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Kane D, Wall E, Malone E, Geary MP, Malone F, Kent E, McCarthy CM. A retrospective cohort study of the characteristics of unsuccessful operative vaginal deliveries. Eur J Obstet Gynecol Reprod Biol 2023; 285:159-163. [PMID: 37120912 DOI: 10.1016/j.ejogrb.2023.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Unsuccessful operative vaginal delivery (OVD) is associated with high rates of materno-fetal morbidity. We aimed to examine institutional rates of unsuccessful OVDs (uOVD) and compare them with successful OVD (sOVD) in order to identify factors to aid patient selection and education. METHODS A 6-month retrospective cohort study was performed on all unsuccessful and successful OVDs in a tertiary level maternity hospital in the Republic of Ireland. Maternal demographics and obstetric factors were assessed to evaluate potential underlying risk factors for unsuccessful operative vaginal delivery versus successful vaginal delivery. RESULTS There were 4,191 births during the study period with an OVD rate of 14.2% (n = 595) with 28 (4.7% of OVDs) being unsuccessful. Unsuccessful OVD were predominately nulliparous (25; 89.2%) with a mean maternal age of 30.1 years (range 20-42), with more than half (n = 15, 53.5%) being induced. The most common indication for induction was prolonged rupture of membranes (PROM) (n = 7, 25%) which was significantly different from the successful OVD group. A senior obstetrician was significantly more likely to be the primary operator in uOVD when compared to sOVD. (82.1 % V 54.1% p < 0.01). The majority of unsuccessful OVD were vacuum deliveries (n = 17; 60.7%), with a significantly higher mean birthweight when compared to successful OVD (3.695 kg V 3.483 kg; p < 0.01). Following an unsuccessful OVD, women were more likely to have a postpartum haemorrhage (64.2 % V 31.5% p < 0.01) and their infant was more likely to require admission to the neonatal intensive care unit (NICU) (32.1 % V 5.8% p < 0.01) when compared with successful OVD. CONCLUSION Risk factors for unsuccessful OVD were higher birth weight and induction of labour. There was a higher incidence of postpartum haemorrhage and NICU admission when compared with successful OVD.
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Affiliation(s)
- D Kane
- Department of Obstetrics & Gynaecology, Rotunda Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland.
| | - E Wall
- Department of Obstetrics & Gynaecology, Rotunda Hospital, Dublin, Ireland
| | - E Malone
- Department of Obstetrics & Gynaecology, Rotunda Hospital, Dublin, Ireland
| | - M P Geary
- Department of Obstetrics & Gynaecology, Rotunda Hospital, Dublin, Ireland
| | - F Malone
- Department of Obstetrics & Gynaecology, Rotunda Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
| | - E Kent
- Department of Obstetrics & Gynaecology, Rotunda Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
| | - C M McCarthy
- Department of Obstetrics & Gynaecology, Rotunda Hospital, Dublin, Ireland
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Martin S, de Haan L, Miro Estruch I, Eder KM, Marzi A, Schnekenburger J, Blosi M, Costa A, Antonello G, Bergamaschi E, Riganti C, Beal D, Carrière M, Taché O, Hutchison G, Malone E, Young L, Campagnolo L, La Civita F, Pietroiusti A, Devineau S, Baeza A, Boland S, Zong C, Ichihara G, Fadeel B, Bouwmeester H. Pre-validation of a reporter gene assay for oxidative stress for the rapid screening of nanobiomaterials. Front Toxicol 2022; 4:974429. [PMID: 36171865 PMCID: PMC9511406 DOI: 10.3389/ftox.2022.974429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/09/2022] [Indexed: 12/04/2022] Open
Abstract
Engineered nanomaterials have been found to induce oxidative stress. Cellular oxidative stress, in turn, can result in the induction of antioxidant and detoxification enzymes which are controlled by the nuclear erythroid 2-related factor 2 (NRF2) transcription factor. Here, we present the results of a pre-validation study which was conducted within the frame of BIORIMA (“biomaterial risk management”) an EU-funded research and innovation project. For this we used an NRF2 specific chemically activated luciferase expression reporter gene assay derived from the human U2OS osteosarcoma cell line to screen for the induction of the NRF2 mediated gene expression following exposure to biomedically relevant nanobiomaterials. Specifically, we investigated Fe3O4-PEG-PLGA nanomaterials while Ag and TiO2 “benchmark” nanomaterials from the Joint Research Center were used as reference materials. The viability of the cells was determined by using the Alamar blue assay. We performed an interlaboratory study involving seven different laboratories to assess the applicability of the NRF2 reporter gene assay for the screening of nanobiomaterials. The latter work was preceded by online tutorials to ensure that the procedures were harmonized across the different participating laboratories. Fe3O4-PEG-PLGA nanomaterials were found to induce very limited NRF2 mediated gene expression, whereas exposure to Ag nanomaterials induced NRF2 mediated gene expression. TiO2 nanomaterials did not induce NRF2 mediated gene expression. The variability in the results obtained by the participating laboratories was small with mean intra-laboratory standard deviation of 0.16 and mean inter laboratory standard deviation of 0.28 across all NRF2 reporter gene assay results. We conclude that the NRF2 reporter gene assay is a suitable assay for the screening of nanobiomaterial-induced oxidative stress responses.
