality of studies. Behavioral biometric technology has the potential to be used in a public health context to address the limitations of current measures of screen time; however, more rigorous research must be performed in child populations first. SYSTEMATIC REVIEW REGISTRATION The protocol has been pre-registered in the Open Science Framework database ( https://doi.org/10.17605/OSF.IO/92YCT ).
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Affiliation(s)
- O L Finnegan
- Department of Exercise Science, University of South Carolina, Columbia, USA.
| | - J W White
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - B Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - E L Adams
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - S Burkart
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - M W Beets
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - S Nelakuditi
- Department of Computer Science and Engineering, University of South Carolina, Columbia, USA
| | - E A Willis
- Center for Health Promotion and Disease Prevention, University of North Carolina Chapel Hill, Chapel Hill, USA
| | - L von Klinggraeff
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - H Parker
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - M Bastyr
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - X Zhu
- Department of Exercise Science, University of South Carolina, Columbia, USA
| | - Z Zhong
- Department of Computer Science and Engineering, University of South Carolina, Columbia, USA
| | - R G Weaver
- Department of Exercise Science, University of South Carolina, Columbia, USA
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3
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Sriram K, Qi Z, Yuan D, Malhi NK, Liu X, Calandrelli R, Luo Y, Tapia A, Jin S, Shi J, Salas M, Dang R, Armstrong B, Priceman SJ, Wang PH, Liao J, Natarajan R, Zhong S, Bouman Chen Z. Regulation of nuclear transcription by mitochondrial RNA in endothelial cells. eLife 2024; 13:e86204. [PMID: 38251974 PMCID: PMC10803041 DOI: 10.7554/elife.86204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 12/12/2023] [Indexed: 01/23/2024] Open
Abstract
Chromatin-associated RNAs (caRNAs) form a relatively poorly recognized layer of the epigenome. The caRNAs reported to date are transcribed from the nuclear genome. Here, leveraging a recently developed assay for detection of caRNAs and their genomic association, we report that mitochondrial RNAs (mtRNAs) are attached to the nuclear genome and constitute a subset of caRNA, thus termed mt-caRNA. In four human cell types analyzed, mt-caRNAs preferentially attach to promoter regions. In human endothelial cells (ECs), the level of mt-caRNA-promoter attachment changes in response to environmental stress that mimics diabetes. Suppression of a non-coding mt-caRNA in ECs attenuates stress-induced nascent RNA transcription from the nuclear genome, including that of critical genes regulating cell adhesion, and abolishes stress-induced monocyte adhesion, a hallmark of dysfunctional ECs. Finally, we report increased nuclear localization of multiple mtRNAs in the ECs of human diabetic donors, suggesting many mtRNA translocate to the nucleus in a cell stress and disease-dependent manner. These data nominate mt-caRNAs as messenger molecules responsible for mitochondrial-nuclear communication and connect the immediate product of mitochondrial transcription with the transcriptional regulation of the nuclear genome.
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Affiliation(s)
- Kiran Sriram
- Department of Diabetes Complications and Metabolism, City of HopeDuarteUnited States
- Irell and Manella Graduate School of Biological Sciences, City of HopeDuarteUnited States
| | - Zhijie Qi
- Department of Bioengineering, University of California San DiegoLa JollaUnited States
| | - Dongqiang Yuan
- Department of Diabetes Complications and Metabolism, City of HopeDuarteUnited States
| | - Naseeb Kaur Malhi
- Department of Diabetes Complications and Metabolism, City of HopeDuarteUnited States
| | - Xuejing Liu
- Department of Diabetes Complications and Metabolism, City of HopeDuarteUnited States
| | - Riccardo Calandrelli
- Department of Bioengineering, University of California San DiegoLa JollaUnited States
| | - Yingjun Luo
- Department of Diabetes Complications and Metabolism, City of HopeDuarteUnited States
| | - Alonso Tapia
- Department of Diabetes Complications and Metabolism, City of HopeDuarteUnited States
- Irell and Manella Graduate School of Biological Sciences, City of HopeDuarteUnited States
| | - Shengyan Jin
- Department of Genetics, Yale University School of MedicineNew HavenUnited States
| | - Ji Shi
- Translura, IncNew HavenUnited States
| | - Martha Salas
- Department of Stem Cell Biology and Regenerative Medicine, City of HopeDuarteUnited States
| | - Runrui Dang
- Department of Bioengineering, University of California RiversideRiversideUnited States
| | - Brian Armstrong
- Department of Stem Cell Biology and Regenerative Medicine, City of HopeDuarteUnited States
| | - Saul J Priceman
- Department of Hematology & Hematopoietic Cell Transplantation, Department of Immuno-oncology, City of HopeDuarteUnited States
| | - Ping H Wang
- Department of Diabetes, Endocrinology, and Metabolism, City of HopeDuarteUnited States
| | - Jiayu Liao
- Department of Bioengineering, University of California RiversideRiversideUnited States
| | - Rama Natarajan
- Department of Diabetes Complications and Metabolism, City of HopeDuarteUnited States
- Irell and Manella Graduate School of Biological Sciences, City of HopeDuarteUnited States
| | - Sheng Zhong
- Department of Bioengineering, University of California San DiegoLa JollaUnited States
| | - Zhen Bouman Chen
- Department of Diabetes Complications and Metabolism, City of HopeDuarteUnited States
- Irell and Manella Graduate School of Biological Sciences, City of HopeDuarteUnited States
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Tajima T, Bernstein D, Boyd SD, Gratzinger D, Lum G, Sasaki K, Tan B, Weinberg K, Armstrong B, Brown M, Chin C, Desai D, Fishbein TM, Mazariegos G, Robien MA, Tekin A, Twist CJ, Venick RS, Krams SM, Martinez OM, Esquivel CO. 311.2: Risk factors for Epstein-Barr virus DNAemia in pediatric transplantation: A multicenter study in the United States. Transplantation 2023; 107:71-72. [PMID: 37845955 DOI: 10.1097/01.tp.0000993400.94644.c0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Affiliation(s)
- Tetsuya Tajima
- Department of Surgery, Division of Abdominal Transplantation, Stanford University School of Medicine, Stanford, CA, United States
| | - Daniel Bernstein
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Scott D Boyd
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - Dita Gratzinger
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - Grant Lum
- Department of Surgery, Division of Abdominal Transplantation, Stanford University School of Medicine, Stanford, CA, United States
| | - Kazunari Sasaki
- Department of Surgery, Division of Abdominal Transplantation, Stanford University School of Medicine, Stanford, CA, United States
| | - Brent Tan
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - Kenneth Weinberg
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | | | - Meredith Brown
- National Institute of Allergy and Infectious Diseases, Rockville, MD, United States
| | - Clifford Chin
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Dev Desai
- Division of Surgical Transplantation, UT Southwestern Medical Center, Dallas, TX, United States
| | - Thomas M Fishbein
- Departments of Surgery and Pediatrics, MedStar Georgetown University Hospital, Washington, DC, United States
| | - George Mazariegos
- Department of Pediatrics, UPMC Children's Hospital, Pittsburgh, PA, United States
| | - Mark A Robien
- National Institute of Allergy and Infectious Diseases, Rockville, MD, United States
| | - Akin Tekin
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Clare J Twist
- Department of Pediatric Oncology, Rosewell Park, Buffalo, NY, United States
| | - Robert S Venick
- Department of Pediatric Gastroenterology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Sheri M Krams
- Department of Surgery, Division of Abdominal Transplantation, Stanford University School of Medicine, Stanford, CA, United States
| | - Olivia M Martinez
- Department of Surgery, Division of Abdominal Transplantation, Stanford University School of Medicine, Stanford, CA, United States
| | - Carlos O Esquivel
- Department of Surgery, Division of Abdominal Transplantation, Stanford University School of Medicine, Stanford, CA, United States
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Rao M, Amouzgar M, Harden JT, Lapasaran MG, Trickey A, Armstrong B, Odim J, Debnam T, Esquivel CO, Bendall SC, Martinez OM, Krams SM. High-dimensional profiling of pediatric immune responses to solid organ transplantation. Cell Rep Med 2023; 4:101147. [PMID: 37552988 PMCID: PMC10439249 DOI: 10.1016/j.xcrm.2023.101147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/05/2023] [Accepted: 07/13/2023] [Indexed: 08/10/2023]
Abstract
Solid organ transplant remains a life-saving therapy for children with end-stage heart, lung, liver, or kidney disease; however, ∼33% of allograft recipients experience acute rejection within the first year after transplant. Our ability to detect early rejection is hampered by an incomplete understanding of the immune changes associated with allograft health, particularly in the pediatric population. We performed detailed, multilineage, single-cell analysis of the peripheral blood immune composition in pediatric solid organ transplant recipients, with high-dimensional mass cytometry. Supervised and unsupervised analysis methods to study cell-type proportions indicate that the allograft type strongly influences the post-transplant immune profile. Further, when organ-specific differences are considered, graft health is associated with changes in the proportion of distinct T cell subpopulations. Together, these data form the basis for mechanistic studies into the pathobiology of rejection and allow for the development of new immunosuppressive agents with greater specificity.
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Affiliation(s)
- Mahil Rao
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA; Transplant Immunology Lab, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Meelad Amouzgar
- Immunology Graduate Program, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - James T Harden
- Transplant Immunology Lab, Stanford University School of Medicine, Palo Alto, CA 94304, USA; Immunology Graduate Program, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - M Gay Lapasaran
- Transplant Immunology Lab, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Amber Trickey
- Department of Surgery, Division of Abdominal Transplant Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | | | - Jonah Odim
- National Institutes of Health, Bethesda, MD, USA
| | | | - Carlos O Esquivel
- Transplant Immunology Lab, Stanford University School of Medicine, Palo Alto, CA 94304, USA; Department of Surgery, Division of Abdominal Transplant Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Sean C Bendall
- Program in Immunology, Stanford University School of Medicine, Palo Alto, CA 94304, USA; Department of Pathology, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Olivia M Martinez
- Transplant Immunology Lab, Stanford University School of Medicine, Palo Alto, CA 94304, USA; Department of Surgery, Division of Abdominal Transplant Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA; Program in Immunology, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Sheri M Krams
- Transplant Immunology Lab, Stanford University School of Medicine, Palo Alto, CA 94304, USA; Department of Surgery, Division of Abdominal Transplant Surgery, Stanford University School of Medicine, Palo Alto, CA 94304, USA; Program in Immunology, Stanford University School of Medicine, Palo Alto, CA 94304, USA.
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Govindarajan A, Salgia NJ, Li H, Castro DV, Mirzapoiazova T, Armstrong B, Zhao D, Mercier BD, Dizman N, Chawla N, Zengin Z, Meza L, Tripathi N, Sayegh N, Chehrazi-Raffle A, Tripathi A, Pal SK. Characterization of papillary and clear cell renal cell carcinoma through imaging mass cytometry reveals distinct immunologic profiles. Front Immunol 2023; 14:1182581. [PMID: 37638025 PMCID: PMC10457014 DOI: 10.3389/fimmu.2023.1182581] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/20/2023] [Indexed: 08/29/2023] Open
Abstract
Objective To characterize and further compare the immune cell populations of the tumor microenvironment (TME) in both clear cell and papillary renal cell carcinoma (RCC) using heavy metal-labeled antibodies in a multiplexed imaging approach (imaging mass cytometry). Materials and methods Formalin-fixed paraffin-embedded (FFPE) baseline tumor tissues from metastatic patients with clear cell renal cell carcinoma (ccRCC) and papillary renal cell carcinoma (pRCC) were retrospectively requisitioned from an institutional biorepository. Pretreated FFPE samples from 33 RCC patients (10 ccRCC, 23 pRCC) were accessioned and stained for imaging mass cytometry (IMC) analysis. Clinical characteristics were curated from an institutional RCC database. FFPE samples were prepared and stained with heavy metal-conjugated antibodies for IMC. An 11-marker panel of tumor stromal and immune markers was used to assess and quantify cellular relationships in TME compartments. To validate our time-of-flight (CyTOF) analysis, we cross-validated findings with The Cancer Genome Atlas Program (TCGA) analysis and utilized the CIBERSORTx tool to examine the abundance of main immune cell types in pRCC and ccRCC patients. Results Patients with ccRCC had a longer median overall survival than did those with pRCC (67.7 vs 26.8 mo, respectively). Significant differences were identified in the proportion of CD4+ T cells between disease subtypes (ccRCC 14.1%, pRCC 7.0%, p<0.01). Further, the pRCC cohort had significantly more PanCK+ tumor cells than did the ccRCC cohort (24.3% vs 9.5%, respectively, p<0.01). There were no significant differences in macrophage composition (CD68+) between cohorts. Our results demonstrated a significant correlation between the CyTOF and TCGA analyses, specifically validating that ccRCC patients exhibit higher levels of CD4+ T cells (ccRCC 17.60%, pRCC 15.7%, p<0.01) and CD8+ T cells (ccRCC 17.83%, pRCC 11.15%, p<0.01). The limitation of our CyTOF analysis was the large proportion of cells that were deemed non-characterizable. Conclusions Our findings emphasize the need to investigate the TME in distinct RCC histological subtypes. We observed a more immune infiltrative phenotype in the TME of the ccRCC cohort than in the pRCC cohort, where a tumor-rich phenotype was noted. As practical predictive biomarkers remain elusive across all subtypes of RCC, further studies are warranted to analyze the biomarker potential of such TME classifications.
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Affiliation(s)
- Ameish Govindarajan
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Nicholas J. Salgia
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
- Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Haiqing Li
- Integrative Genome Core, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, United States
| | - Daniela V. Castro
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Tamara Mirzapoiazova
- Integrative Genome Core, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, United States
| | - Brian Armstrong
- Light Microscopy/Digital Imaging Core, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, United States
| | - Dan Zhao
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
- Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Benjamin D. Mercier
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Nazli Dizman
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Neal Chawla
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Zeynep Zengin
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Luis Meza
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Nishita Tripathi
- Huntsman Cancer Institute-University of Utah Health Care, Salt Lake City, UT, United States
| | - Nicolas Sayegh
- Huntsman Cancer Institute-University of Utah Health Care, Salt Lake City, UT, United States
| | - Alex Chehrazi-Raffle
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Abhishek Tripathi
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Sumanta K. Pal
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
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Weaver RG, Armstrong B, Adams E, Beets MW, White J, Flory K, Wilson D, McLain A, Tennie B. Feasibility and preliminary efficacy of structured programming and a parent intervention to mitigate accelerated summer BMI gain: a pilot study. Pilot Feasibility Stud 2023; 9:83. [PMID: 37189190 PMCID: PMC10184061 DOI: 10.1186/s40814-023-01312-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/02/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND This study assessed the initial feasibility and preliminary efficacy of providing children a free summer day camp and a parent intervention to improve self-regulation and mitigate accelerated summer BMI gain. METHODS This pilot 2x2 factorial randomized control trial used a mixed-methods design to evaluate providing children a free summer day camp (SCV), a parent intervention (PI), and the combination of these two strategies (SCV+PI) to mitigate accelerated summer body mass index (BMI) gain. Progression criteria for feasibility and efficacy were assessed to determine if a full-scale trial was warranted. Feasibility criteria included recruitment capability (≥80 participants recruited) retention (≥70% participants retained), compliance (≥80% of participants attending the summer program with children attending ≥60% of program days, and ≥80% of participants completing goal setting calls with ≥60% of weeks syncing their child's Fitbit), and treatment fidelity (≥80% of summer program days delivered for ≥9 h/day, and ≥80% of participant texts delivered). Efficacy criteria were assessed via achieving a clinically meaningful impact on zBMI (i.e., ≥0.15). Changes in BMI were estimated using intent-to-treat and post hoc dose-response analyses via multilevel mixed-effects regressions. RESULTS For recruitment, capability and retention progression criteria were met with a total of 89 families participating and 24 participants randomized to the PI group, 21 randomized to the SCV group, 23 randomized to the SCV+PI group, and 21 randomized to the control. However, fidelity and compliance progression criteria were not achieved due to COVID-19 and lack of transportation. Progression criteria for efficacy was also not achieved as intent-to-treat analyses did not show changes in BMI gain that were clinically meaningful. Post hoc dose-response analyses showed that for each day (0 to 29) of summer programming children attended they gained -0.009 (95CI= -0.018, -0.001) less in BMI z score. CONCLUSIONS Engagement in both the SCV and PI was not ideal due to COVID-19 and lack of transportation. Providing children with structured summer programming to mitigate accelerated summer BMI gain may be an effective strategy. However, because feasibility and efficacy progression criteria were not met, a larger trial is not warranted until further pilot work is completed to ensure children attend the programming. TRIAL REGISTRATION The trial reported herein was prospectively registered at ClinicalTrials.gov. Trial #: NCT04608188.
