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López-Gil JC, García-Silva S, Ruiz-Cañas L, Navarro D, Palencia-Campos A, Giráldez-Trujillo A, Earl J, Dorado J, Gómez-López G, Monfort-Vengut A, Alcalá S, Gaida MM, García-Mulero S, Cabezas-Sáinz P, Batres-Ramos S, Barreto E, Sánchez-Tomero P, Vallespinós M, Ambler L, Lin ML, Aicher A, García García de Paredes A, de la Pinta C, Sanjuanbenito A, Ruz-Caracuel I, Rodríguez-Garrote M, Guerra C, Carrato A, de Cárcer G, Sánchez L, Nombela-Arrieta C, Espinet E, Sanchez-Arevalo Lobo VJ, Heeschen C, Sainz B. The Peptidoglycan Recognition Protein 1 confers immune evasive properties on pancreatic cancer stem cells. Gut 2024:gutjnl-2023-330995. [PMID: 38754953 DOI: 10.1136/gutjnl-2023-330995] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 04/11/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Pancreatic ductal adenocarcinoma (PDAC) has limited therapeutic options, particularly with immune checkpoint inhibitors. Highly chemoresistant 'stem-like' cells, known as cancer stem cells (CSCs), are implicated in PDAC aggressiveness. Thus, comprehending how this subset of cells evades the immune system is crucial for advancing novel therapies. DESIGN We used the KPC mouse model (LSL-KrasG12D/+; LSL-Trp53R172H/+; Pdx-1-Cre) and primary tumour cell lines to investigate putative CSC populations. Transcriptomic analyses were conducted to pinpoint new genes involved in immune evasion. Overexpressing and knockout cell lines were established with lentiviral vectors. Subsequent in vitro coculture assays, in vivo mouse and zebrafish tumorigenesis studies, and in silico database approaches were performed. RESULTS Using the KPC mouse model, we functionally confirmed a population of cells marked by EpCAM, Sca-1 and CD133 as authentic CSCs and investigated their transcriptional profile. Immune evasion signatures/genes, notably the gene peptidoglycan recognition protein 1 (PGLYRP1), were significantly overexpressed in these CSCs. Modulating PGLYRP1 impacted CSC immune evasion, affecting their resistance to macrophage-mediated and T-cell-mediated killing and their tumourigenesis in immunocompetent mice. Mechanistically, tumour necrosis factor alpha (TNFα)-regulated PGLYRP1 expression interferes with the immune tumour microenvironment (TME) landscape, promoting myeloid cell-derived immunosuppression and activated T-cell death. Importantly, these findings were not only replicated in human models, but clinically, secreted PGLYRP1 levels were significantly elevated in patients with PDAC. CONCLUSIONS This study establishes PGLYRP1 as a novel CSC-associated marker crucial for immune evasion, particularly against macrophage phagocytosis and T-cell killing, presenting it as a promising target for PDAC immunotherapy.
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Affiliation(s)
- Juan Carlos López-Gil
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Cancer Department, Instituto de Investigaciones Biomédicas (IIBM) Sols-Morreale CSIC-UAM, Madrid, Spain
- Biomarkers and Personalized Approach to Cancer Group (BIOPAC), Area 3 Cancer, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Department of Biochemistry, Autónoma University of Madrid (UAM), Madrid, Spain
| | - Susana García-Silva
- Microenvironment and Metastasis Group, Molecular Oncology Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Laura Ruiz-Cañas
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Cancer Department, Instituto de Investigaciones Biomédicas (IIBM) Sols-Morreale CSIC-UAM, Madrid, Spain
- Biomarkers and Personalized Approach to Cancer Group (BIOPAC), Area 3 Cancer, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Biobanco Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Diego Navarro
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Cancer Department, Instituto de Investigaciones Biomédicas (IIBM) Sols-Morreale CSIC-UAM, Madrid, Spain
- Biomarkers and Personalized Approach to Cancer Group (BIOPAC), Area 3 Cancer, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Department of Biochemistry, Autónoma University of Madrid (UAM), Madrid, Spain
| | - Adrián Palencia-Campos
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Cancer Department, Instituto de Investigaciones Biomédicas (IIBM) Sols-Morreale CSIC-UAM, Madrid, Spain
- Biomarkers and Personalized Approach to Cancer Group (BIOPAC), Area 3 Cancer, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Antonio Giráldez-Trujillo
- Grupo de Oncología Cutánea, Servicio de Anatomía Patológica, Hospiral Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Julie Earl
- Biomarkers and Personalized Approach to Cancer Group (BIOPAC), Area 3 Cancer, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Área Cáncer, Centro de Investigación Biomédica en Red (CIBERONC), ISCIII, Madrid, Spain
| | - Jorge Dorado
- Stem Cells and Cancer Group, Clinical Research Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Gonzalo Gómez-López
- Bioinformatics Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Ana Monfort-Vengut
- Cell Cycle and Cancer Biomarkers Laboratory, Cancer Department, Instituto de Investigaciones Biomédicas (IIBM) Sols-Morreale CSIC-UAM, Madrid, Spain
| | - Sonia Alcalá
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Cancer Department, Instituto de Investigaciones Biomédicas (IIBM) Sols-Morreale CSIC-UAM, Madrid, Spain
- Department of Biochemistry, Autónoma University of Madrid (UAM), Madrid, Spain
| | - Matthias M Gaida
- Institute of Pathology, JGU-Mainz, University Medical Center Mainz, Mainz, Germany
- TRON, JGU-Mainz, Translational Oncology at the University Medical Center, Mainz, Germany
- Research Center for Immunotherapy, JGU-Mainz, University Medical Center Mainz, Mainz, Germany
| | - Sandra García-Mulero
- Department of Pathology and Experimental Therapy, Universidad de Barcelona Facultad de Medicina y Ciencias de La Salud, Barcelona, Spain
- Molecular Mechanisms and Experimental Therapy in Oncology Program (Oncobell), IDIBELL, Barcelona, Spain
| | - Pablo Cabezas-Sáinz
- Department of Zoology, Genetics and Physical Anthropology, Veterinary Faculty, Universidade de Santiago de Compostela, Lugo, Spain
| | - Sandra Batres-Ramos
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Cancer Department, Instituto de Investigaciones Biomédicas (IIBM) Sols-Morreale CSIC-UAM, Madrid, Spain
- Biomarkers and Personalized Approach to Cancer Group (BIOPAC), Area 3 Cancer, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Emma Barreto
- Biomarkers and Personalized Approach to Cancer Group (BIOPAC), Area 3 Cancer, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Área Cáncer, Centro de Investigación Biomédica en Red (CIBERONC), ISCIII, Madrid, Spain
- School of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
| | - Patricia Sánchez-Tomero
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Cancer Department, Instituto de Investigaciones Biomédicas (IIBM) Sols-Morreale CSIC-UAM, Madrid, Spain
- Biomarkers and Personalized Approach to Cancer Group (BIOPAC), Area 3 Cancer, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Mireia Vallespinós
- Stem Cells and Cancer Group, Clinical Research Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Leah Ambler
- Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Meng-Lay Lin
- Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Alexandra Aicher
- Precision Immunotherapy, Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Ana García García de Paredes
- Biomarkers and Personalized Approach to Cancer Group (BIOPAC), Area 3 Cancer, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | | | - Alfonso Sanjuanbenito
- Área Cáncer, Centro de Investigación Biomédica en Red (CIBERONC), ISCIII, Madrid, Spain
- Pancreatic and Biliopancreatic Surgery Unit, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Ignacio Ruz-Caracuel
- Área Cáncer, Centro de Investigación Biomédica en Red (CIBERONC), ISCIII, Madrid, Spain
- Ramon y Cajal University Hospital Anatomy Pathology Service, Madrid, Spain
- Molecular Pathology of Cancer Group, Area 3 Cancer, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Mercedes Rodríguez-Garrote
- Biomarkers and Personalized Approach to Cancer Group (BIOPAC), Area 3 Cancer, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Área Cáncer, Centro de Investigación Biomédica en Red (CIBERONC), ISCIII, Madrid, Spain
- Medical Oncology Service, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Carmen Guerra
- Experimental Oncology Group, Molecular Oncology Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Alfredo Carrato
- Área Cáncer, Centro de Investigación Biomédica en Red (CIBERONC), ISCIII, Madrid, Spain
- Medical Oncology Service, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Guillermo de Cárcer
- Cell Cycle and Cancer Biomarkers Laboratory, Cancer Department, Instituto de Investigaciones Biomédicas (IIBM) Sols-Morreale CSIC-UAM, Madrid, Spain
| | - Laura Sánchez
- Department of Zoology, Genetics and Physical Anthropology, Veterinary Faculty, Universidade de Santiago de Compostela, Lugo, Spain
| | - César Nombela-Arrieta
- Department of Medical Oncology and Hematology, University and University Hospital Zurich, Zürich, Switzerland
| | - Elisa Espinet
- Department of Pathology and Experimental Therapy, Universidad de Barcelona Facultad de Medicina y Ciencias de La Salud, Barcelona, Spain
- Molecular Mechanisms and Experimental Therapy in Oncology Program (Oncobell), IDIBELL, Barcelona, Spain
| | - Víctor Javier Sanchez-Arevalo Lobo
- Grupo de Oncología Cutánea, Servicio de Anatomía Patológica, Hospiral Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Grupo de Oncología Molecular, Instituto de Investigaciones Biosanitarias, Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Spain
| | - Christopher Heeschen
- Pancreatic Cancer Heterogeneity, Candiolo Cancer Institute - FPO - IRCCS, Candiolo (TO), Italy
| | - Bruno Sainz
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Cancer Department, Instituto de Investigaciones Biomédicas (IIBM) Sols-Morreale CSIC-UAM, Madrid, Spain
- Biomarkers and Personalized Approach to Cancer Group (BIOPAC), Area 3 Cancer, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Área Cáncer, Centro de Investigación Biomédica en Red (CIBERONC), ISCIII, Madrid, Spain
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Verstraelen P, Van Remoortel S, De Loose N, Verboven R, Garcia-Diaz Barriga G, Christmann A, Gries M, Bessho S, Li J, Guerra C, Tükel Ç, Martinez SI, Schäfer KH, Timmermans JP, De Vos WH. Serum Amyloid A3 Fuels a Feed-Forward Inflammatory Response to the Bacterial Amyloid Curli in the Enteric Nervous System. Cell Mol Gastroenterol Hepatol 2024; 18:89-104. [PMID: 38556049 DOI: 10.1016/j.jcmgh.2024.03.013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/08/2024] [Accepted: 03/18/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND & AIMS Mounting evidence suggests the gastrointestinal microbiome is a determinant of peripheral immunity and central neurodegeneration, but the local disease mechanisms remain unknown. Given its potential relevance for early diagnosis and therapeutic intervention, we set out to map the pathogenic changes induced by bacterial amyloids in the gastrointestinal tract and its enteric nervous system. METHODS To examine the early response, we challenged primary murine myenteric networks with curli, the prototypical bacterial amyloid, and performed shotgun RNA sequencing and multiplex enzyme-linked immunosorbent assay. Using enteric neurosphere-derived glial and neuronal cell cultures, as well as in vivo curli injections into the colon wall, we further scrutinized curli-induced pathogenic pathways. RESULTS Curli induced a proinflammatory response, with strong up-regulation of Saa3 and the secretion of several cytokines. This proinflammatory state was induced primarily in enteric glia, was accompanied by increased levels of DNA damage and replication, and triggered the influx of immune cells in vivo. The addition of recombinant Serum Amyloid A3 (SAA3) was sufficient to recapitulate this specific proinflammatory phenotype while Saa3 knock-out attenuated curli-induced DNA damage and replication. Similar to curli, recombinant SAA3 caused a strong up-regulation of Saa3 transcripts, illustrating its self-amplifying potential . Since colonization of curli-producing Salmonella and dextran sulfate sodium-induced colitis triggered a significant increase in Saa3 transcripts as well, we assume SAA3plays a central role in enteric dysfunction. Inhibition of dual leucine zipper kinase, an upstream regulator of the c-Jun N-terminal kinase pathway responsible for SAA3 production, attenuated curli- and recombinant SAA3-induced Saa3 up-regulation, DNA damage, and replication in enteric glia. CONCLUSIONS Our results position SAA3 as an important mediator of gastrointestinal vulnerability to bacterial-derived amyloids and demonstrate the potential of dual leucine zipper kinase inhibition to dampen enteric pathology.
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Affiliation(s)
- Peter Verstraelen
- Laboratory of Cell Biology and Histology, University of Antwerp, Wilrijk, Belgium
| | - Samuel Van Remoortel
- Laboratory of Cell Biology and Histology, University of Antwerp, Wilrijk, Belgium
| | - Nouchin De Loose
- Laboratory of Cell Biology and Histology, University of Antwerp, Wilrijk, Belgium
| | - Rosanne Verboven
- Laboratory of Cell Biology and Histology, University of Antwerp, Wilrijk, Belgium
| | | | - Anne Christmann
- Working Group Enteric Nervous System, University of Applied Sciences Kaiserslautern, Zweibrücken, Germany
| | - Manuela Gries
- Working Group Enteric Nervous System, University of Applied Sciences Kaiserslautern, Zweibrücken, Germany
| | - Shingo Bessho
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Jing Li
- Experimental Oncology Group, Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
| | - Carmen Guerra
- Experimental Oncology Group, Centro Nacional de Investigaciones Oncológicas, Madrid, Spain; Centro de Investigación Biomédica en Red de Cáncer, Instituto de Salud Carlos III, Madrid, Spain
| | - Çagla Tükel
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Sales Ibiza Martinez
- Laboratory of Cell Biology and Histology, University of Antwerp, Wilrijk, Belgium
| | - Karl-Herbert Schäfer
- Working Group Enteric Nervous System, University of Applied Sciences Kaiserslautern, Zweibrücken, Germany
| | - Jean-Pierre Timmermans
- Laboratory of Cell Biology and Histology, University of Antwerp, Wilrijk, Belgium; Antwerp Centre for Advanced Microscopy, University of Antwerp, Antwerp, Belgium; μNeuro Research Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Winnok H De Vos
- Laboratory of Cell Biology and Histology, University of Antwerp, Wilrijk, Belgium; Antwerp Centre for Advanced Microscopy, University of Antwerp, Antwerp, Belgium; μNeuro Research Centre of Excellence, University of Antwerp, Antwerp, Belgium.
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3
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Dako F, Holden N, Narayan A, Guerra C. Understanding Health-Related Social Risks. J Am Coll Radiol 2024:S1546-1440(24)00280-1. [PMID: 38461918 DOI: 10.1016/j.jacr.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/21/2024] [Accepted: 03/01/2024] [Indexed: 03/12/2024]
Abstract
Because of the established contribution of social factors to health outcomes, approaches that address upstream determinants of health have increasingly been recognized as cost-effective means to improve population health. Understanding and usage of precise terminology is important to facilitate collaboration across disciplines. Social determinants of health affect everyone, not just the socially and economically disadvantaged, whereas health-related social risks (HRSR) are specific adverse conditions at the individual or family level that are associated with poor health and related to the immediate challenges individuals face. Health-related social needs account for patient preference in addressing identified social risks. The use of validated screening tools is important to capture risk factors in a standardized fashion to support research and quality improvement. There is a paucity of studies that address HRSR in the context of radiology. This review provides an understanding of HRSR and outlines various ways in which radiologists can work to mitigate them.