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Affiliation(s)
- Sebastin Martin
- Division of Molecular Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Laura de Haan
- Division of Toxicology, Wageningen University and Research, Wageningen, Netherlands
| | - Ignacio Miro Estruch
- Division of Toxicology, Wageningen University and Research, Wageningen, Netherlands
| | - Kai Moritz Eder
- Biomedical Technology Center, Westfälische Wilhelms-University, Münster, Germany
| | - Anne Marzi
- Biomedical Technology Center, Westfälische Wilhelms-University, Münster, Germany
| | | | - Magda Blosi
- Institute of Science and Technology for Ceramics (ISTEC), CNR, Faenza, Italy
| | - Anna Costa
- Institute of Science and Technology for Ceramics (ISTEC), CNR, Faenza, Italy
| | | | - Enrico Bergamaschi
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Chiara Riganti
- Department of Chemistry, University of Torino, Torino, Italy
| | - David Beal
- Université Grenoble-Alpes, CEA, CNRS, IRIG, SyMMES, Grenoble, France
| | - Marie Carrière
- Université Grenoble-Alpes, CEA, CNRS, IRIG, SyMMES, Grenoble, France
| | - Olivier Taché
- Université Paris-Saclay, CEA, CNRS, NIMBE, Gif-sur-Yvette, France
| | - Gary Hutchison
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Eva Malone
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Lesley Young
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Luisa Campagnolo
- Université Paris Cité, CNRS, Unité de Biologie Fonctionnelle et Adaptative, F-75013 Paris, France
| | - Fabio La Civita
- Université Paris Cité, CNRS, Unité de Biologie Fonctionnelle et Adaptative, F-75013 Paris, France
| | - Antonio Pietroiusti
- Université Paris Cité, CNRS, Unité de Biologie Fonctionnelle et Adaptative, F-75013 Paris, France
| | - Stéphanie Devineau
- Université Paris Cité, Unité de Biologie Fonctionnelle et Adaptative, Paris, France
| | - Armelle Baeza
- Université Paris Cité, Unité de Biologie Fonctionnelle et Adaptative, Paris, France
| | - Sonja Boland
- Université Paris Cité, Unité de Biologie Fonctionnelle et Adaptative, Paris, France
| | - Cai Zong
- Department of Occupational and Environmental Health, Tokyo University of Science, Tokyo, Japan
| | - Gaku Ichihara
- Department of Occupational and Environmental Health, Tokyo University of Science, Tokyo, Japan
| | - Bengt Fadeel
- Division of Molecular Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hans Bouwmeester
- Division of Toxicology, Wageningen University and Research, Wageningen, Netherlands
- *Correspondence: Hans Bouwmeester,
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Kirkwood L, Ingram-Sills L, Taylor MD, Malone E, Florida-James G. Immune Response of Elite Enduro Racers to Laboratory and Racing Environments: The Influence of Training Impulse and Vibration. Int J Environ Res Public Health 2021; 18:ijerph18094603. [PMID: 33926145 PMCID: PMC8123624 DOI: 10.3390/ijerph18094603] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 12/12/2022]
Abstract
Introduction: Understanding the sport-specific immune response elicited during both training and competition is imperative to maximise athlete health and performance. Despite a growing population of professional enduro mountain bike athletes, little is known about the recovery of the immune system following enduro racing events. Methods: Nine international level elite enduro mountain bike athletes (age 24.3 ± 2.4 years, height 178.5 ± 8.7 cm, mass 76.5 ± 12.5 kg) completed a laboratory-based maximal exercise test (LAB) on a cycle ergometer and competed in an international mountain bike enduro race event (RACE). Blood samples were taken before, immediately after, and 1 h after LAB and before, 1 h after, and 17 h after RACE. Leukocyte subsets were enumerated using seven-colour flow cytometry. Lucia’s training impulse (LuTRIMP) and vibration exposure (VIB) were quantified during RACE. Results: Seven participants were included in the final analyses. There was a significant (p < 0.05) increase in neutrophil count alongside a reduction of cytotoxic lymphocyte cell subsets of both the innate (CD3−/CD56+ NK-cells and CD3−/CD56dim NK-cells) and