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Chen JH, Nieman LT, Spurrell M, Jorgji V, Elmelech L, Richieri P, Xu KH, Madhu R, Parikh M, Zamora I, Mehta A, Nabel CS, Freeman SS, Pirl JD, Lu C, Meador CB, Barth JL, Sakhi M, Tang AL, Sarkizova S, Price C, Fernandez NF, Emanuel G, He J, Van Raay K, Reeves JW, Yizhak K, Hofree M, Shih A, Sade-Feldman M, Boland GM, Pelka K, Aryee MJ, Mino-Kenudson M, Gainor JF, Korsunsky I, Hacohen N. Human lung cancer harbors spatially organized stem-immunity hubs associated with response to immunotherapy. Nat Immunol 2024; 25:644-658. [PMID: 38503922 DOI: 10.1038/s41590-024-01792-2] [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] [Received: 04/02/2023] [Accepted: 02/15/2024] [Indexed: 03/21/2024]
Abstract
The organization of immune cells in human tumors is not well understood. Immunogenic tumors harbor spatially localized multicellular 'immunity hubs' defined by expression of the T cell-attracting chemokines CXCL10/CXCL11 and abundant T cells. Here, we examined immunity hubs in human pre-immunotherapy lung cancer specimens and found an association with beneficial response to PD-1 blockade. Critically, we discovered the stem-immunity hub, a subtype of immunity hub strongly associated with favorable PD-1-blockade outcome. This hub is distinct from mature tertiary lymphoid structures and is enriched for stem-like TCF7+PD-1+CD8+ T cells, activated CCR7+LAMP3+ dendritic cells and CCL19+ fibroblasts as well as chemokines that organize these cells. Within the stem-immunity hub, we find preferential interactions between CXCL10+ macrophages and TCF7-CD8+ T cells as well as between mature regulatory dendritic cells and TCF7+CD4+ and regulatory T cells. These results provide a picture of the spatial organization of the human intratumoral immune response and its relevance to patient immunotherapy outcomes.
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Affiliation(s)
- Jonathan H Chen
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA.
- Department of Pathology, MGH, Boston, MA, USA.
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Linda T Nieman
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Maxwell Spurrell
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
- Department of Pathology, MGH, Boston, MA, USA
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
| | - Vjola Jorgji
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
- Department of Pathology, MGH, Boston, MA, USA
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
| | - Liad Elmelech
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
- Department of Pathology, MGH, Boston, MA, USA
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
| | - Peter Richieri
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
| | - Katherine H Xu
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
| | - Roopa Madhu
- Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hospital, Division of Genetics, Boston, MA, USA
| | - Milan Parikh
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
| | - Izabella Zamora
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
| | - Arnav Mehta
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Christopher S Nabel
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Koch Institute for Integrative Cancer Research, Department of Biology, MIT, Cambridge, MA, USA
| | - Samuel S Freeman
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Joshua D Pirl
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Chenyue Lu
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
| | - Catherine B Meador
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Division of Hematology/Oncology, MGH, HMS, Boston, MA, USA
| | | | | | - Alexander L Tang
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
| | - Siranush Sarkizova
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
| | | | | | | | | | | | | | - Keren Yizhak
- Department of Cell Biology and Cancer Science, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Matan Hofree
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
- School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel
- Lautenberg Center for Immunology and Cancer Research, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Angela Shih
- Department of Pathology, MGH, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Moshe Sade-Feldman
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Genevieve M Boland
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Surgery, MGH, Boston, MA, USA
| | - Karin Pelka
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
- Gladstone-UCSF Institute of Genomic Immunology, Gladstone Institutes, San Francisco, CA, USA
| | - Martin J Aryee
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Mari Mino-Kenudson
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA
- Department of Pathology, MGH, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Justin F Gainor
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Center for Thoracic Cancers, MGH, Boston, MA, USA.
| | - Ilya Korsunsky
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Brigham and Women's Hospital, Division of Genetics, Boston, MA, USA.
| | - Nir Hacohen
- Massachusetts General Hospital (MGH) Cancer Center, Harvard Medical School (HMS), Boston, MA, USA.
- Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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Magen A, Hamon P, Fiaschi N, Soong BY, Park MD, Mattiuz R, Humblin E, Troncoso L, D'souza D, Dawson T, Kim J, Hamel S, Buckup M, Chang C, Tabachnikova A, Schwartz H, Malissen N, Lavin Y, Soares-Schanoski A, Giotti B, Hegde S, Ioannou G, Gonzalez-Kozlova E, Hennequin C, Le Berichel J, Zhao Z, Ward SC, Fiel I, Kou B, Dobosz M, Li L, Adler C, Ni M, Wei Y, Wang W, Atwal GS, Kundu K, Cygan KJ, Tsankov AM, Rahman A, Price C, Fernandez N, He J, Gupta NT, Kim-Schulze S, Gnjatic S, Kenigsberg E, Deering RP, Schwartz M, Marron TU, Thurston G, Kamphorst AO, Merad M. Intratumoral dendritic cell-CD4 + T helper cell niches enable CD8 + T cell differentiation following PD-1 blockade in hepatocellular carcinoma. Nat Med 2023; 29:1389-1399. [PMID: 37322116 PMCID: PMC11027932 DOI: 10.1038/s41591-023-02345-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [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: 06/09/2022] [Accepted: 04/10/2023] [Indexed: 06/17/2023]
Abstract
Despite no apparent defects in T cell priming and recruitment to tumors, a large subset of T cell rich tumors fail to respond to immune checkpoint blockade (ICB). We leveraged a neoadjuvant anti-PD-1 trial in patients with hepatocellular carcinoma (HCC), as well as additional samples collected from patients treated off-label, to explore correlates of response to ICB within T cell-rich tumors. We show that ICB response correlated with the clonal expansion of intratumoral CXCL13+CH25H+IL-21+PD-1+CD4+ T helper cells ("CXCL13+ TH") and Granzyme K+ PD-1+ effector-like CD8+ T cells, whereas terminally exhausted CD39hiTOXhiPD-1hiCD8+ T cells dominated in nonresponders. CD4+ and CD8+ T cell clones that expanded post-treatment were found in pretreatment biopsies. Notably, PD-1+TCF-1+ (Progenitor-exhausted) CD8+ T cells shared clones mainly with effector-like cells in responders or terminally exhausted cells in nonresponders, suggesting that local CD8+ T cell differentiation occurs upon ICB. We found that these Progenitor CD8+ T cells interact with CXCL13+ TH within cellular triads around dendritic cells enriched in maturation and regulatory molecules, or "mregDC". These results suggest that discrete intratumoral niches that include mregDC and CXCL13+ TH control the differentiation of tumor-specific Progenitor exhasuted CD8+ T cells following ICB.
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Affiliation(s)
- Assaf Magen
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pauline Hamon
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nathalie Fiaschi
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Brian Y Soong
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew D Park
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Raphaël Mattiuz
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Etienne Humblin
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Leanna Troncoso
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Darwin D'souza
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Travis Dawson
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joel Kim
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven Hamel
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mark Buckup
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christie Chang
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexandra Tabachnikova
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hara Schwartz
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nausicaa Malissen
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yonit Lavin
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alessandra Soares-Schanoski
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bruno Giotti
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Samarth Hegde
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Giorgio Ioannou
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Edgar Gonzalez-Kozlova
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Clotilde Hennequin
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jessica Le Berichel
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zhen Zhao
- The Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephen C Ward
- The Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Isabel Fiel
- The Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Baijun Kou
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Michael Dobosz
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Lianjie Li
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Christina Adler
- Molecular Profiling & Data Science, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Min Ni
- Molecular Profiling & Data Science, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Yi Wei
- Molecular Profiling & Data Science, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Wei Wang
- Molecular Profiling & Data Science, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Gurinder S Atwal
- Molecular Profiling & Data Science, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Kunal Kundu
- VI NEXT, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Kamil J Cygan
- VI NEXT, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Alexander M Tsankov
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adeeb Rahman
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | - Namita T Gupta
- Molecular Profiling & Data Science, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Seunghee Kim-Schulze
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sacha Gnjatic
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ephraim Kenigsberg
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Raquel P Deering
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA
| | - Myron Schwartz
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Thomas U Marron
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Gavin Thurston
- Department of Oncology & Angiogenesis, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA.
| | - Alice O Kamphorst
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Miriam Merad
- The Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Institute for Thoracic Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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3
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Chen JH, Nieman LT, Spurrell M, Jorgji V, Richieri P, Xu KH, Madhu R, Parikh M, Zamora I, Mehta A, Nabel CS, Freeman SS, Pirl JD, Lu C, Meador CB, Barth JL, Sakhi M, Tang AL, Sarkizova S, Price C, Fernandez NF, Emanuel G, He J, Raay KV, Reeves JW, Yizhak K, Hofree M, Shih A, Sade-Feldman M, Boland GM, Pelka K, Aryee M, Korsunsky I, Mino-Kenudson M, Gainor JF, Hacohen N. Spatial analysis of human lung cancer reveals organized immune hubs enriched for stem-like CD8 T cells and associated with immunotherapy response. bioRxiv 2023:2023.04.04.535379. [PMID: 37066412 PMCID: PMC10104028 DOI: 10.1101/2023.04.04.535379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
The organization of immune cells in human tumors is not well understood. Immunogenic tumors harbor spatially-localized multicellular 'immunity hubs' defined by expression of the T cell-attracting chemokines CXCL10/CXCL11 and abundant T cells. Here, we examined immunity hubs in human pre-immunotherapy lung cancer specimens, and found that they were associated with beneficial responses to PD-1-blockade. Immunity hubs were enriched for many interferon-stimulated genes, T cells in multiple differentiation states, and CXCL9/10/11 + macrophages that preferentially interact with CD8 T cells. Critically, we discovered the stem-immunity hub, a subtype of immunity hub strongly associated with favorable PD-1-blockade outcomes, distinct from mature tertiary lymphoid structures, and enriched for stem-like TCF7+PD-1+ CD8 T cells and activated CCR7 + LAMP3 + dendritic cells, as well as chemokines that organize these cells. These results elucidate the spatial organization of the human intratumoral immune response and its relevance to patient immunotherapy outcomes.
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4
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando 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Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, 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K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, 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Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Price C, Chen JH, Pelka K, Chao S, Therrien M, Wiggin T, Fernandez N, He J, Emanuel G, Boland G, Hacohen N. Abstract 2030: A single-cell spatially resolved map of colorectal cancer identifies novel spatial relationships between cancer cells and the microenvironment. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2030] [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
Understanding the tumor microenvironment (TME) requires more than just a catalog of cell types and gene programs. It is critical to see the spatial organization of the cells are and where they form multicellular interaction networks. Here we present a single-cell spatially resolved transcriptomic analysis of human mismatch repair deficient (MMRd) and proficient (MMRp) colorectal cancer (CRC) specimens. High tumor mutational burden MMRd tumors are known to have an immune response characterized by higher cytolytic T cell infiltrates compared to MMRp tumors, making them an ideal system for spatial single-cell profiling and understanding how the immune-driven programs differ between these tumors. MERFISH is a massively multiplexed single molecule imaging technology which can simultaneously capture and measure the quantity and distribution of hundreds to thousands of RNA species within single cells across a tissue1. We designed a MERFISH library of over 450 genes including genes important to proliferation, apoptosis, immune signaling, immune cell type pathways and other critical pathways in CRC. Patient samples, obtained commercially or through MGH, were hybridized with the designed MERFISH library and stained with a cell boundary marker to delineate cells across the tissue. We performed unsupervised clustering to identify cell types and we calculated spatial statistics to characterize how the cell type distribution varied between MMRd and MMRp tumors. We identified the cellular composition of each tumor, including immune and stromal cells, and the spatial distribution of these cell types. We were able to readily identify all cell types and states previously discovered by single-cell RNA sequencing2 in intact patient specimens, thus providing an accurate map of the cellular composition and spatial organization of these cells in the tumor microenvironment. We transformed these cell types into neighborhoods and discovered a highly organized spatial distribution of most cell types throughout the tumor. While spatial organization was observed in both MMRp and MMRd CRC we saw a significant shift in spatial organization between these tumor classifications notably in the immune population. Further, previously predicted multicellular interaction networks2 appeared as spatially organized structures in the tissue and were distinct in MMRd versus MMRp tumor specimens. Our data provide a richness of concrete hypotheses about which cells are working together, how these cells function cooperatively, and where these cells are located which will be critical in advancing therapy in these immunologically distinct types of colorectal cancer. These cancer maps are critical to truly understand the biology of CRC as well as identify avenues for the development of future therapies for CRC patients.
Citation Format: Colles Price, Jonathan H. Chen, Karin Pelka, Sherry Chao, Michael Therrien, Timothy Wiggin, Nicolas Fernandez, Jiang He, George Emanuel, Genevieve Boland, Nir Hacohen. A single-cell spatially resolved map of colorectal cancer identifies novel spatial relationships between cancer cells and the microenvironment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2030.