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Affiliation(s)
- Farouk Dako
- Director, Center for Global and Population Health Research in Radiology, Senior Fellow, Leonard Davis Institute of Health Economics, and Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
| | - Natasha Holden
- College of Osteopathic Medicine of the Pacific Western University of Health Sciences, Pomona, California
| | - Anand Narayan
- Vice Chair, Health Equity, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Carmen Guerra
- Vice Chair of Diversity and Inclusion, Department of Medicine, and Associate Director of Diversity and Inclusion, Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Gazzanelli S, Cavallaro G, Miccini M, Crocetti D, Tarallo M, Accarpio F, Fanello G, Biacchi D, Guerra C, Ranieri MV. Total intravenous anesthesia (TIVA) with propofool and remifentanil during operative endoscopy tracheobronchial laser therapy. Clin Ter 2023; 174:331-335. [PMID: 37378502 DOI: 10.7417/ct.2023.2446] [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] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Background The aim of our study was to assess how total intra-venous anaesthesia (TIVA) achieved by propofol and remifentanil continuous infusion could ensure proper success of the endobronchial laser therapy, in optimal conditions for the endoscopist, determining at the same time an adequate hypnosis and a good analgesia. Methods We studied 50 patients (28M - 22F), ASA class I-IV, mean age 42 ± 32.5 years , subjected to laser endoscopy to repair tracheal stenosis. TIVA was performed in all patients, and spontaneous breathing was maintained. Results 10.2% of patients experienced episodes of coughing during induction. The depth of the anaesthesia plan, monitored by BIS, was 55 ± 5. The awakening was fast in all patients, with an Aldrete score of 7.71 ± 1.14 at 1 minute and 9.31 ± 1.12 at 10 minutes. Conclusion The results of this study allow us to state that the continuous infusion of propofol and remifentanil proved to be the gold standard in patients ASA I-II-III undergoing endobronchial laser therapy. The use of TIVA has also allowed to perform endoscopic intervention on patients who suffered from a significant decrease of both cardiac and respiratory functions.
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Affiliation(s)
- S Gazzanelli
- Department of Anesthesiology, Critical Care and Pain Medicine, "Sapienza" University of Rome, Rome, Italy
| | - G Cavallaro
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - M Miccini
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - D Crocetti
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - M Tarallo
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - F Accarpio
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - G Fanello
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - D Biacchi
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - C Guerra
- Department of Anesthesiology, Critical Care and Pain Medicine, "Sapienza" University of Rome, Rome, Italy
| | - M V Ranieri
- Department of Anesthesiology, Critical Care and Pain Medicine, "Sapienza" University of Rome, Rome, Italy
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Díaz-Alejo JF, April-Monn S, Cihova M, Buocikova V, Villalón López J, Urbanova M, Lechuga CG, Tomas M, Dubovan P, Sánchez BL, Páez SC, Sanjuanbenito A, Lobo E, Romio de la Heras E, Guerra C, de la Pinta C, Barreto Melian E, Rodríguez Garrote M, Carrato A, Ruiz-Cañas L, Sainz B, Torres A, Smolkova B, Earl J. Establishment of Pancreatic Cancer-Derived Tumor Organoids and Fibroblasts From Fresh Tissue. J Vis Exp 2023. [PMID: 37306424 DOI: 10.3791/65229] [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: 06/13/2023] Open
Abstract
Tumor organoids are three-dimensional (3D) ex vivo tumor models that recapitulate the biological key features of the original primary tumor tissues. Patient-derived tumor organoids have been used in translational cancer research and can be applied to assess treatment sensitivity and resistance, cell-cell interactions, and tumor cell interactions with the tumor microenvironment. Tumor organoids are complex culture systems that require advanced cell culture techniques and culture media with specific growth factor cocktails and a biological basement membrane that mimics the extracellular environment. The ability to establish primary tumor cultures highly depends on the tissue of origin, the cellularity, and the clinical features of the tumor, such as the tumor grade. Furthermore, tissue sample collection, material quality and quantity, as well as correct biobanking and storage are crucial elements of this procedure. The technical capabilities of the laboratory are also crucial factors to consider. Here, we report a validated SOP/protocol that is technically and economically feasible for the culture of ex vivo tumor organoids from fresh tissue samples of pancreatic adenocarcinoma origin, either from fresh primary resected patient donor tissue or patient-derived xenografts (PDX). The technique described herein can be performed in laboratories with basic tissue culture and mouse facilities and is tailored for wide application in the translational oncology field.
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Affiliation(s)
- Jesús Frutos Díaz-Alejo
- Molecular Epidemiology and Predictive Tumor Markers Group, Area 3, Ramón y Cajal Health Research Institute (IRYCIS); The Biomedical Research Network in Cancer (CIBERONC); Biobank and Biomodels Platform (PT20/0045), ISCIII research and development platforms in biomedicine and health sciences, BioBank Hospital Ramón y Cajal-IRYCIS, Spanish National Biobanks Network (ISCIII Biobank Register No. B.0000678), Ramón y Cajal Health Research Institute (IRYCIS); Faculty of Medicine, University of Alcalá de Henares
| | | | - Marina Cihova
- Department of Molecular Oncology, Cancer Research Institute, Biomedical Research Center of the Slovak Academy of Sciences
| | - Verona Buocikova
- Department of Molecular Oncology, Cancer Research Institute, Biomedical Research Center of the Slovak Academy of Sciences
| | - Jorge Villalón López
- Molecular Epidemiology and Predictive Tumor Markers Group, Area 3, Ramón y Cajal Health Research Institute (IRYCIS); Biobank and Biomodels Platform (PT20/0045), ISCIII research and development platforms in biomedicine and health sciences, BioBank Hospital Ramón y Cajal-IRYCIS, Spanish National Biobanks Network (ISCIII Biobank Register No. B.0000678), Ramón y Cajal Health Research Institute (IRYCIS)
| | - Maria Urbanova
- Department of Molecular Oncology, Cancer Research Institute, Biomedical Research Center of the Slovak Academy of Sciences
| | - Carmen G Lechuga
- Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO)
| | - Miroslav Tomas
- Department of Molecular Oncology, Cancer Research Institute, Biomedical Research Center of the Slovak Academy of Sciences; Department of Surgical Oncology, National Cancer Institute, Slovak Medical University
| | - Peter Dubovan
- Department of Molecular Oncology, Cancer Research Institute, Biomedical Research Center of the Slovak Academy of Sciences; Department of Surgical Oncology, National Cancer Institute, Slovak Medical University
| | - Bárbara Luna Sánchez
- Biobank and Biomodels Platform (PT20/0045), ISCIII research and development platforms in biomedicine and health sciences, BioBank Hospital Ramón y Cajal-IRYCIS, Spanish National Biobanks Network (ISCIII Biobank Register No. B.0000678), Ramón y Cajal Health Research Institute (IRYCIS)
| | - Sonia Camaño Páez
- Biobank and Biomodels Platform (PT20/0045), ISCIII research and development platforms in biomedicine and health sciences, BioBank Hospital Ramón y Cajal-IRYCIS, Spanish National Biobanks Network (ISCIII Biobank Register No. B.0000678), Ramón y Cajal Health Research Institute (IRYCIS)
| | - Alfonso Sanjuanbenito
- The Biomedical Research Network in Cancer (CIBERONC); Pancreatic and Biliopancreatic Surgery Unit, Hospital Universitario Ramón y Cajal
| | - Eduardo Lobo
- Pancreatic and Biliopancreatic Surgery Unit, Hospital Universitario Ramón y Cajal
| | | | - Carmen Guerra
- The Biomedical Research Network in Cancer (CIBERONC); Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO)
| | | | - Emma Barreto Melian
- Molecular Epidemiology and Predictive Tumor Markers Group, Area 3, Ramón y Cajal Health Research Institute (IRYCIS); The Biomedical Research Network in Cancer (CIBERONC)
| | - Mercedes Rodríguez Garrote
- Molecular Epidemiology and Predictive Tumor Markers Group, Area 3, Ramón y Cajal Health Research Institute (IRYCIS); The Biomedical Research Network in Cancer (CIBERONC)
| | - Alfredo Carrato
- Molecular Epidemiology and Predictive Tumor Markers Group, Area 3, Ramón y Cajal Health Research Institute (IRYCIS); The Biomedical Research Network in Cancer (CIBERONC); Faculty of Medicine, University of Alcalá de Henares
| | - Laura Ruiz-Cañas
- Biobank and Biomodels Platform (PT20/0045), ISCIII research and development platforms in biomedicine and health sciences, BioBank Hospital Ramón y Cajal-IRYCIS, Spanish National Biobanks Network (ISCIII Biobank Register No. B.0000678), Ramón y Cajal Health Research Institute (IRYCIS); Department of Cancer, Instituto de Investigaciones Biomédicas "Alberto Sols" (IIBM); Cancer Stem Cell and Fibroinflammatory Group, Chronic Diseases and Cancer, Area 3, IRYCIS
| | - Bruno Sainz
- The Biomedical Research Network in Cancer (CIBERONC); Biobank and Biomodels Platform (PT20/0045), ISCIII research and development platforms in biomedicine and health sciences, BioBank Hospital Ramón y Cajal-IRYCIS, Spanish National Biobanks Network (ISCIII Biobank Register No. B.0000678), Ramón y Cajal Health Research Institute (IRYCIS); Department of Cancer, Instituto de Investigaciones Biomédicas "Alberto Sols" (IIBM); Cancer Stem Cell and Fibroinflammatory Group, Chronic Diseases and Cancer, Area 3, IRYCIS
| | - Ana Torres
- Biobank and Biomodels Platform (PT20/0045), ISCIII research and development platforms in biomedicine and health sciences, BioBank Hospital Ramón y Cajal-IRYCIS, Spanish National Biobanks Network (ISCIII Biobank Register No. B.0000678), Ramón y Cajal Health Research Institute (IRYCIS)
| | - Bozena Smolkova
- Department of Molecular Oncology, Cancer Research Institute, Biomedical Research Center of the Slovak Academy of Sciences
| | - Julie Earl
- Molecular Epidemiology and Predictive Tumor Markers Group, Area 3, Ramón y Cajal Health Research Institute (IRYCIS); The Biomedical Research Network in Cancer (CIBERONC); Biobank and Biomodels Platform (PT20/0045), ISCIII research and development platforms in biomedicine and health sciences, BioBank Hospital Ramón y Cajal-IRYCIS, Spanish National Biobanks Network (ISCIII Biobank Register No. B.0000678), Ramón y Cajal Health Research Institute (IRYCIS);
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Salmón M, Álvarez-Díaz R, Fustero-Torre C, Brehey O, Lechuga CG, Sanclemente M, Fernández-García F, López-García A, Martín-Guijarro MC, Rodríguez-Perales S, Bousquet-Mur E, Morales-Cacho L, Mulero F, Al-Shahrour F, Martínez L, Domínguez O, Caleiras E, Ortega S, Guerra C, Musteanu M, Drosten M, Barbacid M. Kras oncogene ablation prevents resistance in advanced lung adenocarcinomas. J Clin Invest 2023; 133:e164413. [PMID: 36928090 PMCID: PMC10065067 DOI: 10.1172/jci164413] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 08/10/2022] [Accepted: 02/16/2023] [Indexed: 03/17/2023] Open
Abstract
KRASG12C inhibitors have revolutionized the clinical management of patients with KRASG12C-mutant lung adenocarcinoma. However, patient exposure to these inhibitors leads to the rapid onset of resistance. In this study, we have used genetically engineered mice to compare the therapeutic efficacy and the emergence of tumor resistance between genetic ablation of mutant Kras expression and pharmacological inhibition of oncogenic KRAS activity. Whereas Kras ablation induces massive tumor regression and prevents the appearance of resistant cells in vivo, treatment of KrasG12C/Trp53-driven lung adenocarcinomas with sotorasib, a selective KRASG12C inhibitor, caused a limited antitumor response similar to that observed in the clinic, including the rapid onset of resistance. Unlike in human tumors, we did not observe mutations in components of the RAS-signaling pathways. Instead, sotorasib-resistant tumors displayed amplification of the mutant Kras allele and activation of xenobiotic metabolism pathways, suggesting that reduction of the on-target activity of KRASG12C inhibitors is the main mechanism responsible for the onset of resistance. In sum, our results suggest that resistance to KRAS inhibitors could be prevented by achieving a more robust inhibition of KRAS signaling mimicking the results obtained upon Kras ablation.