adaptive (CD8+/CD62L−/CD45RA− T-cells and CD8+/CD27+/CD28− T-cells) components of the immune system one hour after RACE. All cell counts returned to baseline values 17 h afterwards (p > 0.05). Cell subset redistribution from pre- to post-one-hour time points (%Δpre-post1h) in cell subsets with potent effector functions (Neutrophils, CD3−/CD56+ NK-cells, CD8+/CD62L−/CD45RA− T-cells, CD8+/CD27+/CD28− T-cells, and CD3−/CD56dim/CD57− NK-cells) was significantly greater at RACE than LAB (p < 0.05). VIB was shown to be a superior predictor of %Δpre-post1h CD4+ T-cells, CD4+ early T-cells, CD4+ naïve T-cells, and NK cells as compared with LuTRIMP on its own (ΔR2 = 0.63 − 0.89, p < 0.05). Conclusions: The race event offers a greater challenge to the immune system than LAB, and potentially, whole body vibration is a key component of training load measurement in mountain bike applications.
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Affiliation(s)
- Lewis Kirkwood
- School of Applied Sciences, Edinburgh Napier University, Edinburgh EH11 4BN, UK; (L.I.-S.); (E.M.); (G.F.-J.)
- Mountain Bike Centre of Scotland, Peel Tower, Glentress EH45 8NB, UK
- Correspondence:
| | - Lesley Ingram-Sills
- School of Applied Sciences, Edinburgh Napier University, Edinburgh EH11 4BN, UK; (L.I.-S.); (E.M.); (G.F.-J.)
- Mountain Bike Centre of Scotland, Peel Tower, Glentress EH45 8NB, UK
| | - Mark Dunlop Taylor
- School of Engineering and the Built Environment, Edinburgh Napier University, Edinburgh EH10 5DT, UK;
| | - Eva Malone
- School of Applied Sciences, Edinburgh Napier University, Edinburgh EH11 4BN, UK; (L.I.-S.); (E.M.); (G.F.-J.)
| | - Geraint Florida-James
- School of Applied Sciences, Edinburgh Napier University, Edinburgh EH11 4BN, UK; (L.I.-S.); (E.M.); (G.F.-J.)
- Mountain Bike Centre of Scotland, Peel Tower, Glentress EH45 8NB, UK
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Al-ezzi E, Alshammari K, Kanjanapan Y, Veitch Z, Fasih S, Malone E, Amir E, Albiruni A. Impact of immunotherapy and targeted therapy on tumour growth rate in sarcoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz283.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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5
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Alshammari K, Al-ezzi E, Lewin J, Salah S, Veitch Z, Malone E, Paris G, Mancini M, Zer A, Ahmad M, Beercroft R, Albiruni A. A prospective correlative trial of personalized patient-derived xenograft (PDX) as avatars for drug therapy in patients with metastatic or recurrent soft tissue sarcomas (STS). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz283.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Al-ezzi E, Veitch Z, Salah S, Van der Kwast T, Stockley T, Malone E, Sridhar S, Sacher A, Fallah-rad N, Kulkarni G, Zlotta A, Finelli A, Hansen A. Genomic characterization of non-schistosomiasis-related squamous cell carcinoma (NSR-SCC) of the urinary bladder: A retrospective study of potential prognostic and predictive biomarkers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ross M, Ingram L, Taylor G, Malone E, Simpson RJ, West D, Florida‐James G. Older men display elevated levels of senescence-associated exercise-responsive CD28 null angiogenic T cells compared with younger men. Physiol Rep 2018; 6:e13697. [PMID: 29939490 PMCID: PMC6016626 DOI: 10.14814/phy2.13697] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/03/2018] [Accepted: 04/06/2018] [Indexed: 12/19/2022] Open
Abstract
Aging is associated with elevated cardiovascular disease risk. As a result of aging, endothelial dysfunction develops, partly due to a reduction in vascular regenerative ability. CD31+ T cells (angiogenic T cells; TANG ) possess highly angiogenic capabilities; however, these cells are significantly reduced in older populations. In addition, older populations possess significantly higher senescent and highly differentiated T-cell levels in circulation, and these are reported to be highly exercise responsive. We investigated whether older adults display greater levels of circulating senescent (CD28null ) TANG cells and whether these cells were more