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Affiliation(s)
- R G Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, room 130, Columbia, SC, 29205, USA.
| | - B Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, room 130, Columbia, SC, 29205, USA
| | - E Adams
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, room 130, Columbia, SC, 29205, USA
| | - M W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, room 130, Columbia, SC, 29205, USA
| | - J White
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, room 130, Columbia, SC, 29205, USA
| | - K Flory
- Department of Psychology, University of South Carolina, Columbia, USA
| | - D Wilson
- Department of Psychology, University of South Carolina, Columbia, USA
| | - A McLain
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, USA
| | - B Tennie
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, USA
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Martinez OM, Krams SM, Robien MA, Lapasaran MG, Arvedson MP, Reitsma A, Balachandran Y, Harris-Arnold A, Weinberg K, Boyd SD, Armstrong B, Trickey A, Twist CJ, Gratzinger D, Tan B, Brown M, Chin C, Desai DM, Fishbein TM, Mazariegos GV, Tekin A, Venick RS, Bernstein D, Esquivel CO. Mutations in latent membrane protein 1 of Epstein-Barr virus are associated with increased risk of posttransplant lymphoproliferative disorder in children. Am J Transplant 2023; 23:611-618. [PMID: 36796762 PMCID: PMC10159954 DOI: 10.1016/j.ajt.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023]
Abstract
Epstein-Barr virus (EBV)-positive posttransplant lymphoproliferative disorder (PTLD) results in significant morbidity and mortality in pediatric transplant recipients. Identifying individuals at an increased risk of EBV-positive PTLD could influence clinical management of immunosuppression and other therapies, improving posttransplant outcomes. A 7-center prospective, observational clinical trial of 872 pediatric transplant recipients evaluated the presence of mutations at positions 212 and 366 of EBV latent membrane protein 1 (LMP1) as an indicator of risk of EBV-positive PTLD (clinical trials: NCT02182986). DNA was isolated from peripheral blood of EBV-positive PTLD case patients and matched controls (1:2 nested case:control), and the cytoplasmic tail of LMP1 was sequenced. Thirty-four participants reached the primary endpoint of biopsy-proven EBV-positive PTLD. DNA was sequenced from 32 PTLD case patients and 62 matched controls. Both LMP1 mutations were present in 31 of 32 PTLD cases (96.9%) and in 45 of 62 matched controls (72.6%) (P = .005; OR = 11.7; 95% confidence interval, 1.5, 92.6). The presence of both G212S and S366T carries a nearly 12-fold increased risk of development of EBV-positive PTLD. Conversely, transplant recipients without both LMP1 mutations carry a very low risk of PTLD. Analysis of mutations at positions 212 and 366 of LMP1 can be informative in stratifying patients for risk of EBV-positive PTLD.
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Affiliation(s)
- Olivia M Martinez
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA; Stanford Immunology, Stanford University School of Medicine, Palo Alto, California, USA.
| | - Sheri M Krams
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA; Stanford Immunology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Mark A Robien
- National Institute of Allergy and Infectious Disease, Rockville, Maryland, USA
| | - Mary G Lapasaran
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Matthew P Arvedson
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Andrea Reitsma
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Yarl Balachandran
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Aleishia Harris-Arnold
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA; Stanford Immunology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Kenneth Weinberg
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Scott D Boyd
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | | | - Amber Trickey
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Clare J Twist
- Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Dita Gratzinger
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Brent Tan
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Merideth Brown
- National Institute of Allergy and Infectious Disease, Rockville, Maryland, USA
| | - Clifford Chin
- Department of Pediatrics and Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio, USA
| | - Dev M Desai
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Thomas M Fishbein
- Departments of Surgery and Pediatrics, MedStar Georgetown University Hospital, Georgetown, Washington, DC, USA
| | - George V Mazariegos
- University of Pittsburgh Medical Center, Children's Hospital Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Akin Tekin
- Miller School of Medicine, University of Medicine, Florida, USA
| | - Robert S Venick
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Daniel Bernstein
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Carlos O Esquivel
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA
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9
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Hricik DE, Armstrong B, Alhamad T, Brennan DC, Bromberg JS, Bunnapradist S, Chandran S, Fairchild RL, Foley DP, Formica R, Gibson IW, Kesler K, Kim SJ, Mannon RB, Menon MC, Newell KA, Nickerson P, Odim J, Poggio ED, Sung R, Shapiro R, Tinckam K, Vincenti F, Heeger PS. Infliximab Induction Lacks Efficacy and Increases BK Virus Infection in Deceased Donor Kidney Transplant Recipients: Results of the CTOT-19 Trial. J Am Soc Nephrol 2023; 34:145-159. [PMID: 36195441 PMCID: PMC10101585 DOI: 10.1681/asn.2022040454] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/09/2022] [Accepted: 09/16/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Ischemia-reperfusion (IR) of a kidney transplant (KTx) upregulates TNF α production that amplifies allograft inflammation and may negatively affect transplant outcomes. METHODS We tested the effects of blocking TNF peri-KTx via a randomized, double-blind, placebo-controlled, 15-center, phase 2 clinical trial. A total of 225 primary transplant recipients of deceased-donor kidneys (KTx; 38.2% Black/African American, 44% White) were randomized to receive intravenous infliximab (IFX) 3 mg/kg or saline placebo (PLBO) initiated before kidney reperfusion. All patients received rabbit anti-thymocyte globulin induction and maintenance immunosuppression (IS) with tacrolimus, mycophenolate mofetil, and prednisone. The primary end point was the difference between groups in mean 24-month eGFR. RESULTS There was no difference in the primary end point of 24-month eGFR between IFX (52.45 ml/min per 1.73 m 2 ; 95% CI, 48.38 to 56.52) versus PLBO (57.35 ml/min per 1.73 m 2 ; 95% CI, 53.18 to 61.52; P =0.1). There were no significant differences between groups in rates of delayed graft function, biopsy-proven acute rejection (BPAR), development of de novo donor-specific antibodies, or graft loss/death. Immunosuppression did not differ, and day 7 post-KTx plasma analyses showed approximately ten-fold lower TNF ( P <0.001) in IFX versus PLBO. BK viremia requiring IS change occurred more frequently in IFX (28.9%) versus PLBO (13.4%; P =0.004), with a strong trend toward higher rates of BKV nephropathy in IFX (13.3%) versus PLBO (4.9%; P =0.06). CONCLUSIONS IFX induction therapy does not benefit recipients of kidney transplants from deceased donors on this IS regimen. Because the intervention unexpectedly increased rates of BK virus infections, our findings underscore the complexities of targeting peritransplant inflammation as a strategy to improve KTx outcomes.Clinical Trial registry name and registration number:clinicaltrials.gov (NCT02495077).
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Affiliation(s)
- Donald E Hricik
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | | | - Tarek Alhamad
- Department of Medicine, Washington University, Saint Louis, Missouri
| | | | | | | | - Sindhu Chandran
- Departments of Medicine and Surgery, University of California, San Francisco, California
| | - Robert L Fairchild
- Glickman Urological and Kidney Institute and the Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - David P Foley
- Department of Surgery, University of Wisconsin, Madison, Wisconsin
| | - Richard Formica
- Departments of Medicine and Surgery, Yale University, New Haven, Connecticut
| | - Ian W Gibson
- Departments of Medicine and Pathology, University of Manitoba, Winnipeg, Canada
| | | | - S Joseph Kim
- Department of Medicine, University Health Network, Toronto, Canada
| | - Roslyn B Mannon
- Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Madhav C Menon
- Departments of Medicine and Surgery, Yale University, New Haven, Connecticut
| | | | - Peter Nickerson
- Departments of Medicine and Pathology, University of Manitoba, Winnipeg, Canada
| | - Jonah Odim
- Transplant Branch, Division of Allergy, Immunology and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - Emilio D Poggio
- Glickman Urological and Kidney Institute and the Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Randall Sung
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Ron Shapiro
- Departments of Medicine, Icahn School of Medicine at Mount Sinai and Recanati Miller Transplant Institute, Mount Sinai Hospital, New York, New York
| | - Kathryn Tinckam
- Department of Medicine, University Health Network, Toronto, Canada
| | - Flavio Vincenti
- Departments of Medicine and Surgery, University of California, San Francisco, California
| | - Peter S Heeger
- Departments of Medicine, Icahn School of Medicine at Mount Sinai and Recanati Miller Transplant Institute, Mount Sinai Hospital, New York, New York
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10
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Delaney S, Armstrong B, Gusha-Zinyemba N, Barry E, Johnson E, Saju B. 146 GOLD STANDARD GOAL-SETTING: ARE WE HITTING THE MARK? IMPLEMENTING AN INTERDISCIPLINARY GOAL-SETTING PATHWAY IN STROKE REHABILITATION. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.123] [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: 11/15/2022] Open
Abstract
Abstract
Background
The cornerstone of rehabilitation is effective and realistic interdisciplinary goal-setting with patient and family engagement across the continuum of recovery. The Royal College of Physicians National Clinical Guidelines for Stroke (2016) highlights the importance of encouraging self-management and self-efficacy to support a more person-orientated approach. This quality improvement initiative aimed to introduce a structured interdisciplinary goal-setting pathway on a post-acute 14-bed stroke unit.
Methods
An interdisciplinary working group was established comprising of Physiotherapy, Occupational Therapy, Speech & Language Therapy, Medical Social Work and Nursing. Quality improvement methodology was used to sequentially implement change over a 6-month period. The restructure included the introduction of an initial and review goal-focused family meeting. An interdisciplinary tool was developed based on the East Kent Outcome System (EKOS). A series of workshops was delivered to support implementation.
Results
An interdisciplinary goal-setting pathway is currently being piloted for 6 months on the stroke unit. To date, 22 staff have been trained and 9 patients have progressed through the updated pathway. Analysis has provided useful clinical insights and qualitative feedback has been collated regarding the benefits of the early opportunity to meet the team, establishing patient’s personal goal priorities and clear timeframes.Furthermore, repeat trials followed by reflections have enabled the team to develop consistency and confidence in person-centred, interdisciplinary goal-setting. It is acknowledged that this initiative has been a significant change process for the team and that adjustments are being made, in line with the principles of quality improvement.
Conclusion
This person-orientated interdisciplinary process is evidence-based and in line with national standards and guidelines for stroke rehabilitation. Formal training in EKOS is planned and a clinical audit will follow the pilot phase to systematically evaluate the change in practice.
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Affiliation(s)
- S Delaney
- Royal Hospital Donnybrook , Dublin, Ireland
| | | | | | - E Barry
- Royal Hospital Donnybrook , Dublin, Ireland
| | - E Johnson
- Royal Hospital Donnybrook , Dublin, Ireland
| | - B Saju
- Royal Hospital Donnybrook , Dublin, Ireland
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11
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Herries AIR, Arnold LJ, Boschian G, Blackwood AF, Wilson C, Mallett T, Armstrong B, Demuro M, Petchey F, Meredith-Williams M, Penzo-Kajewski P, Caruana MV. A marine isotope stage 11 coastal Acheulian workshop with associated wood at Amanzi Springs Area 1, South Africa. PLoS One 2022; 17:e0273714. [PMID: 36264956 PMCID: PMC9584507 DOI: 10.1371/journal.pone.0273714] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 08/11/2022] [Indexed: 11/06/2022] Open
Abstract
Amanzi Springs is a series of inactive thermal springs located near Kariega in the Eastern Cape of South Africa. Excavations in the 1960s exposed rare, stratified Acheulian-bearing deposits that were not further investigated over the next 50 years. Reanalysis of the site and its legacy collection has led to a redefined stratigraphic context for the archaeology, a confirmed direct association between Acheulian artefacts and wood, as well as the first reliable age estimates for the site. Thermally transferred optically stimulated luminescence and post-infrared infrared stimulated luminescence dating indicates that the Acheulian deposits from the Amanzi Springs Area 1 spring eye formed during Marine Isotope Stage (MIS) 11 at ~ 404–390 ka. At this time, higher sea levels of ~13-14m would have placed Amanzi Springs around 7 km from a ria that would have formed along what is today the Swartkops River, and which likely led to spring reactivation. This makes the Amanzi Springs Area 1 assemblage an unusual occurrence of a verified late occurring, seaward, open-air Acheulian occupation. The Acheulian levels do not contain any Middle Stone Age (MSA) elements such as blades and points that have been documented in the interior of South Africa at this time. However, a small number of stone tools from the upper layers of the artefact zone, and originally thought of as intrusive, have been dated to ~190 ka, at the transition between MIS 7 to 6, and represent the first potential MSA identified at the site.
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Affiliation(s)
- Andy I. R. Herries
- Palaeoscience, Dept. Archaeology and History, La Trobe University, Melbourne Campus, Bundoora, Victoria, Australia
- The Palaeo-Research Institute, University of Johannesburg, Auckland Park, South Africa
- * E-mail:
| | - Lee J. Arnold
- Environment Institute and Institute for Photonics and Advanced Sensing (IPAS), Department of Earth Sciences, School of Physical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Giovanni Boschian
- The Palaeo-Research Institute, University of Johannesburg, Auckland Park, South Africa
- Dipartimento di Biologia, Università di Pisa. 1, Pisa, Italy
| | - Alexander F. Blackwood
- Palaeoscience, Dept. Archaeology and History, La Trobe University, Melbourne Campus, Bundoora, Victoria, Australia
- Human Evolution Research Institute, University of Cape Town, Western Cape, South Africa
| | - Coen Wilson
- Palaeoscience, Dept. Archaeology and History, La Trobe University, Melbourne Campus, Bundoora, Victoria, Australia
| | - Tom Mallett
- Palaeoscience, Dept. Archaeology and History, La Trobe University, Melbourne Campus, Bundoora, Victoria, Australia
| | - Brian Armstrong
- The Palaeo-Research Institute, University of Johannesburg, Auckland Park, South Africa
| | - Martina Demuro
- Environment Institute and Institute for Photonics and Advanced Sensing (IPAS), Department of Earth Sciences, School of Physical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Fiona Petchey
- Environmental Research Institute, University of Waikato, Hamilton, New Zealand
| | - Matthew Meredith-Williams
- Palaeoscience, Dept. Archaeology and History, La Trobe University, Melbourne Campus, Bundoora, Victoria, Australia
| | - Paul Penzo-Kajewski
- Palaeoscience, Dept. Archaeology and History, La Trobe University, Melbourne Campus, Bundoora, Victoria, Australia
| | - Matthew V. Caruana
- The Palaeo-Research Institute, University of Johannesburg, Auckland Park, South Africa
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12
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Sen A, Enriquez J, Rao M, Glass M, Balachandran Y, Syed S, Twist CJ, Weinberg K, Boyd SD, Bernstein D, Trickey AW, Gratzinger D, Tan B, Lapasaran MG, Robien MA, Brown M, Armstrong B, Desai D, Mazariegos G, Chin C, Fishbein TM, Venick RS, Tekin A, Zimmermann H, Trappe RU, Anagnostopoulos I, Esquivel CO, Martinez OM, Krams SM. Host microRNAs are decreased in pediatric solid-organ transplant recipients during EBV+ Post-transplant Lymphoproliferative Disorder. Front Immunol 2022; 13:994552. [PMID: 36304469 PMCID: PMC9595046 DOI: 10.3389/fimmu.2022.994552] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Post-transplant lymphoproliferative disorder (PTLD) is a serious complication of solid organ transplantation. Predisposing factors include primary Epstein-Barr virus (EBV) infection, reactivation of EBV in recipient B cells, and decreased T cell immunity due to immunosuppression. In our previous studies EBV infection was demonstrated to markedly alter the expression of host B cell microRNA (miR). Specifically, miR-194 expression was uniquely suppressed in EBV+ B cell lines from PTLD patients and the 3’untranslated region of IL-10 was determined to be targeted by miR-194. Although EBV has been shown to regulate host miR expression in B cell lymphoma cell lines, the expression of miRs in the circulation of patients with EBV-associated PTLD has not been studied. The objective of this study was to determine if changes in miR expression are associated with EBV+ PTLD. In this study, we have shown that miR-194 is significantly decreased in EBV+PTLD tumors and that additional miRs, including miRs-17, 19 and 106a are also reduced in EBV+PTLD as compared to EBV-PTLD. We quantitated the levels of miRs-17, 19, 106a, 155, and 194 in the plasma and extracellular vesicles (EV; 50-70 nm as determined by nanoparticle tracking analysis) from pediatric recipients of solid organ transplants with EBV+ PTLD+ that were matched 1:2 with EBV+ PTLD- pediatric transplant recipients as part of the NIH-sponsored Clinical Trials in Organ Transplantation in Children, (CTOTC-06) study. Levels of miRs-17, 19, 106a, and 194 were reduced in the plasma and extracellular vesicles (EV) of EBV+ PTLD+ group compared to matched controls, with miRs-17 (p = 0.034; plasma), miRs-19 (p = 0.029; EV) and miR-106a (p = 0.007; plasma and EV) being significantly reduced. Similar levels of miR-155 were detected in the plasma and EV of all pediatric SOT recipients. Importantly, ~90% of the cell-free miR were contained within the EV supporting that EBV+ PTLD tumor miR are detected in the circulation and suggesting that EVs, containing miRs, may have the potential to target and regulate cells of the immune system. Further development of diagnostic, mechanistic and potential therapeutic uses of the miRs in PTLD is warranted.
