1
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Kalera K, Liu R, Lim J, Pathirage R, Swanson DH, Johnson UG, Stothard AI, Lee JJ, Poston AW, Woodruff PJ, Ronning DR, Eoh H, Swarts BM. Targeting Mycobacterium tuberculosis Persistence through Inhibition of the Trehalose Catalytic Shift. ACS Infect Dis 2024; 10:1391-1404. [PMID: 38485491 PMCID: PMC11019547 DOI: 10.1021/acsinfecdis.4c00138] [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] [Received: 02/22/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 04/13/2024]
Abstract
Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), is the leading cause of death worldwide by infectious disease. Treatment of Mtb infection requires a six-month course of multiple antibiotics, an extremely challenging regimen necessitated by Mtb's ability to form drug-tolerant persister cells. Mtb persister formation is dependent on the trehalose catalytic shift, a stress-responsive metabolic remodeling mechanism in which the disaccharide trehalose is liberated from cell surface glycolipids and repurposed as an internal carbon source to meet energy and redox demands. Here, using a biofilm-persister model, metabolomics, and cryo-electron microscopy (EM), we found that azidodeoxy- and aminodeoxy-d-trehalose analogues block the Mtb trehalose catalytic shift through inhibition of trehalose synthase TreS (Rv0126), which catalyzes the isomerization of trehalose to maltose. Out of a focused eight-member compound panel constructed by chemoenzymatic synthesis, the natural product 2-trehalosamine exhibited the highest potency and significantly potentiated first- and second-line TB drugs in broth culture and macrophage infection assays. We also report the first structure of TreS bound to a substrate analogue inhibitor, obtained via cryo-EM, which revealed conformational changes likely essential for catalysis and inhibitor binding that can potentially be exploited for future therapeutic development. Our results demonstrate that inhibition of the trehalose catalytic shift is a viable strategy to target Mtb persisters and advance trehalose analogues as tools and potential adjunctive therapeutics for investigating and targeting mycobacterial persistence.
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Affiliation(s)
- Karishma Kalera
- Department
of Chemistry and Biochemistry, Central Michigan
University, Mount
Pleasant, Michigan 48859, United States
- Biochemistry,
Cell, and Molecular Biology Program, Central
Michigan University, Mount Pleasant, Michigan 48859, United States
| | - Rachel Liu
- Department
of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, United States
| | - Juhyeon Lim
- Department
of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, United States
| | - Rasangi Pathirage
- Department
of Pharmaceutical Sciences, University of
Nebraska Medical Center, Omaha, Nebraska 68198, United States
| | - Daniel H. Swanson
- Department
of Chemistry and Biochemistry, Central Michigan
University, Mount
Pleasant, Michigan 48859, United States
| | - Ulysses G. Johnson
- Department
of Chemistry and Biochemistry, Central Michigan
University, Mount
Pleasant, Michigan 48859, United States
- Biochemistry,
Cell, and Molecular Biology Program, Central
Michigan University, Mount Pleasant, Michigan 48859, United States
| | - Alicyn I. Stothard
- Department
of Chemistry and Biochemistry, Central Michigan
University, Mount
Pleasant, Michigan 48859, United States
| | - Jae Jin Lee
- Department
of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, United States
| | - Anne W. Poston
- Department
of Chemistry and Biochemistry, Central Michigan
University, Mount
Pleasant, Michigan 48859, United States
| | - Peter J. Woodruff
- Department
of Chemistry, University of Southern Maine, Portland, Maine 04104, United States
| | - Donald R. Ronning
- Department
of Pharmaceutical Sciences, University of
Nebraska Medical Center, Omaha, Nebraska 68198, United States
| | - Hyungjin Eoh
- Department
of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, United States
| | - Benjamin M. Swarts
- Department
of Chemistry and Biochemistry, Central Michigan
University, Mount
Pleasant, Michigan 48859, United States
- Biochemistry,
Cell, and Molecular Biology Program, Central
Michigan University, Mount Pleasant, Michigan 48859, United States
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2
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Liu R, Dang JN, Lee R, Lee JJ, Kesavamoorthy N, Ameri H, Rao N, Eoh H. Mycobacterium dormancy and antibiotic tolerance within the retinal pigment epithelium of ocular tuberculosis. bioRxiv 2024:2024.03.18.585612. [PMID: 38562751 PMCID: PMC10983995 DOI: 10.1101/2024.03.18.585612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Tuberculosis (TB) is a leading cause of death among infectious diseases worldwide due to latent TB infection, which is the critical step for the successful pathogenic cycle. In this stage, Mycobacterium tuberculosis resides inside the host in a dormant and antibiotic-tolerant state. Latent TB infection can lead to a multisystemic diseases because M. tuberculosis invades virtually all organs, including ocular tissues. Ocular tuberculosis (OTB) occurs when the dormant bacilli within ocular tissues reactivate, originally seeded by hematogenous spread from pulmonary TB. Timely and accurate diagnosis as well as efficient chemotherapies are crucial in preventing poor visual outcomes of OTB patients. Histological evidence suggests that retinal pigment epithelium (RPE) cells play a central role in immune privilege and in the protection from the antibiotic effects, making them an anatomical niche for invading M. tuberculosis . RPE cells exhibit high tolerance to environmental redox stresses, allowing phagocytosed M. tuberculosis bacilli to maintain viability in a dormant state. However, the microbiological and metabolic mechanisms determining the interaction between the RPE intracellular environment and phagocytosed M. tuberculosis are largely unknown. Here, liquid chromatography mass spectrometry (LC-MS) metabolomics was used to illuminate the metabolic state within RPE cells reprogrammed to harbor dormant M. tuberculosis bacilli and enhance the antibiotic tolerance. The results have led to propose a novel therapeutic option to synthetically kill the dormant M. tuberculosis inside the RPE cells by modulating the phenotypic state of M. tuberculosis , thus laying the foundation for a new, innovative regimen for treating OTB. Importance Understanding the metabolic environment within the retinal pigment epithelium (RPE) cells altered by infection with M. tuberculosis and mycobacterial dormancy is crucial to identify new therapeutic methods to cure OTB. The present study showed that RPE cellular metabolism is altered to foster intracellular M. tuberculosis to enter into the dormant and drug tolerant state, thereby blunting the efficacy of anti-TB chemotherapy. RPE cells serve as an anatomical niche as the cells protect invading bacilli from antibiotic treatment. LC-MS metabolomics of RPE cells after co-treatment with H2O2 and M. tuberculosis infection showed that intracellular environment within RPE cells is enriched with greater level of oxidative stress. The antibiotic tolerance of intracellular M. tuberculosis within RPE cells can be restored by a metabolic manipulation strategy such as co-treatment of antibiotic with the most downstream glycolysis metabolite, phosphoenolpyruvate.
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Kim S, Ge J, Kim D, Lee JJ, Choi YJ, Chen W, Bowman JW, Foo SS, Chang LC, Liang Q, Hara D, Choi I, Kim MH, Eoh H, Jung JU. TXNIP-mediated crosstalk between oxidative stress and glucose metabolism. PLoS One 2024; 19:e0292655. [PMID: 38329960 PMCID: PMC10852281 DOI: 10.1371/journal.pone.0292655] [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] [Received: 10/19/2022] [Accepted: 09/26/2023] [Indexed: 02/10/2024] Open
Abstract
Thioredoxin-interacting protein (TXNIP) has emerged as a key player in cancer and diabetes since it targets thioredoxin (TRX)-mediated redox regulation and glucose transporter (GLUT)-mediated metabolism. TXNIP consists of two arrestin (ARR, N-ARR and C-ARR) domains at its amino-terminus and two PPxY (PY) motifs and a di-leucine (LL) motif for endocytosis at its carboxyl-terminus. Here, we report that TXNIP shuffles between TRX and GLUTs to regulate homeostasis of intracellular oxidative stress and glucose metabolism. While TXNIP functions as a gatekeeper of TRX by default, it robustly interacted with class I GLUTs through its C-ARR domain upon increase of intracellular reactive oxygen species. This interaction prompted the surface expression downregulation and lysosomal degradation of GLUTs by its carboxyl-terminal LL endocytic signaling motif to attenuate glucose uptake. Consequently, TXNIP expression significantly limited glucose uptake, leading to the suppression of glycolysis, hexosamine biosynthesis, and the pentose phosphate pathway. Our findings establish a fundamental link between ROS and glucose metabolism through TXNIP and provide a promising target for the drug development against GLUT-related metabolic disorders.
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Affiliation(s)
- Stephanie Kim
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- Department of Cancer Biology, Infection Biology Program, and Global Center for Pathogen and Human Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Jianning Ge
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Dokyun Kim
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- Department of Cancer Biology, Infection Biology Program, and Global Center for Pathogen and Human Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Jae Jin Lee
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Youn Jung Choi
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- Department of Cancer Biology, Infection Biology Program, and Global Center for Pathogen and Human Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Weiqiang Chen
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- Department of Cancer Biology, Infection Biology Program, and Global Center for Pathogen and Human Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - James W. Bowman
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Suan-Sin Foo
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- Department of Cancer Biology, Infection Biology Program, and Global Center for Pathogen and Human Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Lin-Chun Chang
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Qiming Liang
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Daiki Hara
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Inpyo Choi
- Immunotherapy Convergence Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - Myung Hee Kim
- Infection and Immunity Research Laboratory, Metabolic Regulation Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - Hyungjin Eoh
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Jae U. Jung
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- Department of Cancer Biology, Infection Biology Program, and Global Center for Pathogen and Human Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
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Sugahara G, Ishida Y, Lee JJ, Li M, Tanaka Y, Eoh H, Higuchi Y, Saito T. Long-term cell fate and functional maintenance of human hepatocyte through stepwise culture configuration. FASEB J 2023; 37:e22750. [PMID: 36607308 PMCID: PMC9830592 DOI: 10.1096/fj.202201292rr] [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: 08/10/2022] [Revised: 12/13/2022] [Accepted: 12/20/2022] [Indexed: 01/07/2023]
Abstract
Human hepatocyte culture system represents by far the most physiologically relevant model for our understanding of liver biology and diseases; however, its versatility has been limited due to the rapid and progressive loss of genuine characteristics, indicating the inadequacy of in vitro milieu for fate maintenance. This study, therefore, is designed to define environmental requirements necessary to sustain the homeostasis of terminally differentiated hepatocytes. Our study reveals that the supplementation of dimethyl sulfoxide (DMSO) is indispensable in mitigating fate deterioration and promoting adaptation to the in vitro environment, resulting in the restoration of tight cell-cell contact, cellular architecture, and polarity. The morphological recovery was overall accompanied by the restoration of hepatocyte marker gene expression, highlighting the interdependence between the cellular architecture and the maintenance of cell fate. However, beyond the recovery phase culture, DMSO supplementation is deemed detrimental due to the potent inhibitory effect on a multitude of hepatocyte functionalities while its withdrawal results in the loss of cell fate. In search of DMSO substitute, our screening of organic substances led to the identification of dimethyl sulfone (DMSO2), which supports the long-term maintenance of proper morphology, marker gene expression, and hepatocytic functions. Moreover, hepatocytes maintained DMSO2 exhibited clinically relevant toxicity in response to prolonged exposure to xenobiotics as well as alcohol. These observations suggest that the stepwise culture configuration consisting of the consecutive supplementation of DMSO and DMSO2 confers the microenvironment essential for the fate and functional maintenance of terminally differentiated human hepatocytes.
