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Kuhn AJ, Chan K, Sajimon M, Yoo S, Balasco Serrão VH, Lee J, Abrams B, Nowick JS, Uversky VN, Wheeler C, Raskatov JA. Amyloid-α Peptide Formed through Alternative Processing of the Amyloid Precursor Protein Attenuates Alzheimer's Amyloid-β Toxicity via Cross-Chaperoning. J Am Chem Soc 2024; 146:2634-2645. [PMID: 38236059 DOI: 10.1021/jacs.3c11511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Amyloid aggregation is a key feature of Alzheimer's disease (AD) and a primary target for past and present therapeutic efforts. Recent research is making it increasingly clear that the heterogeneity of amyloid deposits, extending past the commonly targeted amyloid-β (Aβ), must be considered for successful therapy. We recently demonstrated that amyloid-α (Aα or p3), a C-terminal peptidic fragment of Aβ, aggregates rapidly to form amyloids and can expedite the aggregation of Aβ through seeding. Here, we advance the understanding of Aα biophysics and biology in several important ways. We report the first cryogenic electron microscopy (cryo-EM) structure of an Aα amyloid fibril, proving unambiguously that the peptide is fibrillogenic. We demonstrate that Aα induces Aβ to form amyloid aggregates that are less toxic than pure Aβ aggregates and use nuclear magnetic resonance spectroscopy (NMR) to provide insights into specific interactions between Aα and Aβ in solution. This is the first evidence that Aα can coassemble with Aβ and alter its biological effects at relatively low concentrations. Based on the above, we urge researchers in the field to re-examine the significance of Aα in AD.
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Affiliation(s)
- Ariel J Kuhn
- Department of Chemistry and Biochemistry, University of California, Santa Cruz, Santa Cruz, California 95064, United States
| | - Ka Chan
- Department of Chemistry and Biochemistry, University of California, Santa Cruz, Santa Cruz, California 95064, United States
| | - Maria Sajimon
- Department of Chemistry and Biochemistry, University of California, Santa Cruz, Santa Cruz, California 95064, United States
| | - Stan Yoo
- Department of Chemistry, University of California, Irvine, Irvine, California 92697-2025, United States
| | - Vitor Hugo Balasco Serrão
- Biomolecular Cryoelectron Microscopy Facility, University of California, Santa Cruz, Santa Cruz, California 95064, United States
| | - Jack Lee
- Department of Chemistry and Biochemistry, University of California, Santa Cruz, Santa Cruz, California 95064, United States
| | - Benjamin Abrams
- Department of Biomolecular Engineering, Life Sciences Microscopy Center, University of California, Santa Cruz, Santa Cruz, California 95064, United States
| | - James S Nowick
- Department of Chemistry, University of California, Irvine, Irvine, California 92697-2025, United States
| | - Vladimir N Uversky
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, 12901 Bruce B. Downs Boulevard, MDC07, Tampa, Florida 33612, United States
| | - Christopher Wheeler
- World Brain Mapping Foundation, Society for Brain Mapping & Therapeutics, 860 Via De La Paz, Suite E-1, Pacific Palisades, California 90272-3668, United States
- StemVax Therapeutics (Subsidiary of NovAccess Global), 8584 E. Washington Street #127, Chagrin Falls, Ohio 44023, United States
- StemVax Therapeutics (Subsidiary of NovAccess Global), 2265 E. Foothill Boulevard, Pasadena, California 91107, United States
- T-Neuro Pharma, 1451 Innovation Parkway SE, Suite 600, Albuquerque, New Mexico 87123, United States
- T-Neuro Pharma, P.O. Box 781, Aptos, California 95003, United States
| | - Jevgenij A Raskatov
- Department of Chemistry and Biochemistry, University of California, Santa Cruz, Santa Cruz, California 95064, United States
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Upadhyay R, Dhakal A, Karivedu V, Wheeler C, Hoyd R, Bhateja P, Bonomi M, Valentin S, Gamez ME, Konieczkowski DJ, Baliga S, Grecula JC, Blakaj DM, Gogineni E, Mitchell DL, Denko N, Jhawar SR, Spakowicz D. Comparative Analysis of Tumor Microbiome, Molecular Profile and Immune Cell Abundance by HPV Status in Head and Neck Cancers and Their Impact on Survival. Int J Radiat Oncol Biol Phys 2023; 117:e264. [PMID: 37785006 DOI: 10.1016/j.ijrobp.2023.06.1221] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Traditional clinical and molecular prognostic factors offer valuable insight into the heterogeneous natural history and treatment response of head and neck squamous cell carcinoma (HNSCC) yet fail to explain the full spectrum of observed variability. The tumor microenvironment (TME), comprising microbiome and immune cells can impact treatment response and prognosis. We analyzed The Cancer Genome Atlas (TCGA) to evaluate the association of specific microbes and genes in TME with survival and their differential expression in HPV positive (+) and HPV negative (-) HNSCC. MATERIALS/METHODS HNSCC RNA sequencing (RNAseq) samples from TCGA were processed through the Exogenous sequencing in Tumors and Immune Cells (ExoTIC) pipeline to identify gene expression and microbial presence. HPV status was assessed by detection of papillomaviridae family of microbes. Clinical data from TCGA was extracted to compare overall survival (OS) and control for competing variables using Cox proportional hazards regression. Difference in immune cell abundance was evaluated by Kruskal-Wallis test. All statistical analysis was performed using R. RESULTS A total of 498 RNAseq samples from TCGA were analyzed. Oral cavity, oropharynx, hypopharynx, and larynx tumors comprised 21.6%, 15%, 1.8%, and 22.2% of specimens, respectively. HPV was detected in 111 patients (22%), most commonly Alpha papillomavirus 9 (90.1%). Of the 5838 enriched microbes, 330 were significantly associated with OS after controlling for tumor stage, smoking, and age. Specifically, the presence of Alpha papillomavirus 9 was associated with significantly improved OS [adjusted HR = 0.60 (95% CI 0.40 - 0.89, p = 0.01)]. Microbial species found in more abundance in HPV- tumors included Citrobacter farmeri, Thermoanaerobacter kivui and Yersinia pestis which are gram negative anaerobes. Genes related to cellular transport and DNA repair were enriched while genes related to proliferation (e.g., SAGE1) were depleted in HPV+ samples. HPV- tumors had a significantly higher number of M0 (p < 0.001) and M2 macrophages (p = 0.035) while HPV+ tumors had more T regulatory cells (p < 0.001) and CD8+ T-cells (p < 0.001). CONCLUSION Tumor microenvironment was significantly associated with survival for HNSCC patients, with particular microbes such as Alpha papillomavirus 9 correlating with improved OS. Greater abundance of certain anaerobic microbes was seen in HPV- tumors. These findings suggest TME can be used to predict patient outcomes and potentially guide personalized treatment approaches. We found an abundance of M0 and M2 macrophages in HPV- tumors, which are considered pro-tumorigenic, while anti-tumor M1 macrophages were similar in the two groups. This may help identify mechanism of resistance to immunotherapies and tailor novel immunotherapy combinations in specific patient subgroups. With further prospective research and external validation these findings have the potential to significantly impact the way we treat HNSCC in the future.
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Affiliation(s)
| | - A Dhakal
- The Ohio State University College of Medicine, Columbus, OH
| | - V Karivedu
- The Ohio State University Wexner Medical Center, Columbus, OH
| | - C Wheeler
- The Ohio State University Wexner Medical Center, Columbus, OH
| | - R Hoyd
- The Ohio State University Wexner Medical Center, Columbus, OH
| | - P Bhateja
- The Ohio State University Wexner Medical Center, Columbus, OH
| | - M Bonomi
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - S Valentin
- The Ohio State University Wexner Medical Center, Columbus, OH
| | - M E Gamez
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | | | - S Baliga
- Ohio State University, Columbus, OH
| | - J C Grecula
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - D M Blakaj
- James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH
| | - E Gogineni
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - D L Mitchell
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - N Denko
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - S R Jhawar
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - D Spakowicz
- The Ohio State University Wexner Medical Center, Columbus, OH
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Quick A, Diaz Pardo D, Miller E, Arnett A, Pitter K, Kim J, Flora L, Williams N, Hoyd R, Wheeler C, Mo X, Chambers L, Spakowicz D, Arthur E. Vaginal Microbiome as a Biomarker of Vaginal Health and Patient-Reported Outcomes in Women Receiving Pelvic Radiation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Presley C, Grogan M, Hoyd R, Compston A, Hock K, Knauss B, Redder E, Arrato N, Lo S, Benedict J, Janse S, Hayes S, Williams N, Wheeler C, Carbone D, Paskett E, Andersen B, Spakowicz D. Resiliency among Older Adults Receiving Lung Cancer Treatment (ROAR-LCT, NCT04229381): The feasibility of a novel supportive care intervention with collection of longitudinal gut microbiome specimens and activity tracking during the COVID-19 Pandemic. J Geriatr Oncol 2022. [DOI: 10.1016/s1879-4068(22)00320-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Do W, Russell R, Wheeler C, Lockwood M, De Vos M, Pavord I, Bafadhel M. Performance of Contactless Respiratory Rate Monitoring by Albus Home TM, an Automated System for Nocturnal Monitoring at Home: A Validation Study. Sensors (Basel) 2022; 22:s22197142. [PMID: 36236241 PMCID: PMC9573065 DOI: 10.3390/s22197142] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/01/2022] [Accepted: 09/16/2022] [Indexed: 06/12/2023]
Abstract
Respiratory rate (RR) is a clinically important predictor of cardio-respiratory deteriorations. The mainstay of clinical measurement comprises the manual counting of chest movements, which is variable between clinicians and limited to sporadic readings. Emerging solutions are limited by poor adherence and acceptability or are not clinically validated. Albus HomeTM is a contactless and automated bedside system for nocturnal respiratory monitoring that overcomes these limitations. This study aimed to validate the accuracy of Albus Home compared to gold standards in real-world sleeping environments. Participants undertook overnight monitoring simultaneously using Albus Home and gold-standard polygraphy with thoraco-abdominal respiratory effort belts (SomnomedicsEU). Reference RR readings were obtained by clinician-count of polygraphy data. For both the Albus system and reference, RRs were measured in 30-s segments, reported as breaths/minute, and compared. Accuracy was defined as the percentage of RRs from the Albus system within ±2 breaths/minute of reference counts. Across a diverse validation set of 32 participants, the mean accuracy exceeded 98% and was maintained across different participant characteristics. In a Bland-Altman analysis, Albus RRs had strong agreement with reference mean differences and the limits of agreement of -0.4 and ±1.2 breaths/minute, respectively. Albus Home is a contactless yet accurate system for automated respiratory monitoring. Validated against gold -standard methods, it enables long-term, reliable nocturnal monitoring without patient burden.