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Affiliation(s)
- Marina Salmón
- Experimental Oncology Group, Molecular Oncology Program
| | | | | | - Oksana Brehey
- Experimental Oncology Group, Molecular Oncology Program
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sagrario Ortega
- Mouse Genome Editing Unit, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Carmen Guerra
- Experimental Oncology Group, Molecular Oncology Program
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Monica Musteanu
- Experimental Oncology Group, Molecular Oncology Program
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Complutense University, Madrid, Spain
| | - Matthias Drosten
- Experimental Oncology Group, Molecular Oncology Program
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
- Molecular Mechanisms of Cancer Program, Centro de Investigación del Cáncer (CIC) and Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Consejo Superior de Investigaciones Científicas–Universidad de Salamanca (CSIC-USAL), Salamanca, Spain
| | - Mariano Barbacid
- Experimental Oncology Group, Molecular Oncology Program
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
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7
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Guerra C, Pressman A, Hurley P, Garrett-Mayer E, Bruinooge SS, Howson A, Kaltenbaugh M, Hanley Williams J, Boehmer L, Bernick LA, Byatt L, Charlot M, Crews J, Fashoyin-Aje L, McCaskill-Stevens W, Merrill J, Nowakowski G, Patel MI, Ramirez A, Zwicker V, Oyer RA, Pierce LJ. Increasing Racial and Ethnic Equity, Diversity, and Inclusion in Cancer Treatment Trials: Evaluation of an ASCO-Association of Community Cancer Centers Site Self-Assessment. JCO Oncol Pract 2023; 19:e581-e588. [PMID: 36630663 PMCID: PMC10101254 DOI: 10.1200/op.22.00560] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/25/2022] [Accepted: 11/29/2022] [Indexed: 01/13/2023] Open
Abstract
Clinical trial participants do not reflect the racial and ethnic diversity of people with cancer. ASCO and the Association of Community Cancer Centers collaborated on a quality improvement study to enhance racial and ethnic equity, diversity, and inclusion (EDI) in cancer clinical trials. The groups conducted a pilot study to examine the feasibility, utility, and face validity of a two-part clinical trial site self-assessment to enable diverse types of research sites in the United States to (1) review internal data to assess racial and ethnic disparities in screening and enrollment and (2) review their policies, programs, procedures to identify opportunities and strategies to improve EDI. Overall, 81% of 62 participating sites were satisfied with the assessment; 82% identified opportunities for improvement; and 63% identified specific strategies and 74% thought the assessment had potential to help their site increase EDI. The assessment increased awareness about performance (82%) and helped identify specific strategies (63%) to increase EDI in trials. Although most sites (65%) were able to provide some data on the number of patients that consented, only two sites were able to provide all requested trial screening, offering, and enrollment data by race and ethnicity. Documenting and evaluating such data are critical steps toward improving EDI and are key to identifying and addressing disparities more broadly. ASCO and Association of Community Cancer Centers will partner with sites to better understand their processes and the feasibility of collecting screening, offering, and enrollment data in systematic and automated ways.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Leigh Boehmer
- Association of Community Cancer Centers, Rockville, MD
| | | | - Leslie Byatt
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM
| | | | | | | | | | | | | | | | | | | | - Randall A. Oyer
- Penn Medicine Lancaster General Health, Lancaster, PA
- Ann B Barshinger Cancer Institute, Lancaster, PA
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8
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Lazcanoiturburu N, García‐Sáez J, González‐Corralejo C, Roncero C, Sanz J, Martín‐Rodríguez C, Valdecantos MP, Martínez‐Palacián A, Almalé L, Bragado P, Calero‐Pérez S, Fernández A, García‐Bravo M, Guerra C, Montoliu L, Segovia JC, Valverde ÁM, Fabregat I, Herrera B, Sánchez A. Lack of
EGFR
catalytic activity in hepatocytes improves liver regeneration following
DDC
‐induced cholestatic injury by promoting a pro‐restorative inflammatory response. J Pathol 2022; 258:312-324. [DOI: 10.1002/path.6002] [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: 03/22/2022] [Revised: 07/22/2022] [Accepted: 08/15/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Nerea Lazcanoiturburu
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy Complutense University of Madrid (UCM) Health Research Institute of the “Hospital Clínico San Carlos” (IdISSC), Madrid Spain
| | - Juan García‐Sáez
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy Complutense University of Madrid (UCM) Health Research Institute of the “Hospital Clínico San Carlos” (IdISSC), Madrid Spain
| | - Carlos González‐Corralejo
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy Complutense University of Madrid (UCM) Health Research Institute of the “Hospital Clínico San Carlos” (IdISSC), Madrid Spain
| | - Cesáreo Roncero
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy Complutense University of Madrid (UCM) Health Research Institute of the “Hospital Clínico San Carlos” (IdISSC), Madrid Spain
| | - Julián Sanz
- Anatomical Pathology Service of the “Clínica Universidad de Navarra”, Madrid, Spain, and UCM Madrid Spain
| | - Carlos Martín‐Rodríguez
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy Complutense University of Madrid (UCM) Health Research Institute of the “Hospital Clínico San Carlos” (IdISSC), Madrid Spain
| | - M. Pilar Valdecantos
- “Alberto Sols” Biomedical Research Institute, Spanish National Research Council and Autonomous University of Madrid (IIBM, CSIC‐UAM) Biomedical Research Networking Center in Diabetes and Associated Metabolic Disorders of the Carlos III Health Institute (CIBERDEM‐ISCIII) Madrid Spain
| | - Adoración Martínez‐Palacián
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy Complutense University of Madrid (UCM) Health Research Institute of the “Hospital Clínico San Carlos” (IdISSC), Madrid Spain
| | - Laura Almalé
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy Complutense University of Madrid (UCM) Health Research Institute of the “Hospital Clínico San Carlos” (IdISSC), Madrid Spain
| | - Paloma Bragado
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy Complutense University of Madrid (UCM) Health Research Institute of the “Hospital Clínico San Carlos” (IdISSC), Madrid Spain
| | - Silvia Calero‐Pérez
- “Alberto Sols” Biomedical Research Institute, Spanish National Research Council and Autonomous University of Madrid (IIBM, CSIC‐UAM) Biomedical Research Networking Center in Diabetes and Associated Metabolic Disorders of the Carlos III Health Institute (CIBERDEM‐ISCIII) Madrid Spain
| | - Almudena Fernández
- National Center for Biotechnology (CNB‐CSIC), Biomedical Research Networking Center on Rare Diseases (CIBERER‐ISCIII) Madrid Spain
| | - María García‐Bravo
- Cell Technology Division, Research Center for Energy, Environment and Technology (CIEMAT); Biomedical Research Networking Center on Rare Diseases (CIBERER‐ISCIII); Advanced Therapies Mixed Unit, “Fundación Jiménez Díaz” University Hospital Health Research Institute (CIEMAT/IIS‐FJD) Madrid Spain
| | - Carmen Guerra
- Molecular Oncology Programme, Spanish National Cancer Research Center (CNIO), Madrid Spain
| | - Lluis Montoliu
- National Center for Biotechnology (CNB‐CSIC), Biomedical Research Networking Center on Rare Diseases (CIBERER‐ISCIII) Madrid Spain
| | - José Carlos Segovia
- Cell Technology Division, Research Center for Energy, Environment and Technology (CIEMAT); Biomedical Research Networking Center on Rare Diseases (CIBERER‐ISCIII); Advanced Therapies Mixed Unit, “Fundación Jiménez Díaz” University Hospital Health Research Institute (CIEMAT/IIS‐FJD) Madrid Spain
| | - Ángela M. Valverde
- “Alberto Sols” Biomedical Research Institute, Spanish National Research Council and Autonomous University of Madrid (IIBM, CSIC‐UAM) Biomedical Research Networking Center in Diabetes and Associated Metabolic Disorders of the Carlos III Health Institute (CIBERDEM‐ISCIII) Madrid Spain
| | - Isabel Fabregat
- TGF‐β and Cancer Group, Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona, Spain; Oncology Program, Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBEREHD‐ISCIII), Madrid, Spain; Department of Physiological Sciences Faculty of Medicine and Health Sciences, University of Barcelona (UB) Barcelona Spain
| | - Blanca Herrera
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy Complutense University of Madrid (UCM) Health Research Institute of the “Hospital Clínico San Carlos” (IdISSC), Madrid Spain
| | - Aránzazu Sánchez
- Dept. Biochemistry and Molecular Biology, Faculty of Pharmacy Complutense University of Madrid (UCM) Health Research Institute of the “Hospital Clínico San Carlos” (IdISSC), Madrid Spain
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9
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Diego-González L, Fernández-Carrera A, Igea A, Martínez-Pérez A, Real Oliveira MECD, Gomes AC, Guerra C, Barbacid M, González-Fernández Á, Simón-Vázquez R. Combined Inhibition of FOSL-1 and YAP Using siRNA-Lipoplexes Reduces the Growth of Pancreatic Tumor. Cancers (Basel) 2022; 14:cancers14133102. [PMID: 35804874 PMCID: PMC9265026 DOI: 10.3390/cancers14133102] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/17/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Intercepting the molecular mechanisms implicated in pancreatic cancer progression can be an efficient therapeutic approach to treat this aggressive tumor. The Hippo pathway is a key mechanism driving tumor progression, even in the absence of KRAS activation. When this pathway is switched off, the transcriptional coactivator YAP is translocated into the nucleus and induces the activation of several genes implicated in tumor progression and apoptosis inhibition. FOSL-1 is a transcription factor that synergizes with YAP, forming a transcriptional complex. It has been shown to have a good therapeutic outcome when they are individually inhibited. In this work, we showed for the first time that the combined inhibition of YAP and FOSL-1 mRNA expression, using siRNA-lipoplexes, induces superior control over tumor growth in vitro and in vivo, compared to the individual treatments, and a reduction of the tumor stroma. The results offer a new therapeutic approach for pancreatic cancer treatment. Abstract Pancreatic cancer evades most of the current therapies and there is an urgent need for new treatments that could efficiently eliminate this aggressive tumor, such as the blocking of routes driving cell proliferation. In this work, we propose the use of small interfering RNA (siRNA) to inhibit the combined expression of FOSL-1 and YAP, two signaling proteins related with tumor cell proliferation and survival. To improve the efficacy of cell transfection, DODAB:MO (1:2) liposomes were used as siRNA nanocarriers, forming a complex denominated siRNA-lipoplexes. Liposomes and lipoplexes (carrying two siRNA for each targeted protein, or the combination of four siRNAs) were physico-chemically and biologically characterized. They showed very good biocompatibility and stability. The efficient targeting of FOSL-1 and YAP expression at both mRNA and protein levels was first proved in vitro using mouse pancreatic tumoral cell lines (KRASG12V and p53 knockout), followed by in vivo studies using subcutaneous allografts on mice. The peri-tumoral injection of lipoplexes lead to a significant decrease in the tumor growth in both Athymic Nude-Foxn1nu and C57BL/6 mice, mainly in those receiving the combination of four siRNAs, targeting both YAP and FOSL-1. These results open a new perspective to overcome the fast tumor progression in pancreatic cancer.
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Affiliation(s)
- Lara Diego-González
- CINBIO, Universidade de Vigo, Immunology Group, 36310 Vigo, Spain; (L.D.-G.); (A.F.-C.); (A.I.); (A.M.-P.); (Á.G.-F.)
- Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, 36312 Vigo, Spain
| | - Andrea Fernández-Carrera
- CINBIO, Universidade de Vigo, Immunology Group, 36310 Vigo, Spain; (L.D.-G.); (A.F.-C.); (A.I.); (A.M.-P.); (Á.G.-F.)
- Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, 36312 Vigo, Spain
| | - Ana Igea
- CINBIO, Universidade de Vigo, Immunology Group, 36310 Vigo, Spain; (L.D.-G.); (A.F.-C.); (A.I.); (A.M.-P.); (Á.G.-F.)
- Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, 36312 Vigo, Spain
| | - Amparo Martínez-Pérez
- CINBIO, Universidade de Vigo, Immunology Group, 36310 Vigo, Spain; (L.D.-G.); (A.F.-C.); (A.I.); (A.M.-P.); (Á.G.-F.)
- Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, 36312 Vigo, Spain
| | | | - Andreia C. Gomes
- CBMA (Centre of Molecular and Environmental Biology), Department of Biology, University of Minho, Campus of Gualtar, 4710-057 Braga, Portugal;
| | - Carmen Guerra
- CNIO (Centro Nacional de Investigaciones Oncológicas), Experimental Oncology Group, 28029 Madrid, Spain; (C.G.); (M.B.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mariano Barbacid
- CNIO (Centro Nacional de Investigaciones Oncológicas), Experimental Oncology Group, 28029 Madrid, Spain; (C.G.); (M.B.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - África González-Fernández
- CINBIO, Universidade de Vigo, Immunology Group, 36310 Vigo, Spain; (L.D.-G.); (A.F.-C.); (A.I.); (A.M.-P.); (Á.G.-F.)
- Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, 36312 Vigo, Spain
| | - Rosana Simón-Vázquez
- CINBIO, Universidade de Vigo, Immunology Group, 36310 Vigo, Spain; (L.D.-G.); (A.F.-C.); (A.I.); (A.M.-P.); (Á.G.-F.)
- Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, 36312 Vigo, Spain
- Correspondence: ; Tel.: +34-986130142
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10
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Santos Martins F, Guerra C. 22q11.2 deletion syndrome and psychosis – regarding a clinical case. Eur Psychiatry 2022. [PMCID: PMC9567216 DOI: 10.1192/j.eurpsy.2022.1980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
22q11.2 deletion syndrome is the most common microdeletion syndrome. Its clinical presentation varies and it may present several medical complications, namely heart defects, cleft palate, autoimmune diseases, delayed development, and psychiatric disorders. In these patients, psychiatric disorders are frequent and may include attention-deficit hyperactivity disorder, anxiety disorders, autism spectrum disorder, and schizophrenia spectrum disorders.
Objectives
We aim to characterize psychosis in patients diagnosed with 2q11.2 deletion syndrome, which is one of the most frequent psychiatric presentations.
Methods
To introduce the topic of 22q11.2 psychiatric symptoms, we will start by presenting a clinical case. Then, a review of the related literature using the Pubmed database using the following expression “22q11.2 deletion syndrome”; “DiGeorge syndrome”; “velocardiofacial syndrome”; “psychosis”; “psychiatric disorders”.
Results
Patients diagnosed with 22q11.2 deletion syndrome are considered high-risk for psychosis. In this clinical case, we present a 19-year old man diagnosed with 22q11.2 deletion syndrome who was admitted to a psychiatric ward for psychosis. The knowledge of the increased risk for psychosis in these patients should be taken into account in the face of behavioral changes de novo to assure a timely therapeutic approach. Currently, the treatment does not differ from other patients, but this is mainly due to the lack of knowledge on the best therapeutic approach in this specific diagnosis.
Conclusions
Genetic syndromes are often associated with psychiatric disorders. Patients diagnosed with 22q11.2 deletion syndrome are at high risk for psychosis and should deserve a multidisciplinary approach so that their diagnosis and treatment are established as early as possible.
Disclosure
No significant relationships.
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11
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Barrett N, Boehmer L, Schrag J, Benson AB, Green S, Hamroun L, Howson A, Matin K, Oyer RA, Pierce LJ, Jeames SE, Winkfield KM, Yang ESH, Zwicker V, Bruinooge SS, Hurley PA, Hanley Williams JH, Guerra C. Assessing feasibility and utility of an implicit bias training program for addressing disparities in cancer clinical trial participation. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e18599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18599 Background: Low participation of Black, Hispanic, Latinx and other underrepresented racial/ethnic groups in clinical research remains a problem across the U.S. Recent studies have highlighted that stereotypes, assumptions, and bias play a role in lack of diversity in cancer trial participation. To help address this, the Association of Community Cancer Centers (ACCC) and American Society of Clinical Oncology (ASCO) piloted an implicit bias training program for clinical research teams. Methods: Adapted from the Duke University Just Ask™ program, the pilot program is comprised of eLearning modules which can be completed in about 60 minutes. Features include education on diversity, equity, and bias in clinical trial participation, case vignettes, and strategies to mitigate disparities. A call was issued to members of both organizations. After completing the training, all individual participants were asked to complete a retrospective pre/post survey to assess change in knowledge and attitude. Focus groups explored participants’ experience with the training. Another survey was administered 6 weeks later to assess sustainability of changes. Results: Research teams from 50 programs were selected for the pilot. 129 individuals consented, and 126 completed the training and evaluations (98% response rate). 48% of participants reported that they had completed training on implicit bias and/or related topics prior to the pilot. Increased levels of knowledge were reported across all key training concepts, with an average % increase from 19% to 45%. Similar increases were observed for strategies for addressing implicit bias, with an average % increase from 10% to 31%. At 6 weeks post-training, there was a slight decrease in knowledge across most items, from -1% to -8%. Most (92%) participants reported satisfaction with the course, and most (92%) indicated they would recommend it to a colleague and would recommend implementing it at their program. Suggestions to improve the course included streamlining content and providing additional tools and resources. Conclusions: Pilot findings support the feasibility and utility of the training, which can help cancer programs to address disparities in clinical research. Next steps include modifying the course based on participant feedback, disseminating the training and supplementary resources, and exploring options for assessing the impact on upstream outcomes such as diversity in trial participation.[Table: see text]
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Affiliation(s)
- Nadine Barrett
- Office of Health Equity and Disparities, Duke Cancer Institute, Duke University, Durham, NC
| | - Leigh Boehmer
- Association of Community Cancer Centers, Rockville, MD
| | | | | | | | - Leila Hamroun
- Oncology Patient Advocates for Clinical Trials - Christiana Care Health System, Newark, DE
| | | | | | - Randall A. Oyer
- Ann B. Barshinger Cancer Institute, Penn Medicine at Lancaster General Health, Lancaster, PA
| | | | | | | | | | | | | | | | | | - Carmen Guerra
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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12
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Pressman AR, Hurley PA, Kaltenbaugh M, Bruinooge SS, Garrett-Mayer E, Boehmer L, Bernick LA, Byatt L, Charlot M, Crews JR, Fashoyin-Aje LA, McCaskill-Stevens WJ, Nowakowski GS, Oyer RA, Patel MI, Pierce LJ, Ramirez AG, Hanley Williams JH, Zwicker V, Guerra C. Availability of data for screening, offering, and consenting patients to cancer clinical trials: Report from an ASCO-ACCC collaboration. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.6530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6530 Background: Only a small fraction of patients with cancer participate in treatment trials. Patients identifying as members of racial and ethnic minority groups are consistently underrepresented in these trials. A recent systematic review reported that patients, regardless of race and ethnicity, are willing to enroll in trials if asked to participate by their treating clinician. Prospective and longitudinal data and metrics at the site- and clinician-level are necessary to understand whether patients are equitably considered for clinical trials. Methods: ASCO and Association of Community Cancer Centers (ACCC) developed a self-assessment for trial sites to record and gauge the number of patients across races and ethnicities screened, offered, and enrolled into clinical trials. Research sites, from across the US, were recruited through an open call to apply to participate in the ASCO-ACCC Pilot Project. There were 65 sites assigned to this pilot study, which tested the feasibility and utility of the site assessment. Sites were asked to enter 2019 and 2020 aggregate data for each step along the clinical trial enrollment continuum by select races and ethnicities (Black, Hispanic/Latinx, White) and overall. Results: 62 of 65 sites completed the study and represented a range of settings and practice types (61% academic, 26% hospital/health system, 13% independent). Only 2 sites (3%) were able to provide the data requested at each enrollment step in the assessment (table). Sites that collected the data did not do so routinely (table) and most had to compile data through multiple sources and/or manual extraction (40-100% across enrollment steps). Sites with missing data reported they did not collect data at all (36-64% across enrollment steps), did not collect data in a systematic way (0-29% across enrollment steps), or stated it would be too burdensome to manually review charts to extract data (12-29% across enrollment steps). Conclusions: Data collection and routine evaluation of participation metrics, by race and ethnicity, are necessary to assess and monitor equity and diversity in clinical trials. Most sites in this study did not collect, or routinely collect, data for screening, offering, and consenting patients to clinical trials. Without these data, sites are unable to evaluate and monitor whether their patients have equitable access to clinical trials or establish strategies to address any inequities. ASCO and ACCC will continue to partner with sites to better understand their processes and the feasibility of collecting such data in a systematic and automated way, such as through electronic health record systems. [Table: see text]
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Affiliation(s)
| | | | | | | | | | - Leigh Boehmer
- Association of Community Cancer Centers, Rockville, MD
| | | | - Leslie Byatt
- New Mexico Cancer Care Alliance, Albuquerque, NM
| | - Marjory Charlot
- The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | | | | | - Randall A. Oyer
- Ann B. Barshinger Cancer Institute, Penn Medicine at Lancaster General Health, Lancaster, PA
| | | | | | - Amelie G. Ramirez
- University ofTexas Health Science Center at San Antonio, San Antonio, TX
| | | | | | - Carmen Guerra
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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13
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Takvorian SU, Chatterjee P, Mamtani R, Wu Y, Guerra C, Werner RM, Schpero W. Association between state Medicaid policies and accrual of Black participants to cancer clinical trials. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.1501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1501 Background: Black individuals remain underrepresented in U.S. cancer clinical trials, partly due to financial barriers to participation. While coverage of the routine costs of trial participation has long been mandatory for Medicare and the commercially insured, only 16 states have enacted similar mandates for Medicaid enrollees. Given the disproportionate representation of Black individuals in state Medicaid programs, we hypothesized that such mandates may have led to improved accrual of Black participants to cancer clinical trials. Methods: We conducted a retrospective, quasi-experimental study using de-identified data from the ECOG-ACRIN Cancer Research Group to evaluate changes in the accrual of Black participants to cancer clinical trials associated with state-mandated Medicaid coverage of routine trial costs. The study population included non-elderly adults enrolled in therapeutic clinical trials for breast, colorectal, lung, or prostate cancer from 2000-2019. We employed a difference-in-differences approach with event-study specification to compare outcomes in states that mandated Medicaid coverage of routine trial costs relative to states that did not, before and after mandates were enacted. Outcomes included the proportion of trial participants who had Medicaid insurance (vs. non-Medicaid) and the proportion who were Black (vs. non-Black). Models adjusted for age, sex, cancer type, cancer stage, study phase, and study site (community vs. academic). Results: Among 24,321 trial participants (mean age 52.0 [SD 8.2] years, 82.8% female), 7.2% had Medicaid coverage and 10.5% were Black. Compared to states without Medicaid coverage mandates, states with mandates had a statistically significant increase in the proportion of Black trial participants in the first year following the mandate (+6.4 percentage points [95%CI 1.8% to 11.0%]) but not in subsequent years. There was no association between state mandates and the proportion of trial participants enrolled in Medicaid (effects ranged from -0.7 percentage points [95%CI -4.6% to 3.3%] in the first year after mandates to -3.9% [95%CI -8.6% to 0.8%] in the third year). Conclusions: State-mandated Medicaid coverage of the routine costs of trial participation was associated with a short-term increase in the proportion of Black trial participants. These findings suggest that Medicaid policies have the potential to improve representation of racial minority groups in cancer clinical trials, and support recent federal legislation mandating state Medicaid programs to cover trial participation costs as of January 2022. Our study was limited by use of data from only one large cancer research group, focus on only four common cancers, and limited power to analyze the policy impact for other racial and ethnic minority groups. Additional work is needed to replicate these findings in larger cohorts of trial participants.