exercise responsive than CD28+ TANG cells. Young (18-25 years; n = 9) and older (60-75 years; n = 10) healthy men undertook a 30-min cycling bout at 70% V˙O2 peak, with circulating TANG cells (CD3+ CD31+ CD28+/null ; including CD4+ and CD8+ subsets) measured preexercise, postexercise, and 1 h post exercise by flow cytometry. Older adults displayed reduced basal levels of TANG cells (mean ± SEM: 410 ± 81 vs. 784 ± 118 cells·μL, P = 0.017), despite a greater proportion of these cells being CD28null (26.26 ± 5.08 vs. 13.36 ± 2.62%, P = 0.044). Exercise significantly increased the circulating number of TANG cells in both young and older men. However, in older men alone, exercise preferentially mobilized CD28null CD8+ TANG cells compared with CD28+ TANG cells (time × phenotype interaction: P = 0.022; Δ74 ± 29 vs. Δ27 ± 15 cells·μL, P = 0.059), with no such difference observed between these phenotypes in the young population. In conclusion, this is the first study to demonstrate that despite observing lower circulating numbers of TANG cells, older adults display greater levels of senescent TANG cells in comparison with younger individuals, and these cells are more exercise responsive than CD28+ TANG cells. Lower number of circulating TANG and greater levels of senescent-associated CD28null TANG may contribute to greater CVD risk with advancing age.
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Affiliation(s)
- Mark Ross
- School of Applied SciencesEdinburgh Napier UniversityEdinburghUnited Kingdom
| | - Lesley Ingram
- School of Applied SciencesEdinburgh Napier UniversityEdinburghUnited Kingdom
| | - Guy Taylor
- Institute of Cellular MedicineNewcastle UniversityNewcastleUnited Kingdom
| | - Eva Malone
- School of Applied SciencesEdinburgh Napier UniversityEdinburghUnited Kingdom
| | - Richard J. Simpson
- Department of Nutritional SciencesDepartment of PediatricsDepartment of ImmunobiologyThe University of ArizonaTucsonArizona
| | - Dan West
- Institute of Cellular MedicineNewcastle UniversityNewcastleUnited Kingdom
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Fraser JA, Kemp S, Young L, Ross M, Prach M, Hutchison GR, Malone E. Silver nanoparticles promote the emergence of heterogeneic human neutrophil sub-populations. Sci Rep 2018; 8:7506. [PMID: 29760395 PMCID: PMC5951814 DOI: 10.1038/s41598-018-25854-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 02/19/2018] [Accepted: 05/01/2018] [Indexed: 12/21/2022] Open
Abstract
Neutrophil surveillance is central to nanoparticle clearance. Silver nanoparticles (AgNP) have numerous uses, however conflicting evidence exists as to their impact on neutrophils and whether they trigger damaging inflammation. Neutrophil’s importance in innate defence and regulating immune networks mean it’s essential we understand AgNP’s impact on neutrophil function. Human neutrophil viability following AgNP or Ag Bulk treatment was analysed by flow cytometry and AnV/PI staining. Whilst AgNP exposure did not increase the total number of apoptotic neutrophils, the number of late apoptotic neutrophils was increased, suggesting AgNP increase transit through apoptosis. Mature (CD16bright/CD62Lbright), immature (CD16dim/CD62Lbright) and apoptotic (CD16dim/CD62Ldim) neutrophil populations were evident within isolated neutrophil preparations. AgNP exposure significantly reduced CD62L staining of CD16bright/CD62Lbright neutrophils, and increased CD16 staining of CD16dim/CD62Lbright populations, suggesting AgNPs trigger neutrophil activation and maturation, respectively. AgNP exposure dramatically increased IL-8, yet not classical pro-inflammatory cytokine release, suggesting AgNP triggers neutrophil activation, without pro-inflammation or damaging, necrotic cell death. For the first time, we show AgNPs differentially affect distinct sub-populations of circulating human neutrophils; activating mature neutrophils with the emergence of CD16bright/CD62Ldim neutrophils. This may stimulate particle clearance without harmful inflammation, challenging previous assumptions that silver nanomaterials induce neutrophil toxicity and damaging inflammatory responses.