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Affiliation(s)
| | - Richard Russell
- Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK
| | | | | | - Maarten De Vos
- Department of Electrical Engineering and Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Ian Pavord
- Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK
| | - Mona Bafadhel
- King’s Centre for Lung Health, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 1UL, UK
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Do W, Russell R, Wheeler C, Javed H, Dogan C, Cunningham G, Khanna V, De Vos M, Satia I, Bafadhel M, Pavord I. Performance of cough monitoring by Albus Home™, a contactless and automated system for nocturnal respiratory monitoring at home. ERJ Open Res 2022; 8:00265-2022. [DOI: 10.1183/23120541.00265-2022] [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] [Received: 06/01/2022] [Accepted: 08/08/2022] [Indexed: 11/05/2022] Open
Abstract
IntroductionObjective cough frequency is a key clinical endpoint but existing wearable monitors are limited to 24-h recordings. Albus Home uses contactless motion, acoustic and environmental sensors to monitor multiple metrics, including respiratory rate and cough without encroaching on patient lifestyle. The aim of this study was to evaluate measurement characteristics of nocturnal cough monitoring by Albus Home compared to manual counts.MethodsAdults with respiratory conditions underwent overnight monitoring using Albus Home in their usual bedroom environments. Participants set-up the plug-and-play device themselves. For reference counts, each audio recording was counted by two annotators, and cough defined as explosive phases audio-visually labelled by both. In parallel, recordings were processed by a proprietary Albus system, comprising a deep-learning algorithm with a human screening step for verifying or excluding occasional events that mimic cough. Performance of the Albus system in detecting individual cough events and reporting hourly cough counts was compared against reference counts.Results30 nights from 10 subjects comprised 375 h(h) of recording. Mean (s.d.) coughs/night were 90 (76). Coughs·h−1 ranged from 0 to 129. Albus counts were accurate across hours with high and low cough frequencies, with median sensitivity, specificity, positive-predictive-value, negative-predictive-values of 94.8,100.0,99.1, and 100.0% respectively. Agreement between Albus and reference was strong (Intra-class Correlation Coefficient[ICC] 0.99; 95%CI 0.99-0.99; p<0.001) and equivalent to agreement between observers and reference counts (ICC 0.98, 0.99 respectively).ConclusionsAlbus Home provides a unique, contactless and accurate system for cough monitoring, enabling collection of high-quality and potentially clinically relevant longitudinal data.
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Garfield SF, Wheeler C, Etkind M, Ogunleye D, Williams M, Boucher C, Taylor A, Norton J, Lloyd J, Grimes T, Kelly D, Franklin BD. Providing pharmacy support to housebound patients: learning from the COVID-19 pandemic. International Journal of Pharmacy Practice 2022. [PMCID: PMC9383631 DOI: 10.1093/ijpp/riac019.031] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Introduction Housebound patients may face challenges to their medicines management due to reduced household mobility and potential lack of access to healthcare services. Previous literature has explored the medication-related needs of housebound patients from pharmacists’ perspectives (1-2). However little work has focussed on the patient/family perspective. In this study, we used data obtained from those staying at home as much as possible during the COVID-19 pandemic to fill this gap. Aim To explore home medicine practices and safety for people who were housebound during the COVID19 pandemic and to create guidance, from the patient/family perspective, for enabling pharmacists to facilitate safe medicine practices for this population. Methods Interviews were carried out with people who were taking at least one long term medication and met the criteria for ‘shielding’ and/or were over 70 years of age during the first wave of the COVID-19 pandemic in the UK and/or their family carers. Respondents were recruited through patient and public involvement representatives, the research team’s networks, and support groups. Potential participants were approached via personal contact and social media. Interviews were conducted by telephone or video conferencing and participants asked about their medicines management while staying at home. Inductive thematic analysis was carried out. Patient and public involvement representatives were involved in the data analysis alongside the researchers. Results Fifty people were interviewed (16 males, 34 females; mean age 68 years, range 26–93 years). Interview data suggested diversity of experiences of medicines management while staying at home. Some respondents reported no or little change, others an initial crisis followed by re-stabilisation, and others that the pandemic was a tipping point, exacerbating underlying challenges and having negative effects on their health and wellbeing. Medicine safety issues reported included omitted doses and less-effective formulations being used. Participants also described experiencing high levels of anxiety related to obtaining medicines, monitoring medicines and feeling at risk of contracting COVID-19 while accessing medicine-related healthcare services. Key factors identified as facilitating a smooth transition included patients’ own agency, support from family, friends and community, good communication with pharmacy staff, continuity of pharmacy services and synchronisation of medicines supply so that a maximum of one collection/delivery was required each month. Conclusion The study findings that we have presented relate to the UK only; this may limit the generalisability of our findings to other countries. Findings from Ireland are in the process of being analysed and will provide a basis of comparison. In addition, more females took part than males, despite efforts to address this. However, our findings suggest pharmacy staff can support medicines management for people who are housebound by synchronisation of medicines supply, delivering medicines where possible, developing/raising awareness of alternative means of communication, providing continuity of pharmacy services and signposting any community support available. References (1) Kayyali R, Funnell G, Harrap N, Patel A. Can community pharmacy successfully bridge the gap in care for housebound patients? Research in Social and Administrative Pharmacy 2019;15:425-439. (2) Latif A, Mandane B, Anderson E, Barraclough C, Travis S. Optimizing medicine use for people who are homebound: an evaluation of a pilot domiciliary Medicine Use Review (dMUR) service in England. Integr Pharm Res Pract 2018;7:33-40.
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Affiliation(s)
- S F Garfield
- UCL School of Pharmacy, UCL, London, UK
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College, London, UK
| | - C Wheeler
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College, London, UK
| | - M Etkind
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
| | - D Ogunleye
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
| | - M Williams
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
| | - C Boucher
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College, London, UK
| | - A Taylor
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College, London, UK
| | - J Norton
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College, London, UK
| | - J Lloyd
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College, London, UK
| | - T Grimes
- The School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Republic of Ireland
| | - D Kelly
- Health Research Institute, University of Limerick
| | - B D Franklin
- UCL School of Pharmacy, UCL, London, UK
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College, London, UK
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Morgan R, Clamp A, Ryder W, Wheeler C, Buckley E, Truelove J, Murphy A, Hasan J, Mitchell C, Burghel G, White D, Price M, Bhaskar S, Shaw J, Dive C, Wallace A, O'Connor J, Rothwell D, Edmondson R, Jayson G. 731P Multi-maintenance olaparib in relapsed, platinum-sensitive BRCA-mutant high-grade serous ovarian carcinoma (MOLTO): A phase II feasibility study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Yamamoto V, Bolanos JF, Fiallos J, Strand SE, Morris K, Shahrokhinia S, Cushing TR, Hopp L, Tiwari A, Hariri R, Sokolov R, Wheeler C, Kaushik A, Elsayegh A, Eliashiv D, Hedrick R, Jafari B, Johnson JP, Khorsandi M, Gonzalez N, Balakhani G, Lahiri S, Ghavidel K, Amaya M, Kloor H, Hussain N, Huang E, Cormier J, Wesson Ashford J, Wang JC, Yaghobian S, Khorrami P, Shamloo B, Moon C, Shadi P, Kateb B. COVID-19: Review of a 21st Century Pandemic from Etiology to Neuro-psychiatric Implications. J Alzheimers Dis 2020; 77:459-504. [PMID: 32925078 PMCID: PMC7592693 DOI: 10.3233/jad-200831] [Citation(s) in RCA: 51] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
COVID-19 is a severe infectious disease that has claimed >150,000 lives and infected millions in the United States thus far, especially the elderly population. Emerging evidence has shown the virus to cause hemorrhagic and immunologic responses, which impact all organs, including lungs, kidneys, and the brain, as well as extremities. SARS-CoV-2 also affects patients', families', and society's mental health at large. There is growing evidence of re-infection in some patients. The goal of this paper is to provide a comprehensive review of SARS-CoV-2-induced disease, its mechanism of infection, diagnostics, therapeutics, and treatment strategies, while also focusing on less attended aspects by previous studies, including nutritional support, psychological, and rehabilitation of the pandemic and its management. We performed a systematic review of >1,000 articles and included 425 references from online databases, including, PubMed, Google Scholar, and California Baptist University's library. COVID-19 patients go through acute respiratory distress syndrome, cytokine storm, acute hypercoagulable state, and autonomic dysfunction, which must be managed by a multidisciplinary team including nursing, nutrition, and rehabilitation. The elderly population and those who are suffering from Alzheimer's disease and dementia related illnesses seem to be at the higher risk. There are 28 vaccines under development, and new treatment strategies/protocols are being investigated. The future management for COVID-19 should include B-cell and T-cell immunotherapy in combination with emerging prophylaxis. The mental health and illness aspect of COVID-19 are among the most important side effects of this pandemic which requires a national plan for prevention, diagnosis and treatment.
