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Wallner K, Kearney KE, Tiwana J, Pristera N, Kim EY, Sandison G, Lombardi WL, Phillips ML, Don C, Azzalini L, Kim M. Extreme coronary radiation doses from intravascular brachytherapy. Cardiovasc Revasc Med 2024; 59:29-34. [PMID: 37684192 DOI: 10.1016/j.carrev.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023]
Abstract
PURPOSE To evaluate coronary artery integrity after very high radiation doses from intravascular brachytherapy (IVBT) in the setting of source asymmetry. METHODS Ten patients treated for right coronary artery (RCA) in-stent restenosis (ISR) between 2017 and 2021 and for whom follow-up angiograms were available were identified from departmental records. Procedural angiograms, taken to document source position, were used to estimate vascular wall doses. The 2.5 mm proximal source marker was used to estimate the distance from source center to the media and adventitia. Distances were converted to dose (Gy) using the manufacturers' dose fall-off table, measured in water. Follow-up films were scrutinized for any sign of late vascular damage. RESULTS The average minimal distance from catheter center to the adjacent media and the adventitia was 0.9 mm (±0.2) mm and 1.4 mm (±0.2), respectively. The average maximum media and adventitial doses adjacent to the source were 75 Gy (±26) and 39 Gy (±14), respectively. Follow-up angiograms were available from 0.6 years to 3.9 years following IVBT (median: 1.6 years). No IVBT-treated vascular segment showed signs of degeneration, dissection or aneurysm. CONCLUSION IVBT vascular wall doses are frequently far higher than prescribed. The lack of complications in this unselected group of patients gives a modicum of reassurance that raising the prescription dose is unlikely to lead to a sudden appearance of complications.
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Affiliation(s)
- Kent Wallner
- Department of Radiation Oncology, University of Washington, Seattle, WA, United States of America.
| | - Kathleen E Kearney
- Department of Cardiology, University of Washington, Seattle, WA, United States of America
| | - Jasleen Tiwana
- Department of Cardiology, University of Washington, Seattle, WA, United States of America
| | - Nicole Pristera
- Department of Cardiology, University of Washington, Seattle, WA, United States of America
| | - Edward Y Kim
- Department of Radiation Oncology, University of Washington, Seattle, WA, United States of America
| | - George Sandison
- Department of Radiation Oncology, University of Washington, Seattle, WA, United States of America
| | - William L Lombardi
- Department of Cardiology, University of Washington, Seattle, WA, United States of America
| | - Mark L Phillips
- Department of Radiation Oncology, University of Washington, Seattle, WA, United States of America
| | - Creighton Don
- Department of Cardiology, University of Washington, Seattle, WA, United States of America
| | - Lorenzo Azzalini
- Department of Cardiology, University of Washington, Seattle, WA, United States of America
| | - Minsun Kim
- Department of Radiation Oncology, University of Washington, Seattle, WA, United States of America
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2
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Chau B, Loggers ET, Cranmer LD, Mogal H, Sharib JM, Kim EY, Schaub SK, Paulson KG, Linden HM, Specht JM, Kim JN, Javid SH, Wagner MJ. Secondary Breast Angiosarcoma After a Primary Diagnosis of Breast Cancer: A Retrospective Analysis of the Surveillance, Epidemiology, and End Results (SEER) Database. Am J Clin Oncol 2023; 46:567-571. [PMID: 37725702 PMCID: PMC10841185 DOI: 10.1097/coc.0000000000001045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
OBJECTIVES Angiosarcoma is a rare complication of breast-conserving therapy. This study evaluated the change in incidence between 1992 and 2016 of secondary breast angiosarcoma (SBA) in patients with a history of breast cancer and the impact of management strategies for the original breast carcinoma on angiosarcoma treatment. METHODS Breast cancer and angiosarcoma cases were abstracted from the Surveillance, Epidemiology, and End Result (SEER) database. SBAs were defined as angiosarcomas located in the breast occurring after a prior breast cancer diagnosis. Primary breast angiosarcomas (PBAs) were defined as an angiosarcoma diagnosis listed as "one primary only." Incidence rates were estimated using a proportion of the US total population. Survival was analyzed by the Kaplan-Meier method, and Cox proportional hazard models were used to assess the association of clinicopathologic characteristics on overall survival. RESULTS Between 1992 and 2016, 193 cases of SBA were reported in the SEER dataset in patients with a prior history of breast cancer. The incidence of breast angiosarcoma in patients with a prior diagnosis of breast cancer increased 3-fold from about 10 cases per 100,000 person-years to about 30 cases per 100,000 person-years over this same period ( P =0.0037). For treatment of SBA (n=193), almost all (95%) had surgery. Nine percent received radiation (compared with 35% of patients with PBA, P <0.001) and 23% received chemotherapy (vs. 45% for PBA, P =0.11). CONCLUSIONS We demonstrate an increasing incidence of SBA over the study period. These data can help inform shared decision-making for optimal management of locoregional breast cancer and raise awareness of secondary angiosarcoma.
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Affiliation(s)
- Bonny Chau
- Division of Medical Oncology
- Department of Surgery
| | | | | | - Harveshp Mogal
- Department of Surgery
- Clinical Research Division, Fred Hutchinson Cancer Center
| | - Jeremy M Sharib
- Department of Surgery
- Clinical Research Division, Fred Hutchinson Cancer Center
| | - Edward Y Kim
- Department of Radiation Oncology, University of Washington
- Clinical Research Division, Fred Hutchinson Cancer Center
| | - Stephanie K Schaub
- Department of Radiation Oncology, University of Washington
- Clinical Research Division, Fred Hutchinson Cancer Center
| | - Kelly G Paulson
- Medical Oncology, Providence-Swedish Cancer Institute, Seattle, WA
| | - Hannah M Linden
- Division of Medical Oncology
- Clinical Research Division, Fred Hutchinson Cancer Center
| | - Jennifer M Specht
- Division of Medical Oncology
- Clinical Research Division, Fred Hutchinson Cancer Center
| | - Janice N Kim
- Department of Radiation Oncology, University of Washington
- Clinical Research Division, Fred Hutchinson Cancer Center
| | - Sara H Javid
- Department of Surgery
- Clinical Research Division, Fred Hutchinson Cancer Center
| | - Michael J Wagner
- Division of Medical Oncology
- Clinical Research Division, Fred Hutchinson Cancer Center
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3
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Seo YD, Lu H, Black G, Smythe K, Yu Y, Hsu C, Ng J, Hermida de Viveiros P, Warren EH, Schroeder BA, O’Malley RB, Cranmer LD, Loggers ET, Wagner MJ, Bonham L, Pillarisetty VG, Kane G, Berglund P, Hsu FJ, Mi X, Alexiev BA, Pierce RH, Riddell SR, Jones RL, ter Meulen J, Kim EY, Pollack SM. Toll-Like Receptor 4 Agonist Injection With Concurrent Radiotherapy in Patients With Metastatic Soft Tissue Sarcoma: A Phase 1 Nonrandomized Controlled Trial. JAMA Oncol 2023; 9:1660-1668. [PMID: 37824131 PMCID: PMC10570919 DOI: 10.1001/jamaoncol.2023.4015] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/07/2023] [Indexed: 10/13/2023]
Abstract
Importance Metastatic soft tissue sarcomas (STSs) have limited systemic therapy options, and immunomodulation has not yet meaningfully improved outcomes. Intratumoral (IT) injection of the toll-like receptor 4 (TLR4) agonist glycopyranosyl lipid A in stable-emulsion formulation (GLA-SE) has been studied as immunotherapy in other contexts. Objective To evaluate the safety, efficacy, and immunomodulatory effects of IT GLA-SE with concurrent radiotherapy in patients with metastatic STS with injectable lesions. Design, Setting, and Participants This phase 1 nonrandomized controlled trial of patients with STS was performed at a single academic sarcoma specialty center from November 17, 2014, to March 16, 2016. Data analysis was performed from August 2016 to September 2022. Interventions Two doses of IT GLA-SE (5 μg and 10 μg for 8 weekly doses) were tested for safety in combination with concurrent radiotherapy of the injected lesion. Main Outcomes and Measures Primary end points were safety and tolerability. Secondary and exploratory end points included local response rates as well as measurement of antitumor immunity with immunohistochemistry and T-cell receptor (TCR) sequencing of tumor-infiltrating and circulating lymphocytes. Results Twelve patients (median [range] age, 65 [34-78] years; 8 [67%] female) were treated across the 2 dose cohorts. Intratumoral GLA-SE was well tolerated, with only 1 patient (8%) experiencing a grade 2 adverse event. All patients achieved local control of the injected lesion after 8 doses, with 1 patient having complete regression (mean regression, -25%; range, -100% to 4%). In patients with durable local response, there were detectable increases in tumor-infiltrating lymphocytes. In 1 patient (target lesion -39% at 259 days of follow-up), TCR sequencing revealed expansion of preexisting and de novo clonotypes, with convergence of numerous rearrangements coding for the same binding sequence (suggestive of clonal convergence to antitumor targets). Single-cell sequencing identified these same expanded TCR clones in peripheral blood after treatment; these T cells had markedly enhanced Tbet expression, suggesting TH1 phenotype. Conclusions and Relevance In this nonrandomized controlled trial, IT GLA-SE with concurrent radiotherapy was well tolerated and provided more durable local control than radiotherapy alone. Patients with durable local response demonstrated enhanced IT T-cell clonal expansion, with matched expansion of these clonotypes in the circulation. Additional studies evaluating synergism of IT GLA-SE and radiotherapy with systemic immune modulation are warranted. Trial Registration ClinicalTrials.gov Identifier: NCT02180698.
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Affiliation(s)
- Yongwoo David Seo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston
- Department of Surgery, University of Washington, Seattle
| | | | - Graeme Black
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Kimberly Smythe
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Yuexin Yu
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Cynthia Hsu
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle
| | - Juliana Ng
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - E. Houston Warren
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle
| | - Brett A. Schroeder
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | | | - Lee D. Cranmer
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle
| | - Elizabeth T. Loggers
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle
| | - Michael J. Wagner
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle
| | - Lynn Bonham
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | | | - Gabrielle Kane
- Department of Radiation Oncology, University of Washington, Seattle
| | | | | | - Xinlei Mi
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | | | - Stanley R. Riddell
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Robin L. Jones
- Royal Marsden and Institute for Cancer Research, London, UK
| | | | - Edward Y. Kim
- Department of Radiation Oncology, University of Washington, Seattle
| | - Seth M. Pollack
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Wallner K, Kearney KE, Tiwana J, Pristera N, Kim EY, Azzalini L, Sandison G, Lombardi WL, Don C, Kim M. Increased prescription dose for large vessel intravascular brachytherapy. Catheter Cardiovasc Interv 2023; 102:1034-1039. [PMID: 37855145 DOI: 10.1002/ccd.30852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/01/2023] [Accepted: 10/06/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Most randomized studies testing the effectiveness of IVBT were limited to vessels less than 4 mm diameter. In fact, it is now common to treat vessels larger than 4 mm. Accordingly, the authors instituted a prescription dose increase to 34 Gy at 2 mm from source center for vessels greater than 4.0 mm. The increase in prescription dose to 34 Gy at 2 mm from center is substantial, being 50% higher than the conventional maximum of 23 Gy. AIM To take a close look at group of patients treated to 34 Gy, and for whom follow-up angiograms are available. METHODS Ten patients treated for ISR with a prescription dose of 34 Gy and for whom follow-up angiograms were available were studied. Beta-radiation brachytherapy was performed with a Novoste Beta-Cath System using a strontium-90 (beta) source (Best Vascular, Springfield, VA). Source lengths of 40 or 60 mm were used. A dose of 34 Gy was prescribed at 2 mm from the source center. RESULTS Patients were re-catheterized from 2 to 21 months (median: 16 months) following IVBT, all for symptoms suggested of restenosis. All patients had some degree of ISR of the target vessel, but no IVBT-treated vascular segment showed angiographic signs of degeneration, dissection or aneurysm. CONCLUSION The authors' clinical impression, along with detailed review of the 10 cases, suggest that using a 34 Gy prescription dose at 2 mm from source center does not result in increased toxicity.
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Affiliation(s)
- Kent Wallner
- Departments of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - Kathleen E Kearney
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Jasleen Tiwana
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Nicole Pristera
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Edward Y Kim
- Departments of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - Lorenzo Azzalini
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - George Sandison
- Departments of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - William L Lombardi
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Creighton Don
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Minsun Kim
- Departments of Radiation Oncology, University of Washington, Seattle, Washington, USA
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5
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Sandison GA, Lehnert A, Miyaoka RS, Kranz M, Kim M, Emery R, Anderson AC, Sponseller PA, Goff PH, Panjwani N, Laramore GE, Parvathaneni U, Liao JJ, Kim EY, Stewart RD. A Novel Approach to Support Quality Assurance (QA) of Intensity Modulated Neutron Therapy (IMNT). Int J Radiat Oncol Biol Phys 2023; 117:e714. [PMID: 37786087 DOI: 10.1016/j.ijrobp.2023.06.2215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Neutron therapy is a form of high linear energy transfer (LET) radiation treatment shown to be beneficial for the treatment of locally advanced head and neck cancers (HNC) resistant to low LET x-ray and proton therapy treatments. The Clinical Neutron Therapy System (CNTS) at our institution has been in clinical operation for over 35 years, and over 3,400 patients have been treated using 3D conformal neutron radiation therapy. In October of 2022, the clinical commissioning of IMNT was completed and the first-ever patient was treated. A novel patient specific quality assurance (PSQA) program has been developed to support IMNT. We present an analysis of our early experiences and PSQA findings for the first 16+ patients treated with IMNT. MATERIALS/METHODS Our pre-treatment IMNT PSQA program includes (1) ionization chamber measurements, (2) a log-file analysis of treatment delivery, and (3) a γ-analysis of the expected and measured doses (fluences) from a novel positron emission portal imaging system based on 12C(n,2n)11C reactions. Patient setup is confirmed on a daily basis with kV portal imaging. We use a modulation factor (MF), defined as the total number of monitor units (MU)/prescribed dose (cGy) per fraction, to identify and help anticipate IMNT plans that may fail our PSQA program. RESULTS We have found that IMNT treatments for large, irregularly shaped treatment volumes (e.g., chest wall or head and neck cancers that require treatment of nodes in the lower neck) are more likely to fail PSQA when the MF exceeds 3 MU/cGy. For smaller, more spherical treatment volumes (e.g., base of tongue cancers), plans with a MF up to 3.5 MU/cGy pass our PSQA criteria. Re-optimized plans subsequently passed PSQA with insignificant or no change in tumor coverage and organ-at-risk (OAR) dose. Re-optimized plans also reduced the total number of MU and number of segments, which has the added benefit of decreasing the overall treatment time and patient time on the table. About 10% of early IMNT patients have required plan re-optimization. CONCLUSION Our pre-treatment clinical PSQA program and workflow provides useful information to guide IMNT treatment planning and delivery, and helps ensure the safe and accurate delivery of IMNT. Our early experiences suggest IMNT plans with smaller MF values are more likely to pass PSQA than plans with larger values of the MF.