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Affiliation(s)
- Go Sugahara
- University of Southern California, Keck School of Medicine, Department of Medicine, Division of Gastrointestinal and Liver Diseases, Los Angeles, California, USA.,Research and Development Department, PhoenixBio, Co., Ltd, Kagamiyama, Higashi-Hiroshima, Hiroshima, Japan
| | - Yuji Ishida
- University of Southern California, Keck School of Medicine, Department of Medicine, Division of Gastrointestinal and Liver Diseases, Los Angeles, California, USA.,Research and Development Department, PhoenixBio, Co., Ltd, Kagamiyama, Higashi-Hiroshima, Hiroshima, Japan
| | - Jae Jin Lee
- University of Southern California, Keck School of Medicine, Department of Molecular Microbiology & Immunology, Los Angeles, California, USA
| | - Meng Li
- University of Southern California, Norris Medical Library, Bioinformatics Service Program, Los Angeles, California, USA
| | - Yasuhito Tanaka
- Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Hyungjin Eoh
- University of Southern California, Keck School of Medicine, Department of Molecular Microbiology & Immunology, Los Angeles, California, USA
| | - Yusuke Higuchi
- Department of Molecular Medicine, Beckman Research Institute of City of Hope, Duarte, California, USA
| | - Takeshi Saito
- University of Southern California, Keck School of Medicine, Department of Medicine, Division of Gastrointestinal and Liver Diseases, Los Angeles, California, USA.,USC Research Center for Liver Diseases, Los Angeles, California, USA.,Corresponding author: Takeshi Saito, M.D., Ph.D., Associate Professor of Medicine, Molecular Microbiology & Immunology, and Pathology, USC Research Center for Liver Diseases, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine of USC, University of Southern California, 2011 Zonal Avenue, HMR 801A, Los Angeles, CA 90033-9141, Phone: +1-323-442-2260, Fax:+1-323-442-5425,
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5
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Hirvasniemi J, Runhaar J, van der Heijden RA, Zokaeinikoo M, Yang M, Li X, Tan J, Rajamohan HR, Zhou Y, Deniz CM, Caliva F, Iriondo C, Lee JJ, Liu F, Martinez AM, Namiri N, Pedoia V, Panfilov E, Bayramoglu N, Nguyen HH, Nieminen MT, Saarakkala S, Tiulpin A, Lin E, Li A, Li V, Dam EB, Chaudhari AS, Kijowski R, Bierma-Zeinstra S, Oei EHG, Klein S. The KNee OsteoArthritis Prediction (KNOAP2020) challenge: An image analysis challenge to predict incident symptomatic radiographic knee osteoarthritis from MRI and X-ray images. Osteoarthritis Cartilage 2023; 31:115-125. [PMID: 36243308 DOI: 10.1016/j.joca.2022.10.001] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/02/2022] [Accepted: 10/03/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The KNee OsteoArthritis Prediction (KNOAP2020) challenge was organized to objectively compare methods for the prediction of incident symptomatic radiographic knee osteoarthritis within 78 months on a test set with blinded ground truth. DESIGN The challenge participants were free to use any available data sources to train their models. A test set of 423 knees from the Prevention of Knee Osteoarthritis in Overweight Females (PROOF) study consisting of magnetic resonance imaging (MRI) and X-ray image data along with clinical risk factors at baseline was made available to all challenge participants. The ground truth outcomes, i.e., which knees developed incident symptomatic radiographic knee osteoarthritis (according to the combined ACR criteria) within 78 months, were not provided to the participants. To assess the performance of the submitted models, we used the area under the receiver operating characteristic curve (ROCAUC) and balanced accuracy (BACC). RESULTS Seven teams submitted 23 entries in total. A majority of the algorithms were trained on data from the Osteoarthritis Initiative. The model with the highest ROCAUC (0.64 (95% confidence interval (CI): 0.57-0.70)) used deep learning to extract information from X-ray images combined with clinical variables. The model with the highest BACC (0.59 (95% CI: 0.52-0.65)) ensembled three different models that used automatically extracted X-ray and MRI features along with clinical variables. CONCLUSION The KNOAP2020 challenge established a benchmark for predicting incident symptomatic radiographic knee osteoarthritis. Accurate prediction of incident symptomatic radiographic knee osteoarthritis is a complex and still unsolved problem requiring additional investigation.
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Affiliation(s)
- J Hirvasniemi
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
| | - J Runhaar
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - R A van der Heijden
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - M Zokaeinikoo
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, USA
| | - M Yang
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, USA
| | - X Li
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, USA
| | - J Tan
- Department of Radiology, New York University Langone Health, New York, USA
| | - H R Rajamohan
- Department of Radiology, New York University Langone Health, New York, USA
| | - Y Zhou
- Department of Radiology, New York University Langone Health, New York, USA
| | - C M Deniz
- Department of Radiology, New York University Langone Health, New York, USA
| | - F Caliva
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - C Iriondo
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - J J Lee
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - F Liu
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - A M Martinez
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - N Namiri
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - V Pedoia
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - E Panfilov
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - N Bayramoglu
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - H H Nguyen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - M T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - S Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - A Tiulpin
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - E Lin
- Akousist Co., Ltd., Taoyuan City, Taiwan
| | - A Li
- Akousist Co., Ltd., Taoyuan City, Taiwan
| | - V Li
- Akousist Co., Ltd., Taoyuan City, Taiwan
| | - E B Dam
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - A S Chaudhari
- Department of Radiology, Stanford University, Stanford, USA
| | - R Kijowski
- Department of Radiology, New York University Langone Health, New York, USA
| | - S Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Orthopedics & Sport Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - E H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - S Klein
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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Pareek M, Bhatt DL, Zheng L, Lee JJ, Leiter LA, Simon T, Mehta SR, Harrington RA, Fox K, Himmelmann A, Vidal-Petiot E, Steg PG. Blood pressure and clinical outcomes in patients with diabetes and stable coronary artery disease in THEMIS. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1226] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Various BP characteristics, e.g., systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP), as well as heart rate (HR) may affect the risk of both cardiovascular events and bleeding events. However, the exact way in which these characteristics and outcomes are associated among patients with diabetes and stable coronary artery disease (CAD) remains debated. Moreover, it is unknown whether the risks and benefits of intensified antiplatelet therapy in this patient population are affected by their baseline BP and HR.
Purpose
To assess the relationship between BP components (including HR) and cardiovascular and bleeding events, and to determine if the effects of ticagrelor vs. placebo varied across the BP and HR spectrum, in patients with diabetes and stable CAD.
Methods
THEMIS was a randomized, controlled trial in which 19,220 individuals ≥50 years of age with stable CAD and type 2 diabetes were randomized to receive either ticagrelor plus aspirin or placebo plus aspirin. Patients with a prior myocardial infarction or stroke, or already on dual antiplatelet therapy, were excluded. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke. The primary safety outcome was TIMI major bleeding. We examined prognostic implications of BP components using 1) restricted cubic splines for the overall trends with outcomes; 2) Cox proportional-hazards regression models with predefined BP component intervals adjusted for demographic, clinical, and laboratory variables; and 3) Cox regression models for the effects of ticagrelor vs. placebo on outcomes across the spectrum of BP component values (test for interaction). THEMIS is registered at ClinicalTrials.gov (NCT01991795).
Results
Mean values of baseline BP components were similar between the two study groups. Median follow-up duration was 39.9 months (range 0–57), with 1554 primary efficacy events and 306 primary safety events occurring over the course of the study. All BP components (including HR) displayed various, independent relationships with the tested outcomes. For example, in adjusted spline models, SBP displayed non-linear relationships with the primary outcome, all-cause death, any bleeding, serious adverse events, and intracranial bleeding, and linear relationships with the remaining outcomes. Figure 1 shows the associations of each BP component with the primary efficacy outcome. BP components did not substantially modify the risks and benefits of ticagrelor vs. placebo for the tested outcomes.
Conclusions
BP components were independently associated with efficacy and safety outcomes in patients with stable CAD and type 2 diabetes. However, no important modification of BP components on the effect of ticagrelor vs. placebo was detected.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): AstraZeneca
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Affiliation(s)
- M Pareek
- Brigham and Women's Hospital, Heart and Vascular Center , Boston , United States of America
| | - D L Bhatt
- Brigham and Women's Hospital, Heart and Vascular Center , Boston , United States of America
| | - L Zheng
- Brigham and Women's Hospital, Heart and Vascular Center , Boston , United States of America
| | - J J Lee
- Brigham and Women's Hospital, Heart and Vascular Center , Boston , United States of America
| | - L A Leiter
- St. Michael's Hospital , Toronto , Canada
| | - T Simon
- Sorbonne University , Paris , France
| | - S R Mehta
- McMaster University , Hamilton , Canada
| | - R A Harrington
- Stanford University Medical Center , Stanford , United States of America
| | - K Fox
- Royal Brompton Hospital Imperial College London , London , United Kingdom
| | - A Himmelmann
- AstraZeneca BioPharmaceuticals , Molndal , Sweden
| | - E Vidal-Petiot
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T , Paris , France
| | - P G Steg
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T , Paris , France
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7
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Eoh H, Liu R, Lim J, Lee JJ, Sell P. Central carbon metabolism remodeling as a mechanism to develop drug tolerance and drug resistance in Mycobacterium tuberculosis. Front Cell Infect Microbiol 2022; 12:958240. [PMID: 36072228 PMCID: PMC9441700 DOI: 10.3389/fcimb.2022.958240] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Suboptimal efficacy of the current antibiotic regimens and frequent emergence of antibiotic-resistant Mycobacterium tuberculosis (Mtb), an etiological agent of tuberculosis (TB), render TB the world’s deadliest infectious disease before the COVID-19 outbreak. Our outdated TB treatment method is designed to eradicate actively replicating populations of Mtb. Unfortunately, accumulating evidence suggests that a small population of Mtb can survive antimycobacterial pressure of antibiotics by entering a “persister” state (slowly replicating or non-replicating and lacking a stably heritable antibiotic resistance, termed drug tolerance). The formation of drug-tolerant Mtb persisters is associated with TB treatment failure and is thought to be an adaptive strategy for eventual development of permanent genetic mutation-mediated drug resistance. Thus, the molecular mechanisms behind persister formation and drug tolerance acquisition are a source of new antibiotic targets to eradicate both Mtb persisters and drug-resistant Mtb. As Mtb persisters are genetically identical to antibiotic susceptible populations, metabolomics has emerged as a vital biochemical tool to differentiate these populations by determining phenotypic shifts and metabolic reprogramming. Metabolomics, which provides detailed insights into the molecular basis of drug tolerance and resistance in Mtb, has unique advantages over other techniques by its ability to identify specific metabolic differences between the two genetically identical populations. This review summarizes the recent advances in our understanding of the metabolic adaptations used by Mtb persisters to achieve intrinsic drug tolerance and facilitate the emergence of drug resistance. These findings present metabolomics as a powerful tool to identify previously unexplored antibiotic targets and improved combinations of drug regimens against drug-resistant TB infection.