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Affiliation(s)
- Jennifer A Fraser
- School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4BN, UK.
| | - Sadie Kemp
- School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4BN, UK
| | - Lesley Young
- School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4BN, UK
| | - Mark Ross
- School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4BN, UK
| | - Morag Prach
- School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4BN, UK
| | - Gary R Hutchison
- School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4BN, UK
| | - Eva Malone
- School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4BN, UK.
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Ross M, Tormey P, Ingram L, Simpson R, Malone E, Florida-James G. A 10 km time trial running bout acutely increases the number of angiogenic T cells in the peripheral blood compartment of healthy males. Exp Physiol 2016; 101:1253-1264. [DOI: 10.1113/ep085771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 07/07/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Mark Ross
- School of Life, Sport and Social Sciences; Edinburgh Napier University; Edinburgh UK
| | - Peter Tormey
- School of Life, Sport and Social Sciences; Edinburgh Napier University; Edinburgh UK
| | - Lesley Ingram
- School of Life, Sport and Social Sciences; Edinburgh Napier University; Edinburgh UK
| | - Richard Simpson
- Department of Health and Human Performance; University of Houston; Houston TX USA
| | - Eva Malone
- School of Life, Sport and Social Sciences; Edinburgh Napier University; Edinburgh UK
| | - Geraint Florida-James
- School of Life, Sport and Social Sciences; Edinburgh Napier University; Edinburgh UK
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10
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Ross M, Malone E, Simpson R, Florida-James G. High Cardiorespiratory Fitness Alleviates the Negative Impact of Increasing Sitting Time on CD31+ T-Cell Number. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000487068.25925.be] [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: 11/21/2022]
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Lyons T, Mallet V, Collins D, Malone E, Milewski M, Egan K, Hennessy B, Grogan L, Breathnach O, Morris P. Abstract OT3-02-03: An observational study of dose dense chemotherapy with lipegfilgrastim support in early breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-ot3-02-03] [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
Background: The combination of the anthracycline, doxorubicin with cyclophosphamide (AC) is a widely used chemotherapy regimen in early stage breast cancer. Studies have shown that dose dense chemotherapy (incorporating AC) improved both disease-free survival and overall survival compared to once every 3 week treatment with daily subcutaneous G-CSF support. An important advance in the use of dose dense chemotherapy regimens was the development of pegylated forms of G-CSF, which offered the convenience of a single subcutaneous injection, rather than multiple daily injections. Lipegfilgrastim is a pegylated long-acting covalent conjugate of filgrastim (G-CSF). In a pivotal randomised phase III study in breast cancer lipegfilgrastim was shown to be non-inferior to pegfilgrastim. Although lipegfilgrastim is licensed in Europe and can facilitate every 2 week (dose dense) scheduling of chemotherapy there are a lack of prospective data about its efficacy in this setting. In this prospective, non-interventional, study we are investigating the incidence of treatment-related neutropaenia following four cycles of dose dense AC with lipegfilgrastim support.
Methods: The primary end point of this prospective, single arm study is to determine the incidence of treatment-related neutropaenia, defined as an absolute neutrophil count (ANC) of <1.0 x 109/L, following four cycles of dose dense AC with lipegfilgrastim support. The secondary end points are to (1) determine the incidence of febrile neutropaenia, defined as temperature > 38°C and ANC <1.0 x 109/L, during 4 cycles of dose dense AC with lipegfilgrastim and (2) examine the incidence of treatment-related neutropaenia during subsequent intravenous chemotherapy post completion of AC. Eligibility criteria include, patients with stage I-III breast cancer, planned treatment with dose dense AC in the adjuvant or neoadjuvant setting, age ≥ 18 years, Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1 and adequate bone marrow function. Patients with prior exposure to chemotherapy and/or G-CSF, who are pregnant, have a cardiac or other concurrent illness, which at the investigator's discretion contraindicates the use of AC will be excluded. We will enrol 40 consecutive patients who are planned to undergo dose dense AC. Based on previous clinical trials, we expect that the incidence of treatment-related neutropaenia will be <12%. However, it is likely that the current study will more closely resemble real-world practice and a higher incidence of treatment-related neutropaenia may be observed. This study has been approved by the Instituational Review Board and 9 patients have been consented to date. (registered with clinicaltrials.gov).