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Affiliation(s)
- Vicky Yamamoto
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
- USC Keck School of Medicine, The USC Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, CA, USA
- USC-Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Joe F. Bolanos
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
| | - John Fiallos
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
| | - Susanne E. Strand
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
| | - Kevin Morris
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
| | - Sanam Shahrokhinia
- Cedars-Sinai Medical Center, Department of Nutrition, Los Angeles, CA, USA
| | - Tim R. Cushing
- UCLA-Cedar-Sinai California Rehabilitation Institute, Los Angeles, CA, USA
| | - Lawrence Hopp
- Cedars Sinai Medical Center Department of Ophthalmology and UCLA Jules Stein Eye Institute, Los Angeles, CA, USA
| | - Ambooj Tiwari
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- New York University, Department of Neurology, New York, NY, USA
| | - Robert Hariri
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Celularity Corporation, Warren, NJ, USA
- Weill Cornell School of Medicine, Department of Neurosurgery, New York, NY, USA
| | - Rick Sokolov
- Cedars-Sinai Medical Center, Department of Infectious Disease Los Angeles, CA, USA
| | - Christopher Wheeler
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
- T-NeuroPharma, Albuquerque, NM, USA
| | - Ajeet Kaushik
- NanoBioTech Laboratory, Department of Natural Sciences, Division of Sciences, Arts, and Mathematics, Florida Polytechnic University, Lakeland, FL, USA
| | - Ashraf Elsayegh
- Cedars Sinai Medical Center, Department of Pulmonology, Los Angeles, CA, USA
| | - Dawn Eliashiv
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- UCLA David Geffen, School of Medicine, Department of Neurology, Los Angeles, CA, USA
| | - Rebecca Hedrick
- Cedars Sinai Medical Center, Department of Psychiatry, Los Angeles, CA, USA
| | - Behrouz Jafari
- University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, USA
| | - J. Patrick Johnson
- Cedars Sinai Medical Center, Spine Institute, Los Angeles, CA, USA
- Cedars-Sinai Medical Center, Department of Neurosurgery, Los Angeles, CA, USA
| | - Mehran Khorsandi
- Cedars-Sinai Medical Center, Department of Cardiology, Los Angeles, CA, USA
| | - Nestor Gonzalez
- Cedars-Sinai Medical Center, Department of Neurosurgery, Los Angeles, CA, USA
| | - Guita Balakhani
- Cedars-Sinai Medical Center, Department of Nephrology, Los Angeles, CA, USA
| | - Shouri Lahiri
- Cedars-Sinai Medical Center, Department of Neurology, Los Angeles, CA, USA
| | - Kazem Ghavidel
- University of Tehran School of Medicine, Department of Cardiology, Tehran, Iran
| | - Marco Amaya
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
| | - Harry Kloor
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
| | - Namath Hussain
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Loma Linda University, Department of Neurosurgery, Loma Linda, CA, USA
| | - Edmund Huang
- Cedars-Sinai Medical Center, Department of Nephrology, Los Angeles, CA, USA
| | - Jason Cormier
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Lafayette Surgical Specialty Hospital, Lafayette, Louisiana, USA
| | - J. Wesson Ashford
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Stanford University School of Medicine (Affiliated), Department of Psychiatry and Behavioral Science and Department of Veteran’s Affair, Palo Alto, CA, USA
| | - Jeffrey C. Wang
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- USC-Keck School of Medicine, Department of Orthopedic Surgery, Los Angeles, CA, USA
| | - Shadi Yaghobian
- Cedars-Sinai Medical Center, Department of Internal Medicine, Los Angeles, CA, USA
| | - Payman Khorrami
- Cedars Sinai Medical Center, Department of Gastroenterology, Los Angeles, CA, USA
| | - Bahman Shamloo
- Cedars Sinai Medical Center, Pain Management, Los Angeles, CA, USA
| | - Charles Moon
- Cedars Sinai Orthopaedic Center, Department of Orthopedics, Los Angeles, CA, USA
| | - Payam Shadi
- Cedars-Sinai Medical Center, Department of Internal Medicine, Los Angeles, CA, USA
| | - Babak Kateb
- Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA
- Brain Mapping Foundation (BMF), Los Angeles, CA, USA
- Loma Linda University, Department of Neurosurgery, Loma Linda, CA, USA
- National Center for NanoBioElectronic (NCNBE), Los Angeles, CA, USA
- Brain Technology and Innovation Park, Los Angeles, CA, USA
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Hu J, Rudnick J, Wheeler C, Mazer M, Wang H, Black K, Yu J. ATIM-18. A PHASE I TRIAL OF VACCINATION WITH AUTOLOGOUS DENDRITIC CELLS PULSED WITH LYSATE DERIVED FROM AN ALLOGENEIC GLIOBLASTOMA STEMLIKE CELL LINE FOR PATIENTS WITH NEWLY DIAGNOSED OR RECURRENT GLIOBLASTOMA. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jethro Hu
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | - Mia Mazer
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Keith Black
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - John Yu
- Cedars-Sinai, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
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Werhahn SM, Dathe H, Rottmann T, Franke T, Wheeler C, Fili M, Hasenfuss G, Seidler T. 1106Validity of activity data collected by mobile Apple devices - Testing a new telemedical care concept for patients after hospitalization for heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1106] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S M Werhahn
- Universitätsmedizin Göttingen, Kardiologie, Göttingen, Germany
| | - H Dathe
- Universitätsmedizin Göttingen, Institut für Medizinische Informatik, Göttingen, Germany
| | - T Rottmann
- Universitätsmedizin Göttingen, Institut für Medizinische Informatik, Göttingen, Germany
| | - T Franke
- Universitätsmedizin Göttingen, Institut für Medizinische Informatik, Göttingen, Germany
| | | | - M Fili
- Medopad Ltd, London, United Kingdom
| | - G Hasenfuss
- Universitätsmedizin Göttingen, Kardiologie, Göttingen, Germany
| | - T Seidler
- Universitätsmedizin Göttingen, Kardiologie, Göttingen, Germany
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Bijsmans ES, Jepson RE, Wheeler C, Syme HM, Elliott J. Plasma N-Terminal Probrain Natriuretic Peptide, Vascular Endothelial Growth Factor, and Cardiac Troponin I as Novel Biomarkers of Hypertensive Disease and Target Organ Damage in Cats. J Vet Intern Med 2017; 31:650-660. [PMID: 28387019 PMCID: PMC5435049 DOI: 10.1111/jvim.14655] [Citation(s) in RCA: 14] [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: 06/20/2016] [Revised: 10/06/2016] [Accepted: 12/12/2016] [Indexed: 12/22/2022] Open
Abstract
Background In the absence of ocular target organ damage (ocular‐TOD), diagnosis of hypertension is challenging in cats. Biomarkers would provide additional support for the diagnosis of hypertension. Hypothesis Vascular endothelial growth factor (VEGF), N‐terminal probrain natriuretic peptide (NT‐proBNP), cardiac troponin I (cTnI), and urine protein‐to‐creatinine ratio (UPC) are predictors of systemic hypertension, will be increased in cats with hypertension with or without ocular‐TOD, and will decrease with antihypertensive treatment. Methods Plasma VEGF, NT‐proBNP, and cTnI concentrations and UPC were determined in healthy geriatric cats, normotensive cats with chronic kidney disease (CKD), hypertensive cats with evidence of hypertensive retinopathy (HT‐ocular‐TOD), and hypertensive cats without hypertensive ocular‐TOD (HT‐noTOD). Comparisons among groups were performed. Multivariable binary logistic regression models were built to identify independent biomarkers of hypertension and ocular‐TOD. Receiver operator characteristic (ROC) curves were drawn to assess clinical use. Results Cats with HT‐ocular‐TOD had significantly higher VEGF than all other groups (P < .05) and significantly higher NT‐proBNP than healthy cats (P < .001). Healthy cats had significantly lower cTnI than all other groups (P < .05). No differences were found among groups for UPC (P = .08). Cardiac troponin I and VEGF were independent predictors of hypertension (P < .05), but none of the biomarkers were independent predictors of ocular‐TOD. N‐terminal probrain natriuretic peptide concentrations decreased with antihypertensive treatment (P < .001). The ROC curves indicated that none of the biomarkers met the criteria to function as diagnostic tests for the diagnosis of hypertension or associated ocular‐TOD. Conclusions and Clinical Significance Despite statistical significance and changes with ocular‐TOD, antihypertensive treatment, or both, VEGF, NT‐proBNP, and cTnI did not function as useful diagnostic tests for hypertension. Persistently increased systolic blood pressure (SBP) measurements in combination with fundoscopy remains the preferred method for diagnosis of feline hypertension.
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Affiliation(s)
- E S Bijsmans
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - R E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - C Wheeler
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - H M Syme
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
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Huguelet PS, Browner-Elhanan KJ, Fleming N, Karjane NW, Loveless M, Sheeder J, Talib HJ, Wheeler C, Kaul P. Does the North American Society for Pediatric and Adolescent Gynecology Short Curriculum Increase Resident Knowledge in Pediatric and Adolescent Gynecology? J Pediatr Adolesc Gynecol 2016; 29:623-627. [PMID: 27216709 DOI: 10.1016/j.jpag.2016.05.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 02/03/2016] [Revised: 04/18/2016] [Accepted: 05/06/2016] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE To determine if the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Short Curriculum improves self-reported knowledge in pediatric and adolescent gynecology (PAG) among obstetrics and gynecology (Ob/Gyn) residents, at programs without PAG-trained faculty. DESIGN Prospective, cross-sectional exposure to the NASPAG short curriculum with a follow-up questionnaire. SETTING Ob/Gyn residency training programs without PAG faculty. PARTICIPANTS Ob/Gyn residents in training from February 2015 to June 2015. INTERVENTIONS Exposure to the NASPAG Short Curriculum. MAIN OUTCOME MEASURES Improvement in self-perceived knowledge after completion of curriculum. RESULTS Two hundred twenty-seven residents met inclusion criteria; 34 completed the study (15% response). Less than 50% of residents reported adequate knowledge in the areas of prepubertal vaginal bleeding, vulvovaginitis, precocious and delayed puberty, Home environment, Education and Employment, Eating, peer-related Activities, Drugs, Sexuality, Suicide/depression, Safety from injury and violence (HEEADSSS) interview, pelvic pain, and bleeding management in teens with developmental delay. After completion of the curriculum, self-reported knowledge improved in 8 of 10 learning objectives, with no significant improvement in bleeding disorders or Müllerian anomalies. There was no association between pretest knowledge and level of residency training, type of residency program, previous exposure to PAG lectures, and previous exposure to patients with PAG complaints. CONCLUSION Significant deficiencies exist regarding self-reported knowledge of core PAG topics among Ob/Gyn residents at programs without PAG-trained faculty. Use of the NASPAG Short Curriculum by residents without access to PAG-trained faculty resulted in improved self-reported knowledge in PAG.