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Affiliation(s)
- Ayantika Sen
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Jeanna Enriquez
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Mahil Rao
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Marla Glass
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Yarl Balachandran
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Sharjeel Syed
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Clare J. Twist
- Department of Pediatric Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Kenneth Weinberg
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Scott D. Boyd
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - Daniel Bernstein
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Amber W. Trickey
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Dita Gratzinger
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - Brent Tan
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - Mary Gay Lapasaran
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Mark A. Robien
- Division of Allergy Immunity Transplantation, National Institute of Allergy and Infectious Diseases, Rockville, MD, United States
| | - Merideth Brown
- Division of Allergy Immunity Transplantation, National Institute of Allergy and Infectious Diseases, Rockville, MD, United States
| | - Brian Armstrong
- Rho Federal Systems Division, Rho, Durham, NC, United States
| | - Dev Desai
- Division of Surgical Transplantation, University of Texas (UT) Southwestern Medical Center, Dallas, TX, United States
| | - George Mazariegos
- Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children’s Hospital, Pittsburgh, PA, United States
| | - Clifford Chin
- Department of Pediatrics and Cincinnati Children’s Hospital, University of Cincinnati, Cincinnati, OH, United States
| | - Thomas M. Fishbein
- Departments of Surgery and Pediatrics, MedStar Georgetown University Hospital, Washington, DC, United States
| | - Robert S. Venick
- Department of Pediatric Gastroenterology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Akin Tekin
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Heiner Zimmermann
- Department of Internal Medicine II: Hematology and Oncology, DIAKO Ev. Diakoniekrankenhaus, Bremen, Germany
| | - Ralf U. Trappe
- Department of Internal Medicine II: Hematology and Oncology, DIAKO Ev. Diakoniekrankenhaus, Bremen, Germany
- Department of Internal Medicine II: Hematology and Oncology , University Medical Center Schleswig-Holstein, Kiel, Germany
- Department of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Carlos O. Esquivel
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Olivia M. Martinez
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Sheri M. Krams
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
- *Correspondence: Sheri M. Krams,
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13
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von Klinggraef L, Dugger R, Okely AD, Lubans D, Jago R, Burkart S, Weaver RG, Armstrong B, Pfedderer CD, Beets MW. Correction to: Early-stage studies to larger-scale trials: investigators' perspectives on scaling-up childhood obesity interventions. Pilot Feasibility Stud 2022; 8:89. [PMID: 35459257 PMCID: PMC9034614 DOI: 10.1186/s40814-022-01047-7] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- L von Klinggraef
- Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Room 130, Columbia, SC, 29205, USA.
| | - R Dugger
- Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Room 130, Columbia, SC, 29205, USA
| | - A D Okely
- School of Health and Society, University of Wollongong, Wollongong, Australia
| | - D Lubans
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - R Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | | | | | | | - C D Pfedderer
- Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Room 130, Columbia, SC, 29205, USA
| | - M W Beets
- Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Room 130, Columbia, SC, 29205, USA
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14
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Webber S, Chin H, Wilkinson J, Armstrong B, Canter C, Dipchand A, Dodd D, Feingold B, Lamour J, Mahle W, Rossano J, Singh T, Zuckerman W, Morrison Y, Diop H, Bentlejewski C, Odim J, Zeevi A. No Association Between Early Donor Specific Antibody and Subsequent Allograft Function at 3 Years Post-Pediatric Heart Transplantation. First Results of a Prospective Multi-Institutional Study. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.200] [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] Open
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15
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Duncan-Park S, Danziger-Isakov L, Armstrong B, Williams N, Odim J, Shemesh E, Sweet S, Annunziato R. Posttraumatic stress and medication adherence in pediatric transplant recipients. Am J Transplant 2022; 22:937-946. [PMID: 34837457 PMCID: PMC8897237 DOI: 10.1111/ajt.16896] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 06/04/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 01/25/2023]
Abstract
Adolescent transplant recipients may encounter a range of potentially traumatic events (PTEs) pre- and posttransplant, yet little is known about the relationship between posttraumatic stress symptoms (PTSS) and medication adherence in this population. In the present study, adolescent recipients and caregivers completed psychosocial questionnaires at enrollment. Outpatient tacrolimus trough level data were collected over 1 year to calculate the Medication Level Variability Index (MLVI), a measure of medication adherence. Nonadherence (MLVI ≥2) was identified in 34.8% of patients, and most (80.7%) reported ≥1 PTE exposure. Levels of PTSS indicating likely posttraumatic stress disorder (PTSD) were endorsed by 9.2% of patients and 43.7% of caregivers. PTSS and MLVI were significantly correlated in the liver subgroup (r = .30, p = .04). Hierarchical multivariable linear regression analyses revealed overall patient PTSS were significantly associated with QoL (p < .001). PTEs are common in adolescent recipients; a minority may meet criteria for PTSD. PTSS screening to identify nonadherence risk requires further investigation and addressing PTSS may improve QoL. Caregivers appear at greater risk for PTSD and may require their own supports. The study was approved by each participating center's Institutional Review Board.
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Affiliation(s)
- Sarah Duncan-Park
- Icahn School of Medicine at Mount Sinai, NY, NY,Fordham University, Bronx, NY
| | | | | | | | | | | | | | - Rachel Annunziato
- Icahn School of Medicine at Mount Sinai, NY, NY,Fordham University, Bronx, NY
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16
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von Klinggraeff L, Dugger R, Okely AD, Lubans D, Jago R, Burkart S, Weaver RG, Armstrong B, Pfledderer CD, Beets MW. Early-stage studies to larger-scale trials: investigators’ perspectives on scaling-up childhood obesity interventions. Pilot Feasibility Stud 2022; 8:31. [PMID: 35130976 PMCID: PMC8819854 DOI: 10.1186/s40814-022-00991-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 01/24/2022] [Indexed: 11/24/2022] Open
Abstract
Background Pilot/feasibility studies play an important role in the development and refinement of behavioral interventions by providing information about feasibility, acceptability, and potential efficacy. Despite their importance and wide-spread use, the approaches taken by behavioral scientists to scale-up early-stage studies to larger-scale trials has received little attention. The aim of our study was to understand the role that pilot studies play in the development and execution of larger-scale trials. Methods We conducted interviews with childhood obesity researchers who had published pilot behavioral interventions and larger-scale trials of the same or similar interventions. Questions were asked about the role of pilot studies in developing larger-scale trials and the challenges encountered when scaling-up an intervention based upon pilot findings. Data were coded and analyzed using an inductive analytic approach to identify themes. Results Twenty-four interventionists (54% women, 37–70 years old, mean 20 years since terminal degree) completed a total of 148 pilot studies across their careers (mean 6.4, range 1–20), of which 59% were scaled-up. Scaling was described as resource intensive and pilot work was considered essential to successfully competing for funding by 63% of the sample (n = 15). When asked to define a high-quality pilot study, interventionists described studies that allowed them to evaluate two independent factors: components of their intervention (e.g., acceptability, feasibility) and study parameters (e.g., sample size, measures). Interventionists expressed that more process implementation measures, different study designs, and additional iterations could improve decisions to scale-up. Most agreed that pilot studies were likely to produce inflated estimates of potential efficacy though only nine interventionists provided potential solutions for decreasing inflated measures of efficacy. Suggested major causes of inflated effects included high levels of oversight in pilot studies (e.g., researcher support), reliance on subjective measures, and utilizing convenience or highly motivated samples. Potential solutions included designing pilots for real-world implementation, only conducting randomized controlled pilot studies, and pre-registering pilot studies. Conclusions Pilot studies purposes are multifaceted and deemed essential to obtaining funding for larger-scale trials. Clarifying the form and function of preliminary, early-stage research may enhance the productive utilization of early-stage studies and reduced drops in efficacy when transitioning to larger scale studies. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-00991-8.
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17
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Castaño-Vinyals G, Sadetzki S, Vermeulen R, Momoli F, Kundi M, Merletti F, Maslanyj M, Calderon C, Wiart J, Lee AK, Taki M, Sim M, Armstrong B, Benke G, Schattner R, Hutter HP, Krewski D, Mohipp C, Ritvo P, Spinelli J, Lacour B, Remen T, Radon K, Weinmann T, Petridou ET, Moschovi M, Pourtsidis A, Oikonomou K, Kanavidis P, Bouka E, Dikshit R, Nagrani R, Chetrit A, Bruchim R, Maule M, Migliore E, Filippini G, Miligi L, Mattioli S, Kojimahara N, Yamaguchi N, Ha M, Choi K, Kromhout H, Goedhart G, 't Mannetje A, Eng A, Langer CE, Alguacil J, Aragonés N, Morales-Suárez-Varela M, Badia F, Albert A, Carretero G, Cardis E. Wireless phone use in childhood and adolescence and neuroepithelial brain tumours: Results from the international MOBI-Kids study. Environ Int 2022; 160:107069. [PMID: 34974237 DOI: 10.1016/j.envint.2021.107069] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
In recent decades, the possibility that use of mobile communicating devices, particularly wireless (mobile and cordless) phones, may increase brain tumour risk, has been a concern, particularly given the considerable increase in their use by young people. MOBI-Kids, a 14-country (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain) case-control study, was conducted to evaluate whether wireless phone use (and particularly resulting exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF)) increases risk of brain tumours in young people. Between 2010 and 2015, the study recruited 899 people with brain tumours aged 10 to 24 years old and 1,910 controls (operated for appendicitis) matched to the cases on date of diagnosis, study region and age. Participation rates were 72% for cases and 54% for controls. The mean ages of cases and controls were 16.5 and 16.6 years, respectively; 57% were males. The vast majority of study participants were wireless phones users, even in the youngest age group, and the study included substantial numbers of long-term (over 10 years) users: 22% overall, 51% in the 20-24-year-olds. Most tumours were of the neuroepithelial type (NBT; n = 671), mainly glioma. The odds ratios (OR) of NBT appeared to decrease with increasing time since start of use of wireless phones, cumulative number of calls and cumulative call time, particularly in the 15-19 years old age group. A decreasing trend in ORs was also observed with increasing estimated cumulative RF specific energy and ELF induced current density at the location of the tumour. Further analyses suggest that the large number of ORs below 1 in this study is unlikely to represent an unknown causal preventive effect of mobile phone exposure: they can be at least partially explained by differential recall by proxies and prodromal symptoms affecting phone use before diagnosis of the cases. We cannot rule out, however, residual confounding from sources we did not measure. Overall, our study provides no evidence of a causal association between wireless phone use and brain tumours in young people. However, the sources of bias summarised above prevent us from ruling out a small increased risk.
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Affiliation(s)
- G Castaño-Vinyals
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - S Sadetzki
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Ministry of Health, Jerusalem, Israel
| | - R Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - F Momoli
- School of Epidemiology and Public Health, University of Ottawa, Canada; Risk Science International, Ottawa, Canada
| | - M Kundi
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Austria
| | - F Merletti
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | | | | | - J Wiart
- Laboratoire de Traitement et Communication de l'Information (LTCI), Telecom Paris, Institut Polytechnique de Paris, 91120 Palaiseau, France
| | - A-K Lee
- Radio Technology Research Department, Electronics and Telecommunications Research Institute (ETRI), Yuseong-gu, Daejeon, Korea
| | - M Taki
- Department of Electrical & Electronic Engineering, Graduate Schools of Science and Engineering, Tokyo Metropolitan University, Tokyo, Japan
| | - M Sim
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - B Armstrong
- School of Population and Global Health, The University of Western Australia, Perth 6009, Australia
| | - G Benke
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - R Schattner
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - H-P Hutter
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Austria
| | - D Krewski
- Risk Science International, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada; McLaughlin Centre for Population Health Risk Assessment, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - C Mohipp
- University of Ottawa, Ottawa, Canada
| | - P Ritvo
- York University, Toronto, Ontario, Canada
| | - J Spinelli
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - B Lacour
- French National Registry of Childhood Solid Tumors, CHRU, Nancy, France; Inserm UMR 1153, Center of Research in Epidemiology and StatisticS (CRESS), Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - T Remen
- Inserm UMR 1153, Center of Research in Epidemiology and StatisticS (CRESS), Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - K Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - T Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - E Th Petridou
- Hellenic Society for Social Pediatrics & Health Promotion, Greece; Dept of Hygiene and Epidemiology, Medical School, National and Kapodistrian University of Athens, Greece
| | - M Moschovi
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - A Pourtsidis
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - K Oikonomou
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - P Kanavidis
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - E Bouka
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - R Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, India
| | - R Nagrani
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, India; Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359 Bremen, Germany
| | - A Chetrit
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
| | - R Bruchim
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
| | - M Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | - E Migliore
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | - G Filippini
- Scientific Director's Office, Carlo Besta Foundation and Neurological Institute, Milan, Italy
| | - L Miligi
- Environmental and Occupational Epidemiology Branch, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - S Mattioli
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Italy
| | - N Kojimahara
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan; Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - N Yamaguchi
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan; Saiseikai Research Institute of Care and Welfare, Tokyo, Japan
| | - M Ha
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-ro, Cheonan, Chungnam, South Korea
| | - K Choi
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-ro, Cheonan, Chungnam, South Korea
| | - H Kromhout
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - G Goedhart
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - A 't Mannetje
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - A Eng
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - C E Langer
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain
| | - J Alguacil
- CIBER Epidemiologia y Salud Pública, Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - N Aragonés
- CIBER Epidemiologia y Salud Pública, Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, 28035 Madrid, Spain
| | - M Morales-Suárez-Varela
- CIBER Epidemiologia y Salud Pública, Madrid, Spain; Unit of Public Health and Environmental Care, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Valencia, Spain
| | - F Badia
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; Institut Cartogràfic i Geològic de Catalunya, Barcelona, Spain
| | - A Albert
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain
| | - G Carretero
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain
| | - E Cardis
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain.
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18
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Sweet SC, Armstrong B, Blatter J, Chin H, Conrad C, Goldfarb S, Hayes D, Heeger PS, Lyou V, Melicoff-Portillo E, Mohanakumar T, Odim J, Ravichandran R, Schecter M, Storch GA, Visner G, Williams NM, Danziger-Isakov L. CTOTC-08: A multicenter randomized controlled trial of rituximab induction to reduce antibody development and improve outcomes in pediatric lung transplant recipients. Am J Transplant 2022; 22:230-244. [PMID: 34599540 DOI: 10.1111/ajt.16862] [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: 06/13/2021] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 01/25/2023]
Abstract
We conducted a randomized, placebo-controlled, double-blind study of pediatric lung transplant recipients, hypothesizing that rituximab plus rabbit anti-thymocyte globulin induction would reduce de novo donor-specific human leukocyte antigen antibodies (DSA) development and improve outcomes. We serially obtained clinical data, blood, and respiratory samples for at least one year posttransplant. We analyzed peripheral blood lymphocytes by flow cytometry, serum for antibody development, and respiratory samples for viral infections using multiplex PCR. Of 45 subjects enrolled, 34 were transplanted and 27 randomized to rituximab (n = 15) or placebo (n = 12). No rituximab-treated subjects versus five placebo-treated subjects developed de novo DSA with mean fluorescence intensity >2000. There was no difference between treatment groups in time to the primary composite outcome endpoint (death, bronchiolitis obliterans syndrome [BOS] grade 0-p, obliterative bronchiolitis or listing for retransplant). A post-hoc analysis substituting more stringent chronic lung allograft dysfunction criteria for BOS 0-p showed no difference in outcome (p = .118). The incidence of adverse events including infection and rejection episodes was no different between treatment groups. Although the study was underpowered, we conclude that rituximab induction may have prevented early DSA development in pediatric lung transplant recipients without adverse effects and may improve outcomes (Clinical Trials: NCT02266888).