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8
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Choi UY, Lee JJ, Park A, Jung KL, Lee SA, Choi YJ, Lee HR, Lai CJ, Eoh H, Jung JU. Herpesvirus-induced spermidine synthesis and eIF5A hypusination for viral episomal maintenance. Cell Rep 2022; 40:111234. [PMID: 35977517 DOI: 10.1016/j.celrep.2022.111234] [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: 10/22/2021] [Revised: 05/16/2022] [Accepted: 07/28/2022] [Indexed: 11/03/2022] Open
Abstract
Spermidine is essential for cellular growth and acts as a prerequisite of hypusination, a post-translational modification of eukaryotic initiation factor 5A (eIF5A), allowing the translation of polyproline-containing proteins. Here, we show that oncogenic Kaposi's sarcoma-associated herpesvirus (KSHV) increases spermidine synthesis and eIF5A hypusination to enhance expression of polyproline-containing latency-associated nuclear antigen (LANA) for viral episomal maintenance. KSHV upregulates intracellular spermidine levels by dysregulating polyamine metabolic pathways in three-dimensional (3D) culture and 2D de novo infection conditions. Increased intracellular spermidine leads to increased eIF5A hypusination, ultimately enhancing LANA expression. In contrast, inhibition of spermidine synthesis or eIF5A hypusination alleviates LANA expression, decreasing viral episomal maintenance and KSHV-infected cell proliferation in vitro and in vivo, which is reversed by spermidine supplement. This demonstrates that KSHV hijacks spermidine synthesis and eIF5A hypusination pathways to enhance LANA expression for viral episomal maintenance, suggesting polyamine metabolism and eIF5A hypusination as therapeutic targets for KSHV-induced tumorigenesis.
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Affiliation(s)
- Un Yung Choi
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
| | - Jae Jin Lee
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Angela Park
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Kyle L Jung
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Shin-Ae Lee
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Youn Jung Choi
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Hye-Ra Lee
- Department of Biotechnology and Bioinformatics, College of Science and Technology, Korea University, Sejong 30019, Republic of Korea
| | - Chih-Jen Lai
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Hyungjin Eoh
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Jae U Jung
- Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
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9
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Quinonez CG, Lee JJ, Lim J, Odell M, Lawson CP, Anyogu A, Raheem S, Eoh H. Fatty acid metabolism of Mycobacterium tuberculosis: A double-edged sword. Microb Cell 2022; 9:123-125. [PMID: 35647177 PMCID: PMC9113558 DOI: 10.15698/mic2022.05.777] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 02/21/2022] [Indexed: 11/29/2022]
Abstract
Unlike other heterotrophic bacteria, Mycobacterium tuberculosis (Mtb) can co-catabolize a range of carbon sources simultaneously. Evolution of Mtb within host nutrient environment allows Mtb to consume the host's fatty acids as a main carbon source during infection. The fatty acid-induced metabolic advantage greatly contributes to Mtb's pathogenicity and virulence. Thus, the identification of key enzymes involved in Mtb's fatty acid metabolism is urgently needed to aid new drug development. Two fatty acid metabolism enzymes, phosphoenolpyruvate carboxykinase (PEPCK) and isocitrate lyase (ICL) have been intensively studied as promising drug targets, but recently, Quinonez et al. (mBio, doi: 10.1128/mbio.03559-21) highlighted a link between the fatty acid-induced dormancy-like state and drug tolerance. Using metabolomics profiling of a PEPCK-deficient mutant, Quinonez et al. identified that over-accumulation of methylcitrate cycle (MCC) intermediates are phenotypically associated with enhanced drug tolerance against first- and second- line TB antibiotics. This finding was further corroborated by metabolomics and phenotypic characterization of Mtb mutants lacking either ICL or 2-methylcitrate dehydratase. Fatty acid metabolism induced drug-tolerance was also recapitulated in wildtype Mtb after treatment with authentic 2-methylisocitrate, an MCC intermediate. Together, the fatty acid-induced dormancy-like state and drug tolerance are attributed to dysregulated MCC activity.
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Affiliation(s)
- Camila G Quinonez
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Life Sciences, Faculty of Science and Technology, University of Westminster, London, W1W 6UV, United Kingdom
| | - Jae Jin Lee
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Juhyeon Lim
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Mark Odell
- School of Life Sciences, University of Lincoln, United Kingdom
| | - Christopher P Lawson
- Stratclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Amarachukwu Anyogu
- School of Biomedical Sciences, University of West London, London, United Kingdom
| | - Saki Raheem
- Department of Life Sciences, Faculty of Science and Technology, University of Westminster, London, W1W 6UV, United Kingdom
| | - Hyungjin Eoh
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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10
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Redding LE, Tu V, Abbas A, Alvarez M, Zackular JP, Gu C, Bushman FD, Kelly DJ, Barnhart D, Lee JJ, Bittinger KL. Genetic and phenotypic characteristics of Clostridium (Clostridioides) difficile from canine, bovine, and pediatric populations. Anaerobe 2022; 74:102539. [PMID: 35217150 PMCID: PMC9359814 DOI: 10.1016/j.anaerobe.2022.102539] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/02/2022] [Accepted: 02/17/2022] [Indexed: 12/15/2022]
Abstract
Objectives: Carriage of Clostridioides difficile by different species of animals has led to speculation that animals could represent a reservoir of this pathogen for human infections. The objective of this study was to compare C. difficile isolates from humans, dogs, and cattle from a restricted geographic area. Methods: C. difficile isolates from 36 dogs and 15 dairy calves underwent whole genome sequencing, and phenotypic assays assessing growth and virulence were performed. Genomes of animal-derived isolates were compared to 29 genomes of isolates from a pediatric population as well as 44 reference genomes. Results: Growth rates and relative cytotoxicity of isolates were significantly higher and lower, respectively, in bovine-derived isolates compared to pediatric- and canine-derived isolates. Analysis of core genes showed clustering by host species, though in a few cases, human strains co-clustered with canine or bovine strains, suggesting possible interspecies transmission. Geographic differences (e.g., farm, litter) were small compared to differences between species. In an analysis of accessory genes, the total number of genes in each genome varied between host species, with 6.7% of functional orthologs differentially present/absent between host species and bovine-derived strains having the lowest number of genes. Canine-derived isolates were most likely to be non-toxigenic and more likely to carry phages. A targeted study of episomes identified in local pediatric strains showed sharing of a methicillin-resistance plasmid with dogs, and historic sharing of a wide range of episomes across hosts. Bovine-derived isolates harbored the widest variety of antibiotic-resistance genes, followed by canine Conclusions: While C. difficile isolates mostly clustered by host species, occasional co-clustering of canine and pediatric-derived isolates suggests the possibility of interspecies transmission. The presence of a pool of resistance genes in animal-derived isolates with the potential to appear in humans given sufficient pressure from antibiotic use warrants concern.
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Affiliation(s)
- L E Redding
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, 19348, USA.
| | - V Tu
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, PA, 19104, USA
| | - A Abbas
- Division of Protective Immunity, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - M Alvarez
- Division of Protective Immunity, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - J P Zackular
- Division of Protective Immunity, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA; Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - C Gu
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - F D Bushman
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - D J Kelly
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, 19348, USA
| | - D Barnhart
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, 19348, USA
| | - J J Lee
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, PA, 19104, USA
| | - K L Bittinger
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, PA, 19104, USA
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11
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Kim YJ, Lee JY, Lee JJ, Jeon SM, Silwal P, Kim IS, Kim HJ, Park CR, Chung C, Han JE, Choi JW, Tak EJ, Yoo JH, Jeong SW, Kim DY, Ketphan W, Kim SY, Jhun BW, Whang J, Kim JM, Eoh H, Bae JW, Jo EK. Arginine-mediated gut microbiome remodeling promotes host pulmonary immune defense against nontuberculous mycobacterial infection. Gut Microbes 2022; 14:2073132. [PMID: 35579969 PMCID: PMC9116420 DOI: 10.1080/19490976.2022.2073132] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/08/2022] [Accepted: 04/18/2022] [Indexed: 02/06/2023] Open
Abstract
Nontuberculous mycobacterial pulmonary diseases (NTM-PDs) are emerging as global health threats with issues of antibiotic resistance. Accumulating evidence suggests that the gut-lung axis may provide novel candidates for host-directed therapeutics against various infectious diseases. However, little is known about the gut-lung axis in the context of host protective immunity to identify new therapeutics for NTM-PDs. This study was performed to identify gut microbes and metabolites capable of conferring pulmonary immunity to NTM-PDs. Using metabolomics analysis of sera from NTM-PD patients and mouse models, we showed that the levels of l-arginine were decreased in sera from NTM-PD patients and NTM-infected mice. Oral administration of l-arginine significantly enhanced pulmonary antimicrobial activities with the expansion of IFN-γ-producing effector T cells and a shift to microbicidal (M1) macrophages in the lungs of NTM-PD model mice. Mice that received fecal microbiota transplants from l-arginine-treated mice showed increased protective host defense in the lungs against NTM-PD, whereas l-arginine-induced pulmonary host defense was attenuated in mice treated with antibiotics. Using 16S rRNA sequencing, we further showed that l-arginine administration resulted in enrichment of the gut microbiota composition with Bifidobacterium species. Notably, oral treatment with either Bifidobacterium pseudolongum or inosine enhanced antimicrobial pulmonary immune defense against NTM infection, even with multidrug-resistant clinical NTM strains. Our findings indicate that l-arginine-induced gut microbiota remodeling with enrichment of B. pseudolongum boosts pulmonary immune defense against NTM infection by driving the protective gut-lung axis in vivo.