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Affiliation(s)
- P S Huguelet
- Pediatric and Adolescent Gynecology, Children's Hospital Colorado, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado.
| | - K J Browner-Elhanan
- Division of Adolescent Medicine, Children's Hospital, Memorial University Medical Center, Savannah, Georgia
| | - N Fleming
- Pediatric and Adolescent Gynecology, Children's Hospital of Eastern Ontario, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
| | - N W Karjane
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia
| | - M Loveless
- Pediatric and Adolescent Gynecology, Kosair Children's Hospital, Louisville, Kentucky
| | - J Sheeder
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado
| | - H J Talib
- Division of Adolescent Medicine, Children's Hospital at Montefiore, Albert Einstein College of Medicine, The Bronx, New York City, New York
| | - C Wheeler
- Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, Rhode Island
| | - P Kaul
- Division of Adolescent Medicine, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
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Lewis M, McAndrew M, Wheeler C, Workman N, Agashe P, Koopmann J, Uddin E, Zou L, Stark R, Anson J, Cope A, Vyse T. THU0249 Functional Clusters of Autoantibodies Targeting TLR and Smad Pathways Define New Subgroups in Systemic Lupus Erythematosus. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.6111] [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: 11/04/2022]
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Hu J, Phuphanich S, Rudnick J, Mazer M, Wang H, Wheeler C, Black K, Yu J. IMCT-12A PHASE 1 TRIAL OF VACCINATION WITH AUTOLOGOUS DENDRITIC CELLS PULSED WITH LYSATE DERIVED FROM AN ALLOGENEIC GLIOBLASTOMA STEM-LIKE CELL LINE FOR PATIENTS WITH NEWLY DIAGNOSED OR RECURRENT GLIOBLASTOMA. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov218.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Campian J, Gladstone D, Ambady P, Ye X, King K, Borrello I, Petrik S, Golightly M, Holdhoff M, Grossman S, Bhardwaj R, Chakravadhanula M, Ozols V, Georges J, Carlson E, Hampton C, Decker W, Chiba Y, Hashimoto N, Kagawa N, Hirayama R, Tsuboi A, Oji Y, Oka Y, Sugiyama H, Yoshimine T, Choi B, Gedeon P, Herndon J, Sanchez-Perez L, Mitchell D, Bigner D, Sampson J, Choi YA, Pandya H, Gibo DM, Debinski W, Cloughesy TF, Liau LM, Chiocca EA, Jolly DJ, Robbins JM, Ostertag D, Ibanez CE, Gruber HE, Kasahara N, Vogelbaum MA, Kesari S, Mikkelsen T, Kalkanis S, Landolfi J, Bloomfield S, Foltz G, Pertschuk D, Everson R, Jin R, Safaee M, Lisiero D, Odesa S, Liau L, Prins R, Gholamin S, Mitra SS, Richard CE, Achrol A, Kahn SA, Volkmer AK, Volkmer JP, Willingham S, Kong D, Shin JJ, Monje-Deisseroth M, Cho YJ, Weissman I, Cheshier SH, Kanemura Y, Sumida M, Yoshioka E, Yamamoto A, Kanematsu D, Takada A, Nonaka M, Nakajima S, Goto S, Kamigaki T, Takahara M, Maekawa R, Shofuda T, Moriuchi S, Yamasaki M, Kebudi R, Cakir FB, Gorgun O, Agaoglu FY, Darendeliler E, Lin Y, Wang Y, Qiu X, Jiang T, Lin Y, Wang Y, Jiang T, Zhang G, Wang J, Okada H, Butterfield L, Hamilton R, Drappatz J, Engh J, Amankulor N, Lively M, Chan M, Salazar A, Potter D, Shaw E, Lieberman F, Pandya H, Choi Y, Park J, Phuphanich S, Wheeler C, Rudnick J, Hu J, Mazer M, Wang H, Nuno M, Guevarra A, Sanchez C, Fan X, Ji J, Chu R, Bender J, Hawkins E, Black K, Yu J, Reap E, Archer G, Sanchez-Perez L, Norberg P, Schmittling R, Nair S, Cui X, Snyder D, Chandramohan V, Choi B, Kuan CT, Mitchell D, Bigner D, Yan H, Sampson J, Reardon D, Li G, Recht L, Fink K, Nabors L, Tran D, Desjardins A, Chandramouli N, Duic JP, Groves M, Clarke A, Hawthorne T, Green J, Yellin M, Sampson J, Rigakos G, Spyri O, Nomikos P, Stavridi F, Grossi I, Theodorakopoulou I, Assi A, Kouvatseas G, Papadopoulou E, Nasioulas G, Labropoulos S, Razis E, Rudnick J, Ravi A, Sanchez C, Tang DN, Hu J, Yu J, Sharma P, Black K, Sengupta S, Sampath P, Soto H, Erickson K, Malone C, Hickey M, Ha E, Young E, Ellingson B, Prins R, Liau L, Kruse C, Sul J, Hilf N, Kutscher S, Schoor O, Lindner J, Reinhardt C, Kreisl T, Iwamoto F, Fine H, Singh-Jasuja H, Teijeira L, Gil-Arnaiz I, Hernandez-Marin B, Martinez-Aguillo M, Sanchez SDLC, Viudez A, Hernandez-Garcia I, Lecumberri MJ, Grandez R, de Lascoiti AF, Garcia RV, Thomas A, Fisher J, Baron U, Olek S, Rhodes H, Gui J, Hampton T, Tafe L, Tsongalis G, Lefferts J, Wishart H, Kleen J, Miller M, Ernstoff M, Fadul C, Vlahovic G, Desjardins A, Peters K, Ranjan T, Herndon J, Friedman A, Friedman H, Bigner D, Archer G, Lally-Goss D, Sampson J, Wainwright D, Dey M, Chang A, Cheng Y, Han Y, Lesniak M, Weller M, Kaulich K, Hentschel B, Felsberg J, Gramatzki D, Pietsch T, Simon M, Westphal M, Schackert G, Tonn JC, Loeffler M, Reifenberger G, Yu J, Rudnick J, Hu J, Phuphanich S, Mazer M, Wang H, Xu M, Nuno M, Patil C, Chu R, Black K, Wheeler C. IMMUNOTHERAPY/BIOLOGICAL THERAPIES. Neuro Oncol 2013; 15:iii68-iii74. [PMCID: PMC3823893 DOI: 10.1093/neuonc/not178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
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Lindsay JO, Chipperfield R, Giles A, Wheeler C, Orchard T. A UK retrospective observational study of clinical outcomes and healthcare resource utilisation of infliximab treatment in Crohn's disease. Aliment Pharmacol Ther 2013; 38:52-61. [PMID: 23701393 DOI: 10.1111/apt.12339] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 01/05/2013] [Accepted: 04/30/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND Crohn's disease (CD) places a substantial burden on healthcare systems, with the majority of costs arising from hospitalisation and surgery. AIM To evaluate the 'real-world' clinical effectiveness, impact on healthcare utilisation and cost of infliximab for the treatment of CD in UK practice. METHODS A non-interventional, retrospective analysis of medical records from patients with CD treated with infliximab at 18 hospital centres across the UK. The primary objective was to compare cumulative clinical outcomes and healthcare resource utilisation for the 0- to 24-month post-infliximab period with the 12 months preceding infliximab treatment. Predefined outcomes included the number of elective surgical procedures, hospitalisations and healthcare provider consultations. Costs associated with healthcare utilisation were collected from the perspective of the UK National Health Service (NHS). RESULTS The study involved 380 patients. Infliximab significantly reduced the mean number of elective (from 0.18 to 0.11; P = 0.0035) and non-elective (from 0.46 to 0.29; P < 0.0001) hospitalisations, and the number of consultations with gastroenterologists, gastrointestinal surgeons and radiologists (from 4.0 to 3.5, from 0.7 to 0.5 and from 0.5 to 0.2, respectively; all P < 0.001); all decreases were associated with significant cost reductions. The mean number of elective surgical procedures (including correction of severe anal fistulae and abscess drainage) was significantly reduced. CONCLUSIONS The observed reductions in numbers of hospitalisations, surgical procedures and consultations with healthcare professionals are key indicators of the clinical effectiveness of infliximab for the treatment of CD. These benefits result in overall decreases in healthcare resource utilisation, which translate into cost savings for the NHS.
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Affiliation(s)
- J O Lindsay
- Digestive Diseases Clinical Academic Unit, Barts Health NHS Trust and Barts and the London School of Medicine, Queen Mary University of London, London, UK.
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McAndrew M, Wheeler C, Koopmann J, Uddin E, Lewis M, Vyse T. SAT0528 Novel Autoantibody Biomarkers for the Improved Diagnosis of Systemic Lupus Erythematosus. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cordner R, Jhun M, Panwar A, Wang H, Yeager N, McAbee J, Mardiros A, Takei A, Fan X, Jouanneau E, Black K, Wheeler C. Abstract LB-333: IDH1 modulates the immune response to glioblastoma. Cancer Res 2013. [DOI: 10.1158/1538-7445.am2013-lb-333] [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
Dendritic cell (DC) vaccines for glioblastoma (GBM) can effectively extend overall patient survival, but they are not curative. Younger patients responded poorly to vaccination in ours and other trials. Mutations in isocitrate dehydrogenase 1 (IDH1) are commonly found in younger patients, encouraging the hypothesis that IDH1 mutation may subvert the clinical benefits of DC vaccination. Sequencing IDH1-mutated human GBM samples revealed an increase in IDH1 mutated tumor tissue after vaccination, consistent with this hypothesis. This led us to consider whether CTL recognition might be functionally altered by IDH1 and/or its mutation. Indeed, alloreactive CD8+ hybridoma cells exhibited significantly delayed lysis of GL26 cells expressing mutant IDH1 relative to untransfected GL26, but significantly increased lysis of GL26 transfected with unmutated IDH1. In contrast, wild-type and mutant IDH1 transfectants of GL26 exhibited identical sensitivity to imidazole-induced cell death, as well as identical MHC I expression. Moreover, preliminary studies suggest that wild-type and mutant IDH1 transfectants of GL26 are differentially sensitive to DC vaccination, with mutant IDH1 abrogating the longer survival conferred by such treatment. We therefore examined the possibility that these observed differences were mediated by a novel, immune-specific property of IDH1. Generalized sialidase activity can de-sialylate the CD8 coreceptor on T cells, and such modification enhances CD8 binding to MHC I, thereby modulating T cell responsiveness to MHC I-bound peptides. As the IDH1 catalytic site is structurally similar to microbial sialidase, we hypothesized that IDH1 possesses CD8-directed sialidase activity capable of enhancing CTL lysis, and that IDH1mutation critically diminishes this activity. Accordingly, IDH1 treatment increased binding to tumor pHLA multimers and to PNA lectin by human CD8 T cells, with the pHLA binding inhibited by either free sialic acid prior to treatment, or by anti-CD3 antibody after treatment. In addition, IDH1 treatment increased binding to several tumor pMHCI multimers by mouse CD8 T cells, and markedly increased IFN-γ production in response to stimulation by such multimers. Finally, labeled IDH1 bound to the surface of spleen cells, and physiologic concentrations of IDH1 specifically associated with a putative surface heterodimer resembling the CD8 coreceptor in murine T cell lysates. Together, these results suggest that wild-type IDH1possesses immune-specific sialidase function that enhances CTL lysis. In contrast, mutant IDH1 appears to delay immune lysis of tumor cells expressing it, and abrogates vaccine benefits, potentially by diminishing its immune-specific sialidase function.