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Affiliation(s)
| | | | | | | | - Carol Conrad
- Lucile Packard Children's Hospital/Stanford Children's Health, Palo Alto, California
| | - Samuel Goldfarb
- Masonic Children's Hospital, University of Minnesota, Minneapolis, Minnesota
| | - Don Hayes
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Peter S Heeger
- Department of Medicine, Translational Transplant Research Center, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Victoria Lyou
- Department of Medicine, Translational Transplant Research Center, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | - Jonah Odim
- NIAID, National Institutes of Health, Bethesda, Maryland
| | | | - Marc Schecter
- University of Florida College of Medicine, Gainesville, Florida
| | | | - Gary Visner
- Boston Children's Hospital, Boston, Massachusetts
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19
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Duncan-Park S, Dunphy C, Becker J, D’Urso C, Annunziato R, Blatter J, Conrad C, Goldfarb SB, Hayes D, Melicoff E, Schecter M, Visner G, Armstrong B, Chin H, Kesler K, Williams NM, Odim JN, Sweet SC, Danziger-Isakov L, Shemesh E. Remote intervention engagement and outcomes in the Clinical Trials in Organ Transplantation in Children consortium multisite trial. Am J Transplant 2021; 21:3112-3122. [PMID: 33752251 PMCID: PMC8856090 DOI: 10.1111/ajt.16567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/03/2021] [Accepted: 02/23/2021] [Indexed: 01/25/2023]
Abstract
Remote interventions are increasingly used in transplant medicine but have rarely been rigorously evaluated. We investigated a remote intervention targeting immunosuppressant management in pediatric lung transplant recipients. Patients were recruited from a larger multisite trial if they had a Medication Level Variability Index (MLVI) ≥2.0, indicating worrisome tacrolimus level fluctuation. The manualized intervention included three weekly phone calls and regular follow-up calls. A comparison group included patients who met enrollment criteria after the subprotocol ended. Outcomes were defined before the intent-to-treat analysis. Feasibility was defined as ≥50% of participants completing the weekly calls. MLVI was compared pre- and 180 days postenrollment and between intervention and comparison groups. Of 18 eligible patients, 15 enrolled. Seven additional patients served as the comparison. Seventy-five percent of participants completed ≥3 weekly calls; average time on protocol was 257.7 days. Average intervention group MLVI was significantly lower (indicating improved blood level stability) at 180 days postenrollment (2.9 ± 1.29) compared with pre-enrollment (4.6 ± 2.10), p = .02. At 180 days, MLVI decreased by 1.6 points in the intervention group but increased by 0.6 in the comparison group (p = .054). Participants successfully engaged in a long-term remote intervention, and their medication blood levels stabilized. NCT02266888.
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Affiliation(s)
- Sarah Duncan-Park
- Icahn School of Medicine at Mount Sinai, Department of Pediatrics and Kravis Children’s Hospital, New York, New York,Fordham University, Department of Psychology, Bronx, New York
| | - Claire Dunphy
- Icahn School of Medicine at Mount Sinai, Department of Pediatrics and Kravis Children’s Hospital, New York, New York,Fordham University, Department of Psychology, Bronx, New York
| | - Jacqueline Becker
- Icahn School of Medicine at Mount Sinai, Department of Pediatrics and Kravis Children’s Hospital, New York, New York
| | - Christine D’Urso
- Icahn School of Medicine at Mount Sinai, Department of Pediatrics and Kravis Children’s Hospital, New York, New York
| | - Rachel Annunziato
- Icahn School of Medicine at Mount Sinai, Department of Pediatrics and Kravis Children’s Hospital, New York, New York,Fordham University, Department of Psychology, Bronx, New York
| | | | - Carol Conrad
- Lucille Packard Children’s Hospital, Palo Alto, California
| | | | - Don Hayes
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | | | - Marc Schecter
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Gary Visner
- Boston Children’s Hospital, Boston, Massachusetts
| | | | | | | | | | - Jonah N Odim
- National Institutes of Health, NIAID, Bethesda, Maryland
| | | | | | - Eyal Shemesh
- Icahn School of Medicine at Mount Sinai, Department of Pediatrics and Kravis Children’s Hospital, New York, New York
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20
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Criner GJ, Armstrong B, Shargill NS. Bronchoscopic Lung Volume Reduction with Zephyr Valves for Severe Emphysema. Respiration 2021; 100:1146-1148. [PMID: 34380139 DOI: 10.1159/000517254] [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] [Received: 03/16/2021] [Accepted: 04/30/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Gerard J Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
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21
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Nguyen LXT, Zhang B, Hoang DH, Zhao D, Wang H, Wu H, Su YL, Dong H, Rodriguez-Rodriguez S, Armstrong B, Ghoda LY, Perrotti D, Pichiorri F, Chen J, Li L, Kortylewski M, Rockne RC, Kuo YH, Khaled S, Carlesso N, Marcucci G. Cytoplasmic DROSHA and non-canonical mechanisms of MiR-155 biogenesis in FLT3-ITD acute myeloid leukemia. Leukemia 2021; 35:2285-2298. [PMID: 33589748 PMCID: PMC8973317 DOI: 10.1038/s41375-021-01166-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/07/2021] [Accepted: 01/26/2021] [Indexed: 01/29/2023]
Abstract
We report here on a novel pro-leukemogenic role of FMS-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD) that interferes with microRNAs (miRNAs) biogenesis in acute myeloid leukemia (AML) blasts. We showed that FLT3-ITD interferes with the canonical biogenesis of intron-hosted miRNAs such as miR-126, by phosphorylating SPRED1 protein and inhibiting the "gatekeeper" Exportin 5 (XPO5)/RAN-GTP complex that regulates the nucleus-to-cytoplasm transport of pre-miRNAs for completion of maturation into mature miRNAs. Of note, despite the blockage of "canonical" miRNA biogenesis, miR-155 remains upregulated in FLT3-ITD+ AML blasts, suggesting activation of alternative mechanisms of miRNA biogenesis that circumvent the XPO5/RAN-GTP blockage. MiR-155, a BIC-155 long noncoding (lnc) RNA-hosted oncogenic miRNA, has previously been implicated in FLT3-ITD+ AML blast hyperproliferation. We showed that FLT3-ITD upregulates miR-155 by inhibiting DDX3X, a protein implicated in the splicing of lncRNAs, via p-AKT. Inhibition of DDX3X increases unspliced BIC-155 that is then shuttled by NXF1 from the nucleus to the cytoplasm, where it is processed into mature miR-155 by cytoplasmic DROSHA, thereby bypassing the XPO5/RAN-GTP blockage via "non-canonical" mechanisms of miRNA biogenesis.
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Affiliation(s)
- Le Xuan Truong Nguyen
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA.
| | - Bin Zhang
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Dinh Hoa Hoang
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Dandan Zhao
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Huafeng Wang
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Herman Wu
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Yu-Lin Su
- Department of Immuno-Oncology, City of Hope Medical Center, Duarte, CA, USA
| | - Haojie Dong
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Sonia Rodriguez-Rodriguez
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Brian Armstrong
- Light Microscopy Core, Beckman Research Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Lucy Y Ghoda
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Danilo Perrotti
- Department of Medicine, Biochemistry and Molecular Biology and the Marlene and Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
| | - Flavia Pichiorri
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Jianjun Chen
- Department of System Biology, City of Hope Medical Center, Duarte, CA, USA
| | - Ling Li
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Marcin Kortylewski
- Department of Immuno-Oncology, City of Hope Medical Center, Duarte, CA, USA
| | - Russell C Rockne
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Ya-Huei Kuo
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Samer Khaled
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Nadia Carlesso
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA
| | - Guido Marcucci
- Gehr Family Center for Leukemia Research, Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope Medical Center, Duarte, CA, USA.
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22
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Vicedo-Cabrera AM, Scovronick N, Sera F, Royé D, Schneider R, Tobias A, Astrom C, Guo Y, Honda Y, Hondula DM, Abrutzky R, Tong S, de Sousa Zanotti Stagliorio Coelho M, Saldiva PHN, Lavigne E, Correa PM, Ortega NV, Kan H, Osorio S, Kyselý J, Urban A, Orru H, Indermitte E, Jaakkola JJK, Ryti N, Pascal M, Schneider A, Katsouyanni K, Samoli E, Mayvaneh F, Entezari A, Goodman P, Zeka A, Michelozzi P, de’Donato F, Hashizume M, Alahmad B, Diaz MH, De La Cruz Valencia C, Overcenco A, Houthuijs D, Ameling C, Rao S, Ruscio FD, Carrasco-Escobar G, Seposo X, Silva S, Madureira J, Holobaca IH, Fratianni S, Acquaotta F, Kim H, Lee W, Iniguez C, Forsberg B, Ragettli MS, Guo YLL, Chen BY, Li S, Armstrong B, Aleman A, Zanobetti A, Schwartz J, Dang TN, Dung DV, Gillett N, Haines A, Mengel M, Huber V, Gasparrini A. The burden of heat-related mortality attributable to recent human-induced climate change. Nat Clim Chang 2021; 11:492-500. [PMID: 34221128 PMCID: PMC7611104 DOI: 10.1038/s41558-021-01058-x] [Citation(s) in RCA: 196] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 04/20/2021] [Indexed: 05/19/2023]
Abstract
Climate change affects human health; however, there have been no large-scale, systematic efforts to quantify the heat-related human health impacts that have already occurred due to climate change. Here, we use empirical data from 732 locations in 43 countries to estimate the mortality burdens associated with the additional heat exposure that has resulted from recent human-induced warming, during the period 1991-2018. Across all study countries, we find that 37.0% (range 20.5-76.3%) of warm-season heat-related deaths can be attributed to anthropogenic climate change and that increased mortality is evident on every continent. Burdens varied geographically but were of the order of dozens to hundreds of deaths per year in many locations. Our findings support the urgent need for more ambitious mitigation and adaptation strategies to minimize the public health impacts of climate change.
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Affiliation(s)
- A. M. Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - N. Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - F. Sera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Department of Statistics, Computer Science and Applications ‘G. Parenti’, University of Florence, Florence, Italy
| | - D. Royé
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - R. Schneider
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Φ-Lab, European Space Agency (ESA-ESRIN), Frascati, Italy
- The Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
- European Centre for Medium-Range Weather Forecast (ECMWF), Reading, UK
| | - A. Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - C. Astrom
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Y. Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Y. Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - D. M. Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA
| | - R. Abrutzky
- Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - S. Tong
- Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | | | | | - E. Lavigne
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - P. Matus Correa
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - N. Valdes Ortega
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - H. Kan
- School of Public Health, Fudan University, Shanghai, China
| | - S. Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | - J. Kyselý
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - A. Urban
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - H. Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - E. Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - J. J. K. Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
- Finnish Meteorological Institute, Helsinki, Finland
| | - N. Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - M. Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | - A. Schneider
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - K. Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- MRC-PHE Centre for Environment and Health, Environmental Research Group, School of Public Health, Imperial College London, London, UK
| | - E. Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - F. Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - A. Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - P. Goodman
- School of Physics, Technological University Dublin, Dublin, Ireland
| | - A. Zeka
- Institute for Environment, Health and Societies, Brunel University London, London, UK
| | - P. Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - F. de’Donato
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - M. Hashizume
- Department of Global Health Policy, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - B. Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - M. Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - C. De La Cruz Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - A. Overcenco
- Laboratory of Management in Science and Public Health, National Agency for Public Health of the Ministry of Health, Chisinau, Republic of Moldova
| | - D. Houthuijs
- Centre for Sustainability and Environmental Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - C. Ameling
- Centre for Sustainability and Environmental Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - S. Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - F. Di Ruscio
- Norwegian Institute of Public Health, Oslo, Norway
| | - G. Carrasco-Escobar
- Health Innovation Laboratory, Institute of Tropical Medicine ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - X. Seposo
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - S. Silva
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal
| | - J. Madureira
- Department of Enviromental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - I. H. Holobaca
- Faculty of Geography, Babes-Bolay University, Cluj-Napoca, Romania
| | - S. Fratianni
- Department of Earth Sciences, University of Torino, Turin, Italy
| | - F. Acquaotta
- Department of Earth Sciences, University of Torino, Turin, Italy
| | - H. Kim
- Graduate School of Public Health & Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - W. Lee
- Graduate School of Public Health & Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - C. Iniguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Statistics and Computational Research, Universitat de Valencia, Valencia, Spain
| | - B. Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - M. S. Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Y. L. L. Guo
- Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan,Taiwan
| | - B. Y. Chen
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan,Taiwan
| | - S. Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - B. Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- The Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - A. Aleman
- Department of Preventive Medicine, School of Medicine, University of the Republic, Montevideo, Uruguay
| | - A. Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - J. Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - T. N. Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - D. V. Dung
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - N. Gillett
- Canadian Centre for Climate Modelling and Analysis, Environment and Climate Change Canada, Victoria, British Colombia, Canada
| | - A. Haines
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Φ-Lab, European Space Agency (ESA-ESRIN), Frascati, Italy
| | - M. Mengel
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - V. Huber
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
- Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Seville, Spain
| | - A. Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- The Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
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Koirala A, Yu Z, Schiltz H, Van Hecke A, Armstrong B, Zheng Z. A Preliminary Exploration of Virtual Reality-Based Visual and Touch Sensory Processing Assessment for Adolescents With Autism Spectrum Disorder. IEEE Trans Neural Syst Rehabil Eng 2021; 29:619-628. [PMID: 33684040 DOI: 10.1109/tnsre.2021.3064148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Sensory abnormalities are experienced by 90 - 95% of individuals with Autism Spectrum Disorder (ASD), a developmental disorder that impacts at least 1 in 132 children worldwide. Virtual reality (VR) technologies can precisely present sensory stimuli and be integrated with human sensing technologies to automatically detect sensory responses, and thus has a potential to improve sensory assessment objectiveness and sensitivity, compared to traditional questionnaire-based methods. However, there is a lack of evidence to demonstrate this potential. Therefore, we designed and developed a preliminary sensory assessment VR system (SAVR) to objectively and precisely evaluate the visual and touch sensory processing differences between adolescents with ASD and their typically developing (TD) peers through game playing. A controlled experiment was conducted with 12 adolescents with ASD and 12 TD adolescents. Participants' sensory pattern was assessed by SAVR and a widely used traditional questionnaire-the Adult/Adolescent Sensory Profile (AASP). We hypothesized that: 1) compared to AASP, SAVR can find more significant differences between the two participant groups, and 2) there are significant and strong correlations between the SAVR results and the AASP results. Statistical analyses of the experimental data supported the hypotheses. The implication and limitations of this preliminary exploration as well as future works are discussed.