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Affiliation(s)
- G A Sandison
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - A Lehnert
- University of Washington, Seattle, WA
| | - R S Miyaoka
- University of Washington, Department of Radiology, Seattle, WA
| | - M Kranz
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - M Kim
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - R Emery
- University of Washington, Seattle, WA
| | - A C Anderson
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - P A Sponseller
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - P H Goff
- Department of Radiation Oncology, University of Washington / Fred Hutchinson Cancer Center, Seattle, WA
| | | | | | - U Parvathaneni
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - J J Liao
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - E Y Kim
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - R D Stewart
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
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Anderson AC, Menon M, Cohen SA, Hannan L, Safyan R, Chiorean EG, Schouten J, Apisarnthanarax S, Kim EY. Clinical Outcomes and Immunotoxicity in People with HIV (PWH) after Definitive Chemoradiation (CRT) for Anal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e282-e283. [PMID: 37785053 DOI: 10.1016/j.ijrobp.2023.06.1266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Anal cancer disproportionately affects PWH despite antiretroviral therapy. Data on CRT outcomes are limited. Modern IMRT CRT decreases acute toxicity but may exacerbate immune dysregulation from chronic HIV. Although historical CRT has been associated with prolonged CD4 count suppression, little is known about late immunotoxicity in PWH after contemporary CRT. We report clinical outcomes and long term immunotoxicity. MATERIALS/METHODS Single-center retrospective review of all PWH confirmed on chart review with anal squamous cell carcinoma without prior pelvic irradiation treated with definitive IMRT CRT. Patient and CRT factors including HIV suppression (<200 copies/mL), mean CD4 count (cells/µL), and receipt of capecitabine (C) or 5-fluorouracil (F) +/- mitomycin (M) were summarized with n (%) or median (interquartile range). Progression-free and overall survival (PFS; OS) were estimated per Kaplan-Meier with 95% confidence intervals and compared with log-rank tests. Mean CD4 count and CD4:CD8 were compared by HIV suppression status (Welch's t-test); longitudinal changes in median CD4 count and CD4:CD8 were compared between baseline vs. nadir (within 6 months of CRT start) and 1-year follow-up for patients with complete data (Wilcoxon signed-rank test). RESULTS A total of 23 PWH were treated between 2010-2022, median age 52, median 16 (13 - 19) years after HIV diagnosis; 4 had unsuppressed HIV; AJCC 8th stage I/II/III/IV 5/5/12/1. Radiation dose was median 54 Gy in 30 fractions over 42 (40 - 44) days. Most had C+M (57%); only 43% had 2×M with either C or F. One had neoadjuvant carboplatin/paclitaxel/pembrolizumab. With 2.9 (1.03 - 3.3) years follow-up, median OS was 6.6 (6.2 - unreached [UR]) years. With 2.2 (0.67 - 2.7) years follow-up, median PFS was UR. OS and PFS were similar regardless of HIV suppression status (both P ≥ 0.09). Overall baseline CD4 count was 458 (226 - 484), and CD4:CD8 was 0.54 (0.2 - 0.7). Nadir CD4 was 100 (59 - 126) and CD4:CD8 was 0.3 (0.2 - 0.4). Baseline and nadir CD4 count and CD4:CD8 were lower if HIV-unsuppressed (each P ≤ 0.04). One year after CRT, CD4 count was 252 (102 - 276), while CD4:CD8 was 0.5 (0.2 - 0.7). For 7 patients with repeated values the change in median from baseline to nadir, 6-, and 12-months post-CRT was -282, -549 (both P = 0.02), -480 (P = 0.9) for CD4 counts, and -0.7, -0.5, -0.4 (each P > 0.5) for CD4:CD8 ratios; none had unsuppressed HIV. CONCLUSION Definitive IMRT CRT with guideline-concordant doublet chemotherapy for anal cancer in PWH is effective despite unsuppressed HIV. Treatment leads to prolonged immunological changes that may increase the risk of HIV-related morbidity and mortality. Modifiable treatment-related causes of hematoimmunologic toxicity should be investigated further, and immune surveillance after CRT should be considered to better understand impact on quality of life.
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Affiliation(s)
- A C Anderson
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - M Menon
- Division of Hematology, Department of Medicine, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - S A Cohen
- Division of Oncology, Department of Medicine, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - L Hannan
- Division of Oncology, Department of Medicine, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - R Safyan
- Division of Oncology, Department of Medicine, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - E G Chiorean
- Division of Oncology, Department of Medicine, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - J Schouten
- Division of Allergy & Infectious Diseases, Department of Medicine, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - S Apisarnthanarax
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - E Y Kim
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
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7
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Lussier L, Wallner K, Kearney KE, Tiwana J, Kim EY, Parvathaneni U, Lombardi WL, Phillips M, Don C, Kim M. Image-guided intravascular brachytherapy dose escalation. Brachytherapy 2023; 22:518-523. [PMID: 37211487 DOI: 10.1016/j.brachy.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/15/2023] [Accepted: 04/05/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE Coronary stents reduce IVBT radiation dose with a single layer by 10-30%. However, the impact of multiple stent layers and stent expansion remains unexplored. Individualized dose adjustments considering variations in stent layers and expansion could improve radiation delivery effectiveness. METHODS EGSnrc was used to compute the delivered vessel wall dose in various IVBT scenarios. Stent effects were modeled for the stent density of 25%, 50%, and 75% with 1, 2, and 3 layers respectively. Doses were calculated at 1.75 to 5.00 mm away from the source center, normalized to 100% at 2 mm. RESULTS Dose fall-off increased with increasing stent density. With a single layer, the dose at 2 mm from source fell from 100% of prescription to 92%, 83% and 73% at 25%, 50% and 75% density, respectively. The computed dose to points with increasing radial distance from the source decreased progressively with increasing stent layers. With three layers, at 75% stent density, the dose at 2 mm from source center fell to 38%. CONCLUSIONS A schema for image-guided IVBT dose adjustment is described. While it would be an improvement over current standard of care, myriad factors remain to be addressed in a comprehensive effort to optimize IVBT.
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Affiliation(s)
- Luke Lussier
- Department of Physics, St. Mary's University, San Antonio, TX
| | - Kent Wallner
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | | | - Jasleen Tiwana
- Department of Cardiology, University of Washington, Seattle, WA
| | - Edward Y Kim
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | | | | | - Mark Phillips
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - Creighton Don
- Department of Cardiology, University of Washington, Seattle, WA
| | - Minsun Kim
- Department of Radiation Oncology, University of Washington, Seattle, WA.
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Kang WY, Kim EY, Choi S, Choi BS. Acute exacerbation of chronic obstructive pulmonary disease in a slaughterhouse. Occup Med (Lond) 2023; 73:49-52. [PMID: 36282619 DOI: 10.1093/occmed/kqac111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We describe the case of a 52-year-old male who presented with two episodes of acute exacerbations (AE) of chronic obstructive pulmonary disease (COPD) during work, while suspending live chickens for slaughter. The patient was exposed to high levels of bioaerosols, including endotoxins and microorganisms. Endotoxins can induce bronchoconstriction and airway inflammation, and COPD patients are more vulnerable to airway infections caused by microorganisms inhaled with bioaerosols. This study suggests that a high level of bioaerosols may induce airway infections, resulting in acute exacerbations of COPD.
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Affiliation(s)
- W Y Kang
- Department of Research for Occupational Health, Institute of Occupation and Environment, Korea Workers' Compensation & Welfare Service, Incheon, 21417, Republic of Korea
| | - E Y Kim
- Department of Research for Occupational Health, Institute of Occupation and Environment, Korea Workers' Compensation & Welfare Service, Incheon, 21417, Republic of Korea
| | - S Choi
- Department of Research for Occupational Health, Institute of Occupation and Environment, Korea Workers' Compensation & Welfare Service, Incheon, 21417, Republic of Korea
| | - B S Choi
- Department of Research for Occupational Health, Institute of Occupation and Environment, Korea Workers' Compensation & Welfare Service, Incheon, 21417, Republic of Korea
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Park MJ, Lee SE, Yoon W, Park HJ, Kim SH, Oh SH, Lee DG, Pyeon DB, Kim EY, Park SP. Effect of supplementation of cryoprotectant solution with hydroxypropyl cellulose for vitrification of bovine oocytes. Cryo Letters 2023; 44:37-46. [PMID: 36629840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Successful cryopreservation of bovine oocytes is very important for research and commercial applications. However, the survival and development rate of vitrified-thawed (VT) oocytes are lower than those of non-vitrified-thawed (non-VT) oocytes. OBJECTIVE To investigate the effect of adding hydroxypropyl cellulose (HPC) to the vitrification solution for bovine oocytes. MATERIALS AND METHODS For vitrification, bovine metaphase II oocytes were pretreated with a solution containing 10% ethylene glycol supplemented with 0, 10, 50, or 100 ug/mL HPC for 5 min, exposed to a solution containing 30% ethylene glycol supplemented with 0, 10, 50, or 100 ug/mL HPC for 30 s, and then directly plunged into liquid nitrogen. RESULTS The survival rate of oocytes was significantly higher in the 50 HPC group than in the 0, 10, and 100 HPC groups. The reactive oxygen species level was lower in the non-VT and 50 HPC groups than in the other groups. The mRNA levels of proapoptotic genes (Bax) were lower in the non-VT, 0, and 50 HPC groups than in the other groups. The mRNA levels of antiapoptotic genes (BCl2) were higher in the non-VT than in the other groups. The development rates of embryos (day 8) obtained via parthenogenetic activation (PA) were determined in the non-VT, 0 HPC, and 50 HPC groups. The cleavage rate was significantly higher in the non-VT group. CONCLUSION Supplementation of vitrification solution with HPC improves the survival of VT bovine oocytes and the development capacity of embryos derived from these oocytes via PA. doi.org/10.54680/fr23110110212.
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Affiliation(s)
- M J Park
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - S E Lee
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - W Yoon
- Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - H J Park
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - S H Kim
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - S H Oh
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - D G Lee
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - D B Pyeon
- Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - E Y Kim
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243; Mirae Cell Bio Inc., Seoul 04795, Korea
| | - S P Park
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243; Mirae Cell Bio Inc., Seoul 04795, Korea.
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10
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Wallner K, Kearney KE, Kim M, Tiwana J, Elison D, Kim EY, Parvathaneni U, Lombardi WL, Phillips ML, Don C. Failure patterns after intravascular brachytherapy for in-stent coronary restenosis. Catheter Cardiovasc Interv 2022; 100:759-762. [PMID: 36098336 DOI: 10.1002/ccd.30399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION One strategy to improve the effectiveness of intravascular brachytherapy (IVBT) is to study its failures. Previous investigations described mostly discrete, focal recurrences, typically at the proximal or distal edges of the irradiated segment after plain angioplasty or bare metal stents. We reviewed failure patterns of 30 unselected drug-eluting stent (DES) patients who had follow-up angiograms for recurrence within their IVBT-treated vessel. METHODS Records of 53 unselected IVBT patients treated between 2016 and 2021 were reviewed. Thirty of the 53 patients had at least one subsequent percutaneous intervention (PCI) for in-stent restenosis (ISR) after IVBT. Angiographic findings of those 30 patients with ISR within their previously irradiated vessel are reported here. RESULTS Of the 30 patients, 21 (70%) developed recurrent ISR within the irradiated segment. Six of the 21 patients who failed within the irradiated segment also experienced ISR proximal or distal to the irradiated segment. Only 15 patients (50%) failed exclusively within the irradiated segment. In nine patients (30%), restenosis occurred proximally and/or distally to the irradiated segment, but not inside of the irradiated segment itself. CONCLUSIONS We have shown here that 50% of failures after coronary IVBT for DES ISR occur exclusively within the irradiated segment. An additional 20% of patients had failure within and outside of the irradiated segment. These percentages suggest that a higher radiation dose might improve the long-term patency rates, a conclusion that should be tempered by the lack of universal follow-up.