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Affiliation(s)
- Samuel U Takvorian
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Paula Chatterjee
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ronac Mamtani
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Yaxin Wu
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Carmen Guerra
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Rachel M. Werner
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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14
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Bange EM, Coughlin KQ, Brown TJ, Li W, Moriarty E, Bange TE, Rosin R, Josephs M, Smith DR, Cohen RB, Getz KD, Ragusano D, Balar E, Schuchter LM, Balachandran M, Long Q, Shulman LN, Guerra C, Mamtani R. Saving TIME: Accuracy of a text intervention to minimize the time burden of cancer care. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.6527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6527 Background: Patients with cancer spend substantial time receiving cancer care. There is a need for innovative strategies to decrease the time burden of cancer therapy. The current care model consists largely of in-person visits to assess treatment toxicity. Most patients treated with immunotherapy, however, do not experience substantial toxicity. We designed and evaluated a text-based instrument to identify patients without symptoms of immunotherapy toxicity. This instrument has the potential to be combined with lab assessment to identify individuals who can safely proceed directly to treatment, lessening the need for in-person office visits. Methods: This cross-sectional study evaluated the performance characteristics of a text-based instrument to identify patient-reported immunotherapy toxicity, against the gold standard in-person provider assessment documented in the electronic medical record (EMR). Those eligible for inclusion spoke English, were receiving single agent immune checkpoint blockade for a solid tumor, and had access to a mobile device with text messaging capabilities. The instrument contained 16 questions adapted from the NCI Pro-CTCAE and was administered via text-message 96 hours prior to the patient’s scheduled infusion visit. Patient perspectives were quantified via a 13-item questionnaire. Results: Between October 1 and November 25, 2021, 50 patients enrolled in the study, and 45 patients completed the instrument (90% response). The median age was 68 (IQR 60-72), 31 (62%) were male, and 44 (88%) were white. Most patients received either pembrolizumab (n=27, 54%) or nivolumab (n=17, 34%) in the palliative setting (n=37, 74%) for genitourinary (n=15, 30%), lung (n=13, 26%), or skin (n=11, 22%) cancer. Patients who completed the instrument were younger (median age 67 vs 76) than those who did not complete the instrument. The prevalence of immune related toxicity documented in the EMR was 57.8%. The sensitivity and negative predictive value of the instrument was 100% (95% CI 0.87-1.00) and 100% (95% CI 0.664-1.00), respectively; other accuracy parameters are presented in the Table. The patient user questionnaire revealed that visual impairment, lack of access to a smart phone, and lack of recognition of the instrument were barriers to completion. Conclusions: A text-based platform is both feasible and effective at identifying patients who are not experiencing symptoms of immune toxicity, and when combined with lab assessment, can eliminate office visits for up to 47% of patients. A prospective clinical trial to assess this is underway (NCT05134636). [Table: see text]
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Affiliation(s)
| | | | - Timothy J Brown
- Abramson Cancer Center, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Wenrui Li
- University of Pennsylvania, Philadelphia, PA
| | | | - Tara E. Bange
- Hospital of the University of Pennsylvania, Philadelphia, PA
| | | | | | | | | | - Kelly D. Getz
- The Children's Hospital of Philadelphia, Philadelphia, PA
| | | | - Eesha Balar
- University of Pennsylvania, Philadelphia, PA
| | | | | | - Qi Long
- University of Pennsylvania, Philadelphia, PA
| | | | - Carmen Guerra
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ronac Mamtani
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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15
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Gazzanelli S, Miccini M, Sapienza P, Cavallaro G, Biacchi D, Crocetti D, Fiori E, Sammartino P, Guerra C, Ranieri MV. Fracture and migration in right atrium of a permanent venous central access system in a elderly patient: case report and literature review. Clin Ter 2022; 173:207-213. [PMID: 35612331 DOI: 10.7417/ct.2022.2419] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Catheter dislocation and fracture with migration of central venous lines have been reported in the International literature. Catheter fracture with consequent migration has been observed in 0.5-3.0% and may either be consequent to catheter removal or it can occur spontane-ously. Our case report concerns the migration of a Hickman catheter connected to a venous port to the right atrium in a 61-year old patient. A literature up-to-date has been performed to assess the risk of port-a-cath positioning. The position of catheter tip is considered critical for the risk of migration, that is greater as higher the tip localization respect to the carina. The aim of our study is to underline the critical role of X-ray to visualize the exact location of the catheter tip, regard-less of the approach used for catheter positioning.
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Affiliation(s)
- S Gazzanelli
- Department of Anesthesiology and Palliative Care, Sapienza University, Rome, Italy
| | - M Miccini
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - P Sapienza
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - G Cavallaro
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - D Biacchi
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - D Crocetti
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - E Fiori
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - P Sammartino
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - C Guerra
- Department of Anesthesiology and Palliative Care, Sapienza University, Rome, Italy
| | - M V Ranieri
- Department of Anesthesiology and Palliative Care, Sapienza University, Rome, Italy
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16
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Jacinto S, Silva Cunha P, Portugal G, Valente B, Coutinho Cruz M, Lousinha A, Veiga J, Delgado AS, Bras M, Paulo M, Guerra C, Teixeira AR, Lacerda Teixeira B, Cruz Ferreira R, Martins Oliveira M. Fluoroless cavotricuspid isthmus radiofrequency ablation of typical atrial flutter achieves success with zero radiation and shorter procedural duration. Europace 2022. [DOI: 10.1093/europace/euac053.066] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Cavotricuspid isthmus (CTI) ablation in patients with typical atrial flutter (AFL) has improved in the past years, especially by the use of threedimensional (3D) electroanatomic mapping systems. These mapping tools contributed to reduce radiation exposure, but most ablation procedures still require varying amounts of fluoroscopy.
Purpose
We aim to examine whether fluoroless CTI ablation is effective and safe in reducing AFL recurrence, compared with CTI ablation using fluoroscopy and a 3D mapping system.
Methods
A retrospective analysis of CTI ablation procedures performed at a tertiary center between December 2008 and December 2020 was conducted. Cases were divided in two groups: fluoroless and fluoroscopic, according to the use of radiation. Procedural duration, fluoroscopy time (FT), use of 3D mapping system, complications and recurrence rate at one year were analyzed.
Results
A total of 324 CTI ablations performed on patients with documented typical AFL were included. Mean age was 62.3±14.0, with 78.1% male patients. Fluoroless ablations were performed based on a 3D mapping system, and all fluoroscopic procedures also used 3D electroanatomic mapping. The FT was zero in the fluoroless group - 31 cases (9.6%), and 7.0±4.4 minutes in the fluoroscopic group - 291 cases (90.4%) (p<0.001). There was no statistically significant difference between the two groups, regarding AFL recurrence at one year (21.7% in the fluoroless group versus 13% in the fluoroscopic group; odds ratio [OD] 0.54; 95% confidence interval [CI] 0.18-1.62; p=0.27). Total procedure duration was significantly shorter in the fluoroless group (1h07m versus 1h40m; t-test 4.261, p<0.001, CI 0h16m-0h50m). There were no acute complications for both groups.
Conclusion
Fluoroless CTI ablation avoids radiation exposure to the patient and operator and can be performed in patients with typical AFL, without compromising duration, safety or efficacy of the procedure.
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Affiliation(s)
- S Jacinto
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - A Lousinha
- Hospital de Santa Marta, Lisbon, Portugal
| | - J Veiga
- Hospital de Santa Marta, Lisbon, Portugal
| | - AS Delgado
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Bras
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Paulo
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Guerra
- Hospital de Santa Marta, Lisbon, Portugal
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17
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Jacinto S, Silva Cunha P, Portugal G, Valente B, Coutinho Cruz M, Lousinha A, Bras P, Delgado AS, Bras M, Paulo M, Guerra C, Teixeira AR, Lacerda Teixeira B, Martins Oliveira M. Combined pulmonary vein isolation and cavotricuspid isthmus ablation shows no benefit in recurrence of atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.064] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Pulmonary vein isolation (PVI) is the mainstay of catheter ablation (CA) for atrial fibrillation (AF). Strategies have been proposed to improve the success rate of CA, such as prophylactic cavotricuspid isthmus (CTI) ablation. Despite some studies providing no, or limited, incremental benefit of CTI ablation in patients with AF, it is still frequently performed worldwide.
Purpose
The aim of this study is to examine whether CTI ablation, combined with PVI, is associated with improvement in recurrence of AF, compared with PVI alone in AF patients with or without atrial flutter (AFL).
Methods
We conducted a retrospective analysis of CA for AF performed at a tertiary center between September 2004 and December 2020. The procedures were divided in two groups: "PVI alone" and "PVI plus CTI ablation". Demographic, clinical, and procedure related data was retrieved. Atrial fibrillation recurrence rate at one year was analyzed for both groups and compared using logistic regression.
Results
A total of 453 procedures were analyzed: PVI alone (n=378; 83.4%) and PVI with CTI ablation (n=75; 16.6%). In the PVI alone group, 12.9% of the patients had concomitant typical AFL and in the PVI plus CTI ablation, 45.8% had typical AFL. Mean age was 57.3±12.1 years, with 63.6% male patients. At one year, AF recurrence rate was higher in the combined PVI with CTI ablation group (30.4%; n=21), compared with the PVI alone group (28.4%; n=97), with no statistical difference between the two groups (Odds Ratio [OD] 1.10; 95% confidence interval [CI] 0.62-1.94; p=0.73). In the subgroup analysis, there was no difference in recurrence between patients with AF without AFL (OR: 1.9; 95% CI: 0.39-9.36; p=0.43), and in patients with AF with concomitant AFL (OR: 10.0; 95% CI: 0.9-110.3; p=0.06).
Conclusion
In AF patients, irrespective of the presence of typical AFL, additional CTI ablation, compared with PVI alone, was not associated with improvement in recurrence of AF.
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Affiliation(s)
- S Jacinto
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - A Lousinha
- Hospital de Santa Marta, Lisbon, Portugal
| | - P Bras
- Hospital de Santa Marta, Lisbon, Portugal
| | - AS Delgado
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Bras
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Paulo
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Guerra
- Hospital de Santa Marta, Lisbon, Portugal
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18
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Paniagua G, Jacob HKC, Brehey O, García-Alonso S, Lechuga CG, Pons T, Musteanu M, Guerra C, Drosten M, Barbacid M. KSR induces RAS-independent MAPK pathway activation and modulates the efficacy of KRAS inhibitors. Mol Oncol 2022; 16:3066-3081. [PMID: 35313064 PMCID: PMC9441002 DOI: 10.1002/1878-0261.13213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 03/09/2022] [Accepted: 03/18/2022] [Indexed: 11/12/2022] Open
Abstract
The kinase suppressor of rat sarcoma (RAS) proteins (KSR1 and KSR2) have long been considered as scaffolding proteins required for optimal mitogen‐activated protein kinase (MAPK) pathway signalling. However, recent evidence suggests that they play a more complex role within this pathway. Here, we demonstrate that ectopic expression of KSR1 or KSR2 is sufficient to activate the MAPK pathway and to induce cell proliferation in the absence of RAS proteins. In contrast, the ectopic expression of KSR proteins is not sufficient to induce cell proliferation in the absence of either rapidly accelerated fibrosarcoma (RAF) or MAPK‐ERK kinase proteins, indicating that they act upstream of RAF. Indeed, KSR1 requires dimerization with at least one member of the RAF family to stimulate proliferation, an event that results in the translocation of the heterodimerized RAF protein to the cell membrane. Mutations in the conserved aspartic acid–phenylalanine–glycine motif of KSR1 that affect ATP binding impair the induction of cell proliferation. We also show that increased expression levels of KSR1 decrease the responsiveness to the KRASG12C inhibitor sotorasib in human cancer cell lines, thus suggesting that increased levels of expression of KSR may make tumour cells less dependent on KRAS oncogenic signalling.
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Affiliation(s)
- Guillem Paniagua
- Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029, Madrid, Spain
| | - Harrys K C Jacob
- Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029, Madrid, Spain.,Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Florida, 33136, USA
| | - Oksana Brehey
- Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029, Madrid, Spain
| | - Sara García-Alonso
- Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029, Madrid, Spain
| | - Carmen G Lechuga
- Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029, Madrid, Spain
| | - Tirso Pons
- Department of Immunology and Oncology, National Center for Biotechnology (CNB-CSIC), Spanish National Research Council, 28049, Madrid, Spain
| | - Monica Musteanu
- Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029, Madrid, Spain.,Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Complutense University, 28040, Madrid, Spain
| | - Carmen Guerra
- Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029, Madrid, Spain
| | - Matthias Drosten
- Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029, Madrid, Spain.,Molecular Mechanisms of Cancer Program, Centro de Investigación del Cáncer and Instituto de Biología Molecular y Celular del Cáncer, CSIC-University of Salamanca, 37007, Salamanca, Spain
| | - Mariano Barbacid
- Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029, Madrid, Spain
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19
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Martínez-Bosch N, Cristóbal H, Iglesias M, Gironella M, Barranco L, Visa L, Calafato D, Jiménez-Parrado S, Earl J, Carrato A, Manero-Rupérez N, Moreno M, Morales A, Guerra C, Navarro P, García de Frutos P. Soluble AXL is a novel blood marker for early detection of pancreatic ductal adenocarcinoma and differential diagnosis from chronic pancreatitis. EBioMedicine 2022; 75:103797. [PMID: 34973624 PMCID: PMC8724936 DOI: 10.1016/j.ebiom.2021.103797] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 10/11/2021] [Revised: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 02/07/2023] Open
Abstract
Background Early diagnosis is crucial for patients with pancreatic ductal adenocarcinoma (PDAC). The AXL receptor tyrosine kinase is proteolytically processed releasing a soluble form (sAXL) into the blood stream. Here we explore the use of sAXL as a biomarker for PDAC. Methods AXL was analysed by immunohistochemistry in human pancreatic tissue samples. RNA expression analysis was performed using TCGA/GTEx databases. The plasma concentrations of sAXL, its ligand GAS6, and CA19-9 were studied in two independent cohorts, the HMar cohort (n = 59) and the HClinic cohort (n = 142), including healthy controls, chronic pancreatitis (CP) or PDAC patients, and in a familial PDAC cohort (n = 68). AXL expression and sAXL release were studied in PDAC cell lines and murine models. Findings AXL is increased in PDAC and precursor lesions as compared to CP or controls. sAXL determined in plasma from two independent cohorts was significantly increased in the PDAC group as compared to healthy controls or CP patients. Patients with high levels of AXL have a lower overall survival. ROC analysis of the plasma levels of sAXL, GAS6, or CA19-9 in our cohorts revealed that sAXL outperformed CA19-9 for discriminating between CP and PDAC. Using both sAXL and CA19-9 increased the diagnostic value. These results were validated in murine models, showing increased sAXL specifically in animals developing PDAC but not those with precursor lesions or acinar tumours. Interpretation sAXL appears as a biomarker for early detection of PDAC and PDAC–CP discrimination that could accelerate treatment and improve its dismal prognosis. Funding This work was supported by grants PI20/00625 (PN), RTI2018-095672-B-I00 (AM and PGF), PI20/01696 (MG) and PI18/01034 (AC) from MICINN-FEDER and grant 2017/SGR/225 (PN) from Generalitat de Catalunya.