Citation Format: Lyons T, Mallet V, Collins D, Malone E, Milewski M, Egan K, Hennessy B, Grogan L, Breathnach O, Morris P. An observational study of dose dense chemotherapy with lipegfilgrastim support in early breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT3-02-03.
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Affiliation(s)
- T Lyons
- Cancer Clinical Trials and Research Unit, Beaumont Hospital, Dublin, Ireland
| | - V Mallet
- Cancer Clinical Trials and Research Unit, Beaumont Hospital, Dublin, Ireland
| | - D Collins
- Cancer Clinical Trials and Research Unit, Beaumont Hospital, Dublin, Ireland
| | - E Malone
- Cancer Clinical Trials and Research Unit, Beaumont Hospital, Dublin, Ireland
| | - M Milewski
- Cancer Clinical Trials and Research Unit, Beaumont Hospital, Dublin, Ireland
| | - K Egan
- Cancer Clinical Trials and Research Unit, Beaumont Hospital, Dublin, Ireland
| | - B Hennessy
- Cancer Clinical Trials and Research Unit, Beaumont Hospital, Dublin, Ireland
| | - L Grogan
- Cancer Clinical Trials and Research Unit, Beaumont Hospital, Dublin, Ireland
| | - O Breathnach
- Cancer Clinical Trials and Research Unit, Beaumont Hospital, Dublin, Ireland
| | - P Morris
- Cancer Clinical Trials and Research Unit, Beaumont Hospital, Dublin, Ireland
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12
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Ingram LA, Simpson RJ, Malone E, Florida-James GD. Sleep disruption and its effect on lymphocyte redeployment following an acute bout of exercise. Brain Behav Immun 2015; 47:100-8. [PMID: 25582807 DOI: 10.1016/j.bbi.2014.12.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 09/18/2014] [Revised: 12/08/2014] [Accepted: 12/15/2014] [Indexed: 12/01/2022] Open
Abstract
Sleep disruption and deprivation are common in contemporary society and have been linked with poor health, decreased job performance and increased life-stress. The rapid redeployment of lymphocytes between the blood and tissues is an archetypal feature of the acute stress response, but it is not known if short-term perturbations in sleep architecture affect lymphocyte redeployment. We examined the effects of a disrupted night sleep on the exercise-induced redeployment of lymphocytes and their subtypes. 10 healthy male cyclists performed 1h of cycling at a fixed power output on an indoor cycle ergometer, following a night of undisrupted sleep (US) or a night of disrupted sleep (DS). Blood was collected before, immediately after and 1h after exercise completion. Lymphocytes and their subtypes were enumerated using direct immunofluorescence assays and 4-colour flow cytometry. DS was associated with elevated concentrations of total lymphocytes and CD3(-)/CD56(+) NK-cells. Although not affecting baseline levels, DS augmented the exercise-induced redeployment of CD8(+) T-cells, with the naïve/early differentiated subtypes (KLRG1(-)/CD45RA(+)) being affected most. While the mobilisation of cytotoxic lymphocyte subsets (NK cells, CD8(+) T-cells γδ T-cells), tended to be larger in response to exercise following DS, their enhanced egress at 1h post-exercise was more marked. This occurred despite similar serum cortisol and catecholamine levels between the US and DS trials. NK-cells redeployed with exercise after DS retained their expression of perforin and Granzyme-B indicating that DS did not affect NK-cell 'arming'. Our findings indicate that short-term changes in sleep architecture may 'prime' the immune system and cause minor enhancements in lymphocyte trafficking in response to acute dynamic exercise.
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Affiliation(s)
- Lesley A Ingram
- Biomedicine and Sport and Exercise Research Group, School of Life, Sport & Social Science, Edinburgh Napier University, Sighthill Campus, Edinburgh, Scotland EH11 4BN, United Kingdom.
| | - Richard J Simpson
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, 3855 Holman Street, Houston, TX 77204, USA.
| | - Eva Malone
- Biomedicine and Sport and Exercise Research Group, School of Life, Sport & Social Science, Edinburgh Napier University, Sighthill Campus, Edinburgh, Scotland EH11 4BN, United Kingdom.
| | - Geraint D Florida-James
- Biomedicine and Sport and Exercise Research Group, School of Life, Sport & Social Science, Edinburgh Napier University, Sighthill Campus, Edinburgh, Scotland EH11 4BN, United Kingdom.