Citation Format: Ryan Cordner, Michelle Jhun, Akanksha Panwar, HongQiang Wang, Nicole Yeager, Joseph McAbee, Armen Mardiros, Akane Takei, Xuemo Fan, Emmaunel Jouanneau, Keith Black, Christopher Wheeler. IDH1 modulates the immune response to glioblastoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr LB-333. doi:10.1158/1538-7445.AM2013-LB-333
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Affiliation(s)
| | | | | | | | | | | | | | - Akane Takei
- Cedars-Sinai Medical Center, Los Angeles, CA
| | - Xuemo Fan
- Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - Keith Black
- Cedars-Sinai Medical Center, Los Angeles, CA
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Gore M, Bellmunt J, Eisen T, Escudier B, Mickisch G, Patard J, Porta C, Ravaud A, Schmidinger M, Schöffski P, Sternberg C, Szczylik C, De Nigris E, Wheeler C, Kirpekar S. Evaluation of treatment options for patients with advanced renal cell carcinoma: Assessment of appropriateness, using the validated semi-quantitative RAND corporation/University of California, Los Angeles methodology. Eur J Cancer 2012; 48:1038-47. [DOI: 10.1016/j.ejca.2012.02.058] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 02/19/2012] [Indexed: 12/18/2022]
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Loharikar A, Newton A, Rowley P, Wheeler C, Bruno T, Barillas H, Pruckler J, Theobald L, Lance S, Brown JM, Barzilay EJ, Arvelo W, Mintz E, Fagan R. Typhoid Fever Outbreak Associated With Frozen Mamey Pulp Imported From Guatemala to the Western United States, 2010. Clin Infect Dis 2012; 55:61-6. [DOI: 10.1093/cid/cis296] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hickey MJ, Malone CK, Erickson KL, Gerschenson LE, Lin AH, Inagaki A, Hiraoka K, Kasahara N, Mueller B, Kruse CA, Kong S, Tyler B, Zhou J, Carter BS, Brem H, Junghans RP, Sampath P, Lai RK, Recht LD, Reardon DA, Paleologos N, Groves M, Rosenfeld MR, Davis T, Green J, Heimberger A, Sampson J, Hashimoto N, Tsuboi A, Chiba Y, Kijima N, Oka Y, Kinoshita M, Kagawa N, Fujimoto Y, Sugiyama H, Yoshimine T, Birks SM, Burnet M, Pilkington GJ, Yu JS, Wheeler CJ, Rudnick J, Mazer M, Wang HQ, Nuno MA, Richardson JE, Fan X, Ji J, Chu RM, Bender JG, Hawkins EW, Black KL, Phuphanich S, Pollack IF, Jakacki RI, Butterfield LH, Okada H, Hunt MA, Pluhar GE, Andersen BM, Gallardo JL, Seiler CO, SantaCruz KS, Ohlfest JR, Bauer DF, Lamb LS, Harmon DK, Zheng X, Romeo AK, Gillespie GY, Parker JN, Markert JM, Jacobs VL, Landry RP, De Leo JA, Bromberg JE, Doorduijn J, Baars JW, van Imhoff GW, Enting R, van den Bent MJ, Murphy KA, Bedi J, Epstein A, Ohlfest JR, Olin M, Andersen B, Swier L, Ohlfest J, Litterman AJ, Zellmer DM, Ohlfest JR, Chiocca EA, Aguilar LK, Aguilar-Cordova E, Manzanera AG, Harney KR, Portnow J, Badie B, Lesniak M, Bell S, Ray-Chaudhuri A, Kaur B, Hardcastle J, Cavaliere R, McGregor J, Lo S, Chakarvarti A, Grecula J, Newton H, Trask TW, Baskin DS, New PZ, Zeng J, See AP, Phallen J, Belcaid Z, Durham N, Meyer C, Albesiano E, Pradilla G, Ford E, Hammers H, Tyler B, Brem H, Tran PT, Pardoll D, Drake CG, Lim M, Ghazi A, Ashoori A, Hanley P, Salsman V, Schaffer DR, Grada Z, Kew Y, Powell SZ, Grossman R, Scheurer ME, Leen AM, Rooney CM, Bollard CM, Heslop HE, Gottschalk S, Ahmed N, Hu J, Patil C, Nuno M, Wheeler C, Rudnick J, Phuphanich S, Mazer M, Wang HQ, Chu R, Black K, Yu J, Marabelle A, Kohrt H, Brody J, Luong R, Tse V, Levy R, Li YM, Jun H, Shahryar M, Daniel VA, Walter HA, Thaipisuttikul I, Avila E, Mitchell DA, Archer GE, Friedman HS, Herndon JE, Bigner DD, Sampson JH, Johnson LA, Archer GE, Nair SK, Schmittling R, Reap E, Sampson JH, Mitchell DA, Li YM, Shahryar M, Jun H, Daniel VA, Walter HA, Knisely JP, Kluger H, Flanigan J, Sznol M, Yu JB, Chiang VL, Prins RM, Kim W, Soto H, Lisiero DN, Lisiero DN, Liau LM. IMMUNOTHERAPY. Neuro Oncol 2011; 13:iii34-iii40. [PMCID: PMC3199174 DOI: 10.1093/neuonc/nor151] [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: 09/21/2023] Open
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Gore M, Bellmunt J, Eisen T, Mickisch G, Patard J, Porta C, Ravaud A, Schmidinger M, Sternberg C, Szczylik C, De Nigris E, Kirpekar S, Wheeler C. 7114 POSTER DISCUSSION Appropriateness of Treatment Options for the Management of Patients With Advanced Renal Cell Carcinoma (RCC) Using the Validated Semi Quantitative RAND Corporation/University of California, Los Angeles (RAND/UCLA) Methodology. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72029-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Wheeler C, Said H, Prucz R, Rohrich R, Mathes D. Erratum. Aesthet Surg J 2011. [DOI: 10.1177/1090820x11415828] [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: 11/15/2022] Open
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Martin SI, Dodson B, Wheeler C, Davis J, Pesavento T, Bumgardner GL. Monitoring infection with Epstein-Barr virus among seromismatch adult renal transplant recipients. Am J Transplant 2011; 11:1058-63. [PMID: 21449943 DOI: 10.1111/j.1600-6143.2011.03478.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Patients who undergo Epstein-Barr virus (EBV) seromismatch (D+/R-) transplants have a higher risk for the development of post-transplant lymphoproliferative disorder (PTLD). Adult renal transplant recipients at a single institution were prospectively monitored for EBV during the first year post-transplant. Over a 2-year period, 34 patients (7.78%) were identified as being EBV D+/R-recipients. Patients who developed symptoms or had persistent viremia were pre-emptively administered rituximab. Six recipients were discharged without monitoring on the protocol. Of those six, three (50%) developed PTLD and all three lost their grafts. Twenty (60.6%) of the 34 recipients developed viremia during the first year post-transplant. Of the recipients who became viremic, six (30%) received rituximab. None of the six who received rituximab-developed PTLD. We found that recipients who were not monitored on the protocol were more likely to have PTLD and graft loss compared to those who were (p = 0.008). Post-transplant monitoring of adults who undergo EBV D+/R-kidney transplants for viremia and symptoms associated with EBV infection may prompt intervention which reduces the incidence of PTLD within the first year. Use of rituximab in preventing PTLD among patients with primary EBV infection requires further prospective study to determine its overall safety and efficacy.
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Affiliation(s)
- S I Martin
- Division of Infectious Diseases and The Comprehensive Transplant Center, The Ohio State University Medical Center, Columbus, OH, USA.