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Affiliation(s)
- Kent Wallner
- Departments of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - Kathleen E Kearney
- Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Minsun Kim
- Departments of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - Jasleen Tiwana
- Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - David Elison
- Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Edward Y Kim
- Departments of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - Upendra Parvathaneni
- Departments of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - William L Lombardi
- Departments of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - Mark L Phillips
- Departments of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - Creighton Don
- Division of Cardiology, University of Washington, Seattle, Washington, USA
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11
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Goff PH, Riolobos L, LaFleur BJ, Spraker MB, Seo YD, Smythe KS, Campbell JS, Pierce RH, Zhang Y, He Q, Kim EY, Schaub SK, Kane GM, Mantilla JG, Chen EY, Ricciotti R, Thompson MJ, Cranmer LD, Wagner MJ, Loggers ET, Jones RL, Murphy E, Blumenschein WM, McClanahan T, Earls J, Flanagan KC, LaFranzo NA, Kim TS, Pollack SM. Neoadjuvant Therapy Induces a Potent Immune Response to Sarcoma, Dominated by Myeloid and B Cells. Clin Cancer Res 2022; 28:1701-1711. [PMID: 35115306 PMCID: PMC9953754 DOI: 10.1158/1078-0432.ccr-21-4239] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/13/2022] [Accepted: 02/01/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE To characterize changes in the soft-tissue sarcoma (STS) tumor immune microenvironment induced by standard neoadjuvant therapy with the goal of informing neoadjuvant immunotherapy trial design. EXPERIMENTAL DESIGN Paired pre- and postneoadjuvant therapy specimens were retrospectively identified for 32 patients with STSs and analyzed by three modalities: multiplexed IHC, NanoString, and RNA sequencing with ImmunoPrism analysis. RESULTS All 32 patients, representing a variety of STS histologic subtypes, received neoadjuvant radiotherapy and 21 (66%) received chemotherapy prior to radiotherapy. The most prevalent immune cells in the tumor before neoadjuvant therapy were myeloid cells (45% of all immune cells) and B cells (37%), with T (13%) and natural killer (NK) cells (5%) also present. Neoadjuvant therapy significantly increased the total immune cells infiltrating the tumors across all histologic subtypes for patients receiving neoadjuvant radiotherapy with or without chemotherapy. An increase in the percentage of monocytes and macrophages, particularly M2 macrophages, B cells, and CD4+ T cells was observed postneoadjuvant therapy. Upregulation of genes and cytokines associated with antigen presentation was also observed, and a favorable pathologic response (≥90% necrosis postneoadjuvant therapy) was associated with an increase in monocytic infiltrate. Upregulation of the T-cell checkpoint TIM3 and downregulation of OX40 were observed posttreatment. CONCLUSIONS Standard neoadjuvant therapy induces both immunostimulatory and immunosuppressive effects within a complex sarcoma microenvironment dominated by myeloid and B cells. This work informs ongoing efforts to incorporate immune checkpoint inhibitors and novel immunotherapies into the neoadjuvant setting for STSs.
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Affiliation(s)
- Peter H. Goff
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - Laura Riolobos
- Department of Medicine, University of Washington, Seattle, WA.,Cancer Vaccine Institute, University of Washington, Seattle, WA
| | | | - Matthew B. Spraker
- Department of Radiation Oncology, Washington University in St. Louis, St. Louis, MO
| | - Y. David Seo
- Department of Surgery, University of Washington, Seattle, WA
| | - Kimberly S. Smythe
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | | | - Yuzheng Zhang
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Qianchuan He
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Edward Y. Kim
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | | | - Gabrielle M. Kane
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - Jose G. Mantilla
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Eleanor Y. Chen
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Robert Ricciotti
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Matthew J. Thompson
- Department of Orthopedic Surgery, University of Washington, Seattle, WA.,Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Lee D. Cranmer
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA.,Seattle Cancer Care Alliance, Seattle, WA, USA.,Department of Medical Oncology, University of Washington, Seattle, WA
| | - Michael J. Wagner
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA.,Seattle Cancer Care Alliance, Seattle, WA, USA.,Department of Medical Oncology, University of Washington, Seattle, WA
| | - Elizabeth T. Loggers
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA.,Seattle Cancer Care Alliance, Seattle, WA, USA.,Department of Medical Oncology, University of Washington, Seattle, WA
| | - Robin L. Jones
- Sarcoma, Royal Marsden Hospital NHS Trust/ Institute of Cancer Research, London, UK
| | | | | | | | - Jon Earls
- Cofactor Genomics, Inc., San Francisco, CA
| | | | | | - Teresa S. Kim
- Department of Surgery, University of Washington, Seattle, WA.,Department of Medical Oncology, University of Washington, Seattle, WA
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12
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Schaub SK, Kim EY. Controversy of Adjuvant Locoregional Therapy for Node-Positive Anal Mucosal Melanoma. Int J Radiat Oncol Biol Phys 2022; 112:1071-1072. [PMID: 35286876 DOI: 10.1016/j.ijrobp.2018.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 04/28/2018] [Accepted: 07/02/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Stephanie K Schaub
- University of Washington School of Medicine, Department of Radiation Oncology, Seattle, Washington
| | - Edward Y Kim
- University of Washington School of Medicine, Department of Radiation Oncology, Seattle, Washington
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13
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Cranmer LD, Chau B, Mantilla JG, Loggers ET, Pollack SM, Kim TS, Kim EY, Kane GM, Thompson MJ, Harwood JL, Wagner MJ. Is Chemotherapy Associated with Improved Overall Survival in Patients with Dedifferentiated Chondrosarcoma? A SEER Database Analysis. Clin Orthop Relat Res 2022; 480:748-758. [PMID: 34648466 PMCID: PMC8923599 DOI: 10.1097/corr.0000000000002011] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 09/21/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Dedifferentiated chondrosarcoma is a chondrosarcoma subtype associated with high rates of recurrence and a poor prognosis. Others have proposed treatment of dedifferentiated chondrosarcoma using osteosarcoma protocols, including perioperative chemotherapy. However, the rarity of this condition poses difficulties in undertaking single- institution studies of sufficient sample size. QUESTION/PURPOSE Is perioperative chemotherapy associated with improved overall survival in patients with dedifferentiated chondrosarcoma? METHODS We queried the Surveillance, Epidemiology, and End Results (SEER) 1973 to 2016 database for patients with a diagnosis of dedifferentiated chondrosarcoma (n = 308). As dedifferentiated chondrosarcoma was only classified as a distinct entity in SEER starting in 2000, only patients treated in 2000 and later were included. We excluded from our analyses those patients with distant disease at diagnosis, a primary site of disease other than bone or joints, and those who did not receive cancer-directed surgery. These criteria yielded 185 dedifferentiated chondrosarcoma patients for inclusion. We used Kaplan-Meier analyses and Cox proportional hazards models to assess the association of clinical, demographic, and treatment characteristics on overall survival (OS). RESULTS After controlling for confounding variables, including age, sex, tumor size, stage, grade, location, and radiation treatment status, and after adjusting for missing data, no overall survival benefit was associated with receipt of chemotherapy in patients with dedifferentiated chondrosarcoma (hazard ratio 0.75 [95% confidence interval 0.49 to 1.12]; p = 0.16). CONCLUSION Chemotherapy treatment of dedifferentiated chondrosarcoma was not associated with improved OS. These results must be viewed cautiously, given the limited granularity of information on chemotherapy treatment, the concerns regarding chemotherapy misclassification in SEER data, and the small sample of patients with dedifferentiated chondrosarcoma, all of which limit the power to detect a difference. Our findings are nevertheless consistent with those of prior reports in which no benefit of chemotherapy could be detected. Lack of clear benefit from perioperative chemotherapy in dedifferentiated chondrosarcoma argues that it should be used only after careful consideration, and ideally in the context of a clinical trial. LEVEL OF EVIDENCE Level III, therapeutic study.
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Affiliation(s)
- Lee D. Cranmer
- Division of Medical Oncology, University of Washington, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Bonny Chau
- Division of Medical Oncology, University of Washington, Seattle, WA, USA
| | - Jose G. Mantilla
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Elizabeth T. Loggers
- Division of Medical Oncology, University of Washington, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Seth M. Pollack
- Division of Medical Oncology, University of Washington, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Teresa S. Kim
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - Edward Y. Kim
- Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - Gabrielle M. Kane
- Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - Matthew J. Thompson
- Department of Orthopedics and Sports Medicine, University of Washington, Seattle, WA, USA
| | - Jared L. Harwood
- Department of Orthopedics and Sports Medicine, University of Washington, Seattle, WA, USA
| | - Michael J. Wagner
- Division of Medical Oncology, University of Washington, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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14
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Park MJ, Lee SE, Yoon W, Park HJ, Kim SH, Oh SH, Lee DG, Pyeon DB, Kim EY, Park SP. Effect of supplementation of cryoprotectant solution with hydroxypropyl cellulose for vitrification of bovine oocytes. Cryo Letters 2022; 44:37-46. [PMID: 36625874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Successful cryopreservation of bovine oocytes is very important for research and commercial applications. However, the survival and development rate of vitrified-thawed (VT) oocytes are lower than those of non-vitrified-thawed (non-VT) oocytes. OBJECTIVE To investigate the effect of adding hydroxypropyl cellulose (HPC) to the vitrification solution for bovine oocytes. MATERIALS AND METHODS For vitrification, bovine metaphase II oocytes were pretreated with a solution containing 10% ethylene glycol supplemented with 0, 10, 50, or 100 ug/mL HPC for 5 min, exposed to a solution containing 30% ethylene glycol supplemented with 0, 10, 50, or 100 ug/mL HPC for 30 s, and then directly plunged into liquid nitrogen. RESULTS The survival rate of oocytes was significantly higher in the 50 HPC group than in the 0, 10, and 100 HPC groups. The reactive oxygen species level was lower in the non-VT and 50 HPC groups than in the other groups. The mRNA levels of proapoptotic genes (Bax) were lower in the non-VT, 0, and 50 HPC groups than in the other groups. The mRNA levels of antiapoptotic genes (BCl2) were higher in the non-VT than in the other groups. The development rates of embryos (day 8) obtained via parthenogenetic activation (PA) were determined in the non-VT, 0 HPC, and 50 HPC groups. The cleavage rate was significantly higher in the non-VT group. CONCLUSION Supplementation of vitrification solution with HPC improves the survival of VT bovine oocytes and the development capacity of embryos derived from these oocytes via PA. doi.org/10.54680/fr23110110212.
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Affiliation(s)
- M J Park
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - S E Lee
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - W Yoon
- Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - H J Park
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - S H Kim
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - S H Oh
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - D G Lee
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - D B Pyeon
- Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243, Korea
| | - E Y Kim
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243; Mirae Cell Bio Inc., Seoul 04795, Korea
| | - S P Park
- Jeju National University Stem Cell Research Center, Seoul 63243; Faculty of Biotechnology, College of Applied Life Sciences, Jeju National University, Jeju 63243; Mirae Cell Bio Inc., Seoul 04795, Korea.
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15
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Kearney KE, Wallner K, Kim M, Hira RS, Kim EY, Nakamura K, Parvathaneni U, Steinberg ZL, McCabe JM, Lombardi WL, Phillips ML, Don C. Intravascular coronary brachytherapy combined with a drug-coated balloon. Brachytherapy 2021; 20:1276-1281. [PMID: 34226148 DOI: 10.1016/j.brachy.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/30/2021] [Accepted: 04/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Coronary artery disease leads to stenosis of the major cardiac vessels, resulting in ischemia and infarction. Percutaneous intervention (PCI) with balloon angioplasty can re-open stenosed vessels. Drug eluting stents (DES) and intravascular brachytherapy (IVBT) and drug-coated balloons (DCBs) are proven to decrease the likelihood of another restenosis after PCI, but neither is completely effective. Due to the limited long-term effectiveness of IVBT or DCB used separately for salvage PCI, we combined the two in some poor prognosis patients. METHODS Combined IVBT+DCB was intended for a total of 36 patients from 2015-2020. PCI with some combination of ballooning, laser and directional/rotational atherectomy was used to maximally open the stenotic region prior to IVBT+DCB. Beta-radiation brachytherapy for all patients was done with a Novoste Beta-Cath. Lutonix 4.0 x 40 mm paclitaxel-coated balloons (Bard, Murray Hill, NJ) were employed. RESULTS Overall survival at two years was 88%. Nine patients had follow-up angiograms, all for cardiac symptoms. Time from IVBT+DCB to follow-up angiography ranged from 4 to 33 months. The average months PCI-free interval before brachy therapy was 11.1 mos (95% CI 1.03-23.25) versus 23.3 mos after VBT (23.3 95% CI 12.3-32.3). The mean difference was 11.2 mos (95% CI 1.06-21.4, p < 0.031). None of the follow-up angiographic procedures displayed evidence of what could be interpreted as radiation damage. CONCLUSIONS In this uncontrolled series, IVBT plus DCB appeared to lengthen the ISR-free interval relative to what had been achieved prior to the combined intervention. We view these results as mildly encouraging, worthy of further study.
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Affiliation(s)
| | - Kent Wallner
- Radiation Oncology, University of Washington, Seattle, WA.
| | - Minsun Kim
- Radiation Oncology, University of Washington, Seattle, WA
| | - Ravi S Hira
- Departments of Cardiology, University of Washington, Seattle, WA
| | - Edward Y Kim
- Radiation Oncology, University of Washington, Seattle, WA
| | - Kenta Nakamura
- Departments of Cardiology, University of Washington, Seattle, WA
| | | | | | - James M McCabe
- Departments of Cardiology, University of Washington, Seattle, WA
| | | | | | - Creighton Don
- Radiation Oncology, University of Washington, Seattle, WA
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16
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Sarkar A, Kim EY, Jang T, Hongdusit A, Kim H, Choi JM, Fox JM. Microbially Guided Discovery and Biosynthesis of Biologically Active Natural Products. ACS Synth Biol 2021; 10:1505-1519. [PMID: 33988973 DOI: 10.1021/acssynbio.1c00074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The design of small molecules that inhibit disease-relevant proteins represents a longstanding challenge of medicinal chemistry. Here, we describe an approach for encoding this challenge-the inhibition of a human drug target-into a microbial host and using it to guide the discovery and biosynthesis of targeted, biologically active natural products. This approach identified two previously unknown terpenoid inhibitors of protein tyrosine phosphatase 1B (PTP1B), an elusive therapeutic target for the treatment of diabetes and cancer. Both inhibitors appear to target an allosteric site, which confers selectivity, and can inhibit PTP1B in living cells. A screen of 24 uncharacterized terpene synthases from a pool of 4464 genes uncovered additional hits, demonstrating a scalable discovery approach, and the incorporation of different PTPs into the microbial host yielded alternative PTP-specific detection systems. Findings illustrate the potential for using microbes to discover and build natural products that exhibit precisely defined biochemical activities yet possess unanticipated structures and/or binding sites.