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Brooks J, Kumar B, Zuro DM, Raybuck JD, Madabushi SS, Vishwasrao P, Parra LE, Kortylewski M, Armstrong B, Froelich J, Hui SK. Biophysical Characterization of the Leukemic Bone Marrow Vasculature Reveals Benefits of Neoadjuvant Low-Dose Radiation Therapy. Int J Radiat Oncol Biol Phys 2021; 109:60-72. [PMID: 32841681 PMCID: PMC7736317 DOI: 10.1016/j.ijrobp.2020.08.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 08/04/2020] [Accepted: 08/13/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Although vascular alterations in solid tumor malignancies are known to decrease therapeutic delivery, the effects of leukemia-induced bone marrow vasculature (BMV) alterations on therapeutic delivery are not well known. Additionally, functional quantitative measurements of the leukemic BMV during chemotherapy and radiation therapy are limited, largely due to a lack of high-resolution imaging techniques available preclinically. This study develops a murine model using compartmental modeling for quantitative multiphoton microscopy (QMPM) to characterize the malignant BMV before and during treatment. METHODS AND MATERIALS Using QMPM, live time-lapsed images of dextran leakage from the local BMV to the surrounding bone marrow of mice bearing acute lymphoblastic leukemia (ALL) were taken and fit to a 2-compartment model to measure the transfer rate (Ktrans), fractional extracellular extravascular space (νec), and vascular permeability parameters, as well as functional single-vessel characteristics. In response to leukemia-induced BMV alterations, the effects of 2 to 4 Gy low-dose radiation therapy (LDRT) on the BMV, drug delivery, and mouse survival were assessed post-treatment to determine whether neoadjuvant LDRT before chemotherapy improves treatment outcome. RESULTS Mice bearing ALL had significantly altered Ktrans, increased νec, and increased permeability compared with healthy mice. Angiogenesis, decreased single-vessel perfusion, and decreased vessel diameter were observed. BMV alterations resulted in disease-dependent reductions in cellular uptake of Hoechst dye. LDRT to mice bearing ALL dilated BMV, increased single-vessel perfusion, and increased daunorubicin uptake by ALL cells. Consequently, LDRT administered to mice before receiving nilotinib significantly increased survival compared with mice receiving LDRT after nilotinib, demonstrating the importance of LDRT conditioning before therapeutic administration. CONCLUSION The developed QMPM enables single-platform assessments of the pharmacokinetics of fluorescent agents and characterization of the BMV. Initial results suggest BMV alterations after neoadjuvant LDRT may contribute to enhanced drug delivery and increased treatment efficacy for ALL. The developed QMPM enables observations of the BMV for use in ALL treatment optimization.
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Affiliation(s)
- Jamison Brooks
- Department of Radiation Oncology, City of Hope, Duarte, California; Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota
| | - Bijender Kumar
- Department of Radiation Oncology, City of Hope, Duarte, California; Hematology Malignancies and Stem Cell Transplantation Institute, City of Hope National Medical Center, Duarte, California
| | - Darren M Zuro
- Department of Radiation Oncology, City of Hope, Duarte, California; Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota
| | | | | | | | | | - Marcin Kortylewski
- Department of Immuno-Oncology, City of Hope, Duarte, California; Beckman Research Institute of City of Hope, Duarte, California
| | - Brian Armstrong
- Beckman Research Institute of City of Hope, Duarte, California; Department of Development and Stem Cell Biology, City of Hope, Duarte, California
| | - Jerry Froelich
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota
| | - Susanta K Hui
- Department of Radiation Oncology, City of Hope, Duarte, California; Beckman Research Institute of City of Hope, Duarte, California.
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25
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Mannon RB, Armstrong B, Stock PG, Mehta AK, Farris AB, Watson N, Morrison Y, Sarwal M, Sigdel T, Bridges N, Robien M, Newell KA, Larsen CP. Avoidance of CNI and steroids using belatacept-Results of the Clinical Trials in Organ Transplantation 16 trial. Am J Transplant 2020; 20:3599-3608. [PMID: 32558199 PMCID: PMC7710570 DOI: 10.1111/ajt.16152] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 01/25/2023]
Abstract
Immunosuppression devoid of corticosteroids has been investigated to avoid long-term comorbidities. Likewise, alternatives to calcineurin inhibitors have been investigated as a strategy to improve long-term kidney function following transplanion. Costimulatory blockade strategies that include corticosteroids have recently shown promise, despite their higher rates of early acute rejection. We designed a randomized clinical trial utilizing depletional induction therapy to mitigate early rejection risk while limiting calcineurin inhibitors and corticosteroids. This trial, Clinical Trials in Organ Transplantation 16 (CTOT-16), sought to evaluate novel belatacept-based strategies employing tacrolimus and corticosteroid avoidance. Sixty-nine kidney transplant recipients were randomized from 4 US transplant centers comparing a control group of with rabbit antithymocyte globulin (rATG) induction, rapid steroid taper, and maintenance mycophenolate and tacrolimus, to 2 arms using maintenance belatacept. There were no graft losses but there were 2 deaths in the control group. However, the trial was halted early because of rejection in the belatacept treatment groups. Serious adverse events were similar across groups. Although rejection was not uniform in the belatacept maintenance therapy groups, the frequency of rejection limits the practical implementation of this strategy to avoid both calcineurin inhibitors and corticosteroids at this time.
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Affiliation(s)
- Roslyn B. Mannon
- Department of Medicine, Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL
| | | | - Peter G. Stock
- Department of Surgery, Division of Transplantation, University of California San Francisco, San Francisco, CA
| | - Aneesh K. Mehta
- Emory Transplant Center, Emory University School of Medicine, Atlanta GA,Department of Medicine, Emory University School of Medicine, Atlanta GA
| | - Alton B. Farris
- Emory Transplant Center, Emory University School of Medicine, Atlanta GA
| | - Natasha Watson
- Transplantation Branch, National Institute Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Yvonne Morrison
- Transplantation Branch, National Institute Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Minnie Sarwal
- Department of Surgery, Division of Transplantation, University of California San Francisco, San Francisco, CA
| | - Tara Sigdel
- Department of Surgery, Division of Transplantation, University of California San Francisco, San Francisco, CA
| | - Nancy Bridges
- Transplantation Branch, National Institute Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Mark Robien
- Transplantation Branch, National Institute Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Kenneth A. Newell
- Emory Transplant Center, Emory University School of Medicine, Atlanta GA
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Luzzi V, Novali M, Armstrong B, Bezzi M. Prospective Assessment of Collateral Ventilation using Chartis and Fissure Integrity by Quantitative Computed Tomography. Imaging 2020. [DOI: 10.1183/13993003.congress-2020.2094] [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: 11/05/2022] Open
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27
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Thompson J, Ng J, Armstrong B, Feletto E, Ha T. Differences in Colorectal Cancer (CRC) patients who did and did not undergo screening. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1343] [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: 11/14/2022] Open
Abstract
Abstract
Background
The Australian National Bowel Cancer Screening Program (NBSCP) is a free population-based screening program which aims to identify precancerous lesions and early colorectal cancer (CRC) using an immunochemical faecal occult blood test in average risk Australians. Formally commencing in 2006, NBCSP participation rate in eligible 50-74-year-old people was 42% in 2018. The barriers and facilitators of participation in the NBCSP have been explored for the general, at-risk population but not in a population of CRC patients. This is the first study to assess a population of CRC patients, post diagnosis, who would have been eligible for CRC screening to determine the barriers and facilitators to screening.
Methods
A cross sectional study nested within a cohort study. Data from CRC patients who participated in the 45 and Up Study; the largest cohort study in Australia and southern hemisphere, were analysed to compare those who had and had not participated in CRC screening. Logistic regression analyses were conducted using RStudio (version 3.5.2, Boston, Massachusetts, USA.). Multiple Imputation (MI), was used to handle missing values assumed to be missing at random.
Results
A total of 339 CRC patients were included. Patients who were female, overweight (≥25kg/m2), consumed less than the recommended five servings of vegetables per day, consumed less than or equal to fourteen standard drinks per week (compared to non-drinkers) or did not meet physical activity guidelines were significantly less likely to have participated in screening.
Conclusions
Our study has taken a unique approach to identifying a high-risk group by exploring factors to screening participation in CRC patients. CRC patients with less healthy lifestyles were less likely to participate in screening. In contrast to previous studies, female patients were less likely to participate in screening than males were. This was an unexpected finding and should be replicated.
Key messages
Not surprising that those with less healthy lifestyle practices also reflected less than ideal screening practices. Surprising that female patients participated less in screening than males. Future interventions to improve CRC screening participation rates should consider specialised messaging for average-risk females who are overweight not meeting dietary or physical activity guidelines.
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Affiliation(s)
- J Thompson
- School of Health and Society, The University of Wollongong, Wollongong, Australia
| | - J Ng
- School of Health and Society, The University of Wollongong, Wollongong, Australia
| | - B Armstrong
- School of Public Health, University of Sydney, Sydney, Australia
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - E Feletto
- School of Public Health, University of Sydney, Sydney, Australia
- Cancer Research Division, Cancer Council NSW, Sydney, Australia
| | - T Ha
- School of Health and Society, The University of Wollongong, Wollongong, Australia
- Research Assets Division, Sax Institute, Sydney, Australia
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Srivastava S, Guo L, Mohanty A, Nelson M, Armstrong B, Kulkarni P, Salgia R. Abstract 6130: Zebrafish: A prominent tool for cancer drug screening and discovery. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-6130] [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
Zebrafish xenotransplants have been exploited to study a myriad of cancers. Due to high genetic and physiological similarities with humans, zebrafish represents a powerful and cost-effective animal model. The main advantages of using this model are transparency, easy manipulation, larger sample size, and short testing period. We have utilized this model system to study lung cancer by performing high throughput drug screening, genetic knockout, xenotransplant of human cancer cells, and circulating tumor cells (CTCs). Among the various applications mentioned, we discuss here,1) Cisplatin resistance in NSCLC (Non-small cell lung cancer). 2) CTC growth with single cell sequencing to identify gene signature of CTCs. 1) NSCLC is the most commonly diagnosed form of lung cancer (>85% of cases). Cisplatin resistance remains a major hurdle in treating advanced NSCLC. To understand the mechanistic basis of how drug resistance evolves we studied cancer progression and group behavior of cisplatin sensitive vs cisplatin resistant cancer cells in zebrafish. Cells were stained with DiI Red (H23-sensitive) and DiI Green dyes (H2009-resistant) respectively. Single culture and co-culture microinjections were done with 50-100 cells and the growth of tumor cells was monitored using live imaging for 72 hours at 30°C. In single culture injections we identified that H2009 cells tend to grow in larger groups where 90% of the cells grow in perivitelline space whereas H23 grow as single cells and are able travel farther in the animal faster. For H23 cells some grow in punctate groups in perivitelline space and about 30% of the cells travel to tail region. Next steps are to establish co-culture phenotypes by injecting different ratios (1:1; 1:2; 1:4; 1:8) of two cell types and assay drugs. 2) CTCs are major players of metastasis which leads to progression of cancer at secondary sites. With disease progression and treatment, it is known that the CTC repertoire changes with enrichment of certain populations of CTCs termed sub-clonal evolution. Therefore, monitoring CTC populations to study changes in gene expression profiles, especially in mutation status -before and after treatment, is a great tool to study development of resistance mechanisms. However, isolating a pure CTC population is not trivial due to their extreme rarity in peripheral blood. We utilize the ANGEL Parsotix technology which works on the differences in physical properties of CTCs and blood cells, like size and deformability. But still we retrieve merely 5-10 CTCs from 8ml of blood. Therefore, we allow these CTCs to grow by xenotransplanting them in zebrafish to get enough population of cells for single cell sequencing. Based on this information we plan to study CTC population genotype evolution -before and after treatment and comparison of gene expression profiles/mutation status of CTCs in primary tumor and metastatic lesions.
Citation Format: Saumya Srivastava, Linlin Guo, Atish Mohanty, Michael Nelson, Brian Armstrong, Prakash Kulkarni, Ravi Salgia. Zebrafish: A prominent tool for cancer drug screening and discovery [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 6130.
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Affiliation(s)
- Saumya Srivastava
- Beckman Research Center, City of Hope National Medical Center, Monrovia, CA
| | - Linlin Guo
- Beckman Research Center, City of Hope National Medical Center, Monrovia, CA
| | - Atish Mohanty
- Beckman Research Center, City of Hope National Medical Center, Monrovia, CA
| | - Michael Nelson
- Beckman Research Center, City of Hope National Medical Center, Monrovia, CA
| | - Brian Armstrong
- Beckman Research Center, City of Hope National Medical Center, Monrovia, CA
| | - Prakash Kulkarni
- Beckman Research Center, City of Hope National Medical Center, Monrovia, CA
| | - Ravi Salgia
- Beckman Research Center, City of Hope National Medical Center, Monrovia, CA
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Levitsky J, Asrani SK, Schiano T, Moss A, Chavin K, Miller C, Guo K, Zhao L, Kandpal M, Bridges N, Brown M, Armstrong B, Kurian S, Demetris AJ, Abecassis M. Discovery and validation of a novel blood-based molecular biomarker of rejection following liver transplantation. Am J Transplant 2020; 20:2173-2183. [PMID: 32356368 PMCID: PMC7496674 DOI: 10.1111/ajt.15953] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 09/25/2019] [Revised: 02/28/2020] [Accepted: 04/13/2020] [Indexed: 02/06/2023]
Abstract
Noninvasive biomarker profiles of acute rejection (AR) could affect the management of liver transplant (LT) recipients. Peripheral blood was collected following LT for discovery (Northwestern University [NU]) and validation (National Institute of Allergy and Infectious Diseases Clinical Trials in Organ Transplantation [CTOT]-14 study). Blood gene profiling was paired with biopsies showing AR or ADNR (acute dysfunction no rejection) as well as stable graft function samples (Transplant eXcellent-TX). CTOT-14 subjects had serial collections prior to AR, ADNR, TX, and after AR treatment. NU cohort gene expression (46 AR, 45 TX) was analyzed using random forest models to generate a classifier training set (36 gene probe) distinguishing AR vs TX (area under the curve 0.92). The algorithm and threshold were locked and tested on the CTOT-14 validation cohort (14 AR, 50 TX), yielding an accuracy of 0.77, sensitivity 0.57, specificity 0.82, positive predictive value (PPV) 0.47, and negative predictive value (NPV) 0.87 for AR vs TX. The probability score line slopes were positive preceding AR, and negative preceding TX and non-AR (TX + ADNR) (P ≤ .001) and following AR treatment. In conclusion, we have developed a blood biomarker diagnostic for AR that can be detected prior to AR-associated graft injury as well a normal graft function (non-AR). Further studies are needed to evaluate its utility in precision-guided immunosuppression optimization following LT.
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Affiliation(s)
- Josh Levitsky
- Comprehensive Transplant CenterNorthwestern University Feinberg School of MedicineChicagoIllinois,Division of Gastroenterology and HepatologyDepartment of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Sumeet K. Asrani
- Annette C. and Harold C. Simmons Transplant InstituteBaylor University Medical CenterDallasTexas
| | | | | | | | | | - Kexin Guo
- Comprehensive Transplant CenterNorthwestern University Feinberg School of MedicineChicagoIllinois,Biostatistics Collaboration CenterDepartment of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Lihui Zhao
- Comprehensive Transplant CenterNorthwestern University Feinberg School of MedicineChicagoIllinois,Biostatistics Collaboration CenterDepartment of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Manoj Kandpal
- Comprehensive Transplant CenterNorthwestern University Feinberg School of MedicineChicagoIllinois,Biostatistics Collaboration CenterDepartment of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Nancy Bridges
- Division of Allergy, Immunology, and TransplantationNational Institute of Allergy and Infectious DiseasesBethesdaMaryland
| | - Merideth Brown
- Division of Allergy, Immunology, and TransplantationNational Institute of Allergy and Infectious DiseasesBethesdaMaryland
| | | | - Sunil Kurian
- The Scripps Research InstituteLa JollaCalifornia
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Zhang XH, Yin Z, Zhang A, Pillai R, Armstrong B, Rosen ST. DNMT1 and p38γ are inversely expressed in reactive non‐metastatic lymph nodes burdened with colorectal adenocarcinoma. eJHaem 2020; 1:300-303. [PMID: 35847731 PMCID: PMC9176054 DOI: 10.1002/jha2.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/19/2020] [Accepted: 06/19/2020] [Indexed: 02/03/2023]
Abstract
Lymph nodes are important front‐line defense immune tissues, which also act against inflammatory diseases and cancer. Lymph nodes undergo extensive upheavals within newly formed germinal centers (GCs) when exposed to antigens, the molecular mechanisms of which remain elusive. Recently, p38γ was identified as an important target for multiple cancers, including cutaneous T‐cell lymphoma (CTCL). We previously observed that p38γ is overexpressed in CTCL versus normal cells, but it is not clear if p38γ is expressed in B or T lymphocytes of GCs of patients in response to a stress such as cancer. Therefore, in this study, we obtained non‐metastatic reactive lymph nodes adjacent to cancer lesions (colorectal adenocarcinoma), then performed multicolor immunohistochemical staining for p38γ and other relevant markers. We observed for the first time that p38γ was expressed in the light zone of activated B cells and T helper cells in GCs, whereas DNA‐methyltransferase 1 (DNMT1), a marker for GC B cells, was highly expressed in centrocytes and in the dark zone of GCs. This inverse relationship suggests a novel function for p38γ in T cells that cross‐talk to B cells in response to stress.
