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Fründt T, Krause L, Hussey E, Steinbach B, Köhler D, von Felden J, Schulze K, Lohse AW, Wege H, Schwarzenbach H. Diagnostic and Prognostic Value of miR-16, miR-146a, miR-192 and miR-221 in Exosomes of Hepatocellular Carcinoma and Liver Cirrhosis Patients. Cancers (Basel) 2021; 13:cancers13102484. [PMID: 34069692 PMCID: PMC8161187 DOI: 10.3390/cancers13102484] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Exosomes, carrying small non-coding RNA (miRNA), are known to play a pivotal role in the process of tumor progression. In this prospective study, we identified miR-16, miR-146a, miR-192, and miR- 221 to be significantly deregulated in the plasma of patients with hepatocellular carcinoma (HCC) compared to patients with liver cirrhosis and healthy individuals. MiR-146a revealed diagnostic potential to differentiate HCC patients from liver cirrhosis patients with a sensitivity of 81% and a specificity of 58% in logistic regression model. Furthermore, miR- 192 independently correlated with overall survival in patients with HCC. Abstract We aimed to identify a specific microRNA (miRNA) pattern to determine diagnostic and prognostic value in plasma exosomes of hepatocellular carcinoma (HCC) patients. A two-stage study was carried out: exosomal miRNAs were quantified in plasma of HCC patients and healthy individuals by PCR-based microarray cards containing 45 different miRNAs (training cohort). Then, four deregulated miRNAs (miR-16, miR-146a, miR-192, and miR-221) were quantified in the validation analysis using exosomes derived from 85 HCC patients, 50 liver cirrhosis patients, and 20 healthy individuals. Exosomal miR-146a (p = 0.0001), miR-192 (p = 0.002) and miR-221 (p = 0.032) were upregulated only in HCC patients. Repeated 10-fold cross validation showed that miR-146a differentiated HCC from liver cirrhosis patients with AUC of 0.80 ± 0.14 (sensitivity: 81 ± 13%, specificity: 58 ± 22%) in a logistic regression model. High miR-192 presence is associated with poor overall survival (OS) in all HCC patients (p = 0.027) and was predictor of OS in HCC patients in an uni- and multivariate Cox regression model. Moreover, decreased miR-16 levels correlated with OS in liver cirrhosis patients (p = 0.034). Our results emphasized that exosomes secreted into the plasma carry differentially expressed miRNAs of which in particular, miR-192, miR-146, and miR-16 are promising diagnostic and prognostic markers for both HCC and liver cirrhosis patients.
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Affiliation(s)
- Thorben Fründt
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (E.H.); (J.v.F.); (K.S.); (A.W.L.); (H.W.)
- Correspondence: ; Tel.: +49-40-7410-18056
| | - Linda Krause
- Institute of Medical Biometry and Epidemiology, 20246 Hamburg, Germany;
| | - Elaine Hussey
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (E.H.); (J.v.F.); (K.S.); (A.W.L.); (H.W.)
| | - Bettina Steinbach
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (B.S.); (H.S.)
| | - Daniel Köhler
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Johann von Felden
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (E.H.); (J.v.F.); (K.S.); (A.W.L.); (H.W.)
| | - Kornelius Schulze
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (E.H.); (J.v.F.); (K.S.); (A.W.L.); (H.W.)
| | - Ansgar W. Lohse
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (E.H.); (J.v.F.); (K.S.); (A.W.L.); (H.W.)
| | - Henning Wege
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (E.H.); (J.v.F.); (K.S.); (A.W.L.); (H.W.)
- Cancer Center Esslingen, 73730 Esslingen am NEckar, Germany
| | - Heidi Schwarzenbach
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (B.S.); (H.S.)