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Affiliation(s)
- Ankur Sarkar
- Department of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Avenue, Boulder, Colorado 80303, United States
| | - Edward Y. Kim
- Department of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Avenue, Boulder, Colorado 80303, United States
| | - Taehwan Jang
- Department of Chemistry, Korea Advanced Institute of Science and Technology, Yuseong-gu, Daejeon 34141, Republic of Korea
| | - Akarawin Hongdusit
- Department of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Avenue, Boulder, Colorado 80303, United States
| | - Hyungjun Kim
- Department of Chemistry, Korea Advanced Institute of Science and Technology, Yuseong-gu, Daejeon 34141, Republic of Korea
| | - Jeong-Mo Choi
- Department of Chemistry, Pusan National University, Geumjeong-gu, Busan 46241, Republic of Korea
| | - Jerome M. Fox
- Department of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Avenue, Boulder, Colorado 80303, United States
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17
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Kohli K, Yao L, Nowicki TS, Zhang S, Black RG, Schroeder BA, Farrar EA, Cao J, Sloan H, Stief D, Cranmer LD, Wagner MJ, Hawkins DS, Pillarisetty VG, Ribas A, Campbell J, Pierce RH, Kim EY, Jones RL, Riddell SR, Yee C, Pollack SM. IL-15 mediated expansion of rare durable memory T cells following adoptive cellular therapy. J Immunother Cancer 2021; 9:jitc-2020-002232. [PMID: 33963013 PMCID: PMC8108691 DOI: 10.1136/jitc-2020-002232] [Citation(s) in RCA: 4] [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] [Accepted: 03/19/2021] [Indexed: 11/08/2022] Open
Abstract
Background Synovial sarcoma (SS) and myxoid/round cell liposarcoma (MRCL) are ideal solid tumors for the development of adoptive cellular therapy (ACT) targeting NY-ESO-1, as a high frequency of tumors homogeneously express this cancer-testes antigen. Data from early phase clinical trials have shown antitumor activity after the adoptive transfer of NY-ESO-1–specific T cells. In these studies, persistence of NY-ESO-1 specific T cells is highly correlated with response to ACT, but patients often continue to have detectable transferred cells in their peripheral blood following progression. Method We performed a phase I clinical trial evaluating the safety of NY-ESO-1–specific endogenous T cells (ETC) following cyclophosphamide conditioning. Peripheral blood mononuclear cells (PBMCs) from treated patients were evaluated by flow cytometry and gene expression analysis as well as through ex vivo culture assays with and without IL-15. Results Four patients were treated in a cohort using ETC targeting NY-ESO-1 following cyclophosphamide conditioning. Treatment was well tolerated without significant toxicity, but all patients ultimately had disease progression. In two of four patients, we obtained post-treatment tumor tissue and in both, NY-ESO-1 antigen was retained despite clear detectable persisting NY-ESO-1–specific T cells in the peripheral blood. Despite a memory phenotype, these persisting cells lacked markers of proliferation or activation. However, in ex vivo culture assays, they could be induced to proliferate and kill tumor using IL-15. These results were also seen in PBMCs from two patients who received gene-engineered T-cell receptor–based products at other centers. Conclusions ETC targeting NY-ESO-1 with single-agent cyclophosphamide alone conditioning was well tolerated in patients with SS and those with MRCL. IL-15 can induce proliferation and activity in persisting NY-ESO-1–specific T cells even in patients with disease progression following ACT. These results support future work evaluating whether IL-15 could be incorporated into ACT trials post-infusion or at the time of progression.
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Affiliation(s)
- Karan Kohli
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,Division of Oncology, University of Washington, Seattle, WA, USA.,Department of Surgery, University of Washington, Seattle, WA, USA
| | - Lu Yao
- Poseida Therapeutics, San Diego, CA, USA
| | - Theodore Scott Nowicki
- Division of Pediatric Hematology/Oncology, University of California, Los Angeles, California, USA
| | - Shihong Zhang
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA
| | - Ralph Graeme Black
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA
| | - Brett A Schroeder
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,Division of Oncology, University of Washington, Seattle, WA, USA.,Department of Internal Medicine, Virginia Mason Medical Center, Seattle, WA, USA
| | | | - Jianhong Cao
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA
| | - Heather Sloan
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA
| | - Dawn Stief
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA
| | - Lee D Cranmer
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,Division of Oncology, University of Washington, Seattle, WA, USA
| | - Michael J Wagner
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,Division of Oncology, University of Washington, Seattle, WA, USA
| | - Douglas S Hawkins
- Division of Hematology and Oncology, Seattle Children's Hospital, Seattle, WA, USA
| | | | - Antoni Ribas
- Division Hematology and Oncology, University of California, Los Angeles, UK
| | - Jean Campbell
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,Sensei Biotherapeutics, Gaithersburg, Boston, MD, USA
| | - Robert H Pierce
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,Sensei Biotherapeutics, Gaithersburg, Boston, MD, USA
| | - Edward Y Kim
- Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - Robin L Jones
- Sarcoma, Royal Marsden Hospital and Institute of Cancer Research, London, UK
| | - Stanley R Riddell
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA.,Department of Surgery, University of Washington, Seattle, WA, USA.,Lyell Immunopharma, Seattle, WA, USA
| | | | - Seth M Pollack
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA .,Department of Surgery, University of Washington, Seattle, WA, USA.,Division of Oncology, Northwestern University, Chicago, IL, USA
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18
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Wagner MJ, Chau B, Loggers ET, Pollack SM, Kim TS, Kim EY, Thompson MJ, Harwood JL, Cranmer LD. Long-term Outcomes for Extraskeletal Myxoid Chondrosarcoma: A SEER Database Analysis. Cancer Epidemiol Biomarkers Prev 2020; 29:2351-2357. [PMID: 32856598 DOI: 10.1158/1055-9965.epi-20-0447] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 06/24/2020] [Accepted: 08/05/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Extraskeletal myxoid chondrosarcoma (EMCS) is a rare tumor that typically has an indolent course but high rate of recurrence. We queried the Surveillance, Epidemiology, and End Results (SEER) database to assess factors associated with metastasis, treatment, and survival. METHODS We queried the SEER 1973-2016 database for patients with myxoid chondrosarcoma (ICD-O-3: 9231/3). Kaplan-Meier analyses and Cox proportional hazard models assessed effects on overall survival (OS) of demographics and clinical characteristics. Logistic regression assessed associations between tumor location and distant disease. Primary analysis was a complete case analysis; multiple imputation (MI) was used in a sensitivity analysis. RESULTS Locoregional disease (LRD) was found in 373 (85%) of patients. In univariate analysis with LRD, surgery correlated with superior OS [HR = 0.27; 95% confidence interval (CI), 0.16-0.47]; chemotherapy and radiotherapy associated with inferior OS (HR = 1.90; 95% CI, 1.11-3.27 and HR = 1.45; 95% CI, 1.03-2.06, respectively). No treatment modality associated with OS in the adjusted, complete case model. In the adjusted sensitivity analysis, surgery associated with superior outcomes (HR = 0.36; 95% CI, 0.19-0.69). There was no OS difference by primary tumor site. 10-year OS with distant disease was 10% (95% CI, 2%-25%). CONCLUSIONS Surgery in LRD associated with improved OS in univariate analysis and adjusted models correcting for missing data. There was no OS benefit with chemotherapy or radiotherapy. IMPACT This represents the largest report of EMCS with long-term follow-up. Despite the reputedly indolent nature of EMCS, outcomes with metastatic disease are poor. We provide OS benchmarks and guidance for stratification in future prospective trials.
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Affiliation(s)
- Michael J Wagner
- Division of Medical Oncology, University of Washington, Seattle, Washington. .,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Bonny Chau
- Division of Medical Oncology, University of Washington, Seattle, Washington
| | - Elizabeth T Loggers
- Division of Medical Oncology, University of Washington, Seattle, Washington.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Seth M Pollack
- Division of Medical Oncology, University of Washington, Seattle, Washington.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Teresa S Kim
- Department of Surgery, University of Washington, Seattle, Washington
| | - Edward Y Kim
- Department of Radiation Oncology, University of Washington, Seattle, Washington
| | - Matthew J Thompson
- Department of Orthopedic Surgery, University of Washington, Seattle, Washington
| | - Jared L Harwood
- Department of Orthopedic Surgery, University of Washington, Seattle, Washington
| | - Lee D Cranmer
- Division of Medical Oncology, University of Washington, Seattle, Washington.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
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19
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Schaub SK, Ermoian RP, Wang CL, O'Malley RB, Kim EY, Shuman WP, Hendrickson K, Apisarnthanarax S. Bridging the Radiation Oncology and Diagnostic Radiology Communication Gap: A Survey to Determine Usefulness and Optimal Presentation of Radiotherapy Treatment Plans for Radiologists. Curr Probl Diagn Radiol 2020; 49:161-167. [PMID: 30885420 DOI: 10.1067/j.cpradiol.2019.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/13/2019] [Accepted: 02/14/2019] [Indexed: 11/22/2022]
Abstract
RATIONALE AND OBJECTIVES We hypothesized that providing visual-spatial information to radiologists on where radiation has been delivered in an easily accessible way may improve the accuracy of image interpretation and thereby improve quality of patient care. We present a national representation of radiologists' opinions regarding the usefulness and optimal approach for implementing a system to promote access to radiotherapy (RT) plans. METHODS An anonymous survey was sent to the members of the Association of University Radiologists. Descriptive statistics were performed. RESULTS Questionnaires were returned by 95 of 1383 members. Demographics comprised of 76% attendings with 94% practicing within an academic setting. Only 40% of radiologists reported that they knew most of the time whether a patient has received RT in the field scanned. A large majority of respondents (88%) felt that a history of prior radiation in a cancer patient was at least an occasional barrier that affected the ability to interpret imaging findings in a clinically useful way. The following types of information was considered helpful when interpreting a scan: screenshots of the radiation plan (85%), scrollable DICOM data on planning CT showing delivered RT dose lines (54%), and written text RT treatment summary (47%). Nearly all (89%) desired DICOM data within the clinical radiology Picture Archiving and Communication System system. Radiologists expected the ease of accessibility to RT plans to result in increased efficiency (76%) and accuracy (88%). CONCLUSION Diagnostic radiologists desire improved access and integration of radiotherapy plans into the diagnostic radiology clinical workup in the form of visual-spatial data.
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Affiliation(s)
- Stephanie K Schaub
- University of Washington, Department of Radiation Oncology, Seattle, WA.
| | - Ralph P Ermoian
- University of Washington, Department of Radiation Oncology, Seattle, WA
| | - Carolyn L Wang
- University of Washington, Department of Radiology, Seattle, WA
| | - Ryan B O'Malley
- University of Washington, Department of Radiology, Seattle, WA
| | - Edward Y Kim
- University of Washington, Department of Radiation Oncology, Seattle, WA
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20
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Kim EY, Do SI, Yun JS, Park YL, Park CH, Moon JH, Youn I, Choi YJ, Ham SY, Kook SH. Preoperative evaluation of mammographic microcalcifications after neoadjuvant chemotherapy for breast cancer. Clin Radiol 2020; 75:641.e19-641.e27. [PMID: 32291081 DOI: 10.1016/j.crad.2020.03.024] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 03/11/2020] [Indexed: 12/20/2022]
Abstract
AIM To assess the predictive value of preoperative residual mammographic microcalcifications for residual tumours after neoadjuvant chemotherapy (NAC) for breast cancer. MATERIALS AND METHODS This single-centre retrospective study included breast cancer patients who underwent NAC and demonstrated suspicious microcalcifications within or near the tumour bed on mammography from June 2015 to August 2018. The residual microcalcifications and remnant lesion on magnetic resonance imaging (MRI) were correlated with histopathological findings of residual tumours and immunohistochemical markers. RESULTS A total of 96 patients were included. Ten patients achieved pathological complete response (pCR) and previous suspicious microcalcifications were associated with benign pathology in 10.4% (10/96) of the patients. In the remaining 86 patients who did not achieve pCR, 61.5% (59/96) of the residual microcalcifications were associated with invasive or in situ carcinoma and 28.1% (27/96) with benign pathology. Hormone receptor-positive (HR+) patients had the highest proportion of residual malignant microcalcifications compared to HR- patients (48.9% versus 13.5%, respectively; p=0.019). MRI correlated better than residual microcalcifications on mammography in predicting residual tumour extent in all subtypes (ICC=0.709 versus 0.365). MRI also showed higher correlation with residual tumour size for the HR-/HER2+ and HR-/HER2- subtype (ICC=0.925 and 0.876, respectively). CONCLUSION The extent of microcalcifications on mammography after NAC did not correlate with the extent of residual cancer in 38.5% of women. Regardless of the extent of microcalcifications, residual tumour extent on MRI after NAC and molecular subtype could be an accurate tool in evaluating residual cancer after NAC.