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Affiliation(s)
| | | | - Karin Pelka
- 3University of California San Francisco, San Francisco, CA
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Jobanputra D, Cherry L, Walker-Bone K, Price C, D’angelo S, Ntani G. OP0007-HPR AN EPIDEMIOLOGICAL STUDY OF FOOT AND ANKLE PAIN AND HEALTH-RELATED JOB LOSS IN ADULTS OVER 50: CROSS-SECTIONAL FINDINGS FROM THE HEAF COHORT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundFoot and ankle pain (FAP), particularly that of musculoskeletal origin, is increasingly prevalent in our aging populations1. Moreover, governments need people to work to older ages to reduce the costs of pensions and welfare benefits. It is not currently known however whether people with FAP are able to keep working or to what extent it pushes people out of work. We investigated this question in older working adults.ObjectivesTo determine whether FAP is associated with HRJL amongst older working adults.MethodsHealth And Employment After Fifty2 is a longitudinal population-based cohort incepted 2013 to investigate health and retirement. At follow-up two years later, people were asked to complete a full-body mannequin which included the ankles/feet. Mannequins were coded: foot/ankle pain (FAP) with pain at other sites; pain elsewhere but not FAP; and no pain. Two years later, participants were asked whether they had left paid work entirely or partly because of health (Health-related job loss (HRJL). A Cox proportional hazards model was used to explore associations between health-related job loss, FAP, and other potential risk factors (such as age, mental health, BMI, and finances). A sensitivity analysis was carried out to determine which occupational activities were significantly associated with health-related job loss due to FAP.ResultsAt 2 years, 4050 participants completed a pain mannequin, amongst whom 3762 were in paid work. Over 2 further years of follow-up, there were 235 incident HRJLs. Amongst those with HRJL, 73 had no pain, 54 had pain involving FAP, 108 had pain not involving FAP. After adjusting for age and sex, people with FAP had 83% increased risk of HRJL compared to people with no pain (HR=1.83, 95% CI 1.29-2.61), whilst those with pain NOT involving FAP had 34% increased risk (HR1.34, 95% CI 1.00 – 1.80). FAP remained a significant predictor of HRJL within a fully adjusted model (HR=1.65, 95% CI 1.15-2.36). Sensitivity analyses confirmed that doing jobs which involved climbing more than 30 flights of stairs was associated with increased risk of HRJL amongst people with FAP (HR=1.96, 95% CI 1.00-3.80).ConclusionFAP is a risk factor for HRJL amongst older working adults, particularly if their job involves stair climbing. Potentially, modification of duties to reduce stair climbing could mitigate job loss amongst people with FAP.References[1]Executive HaS. Work-related ill health and occupational disease. https://www.hse.gov.uk/statistics/causdis/; 2020.[2]Keith T. Palmer KW-B, E. Clare Harris, Cathy Linaker, Stefania D’ANgelo, Avan Aihi Sayer, Catharine R. Gale, Maria Evandrou, Tjeerd van Staa, Cyrus Cooper, David Coggon. Health and Employment after Fifty (HEAF): a new prospective cohort study. BMC Public Health 2015.Disclosure of InterestsNone declared.
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Jarrar R, Chadwick T, Lally J, Thomson R, Wilkinson C, Price C. Temporal changes in anticoagulant prescribing and atrial fibrillation: results of interrupted time-series analysis of openly available routine data in England. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac019.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
The use of anticoagulants for stroke prevention in patients with atrial fibrillation (AF) has been increasing in England in the recent years (1, 2). The changes in practice coincided with several developments in the area of anticoagulants and AF, including: the emergence of evidence supporting anticoagulant use for stroke prevention in AF, changes in guideline recommendations, and the licensing of direct oral anticoagulants (DOACs) as an alternative to warfarin, which was the mainstay of stroke prevention in AF. Currently, there are four DOACs available for use: dabigatran, rivaroxaban, apixaban, and edoxaban. Recent analyses of time trends of anticoagulant prescribing in England showed an increase in DOACs prescribing and a decrease in warfarin prescribing (1, 2). However, more recent exploration of recent anticoagulant prescribing trends is needed.
Aim
To explore the changes in anticoagulant prescribing for AF in England.
Methods
Interrupted time-series analysis (ITSA) of openly available data on anticoagulant prescribing and AF. Separate analyses were conducted for data from Sentinel Stroke National Audit Programme (SSNAP) and Quality and Outcomes Framework (QOF). The timeframe of the analysis and the length of time intervals depended on the characteristics of each dataset.
Results
Analysis of data from SSNAP showed that the proportion of stroke patients who have a diagnosis of AF who were taking an anticoagulant alone prior to admission increased from 32.51% in the third quarter of 2013 to 62.63% in the third quarter of 2020; this coincided with a decreased proportion of stroke patients who have a diagnosis of AF taking antiplatelets alone from 37.10% to 8.31% during the same period. Analysed QOF data on anticoagulants and AF included information about AF prevalence in QOF datasets, the eligibility of patients with AF for anticoagulant based on stroke risk assessment, and the use of anticoagulants among eligible patients. Prevalence of AF in England in QOF datasets increased from 1.52% in 2012/2013 to 2.05% in 2019/2020 (ITSA gradient=0.08, p-value<.001, 95% confidence interval: 0.07- 0.09). The proportion of patients with AF who are considered eligible for anticoagulation per all patients with AF in QOF datasets increased from 44.95% in 2012/2013 to 80.87% in 2019/2020; there was an increase by 25.24% between 2014/2015 and 2015/2016 which corresponds to modifying risk assessment scores to include additional criteria. The proportion of eligible patients with AF being prescribed anticoagulants also increased in the period between 2012/2013 and 2019/2020 (ITSA gradient = 1.98, p-value<.001, 95% confidence interval: 1.52- 2.44).
Conclusion
The analysis of data from different sources identified an increase in anticoagulant prescribing for patients with AF in England, which is likely to translate into health gains. However, the use of aggregate data in the analysis did not allow for detailed inspection of patient characteristics, and individual anticoagulants were not specified in the datasets. Therefore, quantitative analyses of primary care data of individual anticoagulant prescribing for different patient groups with AF are needed to further understand whether additional improvements are possible in the prevention of complications from atrial fibrillation.
References
(1) Adderley NJ, Ryan R, Nirantharakumar K, Marshall T. Prevalence and treatment of atrial fibrillation in UK general practice from 2000 to 2016. Heart. 2019;105(1):27-33.
(2) Loo SY, Dell’Aniello S, Huiart L, Renoux C. Trends in the prescription of novel oral anticoagulants in UK primary care. British Journal of Clinical Pharmacology. 2017;83(9):2096-106.
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Affiliation(s)
- R Jarrar
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - T Chadwick
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - J Lally
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - R Thomson
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - C Wilkinson
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - C Price
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
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Voinier S, Moore A, Benson J, Price C, Burris D. The modes and competing rates of cartilage fluid loss and recovery. Acta Biomater 2022; 138:390-397. [PMID: 34800716 DOI: 10.1016/j.actbio.2021.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 11/27/2022]
Abstract
Cartilage loses, recovers, and maintains its thickness, hydration, and biomechanical functions based on competing rates of fluid loss and recovery under varying joint-use conditions. While the mechanics and implications of load-induced fluid loss have been studied extensively, those of fluid recovery have not. This study isolates, quantifies, and compares rates of cartilage recovery from three known modes: (1) passive swelling - fluid recovery within a static unloaded contact area; (2) free swelling - unrestricted fluid recovery by an exposed surface; (3) tribological rehydration - fluid recovery within a loaded contact area during sliding. Following static loading of adult bovine articular cartilage to between 100 and 500 μm of compression, passive swelling, free swelling, and tribological rehydration exhibited average rates of 0.11 ± 0.04, 0.71 ± 0.15, and 0.63 ± 0.22 μm/s, respectively, over the first 100 s of recovery; for comparison, the mean exudation rate just prior to sliding was 0.06 ± 0.04 μm/s. For this range of compressions, we detected no significant difference between free swelling and tribological rehydration rates. However, free swelling and tribological rehydration rates, those associated with joint articulation, were ∼7-fold faster than passive swelling rates. While previous studies show how joint articulation prevents fluid loss indefinitely, this study shows that joint articulation reverses fluid loss following static loading at >10-fold the preceding exudation rate. These competitive recovery rates suggest that joint space and function may be best maintained throughout an otherwise sedentary day using brief but regular physical activity. STATEMENT OF SIGNIFICANCE: Cartilage loses, recovers, and maintains its thickness, hydration, and biomechanical functions based on competing rates of fluid loss and recovery under varying joint-use conditions. While load-induced fluid loss is extremely well studied, this is the first to define the competing modes of fluid recovery and to quantify their rates. The results show that the fluid recovery modes associated with joint articulation are 10-fold faster than exudation during static loading and passive swelling during static unloading. The results suggest that joint space and function are best maintained throughout an otherwise sedentary day using brief but regular physical activities.
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Price C, Chen J, Pelka K, Chao S, He J, Boland G, Emanuel G, Hacohen N. 920 A single-cell spatially resolved MERFISH map of the colorectal tumor immune microenvironment. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BackgroundUnderstanding the tumor microenvironment (TIME) requires more than just a catalog of cell types and gene programs. It is critical to see the spatial organization of the cells are and where they form multicellular interaction networks. Here we present a single-cell spatially resolved transcriptomic analysis of human mismatch repair deficient (MMRd) and proficient (MMRp) colorectal cancer (CRC) specimens. High tumor mutational burden MMRd tumors are known to have an immune response characterized by higher cytolytic T cell infiltrates compared to MMRp tumors, making them an ideal system for spatial single-cell profiling and understanding how the immune-driven programs differ between these tumors.MethodsMERFISH is a massively multiplexed single molecule imaging technology which can simultaneously capture and measure the quantity and distribution of hundreds to thousands of RNA species within single cells across a tissue.1 We designed a MERFISH library of over 450 genes including genes important to proliferation, apoptosis, immune signaling, immune cell type pathways and other critical pathways in CRC. Patient samples were obtained commercially or through Massachusetts General Hospital. Samples were hybridized with the designed MERFISH library and stained with a cell boundary marker to delineate cells across the tissue. We performed unsupervised clustering to identify cell types and we explored calculated spatial statistics to characterize how the cell type distribution varied between MMRd and MMRp tumors. We identified the cellular composition of each tumor, including immune and stromal cells, and the spatial distribution of these cell types.ResultsUsing MERFISH, we were able to readily identify all cell types and states previously discovered by single-cell RNA sequencing2 in intact patient specimens, thus providing an accurate map of the cellular composition and spatial organization of these cells in the tumor microenvironment. Of note, previously predicted multicellular interaction networks2 appeared as spatially organized structures in the tissue and were distinct in MMRd versus MMRp tumor specimens. Our data provide a richness of concrete hypotheses about which cells are working together and how these cells function cooperatively, which will be critical in advancing immunotherapy in these immunologically distinct types of colorectal cancer.ConclusionsHere we present a single-cell resolved spatial map of the cell types and states in the tumor microenvironment of MMRd and MMRp cancer. This will aid the development of future immunotherapies for CRC patients.ReferencesChen KH, Boettiger AN, Moffitt JR, Wang S, Zhuang X. RNA imaging. Spatially resolved, highly multiplexed RNA profiling in single cells. Science 2015;348:AAA 6090.Pelka K, Hofree M, Chen J, Sarkizova S, Pirl JD, Jorgji V, et al. Multicellular immune hubs and their organization in MMRd and MMRp colorectal cancer. BioRxiv 2021;426796.Ethics ApprovalAll samples not commercially purchased were collected in accordance with IRB protocol DF/HCC IRB 02-240.
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Jarrar R, Wilkinson C, Chadwick T, Lally J, Thomson R, Price C. Factors influencing oral anticoagulant prescribing decisions for patients with atrial fibrillation: a systematic review of qualitative and quantitative evidence. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab015.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Despite their efficacy in reducing stroke risk in patients with atrial fibrillation (AF), oral anticoagulants (OACs) remain under-prescribed [1]. Until recently, warfarin has been the dominant OAC. The introduction of direct oral anticoagulants (DOACs) led to changes in anticoagulant prescribing patterns, with an increase in OAC prescribing and a shift towards DOACs [2]. Treatment decisions for OACs are complicated, and require a discussion between clinicians and patients when deciding on a treatment [1].
Aim
To investigate the main factors that influence initial and ongoing OAC prescribing decisions for patients with AF according to patient and health professional views.
Methods
A systematic review was conducted according to the Toolkit for Mixed-Methods Reviews, and was registered on PROSPERO: CRD42019145406. Medline, CINAHL, Scopus, EMBASE, Web of Knowledge and PsychInfo were searched in August, 2019. Primary qualitative and quantitative studies, published between 2009 and 2019, exploring patient and health professional perceptions, views and experiences of OACs in AF were included. McMaster critical appraisal tool for quantitative studies and Critical Appraisal Skills Programme (CASP) checklist for qualitative studies were used for quality assessment. The review followed a convergent integrated approach to data extraction and analysis, which involves extracting and analysing results of quantitative and qualitative studies at the same time using the same method. A data extraction form was adapted from Joanna-Briggs Institute (JBI) mixed-methods extraction form. Study author interpretation of quantitative data was summarised as qualitative statements which were coded together with primary qualitative data using NVIVO 12 software; codes were applied to each sentence in the findings, and were grouped into a hierarchical tree structure
Results
The systematic review included 62 papers (58 studies) discussing clinical and non-clinical factors influencing decisions to initiate OACs, the choice between warfarin and DOACs, and the choice between individual OACs. The balance of stroke and bleeding risks was the most influential when making the decision to initiate anticoagulation according to both patients and health professionals. Convenience-related factors, such as monitoring requirements, dosing regimens, and interactions impacted the choice between warfarin and DOACs, whereas, reversibility and dosing regimen influenced the choice between individual medications according to the views of both groups. Health professional specialty and years of experience affected all aspects of treatments, with specialists and senior clinicians more willing to initiate anticoagulation and choose DOACs. Even though health professionals often expressed that patient views were considered when deciding on a treatment, patients generally said that they followed their physician’s recommendations without questioning.
Conclusion
The review revealed similarities and differences across patient and professional views, experiences, and preferences of anticoagulation. The main discrepancies were related to the decision-making process, and whether patient views are being considered when prescribing. Combining quantitative and qualitative evidence helped explore a wide range of views of OAC and AF, however the review only included published research papers in English, which might have led to exclusion of valuable evidence. More research is needed to explore the factors driving the choice between OACs, especially the choice between individual DOACs.
References
1. Noseworthy PA, Brito JP, Kunneman M, Hargraves IG, Zeballos-Palacios C, Montori VM, Ting HH. Shared decision-making in atrial fibrillation: navigating complex issues in partnership with the patient. Journal of Interventional Cardiac Electrophysiology. 2019;56(2):159–163.
2. Loo, S.Y., Dell'Aniello, S., Huiart, L. and Renoux, C. Trends in the prescription of novel oral anticoagulants in UK primary care. British Journal of Clinical Pharmacology. 2017; 83(9): 2096–2106.