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Affiliation(s)
- Xu Hannah Zhang
- Department of HematologyCity of Hope National Medical Center Duarte California USA
| | - Zhirong Yin
- Department of Pathology Solid Tumor CoreCity of Hope National Medical Center Duarte California USA
| | - Aimin Zhang
- Department of Pathology Solid Tumor CoreCity of Hope National Medical Center Duarte California USA
| | - Raju Pillai
- Department of Pathology Solid Tumor CoreCity of Hope National Medical Center Duarte California USA
| | - Brian Armstrong
- Light microscopy coreCity of Hope National Medical Center, Duarte, California, City of Hope National Medical CenterBeckman Research Institute Duarte California USA
| | - Steven T Rosen
- Department of HematologyCity of Hope National Medical Center Duarte California USA
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Dransfield MT, Garner JL, Bhatt SP, Slebos DJ, Klooster K, Sciurba FC, Shah PL, Marchetti NT, Sue RD, Wright S, Rivas-Perez H, Wiese TA, Wahidi MM, Goulart de Oliveira H, Armstrong B, Radhakrishnan S, Shargill NS. Effect of Zephyr Endobronchial Valves on Dyspnea, Activity Levels, and Quality of Life at One Year. Results from a Randomized Clinical Trial. Ann Am Thorac Soc 2020; 17:829-838. [PMID: 32223724 PMCID: PMC7328183 DOI: 10.1513/annalsats.201909-666oc] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 03/30/2020] [Indexed: 12/15/2022] Open
Abstract
Rationale: Bronchoscopic lung volume reduction with Zephyr Valves improves lung function, exercise tolerance, and quality of life of patients with hyperinflated emphysema and little to no collateral ventilation.Objectives:Post hoc analysis of patient-reported outcomes (PROs), including multidimensional measures of dyspnea, activity, and quality of life, in the LIBERATE (Lung Function Improvement after Bronchoscopic Lung Volume Reduction with Pulmonx Endobronchial Valves used in Treatment of Emphysema) study are reported.Methods: A total of 190 patients with severe heterogeneous emphysema and little to no collateral ventilation in the target lobe were randomized 2:1 to the Zephyr Valve or standard of care. Changes in PROs at 12 months in the two groups were compared: dyspnea with the Transitional Dyspnea Index (TDI), focal score; the Chronic Obstructive Pulmonary Disease Assessment Test (CAT; breathlessness on hill/stairs); Borg; the EXAcerbations of Chronic pulmonary disease Tool-PRO, dyspnea domain; activity with the TDI, magnitude of task/effort/functional impairment, CAT (limited activities), and the St. George's Respiratory Questionnaire (SGRQ), activity domain; and psychosocial status with the SGRQ, impacts domain, and CAT (confidence and energy).Results: At 12 months, patients using the Zephyr Valve achieved statistically significant and clinically meaningful improvements in the SGRQ; CAT; and the TDI, focal score, compared with standard of care. Improvements in the SGRQ were driven by the impacts and activity domains (P < 0.05 and P < 0.001, respectively). Reduction in CAT was through improvements in breathlessness (P < 0.05), energy level (P < 0.05), activities (P < 0.001), and increased confidence when leaving home (P < 0.05). The TDI measures of effort, task, and functional impairment were uniformly improved (P < 0.001). The EXAcerbations of Chronic Pulmonary Disease Tool (EXACT)-PRO, dyspnea domain, was significantly improved in the Zephyr Valve group. Improvements correlated with changes in residual volume and residual volume/TLC ratio.Conclusions: Patients with severe hyperinflated emphysema achieving lung volume reductions with Zephyr Valves experience improvements in multidimensional scores for breathlessness, activity, and psychosocial parameters out to at least 12 months.Clinical trial registered with www.clinicaltrials.gov (NCT01796392).
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Affiliation(s)
- Mark T. Dransfield
- Lung Health Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Justin L. Garner
- Royal Brompton Hospital and Imperial College, London, United Kingdom
| | - Surya P. Bhatt
- Lung Health Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Dirk-Jan Slebos
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Karin Klooster
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Frank C. Sciurba
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Pallav L. Shah
- Royal Brompton Hospital and Imperial College, London, United Kingdom
| | - Nathaniel T. Marchetti
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Richard D. Sue
- St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Shawn Wright
- St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
| | - Hiram Rivas-Perez
- Department of Medicine, University of Louisville, Louisville, Kentucky
| | | | - Momen M. Wahidi
- Duke University Medical Center, Duke University, Durham, North Carolina
| | | | | | | | | | - for the LIBERATE Study Group
- Lung Health Center, University of Alabama at Birmingham, Birmingham, Alabama
- Royal Brompton Hospital and Imperial College, London, United Kingdom
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
- St. Joseph’s Hospital and Medical Center, Phoenix, Arizona
- Department of Medicine, University of Louisville, Louisville, Kentucky
- Norton Healthcare, Louisville, Kentucky
- Duke University Medical Center, Duke University, Durham, North Carolina
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
- QST Consultations Ltd., Allendale, Michigan; and
- Pulmonx Corporation, Redwood City, California
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Stock PG, Mannon RB, Armstrong B, Watson N, Ikle D, Robien M, Morrison Y, Odorico J, Fridell J, Mehta AK, Newell KA. Challenges of calcineurin inhibitor withdrawal following combined pancreas and kidney transplantation: Results of a prospective, randomized clinical trial. Am J Transplant 2020; 20:1668-1678. [PMID: 32039559 PMCID: PMC8982902 DOI: 10.1111/ajt.15817] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/26/2020] [Accepted: 01/29/2020] [Indexed: 01/25/2023]
Abstract
In a phase 2 multicenter open-label randomized trial sponsored by the National Institutes of Health, simultaneous pancreas-kidney (SPK) recipients were randomized to a calcineurin inhibitor (CNI)-based immunosuppressive regimen (tacrolimus) (n = 21), or an investigational arm using low-dose CNI plus costimulation blockade (belatacept) with intended CNI withdrawal (n = 22). Both arms included induction therapy with rabbit ATG, mycophenolate sodium, or mycophenolate mofetil and rapid withdrawal of steroids. Enrollment and CNI withdrawal were stopped after 43/60 planned subjects had been enrolled. At that time, the rate of biopsy-proven acute rejection (BPAR) of the pancreas was low in both groups until CNI was withdrawn, with four of the five pancreas rejections occurring during or after CNI withdrawal. The rate of BPAR of kidney allografts was low in both control (9.5%) and investigational (9.1%) arms. Pancreas graft survival at 52 weeks, defined by insulin independence, was 21 (100%) in the control group and 19 (86%) in the investigational arm. One subject in the investigational arm died with functioning pancreas and kidney grafts. Renal function at week 52 was similar in both arms. Costimulation blockade with belatacept did not provide sufficient immunosuppression to reliably prevent pancreas rejection in SPK transplants undergoing CNI withdrawal.
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Affiliation(s)
| | | | | | - Natasha Watson
- Transplantation Branch, National Institute Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | | | - Mark Robien
- Transplantation Branch, National Institute Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Yvonne Morrison
- Transplantation Branch, National Institute Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Jon Odorico
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Dugger R, Brazendale K, Hunt ET, Moore JB, Turner-McGrievy G, Vogler K, Beets MW, Armstrong B, Weaver RG. The impact of summer programming on the obesogenic behaviors of children: behavioral outcomes from a quasi-experimental pilot trial. Pilot Feasibility Stud 2020; 6:78. [PMID: 32514369 PMCID: PMC7254707 DOI: 10.1186/s40814-020-00617-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/14/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Children from low-income families experience accelerated BMI gain and learning loss during summer. Healthy Summer Learners (HSL) addresses accelerated BMI gain and academic learning loss during summer by providing academic- and health-focused programming. This manuscript reports the effects of HSL on underlying obesogenic behaviors (i.e., physical activity, screen time, sleep, diet) that lead to accelerated summer BMI gain, a necessary first step to informing a future randomized controlled trial of HSL. METHODS In the summer of 2018 and 2019 using a quasi-experimental study design, 180 children (90 per summer, 7.9 years [SD = 1.0], 94% non-Hispanic Black, 40% male) at two schools (i.e., one per summer) who were struggling academically (25-75% on a standardized reading test) were provided a free, school-based 6-week health- and academic-focused summer program (i.e., HSL, n = 60), a 4- to 6-week academic-focused summer program (i.e., 21st Century Summer Learning program (21C), n = 60), or no summer program (n = 60). Children wore the Fitbit Charge 2™ over a 10-week period during the summers (June-Aug) of 2018-2019. Differences within (within child days attend vs. not attend) and between (differences between groups attend vs. not attend) were evaluated using mixed effects linear regression. RESULTS Regression estimates indicated that, on days attending, HSL children experienced a greater reduction in sedentary minutes (- 58.6 [95% CI = - 92.7, - 24.4]) and a greater increase in moderate-to-vigorous physical activity (MVPA) (36.2 [95% CI = 25.1, 47.3]) and steps (2799.2 [95% CI = 2114.2, 3484.2]) compared to 21C children. However, both HSL and 21C children were more active (i.e., greater MVPA, total steps) and less sedentary (i.e., less sedentary minutes and total screen time) and displayed better sleeping patterns (i.e., earlier and less variability in sleep onset and offset) on days they attended than children in the control. CONCLUSIONS HSL produced greater changes in physical activity than 21C. However, attendance at either HSL or 21C leads to more healthy obesogenic behaviors. Based on the behavioral data in this pilot study, a larger trial may be warranted. These results must be considered along with the pending primary outcomes (i.e., academics and BMI z-score) of the HSL pilot to determine if a full-scale trial is warranted. TRIAL REGISTRATION NIH-NCT03321071. Registered 25 October 2017.
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Affiliation(s)
- R. Dugger
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina USA
| | - K. Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, Florida USA
| | - E. T. Hunt
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina USA
| | - J. B. Moore
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina USA
| | - G. Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina USA
| | - K. Vogler
- Department of Instruction and Teacher Education, University of South Carolina, Columbia, South Carolina USA
| | - M. W. Beets
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina USA
| | - B. Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina USA
| | - R. G. Weaver
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina USA
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Covington LB, Armstrong B, Black MM. 0984 Less Consistent Bedtimes Explains The Relationship Between Household Poverty And BMI In Toddlers. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.980] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Consistent bedtimes, in conjunction with physical activity and diet have been linked to healthy weight in childhood. Young children living in impoverished families are at risk for obesity, and the mechanisms of obesity etiology are not fully understood. This study compares the role of bedtime consistency, physical activity and diet quality as mediators between household poverty and toddler weight gain.
Methods
207 toddlers participating in an obesity prevention trial wore Actical accelerometers for up to 7 consecutive days, at 3 time points over 12 months. At each assessment, gender-specific BMI-for-age z-scores (zBMI) were calculated from toddlers’ weight/length according to WHO standards. Household poverty ratio was calculated based on the number of household members and annual income. Diet quality was assessed using Healthy Eating Index (HEI-2015) from 24-hour dietary recall. Physical activity and sleep were measured using ankle accelerometry (Actical; Sadeh algorithm used for sleep). Bedtime consistency was defined as SD of sleep onset across 7 days. A multi-level mediation model was conducted in the SPSS macro MLmed examining toddler bedtime consistency, physical activity and diet quality as mediators between household poverty and toddler zBMI. The analysis adjusted for toddler age, gender, total sleep time and intervention group.
Results
Between-person effects revealed that less household poverty was associated with more consistent bedtimes. Children with less consistent bedtimes, but not poor diet quality or physical activity, had higher zBMI. Bedtime consistency indirectly explained the association between average household poverty and average toddler zBMI over 12 months.
Conclusion
Children who generally have less bedtime consistency, above and beyond physical activity and diet quality, had higher zBMI. This link uniquely indirectly explained the association between household poverty and zBMI. Inconsistent bedtimes may indicate lack of structure in other health behaviors, and therefore, continued longitudinal research examining family routines may inform obesity prevention strategies.
Support
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), R01HD056099
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Affiliation(s)
- L B Covington
- University of Delaware School of Nursing, Newark, DE
| | - B Armstrong
- University of South Carolina Arnold School of Public Health, Columbia, SC
| | - M M Black
- University of Maryland School of Medicine, Baltimore, MD
- RTI International, Raleigh, NC
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Starling RC, Armstrong B, Bridges ND, Eisen H, Givertz MM, Kfoury AG, Kobashigawa J, Ikle D, Morrison Y, Pinney S, Stehlik J, Tripathi S, Sayegh MH, Chandraker A. Accelerated Allograft Vasculopathy With Rituximab After Cardiac Transplantation. J Am Coll Cardiol 2020; 74:36-51. [PMID: 31272550 DOI: 10.1016/j.jacc.2019.04.056] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 04/09/2019] [Accepted: 04/11/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The CTOT-11 (Prevention of Cardiac Allograft Vasculopathy Using Rituximab Therapy in Cardiac Transplantation [Clinical Trials in Organ Transplantation-11]) study was a randomized, placebo-controlled, multicenter, double-blinded clinical trial in nonsensitized primary heart transplant (HTX) recipients. OBJECTIVES The study sought to determine whether B cell depletion therapy would attenuate the development of cardiac allograft vasculopathy. METHODS A total of 163 HTX recipients were randomized to rituximab 1,000 mg intravenous or placebo on days 0 and 12 post-transplant. Primary outcome was change in percent atheroma volume (PAV) from baseline to 1 year measured by intravascular ultrasound. Secondary outcomes included treated episodes of acute rejection, de novo anti-HLA antibodies (including donor-specific antibodies), and phenotypic differentiation of B cells. RESULTS There were no significant differences at study entry between the rituximab and placebo groups. Paired intravascular ultrasound measures were available at baseline and 1 year in 86 subjects (49 rituximab, 37 placebo). The mean ± SD change in PAV at 12 months was +6.8 ± 8.2% rituximab versus +1.9 ± 4.4% placebo (p = 0.0019). Mortality at 12 months was 3.4% rituximab versus 6.8% placebo (p = 0.47); there were no retransplants or post-transplant lymphoproliferative disorder. The rate of treated rejection was 24.7% rituximab versus 32.4% placebo (p = 0.28). Rituximab therapy effectively eliminated CD20+/CD19+ B cells followed by a gradual expansion of a CD19- cell population in the rituximab-treated group. CONCLUSIONS A marked, unexpected increase in coronary artery PAV with rituximab was observed during the first year in HTX recipients. One-year mortality was not impacted; however, longer-term follow-up and mechanistic explanations are required. (Prevention of Cardiac Allograft Vasculopathy Using Rituximab [Rituxan] Therapy in Cardiac Transplantation; NCT01278745).
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Affiliation(s)
- Randall C Starling
- Department of Medicine, Cleveland Clinic Foundation, Cleveland, Ohio. https://twitter.com/rcstarling
| | | | - Nancy D Bridges
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Howard Eisen
- Department of Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Michael M Givertz
- Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Jon Kobashigawa
- Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California
| | - David Ikle
- Rho Federal Systems Division, Chapel Hill, North Carolina
| | - Yvonne Morrison
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Sean Pinney
- Department of Medicine, Mount Sinai School of Medicine, New York, New York
| | - Josef Stehlik
- Department of Medicine, University of Utah, Salt Lake City, Utah
| | - Sudipta Tripathi
- Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Mohamed H Sayegh
- Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Anil Chandraker
- Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Boston, Massachusetts.