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Affiliation(s)
- E Y Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S-I Do
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - J-S Yun
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Y L Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - C H Park
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J H Moon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - I Youn
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Y J Choi
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S-Y Ham
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S H Kook
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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21
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Kim EY. Do the Magic Angle Effects or Susceptibility Effects Affect the Visualization of Nigrosome 1? AJNR Am J Neuroradiol 2020; 41:E20. [PMID: 32139430 DOI: 10.3174/ajnr.a6458] [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: 11/07/2022]
Affiliation(s)
- E Y Kim
- Department of RadiologyGil Medical CenterGachon University College of MedicineIncheon, South Korea
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22
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Hjortness MK, Riccardi L, Hongdusit A, Ruppe S, Zhao M, Kim EY, Zwart PH, Sankaran B, Arthanari H, Sousa MC, De Vivo M, Fox JM. Correction to “Abietane-Type Diterpenoids Inhibit Protein Tyrosine Phosphatases by Stabilizing an Inactive Enzyme Conformation”. Biochemistry 2019; 58:2797. [DOI: 10.1021/acs.biochem.9b00423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Roh HG, Kim EY, Kim IS, Lee HJ, Park JJ, Lee SB, Choi JW, Jeon YS, Park M, Kim SU, Kim HJ. A Novel Collateral Imaging Method Derived from Time-Resolved Dynamic Contrast-Enhanced MR Angiography in Acute Ischemic Stroke: A Pilot Study. AJNR Am J Neuroradiol 2019; 40:946-953. [PMID: 31097431 DOI: 10.3174/ajnr.a6068] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/12/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Assessment of the collateral status has been emphasized for appropriate treatment decisions in patients with acute ischemic stroke. The purpose of this study was to introduce a multiphase MRA collateral imaging method (collateral map) derived from time-resolved dynamic contrast-enhanced MRA and to verify the value of the multiphase MRA collateral map in acute ischemic stroke by comparing it with the multiphase collateral imaging method (MRP collateral map) derived from dynamic susceptibility contrast-enhanced MR perfusion. MATERIALS AND METHODS From a prospectively maintained registry of acute ischemic stroke, MR imaging data of patients with acute ischemic stroke caused by steno-occlusive lesions of the unilateral ICA and/or the M1 segment of the MCA were analyzed. We generated collateral maps using dynamic signals from dynamic contrast-enhanced MRA and DSC-MRP using a Matlab-based in-house program and graded the collateral scores of the multiphase MRA collateral map and the MRP collateral map independently. Interobserver reliabilities and intermethod agreement between both collateral maps for collateral grading were tested. RESULTS Seventy-one paired multiphase MRA and MRP collateral maps from 67 patients were analyzed. The interobserver reliabilities for collateral grading using multiphase MRA or MRP collateral maps were excellent (weighted κ = 0.964 and 0.956, respectively). The agreement between both collateral maps was also excellent (weighted κ = 0.884; 95% confidence interval, 0.819-0.949). CONCLUSIONS We demonstrated that the dynamic signals of dynamic contrast-enhanced MRA could be used to generate multiphase collateral images and showed the possibility of the multiphase MRA collateral map as a useful collateral imaging method in acute ischemic stroke.
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Affiliation(s)
- H G Roh
- From the Departments of Radiology (H.G.R., J.W.C.)
| | - E Y Kim
- Department of Radiology (E.Y.K.), Gachon University Gil Medical Center, Incheon, Korea
| | - I S Kim
- Siemens Healthineers Ltd (I.S.K.), Seoul, Korea
| | - H J Lee
- Departments of Neurosurgery (H.J.L., S.U.K.)
| | | | | | - J W Choi
- From the Departments of Radiology (H.G.R., J.W.C.)
| | - Y S Jeon
- Neurosurgery (Y.S.J.), Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - M Park
- Department of Radiology (M.P.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - S U Kim
- Departments of Neurosurgery (H.J.L., S.U.K.)
| | - H J Kim
- Radiology (H.J.K.), Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea
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24
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Di Pilato M, Kim EY, Cadilha BL, Prüßmann JN, Nasrallah MN, Seruggia D, Usmani SM, Misale S, Zappulli V, Carrizosa E, Mani V, Ligorio M, Warner RD, Medoff BD, Marangoni F, Villani AC, Mempel TR. Targeting the CBM complex causes T reg cells to prime tumours for immune checkpoint therapy. Nature 2019; 570:112-116. [PMID: 31092922 PMCID: PMC6656391 DOI: 10.1038/s41586-019-1215-2] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [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: 12/15/2017] [Accepted: 04/17/2019] [Indexed: 12/24/2022]
Abstract
Solid tumors are infiltrated by effector T cells (Teff) with the potential to control or reject them, as well as by regulatory T cells (Treg) that restrict the function of Teff and thereby promote tumor growth.1 The anti-tumor activity of Teff can be therapeutically unleashed and is now being exploited for the treatment of some forms of human cancer. However, weak tumor-associated inflammatory responses and the immune-suppressive function of Treg remain major hurdles to broader effectiveness of tumor immunotherapy.2 Here we show that upon disruption of the CARMA1-BCL10-MALT1 (CBM) signalosome complex, the majority of tumor-infiltrating Treg produce IFN-γ, followed by stunted tumor growth. Remarkably, genetic deletion of both or even just one allele of Carma1 in only a fraction of Treg, which avoided systemic autoimmunity, was sufficient to produce this anti-tumor effect, showing that not mere loss of suppressive function, but gain of effector activity by Treg initiates tumor control. Treg-production of IFN-γ was accompanied by macrophage activation and up-regulation of MHC-I on tumor cells. However, tumor cells also up-regulated expression of PD-L1, indicating activation of adaptive immune resistance.3 Consequently, PD-1 blockade concomitant with CARMA1-deletion caused rejection of tumors that otherwise do not respond to anti-PD-1 monotherapy. This effect was reproduced by pharmacological inhibition of the CBM protein MALT1. Our results demonstrate that partial disruption of the CBM complex and induction of IFN-γ-secretion in the preferentially self-reactive Treg pool does not cause systemic autoimmunity but is sufficient to prime the tumor environment for successful immune checkpoint therapy.
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Affiliation(s)
- Mauro Di Pilato
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Edward Y Kim
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Bruno L Cadilha
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA
| | - Jasper N Prüßmann
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Mazen N Nasrallah
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Davide Seruggia
- Harvard Medical School, Boston, MA, USA.,Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA, USA
| | - Shariq M Usmani
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Sandra Misale
- Harvard Medical School, Boston, MA, USA.,Center for Cancer Research, Massachusetts General Hospital, Boston, MA, USA
| | - Valentina Zappulli
- Department of Comparative Biomedicine and Food Science, University of Padua, Padova, Italy
| | - Esteban Carrizosa
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Vinidhra Mani
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Matteo Ligorio
- Harvard Medical School, Boston, MA, USA.,Center for Cancer Research, Massachusetts General Hospital, Boston, MA, USA
| | - Ross D Warner
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA
| | - Benjamin D Medoff
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Francesco Marangoni
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Alexandra-Chloe Villani
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Thorsten R Mempel
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
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25
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Hartvigson PE, Apisarnthanarax S, Schaub S, Cohen S, Bernier G, Koh WJ, Kim EY. Radiation Therapy Dose Escalation to Clinically Involved Pelvic Sidewall Lymph Nodes in Locally Advanced Rectal Cancer. Adv Radiat Oncol 2019; 4:478-486. [PMID: 31360803 PMCID: PMC6639784 DOI: 10.1016/j.adro.2019.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/24/2019] [Accepted: 03/20/2019] [Indexed: 12/20/2022] Open
Abstract
Purpose Lateral pelvic sidewall lymph nodes (PSW LN) may be involved in up to 24% of locoregionally advanced rectal cancers. PSW LN are not resected in total mesorectal excision (TME), and no standard of care regarding the management of PSW LN exists in the United States. We assessed our institutional experience of preoperative radiation therapy (RT) boost to clinically involved PSW LN that were not planned for resection. Methods and materials Data from all patients with rectal adenocarcinoma treated between 2006 and 2018 were reviewed to identify those who received a cumulative dose of >50.4 Gy to suspicious PSW LN during neoadjuvant chemoradiation therapy (nCRT). Demographic, cancer characteristic, treatment, and toxicity data were derived from the chart. Results Of a total of 261 patients, 12 patients met the inclusion criteria. The median age was 47.5 years, and 83% of patients were men. All patients had T3/4 disease, 17% of patients had N1b disease and the remainder had N2 disease, and 33% had M1 disease (all ≤2 metastases). Seventy-five percent of patients had moderately or poorly differentiated histology. The mean distance from the anal verge was 4.85 cm (range, 2-8.9 cm), and 58% had ≥2 PSW LN with an average short axis diameter of 1.11 cm (range, 0.4-3.2 cm). Boost doses ranged from 53.48 Gy to 60.2 Gy in 27 to 30 fractions (1.8-2.15 Gy/fraction). The median follow-up time was 18 months. One patient who received concurrent capecitabine and irinotecan had grade 3 perineal dermatitis and anemia during nCRT. The median hospitalization time for TME was 6.5 days. Within 90 days of TME, 1 patient required surgical exploration for perineal wound breakdown, and another required a blood transfusion for anemia. At the time of the last follow up, 75% of patients were alive. Local control at 12 months was 90%. Conclusions RT dose escalation to nonresected PSW LN during nCRT was well tolerated with a low risk of acute toxicity and perioperative complications and has a high rate of local control at 12 months. RT boost warrants further study in patients with clinically involved nonresected PSW LN.
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Affiliation(s)
- Pehr E Hartvigson
- Department of Radiation Oncology, Seattle, Washington.,Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon
| | | | | | | | - Greta Bernier
- Department of Surgery, University of Washington School of Medicine, Seattle, Washington
| | - Wui-Jin Koh
- National Comprehensive Cancer Network, Plymouth Meeting, Pennsylvania
| | - Edward Y Kim
- Department of Radiation Oncology, Seattle, Washington
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26
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Spraker MB, Wootton LS, Hippe DS, Ball KC, Peeken JC, Macomber MW, Chapman TR, Hoff MN, Kim EY, Pollack SM, Combs SE, Nyflot MJ. MRI Radiomic Features Are Independently Associated With Overall Survival in Soft Tissue Sarcoma. Adv Radiat Oncol 2019; 4:413-421. [PMID: 31011687 PMCID: PMC6460235 DOI: 10.1016/j.adro.2019.02.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [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: 11/05/2018] [Accepted: 02/12/2019] [Indexed: 11/21/2022] Open
Abstract
Purpose Soft tissue sarcomas (STS) represent a heterogeneous group of diseases, and selection of individualized treatments remains a challenge. The goal of this study was to determine whether radiomic features extracted from magnetic resonance (MR) images are independently associated with overall survival (OS) in STS. Methods and Materials This study analyzed 2 independent cohorts of adult patients with stage II-III STS treated at center 1 (N = 165) and center 2 (N = 61). Thirty radiomic features were extracted from pretreatment T1-weighted contrast-enhanced MR images. Prognostic models for OS were derived on the center 1 cohort and validated on the center 2 cohort. Clinical-only (C), radiomics-only (R), and clinical and radiomics (C+R) penalized Cox models were constructed. Model performance was assessed using Harrell's concordance index. Results In the R model, tumor volume (hazard ratio [HR], 1.5) and 4 texture features (HR, 1.1-1.5) were selected. In the C+R model, both age (HR, 1.4) and grade (HR, 1.7) were selected along with 5 radiomic features. The adjusted c-indices of the 3 models ranged from 0.68 (C) to 0.74 (C+R) in the derivation cohort and 0.68 (R) to 0.78 (C+R) in the validation cohort. The radiomic features were independently associated with OS in the validation cohort after accounting for age and grade (HR, 2.4; P = .009). Conclusions This study found that radiomic features extracted from MR images are independently associated with OS when accounting for age and tumor grade. The overall predictive performance of 3-year OS using a model based on clinical and radiomic features was replicated in an independent cohort. Optimal models using clinical and radiomic features could improve personalized selection of therapy in patients with STS.
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Affiliation(s)
- Matthew B. Spraker
- Department of Radiation Oncology, Washington University in St. Louis, St. Louis, Missouri
- Corresponding author. 4921 Parkview Place, CAM LL, CB 8224, St. Louis, MO 63110.
| | - Landon S. Wootton
- Department of Radiation Oncology, University of Washington, Seattle, Washington
| | - Daniel S. Hippe
- Department of Radiology, University of Washington, Seattle, Washington
| | - Kevin C. Ball
- Aurora St. Luke's Medical Center, Department of Diagnostic Radiology, Milwaukee, Wisconsin
| | - Jan C. Peeken
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Institute of Innovative Radiation therapy, Department of Radiation Sciences, Helmholtz Zentrum München, Neuherberg, Germany
- Deutsches Konsortium für Translationale Krebsforschung, Munich, Germany
| | - Meghan W. Macomber
- Department of Radiation Oncology, University of Washington, Seattle, Washington
| | - Tobias R. Chapman
- Beth Israel Deaconess Medical Center, Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts
| | - Michael N. Hoff
- Department of Radiology, University of Washington, Seattle, Washington
| | - Edward Y. Kim
- Department of Radiation Oncology, University of Washington, Seattle, Washington
| | - Seth M. Pollack
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Division of Medical Oncology, University of Washington, Seattle, Washington
| | - Stephanie E. Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Matthew J. Nyflot
- Department of Radiation Oncology, University of Washington, Seattle, Washington
- Department of Radiology, University of Washington, Seattle, Washington
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27
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Kim EY, Park YL, Park CH, Suh BC. Abstract P4-11-03: Withdrawn. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-11-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
Citation Format: Kim EY, Park YL, Park CH, Suh BC. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-11-03.
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Affiliation(s)
- EY Kim
- Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - YL Park
- Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - CH Park
- Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - BC Suh
- Kangbuk Samsung Hospital, Seoul, Republic of Korea
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28
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Park SE, Yoon SS, Park SC, Kim EY. Analysis of Pre-transplant Resuscitation Factors Influencing Immediate Graft Function After Deceased Donor Kidney Transplantation. Transplant Proc 2018; 50:3088-3094. [PMID: 30577171 DOI: 10.1016/j.transproceed.2018.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/12/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The management of a deceased donor in the intensive care unit before organ transplantation is important for the outcome of the recipient. Herein, we analyze the pre-transplant resuscitation factors managed before procurement that could influence graft function immediately after deceased-donor kidney transplantation (DDKT). METHODS A total of 271 DDKTs performed at Seoul St. Mary's Hospital, Korea, from January 2009 to March 2016 were reviewed. We divided the patients into a delayed graft function (DGF) group and a non-DGF group, and compared postoperative outcomes between the 2 groups. We also analyzed the predisposing factors of DGF using multivariate analysis. RESULTS A total of 36 cases developed DGF while 235 patients did not, and the demographic characteristics of the recipients in the two groups had no significant difference. Of the pre-transplant resuscitation factors, preoperative polyuria, the maximal levels of serum sodium and BUN, and transfer times were significantly higher in the DGF group (P < .001). In a multivariable analysis, preoperative polyuria (odds ratio 4.835, P = .036), elevated preoperative level of sodium (odds ratio 1.227, P = .001), and extended transfer times (odds ratio 1.001, P < .001) were the independent risk factors of the donor in pre-transplant resuscitation management associated with DGF. CONCLUSIONS Polyuria, high levels of sodium before procurement, and prolonged transfer times are independent risk factors for DGF after a DDKT. Active intervention and early implementation of the intensivist can help in managing these factors effectively and thus ultimately improve graft function.