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Affiliation(s)
- R Jarrar
- Newcastle University, Newcastle, UK
| | | | | | - J Lally
- Newcastle University, Newcastle, UK
| | | | - C Price
- Newcastle University, Newcastle, UK
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Benson JM, Kook C, Moore AC, Voinier S, Price C, Burris DL. Range-of-motion affects cartilage fluid load support: functional implications for prolonged inactivity. Osteoarthritis Cartilage 2021; 29:134-142. [PMID: 33227436 DOI: 10.1016/j.joca.2020.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/21/2020] [Revised: 10/09/2020] [Accepted: 11/11/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Joint movements sustain cartilage fluid load support (FLS) through a combination of contact migration and periodic bath exposure. Although there have been suggestions that small involuntary movements may disrupt load-induced exudation during prolonged inactivity, theoretical studies have shown otherwise. This work used well-controlled explant measurements to experimentally test an existing hypothesis that the range-of-motion must exceed the contact length to sustain non-zero FLS. METHOD Smooth glass spheres (1.2-3.2 mm radius) were slid at 1.5 mm/s (Péclet number >100) against bovine osteochondral explants under varying normal loads (0.05-0.1 N) and migration lengths (0.05-7 mm) using a custom instrument. In situ deformation measurements were used to quantify FLS. RESULTS Non-zero FLS was maintained at migration lengths as small as 0.05 mm or <10% the typical contact diameter. FLS peaked when track lengths exceeded 10 times the contact diameter. For migration lengths below this threshold, FLS decreased with increased contact stress. CONCLUSIONS Migration lengths far smaller than the contact diameter can sustain non-zero FLS, which, from a clinical perspective, indicates that fidgeting and drifting can mitigate exudation and loss of FLS during prolonged sitting and standing. Nonetheless, FLS decreased monotonically with decreased migration length when migration lengths were less than 10 times the contact diameter. The results demonstrate: (1) potential biomechanical benefits from small movement (e.g., drifting and fidgeting); (2) the quantitative limits of those benefits; (3) and how loads, movement patterns, and mobility likely impact long term FLS.
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Affiliation(s)
- J M Benson
- Department of Biomedical Engineering, USA
| | - C Kook
- Department of Mechanical Engineering, University of Delaware, Newark, DE, USA
| | - A C Moore
- Department of Biomedical Engineering, USA
| | - S Voinier
- Department of Mechanical Engineering, University of Delaware, Newark, DE, USA
| | - C Price
- Department of Biomedical Engineering, USA
| | - D L Burris
- Department of Biomedical Engineering, USA; Department of Mechanical Engineering, University of Delaware, Newark, DE, USA.
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Seligmann JF, Wright-Hughes A, Pottinger A, Velikova G, Oughton JB, Murden G, Rizwanullah M, Price C, Passant H, Heudtlass P, Marshall H, Johnston S, Dodwell D. Lapatinib plus Capecitabine versus Trastuzumab plus Capecitabine in the Treatment of Human Epidermal Growth Factor Receptor 2-positive Metastatic Breast Cancer with Central Nervous System Metastases for Patients Currently or Previously Treated with Trastuzumab (LANTERN): a Phase II Randomised Trial. Clin Oncol (R Coll Radiol) 2020; 32:656-664. [PMID: 32600919 DOI: 10.1016/j.clon.2020.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/14/2020] [Accepted: 06/03/2020] [Indexed: 11/12/2022]
Abstract
AIMS Brain (central nervous system; CNS) metastases occur in 30-50% of patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC). A substantive evidence base for treatment is lacking, but activity with lapatinib plus capecitabine (lap-cap) has been reported. We compared lap-cap with trastuzumab plus capecitabine (tras-cap) in patients with HER2-positive MBC with CNS metastases previously treated with trastuzumab. MATERIALS AND METHODS This open-label randomised phase II screening trial aimed to randomise 130 participants over 2 years to receive lap-cap or tras-cap. Eligible patients had HER2-positive MBC with newly diagnosed or recently progressed CNS metastases; previous, or current, treatment included: trastuzumab, a taxane or anthracycline and recent completion of local cranial therapy. The primary end point was time to progression of CNS metastases within the 24-week trial period. Secondary objectives included CNS response rate, progression-free survival, steroid use for CNS symptoms and feasibility of recruitment to a large phase III trial. RESULTS Between September 2011 and October 2013, 30 participants were randomised, 16 to lap-cap and 14 to tras-cap. Recruitment to a large phase III trial was determined not to be feasible. At 24 weeks, CNS disease progression was 41.8% (95% confidence interval 16.1-67.5%) in lap-cap and 41.2% (95% confidence interval 12.8-69.6%) in tras-cap arms; progression-free survival was 44.4% (95% confidence interval 18.1-70.8%) in lap-cap and 50.0% (95% confidence interval 20.9-79.1%) in tras-cap arms. CONCLUSION Poor recruitment confirmed that a larger phase III trial would not be feasible and prohibited a preliminary evaluation of the superiority of lap-cap over tras-cap. Descriptive statistics are presented to inform the limited evidence base and future study design.
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Affiliation(s)
- J F Seligmann
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - A Wright-Hughes
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - A Pottinger
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - G Velikova
- St James's Institute of Oncology, St James University Hospital, Leeds, UK
| | - J B Oughton
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - G Murden
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - M Rizwanullah
- Department of Clinical Oncology, The Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - C Price
- Department of Medical Oncology, University Hospitals, Bristol, UK
| | - H Passant
- Department of Medical Oncology, Velindre Hospital, Cardiff, UK
| | - P Heudtlass
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - H Marshall
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - S Johnston
- Department of Medical Oncology, The Royal Marsden NHS Foundation Trust, London, UK
| | - D Dodwell
- St James's Institute of Oncology, St James University Hospital, Leeds, UK; Nuffield Department of Population Health, Oxford University, Oxford, UK.
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Frank B, Dion C, Hizel L, Crowley S, Price C. A-14 Propensity Scores in Neuropsychological Research: Four Aspects of Digital Clock Drawing Distinguish Individuals with Non-Dementia Idiopathic Parkinson’s Disease from Matched Controls. Arch Clin Neuropsychol 2020. [DOI: 10.1093/arclin/acaa067.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
In situations in which randomized experiments are impossible or unethical, propensity score matching offers a method to reduce bias on causal effect estimates (Thoemmes & Kim, 2011). In this study, we examined differences on the digital clock drawing test (dCDT; Souillard-Mandar et al., 2016) between individuals with idiopathic non-dementia Parkinson’s disease (PD) and matched controls.
Method
This study involved a retrospective analysis of two federally funded investigations (NSF-13-543; R01-NS082386). The sample included 261 participants (110 PD, 151 non-PD). Participants were matched according to demographic covariates, as well as measures of mood, comorbidity, and premorbid functioning. The PD group and matched controls were compared using logistic regression in a Bayesian framework, with projection predictive variable selection implemented to obtain a parsimonious model (Piironen, Paasiniemi, & Vehtari, 2018). All effects were standardized.
Results
Of 261 participants, 212 were matched using nearest neighbor matching (Figure 1). The final, parsimonious model included four variables from the dCDT: total strokes (command condition), total time (command condition), and area (command and copy conditions). While all effects were retained, positive to strong evidence was found for dCDT total time (βMedian = 0.91, βSD = 0.25, 95% CI [0.44, 1.42], Bayes factor [BF] = 97.80) and dCDT area (copy condition; βMedian = −0.52, βSD = 0.19, 95% CI [−0.90, −0.17], BF = 4.78).
Conclusions
Propensity scores can be employed in causal comparative studies to match control participants and reduce bias from nuisance covariates. Four aspects of dCDT performance were optimal in distinguishing individuals with PD from matched controls.
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15
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Price C, Gill S, Ho ZV, Davidson SM, Merkel E, McFarland JM, Leung L, Tang A, Kost-Alimova M, Tsherniak A, Jonas O, Vazquez F, Hahn WC. Abstract A67: Understanding HIF1A-mediated therapy in clear cell ovarian cancer. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.ovca19-a67] [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
Previously, we have used an integrated approach to use genome-scale screening in RNAi and CRISPR-Cas9 to identify several putative cancer dependencies. From these putative dependencies, we discovered EGLN1 was a significant and selective dependency in ovarian cancer and EGLN1 dependency was further enriched in clear-cell ovarian cancers. Genetic knockout and small-molecule inhibition of EGLN1 reduced cell proliferation and increased apoptosis in vitro and in vivo. We found the function of EGLN1 as a cancer dependency is through its canonical role as a negative HIF1A regulator and knockout of HIF1A, but not HIF2A, rescues genetic knockout and small-molecule inhibition of EGLN1. Genetic and small-molecule suppression of VHL, downstream of EGLN1 in the degradation of HIF1A, similarly reduces proliferation and increases apoptosis, and is rescued by HIF1A knockout. Further, we found that forced expression of a mutated HIF1A that blocks EGLN1-dependent hydroxylation reduces proliferation and promotes apoptosis. Using RNA-sequencing, we identified several putative downstream targets of HIF1A and confirmed that HIF1A directly binds and drives transcription of negative MYC regulator MXI1. Further, we found that knockout of MXI1 reduced the effects of EGLN1-mediated suppression, indicating HIF1A-driven MYC suppression as one mechanism underlying EGLN1 dependency. Further understanding of HIF1A-mediated suppression of ovarian cancer progression will be critical to potential small-molecule therapy.
Citation Format: Colles Price, Stanley Gill, Zandra V. Ho, Shawn M. Davidson, Erin Merkel, James M. McFarland, Lisa Leung, Andrew Tang, Maria Kost-Alimova, Aviad Tsherniak, Oliver Jonas, Francisca Vazquez, William C. Hahn. Understanding HIF1A-mediated therapy in clear cell ovarian cancer [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research; 2019 Sep 13-16, 2019; Atlanta, GA. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(13_Suppl):Abstract nr A67.
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Affiliation(s)
- Colles Price
- 1Dana-Farber Cancer Institute, Broad Institute of MIT and Harvard, Boston, MA,
| | - Stanley Gill
- 2Broad Institute of MIT and Harvard, Cambridge, MA,
| | - Zandra V. Ho
- 2Broad Institute of MIT and Harvard, Cambridge, MA,
| | | | - Erin Merkel
- 2Broad Institute of MIT and Harvard, Cambridge, MA,
| | | | - Lisa Leung
- 2Broad Institute of MIT and Harvard, Cambridge, MA,
| | - Andrew Tang
- 2Broad Institute of MIT and Harvard, Cambridge, MA,
| | | | | | | | | | - William C. Hahn
- 1Dana-Farber Cancer Institute, Broad Institute of MIT and Harvard, Boston, MA,
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16
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Lax JY, Price C, Saaroni H. On the Spontaneous Build-Up of Voltage between Dissimilar Metals Under High Relative Humidity Conditions. Sci Rep 2020; 10:7642. [PMID: 32376839 PMCID: PMC7203220 DOI: 10.1038/s41598-020-64409-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/16/2020] [Indexed: 11/09/2022] Open
Abstract
Certain metals can surprisingly build-up charge spontaneously, when exposed to high relative humidity (RH), although they need to be isolated from the ground. We have explored this phenomenon, building on former experimental knowledge and carrying out additional experiments, to identify the parameters that could enhance this charging. We used many types of metals with different characteristics under different RH and temperature conditions. While some metals were unaffected by high RH, others, like zinc and stainless steel, did acquire charge, when RH was >60%, and charged a capacitor to a voltage of 1 V. For the first time, we also performed outdoors experiments, showing this phenomenon is also valid under similar natural ambient humid conditions. If these results can be scaled up, it may lead to the development of practical applications for regions and times of high RH conditions.
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Affiliation(s)
- J Y Lax
- Porter School of the Environment and Earth Sciences, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - C Price
- Porter School of the Environment and Earth Sciences, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
| | - H Saaroni
- Porter School of the Environment and Earth Sciences, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
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17
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Michaelsen V, VP Ribeiro R, Wang A, Price C, Wannberg B, Zhang Y, Pires L, del Sorbo L, Ramadan K, Gomes B, Galasso M, Brambate E, Gazzalle A, Liu M, Keshavjee S, Cypel M. Gaseous Nitric Oxide (gNO) as a Potential Antimicrobial Therapy during Ex Vivo Lung Perfusion: An Efficacy and Safety Study. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1217] [Citation(s) in RCA: 1] [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: 11/25/2022] Open
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18
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Ali A, Nykanen A, Brambate E, Mariscal A, Chen M, Wannberg B, Price C, Gomes B, Wang A, Ribeiro R, Michaelsen V, Zhang Y, Waddell T, Liu M, Keshavjee S, Cypel M. Successful Transplantation of Porcine Lungs Following 3 Days of Preservation Using a Modified Cold Static Method Paired with Intermittent Normothermic Ex Vivo Lung Perfusion (EVLP). J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.413] [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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19
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Katsanos AH, Palaiodimou L, Price C, Giannopoulos S, Lemmens R, Kosmidou M, Georgakis MK, Weimar C, Kelly PJ, Tsivgoulis G. Colchicine for stroke prevention in patients with coronary artery disease: a systematic review and meta-analysis. Eur J Neurol 2020; 27:1035-1038. [PMID: 32134555 DOI: 10.1111/ene.14198] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/28/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Although clinical trials suggest that colchicine may reduce the risk of vascular events in patients with a history of coronary artery disease, its effect on the prevention of cerebrovascular events still remains unclear. METHODS A systematic review and meta-analysis was performed of all available randomized controlled trials (RCTs) reporting on incident strokes during the follow-up of patients with a history of cardiovascular disease randomized to colchicine treatment or control (placebo or usual care). RESULTS Four RCTs were identified, including a total of 5553 patients (mean age 61 years, 81% males), with a follow-up ranging from 1 to 36 months. Colchicine treatment was associated with a significantly lower risk of incident stroke during follow-up compared to control (risk ratio 0.31, 95% confidence interval 0.13-0.71), without heterogeneity across included studies (I2 = 0%). Based on the pooled incident stroke rate of control groups (0.9%) in the included RCTs, it was estimated that administration of low-dose colchicine to 161 patients with coronary artery disease would prevent one stroke during a follow-up of 23 months. CONCLUSION Colchicine treatment decreases stroke risk in patients with a history of coronary artery disease. The effect of colchicine in secondary stroke prevention is currently being evaluated in an ongoing RCT.