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Levitsky J, Asrani SK, Klintmalm G, Schiano T, Moss A, Chavin K, Miller C, Guo K, Zhao L, Jennings LW, Brown M, Armstrong B, Abecassis M. Discovery and Validation of a Biomarker Model (PRESERVE) Predictive of Renal Outcomes After Liver Transplantation. Hepatology 2020; 71:1775-1786. [PMID: 31509263 PMCID: PMC7883482 DOI: 10.1002/hep.30939] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 09/05/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS A high proportion of patients develop chronic kidney disease (CKD) after liver transplantation (LT). We aimed to develop clinical/protein models to predict future glomerular filtration rate (GFR) deterioration in this population. APPROACH AND RESULTS In independent multicenter discovery (CTOT14) and single-center validation (BUMC) cohorts, we analyzed kidney injury proteins in serum/plasma samples at month 3 after LT in recipients with preserved GFR who demonstrated subsequent GFR deterioration versus preservation by year 1 and year 5 in the BUMC cohort. In CTOT14, we also examined correlations between serial protein levels and GFR over the first year. A month 3 predictive model was constructed from clinical and protein level variables using the CTOT14 cohort (n = 60). Levels of β-2 microglobulin and CD40 antigen and presence of hepatitis C virus (HCV) infection predicted early (year 1) GFR deterioration (area under the curve [AUC], 0.814). We observed excellent validation of this model (AUC, 0.801) in the BUMC cohort (n = 50) who had both early and late (year 5) GFR deterioration. At an optimal threshold, the model had the following performance characteristics in CTOT14 and BUMC, respectively: accuracy (0.75, 0.8), sensitivity (0.71, 0.67), specificity (0.78, 0.88), positive predictive value (0.74, 0.75), and negative predictive value (0.76, 0.82). In the serial CTOT14 analysis, several proteins, including β-2 microglobulin and CD40, correlated with GFR changes over the first year. CONCLUSIONS We have validated a clinical/protein model (PRESERVE) that early after LT can predict future renal deterioration versus preservation with high accuracy. This model may help select recipients at higher risk for subsequent CKD for early, proactive renal sparing strategies.
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Affiliation(s)
- Josh Levitsky
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | | | | | | | | | | | - Kexin Guo
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lihui Zhao
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Merideth Brown
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, Bethesda, MD
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Yoon S, Li H, Quintanar L, Armstrong B, Rossi JJ. Uncovering Differently Expressed Markers and Heterogeneity on Human Pancreatic Cancer. Transl Oncol 2020; 13:100749. [PMID: 32143178 PMCID: PMC7056725 DOI: 10.1016/j.tranon.2020.100749] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 12/15/2022] Open
Abstract
Discovery of biomarkers is critical to understand tumor heterogeneity and microenvironment. To determine differently expressed makers on cancer tissue for comprehensive profiling, the multiplexed tissue imaging mass cytometer (IMC) which uniquely combines time-of-flight mass spectrometry with metal-labeling technology to enable breakthrough discovery on single cell level was employed to investigate the expression of seven markers related to the epithelial-to-mesenchymal transition [α-smooth muscle actin (α-SMA), vimentin, collagen I, cytokeratin 7, pan-keratin], tumor proliferation (Ki-67), and human leucocyte antigen (HLA-DR) on human pancreatic cancer tissue. The difference was analyzed using bioinformatic tools. We observed the high expression of α-SMA, vimentin, collagen I, and Ki-67 on grade I but not on grade III. HLA-DR was highly expressed on grade I/III but not on grade II. Overall, the expression of markers has elucidated the heterogeneity intratumors. Additionally, to identify biomarkers on pancreatic cancer cells by blind systematic evolution of ligands by exponential enrichment (SELEX), aptamer pull-down assay and liquid chromatography–tandem mass spectrometry were used. Mortalin was identified as a potential a prognostic marker of pancreatic cancer. Our studies demonstrate that the IMC and blind SELEX might be implemented to discover biomarkers which can be used to better understand tumor biology and biomedical research applications.
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Affiliation(s)
- Sorah Yoon
- Department of Molecular and Cellular Biology, Beckman Research Institute of City of Hope, Duarte, California, 91010, USA
| | - Haiqing Li
- Research Informatics, City of Hope, Duarte, California, 91010, USA
| | - Loren Quintanar
- Light Microscopy core, City of Hope, Duarte, California, 91010, USA
| | - Brian Armstrong
- Light Microscopy core, City of Hope, Duarte, California, 91010, USA
| | - John J Rossi
- Department of Molecular and Cellular Biology, Beckman Research Institute of City of Hope, Duarte, California, 91010, USA.
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Song A, Dai W, Jang MJ, Medrano L, Li Z, Zhao H, Shao M, Tan J, Li A, Ning T, Miller MM, Armstrong B, Huss JM, Zhu Y, Liu Y, Gradinaru V, Wu X, Jiang L, Scherer PE, Wang QA. Low- and high-thermogenic brown adipocyte subpopulations coexist in murine adipose tissue. J Clin Invest 2020; 130:247-257. [PMID: 31573981 PMCID: PMC6934193 DOI: 10.1172/jci129167] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 09/25/2019] [Indexed: 12/29/2022] Open
Abstract
Brown adipose tissue (BAT), as the main site of adaptive thermogenesis, exerts beneficial metabolic effects on obesity and insulin resistance. BAT has been previously assumed to contain a homogeneous population of brown adipocytes. Utilizing multiple mouse models capable of genetically labeling different cellular populations, as well as single-cell RNA sequencing and 3D tissue profiling, we discovered a brown adipocyte subpopulation with low thermogenic activity coexisting with the classical high-thermogenic brown adipocytes within the BAT. Compared with the high-thermogenic brown adipocytes, these low-thermogenic brown adipocytes had substantially lower Ucp1 and Adipoq expression, larger lipid droplets, and lower mitochondrial content. Functional analyses showed that, unlike the high-thermogenic brown adipocytes, the low-thermogenic brown adipocytes have markedly lower basal mitochondrial respiration, and they are specialized in fatty acid uptake. Upon changes in environmental temperature, the 2 brown adipocyte subpopulations underwent dynamic interconversions. Cold exposure converted low-thermogenic brown adipocytes into high-thermogenic cells. A thermoneutral environment had the opposite effect. The recruitment of high-thermogenic brown adipocytes by cold stimulation is not affected by high-fat diet feeding, but it does substantially decline with age. Our results revealed a high degree of functional heterogeneity of brown adipocytes.
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Affiliation(s)
- Anying Song
- Department of Molecular & Cellular Endocrinology, Diabetes & Metabolism Research Institute, City of Hope Medical Center, Duarte, California, USA
| | - Wenting Dai
- Department of Molecular & Cellular Endocrinology, Diabetes & Metabolism Research Institute, City of Hope Medical Center, Duarte, California, USA
| | - Min Jee Jang
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, California, USA
| | - Leonard Medrano
- Department of Translational Research & Cellular Therapeutics, Diabetes & Metabolism Research Institute, and
| | - Zhuo Li
- Electron Microscopy and Atomic Force Microscopy Core, Beckman Research Institute, City of Hope Medical Center, Duarte, California, USA
| | - Hu Zhao
- Department of Restorative Sciences, School of Dentistry, Texas A&M University, Dallas, Texas, USA
| | - Mengle Shao
- Touchstone Diabetes Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jiayi Tan
- Department of Molecular & Cellular Endocrinology, Diabetes & Metabolism Research Institute, City of Hope Medical Center, Duarte, California, USA
| | - Aimin Li
- Pathology Core of Shared Resources and
| | - Tinglu Ning
- Department of Molecular & Cellular Endocrinology, Diabetes & Metabolism Research Institute, City of Hope Medical Center, Duarte, California, USA
| | - Marcia M. Miller
- Electron Microscopy and Atomic Force Microscopy Core, Beckman Research Institute, City of Hope Medical Center, Duarte, California, USA
| | - Brian Armstrong
- Light Microscopy Digital Imaging Core, Beckman Research Institute, City of Hope Medical Center, Duarte, California, USA
| | - Janice M. Huss
- Department of Molecular & Cellular Endocrinology, Diabetes & Metabolism Research Institute, City of Hope Medical Center, Duarte, California, USA
| | - Yi Zhu
- Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Yong Liu
- Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, Institute for Advanced Studies, Wuhan University, Wuhan, China
| | - Viviana Gradinaru
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, California, USA
| | | | - Lei Jiang
- Department of Molecular & Cellular Endocrinology, Diabetes & Metabolism Research Institute, City of Hope Medical Center, Duarte, California, USA
- Comprehensive Cancer Center, Beckman Research Institute, City of Hope Medical Center, Duarte, California, USA
| | - Philipp E. Scherer
- Touchstone Diabetes Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Qiong A. Wang
- Department of Molecular & Cellular Endocrinology, Diabetes & Metabolism Research Institute, City of Hope Medical Center, Duarte, California, USA
- Comprehensive Cancer Center, Beckman Research Institute, City of Hope Medical Center, Duarte, California, USA
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Mirzapoiazova T, Li H, Nathan A, Srivstava S, Nasser MW, Lennon F, Armstrong B, Mambetsariev I, Chu PG, Achuthan S, Batra SK, Kulkarni P, Salgia R. Monitoring and Determining Mitochondrial Network Parameters in Live Lung Cancer Cells. J Clin Med 2019; 8:jcm8101723. [PMID: 31635288 PMCID: PMC6832496 DOI: 10.3390/jcm8101723] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/10/2019] [Accepted: 10/16/2019] [Indexed: 02/06/2023] Open
Abstract
Mitochondria are dynamic organelles that constantly fuse and divide, forming dynamic tubular networks. Abnormalities in mitochondrial dynamics and morphology are linked to diverse pathological states, including cancer. Thus, alterations in mitochondrial parameters could indicate early events of disease manifestation or progression. However, finding reliable and quantitative tools for monitoring mitochondria and determining the network parameters, particularly in live cells, has proven challenging. Here, we present a 2D confocal imaging-based approach that combines automatic mitochondrial morphology and dynamics analysis with fractal analysis in live small cell lung cancer (SCLC) cells. We chose SCLC cells as a test case since they typically have very little cytoplasm, but an abundance of smaller mitochondria compared to many of the commonly used cell types. The 2D confocal images provide a robust approach to quantitatively measure mitochondrial dynamics and morphology in live cells. Furthermore, we performed 3D reconstruction of electron microscopic images and show that the 3D reconstruction of the electron microscopic images complements this approach to yield better resolution. The data also suggest that the parameters of mitochondrial dynamics and fractal dimensions are sensitive indicators of cellular response to subtle perturbations, and hence, may serve as potential markers of drug response in lung cancer.
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Affiliation(s)
- Tamara Mirzapoiazova
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA 91010, USA.
| | - Haiqing Li
- Center for Informatics, City of Hope National Medical Center, Duarte, CA 91010, USA.
- Department of Computational & Quantitative Medicine, Beckman Research Institute, City of Hope Medical Center, Duarte, CA 91010, USA.
| | - Anusha Nathan
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA 91010, USA.
| | - Saumya Srivstava
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA 91010, USA.
| | - Mohd W Nasser
- University of Nebraska, Medical Center, Nebraska, NE 68198, USA.
| | | | - Brian Armstrong
- Department of Developmental and Stem Cell Biology, City of Hope National Medical Center, Duarte, CA 91010, USA.
| | - Isa Mambetsariev
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA 91010, USA.
| | - Peiguo G Chu
- Department of Anatomic Pathology, City of Hope National Medical Center, Duarte, CA 91010, USA.
| | - Srisairam Achuthan
- Center for Informatics, City of Hope National Medical Center, Duarte, CA 91010, USA.
| | - Surinder K Batra
- University of Nebraska, Medical Center, Nebraska, NE 68198, USA.
| | - Prakash Kulkarni
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA 91010, USA.
| | - Ravi Salgia
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA 91010, USA.
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Criner GJ, Sue R, Wright S, Dransfield M, Rivas-Perez H, Wiese T, Sciurba FC, Shah PL, Wahidi MM, de Oliveira HG, Morrissey B, Cardoso PFG, Hays S, Majid A, Pastis N, Kopas L, Vollenweider M, McFadden PM, Machuzak M, Hsia DW, Sung A, Jarad N, Kornaszewska M, Hazelrigg S, Krishna G, Armstrong B, Shargill NS, Slebos DJ. A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE). Am J Respir Crit Care Med 2019; 198:1151-1164. [PMID: 29787288 DOI: 10.1164/rccm.201803-0590oc] [Citation(s) in RCA: 209] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE This is the first multicenter randomized controlled trial to evaluate the effectiveness and safety of Zephyr Endobronchial Valve (EBV) in patients with little to no collateral ventilation out to 12 months. OBJECTIVES To evaluate the effectiveness and safety of Zephyr EBV in heterogeneous emphysema with little to no collateral ventilation in the treated lobe. METHODS Subjects were enrolled with a 2:1 randomization (EBV/standard of care [SoC]) at 24 sites. Primary outcome at 12 months was the ΔEBV-SoC of subjects with a post-bronchodilator FEV1 improvement from baseline of greater than or equal to 15%. Secondary endpoints included absolute changes in post-bronchodilator FEV1, 6-minute-walk distance, and St. George's Respiratory Questionnaire scores. MEASUREMENTS AND MAIN RESULTS A total of 190 subjects (128 EBV and 62 SoC) were randomized. At 12 months, 47.7% EBV and 16.8% SoC subjects had a ΔFEV1 greater than or equal to 15% (P < 0.001). ΔEBV-SoC at 12 months was statistically and clinically significant: for FEV1, 0.106 L (P < 0.001); 6-minute-walk distance, +39.31 m (P = 0.002); and St. George's Respiratory Questionnaire, -7.05 points (P = 0.004). Significant ΔEBV-SoC were also observed in hyperinflation (residual volume, -522 ml; P < 0.001), modified Medical Research Council Dyspnea Scale (-0.8 points; P < 0.001), and the BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index (-1.2 points). Pneumothorax was the most common serious adverse event in the treatment period (procedure to 45 d), in 34/128 (26.6%) of EBV subjects. Four deaths occurred in the EBV group during this phase, and one each in the EBV and SoC groups between 46 days and 12 months. CONCLUSIONS Zephyr EBV provides clinically meaningful benefits in lung function, exercise tolerance, dyspnea, and quality of life out to at least 12 months, with an acceptable safety profile in patients with little or no collateral ventilation in the target lobe. Clinical trial registered with www.clinicaltrials.gov (NCT 01796392).
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Affiliation(s)
- Gerard J Criner
- 1 Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Richard Sue
- 2 St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Shawn Wright
- 2 St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Mark Dransfield
- 3 University of Alabama at Birmingham UAB Lung Health Center, Birmingham, Alabama
| | - Hiram Rivas-Perez
- 4 Department of Medicine, University of Louisville, Louisville, Kentucky
| | - Tanya Wiese
- 4 Department of Medicine, University of Louisville, Louisville, Kentucky
| | - Frank C Sciurba
- 5 Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Pallav L Shah
- 6 Royal Brompton Hospital and Imperial College, London, United Kingdom
| | - Momen M Wahidi
- 7 Duke University Medical Center, Duke University, Durham, North Carolina
| | | | - Brian Morrissey
- 9 Division of Pulmonary, Critical Care and Sleep Medicine, University of California, Davis, Sacramento, California
| | - Paulo F G Cardoso
- 10 Instituto do Coracao, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Steven Hays
- 11 University of California, San Francisco, San Francisco, California
| | - Adnan Majid
- 12 Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Nicholas Pastis
- 13 Medical University of South Carolina, Charleston, South Carolina
| | - Lisa Kopas
- 14 Pulmonary Critical Care and Sleep Medicine Consultants, Houston Methodist, Houston, Texas
| | - Mark Vollenweider
- 15 Orlando Health Pulmonary and Sleep Medicine Group, Orlando Regional Medical Center, Orlando, Florida
| | - P Michael McFadden
- 16 Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Michael Machuzak
- 17 Center for Major Airway Diseases, Cleveland Clinic, Cleveland Clinic Foundation, Respiratory Institute, Cleveland, Ohio
| | - David W Hsia
- 18 Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles, Torrance, California
| | - Arthur Sung
- 19 Stanford Hospital and Clinics, Stanford, California
| | - Nabil Jarad
- 20 University Hospital Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Malgorzata Kornaszewska
- 21 Department of Cardiothoracic Surgery, University Hospital of Wales, Cardiff, United Kingdom
| | - Stephen Hazelrigg
- 22 Division of Cardiothoracic Surgery, Department of Surgery, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Ganesh Krishna
- 23 Palo Alto Medical Foundation, El Camino Hospital, Mountain View, California
| | | | | | - Dirk-Jan Slebos
- 26 Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Chang L, Shen L, Zhou H, Gao J, Pan H, Zheng L, Armstrong B, Peng Y, Peng G, Zhou BP, Rosen ST, Shen B. ITCH nuclear translocation and H1.2 polyubiquitination negatively regulate the DNA damage response. Nucleic Acids Res 2019; 47:824-842. [PMID: 30517763 PMCID: PMC6344871 DOI: 10.1093/nar/gky1199] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 11/15/2018] [Indexed: 01/05/2023] Open
Abstract
The downregulation of the DNA damage response (DDR) enables aggressive tumors to achieve uncontrolled proliferation against replication stress, but the mechanisms underlying this process in tumors are relatively complex. Here, we demonstrate a mechanism through which a distinct E3 ubiquitin ligase, ITCH, modulates DDR machinery in triple-negative breast cancer (TNBC). We found that expression of a nuclear form of ITCH was significantly increased in human TNBC cell lines and tumor specimens. Phosphorylation of ITCH at Ser257 by AKT led to the nuclear localization of ITCH and ubiquitination of H1.2. The ITCH-mediated polyubiquitination of H1.2 suppressed RNF8/RNF168-dependent formation of 53BP1 foci, which plays important roles in DDR. Consistent with these findings, impaired ITCH nuclear translocation and H1.2 polyubiquitination sensitized cells to replication stress and limited cell growth and migration. AKT activation of ITCH-H1.2 axis may confer TNBC cells with a DDR repression to counteract the replication stress and increase cancer cell survivorship and growth potential.