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Affiliation(s)
- S E Park
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - S S Yoon
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - S C Park
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - E Y Kim
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea.
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Schaub SK, Hartvigson PE, Lock MI, Høyer M, Brunner TB, Cardenes HR, Dawson LA, Kim EY, Mayr NA, Lo SS, Apisarnthanarax S. Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma: Current Trends and Controversies. Technol Cancer Res Treat 2018; 17:1533033818790217. [PMID: 30068240 PMCID: PMC6071169 DOI: 10.1177/1533033818790217] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Hepatocellular carcinoma is the fourth leading cause of cancer-related death worldwide.
Depending on the extent of disease and competing comorbidities for mortality, multiple
liver-directed therapy options exist for the treatment of hepatocellular carcinoma.
Advancements in radiation oncology have led to the emergence of stereotactic body
radiation therapy as a promising liver-directed therapy, which delivers high doses of
radiation with a steep dose gradient to maximize local tumor control and minimize
radiation-induced treatment toxicity. In this study, we review the current clinical data
as well as the unresolved issues and controversies regarding stereotactic body radiation
therapy for hepatocellular carcinoma: (1) Is there a radiation dose–response relationship
with hepatocellular carcinoma? (2) What are the optimal dosimetric predictors of
radiation-induced liver disease, and do they differ for patients with varying liver
function? (3) How do we assess treatment response on imaging? (4) How does stereotactic
body radiation therapy compare to other liver-directed therapy modalities, including
proton beam therapy? Based on the current literature discussed, this review highlights
future possible research and clinical directions.
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Affiliation(s)
- Stephanie K Schaub
- 1 Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - Pehr E Hartvigson
- 1 Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - Michael I Lock
- 2 Department of Radiation Oncology, University of Western Ontario, London, Canada
| | - Morten Høyer
- 3 Aarhus University Hospital, Danish Center for Particle Therapy, Aarhus, Denmark
| | - Thomas B Brunner
- 4 Klinik für Strahlentherapie, Universitätsklinikum Magdeburg, Magdeburg, Germany
| | | | - Laura A Dawson
- 6 Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Edward Y Kim
- 1 Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - Nina A Mayr
- 1 Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - Simon S Lo
- 1 Department of Radiation Oncology, University of Washington, Seattle, WA, USA
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Hjortness MK, Riccardi L, Hongdusit A, Ruppe A, Zhao M, Kim EY, Zwart PH, Sankaran B, Arthanari H, Sousa MC, De Vivo M, Fox JM. Abietane-Type Diterpenoids Inhibit Protein Tyrosine Phosphatases by Stabilizing an Inactive Enzyme Conformation. Biochemistry 2018; 57:5886-5896. [PMID: 30169954 DOI: 10.1021/acs.biochem.8b00655] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Protein tyrosine phosphatases (PTPs) contribute to a striking variety of human diseases, yet they remain vexingly difficult to inhibit with uncharged, cell-permeable molecules; no inhibitors of PTPs have been approved for clinical use. This study uses a broad set of biophysical analyses to evaluate the use of abietane-type diterpenoids, a biologically active class of phytometabolites with largely nonpolar structures, for the development of pharmaceutically relevant PTP inhibitors. Results of nuclear magnetic resonance analyses, mutational studies, and molecular dynamics simulations indicate that abietic acid can inhibit protein tyrosine phosphatase 1B, a negative regulator of insulin signaling and an elusive drug target, by binding to its active site in a non-substrate-like manner that stabilizes the catalytically essential WPD loop in an inactive conformation; detailed kinetic studies, in turn, show that minor changes in the structures of abietane-type diterpenoids (e.g., the addition of hydrogens) can improve potency (i.e., lower IC50) by 7-fold. These findings elucidate a previously uncharacterized mechanism of diterpenoid-mediated inhibition and suggest, more broadly, that abietane-type diterpenoids are a promising source of structurally diverse-and, intriguingly, microbially synthesizable-molecules on which to base the design of new PTP-inhibiting therapeutics.
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Affiliation(s)
- Michael K Hjortness
- Department of Chemical and Biological Engineering , University of Colorado , 3415 Colorado Avenue , Boulder , Colorado 80303 , United States
| | - Laura Riccardi
- Laboratory of Molecular Modeling and Drug Discovery , Istituto Italiano di Tecnologia , Via Morego 30 , 16163 Genova , Italy
| | - Akarawin Hongdusit
- Department of Chemical and Biological Engineering , University of Colorado , 3415 Colorado Avenue , Boulder , Colorado 80303 , United States
| | - Alex Ruppe
- Department of Chemical and Biological Engineering , University of Colorado , 3415 Colorado Avenue , Boulder , Colorado 80303 , United States
| | - Mengxia Zhao
- Department of Chemistry and Chemical Biology , Harvard University , 12 Oxford Street , Cambridge , Massachusetts 02138 , United States
| | - Edward Y Kim
- Department of Chemical and Biological Engineering , University of Colorado , 3415 Colorado Avenue , Boulder , Colorado 80303 , United States
| | - Peter H Zwart
- Molecular Biophysics and Integrated Bioimaging , Lawrence Berkeley National Laboratory , Berkeley , California 94720 , United States
| | - Banumathi Sankaran
- Molecular Biophysics and Integrated Bioimaging , Lawrence Berkeley National Laboratory , Berkeley , California 94720 , United States
| | - Haribabu Arthanari
- Department of Biological Chemistry and Molecular Pharmacology , Harvard Medical School , 240 Longwood Avenue , Boston , Massachusetts 02115 , United States
| | - Marcelo C Sousa
- Department of Biochemistry , University of Colorado , 3415 Colorado Avenue , Boulder , Colorado 80303 , United States
| | - Marco De Vivo
- Laboratory of Molecular Modeling and Drug Discovery , Istituto Italiano di Tecnologia , Via Morego 30 , 16163 Genova , Italy
| | - Jerome M Fox
- Department of Chemical and Biological Engineering , University of Colorado , 3415 Colorado Avenue , Boulder , Colorado 80303 , United States
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Seo YD, Zhou J, Morse K, Patino J, Mackay S, Kim EY, Conrad EU, O'Malley RB, Cranmer LD, Lu H, Hsu FJ, Xu Y, Loggers ET, Hain T, Pillarisetty VG, Kane G, Riddell S, ter Meulen JH, Jones RL, Pollack S. Effect of intratumoral (IT) injection of the toll-like receptor 4 (TLR4) agonist G100 on a clinical response and CD4 T-cell response locally and systemically. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.5_suppl.71] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
71 Background: Soft tissue sarcomas (STS) are heterogeneous tumors which are morbid and lethal. G100 is under investigation in multiple clinical trials and contains a potent TLR4 agonist (oil-in-water emulsion of glucopyranosyl lipid A) that has been tested as vaccine adjuvant. We hypothesized IT G100 would induce robust local and potentially systemic anti-tumor immune response, leading to improved outcomes. Methods: 15 metastatic STS patients with superficial lesions were treated with weekly IT G100 for 8-12 wks; 12 patients received radiation (RT) for 2 wks to start, while 3 received IT G100 for 6 wks prior to RT. Biopsies and PBMC were collected pre and post treatment, and flow cytometry was performed on biopsies. TIL and PBMC were analyzed with TCR deep sequencing. PBMC were analyzed by single cell multiplex cytokine profiling. Results: No grade ≥ 3 toxicity was observed, and local tumor control was achieved in all evaluable tumors (14/14). Treated tumors tracked post-trial (mean 156 days) had persistent local control with 1 CR (7%), 1 PR (7%), and 11 SD (79%). In 3 patients with long term follow up, treated lesions remained controlled vs index lesions (-53% vs +31% at mean 235 days, p = 0.002). In all tumors after G100 alone, T cell infiltration increased. In P14, CD3 live cells in tumor rose from < 1% to 62%. PBMC clonality increased in 8/14 tested including P06, who had 4× increase in clonality and CR in the injected lesion; PBMC and TIL TCR overlap increased from 13.4% to 21.5%. P13 had a 2.3× rise in TIL clonality; the top clone (a CD4 T cell) expanded from 0.1% to 38% and expressed more TNFα than the rest (p < 0.0001). Single cell cytokine analysis of PBMC showed 7/13 (54%) increased in polyfunctionality (producing > 2 cytokines) in CD4 T cells; no consistent increase was seen in CD8 T cells. TNFα levels in pre-treatment monocytes correlated with PFS (R2= 0.5, p = 0.02). Conclusions: IT G100 is a viable agent for local control of metastatic STS lesions. With or without RT, G100 appears to cause CD4 T cell mediated local and systemic response. Combination of G100 with other immunomodulators could induce clinically significant systemic responses, as seen in follicular NHL treated with G100. Clinical trial information: NCT02180698.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Yuexin Xu
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Taylor Hain
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | | | | | | | - Robin Lewis Jones
- Royal Marsden Hospital, The Institute of Cancer Research, London, United Kingdom
| | - Seth Pollack
- Fred Hutchinson Cancer Research Center, Seattle, WA
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Kim HR, Kang HN, Shim HS, Kim EY, Kim J, Kim DJ, Lee JG, Lee CY, Hong MH, Kim SM, Kim H, Pyo KH, Yun MR, Park HJ, Han JY, Youn HA, Ahn MJ, Paik S, Kim TM, Cho BC. Co-clinical trials demonstrate predictive biomarkers for dovitinib, an FGFR inhibitor, in lung squamous cell carcinoma. Ann Oncol 2018; 28:1250-1259. [PMID: 28460066 DOI: 10.1093/annonc/mdx098] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background We conducted co-clinical trials in patient-derived xenograft (PDX) models to identify predictive biomarkers for the multikinase inhibitor dovitinib in lung squamous cell carcinoma (LSCC). Methods The PDX01-02 were established from LSCC patients enrolled in the phase II trial of dovitinib (NCT01861197) and PDX03-05 were established from LSCC patients receiving surgery. These five PDX tumors were subjected to in vivo test of dovitinib efficacy, whole exome sequencing and gene expression profiling. Results The PDX tumors recapitulate histopathological properties and maintain genomic characteristics of originating tumors. Concordant with clinical outcomes of the trial enrolled-LSCC patients, dovitinib produced substantial tumor regression in PDX-01 and PDX-05, whereas it resulted in tumor progression in PDX-02. PDX-03 and -04 also displayed poor antitumor efficacy to dovitinib. Mutational and genome-wide copy number profiles revealed no correlation between genomic alterations of FGFR1-3 and sensitivity to dovitinib. Of note, gene expression profiles revealed differentially expressed genes including FGF3 and FGF19 between PDX-01 and 05 and PDX-02-04. Pathway analysis identified two FGFR signaling-related gene sets, FGFR ligand binding/activation and SHC-mediated cascade pathway were substantially up-regulated in PDX-01 and 05, compared with PDX-02-04. The comparison of gene expression profiles between dovitinib-sensitive versus -resistant lung cancer cell lines in the Cancer Cell Line Encyclopedia database also found that transcriptional activation of 18 key signaling components in FGFR pathways can predict the sensitivity to dovitinib both in cell lines and PDX tumors. These results highlight FGFR pathway activation as a key molecular determinant for sensitivity to dovitinib. Conclusions FGFR gene expression signatures are predictors for the response to dovitinib in LSCC.
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Affiliation(s)
- H R Kim
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul
| | - H N Kang
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | | | - E Y Kim
- Pulmonology, Yonsei University College of Medicine, Seoul
| | - J Kim
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul
| | - D J Kim
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul
| | - J G Lee
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul
| | - C Y Lee
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul
| | - M H Hong
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul
| | - S-M Kim
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - H Kim
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - K-H Pyo
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - M R Yun
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - H J Park
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - J Y Han
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - H A Youn
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - M-J Ahn
- Division of Hematology & Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S Paik
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul
| | - T-M Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - B C Cho
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul.,JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
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Shin DH, Kim EY. Regarding "Perfusion MR Imaging Using a 3D Pulsed Continuous Arterial Spin-Labeling Method for Acute Cerebral Infarction Classified as Branch Atheromatous Disease Involving the Lenticulostriate Artery Territory". AJNR Am J Neuroradiol 2017; 38:E103. [PMID: 28818823 DOI: 10.3174/ajnr.a5356] [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: 11/07/2022]
Affiliation(s)
| | - E Y Kim
- Department of Radiology Gachon University Gil Medical Center Incheon, South Korea
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Kim EY, Tyndall ER, Huang KC, Tian F, Ramamurthi KS. Dash-and-Recruit Mechanism Drives Membrane Curvature Recognition by the Small Bacterial Protein SpoVM. Cell Syst 2017; 5:518-526.e3. [PMID: 29102609 DOI: 10.1016/j.cels.2017.10.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 04/26/2017] [Revised: 07/24/2017] [Accepted: 10/05/2017] [Indexed: 10/18/2022]
Abstract
In Bacillus subtilis, sporulation requires that the 26-amino acid protein SpoVM embeds specifically into the forespore membrane, a structure with convex curvature. How this nanometer-sized protein can detect curves on a micrometer scale is not well understood. Here, we report that SpoVM exploits a "dash-and-recruit" mechanism to preferentially accumulate on the forespore. Using time-resolved imaging and flow cytometry, we observe that SpoVM exhibits a faster adsorption rate onto membranes of higher convex curvature. This preferential adsorption is accurately modeled as a two-step process: first, an initial binding event occurs with a faster on rate, then cooperative recruitment of additional SpoVM molecules follows. We demonstrate that both this biochemical process and effective sporulation in vivo require an unstructured and flexible SpoVM N terminus. We propose that this two-pronged strategy of fast adsorption followed by recruitment of subsequent molecules is a general mechanism that allows small proteins to detect subtle curves with a radius 1,000-fold their size.