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Affiliation(s)
- A H Katsanos
- Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, ON, Canada.,Second Department of Neurology, School of Medicine, 'Attikon University Hospital', National and Kapodistrian University of Athens, Athens, Greece
| | - L Palaiodimou
- Second Department of Neurology, School of Medicine, 'Attikon University Hospital', National and Kapodistrian University of Athens, Athens, Greece
| | - C Price
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - S Giannopoulos
- Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece
| | - R Lemmens
- Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), KU Leuven - University of Leuven, Leuven, Belgium.,Center for Brain and Disease Research, Laboratory of Neurobiology, VIB, Leuven, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - M Kosmidou
- First Department of Internal Medicine, University of Ioannina School of Medicine, Ioannina, Greece
| | - M K Georgakis
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - C Weimar
- Department of Neurology, University of Duisburg-Essen, Essen, Germany
| | - P J Kelly
- Health Research Board Stroke Clinical Trials Network Ireland and Mater University Hospital/University College Dublin, Dublin, Ireland
| | - G Tsivgoulis
- Second Department of Neurology, School of Medicine, 'Attikon University Hospital', National and Kapodistrian University of Athens, Athens, Greece.,Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA
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20
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Feldsine PT, Falbo-Nelson MT, Brunelle SL, Forgey RL, Al-Hasani S, Ball C, Beatty S, Blanchfield B, Bowen B, Bremer N, Brookman D, Brookman S, Brushaber M, Bryant J, Bryant D, Bryant R, Chlebowski ET, Copeland F, Culak DA, Dalley E, Destro C, Finkenbiner D, Frissora R, Fung DYC, Garcia GR, Gray MR, Hagen CJ, Harshavardhan T, Hart-Thakur R, Inami G, Johnson S, Kandakai LV, Lessard D, Lin S, Liu V, Matiuck S, McAteer L, Miller L, Moon B, Nasri H, Pack L, Pilot K, Price C, Pruett P, Ramirez C, Richter D, Schmieg JA, Schultz G, Sloan EM, Sprague DM, Tebay D, Tomer J, Tuncan E, Warburton D, Watson M, West D. Assurance Enzyme Immunoassay for Detection of Enterohemorrhagic Escherichia coli 0157:H7 in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.3.530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Five foods types were analyzed by the Assurance EHEC (Escherichia coli 0157:H7) enzyme immunoassay (EIA) and by the Bacteriological Analytical Manual (BAM) culture method. Each sample of each food type at each inoculation level was simultaneously analyzed by both methods. A total of 21 laboratories representing state and federal government agencies and private industry in the United States and Canada participated. Samples were inoculated with E. coli 0157:H7, except for one lot of poultry that was naturally contaminated. A total of 1304 samples and controls were analyzed and confirmed, of which 473 were positive and 818 were negative by both methods. Thirteen samples were positive by BAM but negative by EIA. Because of the study design, it was not possible for the BAM method to produce false-negative or falsepositive results. The Assurance method for detection of E. coli OI57:H7 in selected foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | | | | | - Robin L Forgey
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
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21
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Feldsine PT, Albo-Nelson MT, Brunelle SL, Forgey RL, Al-Hasani S, Ball C, Beatty S, Blanchfield B, Bowen B, Bremer N, Brookman D, Brookman S, Brushaber M, Bryant J, Bryant D, Bryant R, Chlebowski ET, Copeland F, Culak DA, Dalley E, Destro C, Finkenbiner D, Frissora R, Fung DYC, Garcia GR, Gray MR, Hagen CJ, Harshavardhan T, Hart-Thakur R, Inami G, Johnson S, Kandakai LV, Lessard D, Lin S, Liu V, Matiuck S, McAteer L, Miller L, Moon B, Nasri H, Pack L, Pilot K, Price C, Pruett P, Ramirez C, Richter D, Schmieg JA, Schultz G, Sloan EM, Sprague DM, Tebay D, Tomer J, Tuncan E, Warburton D, Watson M, West D. Visual Immunoprecipitate Assay (VIP) for Detection of Enterohemorrhagic Escherichia coli (EHEC) 0157:H7 in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.3.517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Five foods representative of a variety of food products were analyzed by the Visual Immunoprecipitate Assay (VIP) and the Bacteriological Analytical Manual (BAM) culture method for the presence of Escherichia coli 0157: H7. A total of 21 laboratories representing state and federal government agencies, as well as private industry, in the United States and Canada participated. Food types were inoculated with strains of E. coli 0157:H7, with the exception of one lot of poultry, which was naturally contaminated. During this study, a total of 1377 samples and controls were analyzed and confirmed, of which 508 were positive and 867 were negative by both methods. Two samples were positive by BAM and negative by VIP. Because of the study design, it was not possible for the BAM method to produce false-negative or false-positive results. The VIP assay for detection of EHEC in selected foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | | | | | - Robin L Forgey
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
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22
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Koser S, Weiner S, Suzuki J, Price C. 23 Implementation of a Substance Use Disorder Bridge Clinic. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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23
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Kümin M, Deery J, Turney S, Price C, Vinayakam P, Smith A, Filippa A, Wilkinson-Guy L, Moore F, O'Sullivan M, Dunbar M, Gaylard J, Newman J, Harper CM, Minney D, Parkin C, Mew L, Pearce O, Third K, Shirley H, Reed M, Jefferies L, Hewitt-Gray J, Scarborough C, Lambert D, Jones CI, Bremner S, Fatz D, Perry N, Costa M, Scarborough M. Reducing Implant Infection in Orthopaedics (RIIiO): Results of a pilot study comparing the influence of forced air and resistive fabric warming technologies on postoperative infections following orthopaedic implant surgery. J Hosp Infect 2019; 103:412-419. [PMID: 31493477 DOI: 10.1016/j.jhin.2019.08.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/28/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Active warming during surgery prevents perioperative hypothermia but the effectiveness and postoperative infection rates may differ between warming technologies. AIM To establish the recruitment and data management strategies needed for a full trial comparing postoperative infection rates associated with forced air warming (FAW) versus resistive fabric warming (RFW) in patients aged >65 years undergoing hemiarthroplasty following fractured neck of femur. METHODS Participants were randomized 1:1 in permuted blocks to FAW or RFW. Hypothermia was defined as a temperature of <36°C at the end of surgery. Primary outcomes were the number of participants recruited and the number with definitive deep surgical site infections. FINDINGS A total of 515 participants were randomized at six sites over a period of 18 months. Follow-up was completed for 70.1%. Thirty-seven participants were hypothermic (7.5% in the FAW group; 9.7% in the RFW group). The mean temperatures before anaesthesia and at the end of surgery were similar. For the primary clinical outcome, there were four deep surgical site infections in the FAW group and three in the RFW group. All participants who developed a postoperative infection had antibiotic prophylaxis, a cemented prosthesis, and were operated under laminar airflow; none was hypothermic. There were no serious adverse events related to warming. CONCLUSION Surgical site infections were identified in both groups. Progression from the pilot to the full trial is possible but will need to take account of the high attrition rate.
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Affiliation(s)
- M Kümin
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - J Deery
- East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - S Turney
- East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - C Price
- East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - P Vinayakam
- East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - A Smith
- East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - A Filippa
- Heart of England NHS Foundation Trust, Birmingham, UK
| | | | - F Moore
- Heart of England NHS Foundation Trust, Birmingham, UK
| | - M O'Sullivan
- Heart of England NHS Foundation Trust, Birmingham, UK
| | - M Dunbar
- Heart of England NHS Foundation Trust, Birmingham, UK
| | - J Gaylard
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - J Newman
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - C M Harper
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK; Brighton and Sussex Medical School, Brighton, UK
| | - D Minney
- Milton Keynes University Hospitals NHS Foundation Trust, Milton Keynes, UK
| | - C Parkin
- Milton Keynes University Hospitals NHS Foundation Trust, Milton Keynes, UK
| | - L Mew
- Milton Keynes University Hospitals NHS Foundation Trust, Milton Keynes, UK
| | - O Pearce
- Milton Keynes University Hospitals NHS Foundation Trust, Milton Keynes, UK
| | - K Third
- Northumbria Healthcare NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - H Shirley
- Northumbria Healthcare NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - M Reed
- Northumbria Healthcare NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - L Jefferies
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - J Hewitt-Gray
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - C Scarborough
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - D Lambert
- Brighton and Sussex Medical School, Brighton, UK
| | - C I Jones
- Brighton and Sussex Medical School, Brighton, UK
| | - S Bremner
- Brighton and Sussex Medical School, Brighton, UK
| | - D Fatz
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - N Perry
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - M Costa
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - M Scarborough
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
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24
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Price C, Gill S, Ho ZV, Davidson SM, Merkel E, McFarland JM, Leung L, Tang A, Kost-Alimova M, Tsherniak A, Jonas O, Vazquez F, Hahn WC. Genome-Wide Interrogation of Human Cancers Identifies EGLN1 Dependency in Clear Cell Ovarian Cancers. Cancer Res 2019; 79:2564-2579. [PMID: 30898838 DOI: 10.1158/0008-5472.can-18-2674] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 01/18/2019] [Accepted: 03/14/2019] [Indexed: 12/17/2022]
Abstract
We hypothesized that candidate dependencies for which there are small molecules that are either approved or in advanced development for a nononcology indication may represent potential therapeutic targets. To test this hypothesis, we performed genome-scale loss-of-function screens in hundreds of cancer cell lines. We found that knockout of EGLN1, which encodes prolyl hydroxylase domain-containing protein 2 (PHD2), reduced the proliferation of a subset of clear cell ovarian cancer cell lines in vitro. EGLN1-dependent cells exhibited sensitivity to the pan-EGLN inhibitor FG-4592. The response to FG-4592 was reversed by deletion of HIF1A, demonstrating that EGLN1 dependency was related to negative regulation of HIF1A. We also found that ovarian clear cell tumors susceptible to both genetic and pharmacologic inhibition of EGLN1 required intact HIF1A. Collectively, these observations identify EGLN1 as a cancer target with therapeutic potential. SIGNIFICANCE: These findings reveal a differential dependency of clear cell ovarian cancers on EGLN1, thus identifying EGLN1 as a potential therapeutic target in clear cell ovarian cancer patients.
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Affiliation(s)
- Colles Price
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Stanley Gill
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Zandra V Ho
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Shawn M Davidson
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Erin Merkel
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | | | - Lisa Leung
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Andrew Tang
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | | | - Aviad Tsherniak
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Oliver Jonas
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Francisca Vazquez
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - William C Hahn
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts. .,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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25
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Rodgers H, Shaw L, Bhattarai N, Cant R, Drummond A, Ford GA, Forster A, Francis R, Hills K, Howel D, Laverty AM, McKevitt C, McMeekin P, Price C, Stamp E, Stevens E, Vale L. 137A trial to evaluate an eXTended RehAbilitation service for Stroke patients (EXTRAS): main patient results. Age Ageing 2019. [DOI: 10.1093/ageing/afz001.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H Rodgers
- Newcastle University
- Northumbria Healthcare NHS Foundation Trust
- Newcastle upon Tyne Hospitals NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | - C Price
- Newcastle University
- Northumbria Healthcare NHS Foundation Trust
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26
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Elhalel G, Price C, Fixler D, Shainberg A. Cardioprotection from stress conditions by weak magnetic fields in the Schumann Resonance band. Sci Rep 2019; 9:1645. [PMID: 30733450 PMCID: PMC6367437 DOI: 10.1038/s41598-018-36341-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/19/2018] [Indexed: 01/19/2023] Open
Abstract
The Schumann Resonances (ScR) are Extremely Low Frequency (ELF) electromagnetic resonances in the Earth-ionosphere cavity excited by global lightning discharges. This natural electromagnetic noise has likely existed on the Earth ever since the Earth had an atmosphere and an ionosphere, hence surrounding us throughout our evolutionary history. The purpose of this study was to examine the influence of extremely weak magnetic fields in the ScR first mode frequency range on the spontaneous contractions, calcium transients and Creatine Kinase (CK) release of rat cardiac cell cultures. We show that applying 7.8 Hz, 90 nT magnetic fields (MF) causes a gradual decrease in the spontaneous calcium transients’ amplitude, reaching 28% of the initial amplitude after 40 minutes of MF application, and accompanied with a gradual decrease in the calcium transients’ rise time. The mechanical spontaneous contractions cease after the ScR fields have been applied for more than 30 minutes, when the calcium transient’s amplitude reached ~60% of its initial value. The influence of the ScR MF was reversible, independent of the field magnitude in the range 20 pT-100 nT, and independent of the external DC magnetic field. However, the effect is frequency dependent; the described changes occurred only in the 7.6–8 Hz range. In addition, applying 7.8 Hz, 90 nT MF for 1.5 hours, reduced the amount of CK released to the buffer, during normal conditions, hypoxic conditions and oxidative stress induced by 80 μM H2O2. We show that the ScR field induced reduction in CK release is associated with a stress response process and has a protective character.
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Affiliation(s)
- G Elhalel
- Porter School of the Environment and Earth Sciences, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
| | - C Price
- Porter School of the Environment and Earth Sciences, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - D Fixler
- Faculty of Engineering and the Institute of Nanotechnology and Advanced Materials, Bar Ilan University, Tel Aviv, Israel
| | - A Shainberg
- Faculty of Life Sciences, Bar Ilan University, Tel Aviv, Israel
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Kellett J, Sampson M, Swords F, Murphy HR, Clark A, Howe A, Price C, Datta V, Myint KS. Young people's experiences of managing Type 1 diabetes at university: a national study of UK university students. Diabet Med 2018; 35:1063-1071. [PMID: 29687498 DOI: 10.1111/dme.13656] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2018] [Indexed: 01/30/2023]
Abstract
AIM Little is known about the challenges of transitioning from school to university for young people with Type 1 diabetes. In a national survey, we investigated the impact of entering and attending university on diabetes self-care in students with Type 1 diabetes in all UK universities. METHODS Some 1865 current UK university students aged 18-24 years with Type 1 diabetes, were invited to complete a structured questionnaire. The association between demographic variables and diabetes variables was assessed using logistic regression models. RESULTS In total, 584 (31%) students from 64 hospitals and 37 university medical practices completed the questionnaire. Some 62% had maintained routine diabetes care with their home team, whereas 32% moved to the university provider. Since starting university, 63% reported harder diabetes management and 44% reported higher HbA1c levels than before university. At university, 52% had frequent hypoglycaemia, 9.6% reported one or more episodes of severe hypoglycaemia and 26% experienced diabetes-related hospital admissions. Female students and those who changed healthcare provider were approximately twice as likely to report poor glycaemic control, emergency hospital admissions and frequent hypoglycaemia. Females were more likely than males to report stress [odds ratio (OR) 4.78, 95% confidence interval (CI) 3.19-7.16], illness (OR 3.48, 95% CI 2.06-5.87) and weight management issues (OR 3.19, 95% CI 1.99-5.11) as barriers to self-care. Despite these difficulties, 91% of respondents never or rarely contacted university support services about their diabetes. CONCLUSION The study quantifies the high level of risk experienced by students with Type 1 diabetes during the transition to university, in particular, female students and those moving to a new university healthcare provider.