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Phuphanich S, Rudnick J, Mazer M, Wang HQ, Serrano N, Richardson J, Wheeler C, Singh M, Black K, Yu J. Immune response correlation with progression-free survival in glioblastoma following dendritic cell immunotherapy (ICT-107). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.2097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Miller W, Wheeler C, Panoskaltsis-Mortari A, Kirk A, Larsen C, Blazar B, Kean L. Prevention Of Acute GvHD During MHC Haploidentical HSCT: Evaluating The Efficacy Of T-Cell Costimulation Blockade Using A Novel Rhesus Macaque Transplant Model. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Phuphanich S, Rudnick J, Chu R, Mazer M, Wang H, Serrano N, Francisco M, Wheeler C, Singh M, Yu JS. A phase I trial of tumor-associated antigen-pulsed dendritic cell immunotherapy for patients with brain stem glioma and glioblastoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.2032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2032 Background: Previous immunotherapy trials for malignant glioma (Yu, J.,et al, Cancer Res. 2001;61:842–7 and 2004;64;4973–9) have demonstrated efficacy in generating a tumor specific immune response. Here we set out to determine feasibility and immunogenecity of dendritic vaccination with specific glioma-associated antigens. Methods: The goal of this study is to use tumor associated antigens (TAA) known to be expressed on gliomas and pulse dendritic cells with these antigens in an MHC compatible fashion using epitopes of HER-2, TRP-2, gp100, MAGE-1, IL13R alpha, and AIM-3. In this phase I trial, HLA-A1 and/or HLA-A2-positive patients with newly diagnosed or recurrent glioblastoma were eligible. Leukapheresis was used to isolate mononuclear cells which were differentiated into dendritic cells in culture, pulsed with tumor peptide, and then administered intradermally three times at 2-week intervals. Results: Twenty patients, 15 males and five females, were enrolled between November 2006 and December 2008 with one screen failure. The median patient age was 47 years (range: 26–65) and patients had a median Karnofsky performance status of 90% (range: 90–100). There were 16 newly diagnosed and three recurrent glioblastoma multiforme (GBM) patients, who underwent surgery prior to vaccination. Our data on 19 patients and 54 courses of dendritic cell vaccines demonstrate zero grade 3 /4 toxicities that were attributable to the vaccination. Thirteen patients continue to have stable disease (ranging from 15 to 115 weeks), six patients have demonstrated tumor progression. Median survival from surgery was 60 weeks (ranging from 26 to 115 weeks). Of 15 patients tested to date, six patients demonstrated an antigen-specific cytotoxic T-cell response to at least one antigen after vaccination. Only 17% of CTL responders (1/6) demonstrated tumor progression compared to 56% (5/9) of nonresponders to date. Conclusions: This phase I study demonstrated the feasibility, safety, and bioactivity of a TAA-pulsed dendritic cell vaccine for patients with glioblastoma progression free survival correlated with CTL response. [Table: see text]
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Affiliation(s)
- S. Phuphanich
- Cedars-Sinai Medical Center, Los Angeles, CA; Immunocellular Therapeutics Ltd., Woodland Hills, CA
| | - J. Rudnick
- Cedars-Sinai Medical Center, Los Angeles, CA; Immunocellular Therapeutics Ltd., Woodland Hills, CA
| | - R. Chu
- Cedars-Sinai Medical Center, Los Angeles, CA; Immunocellular Therapeutics Ltd., Woodland Hills, CA
| | - M. Mazer
- Cedars-Sinai Medical Center, Los Angeles, CA; Immunocellular Therapeutics Ltd., Woodland Hills, CA
| | - H. Wang
- Cedars-Sinai Medical Center, Los Angeles, CA; Immunocellular Therapeutics Ltd., Woodland Hills, CA
| | - N. Serrano
- Cedars-Sinai Medical Center, Los Angeles, CA; Immunocellular Therapeutics Ltd., Woodland Hills, CA
| | - M. Francisco
- Cedars-Sinai Medical Center, Los Angeles, CA; Immunocellular Therapeutics Ltd., Woodland Hills, CA
| | - C. Wheeler
- Cedars-Sinai Medical Center, Los Angeles, CA; Immunocellular Therapeutics Ltd., Woodland Hills, CA
| | - M. Singh
- Cedars-Sinai Medical Center, Los Angeles, CA; Immunocellular Therapeutics Ltd., Woodland Hills, CA
| | - J. S. Yu
- Cedars-Sinai Medical Center, Los Angeles, CA; Immunocellular Therapeutics Ltd., Woodland Hills, CA
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Rudnick JD, Phuphanich S, Chu R, Mazer M, Wang H, Serrano N, Francisco M, Black KL, Wheeler C, Yu J. A phase I trial of surgical resection with biodegradable carmustine (BCNU) wafer placement followed by vaccination with dendritic cells pulsed with tumor lysate for patients with malignant glioma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.2033] [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
2033 Background: Our prior immunotherapy trials demonstrated efficacy in generating a tumor specific immune response in malignant glioma and the potential for high tumor-specific toxicity and sustained tumoricidal activity. Immunotherapy may synergize with chemotherapy and biodegradable carmustine (BCNU) wafers extend overall survival from 11.6 to 13.9 months. Methods: We exploited this synergistic effect to maintain a cytotoxic environment around the tumor milieu. Patients with high-grade glioma were eligible after maximal resection with biodegradable carmustine (BCNU) wafer placement. Screening leukapheresis is used to isolate mononuclear cells which are differentiated into dendritic cells, pulsed with tumor lysate, and then 3 intradermal vaccines are administered at 2-week intervals. Patients continued systemic chemotherapy after vaccine or at progression. Results: Eighteen patients have been enrolled (7 Male, 11 Female) between April 2007 and February 2009 with one screen failure and two patients with clinical progression prior to vaccination. The median patient age was 57 years (26 to 74 ) and median Karnofsky performance status was 90% (80–100). The histology included 3 newly diagnosed glioblastoma multiforme (GBM), 8 recurrent GBM, 2 newly diagnosed anaplastic astrocytoma (AA), and 2 recurrent AA. 15 patients were successfully treated by vaccine injections with 12 patients receiving vaccine every 2 weeks x 3 followed by adjuvant chemotherapy. Our preliminary data on 15 patients and 39 courses of Dendritic Cell vaccines demonstrate one grade 3 toxicity of fever/chest pain. A stable disease interval of 13 to 90 weeks was observed for patients who received vaccine. The 3 newly diagnosed GBM patients have stable disease (18 to 71 weeks). In the recurrent GBM cohort 7/8 patients had progression within 6 months from the post-vaccination MRI. Conclusions: This phase I study demonstrates the safety, feasibility of dendritic cell vaccination with biodegradable carmustine (BCNU) wafers with one grade 3 AE. Immunological data is pending to determine potential synergy of dendritic cell vaccination with intracranial chemotherapy. No significant financial relationships to disclose.
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Affiliation(s)
| | | | - R. Chu
- Cedars-Sinai Medical Center, Los Angeles, CA
| | - M. Mazer
- Cedars-Sinai Medical Center, Los Angeles, CA
| | - H. Wang
- Cedars-Sinai Medical Center, Los Angeles, CA
| | - N. Serrano
- Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - K. L. Black
- Cedars-Sinai Medical Center, Los Angeles, CA
| | - C. Wheeler
- Cedars-Sinai Medical Center, Los Angeles, CA
| | - J. Yu
- Cedars-Sinai Medical Center, Los Angeles, CA
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Wheeler C, Vugia DJ, Thomas G, Beach MJ, Carnes S, Maier T, Gorman J, Xiao L, Arrowood MJ, Gilliss D, Werner SB. Outbreak of cryptosporidiosis at a California waterpark: employee and patron roles and the long road towards prevention. Epidemiol Infect 2007; 135:302-10. [PMID: 17291365 PMCID: PMC2870568 DOI: 10.1017/s0950268806006777] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2006] [Indexed: 11/06/2022] Open
Abstract
In August-September 2004, a cryptosporidiosis outbreak affected >250 persons who visited a California waterpark. Employees and patrons of the waterpark were affected, and three employees and 16 patrons admitted to going into recreational water while ill with diarrhoea. The median illness onset date for waterpark employees was 8 days earlier than that for patrons. A case-control study determined that getting water in one's mouth on the waterpark's waterslides was associated with illness (adjusted odds ratio 7.4, 95% confidence interval 1.7-32.2). Laboratory studies identified Cryptosporidium oocysts in sand and backwash from the waterslides' filter, and environmental investigations uncovered inadequate water-quality record keeping and a design flaw in one of the filtration systems. Occurring more than a decade after the first reported outbreaks of cryptosporidiosis in swimming pools, this outbreak demonstrates that messages about healthy swimming practices have not been adopted by pool operators and the public.
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Affiliation(s)
- C Wheeler
- Epidemic Intelligence Service assigned to the California Department of Health Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Bowler RP, Hokanson J, Taylor M, Levy S, Canaham EM, Regan E, Wheeler C, Nicks M, Chan E, Crapo JD. Extracellular superoxide dismutase (EC-SOD) as a protective factor for risk of chronic obstructive pulmonary disease. Eur Respir Rev 2006. [DOI: 10.1183/09059180.00010117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Holden SN, Eckhardt SG, Basser R, de Boer R, Rischin D, Green M, Rosenthal MA, Wheeler C, Barge A, Hurwitz HI. Clinical evaluation of ZD6474, an orally active inhibitor of VEGF and EGF receptor signaling, in patients with solid, malignant tumors. Ann Oncol 2005; 16:1391-7. [PMID: 15905307 DOI: 10.1093/annonc/mdi247] [Citation(s) in RCA: 259] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND ZD6474 selectively inhibits the tyrosine kinase activity of vascular endothelial growth factor receptor and epidermal growth factor receptor. The safety, tolerability and pharmacokinetics of ZD6474 were assessed in a phase I dose-escalation study of patients with advanced solid tumors. PATIENTS AND METHODS Adult patients with tumors refractory to standard treatments received once-daily oral ZD6474 (50-600 mg) in 28-day cycles, until disease progression or unacceptable toxicity was observed. RESULTS Seventy-seven patients were treated at doses of 50 mg (n=9), 100 mg (n=19), 200 mg (n=8), 300 mg (n=25), 500 mg (n=8), and 600 mg (n=8). Adverse events were generally mild, and the most common dose-limiting toxicities (DLT) were diarrhea (n=4), hypertension (n=4), and rash (n=3). The incidence of most adverse events appeared to be dose-dependant. In the 500 mg/day cohort, 3/8 patients experienced DLT and this dose was therefore considered to exceed the maximum tolerated dose. Pharmacokinetic analysis confirmed that ZD6474 was suitable for once-daily oral dosing. CONCLUSIONS Once-daily oral dosing of ZD6474 at 300 mg/day is generally well tolerated in patients with advanced solid tumors, and this dose is being investigated in phase II trials.
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Affiliation(s)
- S N Holden
- University of Colorado Cancer Center, Aurora, CO, USA.
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Lambert N, Plumb J, Looise B, Johnson IT, Harvey I, Wheeler C, Robinson M, Rolfe P. Using smart card technology to monitor the eating habits of children in a school cafeteria: 1. Developing and validating the methodology. J Hum Nutr Diet 2005; 18:243-54. [PMID: 16011560 DOI: 10.1111/j.1365-277x.2005.00617.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of the study was to test the feasibility of using smart card technology to track the eating behaviours of nearly a thousand children in a school cafeteria. METHODS Within a large boys' school a smart card based system was developed that was capable of providing a full electronic audit of all the individual transactions that occurred within the cafeteria. This dataset was interfaced to an electronic version of the McCance and Widdowson composition of foods dataset. The accuracy of the smart card generated data and the influence of portion size and wastage were determined empirically during two 5-day trials. RESULTS The smart card system created succeeded in generating precise data on the food choices made by hundreds of children over an indefinite time period. The data was expanded to include a full nutrient analysis of all the foods chosen. The accuracy of this information was only constrained by the limitations facing all food composition research, e.g. variations in recipes, portion sizes, cooking practices, etc. Although technically possible to introduce wastage correction factors into the software, thereby providing information upon foods consumed, this was not seen as universally practical. CONCLUSION The study demonstrated the power of smart card technology for monitoring food/nutrient choice over limitless time in environments such as school cafeterias. The strengths, limitations and applications of such technology are discussed.
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Affiliation(s)
- N Lambert
- Institute of Food Research, Norwich Research Park, Colney, Norwich, UK.