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Affiliation(s)
- Neus Martínez-Bosch
- Cancer Research Program, Hospital del Mar Medical Research Institute (IMIM), Unidad Asociada IIBB-CSIC, Barcelona, Spain
| | - Helena Cristóbal
- Department of Cell Death and Proliferation, Institute of Biomedical Research of Barcelona (IIBB)-CSIC and Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Mar Iglesias
- Department of Pathology, Autonomous University of Barcelona, Hospital del Mar, Centro de Investigación Biomédica en Red de Oncología (CIBERONC), Barcelona, Spain
| | - Meritxell Gironella
- Gastrointestinal & Pancreatic Oncology Group, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD); Hospital Clínic of Barcelona and IDIBAPS; Barcelona, Spain
| | - Luis Barranco
- Cancer Research Program, Hospital del Mar Medical Research Institute (IMIM), Unidad Asociada IIBB-CSIC, Barcelona, Spain; Department of Gastroenterology, Hospital del Mar, Barcelona, Spain
| | - Laura Visa
- Department of Medical Oncology, Hospital del Mar, Barcelona, Spain
| | - Domenico Calafato
- Department of Cell Death and Proliferation, Institute of Biomedical Research of Barcelona (IIBB)-CSIC and Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Silvia Jiménez-Parrado
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Julie Earl
- Molecular Epidemiology and Predictive Tumour Markers Group, Medical Oncology Research Laboratory, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain. CIBERONC
| | - Alfredo Carrato
- Molecular Epidemiology and Predictive Tumour Markers Group, Medical Oncology Research Laboratory, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain. CIBERONC
| | - Noemí Manero-Rupérez
- Cancer Research Program, Hospital del Mar Medical Research Institute (IMIM), Unidad Asociada IIBB-CSIC, Barcelona, Spain
| | - Mireia Moreno
- Cancer Research Program, Hospital del Mar Medical Research Institute (IMIM), Unidad Asociada IIBB-CSIC, Barcelona, Spain
| | - Albert Morales
- Department of Cell Death and Proliferation, IIBB-CSIC, Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic, CIBEREHD and IDIBAPS, Barcelona, Spain
| | - Carmen Guerra
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Pilar Navarro
- Cancer Research Program, Hospital del Mar Medical Research Institute (IMIM), Unidad Asociada IIBB-CSIC, Barcelona, Spain; Department of Cell Death and Proliferation, Institute of Biomedical Research of Barcelona (IIBB)-CSIC and Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain.
| | - Pablo García de Frutos
- Department of Cell Death and Proliferation, IIBB-CSIC, Unidad Asociada IMIM/IIBB-CSIC; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), and IDIBAPS, Barcelona, Spain.
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20
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Wiredu C, Haynes N, Guerra C, Ky B. Racial and Ethnic Disparities in Cancer Associated Thrombosis. Thromb Haemost 2021; 122:662-665. [PMID: 34670288 DOI: 10.1055/a-1674-0259] [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: 10/20/2022]
Abstract
Active malignancy increases the risk of developing venous thromboembolism (VTE) by four- to seven-fold. The risk of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE), in patients with cancer varies based on several clinical factors, such as cancer stage and age. However, race and ethnicity are also associated with increased VTE risk. Black (African American) patients with cancer have a higher risk of developing VTE than White patients, while Asian/Pacific Islanders have a lower risk. Studies on cancer associated thrombosis (CAT) demonstrate a need to advance our understanding of both the biologic and sociologic underpinnings of the observed differences according to race. Addressing the causes of these disparities can better health outcomes for historically underserved patient populations.
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Affiliation(s)
| | - Norrisa Haynes
- Cardiology, University of Pennsylvania, Philadelphia, United States.,Leonard Davis Institute of Health Economics, Philadelphia, United States
| | - Carmen Guerra
- Internal Medicine, University of Pennsylvania, Philadelphia, United States.,Abramson Cancer Center, Philadelphia, United States.,Leonard Davis Institute of Health Economics, Philadelphia, United States.,University of Pennsylvania Center for Clinical Epidemiology and Biostatistics, Philadelphia, United States
| | - Bonnie Ky
- Cardiology, University of Pennsylvania, Philadelphia, United States.,Abramson Cancer Center, Philadelphia, United States.,University of Pennsylvania Center for Clinical Epidemiology and Biostatistics, Philadelphia, United States
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21
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Rosigkeit S, Kruchem M, Thies D, Kreft A, Eichler E, Boegel S, Jansky S, Siegl D, Kaps L, Pickert G, Haehnel P, Kindler T, Hartwig UF, Guerra C, Barbacid M, Schuppan D, Bockamp E. Definitive evidence for Club cells as progenitors for mutant Kras/Trp53-deficient lung cancer. Int J Cancer 2021; 149:1670-1682. [PMID: 34331774 DOI: 10.1002/ijc.33756] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/10/2021] [Accepted: 07/14/2021] [Indexed: 12/30/2022]
Abstract
Accumulating evidence suggests that both the nature of oncogenic lesions and the cell-of-origin can strongly influence cancer histopathology, tumor aggressiveness and response to therapy. Although oncogenic Kras expression and loss of Trp53 tumor suppressor gene function have been demonstrated to initiate murine lung adenocarcinomas (LUADs) in alveolar type II (AT2) cells, clear evidence that Club cells, representing the second major subset of lung epithelial cells, can also act as cells-of-origin for LUAD is lacking. Equally, the exact anatomic location of Club cells that are susceptible to Kras transformation and the resulting tumor histotype remains to be established. Here, we provide definitive evidence for Club cells as progenitors for LUAD. Using in vivo lineage tracing, we find that a subset of Kras12V -expressing and Trp53-deficient Club cells act as precursors for LUAD and we define the stepwise trajectory of Club cell-initiated tumors leading to lineage marker conversion and aggressive LUAD. Our results establish Club cells as cells-of-origin for LUAD and demonstrate that Club cell-initiated tumors have the potential to develop aggressive LUAD.
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Affiliation(s)
- Sebastian Rosigkeit
- Institute of Translational Immunology (TIM), University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Marie Kruchem
- Institute of Translational Immunology (TIM), University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Dorothe Thies
- Institute of Translational Immunology (TIM), University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Andreas Kreft
- Institute of Pathology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Emma Eichler
- Institute of Translational Immunology (TIM), University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Sebastian Boegel
- Department of Internal Medicine, University Center of Autoimmunity, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Sandrine Jansky
- Institute of Translational Immunology (TIM), University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Dominik Siegl
- Institute of Translational Immunology (TIM), University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Leonard Kaps
- Institute of Translational Immunology (TIM), University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Geethanjali Pickert
- Institute of Translational Immunology (TIM), University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Patricia Haehnel
- III. Department of Medicine Hematology, Internal Oncology and Pneumology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Thomas Kindler
- III. Department of Medicine Hematology, Internal Oncology and Pneumology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Udo F Hartwig
- Research Center for Immunotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany.,III. Department of Medicine Hematology, Internal Oncology and Pneumology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Carmen Guerra
- Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Mariano Barbacid
- Experimental Oncology, Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Detlef Schuppan
- Institute of Translational Immunology (TIM), University Medical Center, Johannes Gutenberg-University, Mainz, Germany.,Research Center for Immunotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany.,Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Ernesto Bockamp
- Institute of Translational Immunology (TIM), University Medical Center, Johannes Gutenberg-University, Mainz, Germany.,Research Center for Immunotherapy, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
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22
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Linde-Medina M, Guerra C, Alcover JA. A revision of vulture feeding classification. ZOOLOGY 2021; 148:125946. [PMID: 34388442 DOI: 10.1016/j.zool.2021.125946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/10/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
Pioneering fieldwork identified the existence of three feeding groups in vultures: gulpers, rippers and scrappers. Gulpers engulf soft tissue from carcasses and rippers tear off pieces of tough tissue (skin, tendons, muscle), whereas scrappers peck on small pieces of meat they find on and around carcasses. It has been shown that these feeding preferences are reflected in the anatomy of the skull and neck. Here, we demonstrate that these three feeding groups also emerge when body core and limb bones are added to the analysis. However, the resulting classification differs from that which is based on skull morphology for three species, namely Gypaetus barbatus (Linnaeus, 1758), Gypohierax angolensis (Gmelin, 1788) and Gyps indicus (Scopoli, 1786). The proposed classification would improve the interrelationship between form and feeding habits in vultures. Moreover, the results of this study reinforce the value of the categorisation system introduced by Kruuk (1967), and expanded by König (1974, 1983), Houston (1988) and Hertel (1994), as it would affect not only the skull morphology but the whole-body architecture.
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Affiliation(s)
| | - Carmen Guerra
- Carrer Vilanova 35, Esporles, Mallorca, 07190, Spain
| | - Josep Antoni Alcover
- Departament de Biodiversitat Animal i Microbiana, Institut Mediterrani d'Estudis Avançats (CSIC-UIB), Cr Miquel Marqués 21, Esporles, Mallorca, 07190, Spain.
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23
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Castelo A, Portugal G, Vaz Ferreira V, Garcia Bras P, Teixeira B, Valente B, Cunha P, Guerra C, Delgado A, Cruz Ferreira R, Oliveira M. Radiofrequency catheter ablation of focal atrial tachycardia: characteristics and results of a series in a tertiary hospital. Europace 2021. [DOI: 10.1093/europace/euab116.090] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Focal atrial tachycardia (AT) is a relatively uncommon arrhythmia with poor response to medical treatment. Radiofrequency (RF) ablation appears to be a good option for treatment of symptomatic patients (P).
Purpose
To describe the clinical characteristics, electrophysiological (EP) findings, safety and short-term efficacy of catheter ablation in P with AT.
Methods
Retrospective analysis of consecutive P submitted to AT ablation using electroanatomical mapping between 2015 and 2020. If the AT was not present spontaneously, pacing maneuvers (atrial drive or burst pacing with up to 3 extra-stimuli) and isoprenaline was employed until reproducible induction of an ectopic atrial rhythm. Radiofrequency (RF) ablation was delivered at the site of earliest activation after validation of local electrograms until non-inducibility.
Results
A total of 46P (61% female) were included, with a mean age of 48 ± 23 years (minimum 8 months, maximum 86 years). Idiopathic AT was observed in 47,8%, while 52.2% had other relevant comorbidities (chronic pulmonary disease 17.4%; previous cardiac surgery 8,7%; congenital heart disease 10.9%; coronary artery disease 6.5%). Despite anti-arrhythmic therapy, daily palpitations were present in 87% of the cases and dizziness or syncope occurred in 22%). Nearly half (47.8%) had previously sought urgent medical care and 30.4% had a hospital admission due to arrhythmia. The clinical arrhythmia was documented in 34P (47.8% by 12-lead electrocardiography and 26.1% in 24h Holter monitoring). During the EP study a focal AT was documented in all P (spontaneously in 54.3% and induced with pacing maneuvers in 45.7%). AT origin after electroanatomical activation mapping is depicted in figure 1. After focal RF ablation, a second AT was induced in 16P (34.8%) and a new ablation was performed in 15 cases (93.8%). Total RF time was 508 ± 386 sec. One P developed right phrenic nerve palsy after ablation on the lateral wall of the right atrium. No other complications were noted. On follow-up (mean 320 ± 92 days), symptoms improved in 88.1% of the P, with a 3-fold decrease in urgent medical care visits and hospital admission for arrhythmia. Three P (8.7%) were submitted to a new EP study, in which an AT was documented and ablated in 2P.
Conclusion
AT is a very symptomatic arrhythmia, associated with increased usage of hospital resources and poor response to antiarrhythmic therapy. Ablation is an efficient treatment option, with a high success rate, low rate of complications and short-term clinical benefits. Abstract Figure. Distribution of focal atrial tachycardia
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Affiliation(s)
- A Castelo
- Hospital de Santa Marta, Lisbon, Portugal
| | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | | | | | - B Teixeira
- Hospital de Santa Marta, Lisbon, Portugal
| | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | - P Cunha
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Guerra
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Delgado
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
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Ferreira V, Portugal G, Cruz Coutinho M, Silva Cunha P, Valente B, Lousinha A, Castelo A, Garcia Bras P, Grazina A, Guerra C, Delgado A, Paulo M, Cruz Ferreira R, Oliveira M. Low-fluoro workflows and impact in radiation exposure in the electrophysiology lab. Europace 2021. [DOI: 10.1093/europace/euab116.093] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
During electrophysiology (EP) procedures, fluoroscopy imaging is employed to visualise catheters position in real-time. However, ionizing radiation is a health hazard to both the patient and operator. In recent years, the use of electroanatomical mapping systems and operator adoption of low-fluoro workflows has allowed a reduction of radiation exposure. The aim of this study was to assess the evolution of fluoroscopy time (FT) in EP procedures, using conventional technique or an electroanatomical mapping system (EMS).
Methods
A retrospective analysis of consecutive EP procedures performed at a tertiary centre between September 2018 and October 2020 was conducted. The procedures were divided in 3 tertiles according to date (T1, T2 and T3), with T3 corresponding to the most recent interventions. Procedural duration, FT, use of EMS, radiofrequency time (RT), acute ablation success and procedural complications were examined.
Results
A total of 615 procedures were analysed: atrioventricular node reentry tachycardia (AVNRT) – n = 144, accessory pathways (AP) – n = 83, typical atrial flutter – n = 106, atrial fibrillation (AF) ablation with radiofrequency (RF) – n = 61, AF ablation with cryoballoon – n = 92, ablation of ventricular arrhythmias – n = 53, and 75 miscellaneous procedures (including atrioventricular node ablation, left atrial flutter ablation and cardioneuroablation). Mean age was 54.6 ± 18.2 years with 59.4% male sex patients. An EMS was used in 75% of the procedures, without significant differences between tertiles. A progressive reduction in median FT was observed over the tertiles (T1 6.3 min, interquartile range [IQR] 2.9-13.6; T2 5.4 min, IQR 2.1-12.0, and T3 3.1 min, IQR 1.2-7.2, Figure 1), and a statistical significant difference was found when comparing T1 to T3 (p < 0.001) and T2 to T3 (p < 0.001). The decrease in FT was observed throughout the study period for all different EP procedures (Figure 2). The number of procedures with zero fluoroscopy had gradually increased (T1 6.1%, T2 8.5% and T3 14.1%; T1 vs. T3 p <0.01). Younger patients (<20 years) were submitted to low fluoroscopy doses with a significant decrease over tertiles (T1 1.2 min, IQR 0.0-4.3; T2 0.9 min, IQR 0.0-2.5; T3 0.0, IQR 0.0-2.2, T1 vs.T3 p < 0.001). No significant difference in procedural duration, RT, acute procedural success or complication rate were noted between tertiles.