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Affiliation(s)
- Lufen Chang
- Department of Cancer Genetics and Epigenetics, Beckman Research Institute, City of Hope, Duarte, CA 91010, USA
| | - Lei Shen
- Department of Cancer Genetics and Epigenetics, Beckman Research Institute, City of Hope, Duarte, CA 91010, USA
| | - Hu Zhou
- Department of Analytical Chemistry, Shanghai Institute of Material Medical Science, Chinese Academy of Sciences, Shanghai, China
| | - Jing Gao
- Department of Analytical Chemistry, Shanghai Institute of Material Medical Science, Chinese Academy of Sciences, Shanghai, China
| | - Hangyi Pan
- Department of Cancer Genetics and Epigenetics, Beckman Research Institute, City of Hope, Duarte, CA 91010, USA
| | - Li Zheng
- Department of Cancer Genetics and Epigenetics, Beckman Research Institute, City of Hope, Duarte, CA 91010, USA
| | - Brian Armstrong
- Department of Developmental and Stem Cell Biology, Beckman Research Institute, City of Hope, Duarte, CA 91010, USA
| | - Yang Peng
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Guang Peng
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Binhua P Zhou
- Department of Molecular and Cellular Biochemistry, Markey Cancer Center, University of Kentucky, College of Medicine, Lexington, KY 40506, USA
| | - Steven T Rosen
- Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute, City of Hope, Duarte, CA 91010, USA
| | - Binghui Shen
- Department of Cancer Genetics and Epigenetics, Beckman Research Institute, City of Hope, Duarte, CA 91010, USA
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Stehlik J, Armstrong B, Baran DA, Bridges ND, Chandraker A, Gordon R, De Marco T, Givertz MM, Heroux A, Iklé D, Hunt J, Kfoury AG, Madsen JC, Morrison Y, Feller E, Pinney S, Tripathi S, Heeger PS, Starling RC. Early immune biomarkers and intermediate-term outcomes after heart transplantation: Results of Clinical Trials in Organ Transplantation-18. Am J Transplant 2019; 19:1518-1528. [PMID: 30549425 PMCID: PMC6482086 DOI: 10.1111/ajt.15218] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/07/2018] [Accepted: 11/28/2018] [Indexed: 01/25/2023]
Abstract
Clinical Trials in Organ Transplantation-18 (CTOT-18) is a follow-up analysis of the 200-subject multicenter heart transplant CTOT-05 cohort. CTOT-18 aimed to identify clinical, epidemiologic, and biologic markers associated with adverse clinical events past 1 year posttransplantation. We examined various candidate biomarkers including serum antibodies, angiogenic proteins, blood gene expression profiles, and T cell alloreactivity. The composite endpoint (CE) included death, retransplantation, coronary stent, myocardial infarction, and cardiac allograft vasculopathy. The mean follow-up was 4.5 ± SD 1.1 years. Subjects with serum anti-cardiac myosin (CM) antibody detected at transplantation and at 12 months had a higher risk of meeting the CE compared to those without anti-CM antibody (hazard ratio [HR] = 2.9, P = .046). Plasma VEGF-A and VEGF-C levels pretransplant were associated with CE (odds ratio [OR] = 13.24, P = .029; and OR = 0.13, P = .037, respectively). Early intravascular ultrasound findings or other candidate biomarkers were not associated with the study outcomes. In conclusion, anti-CM antibody and plasma levels of VEGF-A and VEGF-C were associated with an increased risk of adverse events. Although this multicenter report supports further evaluation of the mechanisms through which anti-CM antibody and plasma angiogenesis proteins lead to allograft injury, we could not identify additional markers of adverse events or potential novel therapeutic targets.
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Affiliation(s)
- Josef Stehlik
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | | | - Nancy D Bridges
- Transplantation Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | | | | | - Teresa De Marco
- University of California at San Francisco, San Francisco CA, USA
| | | | - Alain Heroux
- Loyola University Medical Center, Maywood, IL, USA
| | | | - Judson Hunt
- Medical City Dallas Hospital, Dallas TX, USA
| | | | | | - Yvonne Morrison
- Transplantation Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | | | - Sean Pinney
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Peter S Heeger
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Mahle W, Mason K, Dipchand A, Richmond M, Canter C, Hsu D, Singh T, Shaddy R, Armstrong B, Zeevi A, Ikle D, Diop H, Odim J, Webber S. Hospital Readmission Following Pediatric Heart Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.040] [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] Open
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Abstract
BackgroundThe academic literature demonstrates that organisational culture contributes to variation between healthcare organisations in outcomes and performance, patient satisfaction, innovation, healthcare quality and safety and employee job satisfaction.Objectives/methodsThe aims of this research were: (1) to review literature on organisational culture; (2) to identify the dominant culture within the Belfast RVH Emergency Department by using a combination of both the ‘Organisational Culture Assessment Instrument’ and ‘Rich Pictures’ soft systems methodology; and (3) to formulate recommendations.Results/conclusionWe found that the dominant organisational culture is a market culture (29.74 points), followed by hierarchy culture (28.97 points) then a clan culture (25.55 points) and an adhocracy culture (15.74 points), this infers an emphasis is placed predominantly on results and profitability. The results also look at the difference between current and preferred organisational culture. The largest desired difference can be seen in clan culture, with an increase of 12.93 points. Market culture decreases by 12.39 points. Hierarchy culture decreases with 3.58 points and adhocracy culture increases with 3.04 points. The dominant culture in the preferred situation becomes clan culture, followed by hierarchy culture, adhocracy culture and market culture. The results also show there was a differing gap within all professional groupings with admin (24.97 points), doctors (33.71 points), nurses (40.36 points) and others (11.08 points). The Rich Pictures results highlight contrasting multidisciplinary dynamics in regard to hierarchy, interteam cooperation and a team while working under extreme pressure, and were committed to quality, patient safety and service innovation.
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Yoon S, Wu X, Armstrong B, Habib N, Rossi JJ. An RNA Aptamer Targeting the Receptor Tyrosine Kinase PDGFRα Induces Anti-tumor Effects through STAT3 and p53 in Glioblastoma. Mol Ther Nucleic Acids 2018; 14:131-141. [PMID: 30594071 PMCID: PMC6307106 DOI: 10.1016/j.omtn.2018.11.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 11/21/2018] [Accepted: 11/22/2018] [Indexed: 01/02/2023]
Abstract
Human glioblastoma (GBM) is the most aggressive malignancy of the CNS, with less than 5% survival. Despite great efforts to find effective therapeutics, current options remain very limited. To develop a targeted cancer therapeutic, we selected RNA aptamers against platelet-derived growth factor receptor α (PDGFRα), which is a receptor tyrosine kinase. One RNA aptamer (PDR3) with high affinity (0.25 nM) showed PDGFRα specificity and was internalized in U251-MG cells. Following treatment with the PDR3 aptamer, expression of the transcription factor STAT3 (signal transducer and activator of transcription 3) was inhibited, whereas the expression of the histone demethylase JMJD3 and the tumor suppressor p53 were upregulated. PDR3 also upregulated serine phosphorylation of p53, which subsequently mediated apoptosis through the death receptors: tumor necrosis factor (TNF)-related apoptosis-inducing ligand receptors 1/2 (TRAIL-R1/R2), Fas-associated via death domain (FADD), and Fas. PDR3 significantly decreased cell viability in a dose-dependent manner. Furthermore, translocation of PDR3 into the nucleus induced hypomethylation at the promoters of cyclin D2. To assess the feasibility of targeted delivery, we conjugated PDR3 aptamer with STAT3-siRNA for a chimera. The PDR3-siSTAT3 chimera successfully inhibited the expression of target genes and showed significant inhibition of cell viability. In summary, our results show that well-tailored RNA aptamers targeting the PDGFRα-STAT3 axis have the potential to act as anti-cancer therapeutics in GBM.
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Affiliation(s)
- Sorah Yoon
- Department of Molecular and Cellular Biology, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Xiwei Wu
- Integrative Genomic Core, City of Hope, Duarte, CA 91010, USA
| | | | - Nagy Habib
- Department of Surgery and Cancer, Imperial College London, London W12 0NN, UK
| | - John J Rossi
- Department of Molecular and Cellular Biology, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA; Irell and Manella Graduate School of Biological Sciences, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA.
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Peyronnet B, Sussman R, Zhao L, Hoffman D, Armstrong B, Telegrafi S, Granieri M, Palmerola R, Malacarne D, Rosenblum N, Nitti V, Brucker B. Évaluation échographique et traitement de la sténose urétrale de la femme par urétroplastie muqueuse buccale. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.261] [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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Dipchand AI, Webber S, Mason K, Feingold B, Bentlejewski C, Mahle WT, Shaddy R, Canter C, Blume ED, Lamour J, Zuckerman W, Diop H, Morrison Y, Armstrong B, Ikle D, Odim J, Zeevi A. Incidence, characterization, and impact of newly detected donor-specific anti-HLA antibody in the first year after pediatric heart transplantation: A report from the CTOTC-04 study. Am J Transplant 2018; 18:2163-2174. [PMID: 29442424 PMCID: PMC6092243 DOI: 10.1111/ajt.14691] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 01/30/2018] [Accepted: 02/04/2018] [Indexed: 01/25/2023]
Abstract
Data on the clinical importance of newly detected donor-specific anti-HLA antibodies (ndDSAs) after pediatric heart transplantation are lacking despite mounting evidence of the detrimental effect of de novo DSAs in solid organ transplantation. We prospectively tested 237 pediatric heart transplant recipients for ndDSAs in the first year posttransplantation to determine their incidence, pattern, and clinical impact. One-third of patients developed ndDSAs; when present, these were mostly detected within the first 6 weeks after transplantation, suggesting that memory responses may predominate over true de novo DSA production in this population. In the absence of preexisting DSAs, patients with ndDSAs had significantly more acute cellular rejection but not antibody-mediated rejection, and there was no impact on graft and patient survival in the first year posttransplantation. Risk factors for ndDSAs included common sensitizing events. Given the early detection of the antibody response, memory responses may be more important in the first year after pediatric heart transplantation and patients with a history of a sensitizing event may be at risk even with a negative pretransplantation antibody screen. The impact on late graft and patient outcomes of first-year ndDSAs is being assessed in an extended cohort of patients.
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Affiliation(s)
- A. I. Dipchand
- Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - S. Webber
- Vanderbilt University Medical Center, Nashville, TN
| | | | - B. Feingold
- Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA
| | | | - W. T. Mahle
- Children’s Healthcare of Atlanta, Atlanta, GA
| | - R. Shaddy
- Children’s Hospital of Philadelphia, Philadelphia, PA
| | - C. Canter
- St Louis Children’s Hospital, St Louis, MO
| | | | - J. Lamour
- Montefiore Children’s Hospital, New York, NY
| | | | - H. Diop
- National Institutes of Health, Bethesda, MD
| | | | | | | | - J. Odim
- National Institutes of Health, Bethesda, MD
| | - A. Zeevi
- Department of Pathology, UPMC, Pittsburgh, PA
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48
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Webber S, Zeevi A, Mason K, Addonizio L, Blume E, Dipchand A, Shaddy R, Feingold B, Canter C, Hsu D, Mahle W, Armstrong B, Morrison Y, Ikle D, Diop H, Odim J. Pediatric heart transplantation across a positive crossmatch: First year results from the CTOTC-04 multi-institutional study. Am J Transplant 2018; 18:2148-2162. [PMID: 29673058 DOI: 10.1111/ajt.14876] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 04/01/2018] [Accepted: 04/03/2018] [Indexed: 01/25/2023]
Abstract
Sensitization is common in pediatric heart transplant candidates and waitlist mortality is high. Transplantation across a positive crossmatch may reduce wait time, but is considered high risk. We prospectively recruited consecutive candidates at eight North American centers. At transplantation, subjects were categorized as nonsensitized or sensitized (presence of ≥1 HLA antibody with MFI ≥1000 using single antigen beads). Sensitized subjects were further classified as complement-dependent cytotoxicity crossmatch (CDC-crossmatch) positive or negative and as donor-specific antibodies (DSA) positive or negative. Immunosuppression was standardized. CDC-crossmatch-positive subjects also received perioperative antibody removal, maintenance corticosteroids, and intravenous immunoglobulin. The primary endpoint was the 1 year incidence rate of a composite of death, retransplantation, or rejection with hemodynamic compromise. 317 subjects were screened, 290 enrolled and 240 transplanted (51 with pretransplant DSA, 11 with positive CDC-crossmatch). The incidence rates of the primary endpoint did not differ statistically between groups; nonsensitized 6.7% (CI: 2.7%, 13.3%), sensitized crossmatch positive 18.2% (CI: 2.3%, 51.8%), sensitized crossmatch negative 10.7% (CI: 5.7%, 18.0%), P = .2354. The primary endpoint also did not differ by DSA status. Freedom from antibody-mediated and cellular rejection was lower in the crossmatch positive group and/or in the presence of DSA. Follow-up will determine if acceptable outcomes can be achieved long-term.
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Affiliation(s)
- S Webber
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - A Zeevi
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - K Mason
- Rho Federal Systems Division, Chapel Hill, NC, USA
| | - L Addonizio
- Division of Pediatric Cardiology, Columbia University Medical Center, New York, NY, USA
| | - E Blume
- Department of Pediatric Cardiology, Boston Children's Hospital, Boston, MA, USA
| | - A Dipchand
- Department of Paediatrics, Hospital for Sick Children, Labatt Family Heart Center, Toronto, Ontario, Canada
| | - R Shaddy
- Division of Pediatric Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - B Feingold
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - C Canter
- Division of Pediatric Cardiology, Washington University School of Medicine, St. Louis, MO, USA
| | - D Hsu
- Division of Pediatric Cardiology, Albert Einstein College of Medicine/Children's Hospital at Montefiore, Bronx, NY, USA
| | - W Mahle
- Division of Pediatric Cardiology, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - B Armstrong
- Rho Federal Systems Division, Chapel Hill, NC, USA
| | - Y Morrison
- Transplantation Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - D Ikle
- Rho Federal Systems Division, Chapel Hill, NC, USA
| | - H Diop
- Transplantation Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - J Odim
- Transplantation Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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Covington LB, Armstrong B, Black MM. 0826 Poverty Mediates the Relation Between Bed Sharing and Decreased Toddler Nighttime Sleep Over Six Months. Sleep 2018. [DOI: 10.1093/sleep/zsy061.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L B Covington
- University of Maryland School of Nursing, Baltimore, MD
| | - B Armstrong
- University of Maryland School of Medicine, Baltimore, MD
| | - M M Black
- University of Maryland School of Medicine, Baltimore, MD
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50
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Armstrong B, Lemay E, Covington L, Black M. 0828 Sedentary Behavior And Sleep In Toddlers: Within And Between Subject Effects. Sleep 2018. [DOI: 10.1093/sleep/zsy061.827] [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: 11/12/2022] Open
Affiliation(s)
- B Armstrong
- University of Maryland School of Medicine, Baltimore, MD
| | - E Lemay
- University of Maryland at College Park, College Park, MD
| | - L Covington
- University of Maryland School of Nursing, Baltimore, MD
| | - M Black
- University of Maryland School of Medicine, Baltimore, MD
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