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Affiliation(s)
- Edward Y Kim
- Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Erin R Tyndall
- Department of Biochemistry and Molecular Biology, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA
| | - Kerwyn Casey Huang
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA; Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - Fang Tian
- Department of Biochemistry and Molecular Biology, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA.
| | - Kumaran S Ramamurthi
- Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Seo YD, Kim EY, Conrad EU, O'Malley RB, Cooper S, Donahue B, Cranmer LD, Lu H, Hsu F, Loggers ET, Hain T, Davidson DJ, Bonham L, Pillarisetty VG, Kane GM, Riddell SR, Jones RL, Pollack SM. Abstract 2947: Intratumoral injection of the toll-like receptor 4 agonist G100 induces a T-cell response in the soft tissue sarcoma microenvironment. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-2947] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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
Introduction: Soft tissue sarcomas (STS) are heterogeneous mesenchymal tumors which are both morbid and lethal. G100 is a stable oil-in-water emulsion of glucopyranosyl lipid adjuvant, a highly potent toll-like receptor 4 (TLR4) agonist, which has been utilized for intratumoral (IT) injections and as vaccine adjuvants without significant toxicity. We hypothesized that IT G100 would induce a robust local and potentially systemic anti-tumor immune response in the STS microenvironment, leading to improved outcomes.
Methods: 15 metastatic STS patients who had a superficial injectable lesion were treated with weekly IT G100 for 8-12 weeks; 12 patients received concurrent radiation for 2 weeks at the start, while 3 got IT G100 alone for 6 weeks prior to radiation. Biopsies and blood were collected pre and post treatment, and flow cytometry was performed on fresh tumor samples. T-cell receptor (TCR) deep sequencing of tumor-infiltrating lymphocytes (TIL) and peripheral blood mononuclear cells (PBMC) was performed on 7 patients. RECIST v1.1 and the Common Terminology Criteria for Adverse Events were used to monitor clinical outcomes.
Results: Patients had a median of 3 (0~5) prior lines of therapy and mean tumor size of 5.6cm (1~20cm). No grade 3 or higher treatment-related toxicity was observed, and local tumor control was achieved in 93% (14/15). 6 (40%) had stable disease after treatment, and 1 (P06) had complete regression of injected tumor. This tumor had a high percentage of infiltrating pre-treatment immune cells (12% CD45+ on flow cytometry versus 2.7% for all other tumors). TCR sequencing showed that the increase in clonality of PBMC after treatment was greater in P06 (389%) compared to 6 other patients (mean 34%). There was also higher overlap in TCR sequence between TIL versus PBMC after treatment (13% versus 22%), suggesting systemic expansion of tumor-specific T-cells. In 7 patients evaluable for tumor-associated macrophages (tumors with >1000 CD45+CD11b+ cells), 71% had a shift from an M2 to M1 phenotype. In all patients who received G100 alone, there was an increase in T-cell infiltration into tumor after treatment. In one patient (P14), the proportion of CD3+ live cells in tumor went from <1% to 62%; of these, 51% were CD4+ and 44% were CD8+. TIL from P14 had a 251% increase in clonality after treatment; at the same time, percentage of live tumor cells that were PD-L1+ increased from 0.02% to 1.3%.
Conclusion: IT G100 provides a potentially viable agent for local control of metastatic STS. With or without radiation, G100 appears to shift the tumor microenvironment into a more inflammatory state with significant infiltration of T cells. The increase in clonality in PBMC and TIL, as well as increased overlap of tumor-associated versus peripheral TCR sequences, suggest induction of a tumor-specific response. Combination of G100 with other immunomodulators may further enhance the adaptive anti-tumor response.
Citation Format: Yongwoo D. Seo, Edward Y. Kim, Ernest U. Conrad, Ryan B. O'Malley, Sara Cooper, Bailey Donahue, Lee D. Cranmer, Hailing Lu, Frank Hsu, Elizabeth T. Loggers, Taylor Hain, Darin J. Davidson, Lynn Bonham, Venu G. Pillarisetty, Gabrielle M. Kane, Stanley R. Riddell, Robin L. Jones, Seth M. Pollack. Intratumoral injection of the toll-like receptor 4 agonist G100 induces a T-cell response in the soft tissue sarcoma microenvironment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2947. doi:10.1158/1538-7445.AM2017-2947
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Affiliation(s)
| | | | | | | | - Sara Cooper
- 3Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | | | | | | | | | - Taylor Hain
- 3Fred Hutchinson Cancer Research Center, Seattle, WA
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Lock MI, Klein J, Chung HT, Herman JM, Kim EY, Small W, Mayr NA, Lo SS. Strategies to tackle the challenges of external beam radiotherapy for liver tumors. World J Hepatol 2017; 9:645-656. [PMID: 28588749 PMCID: PMC5437609 DOI: 10.4254/wjh.v9.i14.645] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 12/20/2016] [Accepted: 04/20/2017] [Indexed: 02/06/2023] Open
Abstract
Primary and metastatic liver cancer is an increasingly common and difficult to control disease entity. Radiation offers a non-invasive treatment alternative for these patients who often have few options and a poor prognosis. However, the anatomy and aggressiveness of liver cancer poses significant challenges such as accurate localization at simulation and treatment, management of motion and appropriate selection of dose regimen. This article aims to review the options available and provide information for the practical implementation and/or improvement of liver cancer radiation programs within the context of stereotactic body radiotherapy and image-guided radiotherapy guidelines. Specific patient inclusion and exclusion criteria are presented given the significant toxicity found in certain sub-populations treated with radiation. Indeed, certain sub-populations, such as those with tumor thrombosis or those with larger lesions treated with transarterial chemoembolization, have been shown to have significant improvements in outcome with the addition of radiation and merit special consideration. Implementing a liver radiation program requires three primary challenges to be addressed: (1) immobilization and motion management; (2) localization; and (3) dose regimen and constraint selection. Strategies to deal with motion include simple internal target volume (ITV) expansions, non-gated ITV reduction strategies, breath hold methods, and surrogate marker methods to enable gating or tracking. Localization of the tumor and organs-at-risk are addressed using contrast infusion techniques to take advantage of different normal liver and cancer vascular anatomy, imaging modalities, and margin management. Finally, a dose response has been demonstrated and dose regimens appear to be converging. A more uniform approach to treatment in terms of technique, dose selection and patient selection will allow us to study liver radiation in larger and, hopefully, multicenter randomized studies.
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Kim EY, Lee HY, Kim YS, Park I, Ahn HK, Cho EK, Jeong YM, Kim JH. Prognostic significance of cachexia score assessed by CT in male patients with small cell lung cancer. Eur J Cancer Care (Engl) 2017; 27. [PMID: 28426181 DOI: 10.1111/ecc.12695] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2017] [Indexed: 11/26/2022]
Abstract
To determine the prognostic significance of CT-determined cachexia scores (CSs) in 127 consecutive male small cell lung cancer (SCLC) patients, cross-sectional areas of muscle and fat tissues at the third lumbar vertebra (L3) were retrospectively measured on baseline CT images. CSs were determined based on the presence of sarcopenia and/or adipopenia. According to the presence of sarcopenia (L3 muscle index <55 cm2 /m2 , 86.8%) and adipopenia (L3 fat index <22 cm2 /m2 , 11.8%), CSs were defined as follows: CS2 (sarcopenia and adipopenia, 11.8%), CS1 (sarcopenia only, 74.8%) and CS0 (13.4%). CS2 was significantly related to lower body mass index (p < .001) and poor performance status (p = .002), and patients with CS2 had shorter OS than patients with CS1 or CS0 (median OS, 5.0 months vs. 8.9 months vs. 18.3 months; p = .007). Multivariable analysis revealed that CS was an independent prognostic factor of poor survival (HR, 1.99 for CS1 and 2.59 for CS2, p = .036 and .023, CS0 as a reference), along with extensive stage (p < .001), supportive care only (p < .001) and an elevated lactate dehydrogenase (p = .005). CT-determined CSs, based on the presence of sarcopenia and/or adipopenia, could be used to predict prognosis in male SCLC.
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Affiliation(s)
- E Y Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea
| | - H Y Lee
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea
| | - Y S Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - I Park
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - H K Ahn
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - E K Cho
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Y M Jeong
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea
| | - J H Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea
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Chvetsov AV, Rajendran JG, Zeng J, Patel SA, Bowen SR, Kim EY. Theoretical effectiveness of cell survival in fractionated radiotherapy with hypoxia-targeted dose escalation. Med Phys 2017; 44:1975-1982. [PMID: 28236652 DOI: 10.1002/mp.12177] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 02/07/2017] [Accepted: 02/07/2017] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The goal of this article is to compute the cell survival during fractionated radiotherapy with non-uniform hypoxia-targeted dose distribution relative to cell survival for a uniform dose distribution with equal integral tumor dose. The analysis is performed for different parameters of radiotherapy with conventional and hypofractionated dose regimens. METHODS Our analysis is done using a parsimonious tumor response model that describes the major components of tumor response to radiotherapy such as radiosensitivity, cell proliferation, and hypoxia using as few variables as possible. Two levels of oxygenated and hypoxic cells with the survival curves described by the linear quadratic (LQ) model are implemented in the model. The model allows for analytical solutions for relative cell survival in a single fraction simulation which can be used for additional validation of our numerical simulations. The relative cell survival was computed for conventional and hypofractionated dose regimens in a model problem with radiobiological parameters for the non-small-cell lung cancer. Sensitivity of cell survival to different parameters of radiotherapy such as the relative volume of hypoxic fraction, boost dose ratio, re-oxygenation rate, and delivery errors was investigated. RESULTS Our computational and analytical results show that relative cell survival for non-uniform and uniform dose distributions is larger than 1.0 during the first few fractions of radiotherapy with conventional fractionation. This indicates that the uniform dose distribution produces a higher cell killing effect for the equal integral dose. This may stem from domination of linear contribution to the cell killing effect seen in the dose range of 1-2 Gy and a steeper slope of survival curve in the oxygenated tumor region. This effect can only happen if the distribution of clonogens is nearly uniform; therefore, after the first few fractions, the non-uniform dose distributions outperform the uniform dose distribution and relative cell survival becomes less than 1.0. However, re-oxygenation and delivery errors can also reduce the effectiveness of hypoxia-targeted non-uniform dose distributions toward the end of treatment. For hypofractionated radiotherapy with fractional dose >3 Gy, the relative cell survival was always below 1.0, which means the non-uniform dose distributions produced higher cell killing effect than the uniform dose distribution during the entire treatment. CONCLUSION The data obtained in this work suggest that non-uniform hypoxia-targeted dose distributions are less effective at cell killing than uniform dose distributions at the beginning of radiotherapy with conventional fractionation. However; non-uniform dose distributions can outperform uniform dose distribution by the end of the treatment if the effects of re-oxygenation and delivery errors are reduced. In hypofractionated radiotherapy, non-uniform hypoxia-targeted dose distributions are more efficient than uniform dose distributions during the entire treatment.
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Affiliation(s)
- Alexei V Chvetsov
- Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195-6043, USA
| | - Joseph G Rajendran
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195-6043, USA
| | - Jing Zeng
- Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195-6043, USA
| | - Shilpen A Patel
- Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195-6043, USA
| | - Stephen R Bowen
- Departments of Radiation Oncology and Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195-6043, USA
| | - Edward Y Kim
- Department of Radiation Oncology, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195-6043, USA
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Mullen TD, Kim EY, Apisarnthanarax S. Short-Course Radiation Therapy Versus Long-Course Chemoradiation in the Neoadjuvant Treatment of Locally Advanced Rectal Cancer: New Insights from Randomized Trials. Curr Colorectal Cancer Rep 2017. [DOI: 10.1007/s11888-017-0359-4] [Citation(s) in RCA: 4] [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] [Indexed: 01/13/2023]
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Torti E, Park JO, Chiorean EG, Kim EY, Cohen S, Coveler AL. Retrospective review of outcomes in patients (pts) with synchronous metastatic rectal cancer (mRC) receiving initial non-surgical management. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
797 Background: Management of mRC trends toward initial non-surgical management of the primary tumor based on studies demonstrating low complications rates from un-resected primary colonic tumors. The fixed location of the rectum may increase local complications. This study characterizes complications of pts with synchronous mRC with an intact primary tumor. Methods: A retrospective review of records from 2001 to 2013 identified pts with mRC by ICD-9/10 codes. Pts with treatment-naïve mRC without significant local symptomatology were evaluated. Time to complications and death were calculated. Pathology, stage, baseline CEA, RAS, BRAF and initial treatment were evaluated for prognostic significance. Results: Forty-four pts were identified with mRC; eight were excluded for initial resection for a symptomatic primary. Among the 36 evaluable pts treated with initial chemotherapy, 14 (39%) developed complications related to the primary tumor, of whom 5 (14%) developed two or more complications. Six (17%) required operative intervention due to primary tumor complications (two died prior to planned procedure). Complications were: perforations/abscesses/fistulae (6), bowel obstruction (5), severe bleeding (5), urinary obstruction/infection (3) and, pain requiring palliative treatment (1). Interventions included blood transfusions (5), stents (3), radiotherapy (3), I&D/drains (3) and, nephrostomy (2). Of 22 pts who did not develop any complications, 15 underwent curative resection of all sites of disease. Six remain disease free and nine relapsed, all distantly. None of the 14 who developed complications underwent curative operation. The median time to complication was 2.5 months. Median overall survival was 37 and 52 months for those with and without complications, respectively. Median time from complication to death was 21 months. Pts aged > 50 vs < 50 were more likely to have complications of the primary tumor (57% vs 21%). Conclusions: mRC pts with intact primary tumors may develop complications at a higher rate (39%) than those with colon cancer (11%). These findings will need to be confirmed with larger datasets and examine for specific treatment effects.