Conclusion
Reduction in radiation exposure can be achieved without compromising duration, safety and effectiveness of the procedure. The commitment of operators to reduce radiation exposure using 3D mapping technology can lead to a significant decrease in the use of fluoroscopy. Abstract Figure. Fluoroscopic time analysis
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Affiliation(s)
- V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | | | | | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Lousinha
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Castelo
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - A Grazina
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Guerra
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Delgado
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Paulo
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
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Sanclemente M, Nieto P, Garcia-Alonso S, Fernández-García F, Esteban-Burgos L, Guerra C, Drosten M, Caleiras E, Martinez-Torrecuadrada J, Santamaría D, Musteanu M, Barbacid M. RAF1 kinase activity is dispensable for KRAS/p53 mutant lung tumor progression. Cancer Cell 2021; 39:294-296. [PMID: 33513349 DOI: 10.1016/j.ccell.2021.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Manuel Sanclemente
- Molecular Oncology, Centro Nacional de Investigaciones Oncológicas (CNIO), Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - Patricia Nieto
- Molecular Oncology, Centro Nacional de Investigaciones Oncológicas (CNIO), Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - Sara Garcia-Alonso
- Molecular Oncology, Centro Nacional de Investigaciones Oncológicas (CNIO), Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - Fernando Fernández-García
- Molecular Oncology, Centro Nacional de Investigaciones Oncológicas (CNIO), Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - Laura Esteban-Burgos
- Molecular Oncology, Centro Nacional de Investigaciones Oncológicas (CNIO), Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - Carmen Guerra
- Molecular Oncology, Centro Nacional de Investigaciones Oncológicas (CNIO), Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - Matthias Drosten
- Molecular Oncology, Centro Nacional de Investigaciones Oncológicas (CNIO), Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - Eduardo Caleiras
- Biotechnology, Centro Nacional de Investigaciones Oncológicas (CNIO), Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - Jorge Martinez-Torrecuadrada
- Structural Biology Programs, Centro Nacional de Investigaciones Oncológicas (CNIO), Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - David Santamaría
- Molecular Oncology, Centro Nacional de Investigaciones Oncológicas (CNIO), Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - Monica Musteanu
- Molecular Oncology, Centro Nacional de Investigaciones Oncológicas (CNIO), Melchor Fernández Almagro 3, 28029 Madrid, Spain.
| | - Mariano Barbacid
- Molecular Oncology, Centro Nacional de Investigaciones Oncológicas (CNIO), Melchor Fernández Almagro 3, 28029 Madrid, Spain.
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26
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Assi M, Achouri Y, Loriot A, Dauguet N, Dahou H, Baldan J, Libert M, Fain JS, Guerra C, Bouwens L, Barbacid M, Lemaigre FP, Jacquemin P. Dynamic Regulation of Expression of KRAS and Its Effectors Determines the Ability to Initiate Tumorigenesis in Pancreatic Acinar Cells. Cancer Res 2021; 81:2679-2689. [PMID: 33602788 DOI: 10.1158/0008-5472.can-20-2976] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/14/2021] [Accepted: 02/16/2021] [Indexed: 11/16/2022]
Abstract
Pancreatic acinar cells are a cell type of origin for pancreatic cancer that become progressively less sensitive to tumorigenesis induced by oncogenic Kras mutations after birth. This sensitivity is increased when Kras mutations are combined with pancreatitis. Molecular mechanisms underlying these observations are still largely unknown. To identify these mechanisms, we generated the first CRISPR-edited mouse models that enable detection of wild-type and mutant KRAS proteins in vivo. Analysis of these mouse models revealed that more than 75% of adult acinar cells are devoid of detectable KRAS protein. In the 25% of acinar cells expressing KRAS protein, transcriptomic analysis highlighted a slight upregulation of the RAS and MAPK pathways. However, at the protein level, only marginal pancreatic expression of essential KRAS effectors, including C-RAF, was observed. The expression of KRAS and its effectors gradually decreased after birth. The low sensitivity of adult acinar cells to Kras mutations resulted from low expression of KRAS and its effectors and the subsequent lack of activation of RAS/MAPK pathways. Pancreatitis triggered expression of KRAS and its effectors as well as subsequent activation of downstream signaling; this induction required the activity of EGFR. Finally, expression of C-RAF in adult pancreas was required for pancreatic tumorigenesis. In conclusion, our study reveals that control of the expression of KRAS and its effectors regulates the sensitivity of acinar cells to transformation by oncogenic Kras mutations. SIGNIFICANCE: This study generates new mouse models to study regulation of KRAS during pancreatic tumorigenesis and highlights a novel mechanism through which pancreatitis sensitizes acinar cells to Kras mutations.
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Affiliation(s)
- Mohamad Assi
- Université catholique de Louvain, de Duve Institute, Brussels, Belgium
| | - Younes Achouri
- Université catholique de Louvain, de Duve Institute, Brussels, Belgium
| | - Axelle Loriot
- Université catholique de Louvain, de Duve Institute, Brussels, Belgium
| | - Nicolas Dauguet
- Université catholique de Louvain, de Duve Institute, Brussels, Belgium
| | - Hajar Dahou
- Université catholique de Louvain, de Duve Institute, Brussels, Belgium
| | - Jonathan Baldan
- Cell Differentiation Laboratory, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maxime Libert
- Université catholique de Louvain, de Duve Institute, Brussels, Belgium
| | - Jean S Fain
- Université catholique de Louvain, de Duve Institute, Brussels, Belgium
| | - Carmen Guerra
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Luc Bouwens
- Cell Differentiation Laboratory, Vrije Universiteit Brussel, Brussels, Belgium
| | - Mariano Barbacid
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | | | - Patrick Jacquemin
- Université catholique de Louvain, de Duve Institute, Brussels, Belgium.
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27
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Quilichini E, Fabre M, Dirami T, Stedman A, De Vas M, Ozguc O, Pasek RC, Cereghini S, Morillon L, Guerra C, Couvelard A, Gannon M, Haumaitre C. Pancreatic Ductal Deletion of Hnf1b Disrupts Exocrine Homeostasis, Leads to Pancreatitis, and Facilitates Tumorigenesis. Cell Mol Gastroenterol Hepatol 2019; 8:487-511. [PMID: 31229598 PMCID: PMC6722301 DOI: 10.1016/j.jcmgh.2019.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS The exocrine pancreas consists of acinar cells that produce digestive enzymes transported to the intestine through a branched ductal epithelium. Chronic pancreatitis is characterized by progressive inflammation, fibrosis, and loss of acinar tissue. These changes of the exocrine tissue are risk factors for pancreatic cancer. The cause of chronic pancreatitis cannot be identified in one quarter of patients. Here, we investigated how duct dysfunction could contribute to pancreatitis development. METHODS The transcription factor Hnf1b, first expressed in pancreatic progenitors, is strictly restricted to ductal cells from late embryogenesis. We previously showed that Hnf1b is crucial for pancreas morphogenesis but its postnatal role still remains unelucidated. To investigate the role of pancreatic ducts in exocrine homeostasis, we inactivated the Hnf1b gene in vivo in mouse ductal cells. RESULTS We uncovered that postnatal Hnf1b inactivation in pancreatic ducts leads to chronic pancreatitis in adults. Hnf1bΔduct mutants show dilatation of ducts, loss of acinar cells, acinar-to-ductal metaplasia, and lipomatosis. We deciphered the early events involved, with down-regulation of cystic disease-associated genes, loss of primary cilia, up-regulation of signaling pathways, especially the Yap pathway, which is involved in acinar-to-ductal metaplasia. Remarkably, Hnf1bΔduct mutants developed pancreatic intraepithelial neoplasia and promote pancreatic intraepithelial neoplasia progression in concert with KRAS. We further showed that adult Hnf1b inactivation in pancreatic ducts is associated with impaired regeneration after injury, with persistent metaplasia and initiation of neoplasia. CONCLUSIONS Loss of Hnf1b in ductal cells leads to chronic pancreatitis and neoplasia. This study shows that Hnf1b deficiency may contribute to diseases of the exocrine pancreas and gains further insight into the etiology of pancreatitis and tumorigenesis.
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Affiliation(s)
- Evans Quilichini
- UMR7622 Sorbonne Université, Centre National de la Recherche Scientifique, Institut de Biologie Paris-Seine, Paris, France
| | - Mélanie Fabre
- UMR7622 Sorbonne Université, Centre National de la Recherche Scientifique, Institut de Biologie Paris-Seine, Paris, France
| | - Thassadite Dirami
- UMR7622 Sorbonne Université, Centre National de la Recherche Scientifique, Institut de Biologie Paris-Seine, Paris, France
| | - Aline Stedman
- UMR7622 Sorbonne Université, Centre National de la Recherche Scientifique, Institut de Biologie Paris-Seine, Paris, France
| | - Matias De Vas
- UMR7622 Sorbonne Université, Centre National de la Recherche Scientifique, Institut de Biologie Paris-Seine, Paris, France
| | - Ozge Ozguc
- UMR7622 Sorbonne Université, Centre National de la Recherche Scientifique, Institut de Biologie Paris-Seine, Paris, France
| | - Raymond C. Pasek
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Silvia Cereghini
- UMR7622 Sorbonne Université, Centre National de la Recherche Scientifique, Institut de Biologie Paris-Seine, Paris, France
| | - Lucie Morillon
- UMR7622 Sorbonne Université, Centre National de la Recherche Scientifique, Institut de Biologie Paris-Seine, Paris, France
| | - Carmen Guerra
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
| | - Anne Couvelard
- Hôpital Bichat, Département de Pathologie, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France
| | - Maureen Gannon
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Cécile Haumaitre
- UMR7622 Sorbonne Université, Centre National de la Recherche Scientifique, Institut de Biologie Paris-Seine, Paris, France,Correspondence Address correspondence to: Cecile Haumaitre, PhD, Sorbonne Université, Centre National de la Recherche Scientifique, Institut de Biologie Paris-Seine, 9 Quai Saint-Bernard, Batiment C-7eme Etage-Case 24, 75252 Paris Cedex 05, France. fax: (33) 1-44-27-34-45.
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Blasco MT, Navas C, Martín-Serrano G, Graña-Castro O, Lechuga CG, Martín-Díaz L, Djurec M, Li J, Morales-Cacho L, Esteban-Burgos L, Perales-Patón J, Bousquet-Mur E, Castellano E, Jacob HKC, Cabras L, Musteanu M, Drosten M, Ortega S, Mulero F, Sainz B, Dusetti N, Iovanna J, Sánchez-Bueno F, Hidalgo M, Khiabanian H, Rabadán R, Al-Shahrour F, Guerra C, Barbacid M. Complete Regression of Advanced Pancreatic Ductal Adenocarcinomas upon Combined Inhibition of EGFR and C-RAF. Cancer Cell 2019; 35:573-587.e6. [PMID: 30975481 PMCID: PMC10132447 DOI: 10.1016/j.ccell.2019.03.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 01/08/2019] [Accepted: 03/04/2019] [Indexed: 12/13/2022]
Abstract
Five-year survival for pancreatic ductal adenocarcinoma (PDAC) patients remains below 7% due to the lack of effective treatments. Here, we report that combined ablation of EGFR and c-RAF expression results in complete regression of a significant percentage of PDAC tumors driven by Kras/Trp53 mutations in genetically engineered mice. Moreover, systemic elimination of these targets induces toxicities that are well tolerated. Response to this targeted therapy correlates with transcriptional profiles that resemble those observed in human PDACs. Finally, inhibition of EGFR and c-RAF expression effectively blocked tumor progression in nine independent patient-derived xenografts carrying KRAS and TP53 mutations. These results open the door to the development of targeted therapies for PDAC patients.
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Affiliation(s)
- María Teresa Blasco
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Carolina Navas
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | | | - Osvaldo Graña-Castro
- Bioinformatics Unit, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain
| | - Carmen G Lechuga
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Laura Martín-Díaz
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain
| | - Magdolna Djurec
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain
| | - Jing Li
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Lucia Morales-Cacho
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Laura Esteban-Burgos
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Javier Perales-Patón
- Bioinformatics Unit, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain
| | - Emilie Bousquet-Mur
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain
| | - Eva Castellano
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain
| | - Harrys K C Jacob
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain
| | - Lavinia Cabras
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain
| | - Monica Musteanu
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Matthias Drosten
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Sagrario Ortega
- Transgenic Unit, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain
| | - Francisca Mulero
- Molecular Imaging Unit, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain
| | - Bruno Sainz
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; Department of Biochemistry, School of Medicine, Autonomous University of Madrid, 28018 Madrid, Spain
| | - Nelson Dusetti
- Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm U1068, CNRS UMR 7258, Aix-Marseille Université et Institut Paoli-Calmettes, Parc Scientifique et Technologique de Luminy, 163, Avenue de Luminy, 13288 Marseille, France
| | - Juan Iovanna
- Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm U1068, CNRS UMR 7258, Aix-Marseille Université et Institut Paoli-Calmettes, Parc Scientifique et Technologique de Luminy, 163, Avenue de Luminy, 13288 Marseille, France
| | - Francisco Sánchez-Bueno
- Department of Surgery, Clinical University Hospital 'Virgen Arrixaca' - Murcian Institute of Biomedical Investigation (IMIB), 30120 Murcia, Spain
| | - Manuel Hidalgo
- Rosenberg Clinical Cancer Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Hossein Khiabanian
- Department of Systems Biology, Columbia University Medical Center, New York, NY 10032, USA
| | - Raul Rabadán
- Department of Systems Biology, Columbia University Medical Center, New York, NY 10032, USA
| | - Fátima Al-Shahrour
- Bioinformatics Unit, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain
| | - Carmen Guerra
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain.
| | - Mariano Barbacid
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), 28029 Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain.
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Guerra C, Navarro P, Valverde AM, Arribas M, Brüning J, Kozak LP, Kahn CR, Benito M. Brown adipose tissue-specific insulin receptor knockout shows diabetic phenotype without insulin resistance. J Clin Invest 2019; 129:437. [PMID: 30601142 DOI: 10.1172/jci126191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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30
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Mehta SJ, Khan T, Guerra C, Reitz C, McAuliffe T, Volpp KG, Asch DA, Doubeni CA. A Randomized Controlled Trial of Opt-in Versus Opt-Out Colorectal Cancer Screening Outreach. Am J Gastroenterol 2018; 113:1848-1854. [PMID: 29925915 PMCID: PMC6768589 DOI: 10.1038/s41395-018-0151-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [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: 02/14/2018] [Accepted: 05/14/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES METHODS:: RESULTS:: Patients randomized to opt-in agreed to participate 23.1% of the time, and only 2.5% of those in opt-out chose not to participate. FIT kits were mailed to 22.4% and 93% of patients in opt-in and opt-out arms, respectively. In intention-to-screen analysis, patients in the opt-out arm had a higher FIT completion rate (29.1%) than in the opt-in arm (9.6%) (absolute difference 19.5%; 95% confidence interval, 10.9-27.9%; P < .001). Results were similar in subgroup analysis of those sent initial messaging through the EHR portal (9.5% opt-in versus 37.5% in opt-out). CONCLUSIONS .