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Affiliation(s)
- J Kellett
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Clinical Research and Trials Unit, Norwich, UK
| | - M Sampson
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Clinical Research and Trials Unit, Norwich, UK
| | - F Swords
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Clinical Research and Trials Unit, Norwich, UK
| | - H R Murphy
- University Medical Centre, University of East Anglia, Norwich, UK
| | - A Clark
- Norwich Medical School, Faculty of Health and Medical Sciences, Norwich, UK
| | - A Howe
- Norwich Medical School, Faculty of Health and Medical Sciences, Norwich, UK
| | - C Price
- University Medical Centre, University of East Anglia, Norwich, UK
| | - V Datta
- Department of Paediatrics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - K S Myint
- Department of Diabetes and Endocrinology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
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Morikawa E, Mudau M, Olivier D, de Vos L, Joseph Davey D, Price C, McIntyre JA, Peters RP, Klausner JD, Medina-Marino A. Acceptability and Feasibility of Integrating Point-of-Care Diagnostic Testing of Sexually Transmitted Infections into a South African Antenatal Care Program for HIV-Infected Pregnant Women. Infect Dis Obstet Gynecol 2018; 2018:3946862. [PMID: 29861622 PMCID: PMC5971359 DOI: 10.1155/2018/3946862] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 03/10/2018] [Accepted: 03/29/2018] [Indexed: 11/25/2022] Open
Abstract
Background Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) infections may increase the risk of vertical transmission of the human immunodeficiency virus (HIV). In resource-limited settings, symptomatic screening, and syndromic management of sexually transmitted infections (STIs) during pregnancy continue to be the standard of care. In the absence of diagnostic testing, asymptomatic infections in pregnant women go untreated. Objective To describe the acceptability and feasibility of integrating diagnostic STI screening into first antenatal care visits for HIV-infected pregnant women. Methods HIV-infected pregnant women were recruited during their first antenatal care visit from three antenatal care clinics in Tshwane District, South Africa, between June 2016 and October 2017. Self-collected vaginal swabs were used to screen for CT, NG, and TV with a diagnostic point-of-care (POC) nucleic acid amplification test. Those with STIs were provided treatment per South African national guidelines. Results Of 442 eligible women, 430 (97.3%) agreed to participate and were tested. Of those with a positive STI test result (n = 173; 40.2%), 159 (91.9%) received same-day results and treatment; 100% of STI-infected women were treated within seven days. Conclusions Integration of POC diagnostic STI screening into first-visit antenatal care services was feasible and highly acceptable for HIV-infected pregnant women.
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Affiliation(s)
- E. Morikawa
- Division of Infectious Disease, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - M. Mudau
- Research Unit, Foundation for Professional Development, Pretoria, South Africa
| | - D. Olivier
- Research Unit, Foundation for Professional Development, Pretoria, South Africa
| | - L. de Vos
- Research Unit, Foundation for Professional Development, Pretoria, South Africa
| | - D. Joseph Davey
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - C. Price
- Division of Infectious Disease, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - J. A. McIntyre
- Anova Health Institute, Johannesburg, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - R. P. Peters
- Anova Health Institute, Johannesburg, South Africa
- Department of Medical Microbiology, School of Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
| | - J. D. Klausner
- Division of Infectious Disease, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - A. Medina-Marino
- Research Unit, Foundation for Professional Development, Pretoria, South Africa
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Benschop HOG, Guerin AJ, Brinkmann A, Dale ML, Finnie AA, Breugem WP, Clare AS, Stübing D, Price C, Reynolds KJ. Drag-reducing riblets with fouling-release properties: development and testing. Biofouling 2018; 34:532-544. [PMID: 29806493 DOI: 10.1080/08927014.2018.1469747] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 01/26/2018] [Accepted: 04/19/2018] [Indexed: 06/08/2023]
Abstract
The manufacture and preliminary testing of a drag-reducing riblet texture with fouling-control properties is presented. The commercial fouling-release product Intersleek® 1100SR was modified to manufacture riblet-textured coatings with an embossing technology. Hydrodynamic drag measurements in a Taylor-Couette set-up showed that the modified Intersleek® riblets reduced drag by up to 6% compared to a smooth surface. Barnacle settlement assays demonstrated that the riblets did not substantially reduce the ability of Intersleek® 1100SR to prevent fouling by cyprids of Balanus amphitrite. Diatom adhesion tests revealed significantly higher diatom attachment on the riblet surface compared to smooth Intersleek® 1100SR. However, after exposure to flow, the final cell density was similar to the smooth surface. Statically immersed panels in natural seawater showed an increase of biofilm cover due to the riblets. However, the release of semi-natural biofilms grown in a multi-species biofilm culturing reactor was largely unaffected by the presence of a riblet texture.
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Affiliation(s)
- H O G Benschop
- a Laboratory for Aero and Hydrodynamics , Delft University of Technology , Delft , the Netherlands
| | - A J Guerin
- b School of Natural and Environmental Sciences , Newcastle University , Newcastle upon Tyne , UK
| | - A Brinkmann
- c Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM , Bremen , Germany
| | - M L Dale
- d AkzoNobel/International Paint Ltd , Gateshead , UK
| | - A A Finnie
- d AkzoNobel/International Paint Ltd , Gateshead , UK
| | - W-P Breugem
- a Laboratory for Aero and Hydrodynamics , Delft University of Technology , Delft , the Netherlands
| | - A S Clare
- b School of Natural and Environmental Sciences , Newcastle University , Newcastle upon Tyne , UK
| | - D Stübing
- c Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM , Bremen , Germany
| | - C Price
- d AkzoNobel/International Paint Ltd , Gateshead , UK
| | - K J Reynolds
- d AkzoNobel/International Paint Ltd , Gateshead , UK
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Abstract
AbstractThe Read Thesaurus is a comprehensive user-led clinical vocabulary developed from earlier, and structurally simpler, versions of the Read Codes, with substantial input from United Kingdom health care professionals. A constituent template table underpins a range of functions, including semantic definition of concepts using object-attribute-value triples. Concept representation for surgical procedures has been investigated by a number of groups and a standard European structure has been proposed. Over 50% ofthe surgical procedures in the Read Thesaurus have been fully characterised using a number of attributes each with a defined concept field. We report progress to date and, based on our large-scale experience, examine the applicability of the European model to a user-defined terminology.
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Abstract
AbstractThe disorder chapter of Version 3 of the Read codes is a rich source of clinically derived terminology. The file structure has been designed to meet a clinical need to support both enumerated and compositional taxonomy. This requirement coupled with the maintenance of multiple classification necessitates a mechanism to identify consistent hierarchical placement and equivalence between concepts. The early work on the semantic definition of the disorder chapter, to support these requirements, is outlined and the attributes that have been found to be important are presented. We also describe different categories of completeness of definition that have been identified, and the scope of those that are likely to remain incompletely characterised.
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Kobayashi A, Czlonkowska A, Ford GA, Fonseca AC, Luijckx GJ, Korv J, de la Ossa NP, Price C, Russell D, Tsiskaridze A, Messmer-Wullen M, De Keyser J. European Academy of Neurology and European Stroke Organization consensus statement and practical guidance for pre-hospital management of stroke. Eur J Neurol 2018; 25:425-433. [PMID: 29218822 DOI: 10.1111/ene.13539] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 12/01/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND PURPOSE The reduction of delay between onset and hospital arrival and adequate pre-hospital care of persons with acute stroke are important for improving the chances of a favourable outcome. The objective is to recommend evidence-based practices for the management of patients with suspected stroke in the pre-hospital setting. METHODS The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to define the key clinical questions. An expert panel then reviewed the literature, established the quality of the evidence, and made recommendations. RESULTS Despite very low quality of evidence educational campaigns to increase the awareness of immediately calling emergency medical services are strongly recommended. Moderate quality evidence was found to support strong recommendations for the training of emergency medical personnel in recognizing the symptoms of a stroke and in implementation of a pre-hospital 'code stroke' including highest priority dispatch, pre-hospital notification and rapid transfer to the closest 'stroke-ready' centre. Insufficient evidence was found to recommend a pre-hospital stroke scale to predict large vessel occlusion. Despite the very low quality of evidence, restoring normoxia in patients with hypoxia is recommended, and blood pressure lowering drugs and treating hyperglycaemia with insulin should be avoided. There is insufficient evidence to recommend the routine use of mobile stroke units delivering intravenous thrombolysis at the scene. Because only feasibility studies have been reported, no recommendations can be provided for pre-hospital telemedicine during ambulance transport. CONCLUSIONS These guidelines inform on the contemporary approach to patients with suspected stroke in the pre-hospital setting. Further studies, preferably randomized controlled trials, are required to examine the impact of particular interventions on quality parameters and outcome.
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Affiliation(s)
- A Kobayashi
- Institute of Psychiatry and Neurology, Interventional Stroke and Cerebrovascular Diseases Treatment Centre, Warsaw, Poland.,Department of Neuroradiology, Institute of Psychiatry and Neurology, Warsaw, Poland.,Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - A Czlonkowska
- Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.,Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
| | - G A Ford
- Division of Medical Sciences, Oxford University, Oxford, UK
| | - A C Fonseca
- Department of Neurology, Hospital de Santa Maria, University of Lisbon, Lisbon, Portugal
| | - G J Luijckx
- Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - J Korv
- Department of Neurology, Estonia Department of Neurology and Neurosurgery, Neurology Clinic, Tartu University Hospital, University of Tartu, Tartu, Estonia
| | - N Pérez de la Ossa
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - C Price
- Institute of Neuroscience (Stroke Research Group), Newcastle University, Newcastle upon Tyne, UK
| | - D Russell
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - A Tsiskaridze
- Department of Neurology, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - M Messmer-Wullen
- Austrian Stroke Selfhelp Association, Lochau, Austria.,European Federation of Neurological Associations (EFNA) and Stroke Alliance for Europe (SAFE), Brussels, Belgium
| | - J De Keyser
- Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.,Department of Neurology, Centre for Neurosciences, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Oates L, Price C, Plank J, Riddell V. 4PROMOTING ORAL FLUID INTAKE IN HOSPITAL: THE NORTHUMBRIA ASSESSMENT OF HYDRATION. Age Ageing 2017. [DOI: 10.1093/ageing/afx055.4] [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: 11/13/2022] Open
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Price C, Burley R. An evaluation of information sources for retrospective literature searching on occupational diseases. J Inf Sci 2016. [DOI: 10.1177/016555158701300312] [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]
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Abstract
Barrett's esophagus is a well-recognized risk factor for esophageal adenocarcinoma. The natural history of Barrett's esophagus classified as ‘indefinite for dysplasia’ (IND) is poorly characterized. The aim of this study is to characterize the natural history of IND by determining the rate of neoplastic progression and identifying risk factors for progression. Patients from the University of Pennsylvania Health System pathology database and Barrett's esophagus registry with a diagnosis of IND between 2000 and 2014 were identified. Exclusion criteria included: (1) prior diagnosis of low-grade dysplasia (LGD), high-grade dysplasia (HGD), or esophageal adenocarcinoma (EAC); (2) presence of LGD, HGD, or EAC at the time of diagnosis of IND; and (3) lack of follow-up endoscopy after diagnosis. Patients with neoplastic progression were classified as having either prevalent disease (LGD, HGD, or EAC on surveillance biopsy within 12 months of IND diagnosis) or incident disease (LGD, HGD, or EAC on surveillance biopsy >12 months after IND diagnosis). One hundred six patients were eligible for analysis. Of 87 patients with follow-up endoscopy and biopsies within 1 year of IND diagnosis, 7 (8%) had prevalent disease (2 LGD, 4 HGD, 1 EAC). The prevalence of LGD was 2.3%, HGD was 4.6%, and EAC was 1.1%. Importantly, four of the seven prevalent (2 LGD, 2 HGD) cases were found to have dysplasia within 6 months of IND diagnosis. No demographic or endoscopic characteristics studied were associated with prevalent disease. Of the 106 IND patients, there were 66 patients without prevalent dysplasia with >1-year follow-up. Three (4.5%) progressed (1 to LGD after 12 months, 2 to HGD after 16.5 and 28 months), yielding an incidence rate for any dysplasia of 1.4 cases/100 person-years and HGD/EAC of 0.9/100 person-years. Risk factors for incident disease were smoking (p = 0.02) and Barrett's esophagus segment length (p = 0.03). IND is associated with considerable risk of prevalent dysplasia, especially within the first 6 months after diagnosis. However, the incidence of HGD/EAC is low and similar to previous studies of IND. These data suggest that IND patients should have repeat endoscopy within 6 months with careful surveillance protocols. Longer BE length and smoking history may help predict which patients are more likely to develop dysplasia, and therefore identify patients who may warrant even closer monitoring.