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Horvatits T, Schulze zur Wiesch J, Polywka S, Buescher G, Lütgehetmann M, Hussey E, Horvatits K, Peine S, Haag F, Addo MM, Lohse AW, Weiler-Normann C, Pischke S. Significance of Anti-Nuclear Antibodies and Cryoglobulins in Patients with Acute and Chronic HEV Infection. Pathogens 2020; 9:E755. [PMID: 32947995 PMCID: PMC7558372 DOI: 10.3390/pathogens9090755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hepatitis E virus (HEV) has been associated with immunological phenomena. Their clinical significance, however, still needs to be clarified, that is, whether cryoglobulins or autoantibodies impact overt disease in HEV-infected individuals. To better understand, we analyzed these different immune phenomena in three cohorts, each representing different types of HEV infection. METHODS The cohorts included: (i) immunocompetent patients with acute hepatitis E, (ii) immunosuppressed patients with chronic hepatitis E, and (iii) individuals with asymptomatic HEV infection. Together, they consisted of 57 individuals and were studied retrospectively for the presence of anti-nuclear antibodies (ANAs), cryoglobulins, and serum total IgG. They were then compared with a control cohort of 17 untreated patients with chronic hepatitis B virus (HBV) infection or hepatitis C virus (HCV) infection. RESULTS Thirteen (23%) were immunocompetent patients with acute hepatitis E (median alanine aminotransferase (ALT) = 872 U/L), 15 (26%) were immunosuppressed patients with chronic hepatitis E (median ALT = 137 U/L), and 29 (51%) were blood donors with asymptomatic HEV infection (median ALT = 35 U/L). Overall, 24% tested positive for elevated ANA titers of >1:160, and 11% presented with a specific ANA pattern. ANA detection was not associated with the type of HEV infection, IgG levels, sex, or age. All individuals tested negative for anti-mitochondrial antibodies, anti-neutrophil cytoplasmic antibodies, liver-kidney microsomal antibodies, anti-myeloperoxidase-, and anti-proteinase-3 antibodies. Five patients (9%) tested positive for cryoglobulins. Notably, cryoglobulinemia was present in overt hepatitis E (Groups (i) and (ii); one acute and four chronic HEV infections), but was not present in any of the asymptomatic blood donors (p = 0.02). The frequency of cryoglobulins and elevated ANAs did not differ significantly between HEV and HBV/HCV patients. CONCLUSION In line with findings on HBV and HCV infections, we frequently observed detection of ANAs (24%) and cryoglobulins (9%) in association with HEV infections. The presence of cryoglobulins was limited to patients with overt hepatitis E. We add to the findings on the immune phenomena of hepatitis E.
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Affiliation(s)
- Thomas Horvatits
- I. Department of Medicine, Gastroenterology and Hepatology, with the Sections Infectious Diseases and Tropical Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.S.z.W.); (G.B.); (E.H.); (K.H.); (M.M.A.); (A.W.L.); (C.W.-N.); (S.P.)
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, 20359 Hamburg, Germany;
| | - Julian Schulze zur Wiesch
- I. Department of Medicine, Gastroenterology and Hepatology, with the Sections Infectious Diseases and Tropical Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.S.z.W.); (G.B.); (E.H.); (K.H.); (M.M.A.); (A.W.L.); (C.W.-N.); (S.P.)
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, 20359 Hamburg, Germany;
| | - Susanne Polywka
- Institute of Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Gustav Buescher
- I. Department of Medicine, Gastroenterology and Hepatology, with the Sections Infectious Diseases and Tropical Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.S.z.W.); (G.B.); (E.H.); (K.H.); (M.M.A.); (A.W.L.); (C.W.-N.); (S.P.)
| | - Marc Lütgehetmann
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, 20359 Hamburg, Germany;
- Institute of Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Elaine Hussey
- I. Department of Medicine, Gastroenterology and Hepatology, with the Sections Infectious Diseases and Tropical Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.S.z.W.); (G.B.); (E.H.); (K.H.); (M.M.A.); (A.W.L.); (C.W.-N.); (S.P.)
| | - Karoline Horvatits
- I. Department of Medicine, Gastroenterology and Hepatology, with the Sections Infectious Diseases and Tropical Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.S.z.W.); (G.B.); (E.H.); (K.H.); (M.M.A.); (A.W.L.); (C.W.-N.); (S.P.)
| | - Sven Peine
- Institute of Transfusion Medicine, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Friedrich Haag
- Institute of Immunology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Marylyn M. Addo
- I. Department of Medicine, Gastroenterology and Hepatology, with the Sections Infectious Diseases and Tropical Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.S.z.W.); (G.B.); (E.H.); (K.H.); (M.M.A.); (A.W.L.); (C.W.-N.); (S.P.)
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, 20359 Hamburg, Germany;
| | - Ansgar W. Lohse
- I. Department of Medicine, Gastroenterology and Hepatology, with the Sections Infectious Diseases and Tropical Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.S.z.W.); (G.B.); (E.H.); (K.H.); (M.M.A.); (A.W.L.); (C.W.-N.); (S.P.)
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, 20359 Hamburg, Germany;
| | - Christina Weiler-Normann
- I. Department of Medicine, Gastroenterology and Hepatology, with the Sections Infectious Diseases and Tropical Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.S.z.W.); (G.B.); (E.H.); (K.H.); (M.M.A.); (A.W.L.); (C.W.-N.); (S.P.)
- Martin Zeitz Center for rare diseases, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Sven Pischke
- I. Department of Medicine, Gastroenterology and Hepatology, with the Sections Infectious Diseases and Tropical Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.S.z.W.); (G.B.); (E.H.); (K.H.); (M.M.A.); (A.W.L.); (C.W.-N.); (S.P.)