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Affiliation(s)
- Shivan J Mehta
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Tanya Khan
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Carmen Guerra
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Catherine Reitz
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Timothy McAuliffe
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Kevin G Volpp
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - David A Asch
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Chyke A Doubeni
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
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Oreto L, Manuri L, Calvaruso D, Guerra C, Ferro G, Campanella I, Nicita G, Grasso N, Zanai R, Trombetta B, Sturiale M, Fonte A, Iorio F, Reali S, Agati S. RF25 HYBRID PALLIATION ALLOWS THE HYPOPLASTIC LEFT VENTRICLE FOR A CHANCE OF BIVENTRICULAR REPAIR. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550031.82141.6c] [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]
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Oreto L, Manuri L, Calvaruso D, Guerra C, Ferro G, Campanella I, Nicita G, Grasso N, Zanai R, Trombetta B, Sturiale M, Fonte A, Iorio F, Reali S, Agati S. OC32 HYBRID PALLIATION FOR HYPOPLASTIC LEFT HEART SYNDROME AND VARIANTS. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549870.57072.d7] [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]
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Manuri L, Calvaruso D, Guerra C, Ferro G, Campanella I, Nicita G, Grasso N, Zanai R, Trombetta B, Sturiale M, Fonte A, Iorio F, Reali S, Agati S. RF58 PATENT DUCTUS ARTERIOSUS IN EARLY PRETERMS. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550030.74517.d8] [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]
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Álvarez-Rodriguez M, Álvarez M, Anel-López L, Guerra C, Chamorro CA, Anel L, de Paz P, Martínez-Pastor F. Effect of length of time post-mortem on quality and freezing capacity of Cantabric chamois (Rupicapra pyrenaica parva) epididymal spermatozoa. Anim Reprod Sci 2018; 198:184-192. [PMID: 30301620 DOI: 10.1016/j.anireprosci.2018.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/17/2018] [Accepted: 09/27/2018] [Indexed: 12/17/2022]
Abstract
Genome Resource Banks are keystones in the ex-situ conservation of wild species. Post-mortem (PM) collection of epididymal spermatozoa is an opportunistic and valuable source of germplasm, the time from the death of the animal limits its use. Seeking to improve germplasm preservation strategies for the chamois (Rupicapra sp.), the effect of PM time on epididymal sperm quality and freezability was studied using the Cantabrian chamois. Samples were classified according to PM collection time, up to 216 h (refrigerated), and cryopreserved (Tris-citric acid-fructose, 430 mOsm/kg, 15% egg yolk, 8% glycerol; freezing at -20 °C/min). Sperm quality was assessed after recovery and post-thawing (motility by CASA, HOS test, abnormal forms, cytoplasmic droplets, and viability and acrosomal damage by flow cytometry). The sperm mass pH and osmolality showed a positive correlation with time. Total sperm motility dropped after 2 days PM, with progressivity and sperm velocities remained similar up to 3 days PM. Sperm freezability was acceptable, with the post-thawing HOST, motility, progressivity, VAP, VCL, VSL and BCF negatively correlating with PM time. Overall, chamois epidydimal samples were not adequate for preservation after 6 days PM. Freezability capacity could make these spermatozoa suitable for specific ART even if kept refrigerated for several days PM.
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Affiliation(s)
- M Álvarez-Rodriguez
- Department of Clinical and Experimental Medicine (IKE), BKH, Obstetrics and Gynecology, Linköping University, Linköping, Sweden; Department of Animal Health and Anatomy, Veterinary Faculty, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Álvarez
- Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain; INDEGSAL, Universidad de León, 24071 León, Spain
| | - L Anel-López
- Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain; INDEGSAL, Universidad de León, 24071 León, Spain
| | - C Guerra
- Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain
| | - C A Chamorro
- Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain; INDEGSAL, Universidad de León, 24071 León, Spain
| | - L Anel
- Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain; INDEGSAL, Universidad de León, 24071 León, Spain
| | - P de Paz
- INDEGSAL, Universidad de León, 24071 León, Spain; Department of Molecular Biology (Cell Biology), Universidad de León, Spain
| | - F Martínez-Pastor
- INDEGSAL, Universidad de León, 24071 León, Spain; Department of Molecular Biology (Cell Biology), Universidad de León, Spain.
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Bruyneel A, Guerra C, Tack J, Droguet M, Maes J, Miranda DR. Traduction sémantique en français et implémentation du Nursing Activities Score en Belgique. Méd Intensive Réa 2018. [DOI: 10.3166/rea-2018-0029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction : L’évaluation du temps de travail en soins infirmiers est une pratique courante aux soins intensifs. Elle permet de calculer un ratio infirmière/patient optimal qui est un enjeu majeur pour assurer la qualité des soins et maîtriser les coûts des soins de santé. Le Nursing Activities Score (NAS) permet de calculer ce ratio, mais l’outil n’a jamais été traduit en français et adapté à la Belgique.
Objectif : Traduire et adapter le NAS à la Belgique francophone.
Méthodes: L’échelle a été traduite par deux traducteurs indépendants de l’anglais vers le français. Ensuite, une traduction rétrograde du français à l’anglais a été réalisée. Une adaptation culturelle a été effectuée en réunissant un groupe de 13 infirmiers belges. Enfin, l’échelle traduite a été validée et implémentée dans deux unités de soins intensifs (USI) distinctes en Belgique francophone.
Résultats : La traduction rétrograde était similaire à la première traduction. La réunion avec le groupe d’experts a permis de trouver un consensus sur l’adaptation de l’échelle et le tutoriel adaptés au contexte des soins en Belgique. Pour la validation, le NAS a été encodé chez 113 patients et avec 981 NAS encodés dans deux USI, la médiane de NAS/patient était respectivement de 69 et 76 %. Le temps médian d’encodage du NAS était de trois minutes par patient. Nous avons observé une compliance élevée de l’encodage du NAS (respectivement 99 et 76 %).
Conclusions : Nous avons validé une échelle traduite en français conforme à la version originale et adaptée au contexte des soins en Belgique.
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Drosten M, Guerra C, Barbacid M. Genetically Engineered Mouse Models of K-Ras-Driven Lung and Pancreatic Tumors: Validation of Therapeutic Targets. Cold Spring Harb Perspect Med 2018; 8:cshperspect.a031542. [PMID: 28778964 DOI: 10.1101/cshperspect.a031542] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
K-RAS signaling has been intensely studied for over 40 years. Yet, as of today, no drugs have been approved to treat K-RAS mutant cancers. Since the turn of the century, scientists have used genetically engineered mouse (GEM) models to reproduce K-RAS mutant cancers in a laboratory setting to elucidate those molecular events responsible for the onset and progression of these tumors and to identify suitable therapies. In this review, we outline a brief description of available GEM models for two tumor types known to be driven by K-RAS mutations: lung adenocarcinoma and pancreatic ductal adenocarcinoma. In addition, we summarize a series of studies that have used these GEM tumor models to validate, either by genetic or pharmacological approaches, the therapeutic potential of a variety of targets, with the ultimate goal of translating these results to the clinical setting.
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Affiliation(s)
- Matthias Drosten
- Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO), E-28029 Madrid, Spain
| | - Carmen Guerra
- Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO), E-28029 Madrid, Spain
| | - Mariano Barbacid
- Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO), E-28029 Madrid, Spain
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Joseph G, Nickell A, Cohen E, Burke NJ, Colen S, Lawlor K, Guerra C, Stewart SL. Abstract P4-10-05: Engaging linguistically and ethnically diverse low income women in health research: A randomized controlled trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-10-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Underserved breast cancer survivors are typically offered fewer opportunities to participate in cancer research. To address this disparity, a community based navigator program, Shanti's Margot Murphy Breast Cancer Program (Shanti) initiated a collaboration with UCSF researchers and BreastCancerTrials.org (BCT), a nonprofit clinical trials matching service to explore the potential role of a trusted community-based organization as a source of culturally appropriate education and access to clinical trial information. Through formative research, we developed the Health Research Engagement Intervention (HREI), a one-on-one navigator-client education session emphasizing the range of treatment and non-treatment quality-of-life and observational studies, conducted at a time when the participant is not in the initial crisis of diagnosis. The HREI ends by providing participants with an information card listing BCT and other organizations that provide information about health research for breast cancer patients and survivors.
Methods: We tested the HREI in a randomized controlled trial, comparing the HREI to simply providing the information card. Pre and post intervention surveys one month apart measured our primary outcome of health research information-seeking behavior. Secondary outcomes include health research knowledge, attitudes towards research participation, and health empowerment. All Shanti clients who spoke English, Cantonese or Spanish and had “low care navigation needs” (either completed treatment or no longer in the crisis of initial diagnosis and/or burdened by treatment protocols) were eligible.
Results: We recruited 133 Shanti Clients, including 59 who spoke English, 48 Cantonese, and 26 Spanish; 66 were randomized to the intervention arm and 67 to the control arm, and 130 completed both pre- and post-test surveys. Almost one-third of participants in both the intervention and control arms reported having talked to someone about health research or having called a telephone number or visited a website listed on the card (30% vs. 30%, p=0.94); a smaller proportion of participants confirmed that their information-seeking was related to the content of the educational materials (17% vs. 9%, p=0.22). On average the change from pre- to post-test in a 5-item knowledge score, adjusted for pre-test knowledge, was greater in the intervention group than in the control group (p=0.028), but the proportion of participants who were very confident that they could find health research information (had health empowerment) remained essentially unchanged in both study arms (intervention: 20% post vs. 21% pre, p=0.76; control: 25% post vs. 25% pre, p=1.00). Women were more likely to seek information if they had higher pre-test knowledge scores (odds ratio [OR]=3.5 per item, 95% confidence interval [CI] 1.5-8.4) or a greater increase in knowledge from pre- to post-test (OR=2.2 per item, 95% CI 1.1-4.7); there was no association between information-seeking and health empowerment (OR=0.6, 95% CI 0.2-2.5) or study arm (OR=1.6, 95% CI 0.5-4.9).
Conclusion: The HREI had a positive impact on knowledge of health research but did not significantly affect health empowerment or health research information-seeking behavior.
Citation Format: Joseph G, Nickell A, Cohen E, Burke NJ, Colen S, Lawlor K, Guerra C, Stewart SL. Engaging linguistically and ethnically diverse low income women in health research: A randomized controlled trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-10-05.
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Affiliation(s)
- G Joseph
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - A Nickell
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - E Cohen
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - NJ Burke
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - S Colen
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - K Lawlor
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - C Guerra
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - SL Stewart
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
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Napoles TM, Guerra C, Orenstein F, Luce JA, Merritt S, Burke NJ. Abstract P6-12-19: Healing art: Breast cancer survivor experiences with nipple-areola tattoo procedures during breast reconstruction. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-12-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Nipple-areola tattoos can provide restoration of a natural looking breast that more closely resembles its pre-surgical appearance while avoiding additional surgeries. To date, the majority of nipple-areola tattoo procedures are performed by healthcare providers with minimal training in tattoo procedures. Substandard results explain the high rates of dissatisfaction among women who receive nipple-areola tattoos. In response, professional tattoo artists have emerged as an alternative provider for women seeking reconstruction. However, few studies have examined expectations and experiences of women undergoing nipple-areola tattoo procedures provided by a professional tattoo artist outside of the traditional healthcare setting. Methods: In-depth interviews were conducted with a racially/ethnically diverse group of 30 women who had undergone nipple-areola tattooing in the past 0-2 years. Interviews were conducted in English, Spanish, Chinese, and Arabic, recorded, and translated and transcribed into English for analysis. A team of three researchers conducted iterative reviews of the data which included closely reading each transcript, coding, running queries of codes, and developing summary documents to highlight recurrent concepts and patterns which were shared and discussed in group meetings. Results: Interview narratives addressed the often unexpected impact nipple-areola tattooing had on body image, self-esteem, emotional well-being, and interpersonal relationships. Women described their decision-making processes as weighing concern about the needle, the pain, and uncertainty about the tattoo artist, setting for the procedure, and outcome with the opportunity to return to a more “normal” appearance without further surgeries. Women discussed how their initial preconceptions of tattoos and tattoo parlors were ameliorated by the spa-like setting and the tattoo artist's anticipation of such concerns which enhanced her ability to put them at ease and provide professional and compassionate care. Participants noted the integral role the tattoo artist played in their positive experiences, describing her as both an “artist” and “caregiver.” The manner in which she guided them through the decision-making process regarding the color, size, shape, and placement of their nipple-areola tattoo was noted as particularly significant and empowering. Conclusions: Nipple-areola tattooing is an acceptable and meaningful reconstruction process for medically underserved public hospital patients. Our results indicate that women should be informed of nipple-areola tattooing as an alternative to more invasive, surgical reconstruction options. Results also illustrate how the healthcare system can extend beyond the traditional healthcare setting to include and leverage non-clinical and non-traditional specialists to provide appropriate care and positive breast health outcomes for women. In order to increase access and legitimacy to these services, additional research is needed to understand how to bring tattoo artists “in-house” (i.e., into the medical setting) and how to incorporate tattoo artists into breast health teams.
Citation Format: Napoles TM, Guerra C, Orenstein F, Luce JA, Merritt S, Burke NJ. Healing art: Breast cancer survivor experiences with nipple-areola tattoo procedures during breast reconstruction [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-12-19.
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Affiliation(s)
- TM Napoles
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - C Guerra
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - F Orenstein
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - JA Luce
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - S Merritt
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - NJ Burke
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
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Augereau C, Collet L, Vargiu P, Guerra C, Ortega S, Lemaigre FP, Jacquemin P. Chronic pancreatitis and lipomatosis are associated with defective function of ciliary genes in pancreatic ductal cells. Hum Mol Genet 2018; 25:5017-5026. [PMID: 28159992 DOI: 10.1093/hmg/ddw332] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 09/23/2016] [Accepted: 09/25/2016] [Indexed: 12/18/2022] Open
Abstract
Genetic diseases associated with defects in primary cilia are classified as ciliopathies. Pancreatic lesions and ductal cysts are found in patients with ciliopathic polycystic kidney diseases suggesting a close connection between pancreatic defects and primary cilia. Here we investigate the role of two genes whose deletion is known to cause primary cilium defects, namely Hnf6 and Lkb1, in pancreatic ductal homeostasis. We find that mice with postnatal duct-specific deletion of Hnf6 or Lkb1 show duct dilations. Cells lining dilated ducts present shorter cilia with swollen tips, suggesting defective intraciliary transport. This is associated with signs of chronic pancreatitis, namely acinar-to-ductal metaplasia, acinar proliferation and apoptosis, presence of inflammatory infiltrates, fibrosis and lipomatosis. Our data reveal a tight association between ductal ciliary defects and pancreatitis with perturbed acinar homeostasis and differentiation. Such injuries can account for the increased risk to develop pancreatic cancer in Peutz-Jeghers patients who carry LKB1 loss-of-function mutations.
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Affiliation(s)
- Cécile Augereau
- Université catholique de Louvain, de Duve Institute, Brussels, Belgium
| | - Louis Collet
- Université catholique de Louvain, de Duve Institute, Brussels, Belgium
| | - Pierfrancesco Vargiu
- Transgenic Mice Core Unit, Spanish National Cancer Research Center (CNIO), Madrid, Spain
| | - Carmen Guerra
- Molecular Oncology, Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
| | - Sagrario Ortega
- Transgenic Mice Core Unit, Spanish National Cancer Research Center (CNIO), Madrid, Spain
| | | | - Patrick Jacquemin
- Université catholique de Louvain, de Duve Institute, Brussels, Belgium
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40
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Sanclemente M, Francoz S, Esteban-Burgos L, Bousquet-Mur E, Djurec M, Lopez-Casas PP, Hidalgo M, Guerra C, Drosten M, Musteanu M, Barbacid M. c-RAF Ablation Induces Regression of Advanced Kras/Trp53 Mutant Lung Adenocarcinomas by a Mechanism Independent of MAPK Signaling. Cancer Cell 2018; 33:217-228.e4. [PMID: 29395869 DOI: 10.1016/j.ccell.2017.12.014] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/24/2017] [Accepted: 12/21/2017] [Indexed: 02/07/2023]
Abstract
A quarter of all solid tumors harbor KRAS oncogenes. Yet, no selective drugs have been approved to treat these malignancies. Genetic interrogation of the MAPK pathway revealed that systemic ablation of MEK or ERK kinases in adult mice prevent tumor development but are unacceptably toxic. Here, we demonstrate that ablation of c-RAF expression in advanced tumors driven by KrasG12V/Trp53 mutations leads to significant tumor regression with no detectable appearance of resistance mechanisms. Tumor regression results from massive apoptosis. Importantly, systemic abrogation of c-RAF expression does not inhibit canonical MAPK signaling, hence, resulting in limited toxicities. These results are of significant relevance for the design of therapeutic strategies to treat K-RAS mutant cancers.
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Affiliation(s)
- Manuel Sanclemente
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid 28029, Spain
| | - Sarah Francoz
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid 28029, Spain
| | - Laura Esteban-Burgos
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid 28029, Spain
| | - Emilie Bousquet-Mur
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid 28029, Spain
| | - Magdolna Djurec
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid 28029, Spain
| | - Pedro P Lopez-Casas
- Clinical Research Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid 28029, Spain
| | - Manuel Hidalgo
- Clinical Research Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid 28029, Spain
| | - Carmen Guerra
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid 28029, Spain
| | - Matthias Drosten
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid 28029, Spain
| | - Monica Musteanu
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid 28029, Spain.
| | - Mariano Barbacid
- Molecular Oncology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid 28029, Spain.