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Lambert N, Plumb J, Looise B, Johnson IT, Harvey I, Wheeler C, Robinson M, Rolfe P. Using smart card technology to monitor the eating habits of children in a school cafeteria: 3. The nutritional significance of beverage and dessert choices. J Hum Nutr Diet 2005; 18:271-9. [PMID: 16011563 DOI: 10.1111/j.1365-277x.2005.00619.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The consumption patterns of beverages and desserts features highly in the current debate surrounding children's nutrition. The aim of this study was to continuously monitor the choice of beverages and desserts made by nearly 1000 children in a school cafeteria. METHODS A newly developed smart card system was used to monitor the food choices of diners (7-16-year-old boys) in a school cafeteria over 89 days. A wide variety of beverages and desserts were on offer daily. RESULTS Despite coming from an affluent, well-educated demographic group, the boys' choices of beverages and desserts mirrored those of children in general. Buns and cookies were over 10 times more popular than fresh fruits and yogurts. Sugary soft-drinks were over 20 times more popular than fresh fruit drinks and milk combined. Appropriate choices could, over a month, reduce intake of added sugar by over 800 g and fat by over 200 g. CONCLUSION The smart card system was very effective at monitoring total product choices for nearly 1000 diners. In agreement with a recent national school meal survey, where choice is extensive, children show a preference for products high in fat and/or sugar. The consequences of these preferences are discussed.
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Affiliation(s)
- N Lambert
- Institute of Food Research, Norwich Research Park, Colney, Norwich, UK.
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Lambert N, Plumb J, Looise B, Johnson IT, Harvey I, Wheeler C, Robinson M, Rolfe P. Using smart card technology to monitor the eating habits of children in a school cafeteria: 2. The nutrient contents of all meals chosen by a group of 8- to 11-year-old boys over 78 days. J Hum Nutr Diet 2005; 18:255-65; quiz 267-9. [PMID: 16011561 DOI: 10.1111/j.1365-277x.2005.00618.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of the study was to test the abilities of the newly created smart card system to track the nutrient contents of foods chosen over several months by individual diners in a school cafeteria. METHODS From the food choice and composition of food data sets, an Access database was created encompassing 30 diners (aged 8-11 years), 78 days and eight nutrients. Data were available for a total of 1909 meals. RESULTS Based upon population mean values the cohort were clearly choosing meals containing higher than the recommended maximum amounts for sugar and lower than the recommended minimum amounts of fibre, iron and vitamin A. Protein and vitamin C contents of meals chosen were well above minimum requirements. Over the 1909 meals, nutrient requirements were met 41% of the time. CONCLUSIONS The system created was very effective at continually monitoring food choices of individual diners over limitless time. The data generated raised questions on the common practice of presenting nutrient intakes as population mean values calculated over a few days. The impact of heavily fortified foods on such studies in general is discussed.
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Affiliation(s)
- N Lambert
- Institute of Food Research, Norwich Research Park, Colney, Norwich, UK.
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Fallone CA, Barkun AN, Mayrand S, Wakil G, Friedman G, Szilagyi A, Wheeler C, Ross D. There is no difference in the disease severity of gastro-oesophageal reflux disease between patients infected and not infected with Helicobacter pylori. Aliment Pharmacol Ther 2004; 20:761-8. [PMID: 15379836 DOI: 10.1111/j.1365-2036.2004.02171.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The role of Helicobacter pylori in gastro-oesophageal reflux disease (GERD) is controversial. AIM To compare the severity of GERD in infected vs. non-infected patients, as part of an ongoing randomized controlled trial that examines the impact of H. pylori eradication on GERD-related outcomes. METHODS Consecutive GERD patients underwent urea breath testing and completed validated GERD symptom severity, and quality of life questionnaires as well as, 24-h pH-metry. These parameters, as well as demographics and endoscopic findings were assessed in double-blinded fashion and compared between H. pylori-infected and non-infected subjects. RESULTS Helicobacter pylori-infected GERD patients (n=50) were significantly older and less educated than non-infected patients (n=51). They also used proton pump inhibitors less often but had no difference in symptoms (as measured with both the Spechler's Activity Index and the Gastrointestinal Symptom Rating Scale), quality of life, endoscopic findings or 24-h pH-metry findings. CONCLUSION This prospective, double-blind study demonstrates, using excellent GERD quantifying measures including validated symptom severity scores, endoscopy, and 24-h pH-metry, that there exist no clinically significant differences in clinical or laboratory-related GERD manifestations between H. pylori-infected and non-infected GERD patients.
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Affiliation(s)
- C A Fallone
- Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada.
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Ward E, Hedlund L, Kurylo W, Viglianti B, Wheeler C, Anscher M, Dewhirst M, Marks L, Vujaskovic Z. Hyperpolarized helium MRI assessment of the spatial heterogeneity in lung function with potential relationship to radiation response. Int J Radiat Oncol Biol Phys 2004. [DOI: 10.1016/j.ijrobp.2004.06.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Francis LJ, Robbins M, Lewis CA, Quigley CF, Wheeler C. Religiosity and general health among undergraduate students: a response to. Personality and Individual Differences 2004. [DOI: 10.1016/j.paid.2003.09.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Heymach JV, Dong RP, Dimery I, Wheeler C, Fidias P, Lu C, Johnson B, Herbst R. ZD6474, a novel antiangiogenic agent, in combination with docetaxel in patients with NSCLC: Results of the run-in phase of a two-part, randomized phase II study. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. V. Heymach
- Dana-Farber Cancer Institute, Boston, MA; AstraZeneca, Wilmington, DE; University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - R.-P. Dong
- Dana-Farber Cancer Institute, Boston, MA; AstraZeneca, Wilmington, DE; University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - I. Dimery
- Dana-Farber Cancer Institute, Boston, MA; AstraZeneca, Wilmington, DE; University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - C. Wheeler
- Dana-Farber Cancer Institute, Boston, MA; AstraZeneca, Wilmington, DE; University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - P. Fidias
- Dana-Farber Cancer Institute, Boston, MA; AstraZeneca, Wilmington, DE; University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - C. Lu
- Dana-Farber Cancer Institute, Boston, MA; AstraZeneca, Wilmington, DE; University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - B. Johnson
- Dana-Farber Cancer Institute, Boston, MA; AstraZeneca, Wilmington, DE; University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - R. Herbst
- Dana-Farber Cancer Institute, Boston, MA; AstraZeneca, Wilmington, DE; University of Texas M. D. Anderson Cancer Center, Houston, TX
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Oliver R, Wheeler C, Langmuir P, Melezinek I, Stone A. Evaluation of the role of body-surface-area dose adjustment of ZD6126, a novel vascular-targeting agent. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. Oliver
- AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Boston, MA
| | - C. Wheeler
- AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Boston, MA
| | - P. Langmuir
- AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Boston, MA
| | - I. Melezinek
- AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Boston, MA
| | - A. Stone
- AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Boston, MA
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Medinger M, Mross K, Zirrgiebel U, Strecker R, Wheeler C, Clack G, Lewis J, Puchalski TA, Unger C, Drevs J. Phase I dose-escalation study of the highly potent VEGF receptor kinase inhibitor, AZD2171, in patients with advanced cancers with liver metastases. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. Medinger
- Albert-Ludwigs University Freiburg, Freiburg, Germany; ProQinase GmbH, Freiburg, Germany; AstraZeneca, Boston, MA; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Wilmington, DE
| | - K. Mross
- Albert-Ludwigs University Freiburg, Freiburg, Germany; ProQinase GmbH, Freiburg, Germany; AstraZeneca, Boston, MA; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Wilmington, DE
| | - U. Zirrgiebel
- Albert-Ludwigs University Freiburg, Freiburg, Germany; ProQinase GmbH, Freiburg, Germany; AstraZeneca, Boston, MA; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Wilmington, DE
| | - R. Strecker
- Albert-Ludwigs University Freiburg, Freiburg, Germany; ProQinase GmbH, Freiburg, Germany; AstraZeneca, Boston, MA; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Wilmington, DE
| | - C. Wheeler
- Albert-Ludwigs University Freiburg, Freiburg, Germany; ProQinase GmbH, Freiburg, Germany; AstraZeneca, Boston, MA; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Wilmington, DE
| | - G. Clack
- Albert-Ludwigs University Freiburg, Freiburg, Germany; ProQinase GmbH, Freiburg, Germany; AstraZeneca, Boston, MA; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Wilmington, DE
| | - J. Lewis
- Albert-Ludwigs University Freiburg, Freiburg, Germany; ProQinase GmbH, Freiburg, Germany; AstraZeneca, Boston, MA; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Wilmington, DE
| | - T. A. Puchalski
- Albert-Ludwigs University Freiburg, Freiburg, Germany; ProQinase GmbH, Freiburg, Germany; AstraZeneca, Boston, MA; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Wilmington, DE
| | - C. Unger
- Albert-Ludwigs University Freiburg, Freiburg, Germany; ProQinase GmbH, Freiburg, Germany; AstraZeneca, Boston, MA; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Wilmington, DE
| | - J. Drevs
- Albert-Ludwigs University Freiburg, Freiburg, Germany; ProQinase GmbH, Freiburg, Germany; AstraZeneca, Boston, MA; AstraZeneca, Macclesfield, United Kingdom; AstraZeneca, Wilmington, DE
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45
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Ellwood BB, Benoist SL, El Hassani A, Wheeler C, Crick RE. Response to Comment on "Impact Ejecta Layer from the Mid-Devonian: Possible Connection to Global Mass Extinctions". Science 2004. [DOI: 10.1126/science.1091164] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Brooks B. Ellwood
- Department of Geology and Geophysics, Louisiana State University, E235 Howe-Russell Geoscience Complex, Baton Rouge, LA 70803, USA
| | - Stephen L. Benoist
- Department of Geology and Geophysics, Louisiana State University, E235 Howe-Russell Geoscience Complex, Baton Rouge, LA 70803, USA
| | - Ahmed El Hassani
- Département de Géologie, Institut Scientifique, B.P. 703 – Rabat-Agdal, Morocco
| | | | - Rex E. Crick
- Department of Geology, University of Texas at Arlington, Post Office Box 19049, Arlington, TX 76019, USA
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Abstract
We have found evidence for a bolide impacting Earth in the mid-Devonian ( approximately 380 million years ago), including high concentrations of shocked quartz, Ni, Cr, As, V, and Co anomalies; a large negative carbon isotope shift (-9 per mil); and microspherules and microcrysts at Jebel Mech Irdane in the Anti Atlas desert near Rissani, Morocco. This impact is important because it is coincident with a major global extinction event (Kacák/otomari event), suggesting a possible cause-and-effect relation between the impact and the extinction. The result may represent the extinction of as many as 40% of all living marine animal genera.