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Affiliation(s)
- Young Jae Kim
- Department of Microbiology, Chungnam National University School of MedicineDaejeon, Korea
- Infection Control Convergence Research Center, Chungnam National University School of MedicineDaejeon, Korea
- Department of Medical Science, Chungnam National University School of MedicineDaejeon, Korea
- Brain Korea 21 FOUR Project for Medical Science, Chungnam National University School of MedicineDaejeon, Korea
| | - June-Young Lee
- Department of Life and Nanopharmaceutical Sciences and Department of Biology, Kyung Hee University, Seoul, Korea
- Department of Biomedical and Pharmaceutical Sciences, Kyung Hee University, Seoul, Korea
| | - Jae Jin Lee
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern CaliforniaCA, USA
| | - Sang Min Jeon
- Department of Microbiology, Chungnam National University School of MedicineDaejeon, Korea
- Infection Control Convergence Research Center, Chungnam National University School of MedicineDaejeon, Korea
- Department of Medical Science, Chungnam National University School of MedicineDaejeon, Korea
- Brain Korea 21 FOUR Project for Medical Science, Chungnam National University School of MedicineDaejeon, Korea
| | - Prashanta Silwal
- Department of Microbiology, Chungnam National University School of MedicineDaejeon, Korea
- Infection Control Convergence Research Center, Chungnam National University School of MedicineDaejeon, Korea
| | - In Soo Kim
- Department of Microbiology, Chungnam National University School of MedicineDaejeon, Korea
- Infection Control Convergence Research Center, Chungnam National University School of MedicineDaejeon, Korea
- Department of Medical Science, Chungnam National University School of MedicineDaejeon, Korea
| | - Hyeon Ji Kim
- Department of Microbiology, Chungnam National University School of MedicineDaejeon, Korea
- Infection Control Convergence Research Center, Chungnam National University School of MedicineDaejeon, Korea
- Department of Medical Science, Chungnam National University School of MedicineDaejeon, Korea
| | - Cho Rong Park
- Department of Microbiology, Chungnam National University School of MedicineDaejeon, Korea
- Infection Control Convergence Research Center, Chungnam National University School of MedicineDaejeon, Korea
- Department of Medical Science, Chungnam National University School of MedicineDaejeon, Korea
| | - Chaeuk Chung
- Infection Control Convergence Research Center, Chungnam National University School of MedicineDaejeon, Korea
- Division of Pulmonary and Critical Care, Department of Internal Medicine, Chungnam National University School of MedicineDaejeon, Korea
| | - Jeong Eun Han
- Department of Life and Nanopharmaceutical Sciences and Department of Biology, Kyung Hee University, Seoul, Korea
| | - Jee-Won Choi
- Department of Life and Nanopharmaceutical Sciences and Department of Biology, Kyung Hee University, Seoul, Korea
| | - Euon Jung Tak
- Department of Life and Nanopharmaceutical Sciences and Department of Biology, Kyung Hee University, Seoul, Korea
- Department of Biomedical and Pharmaceutical Sciences, Kyung Hee University, Seoul, Korea
| | - Ji-Ho Yoo
- Department of Biomedical and Pharmaceutical Sciences, Kyung Hee University, Seoul, Korea
| | - Su-Won Jeong
- Department of Life and Nanopharmaceutical Sciences and Department of Biology, Kyung Hee University, Seoul, Korea
| | - Do-Yeon Kim
- Department of Life and Nanopharmaceutical Sciences and Department of Biology, Kyung Hee University, Seoul, Korea
| | - Warisa Ketphan
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern CaliforniaCA, USA
| | - Su-Young Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, South Korea
| | - Byung Woo Jhun
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, South Korea
| | - Jake Whang
- Korea Mycobacterium Resource Center (KMRC) & Basic Research Section, The Korean Institute of Tuberculosis (KIT), Cheongju, Korea
| | - Jin-Man Kim
- Department of Pathology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hyungjin Eoh
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern CaliforniaCA, USA
| | - Jin-Woo Bae
- Department of Life and Nanopharmaceutical Sciences and Department of Biology, Kyung Hee University, Seoul, Korea
- Department of Biomedical and Pharmaceutical Sciences, Kyung Hee University, Seoul, Korea
| | - Eun-Kyeong Jo
- Department of Microbiology, Chungnam National University School of MedicineDaejeon, Korea
- Infection Control Convergence Research Center, Chungnam National University School of MedicineDaejeon, Korea
- Department of Medical Science, Chungnam National University School of MedicineDaejeon, Korea
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12
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Federico L, McGrail DJ, Bentebibel SE, Haymaker C, Ravelli A, Forget MA, Karpinets T, Jiang P, Reuben A, Negrao MV, Li J, Khairullah R, Zhang J, Weissferdt A, Vaporciyan AA, Antonoff MB, Walsh G, Lin SY, Futreal A, Wistuba I, Roth J, Byers LA, Gaudreau PO, Uraoka N, Cruz AF, Dejima H, Lazcano RN, Solis LM, Parra ER, Lee JJ, Swisher S, Cascone T, Heymach JV, Zhang J, Sepesi B, Gibbons DL, Bernatchez C. Distinct tumor-infiltrating lymphocyte landscapes are associated with clinical outcomes in localized non-small-cell lung cancer. Ann Oncol 2022; 33:42-56. [PMID: 34653632 PMCID: PMC10019222 DOI: 10.1016/j.annonc.2021.09.021] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [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: 04/11/2021] [Revised: 09/11/2021] [Accepted: 09/30/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Despite the importance of tumor-infiltrating T lymphocytes (TILs) in cancer biology, the relationship between TIL phenotypes and their prognostic relevance for localized non-small-cell lung cancer (NSCLC) has not been well established. PATIENTS AND METHODS Fresh tumor and normal adjacent tissue was prospectively collected from 150 patients with localized NSCLC. Tissue was comprehensively characterized by high-dimensional flow cytometry of TILs integrated with immunogenomic data from multiplex immunofluorescence, T-cell receptor sequencing, exome sequencing, RNA sequencing, targeted proteomics, and clinicopathologic features. RESULTS While neither the magnitude of TIL infiltration nor specific TIL subsets were significantly prognostic alone, the integration of high-dimensional flow cytometry data identified two major immunotypes (IM1 and IM2) that were predictive of recurrence-free survival independent of clinical characteristics. IM2 was associated with poor prognosis and characterized by the presence of proliferating TILs expressing cluster of differentiation 103, programmed cell death protein 1, T-cell immunoglobulin and mucin-domain containing protein 3, and inducible T-cell costimulator. Conversely, IM1 was associated with good prognosis and differentiated by an abundance of CD8+ T cells expressing cytolytic enzymes, CD4+ T cells lacking the expression of inhibitory receptors, and increased levels of B-cell infiltrates and tertiary lymphoid structures. While increased B-cell infiltration was associated with good prognosis, the best prognosis was observed in patients with tumors exhibiting high levels of both B cells and T cells. These findings were validated in patient tumors from The Cancer Genome Atlas. CONCLUSIONS Our study suggests that although the number of infiltrating T cells is not associated with patient survival, the nature of the infiltrating T cells, resolved in distinct TIL immunotypes, is prognostically relevant in NSCLC and may inform therapeutic approaches to clinical care.
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Affiliation(s)
- L Federico
- Therapeutics Discovery Division, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - D J McGrail
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S-E Bentebibel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - C Haymaker
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Ravelli
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M-A Forget
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - T Karpinets
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - P Jiang
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Reuben
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M V Negrao
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Li
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - R Khairullah
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Zhang
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Weissferdt
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A A Vaporciyan
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M B Antonoff
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - G Walsh
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S-Y Lin
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Futreal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - I Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Roth
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - L A Byers
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - P-O Gaudreau
- Department of Oncology, Queens' University and the Canadian Cancer Trials Group, Kingston, Canada
| | - N Uraoka
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A F Cruz
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - H Dejima
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - R N Lazcano
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - L M Solis
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - E R Parra
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J J Lee
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S Swisher
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - T Cascone
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J V Heymach
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Zhang
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
| | - B Sepesi
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA.
| | - D L Gibbons
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Molecular and Cellular Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
| | - C Bernatchez
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
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13
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Lee JJ, Kang HY, Lee WI, Cho SY, Kim YJ, Lee HJ. Efflux pump gene expression study using RNA-seq in multidrug-resistant TB. Int J Tuberc Lung Dis 2021; 25:974-981. [PMID: 34886926 DOI: 10.5588/ijtld.21.0117] [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: 11/10/2022] Open
Abstract
BACKGROUND: The mechanism underlying kanamycin (KM) resistance in Mycobacterium tuberculosis is not well understood, although efflux pump proteins are thought to play a role. This study used RNA-seq data to investigate changes in the expression levels of efflux pump genes following exposure to KM.METHODS: RNA expression of efflux pump and regulatory genes following exposure to different concentrations of KM (minimum inhibitory concentration MIC 25 and MIC50) in rrs wild-type strain and rrs A1401G mutated strain were compared with the control group.RESULTS: The selected strains had differential RNA expression patterns. Among the 71 putative efflux pump and regulatory genes, 46 had significant fold changes, and 12 genes (Rv0842, Rv1146, Rv1258c, Rv1473, Rv1686c, Rv1687c, Rv1877, Rv2038c, Rv3065, Rv3197a, Rv3728 and Rv3789) that were overexpressed following exposure to KM were thought to contribute to drug resistance. Rv3197A (whiB7) showed a distinct fold change based on the concentration of KM.CONCLUSION: The significant changes in the expression of the efflux pump and regulatory genes following exposure to KM may provide insights into the identification of a new resistance mechanism.
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Affiliation(s)
- J J Lee
- Department of Laboratory Medicine, Graduate School, Kyung Hee University, Seoul, Korea, Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - H Y Kang
- Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - W-I Lee
- Department of Laboratory Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - S Y Cho
- Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - Y J Kim
- Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - H J Lee
- Korean National Tuberculosis Association, Seoul, Korea
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14
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Lee H, Lee JJ, Park NY, Dubey SK, Kim T, Ruan K, Lim SB, Park SH, Ha S, Kovlyagina I, Kim KT, Kim S, Oh Y, Kim H, Kang SU, Song MR, Lloyd TE, Maragakis NJ, Hong YB, Eoh H, Lee G. Multi-omic analysis of selectively vulnerable motor neuron subtypes implicates altered lipid metabolism in ALS. Nat Neurosci 2021; 24:1673-1685. [PMID: 34782793 PMCID: PMC8639773 DOI: 10.1038/s41593-021-00944-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 09/16/2021] [Indexed: 12/13/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a devastating disorder in which motor neurons degenerate, the causes of which remain unclear. In particular, the basis for selective vulnerability of spinal motor neurons (sMNs) and resistance of ocular motor neurons to degeneration in ALS has yet to be elucidated. Here, we applied comparative multi-omics analysis of human induced pluripotent stem cell-derived sMNs and ocular motor neurons to identify shared metabolic perturbations in inherited and sporadic ALS sMNs, revealing dysregulation in lipid metabolism and its related genes. Targeted metabolomics studies confirmed such findings in sMNs of 17 ALS (SOD1, C9ORF72, TDP43 (TARDBP) and sporadic) human induced pluripotent stem cell lines, identifying elevated levels of arachidonic acid. Pharmacological reduction of arachidonic acid levels was sufficient to reverse ALS-related phenotypes in both human sMNs and in vivo in Drosophila and SOD1G93A mouse models. Collectively, these findings pinpoint a catalytic step of lipid metabolism as a potential therapeutic target for ALS.