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41
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Baldwin MK, Alvarez C, Rincon M, Quintero A, Urrego M, Guerra C, Edna F, Taborda N, Hersh AR, Muñoz LF, Moreno DJ, Rubio ML, Vargas JC, Tolosa JE. An implementation strategy to increase uptake of immediate postpartum contraception: the COMSE trial. Contraception 2017. [DOI: 10.1016/j.contraception.2017.07.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
Noonan syndrome is a RASopathy that results from activating mutations in different members of the RAS/MAPK signaling pathway. At least eleven members of this pathway have been found mutated, PTPN11 being the most frequently mutated gene affecting about 50% of the patients, followed by SOS1 (10%), RAF1 (10%) and KRAS (5%). Recently, even more infrequent mutations have been newly identified by next generation sequencing. This spectrum of mutations leads to a broad variety of clinical symptoms such as cardiopathies, short stature, facial dysmorphia and neurocognitive impairment. The genetic variability of this syndrome makes it difficult to establish a genotype-phenotype correlation, which will greatly help in the clinical management of the patients. Areas covered: Studies performed with different genetically engineered mouse models (GEMMs) developed up to date. Expert commentary: GEMMs have helped us understand the role of some genes and the effect of the different mutations in the development of the syndrome. However, few models have been developed and more characterization of the existing ones should be performed to learn about the impact of the different modifiers in the phenotypes, the potential cancer risk in patients, as well as preventative and therapeutic strategies.
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Affiliation(s)
- Alberto J Schuhmacher
- a Instituto de Investigación Sanitaria Aragón , Centro de Investigación Biomédica de Aragón , Zaragoza , Spain
| | - Isabel Hernández-Porras
- b Molecular Oncology Programs , Centro Nacional de Investigaciones Oncológicas (CNIO) , Madrid , Spain
| | - Raquel García-Medina
- b Molecular Oncology Programs , Centro Nacional de Investigaciones Oncológicas (CNIO) , Madrid , Spain
| | - Carmen Guerra
- b Molecular Oncology Programs , Centro Nacional de Investigaciones Oncológicas (CNIO) , Madrid , Spain
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Sherry V, Guerra C, Ranganathan A, Schneider SM. Metastatic Lung Cancer and Distress: Use of the Distress Thermometer for Patient Assessment. Clin J Oncol Nurs 2017; 21:379-383. [PMID: 28524904 DOI: 10.1188/17.cjon.379-383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patients with metastatic lung cancer experience high levels of distress related to their disease trajectory and treatment. Oncology nurses are experts in patient care and symptom management, giving them an opportunity to screen and treat patients' distress.
. OBJECTIVES The objectives of this study were to screen patients for distress and manage their symptoms to positively affect their quality of life, treatment adherence, and clinical outcomes, and to reduce healthcare costs.
. METHODS This quality improvement project was conducted to pilot the Distress Thermometer (DT) into the care of patients with thoracic cancer and to evaluate the effect of a multifaceted intervention, consisting of a patient education pamphlet and a nurse coaching call, on distress levels.
. FINDINGS Severe distress was reported in more than half the patients. A paired-sample t test revealed a significant decrease in distress scores following the intervention.
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44
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Joseph G, Pasick RJ, Schillinger D, Luce J, Cheng JKY, Guerra C. Effective Cancer Risk Communication to Prevent Disparities in the Era of Precision Medicine. Cancer Epidemiol Biomarkers Prev 2017. [DOI: 10.1158/1055-9965.epi-17-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
As genetics and genomics become part of mainstream Medicine, these advances have the potential to reduce or exacerbate health disparities. Gaps in effective communication (where all parties share the same meaning) are widely recognized as a major contributor to health disparities. The purpose of this study was to examine cancer genetic counselor-patient communication, to assess its effectiveness from the patient perspective, and to pilot intervention strategies to improve it. We used multiple inductive methods, including standard ethnographic techniques to systematically observe and audio-record genetic counseling sessions, and qualitative interviews with observed patients using the audio recordings to stimulate recall and probe specific aspects of the communication. Data analyses were conducted using grounded theory. We observed 64 English-, 35 Spanish- and 25 Cantonese- speaking public hospital patients (n = 124) and 10 Genetic Counselors in 170 appointments, and interviewed 49 patients who had been offered testing. We identified a fundamental mismatch between the information provided by genetic counselors and the information desired and meaningful to patients. Several components of the communication that contributed to this mismatch and often resulted in ineffective communication included: (1) too much information; (2) complex terminology and conceptually difficult presentation of information; (3) information perceived as not relevant by the patient; (4) unintentional inhibition of patient engagement and question-asking; (5) vague discussions of screening and prevention recommendations. To address these communication barriers, we adapted from other fields of Medicine to the genetic counseling context and pilot tested evidence-based strategies for effective communication with limited literacy patients. Our findings indicate a need to transform the standard model of hereditary cancer risk communication. The increasing access of diverse populations to genetic services, high rates of limited health literacy in the US, and growing complexity of genetic information have created a perfect storm. If not directly addressed, this convergence can be expected to exacerbate health disparities in the genomic age.
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45
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Joseph G, Guerra C, Cheng JKY, Lee R. Abstract P3-11-04: Adapting evidenced based strategies for effective communication in cancer genetic counseling. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-11-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- G Joseph
- University of California, San Francisco, San Francisco, CA
| | - C Guerra
- University of California, San Francisco, San Francisco, CA
| | - JKY Cheng
- University of California, San Francisco, San Francisco, CA
| | - R Lee
- University of California, San Francisco, San Francisco, CA
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46
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Marión RM, López de Silanes I, Mosteiro L, Gamache B, Abad M, Guerra C, Megías D, Serrano M, Blasco MA. Common Telomere Changes during In Vivo Reprogramming and Early Stages of Tumorigenesis. Stem Cell Reports 2017; 8:460-475. [PMID: 28162998 PMCID: PMC5312258 DOI: 10.1016/j.stemcr.2017.01.001] [Citation(s) in RCA: 28] [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: 10/03/2016] [Revised: 12/23/2016] [Accepted: 01/02/2017] [Indexed: 12/15/2022] Open
Abstract
Reprogramming of differentiated cells into induced pluripotent stem cells has been recently achieved in vivo in mice. Telomeres are essential for chromosomal stability and determine organismal life span as well as cancer growth. Here, we study whether tissue dedifferentiation induced by in vivo reprogramming involves changes at telomeres. We find telomerase-dependent telomere elongation in the reprogrammed areas. Notably, we found highly upregulated expression of the TRF1 telomere protein in the reprogrammed areas, which was independent of telomere length. Moreover, TRF1 inhibition reduced in vivo reprogramming efficiency. Importantly, we extend the finding of TRF1 upregulation to pathological tissue dedifferentiation associated with neoplasias, in particular during pancreatic acinar-to-ductal metaplasia, a process that involves transdifferentiation of adult acinar cells into ductal-like cells due to K-Ras oncogene expression. These findings place telomeres as important players in cellular plasticity both during in vivo reprogramming and in pathological conditions associated with increased plasticity, such as cancer.
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Affiliation(s)
- Rosa M Marión
- Telomeres and Telomerase Group, Molecular Oncology Program, Spanish National Cancer Research Center (CNIO), Melchor Fernández Almagro 3, Madrid 28029, Spain
| | - Isabel López de Silanes
- Telomeres and Telomerase Group, Molecular Oncology Program, Spanish National Cancer Research Center (CNIO), Melchor Fernández Almagro 3, Madrid 28029, Spain
| | - Lluc Mosteiro
- Tumour Suppression Group, Molecular Oncology Program, Spanish National Cancer Research Center (CNIO), Melchor Fernández Almagro 3, Madrid 28029, Spain
| | - Benjamin Gamache
- Telomeres and Telomerase Group, Molecular Oncology Program, Spanish National Cancer Research Center (CNIO), Melchor Fernández Almagro 3, Madrid 28029, Spain
| | - María Abad
- Tumour Suppression Group, Molecular Oncology Program, Spanish National Cancer Research Center (CNIO), Melchor Fernández Almagro 3, Madrid 28029, Spain
| | - Carmen Guerra
- Experimental Oncology Group, Molecular Oncology Program, Spanish National Cancer Research Center (CNIO), Melchor Fernández Almagro 3, Madrid 28029, Spain
| | - Diego Megías
- Confocal Microscopy Unit, Spanish National Cancer Research Center (CNIO), Melchor Fernández Almagro 3, Madrid 28029, Spain
| | - Manuel Serrano
- Tumour Suppression Group, Molecular Oncology Program, Spanish National Cancer Research Center (CNIO), Melchor Fernández Almagro 3, Madrid 28029, Spain
| | - Maria A Blasco
- Telomeres and Telomerase Group, Molecular Oncology Program, Spanish National Cancer Research Center (CNIO), Melchor Fernández Almagro 3, Madrid 28029, Spain.
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47
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Trotter LA, Patel D, Dubin S, Guerra C, McCloud V, Lockwood P, Messer R, Wataha JC, Lewis JB. Violet/blue light activates Nrf2 signaling and modulates the inflammatory response of THP-1 monocytes. Photochem Photobiol Sci 2017; 16:883-889. [DOI: 10.1039/c6pp00299d] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Several studies suggest that light in the UVA range (320–400 nm) activates signaling pathways that are anti-inflammatory and antioxidative.
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Affiliation(s)
| | - D. Patel
- Augusta University
- Dept. of Oral Biology
- Augusta
- USA
- University of Kentucky
| | - S. Dubin
- Western University of Health Sciences
- College of Dental Medicine
- Pomona
- USA
| | - C. Guerra
- Western University of Health Sciences
- College of Dental Medicine
- Pomona
- USA
| | - V. McCloud
- Augusta University
- Dept. of Oral Biology
- Augusta
- USA
| | - P. Lockwood
- Augusta University
- Dept. of Oral Biology
- Augusta
- USA
| | - R. Messer
- Augusta University
- Dept. of Oral Biology
- Augusta
- USA
| | - J. C. Wataha
- Augusta University
- Dept. of Oral Biology
- Augusta
- USA
- University of Washington
| | - J. B. Lewis
- Augusta University
- Dept. of Oral Biology
- Augusta
- USA
- Western University of Health Sciences
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48
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Bertaglia E, Guerra C, Vertolli U, Varchetta V, Azzurro M, Belmonte P. Thrombogenesis and fibrinolysis: Risk in systemic lupus erythematosus (SLE) patients? Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1982-2413] [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: 11/15/2022]
Affiliation(s)
- E. Bertaglia
- Clinica Medica I Policlinico Universitario, Padova, Italia
| | - C. Guerra
- Clinica Medica I Policlinico Universitario, Padova, Italia
| | - U. Vertolli
- Clinica Medica I Policlinico Universitario, Padova, Italia
| | - V. Varchetta
- Clinica Medica I Policlinico Universitario, Padova, Italia
| | - M. Azzurro
- Clinica Medica I Policlinico Universitario, Padova, Italia
| | - P. Belmonte
- Clinica Medica I Policlinico Universitario, Padova, Italia
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49
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Drosten M, Simón-Carrasco L, Hernández-Porras I, Lechuga CG, Blasco MT, Jacob HKC, Fabbiano S, Potenza N, Bustelo XR, Guerra C, Barbacid M. H-Ras and K-Ras Oncoproteins Induce Different Tumor Spectra When Driven by the Same Regulatory Sequences. Cancer Res 2016; 77:707-718. [PMID: 27872088 DOI: 10.1158/0008-5472.can-16-2925] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 11/16/2022]
Abstract
Genetic studies in mice have provided evidence that H-Ras and K-Ras proteins are bioequivalent. However, human tumors display marked differences in the association of RAS oncogenes with tumor type. Thus, to further assess the bioequivalence of oncogenic H-Ras and K-Ras, we replaced the coding region of the murine K-Ras locus with H-RasG12V oncogene sequences. Germline expression of H-RasG12V or K-RasG12V from the K-Ras locus resulted in embryonic lethality. However, expression of these genes in adult mice led to different tumor phenotypes. Whereas H-RasG12V elicited papillomas and hematopoietic tumors, K-RasG12V induced lung tumors and gastric lesions. Pulmonary expression of H-RasG12V created a senescence-like state caused by excessive MAPK signaling. Likewise, H-RasG12V but not K-RasG12V induced senescence in mouse embryonic fibroblasts. Label-free quantitative analysis revealed that minor differences in H-RasG12V expression levels led to drastically different biological outputs, suggesting that subtle differences in MAPK signaling confer nonequivalent functions that influence tumor spectra induced by RAS oncoproteins. Cancer Res; 77(3); 707-18. ©2016 AACR.
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Affiliation(s)
- Matthias Drosten
- Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain.
| | - Lucía Simón-Carrasco
- Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Isabel Hernández-Porras
- Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Carmen G Lechuga
- Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - María T Blasco
- Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Harrys K C Jacob
- Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Salvatore Fabbiano
- Centro de Investigación del Cáncer and Instituto de Biología Molecular y Celular del Cáncer, CSIC-Universidad de Salamanca, Salamanca, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Salamanca, Spain
| | - Nicoletta Potenza
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), Second University of Naples, Caserta, Italy
| | - Xosé R Bustelo
- Centro de Investigación del Cáncer and Instituto de Biología Molecular y Celular del Cáncer, CSIC-Universidad de Salamanca, Salamanca, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Salamanca, Spain
| | - Carmen Guerra
- Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Mariano Barbacid
- Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain.
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50
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Jeannot P, Callot C, Baer R, Duquesnes N, Guerra C, Guillermet-Guibert J, Bachs O, Besson A. Loss of p27Kip¹ promotes metaplasia in the pancreas via the regulation of Sox9 expression. Oncotarget 2016; 6:35880-92. [PMID: 26416424 PMCID: PMC4742148 DOI: 10.18632/oncotarget.5770] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 09/12/2015] [Indexed: 02/07/2023] Open
Abstract
p27Kip1 (p27) is a negative regulator of proliferation and a tumor suppressor via the inhibition of cyclin-CDK activity in the nucleus. p27 is also involved in the regulation of other cellular processes, including transcription by acting as a transcriptional co-repressor. Loss of p27 expression is frequently observed in pancreatic adenocarcinomas in human and is associated with decreased patient survival. Similarly, in a mouse model of K-Ras-driven pancreatic cancer, loss of p27 accelerates tumor development and shortens survival, suggesting an important role for p27 in pancreatic tumorigenesis. Here, we sought to determine how p27 might contribute to early events leading to tumor development in the pancreas. We found that K-Ras activation in the pancreas causes p27 mislocalization at pre-neoplastic stages. Moreover, loss of p27 or expression of a mutant p27 that does not bind cyclin-CDKs causes the mislocalization of several acinar polarity markers associated with metaplasia and induces the nuclear expression of Sox9 and Pdx1 two transcription factors involved in acinar-to-ductal metaplasia. Finally, we found that p27 directly represses transcription of Sox9, but not that of Pdx1. Thus, our results suggest that K-Ras activation, the earliest known event in pancreatic carcinogenesis, may cause loss of nuclear p27 expression which results in derepression of Sox9, triggering reprogrammation of acinar cells and metaplasia.
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Affiliation(s)
- Pauline Jeannot
- INSERM UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Université de Toulouse, Toulouse, France.,CNRS ERL5294, Toulouse, France
| | - Caroline Callot
- INSERM UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Université de Toulouse, Toulouse, France.,CNRS ERL5294, Toulouse, France
| | - Romain Baer
- INSERM UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Université de Toulouse, Toulouse, France
| | - Nicolas Duquesnes
- INSERM UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Université de Toulouse, Toulouse, France.,CNRS ERL5294, Toulouse, France
| | - Carmen Guerra
- Molecular Oncology, Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
| | - Julie Guillermet-Guibert
- INSERM UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Université de Toulouse, Toulouse, France
| | - Oriol Bachs
- Department of Cell Biology, Immunology and Neurosciences, University of Barcelona - IDIBAPS, Barcelona, Spain
| | - Arnaud Besson
- INSERM UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Université de Toulouse, Toulouse, France.,CNRS ERL5294, Toulouse, France
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