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, 20359 Hamburg, Germany;
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Pene Dumitrescu T, Santos LL, Hughes SC, Pereira AI, Young GC, Hussey E, Charlton P, Baptiste‐Brown S, Stuart JS, Vincent V, van Marle SP, Schmith VD. A Novel Method for Studying the Pharmacokinetics of [(14) C]Umeclidinium After Application to the Axilla or Palm of Healthy Male Subjects. Clin Transl Sci 2016; 9:183-91. [PMID: 27304394 PMCID: PMC5351336 DOI: 10.1111/cts.12406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/27/2016] [Accepted: 05/17/2016] [Indexed: 11/28/2022] Open
Abstract
Umeclidinium (UMEC), a long-acting muscarinic antagonist approved for chronic obstructive pulmonary disease (COPD), was investigated for primary hyperhidrosis as topical therapy. This study evaluated the pharmacokinetics, safety, and tolerability of a single dose of [(14) C]UMEC applied to either unoccluded axilla (UA), occluded axilla (OA), or occluded palm (OP) of healthy males. After 8 h the formulation was removed. [(14) C]UMEC plasma concentrations (Cp) were quantified by accelerator mass spectrometry. Occlusion increased systemic exposure by 3.8-fold. Due to UMEC absorption-limited pharmacokinetics, Cp data from the OA were combined with intravenous data from a phase I study. The data were described by a two-compartment population model with sequential zero and first-order absorption and linear elimination. Simulated systemic exposure following q.d. doses to axilla was similar to the exposure from the inhaled therapy, suggesting that systemic safety following dermal administration can be bridged to the inhaled program, and offering the potential for a reduced number of studies and/or subjects.
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Affiliation(s)
- T Pene Dumitrescu
- Clinical Pharmacology Modeling and SimulationGSKResearch Triangle ParkNorth CarolinaUSA
| | - LL Santos
- Stiefela GSK companyResearch Triangle ParkNorth CarolinaUSA
| | - SC Hughes
- Drug Metabolism and PharmacokineticsGSKWareUK
| | - AI Pereira
- Drug Metabolism and PharmacokineticsGSKWareUK
| | - GC Young
- Drug Metabolism and PharmacokineticsGSKWareUK
| | - E Hussey
- Stiefela GSK companyResearch Triangle ParkNorth CarolinaUSA
| | - P Charlton
- Stiefela GSK companyResearch Triangle ParkNorth CarolinaUSA
| | - S Baptiste‐Brown
- Clinical Pharmacology Sciences & Study OperationsGSKKing of PrussiaPennsylvania, USA
| | - JS Stuart
- Stiefela GSK companyResearch Triangle ParkNorth CarolinaUSA
| | - V Vincent
- R&D Projects Clinical Platforms and SciencesQSciGSKBangaloreIndia
| | - SP van Marle
- Pharmaceutical Research Associates International GroupZuidlarenThe Netherlands
| | - VD Schmith
- Clinical Pharmacology Modeling and SimulationGSKResearch Triangle ParkNorth CarolinaUSA
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Young G, Ellis W, Ayrton J, Hussey E, Adamkiewicz B. Accelerator mass spectrometry (AMS): recent experience of its use in a clinical study and the potential future of the technique. Xenobiotica 2001; 31:619-32. [PMID: 11569529 DOI: 10.1080/00498250110052724] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
1. The technique of accelerator mass spectrometry (AMS) is outlined. 2. The use of AMS in an initial validation study in animals is outlined. As part of the validation of the technique, samples from the animal study were analysed by both liquid scintillation counting (LSC) and, following dilution, by AMS. The results were similar. 3. The use of AMS in support of a clinical study is described. Six healthy male human volunteers were administered 2.7 mg [14C]-GI1817771 (121 Bq; 3.3nCi) to produce an exposure to ionizing radiation of 0.06 microSv. Mass balance in recovery of administered radioactivity was achieved and information about the presence of systemically circulating metabolites was gained. 4. The future potential of the technique of AMS is discussed.
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Affiliation(s)
- G Young
- Division of Bioanalysis and Drug Metabolism, Glaxo Wellcome Research and Development Ltd, Ware, UK.
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Rattray C, Robinson C, Hussey E, Macleod Y, Fagan T, Wynter HH. The Norplant experience at the University Hospital of the West Indies. J OBSTET GYNAECOL 1997; 17:569-72. [PMID: 15511961 DOI: 10.1080/01443619768632] [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: 10/16/2022]
Abstract
Sixty-eight patients had Norplant inserted between May 1992 and November 1993 as part of a pre-introductory study. The main side effect was weight change which occurred in 85.3% (58 patients); weight loss occurred in 25.0% (17 patients, one patient voiced a complaint) and weight gain occurred in 60.3% (41 patients, 10 of whom voiced a complaint). Menstrual problems were the next most frequent side effect occurring in 70.4% (48 patients); spotting occurring in 22% (15 patients, none of whom complained) and heavy bleeding in 7.3% (five patients, all of whom complained). Amenorrhoea occurred in 41.1% (28 patients). Other complaints were minor. No pregnancies have been recorded to date. There were no procedural complications and all patients were satisfied with the cosmetic appearance. To date there have been 36 removals, the majority for menstrual complications. Norplant is a safe, effective means of 'reversible sterilisation' which should be utilised in family planning programmes throughout the country.
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Affiliation(s)
- C Rattray
- Department of Obstetrics and Gynaecology, University of the West Indies, Kingston, Jamaica
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