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Affiliation(s)
| | | | | | | | | | - A. Tierney
- Center for Clinical Epidemiology and Biostatistics, Hospital of the University of Pennsylvania, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
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Fang F, Santoro C, Hristova K, Yoon HJ, Abid L, Poller A, Erdei T, Ahmed T, Geraeli B, Gascuena R, Li YJ, Yang J, Bartel T, Erbel R, Ya Y, Yu CM, Schiano Lomoriello V, Esposito R, Casaretti L, Ilardi F, Fazio V, De Simone G, Trimarco B, Galderisi M, Hristova K, Marinov R, Marinov R, Katova TZ, Katova TZ, Kostova V, Kostova V, Simova I, Kim KH, Cho JY, Park JC, Ben Kahla S, Bech-Hanssen O, Sunderji I, Sanchez-Martinez S, Edwards J, Braim D, Price C, Bijnens B, Fraser AG, Mohmed LA, Abd-Elhady B, Abdellaha M, Mazen A, Sattarzadeh Badkoubeh R, Hassanbeigy HR, Tavoosi A, Larti F, Saberi K, Rubio L, Terol B, Rico C. Moderated Posters session: diastolic function in clinical perspectiveP1260Coronary flow reserve in patients with chest pain but without significant coronary stenosis: the role of hypertensionP1261Diastolic bicycle exercise: normal reference values and determinantsP1262Prediction of left ventricular diastolic dysfunction in breast cancer patients after chemotherapyP1263Impaired diastolic recovery is associated with adverse events in the patients with hypertensive heart failureP1264Diastolic strain parameters in hypertensive heart disease: Insights from a speckle tracking imagingP1265Standard echocardiographic parameters to assess right ventricular diastolic function does not detect increased end diastolic right ventricular pressure in pulmonary vascular diseaseP1266In heart failure with preserved ejection fraction carotid arterial stiffness is increased and may contribute to reduced functional reserveP1267Study of left atrial function by speckle tracking in young Egyptian females with unexplained dyspnea; pilot reportP1268stress effect on diastolic functionP1269Diastolic function and adjusted diastolic index in apparently healthy obese patients. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Martins Fernandes S, Badano L, Garcia Campos A, Erdei T, Mehdipoor G, Hanboly N, Michalski BW, Vriz O, Mo VY, Le TT, Ribeiro JM, Ternacle J, Yurdakul SELEN, Shetye A, Stoebe S, Lisowska A, Chinali M, Orabona M, Contaldi C, De La Chica JA, Codolosa JN, Trzcinski P, Prado Diaz S, Morales Portano JD, Ha SJ, Valente F, Joseph G, Valente F, Scali MC, Cordeiro F, Duchateau N, Fabris E, Costantino MF, Cho IJ, Goublaire C, Lam W, Galli E, Kim KH, Mariani M, Malev E, Zuercher F, Tang Z, Cimino S, Mahia P, De La Chica JA, Petrovic J, Ciobotaru V, Remsey- Semmelweiss E, Kogoj P, Guerreiro S, Saxena A, Mozenska O, Pontone G, Macaya Ten F, Caballero L, Avegliano G, Halmai L, Reis L, Trifunovic D, Gospodinova M, Makavos G, D'ascenzi F, Dantas Tavares De Melo M, Bonapace S, Kulkarni A, Cameli M, Ingvarsson A, Driessen MMP, Tufekcioglu O, Radulescu D, Barac A, Cioffi G, Almeida Morais L, Ledakowicz-Polak A, Portugal G, Naksuk N, Parato VM, Kovalova S, Cherubini A, Corrado G, Malev E, Wierzbowska-Drabik K, Lesevic H, Laredj N, Pieles GE, Generati G, Van Zalen JJ, Aquila I, Cheng HL, Lanzoni L, Asmarats Serra L, Kadrabulatova S, Ranjbar S, Szczesniak-Stanczyk D, Sharka I, Di Salvo G, Ben Kahla S, Li L, Hadeed HA, Habeeb HA, Toscano A, Granata F, Djikic D, Wdowiak-Okrojek K, Girgis HYA, Sharma A, Soro C, Gallego Page JC, Corneli M, Teixeira R, Roussin I, Lynch M, Muraru D, Romeo G, Ermacora D, Marotta C, Aruta P, Cucchini U, Iliceto S, Martin-Fernandez M, De La Hera Galarza JM, Corros-Vicente C, Colunga Blanco S, Velasco-Alonso E, Leon-Aguero V, Rodriguez-Suarez ML, Moris De La Tassa C, Edwards J, Braim D, Price C, Fraser AG, Salmani F, Arjmand Shabestari A, Szymczyk E, Kupczynska K, Peczek L, Nawrot B, Lipiec P, Kasprzak JD, Driussi C, Ferrara F, Brosolo G, Antonini-Canterin F, Magne J, Aboyans V, Bossone E, Bellucci BM, Fisher JM, Balekian AA, Idapalapati S, Huang F, Wong JI, Tan RS, Teixeira R, Madeira M, Almeida I, Reis L, Siserman A, Dinis P, Dias L, Ramos AP, Goncalves L, Wan FW, Sawaki DS, Dubois-Rande JLDR, Adnot SA, Czibik GC, Derumeaux GD, Ercan G, Tekkesin ILKER, Sahin ST, Cengiz B, Celik G, Demircan S, Aytekin SAIDE, Razvi NA, Nazir SA, Price N, Khan JN, Kanagala P, Singh A, Squire I, Mccann GP, Langel M, Pfeiffer D, Hagendorff A, Ptaszynska-Kopczynska K, Marcinkiewicz-Siemion M, Knapp M, Witkowski M, Musial WJ, Kaminski K, Natali B, D' Anna C, Leonardi B, Secinaro A, Pongiglione G, Rinelli G, Renard S, Michel N, Mancini J, Haentjens J, Sitbon O, Habib G, Imbriaco M, Alcidi G, Santoro C, Buonauro A, Lo Iudice F, Lembo M, Cuocolo A, Trimarco B, Galderisi M, Mora Robles J, Roldan Jimenez MA, Mancisidor MA, De Mora MA, Alnabelsi T, Goykhman I, Koshkelashvili N, Romero-Corral A, Pressman GS, Michalski BW, Kupczynska K, Miskowiec D, Lipiec P, Kasprzak JD, Montoro Lopez N, Refoyo Salicio E, Valbuena Lopez SC, Gonzalez O, Alvarez C, Moreno Yanguela M, Bartha Rasero JL, De La Calle M, Guzman Martinez G, Suarez-Cuenca JA, Merino JA, Gomez Alvarez EB, Delgado LG, Woo YM, Bang WD, Sohn GH, Cheong SS, Yoo SY, Rodriguez Palomares JF, Gutierrez L, Maldonado G, Pineda V, Galian L, Teixido G, Gonzalez Allujas MT, Evangelista A, Garcia Dorado D, Zaremba T, Ekeloef S, Heiberg E, Engblom H, Jensen SE, Sogaard P, Rodriguez Palomares JF, Gutierrez L, Garcia G, Pineda V, Galian L, Teixido G, Gonzalez Allujas MT, Evangelista A, Garcia Dorado D, Dini FL, Galli F, Lattanzi F, Picano E, Marzilli M, Leao S, Moz M, Magalhaes P, Trigo J, Mateus PS, Ferreira A, Moreira JI, De Craene M, Legallois D, Labombarda F, Pellissier A, Sermesant M, Saloux E, Merlo M, Moretti M, Barbati G, Stolfo D, Gigli M, Pinamonti B, Sinagra G, Dores E, Matera A, Innelli P, Innelli P, Lopizzo A, Violini R, Fiorilli R, Cappabianca G, Picano E, Tarsia G, Seo J, Chang HJ, Heo R, Kim IC, Shim CY, Hong GR, Chung N, Melissopoulou MM, Nguyen V, Brochet E, Cimadevilla C, Codogno I, Vahanian A, Messika-Zeitoun D, Pontana F, Vassiliou V, Prasad S, Leclercq C, Samset E, Donal E, Lim DS, Bianchi G, Rossi F, Gianetti J, Marchi F, Cerone E, Nardelli A, Terrazzi M, Solinas M, Maffei S, Pshepiy A, Vasina L, Timofeev E, Reeva S, Zemtsovsky E, Brugger N, Jahren S, De Marchi SF, Seiler C, Jin CN, Tang H, Fan K, Kam K, Yan BP, Yu CM, Lee PW, Reali M, Silvetti E, Salatino T, Mancone M, Pennacchi M, Giordano A, Sardella G, Agati L, Tirado G, Nogales-Romo MT, Marcos-Alberca P, De Agustin A, Almeria C, Rodrigo JL, Garcia Fernandez MA, Macaya C, Perez De Isla L, Mancisidor M, Lara Garcia C, Vivancos R, De Mora M, Petrovic M, Vujisic-Tesic B, Trifunovic D, Boricic-Kostic M, Petrovic I, Draganic G, Petrovic O, Tomic-Dragovic M, Furlan T, Ambrozic J, Mohorko Pleskovic PN, Bunc M, Ribeiras R, Abecasis J, Andrade MJ, Mendes M, Ramakrishnan S, Gupta SK, Juneja R, Kothari SS, Zaleska M, Segiet A, Chwesiuk S, Kroc A, Kosior DA, Andreini D, Solbiati A, Guglielmo M, Mushtaq S, Baggiano A, Beltrama V, Rota C, Guaricci AI, Pepi M, Pons Llinares J, Asmarats Serra L, Pericas Ramis P, Caldes Llull O, Grau Sepulveda A, Frontera G, Vaquer Segui A, Noris M, Bethencourt Gonzalez A, Climent Paya V, Martinez Moreno M, Saura D, Oliva MJ, Sanchez Quinones J, Garcia Honrubia A, Valdes M, De La Morena G, Terricabras M, Costabel JP, Ronderos R, Evangelista A, Venturini C, Galve E, Nemes A, Neubauer S, Rahman Haley S, Banner N, Teixeira R, Caetano F, Almeida I, Trigo J, Botelho A, Silva J, Nascimento J, Goncalves L, Tesic M, Jovanovic I, Petrovic O, Boricic-Kostic M, Dragovic M, Petrovic M, Stepanovic J, Banovic M, Vujisic-Tesic B, Guergelcheva V, Chamova T, Sarafov S, Tournev I, Denchev S, Ikonomidis I, Psarogiannakopoulos P, Tsirigotis P, Paraskevaidis I, Lekakis J, Pelliccia A, Natali BM, Cameli M, Focardi M, Bonifazi M, Mondillo S, Lima C, Assed L, Kalil Filho R, Mady C, Bochi EA, Salemi VMC, Targher G, Valbusa F, Rossi A, Lanzoni L, Lipari P, Zenari L, Molon G, Canali G, Barbieri E, Li L, Craft M, Nanda M, Lorenzo JM, Kutty S, Bombardini T, Sparla S, Di Tommaso C, Losito M, Incampo E, Maccherini M, Mondillo S, Werther Evaldsson A, Radegran G, Stagmo M, Waktare J, Roijer A, Meurling CJ, Hui W, Meijboom FJ, Bijnens B, Dragulescu A, Mertens L, Friedberg MK, Sensoy B, Suleymanoglu M, Akin Y, Sahan E, Sasmaz H, Pasca L, Buzdugan E, Chis B, Stoicescu L, Lynce FC, Smith KL, Mete M, Isaacs C, Viapiana O, Di Nora C, Ognibeni F, Fracassi E, Giollo A, Mazzone C, Faganello G, Di Lenarda A, Rossini M, Galrinho A, Branco L, Timoteo AT, Rodrigues I, Daniel P, Rosa S, Ferreira L, Ferreira R, Polak L, Krauza G, Stokfisz K, Zielinska M, Branco LM, Galrinho A, Mota Carmo M, Teresa Timoteo A, Aguiar Rosa S, Abreu J, Pinto Teixeira P, Viveiros Monteiro A, Cruz Ferreira R, Peeraphatdit T, Chaiteerakij R, Klarich KW, Masia S, Necas J, Nistri S, Negri F, Barbati G, Cioffi G, Russo G, Mazzone C, Faganello G, Pandullo C, Di Lenarda A, Durante A, Rovelli E, Genchi V, Trabattoni L, Zerboni SC, Cattaneo L, Butti E, Ferrari G, Luneva E, Mitrofanova L, Uspensky V, Zemtsovsky E, Kasprzak JD, Rosner S, Karl M, Ott I, Sonne C, Ali Lahmar HM, Hammou L, Forsey J, Gowing L, Miller F, Ramanujam P, Stuart AG, Williams CA, Bandera F, Pellegrino M, Carbone F, Labate V, Alfonzetti E, Guazzi M, Patel NR, Raju P, Beale L, Brickley G, Lloyd GW, Fernandez-Golfin C, Gonzalez A, Rincon LM, Hinojar R, Garcia A, Megias A, Jimenez-Nacher JJ, Moya JL, Zamorano JL, Molon G, Canali G, Bonapace S, Chiampan A, Albrigi L, Barbieri E, Noris Mora M, Rodriguez Fernandez A, Exposito Pineda C, Grande C, Gonzalez Colino R, Macaya Ten F, Fernandez Vazquez X, Fortuny Frau E, Bethencourt Gonzalez A, Karvandi M, Blaszczyk R, Zarczuk R, Brzozowski W, Janowski M, Wysokinski A, Stanczyk B, Myftiu S, Teferici D, Quka A, Dado E, Djamandi J, Kresto L, Duka A, Kristo A, Balla I, Issa Z, Moiduddin N, Siblini G, Bulbul Z, Abid L, Abid D, Kammoun S, Rush E, Craft M, Goodwin J, Kreikemeier R, Cantinotti M, Kutty S, Zolaly MA, Khoshhal SQ, El-Harbi K, Tarawah A, Al-Hawsawi Z, Al-Mozainy I, Bakhoum SWG, Nabil MN, Elebrashy IN, Chinali M, Albanese S, Carotti A, Iacobelli R, Esposito C, Secinaro A, Moscogiuri G, Pasquini L, Malvezzi Caracciolo M, Bianchi RM, Caso P, Arenga F, Riegler L, Scarafile R, D'andrea A, Russo MG, Calabro' P, Simic DS, Peric VP, Mujovic NM, Marinkovic MM, Jankovic NJ, Shim A, Wejner-Mik P, Kasprzak JD, Lipiec P, Jain N, Kharwar R, Saran RK, Narain VS, Dwivedi SK, Sethi R, Chandra S, Pradhan A, Safal S, Marchetti MF, Cacace C, Congia M, Nissardi V, Ruscazio M, Meloni L, Montisci R, Gallego Sanchez G, Calero S, Portero JJ, Tercero A, Garcia JC, Barambio M, Martinez Lazaro R, Meretta AH, Perea GO, Belcastro F, Aguirre E, De Luca I, Henquin R, Masoli O. Poster session 2THE IMAGING EXAMINATIONP536Appropriate use criteria of transthoracic echocardiography and its clinical impact: a continuous challengeP537Implementation of proprietary plug-ins in the DICOM-based computerized echo reporting system fuels the use of 3D echo and deformation imaging in the clinical routine of a multivendor laboratoryP538Exercise stress echocardiography appropriate use criteria: real-life cases classification ease and agreement among cardiologistsANATOMY AND PHYSIOLOGY OF THE HEART AND GREAT VESSELSP539Functional capacity in older people with normal ejection fraction correlates with left ventricular functional reserve and carotid-femoral pulse wave velocity but not with E/e and augmentation indexP540Survey of competency of practitioners for diagnosis of acute cardiopulmonary diseases manifest on chest x-rayASSESSMENT OF DIAMETERS, VOLUMES AND MASSP541Left atrium remodeling in dialysis patients with normal ejection fractionP542The prediction of postinfarction left ventricular remodeling and the role of of leptin and MCP-1 in regard to the presence of metabolic syndromeP543Ascending aorta and common carotid artery: diameters and stiffness in a group of 584 healthy subjectsAssessments of haemodynamicsP544Alternate echo parameters in patients without estimable RVSPAssessment of systolic functionP545Reduced contractile performance in heart failure with preserved ejection fraction: determination using novel preload-adjusted maximal left ventricular ejection forceP546Left ventricular dimensions and prognosis in acute coronary syndromesP547Time course of myocardial alterations in a murine model of high fat diet: A strain rate imaging studyP548Subclinical left ventricular systolic dysfunction in patients with premature ventricular contractionsP549Global myocardial strain by CMR-based feature tracking (FT) and tagging to predict development of severe left ventricular systolic dysfunction after acute st-elevation myocardial infarctionP550Echocardiographic analysis of left and right ventricular function in patients after mitral valve reconstructionP551The role of regional longitudinal strain assessment in predicting response to cardiac resynchronization therapy in patients with left ventricular systolic dysfunction and left bundle branch blockP552Speckle tracking automatic border detection improves echocardiographic evaluation of right ventricular systolic function in repaired tetralogy of fallot patients: comparison with MRI findingsP553Echocardiography: a reproducible and relevant tool in pah? intermediate results of the multicentric efort echogardiographic substudy (evaluation of prognostic factors and therapeutic targets in pah)Assessment of diastolic functionP554Relationship between left ventricular filling pressures and myocardial fibrosis in patients with uncomplicated arterial hypertensionP555Cardiac rehabilitation improves echocardiographic parameters of diastolic function in patients with ischemic heart diseaseP556Diastolic parameters in the calcified mitral annulusP557Biomarkers and echocardiography - combined weapon to diagnose and prognose heart failure with and without preserved ejection fractionP558Diastolic function changes of the maternal heart in twin and singleton pregnancyIschemic heart diseaseP559Syntax score as predictor for the correlation between epicardial adipose tissue and the severity of coronary lesions in patients with significant coronary diseaseP560Impact of strain analysis in ergonovine stress echocardiography for diagnosis vasospastic anginaP561Cardiac magnetic resonance tissue tracking: a novel method to predict infarct transmurality in acute myocardial infarctionP562Infarct size is correlated to global longitudinal strain but not left ventricular ejection fraction in the early stage of acute myocardial infarctionP563Magnetic resonance myocardial deformation assessment with tissue tracking and risk stratification in acute myocardial infarction patientsP564Increase in regional end-diastolic wall thickness by transthoracic echocardiography as a biomarker of successful reperfusion in anterior ST elevation acute myocardial infarctionP565Mitral regurgitation is associated with worse long-term prognosis in ST-segment elevation myocardial infarction treated with primary percutaneous coronary interventionP566Statistical significance of 3D motion and deformation indexes for the analysis of LAD