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Ross MD, Malone E, Simpson R, Florida-James G. The Influence of Age and Cardiorespiratory Fitness on Circulating Angiogenic T Cells and CXCR4 Expression. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000476835.48895.42] [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: 11/21/2022]
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Hockaday LA, Kang KH, Colangelo NW, Cheung PYC, Duan B, Malone E, Wu J, Girardi LN, Bonassar LJ, Lipson H, Chu CC, Butcher JT. Rapid 3D printing of anatomically accurate and mechanically heterogeneous aortic valve hydrogel scaffolds. Biofabrication 2012; 4:035005. [PMID: 22914604 DOI: 10.1088/1758-5082/4/3/035005] [Citation(s) in RCA: 367] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The aortic valve exhibits complex three-dimensional (3D) anatomy and heterogeneity essential for the long-term efficient biomechanical function. These are, however, challenging to mimic in de novo engineered living tissue valve strategies. We present a novel simultaneous 3D printing/photocrosslinking technique for rapidly engineering complex, heterogeneous aortic valve scaffolds. Native anatomic and axisymmetric aortic valve geometries (root wall and tri-leaflets) with 12-22 mm inner diameters (ID) were 3D printed with poly-ethylene glycol-diacrylate (PEG-DA) hydrogels (700 or 8000 MW) supplemented with alginate. 3D printing geometric accuracy was quantified and compared using Micro-CT. Porcine aortic valve interstitial cells (PAVIC) seeded scaffolds were cultured for up to 21 days. Results showed that blended PEG-DA scaffolds could achieve over tenfold range in elastic modulus (5.3±0.9 to 74.6±1.5 kPa). 3D printing times for valve conduits with mechanically contrasting hydrogels were optimized to 14 to 45 min, increasing linearly with conduit diameter. Larger printed valves had greater shape fidelity (93.3±2.6, 85.1±2.0 and 73.3±5.2% for 22, 17 and 12 mm ID porcine valves; 89.1±4.0, 84.1±5.6 and 66.6±5.2% for simplified valves). PAVIC seeded scaffolds maintained near 100% viability over 21 days. These results demonstrate that 3D hydrogel printing with controlled photocrosslinking can rapidly fabricate anatomical heterogeneous valve conduits that support cell engraftment.
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Affiliation(s)
- L A Hockaday
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA
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Malone E, Elliott C, Kennedy G, Savage D, Regan L. Surveillance study of a number of synthetic and natural growth promoters in bovine muscle samples using liquid chromatography-tandem mass spectrometry. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2011; 28:597-607. [PMID: 21598141 DOI: 10.1080/19440049.2011.560896] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A simple, new method permitting the simultaneous determination and confirmation of trace residues of 24 different growth promoters and metabolites using liquid chromatography-mass spectrometry was developed and validated. The compounds were extracted from bovine tissue using acetonitrile; sodium sulphate was also added at this stage to aid with purification. The resulting mixture was then evaporated to approximately 1 ml and subsequently centrifuged at high speed and an aliquot injected onto the LC-MS/MS system. The calculated CCα values ranged between 0.11 and 0.46 µg kg(-1); calculated CCβ were in the range 0.19-0.79 µg kg(-1). Accuracy, measurement of uncertainty, repeatability and linearity were also determined for each analyte. The analytical method was applied to a number of bovine tissue samples imported into Ireland from third countries. Levels of progesterone were found in a number of samples at concentrations ranging between 0.28 and 30.30 µg kg(-1). Levels of alpha- and beta-testosterone were also found in a number of samples at concentrations ranging between 0.22 and 8.63 µg kg(-1) and between 0.16 and 2.08 µg kg(-1) respectively.
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Affiliation(s)
- E Malone
- The State Laboratory, Backweston, Celbridge Co., Kildare, Ireland.