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Miyabe Y, Miyabe C, Murooka TT, Kim EY, Newton GA, Kim ND, Haribabu B, Luscinskas FW, Mempel TR, Luster AD. Complement C5a Receptor is the Key Initiator of Neutrophil Adhesion Igniting Immune Complex-induced Arthritis. Sci Immunol 2017; 2. [PMID: 28529998 DOI: 10.1126/sciimmunol.aaj2195] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The deposition of immune complexes (IC) in tissues induces a "type III hypersensitivity" that results in tissue damage and underlies the pathogenesis of many autoimmune diseases. The neutrophil is the first immune cell recruited into sites of IC deposition and plays a critical role in shaping the overall tissue response. However, the mechanism by which IC initiate and propagate neutrophil infiltration into tissue is not known. Here, using intravital multiphoton joint imaging of IC-induced arthritis in live mice, we found that the complement C5a receptor (C5aR) was the key initiator of neutrophil adhesion on joint endothelium. C5a presented on joint endothelium induced β2 integrin-dependent neutrophil arrest, facilitating neutrophil spreading and transition to crawling, and subsequent leukotriene B4 receptor (BLT1)-mediated extravasation of the first neutrophils. The chemokine receptor CCR1 promoted neutrophil crawling on the joint endothelium while CXCR2 amplified late neutrophil recruitment and survival once in the joint. Thus, imaging arthritis has defined a new paradigm for type III hypersensitivity where C5a directly initiates neutrophil adhesion on the joint endothelium igniting inflammation.
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Affiliation(s)
- Yoshishige Miyabe
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Chie Miyabe
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas T Murooka
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Edward Y Kim
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Gail A Newton
- Vascular Research Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy D Kim
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Bodduluri Haribabu
- James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky, USA
| | - Francis W Luscinskas
- Vascular Research Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Thorsten R Mempel
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew D Luster
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Kim EY, Joo SW, Han SJ, Kim MJ, Choi SY. Depression, Impulse Control Disorder, and Life Style According to Smartphone Addiction. Stud Health Technol Inform 2017; 245:1272. [PMID: 29295357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We examined depression, impulse control disorder, and life style by degree of smartphone addiction. Chi-square tests and ANOVA were used to identify significant variables. CART was used to generate a decision making diagram of variables affecting smartphone addiction. The severe smartphone addiction group had rates of depression and impulse control disorder than the initial smartphone group.
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Affiliation(s)
- E Y Kim
- Department of Health Care Administration, Seoyoung University, Paju-si, Gyeonggi-do, Republic of Korea
| | - S W Joo
- ACE Hospital, Ansan-si, Gyeonggi-do, Republic of Korea
| | - S J Han
- Department of Health Care Administration, Seoyoung University, Paju-si, Gyeonggi-do, Republic of Korea
| | - M J Kim
- Department of Health Care Administration, Seoyoung University, Paju-si, Gyeonggi-do, Republic of Korea
| | - S Y Choi
- Department of Health Care Administration, Seoyoung University, Paju-si, Gyeonggi-do, Republic of Korea
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Wu Y, Chandris P, Winter PW, Kim EY, Jaumouillé V, Kumar A, Guo M, Leung JM, Smith C, Rey-Suarez I, Liu H, Waterman CM, Ramamurthi KS, La Riviere PJ, Shroff H. Simultaneous multiview capture and fusion improves spatial resolution in wide-field and light-sheet microscopy. Optica 2016; 3:897-910. [PMID: 27761486 PMCID: PMC5066810 DOI: 10.1364/optica.3.000897] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Most fluorescence microscopes are inefficient, collecting only a small fraction of the emitted light at any instant. Besides wasting valuable signal, this inefficiency also reduces spatial resolution and causes imaging volumes to exhibit significant resolution anisotropy. We describe microscopic and computational techniques that address these problems by simultaneously capturing and subsequently fusing and deconvolving multiple specimen views. Unlike previous methods that serially capture multiple views, our approach improves spatial resolution without introducing any additional illumination dose or compromising temporal resolution relative to conventional imaging. When applying our methods to single-view wide-field or dual-view light-sheet microscopy, we achieve a twofold improvement in volumetric resolution (~235 nm × 235 nm × 340 nm) as demonstrated on a variety of samples including microtubules in Toxoplasma gondii, SpoVM in sporulating Bacillus subtilis, and multiple protein distributions and organelles in eukaryotic cells. In every case, spatial resolution is improved with no drawback by harnessing previously unused fluorescence.
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Affiliation(s)
- Yicong Wu
- Section on High Resolution Optical Imaging, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland 20892, USA
- Corresponding author:
| | - Panagiotis Chandris
- Section on High Resolution Optical Imaging, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Peter W. Winter
- Section on High Resolution Optical Imaging, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Edward Y. Kim
- Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Valentin Jaumouillé
- Cell Biology and Physiology Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Abhishek Kumar
- Section on High Resolution Optical Imaging, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Min Guo
- Section on High Resolution Optical Imaging, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland 20892, USA
- State Key Lab of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Jacqueline M. Leung
- Department of Biology, Indiana University Bloomington, Bloomington, Indiana 47405, USA
| | - Corey Smith
- Department of Radiology, University of Chicago, Chicago, Illinois 60637, USA
| | - Ivan Rey-Suarez
- Section on High Resolution Optical Imaging, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Huafeng Liu
- State Key Lab of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Clare M. Waterman
- Cell Biology and Physiology Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Kumaran S. Ramamurthi
- Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Patrick J. La Riviere
- Department of Radiology, University of Chicago, Chicago, Illinois 60637, USA
- Whitman Center, Marine Biological Laboratory, Woods Hole, Massachusetts 02543, USA
| | - Hari Shroff
- Section on High Resolution Optical Imaging, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland 20892, USA
- Whitman Center, Marine Biological Laboratory, Woods Hole, Massachusetts 02543, USA
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Jakobson CM, Chen Y, Slininger MF, Valdivia E, Kim EY, Tullman-Ercek D. Tuning the Catalytic Activity of Subcellular Nanoreactors. J Mol Biol 2016; 428:2989-96. [PMID: 27427532 DOI: 10.1016/j.jmb.2016.07.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 04/20/2016] [Revised: 06/29/2016] [Accepted: 07/06/2016] [Indexed: 11/25/2022]
Abstract
Bacterial microcompartments are naturally occurring subcellular organelles of bacteria and serve as a promising scaffold for the organization of heterologous biosynthetic pathways. A critical element in the design of custom biosynthetic organelles is quantitative control over the loading of heterologous enzymes to the interior of the organelles. We demonstrate that the loading of heterologous proteins to the 1,2-propanediol utilization microcompartment of Salmonella enterica can be controlled using two strategies: by modulating the transcriptional activation of the microcompartment container and by coordinating the expression of the microcompartment container and the heterologous cargo. These strategies allow general control over the loading of heterologous proteins localized by two different N-terminal targeting peptides and represent an important step toward tuning the catalytic activity of bacterial microcompartments for increased biosynthetic productivity.
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Affiliation(s)
- Christopher M Jakobson
- Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Yiqun Chen
- Department of Chemistry, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Marilyn F Slininger
- Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Elias Valdivia
- Department of Plant and Microbial Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Edward Y Kim
- Department of Chemical and Biomolecular Engineering, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Danielle Tullman-Ercek
- Department of Chemical and Biological Engineering, Northwestern University, Evanston, IL, USA.
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Pollack S, Kim EY, Conrad EU, O'Malley RB, Cooper S, Donahue B, Cranmer LD, Lu H, Loggers ET, Hain T, Davidson DJ, Bonham L, Pillarisetty VG, Kane G, Riddell SR, Jones RL. Using G100 (Glucopyranosyl Lipid A) to transform the sarcoma tumor immune microenvironment. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.11017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Seth Pollack
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | | | | | - Sara Cooper
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | | | | | | | - Tailor Hain
- Fred Hutchinson Cancer Research Center, Seattle, WA
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Lin EH, Kim EY, Wang L, Fong C, Shankaran V, Wu X, Wood DE, Yeung RS, Tian Q. ADAPT therapy vs capecitabine bevacizumab in stage IV colorectal cancer: Pooled 10-year survival experience and a phase II study update. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e15046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Ling Wang
- University of Washington, Seattle, WA
| | | | | | - Xifeng Wu
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Qiang Tian
- The Institute for Systems Biology, Seattle, WA
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Fu R, Gill RL, Kim EY, Briley NE, Tyndall ER, Xu J, Li C, Ramamurthi KS, Flanagan JM, Tian F. Spherical nanoparticle supported lipid bilayers for the structural study of membrane geometry-sensitive molecules. J Am Chem Soc 2015; 137:14031-14034. [PMID: 26488086 DOI: 10.1021/jacs.5b08303] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Many essential cellular processes including endocytosis and vesicle trafficking require alteration of membrane geometry. These changes are usually mediated by proteins that can sense and/or induce membrane curvature. Using spherical nanoparticle supported lipid bilayers (SSLBs), we characterize how SpoVM, a bacterial development factor, interacts with differently curved membranes by magic angle spinning solid-state NMR. Our results demonstrate that SSLBs are an effective system for structural and topological studies of membrane geometry-sensitive molecules.
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Affiliation(s)
- Riqiang Fu
- National High Magnetic Field Laboratory, Tallahassee, Florida 32310, United States
| | - Richard L Gill
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, Hershey, Pennsylvania 17033, United States
| | - Edward Y Kim
- Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, United States
| | - Nicole E Briley
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, Hershey, Pennsylvania 17033, United States
| | - Erin R Tyndall
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, Hershey, Pennsylvania 17033, United States
| | - Jie Xu
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, Hershey, Pennsylvania 17033, United States
| | - Conggang Li
- National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan 430071, P. R. China
| | - Kumaran S Ramamurthi
- Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, United States
| | - John M Flanagan
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, Hershey, Pennsylvania 17033, United States
| | - Fang Tian
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, Hershey, Pennsylvania 17033, United States
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Lee SH, Lee JM, Kim CY, Park MS, Park BH, Jung WJ, Kim SY, Kim EY, Jung JY, Kang YA, Kim YS, Kim SK, Chang J, Chung KS. Prognostic implications of serum lipid metabolism over time during sepsis. Intensive Care Med Exp 2015. [PMCID: PMC4798139 DOI: 10.1186/2197-425x-3-s1-a226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Noh Y, Sung YH, Lee J, Kim EY. Nigrosome 1 Detection at 3T MRI for the Diagnosis of Early-Stage Idiopathic Parkinson Disease: Assessment of Diagnostic Accuracy and Agreement on Imaging Asymmetry and Clinical Laterality. AJNR Am J Neuroradiol 2015; 36:2010-6. [PMID: 26294646 DOI: 10.3174/ajnr.a4412] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 04/12/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In the early stages of idiopathic Parkinson disease, motor symptoms are usually asymmetric. We aimed to assess the feasibility of nigrosome 1 detection at 3T MR imaging to analyze the agreement of its asymmetry and clinical laterality. MATERIALS AND METHODS High-resolution 3D multiecho imaging was performed at 3T MR imaging in 13 healthy subjects and 24 patients with idiopathic Parkinson disease confirmed by N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane ((18)F-FP-CIT) PET. The nigrosome 1 detection findings by using the MR imaging data were rated as "normal," "possibly abnormal," and "abnormal" by 2 independent reviewers. The degree of (18)F-FP-CIT binding was visually assessed in the caudate nucleus and putamen on PET images. Clinical laterality was evaluated by scores of the Unified Parkinson Disease Rating Scale, Part III. Asymmetry of the affected nigrosome 1 and the degree of (18)F-FP-CIT binding were analyzed for agreement with clinical laterality. RESULTS The diagnostic sensitivity, specificity, and accuracy of the nigrosome 1 detection at 3T MR imaging was 100%, 84.6%, and 94.6%, respectively. Interrater agreements for the abnormality and asymmetry of nigrosome 1 were excellent (κ = 0.863 and 0.835, respectively). In patients with idiopathic Parkinson disease, the agreement of asymmetry between clinical laterality and nigrosome 1 detection was good (κ = 0.724). The degree of the (18)F-FP-CIT PET binding showed fair agreement (κ = 0.235) with clinical laterality. CONCLUSIONS The abnormality involving nigrosome 1 can be detected at 3T MR imaging with an accuracy of 94.6%. The clinical laterality is in high concordance with the laterality of the nigrosome 1 detection at 3T (κ = 0.724).
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Affiliation(s)
- Y Noh
- From the Departments of Neurology (Y.N., Y.H.S.)
| | - Y H Sung
- From the Departments of Neurology (Y.N., Y.H.S.)
| | - J Lee
- Department of Electrical and Computer Engineering (Jongho Lee), Seoul National University, Seoul, Korea
| | - E Y Kim
- Radiology (E.Y.K.), Gachon University Gil Medical Center, Incheon, Korea
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Jakobson CM, Kim EY, Slininger MF, Chien A, Tullman-Ercek D. Localization of proteins to the 1,2-propanediol utilization microcompartment by non-native signal sequences is mediated by a common hydrophobic motif. J Biol Chem 2015; 290:24519-33. [PMID: 26283792 DOI: 10.1074/jbc.m115.651919] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [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: 03/16/2015] [Indexed: 12/14/2022] Open
Abstract
Various bacteria localize metabolic pathways to proteinaceous organelles known as bacterial microcompartments (MCPs), enabling the metabolism of carbon sources to enhance survival and pathogenicity in the gut. There is considerable interest in exploiting bacterial MCPs for metabolic engineering applications, but little is known about the interactions between MCP signal sequences and the protein shells of different MCP systems. We found that the N-terminal sequences from the ethanolamine utilization (Eut) and glycyl radical-generating protein MCPs are able to target reporter proteins to the 1,2-propanediol utilization (Pdu) MCP, and that this localization is mediated by a conserved hydrophobic residue motif. Recapitulation of this motif by the addition of a single amino acid conferred targeting function on an N-terminal sequence from the ethanol utilization MCP system that previously did not act as a Pdu signal sequence. Moreover, the Pdu-localized signal sequences competed with native Pdu targeting sequences for encapsulation in the Pdu MCP. Salmonella enterica natively possesses both the Pdu and Eut operons, and our results suggest that Eut proteins might be localized to the Pdu MCP in vivo. We further demonstrate that S. enterica LT2 retained the ability to grow on 1,2-propanediol as the sole carbon source when a Pdu enzyme was replaced with its Eut homolog. Although the relevance of this finding to the native system remains to be explored, we show that the Pdu-localized signal sequences described herein allow control over the ratio of heterologous proteins encapsulated within Pdu MCPs.
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Affiliation(s)
| | - Edward Y Kim
- From the Department of Chemical and Biomolecular Engineering and
| | | | - Alex Chien
- Biophysics Graduate Group, University of California, Berkeley, California 94720
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