infarctionHeart valve DiseasesP567Paradoxical low gradient aortic stenosis: echocardiographic progression from moderate to severe diseaseP568The beneficial effects of TAVI in mitral insufficiencyP569Impact of thoracic aortic calcification on the left ventricular hypertrophy and its regression after aortic valve replacement in patients with severe aortic stenosisP570Additional value of exercise-stress echocardiography in asymptomatic patients with aortic valve stenosisP571Valvulo-arterial impedance in severe aortic stenosis: a dual imaging modalities studyP572Left ventricular mechanics: novel tools to evaluate left ventricular performance in patients with aortic stenosisP573Comparison of long-term outcome after percutaneous mitral valvuloplasty versus mitral valve replacement in moderate to severe mitral stenosis with left ventricular dysfunctionP574Incidence of de novo left ventricular dysfunction in patient treated with aortic valve replacement for severe aortic regurgitationP575Transforming growth factor-beta dependant progression of the mitral valve prolapseP576Quantification of mitral regurgitation with multiple jets: in vitro validation of three-dimensional PISA techniqueP577Impaired pre-systolic contraction and saddle-shape deepening of mitral annulus contributes to atrial functional regurgitation: a three-dimensional echocardiographic studyP578Incidence and determinants of left ventricular (lv) reverse remodeling after MitraClip implantation in patients with moderate-to severe or severe mitral regurgitation and reduced lv ejection fractionP579Severe functional tricuspid regurgitation in rheumatic heart valve disease. New insights from 3D transthoracic echocardiographyP58015 years of evolution of the etiologic profile for prosthetic heart valve replacement through an echocardiography laboratoryP581The role of echocardiography in the differential diagnosis of prolonged fever of unknown originP582Predictive value for paravalvular regurgitation of 3-dimensional anatomic aortic annulus shape assessed by multidetector computed tomography post-transcatheter aortic valve replacementP583The significance and advantages of echo and CT imaging & measurement at transcatherter aortic valve implantation through the left common carotid accessP584Comparison of the self-expandable Medtronic CoreValve versus the balloon-expandable Edwards SAPIEN bioprostheses in high-risk patients undergoing transfemoral aortic valve implantationP585The impact of transcatheter aortic valve implantation on mitral regurgitation severityP586Echocardiographic follow up of children with valvular lesions secondary to rheumatic heart disease: Data from a prospective registryP587Valvular heart disease and different circadian blood pressure profilesCardiomyopathiesP588Comparison of transthoracic echocardiography versus cardiac magnetic for implantable cardioverter defibrillator therapy in primary prevention strategy dilated cardiomyopathy patientsP589Incidence and prognostic significance of left ventricle reverse remodeling in a cohort of patients with idiopathic dilated cardiomyopathyP590Early evaluation of diastolic function in fabry diseaseP591Echocardiographic predictors of atrial fibrillation development in hypertrophic cardiomyopathyP592Altered Torsion mechanics in patients with hypertrophic cardiomyopathy: LVOT-obstruction is the topdog?P593Prevention of sudden cardiac death in hypertrophic cardiomyopathy: what has changed in the guidelines?P594Coronary microcirculatory function as determinator of longitudinal systolic left ventricular function in hypertrophic cardiomyopathyP595Detection of subclinical myocardial dysfunction by tissue Doppler ehocardiography in patients with muscular dystrophiesP596Speckle tracking myocardial deformation analysis and three dimensional echocardiography for early detection of chemotherapy induced cardiac dysfunction in bone marrow transplantation patientsP597Left ventricular non compaction or hypertrabeculation: distinguishing between physiology and pathology in top-level athletesP598Role of multi modality imaging in familiar screening of Danon diseaseP599Early impairment of global longitudinal left ventricular systolic function independently predicts incident atrial fibrillation in type 2 diabetes mellitusP600Fetal cardiovascular programming in maternal diabetes mellitus and obesity: insights from deformation imagingP601Longitudinal strain stress echo evaluation of aged marginal donor hearts: feasibility in the Adonhers project.P602Echocardiographic evaluation of left ventricular size and function following heart transplantation - Gender mattersSystemic diseases and other conditionsP603The impact of septal kinetics on adverse ventricular-ventricular interactions in pulmonary stenosis and pulmonary arterial hypertensionP604Improvement in right ventricular mechanics after inhalation of iloprost in pulmonary hypertensionP605Does the treatment of patients with metabolic syndrome correct the right ventricular diastolic dysfunction?P606Predictors of altered cardiac function in breast cancer survivors who were treated with anthracycline-based therapyP607Prevalence and factors related to left ventricular systolic dysfunction in asymptomatic patients with rheumatoid arthritis: a prospective tissue-doppler echocardiography studyP608Diastolic and systolic left ventricle dysfunction presenting different prognostic implications in cardiac amyloidosisP609Diagnostic accuracy of Bedside Lung Ultrasonography in Emergency (BLUE) protocol for the diagnosis of pulmonary embolismP610Right ventricular systolic dysfunction and its incidence in breast cancer patients submitted to anthracycline therapyP611Right ventricular dysfunction is an independent predictor of survival among cirrhotic patients undergoing liver transplantCongenital heart diseaseP612Hypoplasia or absence of posterior leaflet: a rare congenital anomaly of the mitral valveP613ECHO screening for Barlow disease in proband's relativesDiseases of the aortaP614Aortic size distribution and prognosis in an unselected population of patients referred for standard transthoracic echocardiographyP615Abdominal aorta aneurysm ultrasonographic screening in a large cohort of asympromatic volounteers in an Italian urban settingP616Thoracic aortic aneurysm and left ventricular systolic functionStress echocardiographyP617Wall motion score index, systolic mitral annulus velocity and left ventricular mass predicted global longitudinal systolic strain in 238 patients examined by stress echocardiographyP618Prognostic parameters of exercise-induced severe mitral valve regurgitation and exercise-induced systolic pulmonary hypertensionP619Risk stratification after myocardial infarction: prognostic value of dobutamine stress echocardiographyP620relationship between LV and RV myocardial contractile reserve and metabolic parameters during incremental exercise and recovery in healthy children using 2-D strain analysisP621Increased peripheral extraction as a mechanism compensatory to reduced cardiac output in high risk heart failure patients with group 2 pulmonary hypertension and exercise oscillatory ventilationP622Can exercise induced changes in cardiac synchrony predict response to CRT?Transesophageal echocardiographyP623Fully-automated software for mitral valve assessment in chronic mitral regurgitation by three-dimensional transesophageal echocardiographyP624Real-time 3D transesophageal echocardiography provides more accurate orifice measurement in percutaneous transcatheter left atrial appendage closureP625Percutaneous closure of left atrial appendage: experience of 36 casesReal-time three-dimensional TEEP626Real-time three-dimensional transesophageal echocardiography during pulmonary vein cryoballoon ablation for atrial fibrilationP627Three dimensional ultrasound anatomy of intact mitral valve and in the case of type 2 disfunctionTissue Doppler and speckle trackingP629Left ventricle wall motion tracking from echocardiographic images by a non-rigid image registrationP630The first experience with the new prototype of a robotic system for remote echocardiographyP631Non-invasive PCWP influence on a loop diuretics regimen monitoring model in ADHF patients.P632Normal range of left ventricular strain, dimensions and ejection fraction using three-dimensional speckle-tracking echocardiography in neonatesP633Circumferential ascending aortic strain: new parameter in the assessment of arterial stiffness in systemic hypertensionP634Aortic vascular properties in pediatric osteogenesis imperfecta: a two-dimensional echocardiography derived aortic strain studyP635Assessment of cardiac functions in children with sickle cell anemia: doppler tissue imaging studyP636Assessment of left ventricular function in type 1 diabetes mellitus patients by two-dimensional speckle tracking echocardiography: relation to duration and control of diabetesP637A study of left ventricular torsion in l-loop ventricles using speckle-tracking echocardiographyP638Despite No-Reflow, global and regional longitudinal strains assessed by two-dimensional speckle tracking echocardiography are predictive indexes of left ventricular remodeling in patients with STEMIP639The function of reservoir of the left atrium in patients with medicaly treated arterial hypertensionP640The usefulness of speckle tracking analysis for predicting the recovery of regional systolic function after myocardial infarctionP641Two dimensional speckle tracking echocardiography in assessment of left ventricular systolic function in patients with rheumatic severe mitral regurgitation and normal ejection fractionP642The prediction of left-main and tripple vessel coronary artery disease by tissue doppler based longitudinal strain and strain rate imagingP643Role of speckle tracking in predicting arrhythmic risk and occurrence of appropriate implantable defibrillator Intervention in patients with ischemic and non-ischemic cardiomyopathyComputed Tomography & Nuclear CardiologyP644Cardiac adrenergic activity in patients with nonischemic dilated cardiomyopathy. Correlation with echocardiographyP645Different vascular territories and myocardial ischemia, there is a gradient of association? Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ponsford M, Carne E, Kingdon C, Joyce C, Price C, Williams C, El-Shanawany T, Williams P, Jolles S. Facilitated subcutaneous immunoglobulin (fSCIg) therapy--practical considerations. Clin Exp Immunol 2015; 182:302-13. [PMID: 26288095 DOI: 10.1111/cei.12694] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 08/03/2015] [Accepted: 08/05/2015] [Indexed: 12/30/2022] Open
Abstract
There is an increasing range of therapeutic options for primary antibody-deficient patients who require replacement immunoglobulin. These include intravenous immunoglobulin (IVIg), subcutaneous immunoglobulin (SCIg), rapid push SCIg and most recently recombinant human hyaluronidase-facilitated SCIg (fSCIg). Advantages of fSCIg include fewer needle punctures, longer infusion intervals and an improved adverse effect profile relative to IVIg. Limited real-life experience exists concerning the practical aspects of switching or starting patients on fSCIg. We describe the first 14 patients who have been treated with fSCIg at the Immunodeficiency Centre for Wales (ICW), representing more than 6 patient-years of experience. The regimen was well tolerated, with high levels of satisfaction and no increase in training requirement, including for a treatment-naive patient. Two patients discontinued fSCIg due to pain and swelling at the infusion site, and one paused therapy following post-infusion migraines. Ultrasound imaging of paired conventional and facilitated SCIg demonstrated clear differences in subcutaneous space distribution associated with a 10-fold increase in rate and volume delivery with fSCIg. Patient profiles for those choosing fSCIg fell into two main categories: those experiencing clinical problems with their current treatment and those seeking greater convenience and flexibility. When introducing fSCIg, consideration of the type and programming of infusion pump, needle gauge and length, infusion site, up-dosing schedule, home training and patient information are important, as these may differ from conventional SCIg. This paper provides guidance on practical aspects of the administration, training and outcomes to help inform decision-making for this new treatment modality.
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Affiliation(s)
- M Ponsford
- Immunodeficiency Centre for Wales, Department of Immunology
| | - E Carne
- Immunodeficiency Centre for Wales, Department of Immunology
| | - C Kingdon
- Immunodeficiency Centre for Wales, Department of Immunology
| | - C Joyce
- Immunodeficiency Centre for Wales, Department of Immunology
| | - C Price
- Immunodeficiency Centre for Wales, Department of Immunology
| | - C Williams
- Department of Radiology, University Hospital of Wales, Cardiff, UK
| | - T El-Shanawany
- Immunodeficiency Centre for Wales, Department of Immunology
| | - P Williams
- Immunodeficiency Centre for Wales, Department of Immunology
| | - S Jolles
- Immunodeficiency Centre for Wales, Department of Immunology
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Thies SB, Price C, Kenney LPJ, Baker R. Effects of shoe sole geometry on toe clearance and walking stability in older adults. Gait Posture 2015; 42:105-9. [PMID: 26032398 DOI: 10.1016/j.gaitpost.2015.04.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 10/29/2014] [Revised: 02/10/2015] [Accepted: 04/20/2015] [Indexed: 02/02/2023]
Abstract
Thirty-five percent of people above age 65 fall each year, and half of their falls are associated with tripping: tripping, an apparently 'mundane' everyday problem, therefore, significantly impacts on older people's health and associated medical costs. To avoid tripping and subsequent falling, sufficient toe clearance during the swing phase is crucial. We previously found that a rocker-shaped shoe sole enhances toe clearance in young adults, thereby decreasing their trip-risk. This study investigates whether such sole design also enhances older adults' toe clearance, without inadvertently affecting their walking stability. Toe clearance and its variability are reported together with measures of walking stability for twelve older adults, walking in shoes with rocker angles of 10°, 15°, and 20°. Surface inclinations (flat, incline, decline) were chosen to reflect a potential real-world environment. Toe clearance increased substantially from the 10° to the 15° rocker angle (p=0.003) without compromising measures of walking stability (p>0.05). A further increase in rocker angle to 20° resulted in less substantial enhancement of toe clearance and came at the cost of a decrease in gait speed on the decline. The novelty of this investigation lies in the exploration of the trade-off between reduction of trip-risk through footwear design and adverse effects on walking stability on real-life relevant surfaces. Our two studies suggest that the current focus on slip-resistance in footwear design may need to be generalised to include other factors that affect trip-risk.