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16
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Cronly M, Behan P, Foley B, Malone E, Martin S, Doyle M, Regan L. Rapid multi-class multi-residue method for the confirmation of chloramphenicol and eleven nitroimidazoles in milk and honey by liquid chromatography-tandem mass spectrometry (LC-MS). Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2010; 27:1233-46. [DOI: 10.1080/19440049.2010.489579] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cronly M, Behan P, Foley B, Malone E, Earley S, Gallagher M, Shearan P, Regan L. Development and validation of a rapid multi-class method for the confirmation of fourteen prohibited medicinal additives in pig and poultry compound feed by liquid chromatography-tandem mass spectrometry. J Pharm Biomed Anal 2010; 53:929-38. [PMID: 20643524 DOI: 10.1016/j.jpba.2010.06.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Revised: 06/22/2010] [Accepted: 06/24/2010] [Indexed: 10/19/2022]
Abstract
A confirmatory method has been developed to allow for the analysis of fourteen prohibited medicinal additives in pig and poultry compound feed. These compounds are prohibited for use as feed additives although some are still authorised for use in medicated feed. Feed samples are extracted by acetonitrile with addition of sodium sulfate. The extracts undergo a hexane wash to aid with sample purification. The extracts are then evaporated to dryness and reconstituted in initial mobile phase. The samples undergo an ultracentrifugation step prior to injection onto the LC-MS/MS system and are analysed in a run time of 26 min. The LC-MS/MS system is run in MRM mode with both positive and negative electrospray ionisation. The method was validated over three days and is capable of quantitatively analysing for metronidazole, dimetridazole, ronidazole, ipronidazole, chloramphenicol, sulfamethazine, dinitolimide, ethopabate, carbadox and clopidol. The method is also capable of qualitatively analysing for sulfadiazine, tylosin, virginiamycin and avilamycin. A level of 100 microg kg(-1) was used for validation purposes and the method is capable of analysing to this level for all the compounds. Validation criteria of trueness, precision, repeatability and reproducibility along with measurement uncertainty are calculated for all analytes.
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Affiliation(s)
- Mark Cronly
- School of Pharmaceutical and Chemical Sciences, Dublin Institute of Technology, Kevin St., Dublin 8, Ireland.
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Taylor MD, LeGoff L, Harris A, Malone E, Allen JE, Maizels RM. Removal of Regulatory T Cell Activity Reverses Hyporesponsiveness and Leads to Filarial Parasite Clearance In Vivo. J Immunol 2005; 174:4924-33. [PMID: 15814720 DOI: 10.4049/jimmunol.174.8.4924] [Citation(s) in RCA: 236] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Human filarial parasites cause chronic infection associated with long-term down-regulation of the host's immune response. We show here that CD4+ T cell regulation is the main determinant of parasite survival. In a laboratory model of infection, using Litomosoides sigmodontis in BALB/c mice, parasites establish for >60 days in the thoracic cavity. During infection, CD4+ T cells at this site express increasing levels of CD25, CTLA-4, and glucocorticoid-induced TNF receptor family-related gene (GITR), and by day 60, up to 70% are CTLA-4(+)GITR(high), with a lesser fraction coexpressing CD25. Upon Ag stimulation, CD4(+)CTLA-4(+)GITR(high) cells are hyporesponsive for proliferation and cytokine production. To test the hypothesis that regulatory T cell activity maintains hyporesponsiveness and prolongs infection, we treated mice with Abs to CD25 and GITR. Combined Ab treatment was able to overcome an established infection, resulting in a 73% reduction in parasite numbers (p < 0.01). Parasite killing was accompanied by increased Ag-specific immune responses and markedly reduced levels of CTLA-4 expression. The action of the CD25(+)GITR+ cells was IL-10 independent as in vivo neutralization of IL-10R did not restore the ability of the immune system to kill parasites. These data suggest that regulatory T cells act, in an IL-10-independent manner, to suppress host immunity to filariasis.
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Affiliation(s)
- Matthew D Taylor
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
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Malone E, Roertgen K, Kobluk C. Anaplastic sarcoma of the mandible in a llama. Can Vet J 1996; 37:426-8. [PMID: 8809396 PMCID: PMC1576447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- E Malone
- Department of Clinical and Population Sciences, Veterinary Teaching Hospital, Saint Paul, Minnesota, USA
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Malone E. Gastro-intestinal Bleeding due to Vitamin K Deficiency complicating Labour. West J Med 1944; 2:559-60. [DOI: 10.1136/bmj.2.4373.559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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