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Affiliation(s)
- Hojae Lee
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Robert Packard Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jae Jin Lee
- Department of Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, Los Angeles, CA, USA
| | - Na Young Park
- Department of Biochemistry, College of Medicine, Dong-A University, Busan, Korea
- Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan, Korea
| | - Sandeep Kumar Dubey
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Taeyong Kim
- Department of Biology, San Diego State University, San Diego, CA, USA
| | - Kai Ruan
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Su Bin Lim
- Department of Biochemistry and Molecular Biology, Ajou University School of Medicine, Suwon, Korea
| | - Seong-Hyun Park
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shinwon Ha
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Irina Kovlyagina
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Institute of Physiological Chemistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Kyung-Tai Kim
- School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
- Jeonbuk Branch Institute, Korea Institute of Toxicology, Jeongeup, Republic of Korea
| | - Seongjun Kim
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yohan Oh
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Biomedical Science, Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul, Republic of Korea
| | - Hyesoo Kim
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sung-Ung Kang
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mi-Ryoung Song
- School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
| | - Thomas E Lloyd
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Cellular and Molecular Medicine Program, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Nicholas J Maragakis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Young Bin Hong
- Department of Biochemistry, College of Medicine, Dong-A University, Busan, Korea.
- Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan, Korea.
| | - Hyungjin Eoh
- Department of Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, Los Angeles, CA, USA.
| | - Gabsang Lee
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- The Robert Packard Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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15
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Lee JJ, Choi SR, Lee EJ, Yang HY, Baek SH, Seo JW, Koo JR. Changes in duplex ultrasound parameters during maturation according to arteriovenous access types in incident hemodialysis patients. J Vasc Access 2021; 23:574-580. [PMID: 33779359 DOI: 10.1177/11297298211005248] [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] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Little is known about the changes in hemodynamic parameters during arteriovenous (AV) access maturation using duplex ultrasound according to radiocephalic fistula (RCF), brachiocephalic fistula (BCF), and AV graft (AVG) in incident hemodialysis (HD) patient. The objective of this study was to evaluate changes and differences in brachial artery flow rate (BAFR) and related parameters affecting maturation by duplex ultrasound in incident HD patients according to access type. METHODS This study was an observational study conducted from March 2019 to October 2020. During the study period, 109 incident patients underwent new AV access creation, of which 100 were included in the study. The duplex ultrasound was performed on the day prior to access creation, further, day 1, 2 weeks, and 4 weeks later after access creation in incident HD patients. RESULTS Among all the patients, 38 (38%) received BCF, while 26 (26%) underwent RCF. Of the patients with AVG, 18 (50%) had a forearm loop AVG. The overall mean age was 62.2 ± 13.8 years (range, 32-89). The BAFR increased about 6.9 times in the RCF, 17.4 times in the BCF, and 19.5 times in the AVG at day 1. The median BAFR measured on day 1 was 580.4 mL/min for RC, 1029.0 mL/min for BC, and 1133.0 mL/min for AVG. Relative to the values measured in week 4, the BAFR on day 1 was 69.5% in RCF, 90.6% in BCF, and 93.9% in AVG. The acceleration decreased most significantly on day 1(p < 0.05). The acceleration time increased significantly on day 1 (p < 0.05) and beyond during maturation in the RCF and BCF. The BAFR of the RCF had a significantly negative correlation with the pulsatility index. The BAFR of the BCF showed a significantly positive correlation with the systolic and diastolic blood pressure but negatively correlated with pulse rate. The BAFR of the AVG showed a significant positive correlation with the diameter of the outflow vein. CONCLUSIONS There were differences in the clinical and duplex parameters during maturation according to access type. The most dramatic changes of duplex parameters were on the day after AV access creation regardless of AV access types. Though RCF had a lower BAFR rate compared to BCF and AVG, it already had a sufficient BAFR required for adequate HD treatment the day after creation. The BAFR of BCF was not different from that of AVG.
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Affiliation(s)
- Jae Jin Lee
- Department of Thoracic & Cardiovascular Surgery, Hallym University Dongtan Sacred Heart Hospital, Dongtan, Republic of Korea
| | - Sun Ryoung Choi
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Dongtan, Republic of Korea
| | - Eun Ju Lee
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Dongtan, Republic of Korea
| | - Ha Youn Yang
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Dongtan, Republic of Korea
| | - Seon Ha Baek
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Dongtan, Republic of Korea
| | - Jang-Won Seo
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Dongtan, Republic of Korea
| | - Ja-Ryong Koo
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Dongtan, Republic of Korea
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16
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Kim J, Yu JZ, Chan RHW, Leung KL, Sumerlin TS, Fong B, Siu S, Lee JJ, Chung RY. Knowledge, attitudes and binge drinking among urban Chinese university students in Hong Kong. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.396] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although dormitory residents have been identified as a high-risk group for alcohol misuse in Chinese university settings, the factors associated with their drinking behaviors has not be characterized.
Methods
A cross-sectional study was conducted among hostel residents in two Hong Kong universities (n = 1455) using self-administered, anonymous surveys. In addition to examining the knowledge levels and drinking-related attitudes, we examined the factors associated with binge drinking in this population using multivariable regression analysis.
Results
Among university dormitory residents, the prevalence of past-month binge drinking was 26.8% among males and 12.8% among females. It was noted that although respondents demonstrated attitudes conducive towards alcohol-free socialization, they exhibited low levels of alcohol-related knowledge (mean knowledge score: 3.3/ 10, SD = 2.0). While about 59% were aware that alcohol is a carcinogen and that some medications should not be taken with alcohol, only 10.4% were familiar with symptoms of alcohol poisoning and only 23% were familiar with relative amounts of alcohol in different beverage categories. Of the respondents the factors independently associated with past-month binge drinking were: male sex, older age, full-time hostel residence, drinking roommates, drinking romantic partner, participation in drinking games, and having pro-alcohol attitudes (OR ranging from 1.33-3.69). Alcohol-related knowledge was not associated with binge drinking.
Conclusions
Although southern China is a low alcohol consumption area, binge drinking is common among university residents and requires multi-prong interventions. Heavy drinking is a neglected health problem among urban Chinese university students. Interventions targeting binge drinkers need to counteract pro-alcohol attitudes and peer effects. Increasing alcohol knowledge may additionally help to reduce alcohol-related harms in this age group.
Key messages
Urban Chinese university dormitory residents demonstrate low levels of alcohol knowledge. Pro-alcohol attitudes and peers effects need to be addressed in university anti-binge drinking interventions.
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Affiliation(s)
- J Kim
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - J Z Yu
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - R H W Chan
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - K L Leung
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - T S Sumerlin
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - B Fong
- Hong Kong Polytechnic University, Hong Kong, China
| | - S Siu
- KELY Organization, Hong Kong, China
| | - J J Lee
- The School of Nursing, Hong Kong University, Hong Kong, China
| | - R Y Chung
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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17
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Kim J, Chan RHW, Leung KL, Chan KYM, Chung RY, Fong B, Sumerlin TS, Siu S, Lee JJ. Second-hand harms of alcohol use in urban Chinese university students: A study from Hong Kong. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although second-harms alcohol harms, harms caused by the drinking of others, may contribute significantly to the public health burden of alcohol, these harms are an understudied area of public health research. This study aims to examine second-hand alcohol harms in among urban Chinese university students residing on campus who are were previously identified as a high risk group for alcohol misuse.
Methods
A cross-sectional study was conducted among hostel residents in two Hong Kong universities (n = 1455) using self-administered, anonymous surveys. We examined the prevalance and the factors associated with second-hand alcohol harms this population using multivariable regression analysis.
Results
Approximately 2/3 of the university residents experienced at least one second-hand drinking harm in the past year while 1/5 experienced 4 or more harms. The harms reported were: 1) inconveniences/disturbances (46.2%), psychological distress/anxiety/depression (32.9%), home arguments (28.3%), conflicts/arguments/insults in public (25.3%), worsened productivity/academics (22.2%), property damage/monetary loss (13.2%), accidents/injury/assault (11.7%) and having to deal with authorities/law enforcement (11.5%). Only 9.1% reported these harms to authorities. Participation in drinking games (OR = 1.44), having drinking roomates (OR = 1.37) or drinking romantic partner (OR = 1.89) were independently associated with likelihood of second-hand alcohol harms (p < 0.05).
Conclusions
Although southern China is a low alcohol consumption region, there is a high prevalence of second-hand alcohol harms among university dorm residents. Universities in the region should rectify the near absence of alcohol-related topics in university health promotion.
Key messages
Harms from the drinking of others is a commonplace but underappreciated phenomenon among university campus residents. University health promotion in the region should include alcohol harms reduction topics.
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Affiliation(s)
- J Kim
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - R H W Chan
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - K L Leung
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - K Y M Chan
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - R Y Chung
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - B Fong
- Hong Kong Polytechnic University, Hong Kong, China
| | - T S Sumerlin
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - S Siu
- KELY Organization, Hong Kong, China
| | - J J Lee
- The School of Nursing, Hong Kong University, Hong Kong, China
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18
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Choi UY, Lee JJ, Park A, Zhu W, Lee HR, Choi YJ, Yoo JS, Yu C, Feng P, Gao SJ, Chen S, Eoh H, Jung JU. Oncogenic human herpesvirus hijacks proline metabolism for tumorigenesis. Proc Natl Acad Sci U S A 2020; 117:8083-8093. [PMID: 32213586 PMCID: PMC7149499 DOI: 10.1073/pnas.1918607117] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Three-dimensional (3D) cell culture is well documented to regain intrinsic metabolic properties and to better mimic the in vivo situation than two-dimensional (2D) cell culture. Particularly, proline metabolism is critical for tumorigenesis since pyrroline-5-carboxylate (P5C) reductase (PYCR/P5CR) is highly expressed in various tumors and its enzymatic activity is essential for in vitro 3D tumor cell growth and in vivo tumorigenesis. PYCR converts the P5C intermediate to proline as a biosynthesis pathway, whereas proline dehydrogenase (PRODH) breaks down proline to P5C as a degradation pathway. Intriguingly, expressions of proline biosynthesis PYCR gene and proline degradation PRODH gene are up-regulated directly by c-Myc oncoprotein and p53 tumor suppressor, respectively, suggesting that the proline-P5C metabolic axis is a key checkpoint for tumor cell growth. Here, we report a metabolic reprogramming of 3D tumor cell growth by oncogenic Kaposi's sarcoma-associated herpesvirus (KSHV), an etiological agent of Kaposi's sarcoma and primary effusion lymphoma. Metabolomic analyses revealed that KSHV infection increased nonessential amino acid metabolites, specifically proline, in 3D culture, not in 2D culture. Strikingly, the KSHV K1 oncoprotein interacted with and activated PYCR enzyme, increasing intracellular proline concentration. Consequently, the K1-PYCR interaction promoted tumor cell growth in 3D spheroid culture and tumorigenesis in nude mice. In contrast, depletion of PYCR expression markedly abrogated K1-induced tumor cell growth in 3D culture, not in 2D culture. This study demonstrates that an increase of proline biosynthesis induced by K1-PYCR interaction is critical for KSHV-mediated transformation in in vitro 3D culture condition and in vivo tumorigenesis.