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Affiliation(s)
- Brooks B Ellwood
- Department of Geology and Geophysics, Louisiana State University, E235 Howe-Russell Geoscience Complex, Baton Rouge, LA 70803, USA
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47
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Elias AD, Ibrahim J, Richardson P, Avigan D, Joyce R, Reich E, McCauley M, Wheeler C, Frei E. The impact of induction duration and the number of high-dose cycles on the long-term survival of women with metastatic breast cancer treated with high-dose chemotherapy with stem cell rescue: an analysis of sequential phase I/II trials from the Dana-Farber/Beth Israel STAMP program. Biol Blood Marrow Transplant 2002; 8:198-205. [PMID: 12017145 DOI: 10.1053/bbmt.2002.v8.pm12017145] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Although high-dose chemotherapy (HDC) with stem cell rescue for the treatment of women with metastatic breast cancer (MBC) is currently a controversial strategy, we report the long-term outcomes of women undergoing high-dose therapy for MBC over the past 12 years while participating in a sequence of research studies transitioning between a single to a double intensification approach. Univariate and multivariate analyses provide a framework to understand the prognostic factors important for event-free and overall survival. Between May 1988 and April 1998, we enrolled 188 women with MBC into 3 trials of previously reported sequential transplantation strategies. Trial I (long induction/single transplantation) accepted 62 women in partial or complete response to an unspecified induction therapy and treated them with high-dose CTCb (cyclophosphamide, thiotepa, and carboplatin) supported by marrow or peripheral blood progenitor cells (PBPC). Trial II (long induction/double transplantation) accepted 68 women in partial or complete response to an unspecified induction therapy, and mobilized stem cells with 2 cycles of AF (doxorubicin and 5-fluorouracil) with granulocyte colony-stimulating factor (G-CSF). These women then received 1 cycle of high-dose single-agent melphalan followed 3 to 5 weeks later by CTCb, each with marrow or PBPC support. Trial III (short induction/double transplantation) enrolled 58 women prior to chemotherapy treatment for metastatic disease. Induction/mobilization consisted of 2 cycles given 14 days apart of doxorubicin and G-CSF. In contrast to trials I and II, patients with stable disease or better response to induction were eligible to proceed ahead with 2 cycles of HDC, 1 being CTCb and the other being dose escalated paclitaxel together with high-dose melphalan (TxM). These 2 HDC regimens were administered 5 weeks apart. TxM was given first in 32 patients and CTCb was given first in 26 patients. The median follow-up periods for trials I, II, and III were 98, 62, and 39 months from the initiation of induction chemotherapy and 92, 55, and 36 months from last high-dose therapy, respectively. The patient characteristics upon entry into these trials were similar. Important differences were that only those patients achieving a partial response or better to induction therapy were enrolled and analyzed for trials I and II, but all patients were analyzed on an intent-to-treat basis for trial III, including those who did not receive intensification. The median event-free survival (EFS) times from induction chemotherapy were 13, 19, and 27 months for trials I, II, and III, respectively (III versus I + II, P = .0004; III versus I, P = .0005; III versus II, P = .005; II versus I, P = .25). The median overall survival (OS) times from induction chemotherapy were 30, 29, and 57 months for trials I, II, and III, respectively (III versus I + II, P = .002; III versus I, P = .003; III versus II, P = .009; II versus I, P = .47). By multivariate Cox regression, participation in the short induction/double transplantation trial III and having no prior adjuvant chemotherapy remained favorable prognostic factors for both EFS and OS. The presence of visceral disease shortened EFS, and hormone sensitivity was of borderline significance. No substantive differences in the characteristics of the patient populations between the 3 trials appeared to interact with outcomes. In conclusion, we found that single transplantation in responding patients after long induction achieves a small cohort of long-term survivors, similar to the results reported by other transplantation centers. Adding a cycle of single-agent high-dose melphalan in this context delayed median time to relapse but did not affect long-term EFS or OS. The double transplantation approach using CTCb and TxM early in the course of treatment was associated with the best EFS and overall survival and was safe, feasible, and tolerable. Treatment duration was only 14 weeks, and this treatment option eliminated lengthy induction chemotherapy. Although selection biases may have in part contributed to this effect, a randomized comparison of standard therapy versus short induction/double transplantation is warranted.
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Affiliation(s)
- A D Elias
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
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48
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D'Souza S, Rosseels V, Denis O, Tanghe A, De Smet N, Jurion F, Palfliet K, Castiglioni N, Vanonckelen A, Wheeler C, Huygen K. Improved tuberculosis DNA vaccines by formulation in cationic lipids. Infect Immun 2002; 70:3681-8. [PMID: 12065510 PMCID: PMC128113 DOI: 10.1128/iai.70.7.3681-3688.2002] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Mice were vaccinated with plasmid DNA (pDNA) encoding antigen 85A (Ag85A), Ag85B, or PstS-3 from Mycobacterium tuberculosis either in saline or formulated for intramuscular injections in VC1052:DPyPE (aminopropyl-dimethyl-myristoleyloxy-propanaminium bromide-diphytanoylphosphatidyl-ethanolamine) (Vaxfectin; Vical, Inc., San Diego, Calif.) or for intranasal instillations in GAP-DLRIE:DOPE (aminopropyl-dimethyl-bis-dodecyloxy-propanaminium bromide-dioleoylphosphatidyl-ethanolamine). These two novel cationic and neutral colipid formulations were previously reported to be effective adjuvants for pDNA-induced antibody responses. The levels of Ag85-specific total immunoglobulin G (IgG) and IgG isotypes were all increased 3- to 10-fold by formulation of pDNA in Vaxfectin. The level of production of splenic T-cell-derived Th1-type cytokines (interleukin-2 and gamma interferon) in response to purified Ag85 and to synthetic peptides spanning the entire Ag85A protein was also significantly higher in animals vaccinated with pDNA formulated in Vaxfectin. Cytolytic T-lymphocyte responses generated by pDNA encoding phosphate-binding protein PstS-3 in Vaxfectin were better sustained over time than were those generated by PstS-3 DNA in saline. Intranasal immunization with Ag85A DNA in saline was completely ineffective, whereas administration in GAP-DLRIE:DOPE induced a positive Th1-type cytokine response; however, the extent of the latter response was clearly lower than that obtained following intramuscular immunization with the same DNA dose. Combined intramuscular and intranasal administrations in cationic lipids resulted in stronger immune responses in the spleen and, more importantly, in the lungs as well. Finally, formulation in Vaxfectin increased the protective efficacy of the Ag85B DNA vaccine, as measured by reduced relative light unit counts and CFU counts in the spleen and lungs from mice challenged with bioluminescent M. tuberculosis H37Rv. These results may be of importance for future clinical use of DNA vaccines in humans.
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MESH Headings
- ATP-Binding Cassette Transporters/genetics
- ATP-Binding Cassette Transporters/immunology
- Acyltransferases
- Adjuvants, Immunologic
- Administration, Intranasal
- Animals
- Antibodies, Bacterial/biosynthesis
- Antigens, Bacterial/genetics
- Antigens, Bacterial/immunology
- BCG Vaccine/immunology
- Bacterial Proteins/genetics
- Bacterial Proteins/immunology
- Cations
- Injections, Intramuscular
- Interferon-gamma/biosynthesis
- Interleukin-2/biosynthesis
- Lipids
- Lung/immunology
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Phosphatidylethanolamines/immunology
- Spleen/immunology
- T-Lymphocytes, Cytotoxic/immunology
- Th1 Cells/immunology
- Tuberculosis/prevention & control
- Vaccination
- Vaccines, DNA/immunology
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Affiliation(s)
- S D'Souza
- Mycobacterial Immunology, Pasteur Institute of Brussels, B1180 Brussels, Belgium
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49
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Barnfield C, Brew R, Tilling R, Rae A, Wheeler C, Klavinskis LS. The cellular basis of immune induction at mucosal surfaces by DNA vaccination. Dev Biol (Basel) 2002; 104:159-64. [PMID: 11713815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
The nasal mucosa provides a simple, non-invasive route to deliver DNA encoding the gene of interest to stimulate mucosal and systemic immune responses. However, unlike the intradermal or intramuscular routes for plasmid DNA (pDNA) delivery, immune responsiveness to antigen exposure at the respiratory mucosa is tightly regulated, consistent with the balance between active immunity and non-responsiveness to pathogenic or inert environmental antigens. We have characterised the antigen presenting cell types, their distribution and activation status following nasal vaccination with pDNA-cytofectin complexes encoding model antigens. We demonstrate that nasal immunisation is associated with expression of the encoded protein in a small population of dendritic cells and macrophages at the site of pDNA delivery, in the draining lymph nodes (LN) and in the spleen. Antigen expression by nasal dendritic cells was associated with up-regulation of surface MHC class II and CD86 expression and functional activation of T-lymphocytes. The results highlight the potential of intranasal vaccination with pDNA, provided the activation / costimulatory requirements for an active immune response are achieved.
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Affiliation(s)
- C Barnfield
- Peter Gorer Department of Immunobiology, Guy's Hospital, GKT, London, UK
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50
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Elias AD, Richardson P, Avigan D, Ibrahim J, Joyce R, McDermott D, Levine J, Warren D, McCauley M, Wheeler C, Frei E. A short course of induction chemotherapy followed by two cycles of high-dose chemotherapy with stem cell rescue for chemotherapy naive metastatic breast cancer: sequential phase I/II studies. Bone Marrow Transplant 2001; 28:447-54. [PMID: 11593317 DOI: 10.1038/sj.bmt.1703148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2000] [Accepted: 05/15/2001] [Indexed: 11/09/2022]
Abstract
Two cycles of high-dose chemotherapy with stem cell support (HDC) may increase the total dose delivered and dose intensity. A brief induction phase and different non-cross-resistant agents for each HDC cycle were used to avoid drug resistance. Twenty-six women with metastatic BC had induction and stem cell mobilization with two cycles of doxorubicin/G-CSF given every 14 days. Patients with stable disease or better after induction received HD CTCb followed by HD melphalan and dose-escalated paclitaxel. At 475 mg/m(2) of paclitaxel by 24-h infusion, dose-limiting transient peripheral sensory neuropathy was encountered. No toxic deaths occurred. Complete and near complete response after completion of therapy was achieved in 22 (85%) of 26 patients. The median EFS was 38 months. The median OS has not yet been reached. At a median follow-up of 33 (25-43) months, actuarial EFS and OS were 54% (95% confidence interval (CI), 39-69%) and 69% (95% CI, 56-79%), respectively. This double transplant approach lasts only 14 weeks and is feasible, safe, and tolerable. Whilst selection biases may in part contribute to favorable EFS and OS, a randomized comparison of standard therapy vs double transplant in both metastatic and locally advanced breast cancer is warranted.
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Affiliation(s)
- A D Elias
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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