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Affiliation(s)
- S B Thies
- Centre for Health Sciences Research, Salford University, UK.
| | - C Price
- Centre for Health Sciences Research, Salford University, UK
| | - L P J Kenney
- Centre for Health Sciences Research, Salford University, UK
| | - R Baker
- Operations Management, Management Science and Statistics, Salford University, UK
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Yapura J, Badea I, Zamberlam G, Price C, Mapletoft R, Pierson R, Singh J, Adams G. Formulation and testing of a non-steroidal aromatase inhibitor intravaginal device for the control of ovarian function in cattle. Anim Reprod Sci 2015; 156:91-102. [DOI: 10.1016/j.anireprosci.2015.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 02/17/2015] [Accepted: 03/10/2015] [Indexed: 12/11/2022]
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Price C. Opioid Risk Management. Br J Anaesth 2014. [DOI: 10.1093/bja/aeu327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Price C, Lee J, Taylor AM, Baranowski AP. Initial assessment and management of pain: a pathway for care developed by the British Pain Society. Br J Anaesth 2014; 112:816-23. [PMID: 24638234 DOI: 10.1093/bja/aet589] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
There is wide variation in how pain is managed in the UK. Patients often find themselves caught in a sea of referrals while continuing to suffer with poorly relieved symptoms. The British Pain Society's (BPS) Initial Assessment and Management of Pain care pathway (one of the five new BPS care pathways published by the Map of Medicine(®)) sets out how best to initially manage persistent pain. Patient education and supported self-management is recommended from an early stage. This pathway focuses on the start of the journey of a patient with pain, where a full diagnostic work-up is not yet complete. The pathway covers diverse recommendations such as appropriate content of a pain consultation, the use of clinical decision management tools to aid stratification of care, and resources to support patients to make informed decisions. Recommendations for monitoring of therapeutic effect are also included. Early identification of people at high risk of chronic disability may allow more intensive management, better use of resources, and reduction in disability. Implementation poses significant challenges; more research is needed to determine the most effective interventions. This article highlights practice points for the non-specialist, discusses areas of controversy, and examines the challenges of implementation.
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Affiliation(s)
- C Price
- Pain Medicine, Pain Clinic, University Hospital of Southampton Foundation Trust, Tremona Road, Room OC9, Southampton, Hampshire SO16 6YD, UK
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Baranowski AP, Lee J, Price C, Hughes J. Pelvic pain: a pathway for care developed for both men and women by the British Pain Society. Br J Anaesth 2014; 112:452-9. [PMID: 24394942 DOI: 10.1093/bja/aet421] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This paper aims to explain the key points and highlight some of the controversies in the development of the British Pain Society's pelvic pain patient pathway map. Many clinicians lack experience and confidence with this group of patients, and this issue is highlighted. Additionally, the difficulties of classification and definitions in this area are discussed in detail. These are historical causes of disagreement among specialists which can lead to confused clinical care. This group of patients have multiple issues that cross many professional boundaries; they are best managed by the co-ordinated involvement of multiple teams. Patients suffer from significant distress and disability that often needs specialist assessment and intervention (interdisciplinary). This suggests that an integrated approach is required across the historic boundaries of primary and secondary care. A variety of interventions, including opioids and neuromodulation are recommended in the pathway and the controversies surrounding these inclusions are aired in detail.
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Affiliation(s)
- A P Baranowski
- Pain Medicine, Pain Management Centre, National Hospital for Neurology & Neurosurgery, University College London Hospitals Foundation Trust, London WC1N 3BG, UK
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Lee J, Ellis B, Price C, Baranowski A. Chronic widespread pain, including fibromyalgia: a pathway for care developed by the British Pain Society. Br J Anaesth 2014; 112:16-24. [DOI: 10.1093/bja/aet351] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ho MA, Price C, King CK, Virtue P, Byrne M. Effects of ocean warming and acidification on fertilization in the Antarctic echinoid Sterechinus neumayeri across a range of sperm concentrations. Mar Environ Res 2013; 90:136-141. [PMID: 23948149 DOI: 10.1016/j.marenvres.2013.07.007] [Citation(s) in RCA: 6] [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: 06/16/2013] [Revised: 07/20/2013] [Accepted: 07/22/2013] [Indexed: 06/02/2023]
Abstract
The gametes of marine invertebrates are being spawned into an ocean that is simultaneously warming and decreasing in pH. Predicting the potential for interactive effects of these stressors on fertilization is difficult, especially for stenothermal polar invertebrates adapted to fertilization in cold, viscous water and, when decreased sperm availability may be an additional stressor. The impact of increased temperature (2-4 °C above ambient) and decreased pH (0.2-0.4 pH units below ambient) on fertilization in the Antarctic echinoid Sterechinus neumayeri across a range of sperm concentrations was investigated in cross-factorial experiments in context with near future ocean change projections. The high temperature treatment (+4 °C) was also used to assess thermal tolerance. Gametes from multiple males and females in replicate experiments were used to reflect the multiple spawner scenario in nature. For fertilization at low sperm density we tested three hypotheses, 1) increased temperature enhances fertilization success, 2) low pH reduces fertilization and, 3) due to the cold stenothermal physiology of S. neumayeri, temperature would be the more significant stressor. Temperature and sperm levels had a significant effect on fertilization, but decreased pH did not affect fertilization. Warming enhanced fertilization at the lowest sperm concentration tested likely through stimulation of sperm motility and reduced water viscosity. Our results indicate that fertilization in S. neumayeri, even at low sperm levels potentially found in nature, is resilient to near-future ocean warming and acidification.
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Affiliation(s)
- M A Ho
- School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
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Smith B, Lee J, Price C, Baranowski A. Neuropathic pain: a pathway for care developed by the British Pain Society. Br J Anaesth 2013. [DOI: 10.1093/bja/aet302] [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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Abstract
Neuropathic pain is a common chronic pain condition that can be challenging to treat, particularly for non-specialists. The development of the Map of Medicine care pathway for the management of neuropathic pain was led by the British Pain Society. Focusing on treatment by non-specialists, this pathway is based on new evidence, consensus, and the interests of service users. This paper presents the care pathway and accompanying evidence base, highlighting its salient features, and discussing important treatment points. After initial assessment, the pathway progresses through first-, second-, and third-line drug treatment, includes advice on topical treatment and opioids (in specific circumstances), and describes non-pharmacological approaches. Importantly, timely review of patients and referral to specialist secondary or tertiary care must be considered as vital components of the pathway. Although the emphasis was not on specialist treatment, advice is given on existing interventions, including neural stimulation and multi-disciplinary care. These, and other steps on the pathway, will be subject to further review as more evidence becomes available. In the meantime, the pathway represents a straightforward, valuable and accessible approach for healthcare professionals managing the distress and impact of neuropathic pain.
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Affiliation(s)
- B H Smith
- Division of Population Health Sciences, Ninewells Hospital & Medical School, University of Dundee, Dundee DD2 4DB, UK.
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Parke E, Hart J, Baldock D, Barchard K, Etcoff L, Allen D, Stolberg P, Nardi N, Cohen J, Jones W, Loe S, Etcoff L, Delgaty L, Tan A, Bunner M, Delgaty L, Tan A, Bunner M, Tan A, Delgaty L, Bunner M, Tan A, Delgaty L, Bunner M, Goodman G, Kim W, Nolty A, Marion S, Davis A, Finch W, Piehl J, Moss L, Nogin R, Dean R, Davis J, Lindstrom W, Poon M, Fonseca F, Bure-Reyes A, Stewart J, Golden C, Fonseca F, Bure-Reyes A, Stewart J, Golden C, Fields K, Hill B, Corley E, Russ K, Boettcher A, Musso M, Rohling M, Rowden A, Downing K, Benners M, Miller D, Maricle D, Dugbartey T, Anum A, Anderson J, Daniel M, Hoskins L, Gillis K, Khen S, Carter K, Ayers C, Neeland I, Cullum M, Weiner M, Rossetti H, Buddin W, Mahal S, Schroeder R, Baade L, Macaluso M, Phelps K, Evans C, Clark J, Vickery C, Chow J, Stokic D, Phelps K, Evans C, Watson S, Odom R, Clark J, Clark J, Odom R, Evans C, Vickery C, Thompson J, Noggle C, Kane C, Kecala N, Lane E, Raymond M, Woods S, Iudicello J, Dawson M, Ghias A, Choe M, 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Graca J, Olson S, Melville T, Harley A, La D, Phoong M, Gill S, Jocson VA, Nunan-Saah J, Keller J, Gomez R, Melville T, Kaminetskaya M, Poole J, Vernon A, Van Vleet T, DeGutis J, Chen A, Marini C, Dabit S, Gallegos J, Zomet A, Merzenich M, Thaler N, Linck J, Heyanka D, Pastorek N, Miller B, Romesser J, Sim A, Allen D, Zimmer A, Marcinak J, Hibyan S, Webbe F, Rainwater B, Francis J, Baum L, Sautter S, Donders J, Hui E, Barnes K, Walls G, Erikson S, Bailie J, Schwab K, Ivins B, Boyd C, Neff J, Cole W, Lewis S, Bailie J, Schwab K, Ivins B, Boyd C, Neff J, Cole W, Lewis S, Ramirez C, Oganes M, Gold S, Tanner S, Pina D, Merritt V, Arnett P, Heyanka D, Linck J, Thaler N, Pastorek N, Miller B, Romesser J, Sim A, Parks A, Roskos P, Gfeller J, Clark A, Isham K, Carter J, McLeod J, Romero R, Dahdah M, Barisa M, Schmidt K, Barnes S, Dubiel R, Dunklin C, Harper C, Callender L, Wilson A, Diaz-Arrastia R, Shafi S, Jacquin K, Bolshin L, Jacquin K, Romers C, Gutierrez E, Messerly J, Tsou J, Adler M, Golden C, Harmell A, Mausbach B, Moore R, Depp C, Jeste D, Palmer B, Hoadley R, Hill B, Rohling M, Mahdavi S, Fine J, daCruz K, Dinishak D, Richardson G, Vertinski M, Allen D, Mayfield J, Margolis S, Miele A, Rabinovitz B, Schaffer S, Kline J, Boettcher A, Hill B, Hoadley R, Rohling M, Eichstaedt K, Vale F, Benbadis S, Bozorg A, Rodgers-Neame N, Rinehardt E, Mattingly M, Schoenberg M, Fares R, Fares R, Carrasco R, Grups J, Evans B, Simco E, Mittenberg W, Carrasco R, Grups J, Evans B, Simco E, Mittenberg W, Rach A, Baughman B, Young C, Bene E, Irwin C, Li Y, Poulin R, Jerram M, Susmaras T, Gansler D, Ashendorf L, Miarmi L, Fazio R, Cantor J, Fernandez A, Godoy-Garcete G, Marchetti P, Harrison A, Armstrong I, Harrison L, Iverson G, Brinckman D, Ayaz H, Schultheis M, Heinly M, Vitelli K, Russler K, Sanchez I, Jones W, Loe S, Raines T, Hart J, Bene E, Li Y, Irwin C, Baughman B, Rach A, Bravo J, Schilling B, Weiss L, Lange R, Shewchuk J, Heran M, Rauscher A, Jarrett M, Brubacher J, Iverson 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POSTER SESSIONS SCHEDULE. Arch Clin Neuropsychol 2013. [DOI: 10.1093/arclin/act054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lee J, Gupta S, Price C, Baranowski A. Low back and radicular pain: a pathway for care developed by the British Pain Society. Br J Anaesth 2013; 111:112-20. [DOI: 10.1093/bja/aet172] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [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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Sui X, Price C, Li Z, Chen J. Crosstalk Between DNA and Histones: Tet's New Role in Embryonic Stem Cells. Curr Genomics 2013; 13:603-8. [PMID: 23730200 PMCID: PMC3492800 DOI: 10.2174/138920212803759730] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Revised: 09/05/2012] [Accepted: 09/05/2012] [Indexed: 01/09/2023] Open
Abstract
Embryonic stem (ES) cells are characterized by the expression of an extensive and interconnected network of pluripotency factors which are downregulated in specialized cells. Epigenetic mechanisms, including DNA methylation and histone modifications, are also important in maintaining this pluripotency program in ES cells and in guiding correct differentiation of the developing embryo. Methylation of the cytosine base of DNA blocks gene expression in all cell types and further modifications of methylated cytosine have recently been discovered. These new modifications, putative intermediates in a pathway to erase DNA methylation marks, are catalyzed by the ten-eleven translocation (Tet) proteins, specifically by Tet1 and Tet2 in ES cells. Surprisingly, Tet1 shows repressive along with active effects on gene expression depending on its distribution throughout the genome and co-localization with Polycomb Repressive Complex 2 (PRC2). PRC2 di- and tri-methylates lysine 27 of histone 3 (H3K27me2/3 activity), marking genes for repression. In ES cells, almost all gene loci containing the repressive H3K27me3 modification also bear the active H3K4me3 modification, creating "bivalent domains" which mark important developmental regulators for timely activation. Incorporation of Tet1 into the bivalent domain paradigm is a new and exciting development in the epigenetics field, and the ramifications of this novel crosstalk between DNA and histone modifications need to be further investigated. This knowledge would aid reprogramming of specialized cells back into pluripotent stem cells and advance understanding of epigenetic perturbations in cancer.
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Affiliation(s)
- Xinyi Sui
- Section of Hematology/Oncology, Department of Medicine ; The College, University of Chicago, Chicago, IL 60637, USA
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