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Affiliation(s)
- Un Yung Choi
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033
| | - Jae Jin Lee
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033
| | - Angela Park
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033
| | - Wei Zhu
- Department of NanoEngineering, University of California San Diego, La Jolla, CA 92093
| | - Hye-Ra Lee
- Department of Biotechnology and Bioinformatics, College of Science and Technology, Korea University, 30019 Sejong, South Korea
| | - Youn Jung Choi
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033
| | - Ji-Seung Yoo
- Department of Immunology, Faculty of Medicine, Hokkaido University, 060-8638 Sapporo, Japan
| | - Claire Yu
- Department of NanoEngineering, University of California San Diego, La Jolla, CA 92093
| | - Pinghui Feng
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033
- Section of Infection and Immunity, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089
| | - Shou-Jiang Gao
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033
- University of Pittsburgh Medical Center (UPMC), Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, PA 15219
- Laboratory of Human Virology and Oncology, Shantou University Medical College, 515041 Shantou, Guangdong, China
| | - Shaochen Chen
- Department of NanoEngineering, University of California San Diego, La Jolla, CA 92093
| | - Hyungjin Eoh
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033;
| | - Jae U Jung
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033;
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19
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Haddad RI, Massarelli E, Lee JJ, Lin HY, Hutcheson K, Lewis J, Garden AS, Blumenschein GR, William WN, Pharaon RR, Tishler RB, Glisson BS, Pickering C, Gold KA, Johnson FM, Rabinowits G, Ginsberg LE, Williams MD, Myers J, Kies MS, Papadimitrakopoulou V. Weekly paclitaxel, carboplatin, cetuximab, and cetuximab, docetaxel, cisplatin, and fluorouracil, followed by local therapy in previously untreated, locally advanced head and neck squamous cell carcinoma. Ann Oncol 2020; 30:471-477. [PMID: 30596812 DOI: 10.1093/annonc/mdy549] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The survival advantage of induction chemotherapy (IC) followed by locoregional treatment is controversial in locally advanced head and neck squamous cell carcinoma (LAHNSCC). We previously showed feasibility and safety of cetuximab-based IC (paclitaxel/carboplatin/cetuximab-PCC, and docetaxel/cisplatin/5-fluorouracil/cetuximab-C-TPF) followed by local therapy in LAHNSCC. The primary end point of this phase II clinical trial with randomization to PCC and C-TPF followed by combined local therapy in patients with LAHNSCC stratified by human papillomavirus (HPV) status and T-stage was 2-year progression-free survival (PFS) compared with historical control. PATIENTS AND METHODS Eligible patients were ≥18 years with squamous cell carcinoma of the oropharynx, oral cavity, nasopharynx, hypopharynx, or larynx with measurable stage IV (T0-4N2b-2c/3M0) and known HPV by p16 status. Stratification was by HPV and T-stage into one of the two risk groups: (i) low-risk: HPV-positive and T0-3 or HPV-negative and T0-2; (ii) intermediate/high-risk: HPV-positive and T4 or HPV-negative and T3-4. Patient reported outcomes were carried out. RESULTS A total of 136 patients were randomized in the study, 68 to each arm. With a median follow up of 3.2 years, the 2-year PFS in the PCC arm was 89% in the overall, 96% in the low-risk and 67% in the intermediate/high-risk groups; in the C-TPF arm 2-year PFS was 88% in the overall, 88% in the low-risk and 89% in the intermediate/high-risk groups. CONCLUSION The observed 2-year PFS of PCC in the low-risk group and of C-TPF in the intermediate/high-risk group showed a 20% improvement compared with the historical control derived from RTOG-0129, therefore reaching the primary end point of the trial.
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Affiliation(s)
- R I Haddad
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston
| | - E Massarelli
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston; Department of Medical Oncology and Therapeutics Research, City of Hope Cancer Center, Duarte
| | - J J Lee
- Departments of Biostatistics
| | - H Y Lin
- Departments of Biostatistics
| | | | - J Lewis
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - A S Garden
- Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - G R Blumenschein
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - W N William
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston; Oncology Center, Hospital BP, A Beneficencia Portuguesa de São Paulo, São Paulo, Brazil
| | - R R Pharaon
- Department of Medical Oncology and Therapeutics Research, City of Hope Cancer Center, Duarte
| | - R B Tishler
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston
| | - B S Glisson
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | | | - K A Gold
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston; Division of Hematology and Oncology, University of California San Diego Moores Cancer Center, La Jolla
| | - F M Johnson
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - G Rabinowits
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston; Department of Head and Neck Oncology, Baptist Health South Florida, Coral Gables
| | | | - M D Williams
- Pathology, University of Texas MD Anderson Cancer Center, Houston, USA
| | | | - M S Kies
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - V Papadimitrakopoulou
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston.
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20
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Belkina AC, Azer M, Lee JJ, Elgaali HH, Pihl R, Cleveland M, Carr J, Kim S, Habib C, Hasturk H, Snyder-Cappione JE, Nikolajczyk BS. Single-Cell Analysis of the Periodontal Immune Niche in Type 2 Diabetes. J Dent Res 2020; 99:855-862. [PMID: 32186942 DOI: 10.1177/0022034520912188] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Periodontitis (PD) is a common source of uncontrolled inflammation in obesity-associated type 2 diabetes (T2D). PD apparently fuels the inflammation of T2D and associates with poor glycemic control and increased T2D morbidity. New therapeutics are critically needed to counter the sources of periodontal infection and inflammation that are accelerated in people with T2D. The precise mechanisms underlying the relationship between PD and T2D remain poorly understood. Every major immune cell subset has been implicated in the unresolved inflammation of PD, regardless of host metabolic health. However, analyses of inflammatory cells in PD with human periodontal tissue have generally focused on mRNA quantification and immunohistochemical analyses, both of which provide limited information on immune cell function. We used a combination of flow cytometry for cell surface markers and enzyme-linked immunospot methods to assess the subset distribution and function of immune cells isolated from gingiva of people who had PD and were systemically healthy, had PD and T2D (PD/T2D), or, for flow cytometry, were systemically and orally healthy. T-cell subsets dominated the cellular immune compartment in gingiva from all groups, and B cells were relatively rare. Although immune cell frequencies were similar among groups, a higher proportion of CD11b+ or CD4+ cells secreted IFNγ/IL-10 or IL-8, respectively, in cells from PD/T2D samples as compared with PD-alone samples. Our data indicate that fundamental differences in gingival immune cell function between PD and T2D-potentiated PD may account for the increased risk and severity of PD in subjects with T2D. Such differences may suggest unexpected therapeutic targets for alleviating periodontal inflammation in people with T2D.
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Affiliation(s)
- A C Belkina
- Department of Pathology and Laboratory Medicine, School of Medicine, Boston University, Boston, MA, USA.,Flow Cytometry Core Facility, School of Medicine, Boston University, Boston, MA, USA
| | - M Azer
- Department of Oral Biology, Goldman School of Dental Medicine, Boston University, Boston, MA, USA
| | - J J Lee
- Department of Pharmacology and Nutritional Sciences and Barnstable Brown Diabetes and Obesity Research Center, University of Kentucky, Lexington, KY, USA
| | - H H Elgaali
- Department of Pharmacology and Nutritional Sciences and Barnstable Brown Diabetes and Obesity Research Center, University of Kentucky, Lexington, KY, USA
| | - R Pihl
- Flow Cytometry Core Facility, School of Medicine, Boston University, Boston, MA, USA
| | - M Cleveland
- Department of Pharmacology and Nutritional Sciences and Barnstable Brown Diabetes and Obesity Research Center, University of Kentucky, Lexington, KY, USA
| | - J Carr
- Department of Microbiology, School of Medicine, Boston University, Boston, MA, USA
| | - S Kim
- Department of Medicine, School of Medicine, Boston University, Boston, MA, USA
| | - C Habib
- Department of Medicine, School of Medicine, Boston University, Boston, MA, USA
| | - H Hasturk
- The Forsyth Institute, Cambridge, MA, USA
| | - J E Snyder-Cappione
- Flow Cytometry Core Facility, School of Medicine, Boston University, Boston, MA, USA.,Department of Microbiology, School of Medicine, Boston University, Boston, MA, USA
| | - B S Nikolajczyk
- Department of Pharmacology and Nutritional Sciences and Barnstable Brown Diabetes and Obesity Research Center, University of Kentucky, Lexington, KY, USA.,Department of Microbiology, School of Medicine, Boston University, Boston, MA, USA
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21
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Kudo Y, Haymaker C, Zhang J, Reuben A, Duose DY, Fujimoto J, Roy-Chowdhuri S, Solis Soto LM, Dejima H, Parra ER, Mino B, Abraham R, Ikeda N, Vaporcyan A, Gibbons D, Zhang J, Lang FF, Luthra R, Lee JJ, Moran C, Huse JT, Kadara H, Wistuba II. Suppressed immune microenvironment and repertoire in brain metastases from patients with resected non-small-cell lung cancer. Ann Oncol 2019; 30:1521-1530. [PMID: 31282941 PMCID: PMC6771224 DOI: 10.1093/annonc/mdz207] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The tumor immune microenvironment (TIME) of lung cancer brain metastasis is largely unexplored. We carried out immune profiling and sequencing analysis of paired resected primary tumors and brain metastases of non-small-cell lung carcinoma (NSCLC). PATIENTS AND METHODS TIME profiling of archival formalin-fixed and paraffin-embedded specimens of paired primary tumors and brain metastases from 39 patients with surgically resected NSCLCs was carried out using a 770 immune gene expression panel and by T-cell receptor beta repertoire (TCRβ) sequencing. Immunohistochemistry was carried out for validation. Targeted sequencing was carried out to catalog hot spot mutations in cancer genes. RESULTS Somatic hot spot mutations were mostly shared between both tumor sites (28/39 patients; 71%). We identified 161 differentially expressed genes, indicating inhibition of dendritic cell maturation, Th1, and leukocyte extravasation signaling pathways, in brain metastases compared with primary tumors (P < 0.01). The proinflammatory cell adhesion molecule vascular cell adhesion protein 1 was significantly suppressed in brain metastases compared with primary tumors. Brain metastases exhibited lower T cell and elevated macrophage infiltration compared with primary tumors (P < 0.001). T-cell clones were expanded in 64% of brain metastases compared with their corresponding primary tumors. Furthermore, while TCR repertoires were largely shared between paired brain metastases and primary tumors, T-cell densities were sparse in the metastases. CONCLUSION We present findings that suggest that the TIME in brain metastases from NSCLC is immunosuppressed and comprises immune phenotypes (e.g. immunosuppressive tumor-associated macrophages) that may help guide immunotherapeutic strategies for NSCLC brain metastases.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/immunology
- Brain Neoplasms/immunology
- Brain Neoplasms/pathology
- Brain Neoplasms/secondary
- Carcinoma, Non-Small-Cell Lung/genetics
- Carcinoma, Non-Small-Cell Lung/immunology
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Non-Small-Cell Lung/surgery
- Dendritic Cells/immunology
- Female
- Gene Expression Regulation, Neoplastic/immunology
- Humans
- Immunohistochemistry
- Male
- Middle Aged
- Mutation/genetics
- Neoplasm Proteins/genetics
- Neoplasm Proteins/immunology
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Receptors, Antigen, T-Cell, alpha-beta/immunology
- Tumor Microenvironment/genetics
- Tumor Microenvironment/immunology
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Affiliation(s)
- Y Kudo
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - C Haymaker
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Zhang
- Departments of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Reuben
- Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - D Y Duose
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Fujimoto
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S Roy-Chowdhuri
- Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - L M Solis Soto
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - H Dejima
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - E R Parra
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - B Mino
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - R Abraham
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - N Ikeda
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - A Vaporcyan
- Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - D Gibbons
- Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Zhang
- Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - F F Lang
- Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - R Luthra
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA; Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J J Lee
- Departments of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - C Moran
- Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J T Huse
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA; Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - H Kadara
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - I I Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA; Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
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22
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Yang KC, Wang ST, Lee JJ, Fann JCY, Chiu SYH, Chen SLS, Yen AMF, Chen HH, Chen MK, Hung HF. Bone mineral density as a dose-response predictor for osteoporosis: a propensity score analysis of longitudinal incident study (KCIS no. 39). QJM 2019; 112:327-333. [PMID: 30629251 DOI: 10.1093/qjmed/hcz009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/16/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Osteoporosis is a global disease burden for aging society. The role of quantitative ultrasound (QUS) in the prediction for osteoporosis in a dose-response manner is hardly addressed. AIM We aimed to show the dose-response of QUS measurement in the prediction for osteoporosis by a community-based study. DESIGN A prospective cohort study. METHODS Participants were recruited between 2000 and 2004. Demographic data and heel QUS measurement were collected at baseline. Diagnosis of osteoporosis was ascertained by the follow-up of this cohort over time. In order to reduce the imbalance of baseline characteristics in the observational study, we applied propensity score by using proportional odds regression analysis to match the quintiles of QUS T-score. RESULTS A total of 44 957 subjects composed of 17 678 men (39.3%) and 27 279 women (69.7%) were recruited. After adjustments for propensity score, an increase in one unit of QUB T-score led to 7% reduction in the risk for osteoporosis [adjusted odds ratio (OR) = 0.93, 95% confidence interval (CI): 0.89-0.96, P < 0.0001]. Higher quintile of QUS T-score yielded a lower risk of osteoporosis with a gradient relationship [OR: 0.82 (95%CI: 0.72-0.92); OR: 0.81 (95%CI: 0.71-0.91); OR: 0.77 (95%CI: 0.68-0.87) and OR: 0.76 (95%CI: 0.67-0.86)] from the second to highest quintile opposed to first quintile (P < 0.0001). The cumulative incidence of osteoporosis was higher in the lower quintile during follow-up (log-rank test, P < 0.001). CONCLUSION QUS is an independent predictor for osteoporosis in a dose-response manner using a large population-based cohort. Due to the lower cost and portability of QUS measurement, the pre-screening for osteoporosis by QUS can be considered in the area with limited resources can be a feasible and alternative method.
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Affiliation(s)
- K-C Yang
- Department of Family Medicine, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
- Health Science and Wellness Center, National Taiwan University, Taipei, Taiwan
| | - S-T Wang
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Health Management Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - J J Lee
- Department of Family Medicine, Taipei City Hospital, Yangming Branch, Taipei, Taiwan
| | - J C-Y Fann
- Department of Health Industry Management, School of Healthcare Management, Kainan University, Tao-Yuan, Taiwan
| | - S Y-H Chiu
- Department of Health Care Management and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan
- Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - S L-S Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - A M-F Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - H-H Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - M-K Chen
- Department of Community and Family Medicine, National Taiwan University Hospital Hsinchu Branch, No.25, Lane 442, Sec.1, Jingguo Rd., Hsinchu City, Taiwan
| | - H-F Hung
- Department of Community and Family Medicine, National Taiwan University Hospital Hsinchu Branch, No.25, Lane 442, Sec.1, Jingguo Rd., Hsinchu City, Taiwan
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23
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Dutta NK, Klinkenberg LG, Vazquez MJ, Segura-Carro D, Colmenarejo G, Ramon F, Rodriguez-Miquel B, Mata-Cantero L, Porras-De Francisco E, Chuang YM, Rubin H, Lee JJ, Eoh H, Bader JS, Perez-Herran E, Mendoza-Losana A, Karakousis PC. Inhibiting the stringent response blocks Mycobacterium tuberculosis entry into quiescence and reduces persistence. Sci Adv 2019; 5:eaav2104. [PMID: 30906866 PMCID: PMC6426458 DOI: 10.1126/sciadv.aav2104] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 02/04/2019] [Indexed: 06/01/2023]
Abstract
The stringent response enables Mycobacterium tuberculosis (Mtb) to shut down its replication and metabolism under various stresses. Here we show that Mtb lacking the stringent response enzyme RelMtb was unable to slow its replication rate during nutrient starvation. Metabolomics analysis revealed that the nutrient-starved relMtb -deficient strain had increased metabolism similar to that of exponentially growing wild-type bacteria in nutrient-rich broth, consistent with an inability to enter quiescence. Deficiency of relMtb increased the susceptibility of mutant bacteria to killing by isoniazid during nutrient starvation and in the lungs of chronically infected mice. We screened a pharmaceutical library of over 2 million compounds for inhibitors of RelMtb and showed that the lead compound X9 was able to directly kill nutrient-starved M. tuberculosis and enhanced the killing activity of isoniazid. Inhibition of RelMtb is a promising approach to target M. tuberculosis persisters, with the potential to shorten the duration of TB treatment.
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Affiliation(s)
- Noton K. Dutta
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lee G. Klinkenberg
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - Gonzalo Colmenarejo
- Molecular Discovery Research, GlaxoSmithKline, Tres Cantos, Madrid, Spain
- Biostatistics and Bioinformatics Unit, IMDEA Food Institute, Madrid, Spain
| | - Fernando Ramon
- Molecular Discovery Research, GlaxoSmithKline, Tres Cantos, Madrid, Spain
| | | | - Lydia Mata-Cantero
- Diseases of the Developing World, GlaxoSmithKline, Tres Cantos, Madrid, Spain
| | | | - Yu-Min Chuang
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Harvey Rubin
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jae Jin Lee
- Department of Molecular Microbiology and Immunology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Hyungjin Eoh
- Department of Molecular Microbiology and Immunology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Joel S. Bader
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Esther Perez-Herran
- Diseases of the Developing World, GlaxoSmithKline, Tres Cantos, Madrid, Spain
| | | | - Petros C. Karakousis
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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24
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Trivedi MS, Samimi G, Wright JD, Holcomb K, Garber JE, Horowitz NS, Arber N, Friedman E, Wenham RM, House M, Parnes H, Lee JJ, Abutaseh S, Vornik LA, Heckman-Stoddard BM, Brown PH, Crew KD. Abstract OT2-09-01: Pilot study of denosumab in BRCA1/2 mutation carriers scheduling for risk-reducing salpingo-oophorectomy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-09-01] [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: Denosumab is a monoclonal antibody that inhibits RANKL and is approved for the prevention of fractures in patients with osteoporosis or bone metastases. The RANKL signaling pathway is also involved in BRCA1-associated mammary tumorigenesis via a progesterone-induced paracrine effect of RANKL on luminal progenitor cells. Pre-clinical studies have demonstrated that RANKL inhibition resulted in reduced proliferation of mammary tumors. Early findings from an ongoing pre-surgical study demonstrated that denosumab treatment resulted in decreased Ki67 proliferation index in benign breast tissue. Based on these data, denosumab is being pursued as a potential preventive agent for breast cancer in BRCA1 mutation carriers. While promising, the effect of RANKL inhibition on gynecologic tissues such as the ovaries and fallopian tubes, in which progesterone has a protective effect, is unknown.
Trial design: We will conduct a multicenter, open-label randomized pilot study of presurgical administration of denosumab versus no treatment in premenopausal women with BRCA1/2 mutations undergoing risk-reducing salpingo-oophorectomy (RRSO). A total of 60 women will be randomized 1:1 to Arm 1) 3-4 doses of 120 mg denosumab subcutaneously every 4 weeks or Arm 2) No treatment. Participants will be stratified by 1) BRCA1 versus BRCA2 mutation status and 2) Use of hormonal contraceptives within the past 3 months (yes/no). Assuming a 10% unevaluable rate, we expect to have 54 evaluable participants (27 per arm).
Eligibility criteria: 1) Premenopausal women (defined as < 3 months since last menstrual period OR serum follicle-stimulating hormone (FSH) < 20 mIU/mL), age > 18 years; 2) Documented germline pathogenic mutation or likely pathogenic variant in the BRCA1 or BRCA2 gene; 3) Plan for RRSO with or without hysterectomy; 4) ECOG performance status ≤ 1 (Karnofsky ≥ 70%); 5) Normal organ and marrow function; 6) Negative pregnancy test and use of adequate contraception; 7) Willingness to take supplemental oral calcium and vitamin D3; 8) Dental examination within 6 months of enrollment and no evidence of active dental issues; 9) Ability to understand and willingness to provide informed consent.
Specific aims: Our primary objective is to compare the effect of denosumab to no treatment on Ki67 expression in the fimbrial end of the fallopian tube. Secondary objectives are to assess Ki67 in ovary and endometrium; cleaved caspase-3, RANK/RANKL, ER/PR, CD44, and STAT3/pSTAT3 expression in fallopian tube, ovary, and endometrium; gene expression profiling in the fallopian tube and ovary; serum markers (progesterone, estradiol, C-terminal telopeptide) and denosumab levels; and toxicity.
Statistical methods: The primary endpoint is post-treatment Ki67 expression in the fimbrial end of the fallopian tube in the denosumab arm compared to the no treatment arm. Assuming a standard deviation of 5.0%, we will have 82% power to detect a 4.0% absolute difference (or effect size of 0.8) in Ki67 proliferation index between the denosumab and no treatment groups by applying a 2-sample t-test at a 0.05 significance level.
Target accrual: 60 participants, to be activated in Summer 2018.
Citation Format: Trivedi MS, Samimi G, Wright JD, Holcomb K, Garber JE, Horowitz NS, Arber N, Friedman E, Wenham RM, House M, Parnes H, Lee JJ, Abutaseh S, Vornik LA, Heckman-Stoddard BM, Brown PH, Crew KD. Pilot study of denosumab in BRCA1/2 mutation carriers scheduling for risk-reducing salpingo-oophorectomy [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 OT2-09-01.
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Affiliation(s)
- MS Trivedi
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - G Samimi
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - JD Wright
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - K Holcomb
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - JE Garber
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - NS Horowitz
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - N Arber
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - E Friedman
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - RM Wenham
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - M House
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - H Parnes
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - JJ Lee
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Abutaseh
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - LA Vornik
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - BM Heckman-Stoddard
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - PH Brown
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
| | - KD Crew
- Columbia University Medical Center, New York, NY; National Cancer Institute, NIH, Bethesda, MD; Weill Cornell Medical Center, New York, NY; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Chaim Sheba Medical Center, Tel-Hashomer, Israel; Moffitt Cancer Center, Tampa, FL; University of Texas MD Anderson Cancer Center, Houston, TX
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25
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Thomas PS, Patel AB, Contreras A, Liu DD, Lee JJ, Khan S, Vornik LA, Dimond EP, Perloff M, Heckman-Stoddard BM, Brown PH. Abstract OT2-09-02: A phase I dose escalation study of topical bexarotene in women at high risk for breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-09-02] [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: Breast cancer prevention with anti-estrogens, including tamoxifen, raloxifene, and exemestane, has been shown to reduce the incidence of hormone receptor-positive breast cancer. However, agents that can reduce the incidence of hormone receptor negative breast cancer are currently lacking. Rexinoids such as bexarotene are vitamin A analogues that have been shown to be involved in cell differentiation, growth, and apoptosis. In preclinical mouse models that develop ER-negative breast cancers, bexarotene showed a significant reduction in mammary tumor development. Oral bexarotene has been evaluated in BRCA mutation carriers and significant decreases in cyclin D1 were noted in breast cells suggesting biological activity of bexarotene on breast tissue. Systemic side effects of hyperlipidemia and hypothyroidism were also found. Data from chemoprevention studies with topical 4-hydroxytamoxifen support the concept of topical agents penetrating into the breast tissue and exhibiting biological activity in the tissue. We hypothesize that topical bexarotene can be applied to the breast as a chemoprevention agent with penetration to the breast tissue without subsequent systemic side effects and toxicity as seen with oral bexarotene.
Trial Design: Women at high risk for breast cancer will be recruited and assigned to one of three different dose levels: 10mg (1ml) every other day, 10mg (1ml) daily, 20mg (2ml) daily to one unaffected breast for 4 weeks. The primary endpoint of the study is to determine the recommended phase II dose of topical bexarotene 1% gel for evaluation in healthy at-risk women. Dose Limiting Toxicity (DLT) is defined as a grade 2 skin adverse event that persists for at least 6 days or any grade 3 or greater adverse event related to the study drug. A grade 2 skin adverse event that recurs and persists for at least 3 days is also a DLT. The Maximum Tolerated Dose (MTD) will be defined as the highest dose level at which no more than 2 participants experience a DLT among 10 participants treated. A conservative modification of the standard “3+3” design will be applied. The first three participants will be assigned to the lowest dose level. New cohorts of 3-4 participants will not be treated until toxicity has been fully evaluated for all current participants through 4 weeks. Once the MTD has been determined, an expansion cohort of an additional 10 patients will be recruited at the MTD to further evaluate safety and toxicity at this dose level as well bexarotene concentration in the breast tissue. Secondary endpoints include serum bexarotene level, tissue bexarotene levels, and changes in thyroid function tests, lipid profile, and calcium. The planned accrual for this study if maximally accrued to all dose levels and the dose expansion cohort will be 40 participants.
Citation Format: Thomas PS, Patel AB, Contreras A, Liu DD, Lee JJ, Khan S, Vornik LA, Dimond EP, Perloff M, Heckman-Stoddard BM, Brown PH. A phase I dose escalation study of topical bexarotene in women at high risk for breast cancer [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 OT2-09-02.
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Affiliation(s)
- PS Thomas
- University of Texas at MD Anderson Cancer Center, Houston, TX; Northwestern University, Chicago, IL; National Cancer Institute, Bethesda, MD
| | - AB Patel
- University of Texas at MD Anderson Cancer Center, Houston, TX; Northwestern University, Chicago, IL; National Cancer Institute, Bethesda, MD
| | - A Contreras
- University of Texas at MD Anderson Cancer Center, Houston, TX; Northwestern University, Chicago, IL; National Cancer Institute, Bethesda, MD
| | - DD Liu
- University of Texas at MD Anderson Cancer Center, Houston, TX; Northwestern University, Chicago, IL; National Cancer Institute, Bethesda, MD
| | - JJ Lee
- University of Texas at MD Anderson Cancer Center, Houston, TX; Northwestern University, Chicago, IL; National Cancer Institute, Bethesda, MD
| | - S Khan
- University of Texas at MD Anderson Cancer Center, Houston, TX; Northwestern University, Chicago, IL; National Cancer Institute, Bethesda, MD
| | - LA Vornik
- University of Texas at MD Anderson Cancer Center, Houston, TX; Northwestern University, Chicago, IL; National Cancer Institute, Bethesda, MD
| | - EP Dimond
- University of Texas at MD Anderson Cancer Center, Houston, TX; Northwestern University, Chicago, IL; National Cancer Institute, Bethesda, MD
| | - M Perloff
- University of Texas at MD Anderson Cancer Center, Houston, TX; Northwestern University, Chicago, IL; National Cancer Institute, Bethesda, MD
| | - BM Heckman-Stoddard
- University of Texas at MD Anderson Cancer Center, Houston, TX; Northwestern University, Chicago, IL; National Cancer Institute, Bethesda, MD
| | - PH Brown
- University of Texas at MD Anderson Cancer Center, Houston, TX; Northwestern University, Chicago, IL; National Cancer Institute, Bethesda, MD
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26
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Kim KH, Lee JJ, Kim J, Zhou JM, Gomes F, Sehovic M, Extermann M. Association of multidimensional comorbidities with survival, toxicity, and unplanned hospitalizations in older adults with metastatic colorectal cancer treated with chemotherapy. J Geriatr Oncol 2019; 10:733-741. [PMID: 30765268 DOI: 10.1016/j.jgo.2019.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 08/09/2018] [Revised: 01/10/2019] [Accepted: 02/04/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Studies of older patients with colorectal cancer(CRC) have found inconsistent results about the correlation of various comorbidities with overall survival(OS) and treatment tolerance. To refine our understanding, we evaluated this correlation using the Cumulative Illness Rating Scale-Geriatric(CIRS-G) and heat maps to identify subgroups with the highest impact. METHODS We retrospectively reviewed 153 patients aged 65 years and older with stage IV CRC undergoing chemotherapy. We calculated CIRS-G scores, and a Total Risk Score(TRS) derived from a previous heat map study. The association between CIRS-G scores/TRS and OS, unplanned hospitalizations, and chemotoxicity was examined by the Cox proportional hazards model. RESULTS Median age was 71 years. Median MAX2 score of chemotherapies was 0.134(0.025-0.231). The most common comorbidities were vascular(79.8%), eye/ear/nose/throat(68%), and respiratory disease(52.4%). Median OS was 25.1 months(95% confidence interval: 21.2-27.6). In univariate analysis, ECOG PS ≥ 2(HR 1.86(1.1-3.17), p = 0.019), poorly differentiated histology(HR 2.03(1.27-3.25), p = 0.003), primary site(rectum vs colon)(HR 0.58 (0.34-0.98), p = 0.04), age at diagnosis(HR per 5y 1.20 (1.04-1.39), p = 0.012), and number of CIRS-G grade 4 comorbidities(HR 1.86 (1.1-3.17), p = 0.019) were associated with OS. In multivariate analysis, the number of CIRS-G grade 4 comorbidities lost significance, although it retained it in the subgroup of patients with colon cancer. Conversely, the TRS was associated with OS in patients with rectal cancer. No association of comorbidity with unplanned hospitalization or chemotoxicity was observed. CONCLUSIONS In older adults with metastatic CRC, the number of CIRS-G grade 4 comorbidities was associated with worse OS but no specific CIRS-G category was independently associated with OS, unplanned hospitalization, or toxicities.
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Affiliation(s)
- Ki Hyang Kim
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea; Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jae Jin Lee
- Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA; Division of Medical Oncology and Hematology, Department of Internal Medicine, Yonsei Noble Hospital, Seoul, South Korea
| | - Jongphil Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jun-Min Zhou
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Fabio Gomes
- Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA; Medical Oncology Department, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Marina Sehovic
- Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Martine Extermann
- Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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27
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Hong DS, Bauer TM, Lee JJ, Dowlati A, Brose MS, Farago AF, Taylor M, Shaw AT, Montez S, Meric-Bernstam F, Smith S, Tuch BB, Ebata K, Cruickshank S, Cox MC, Burris HA, Doebele RC. Larotrectinib in adult patients with solid tumours: a multi-centre, open-label, phase I dose-escalation study. Ann Oncol 2019; 30:325-331. [PMID: 30624546 PMCID: PMC6386027 DOI: 10.1093/annonc/mdy539] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND NTRK1, NTRK2 and NTRK3 gene fusions (NTRK gene fusions) occur in a range of adult cancers. Larotrectinib is a potent and highly selective ATP-competitive inhibitor of TRK kinases and has demonstrated activity in patients with tumours harbouring NTRK gene fusions. PATIENTS AND METHODS This multi-centre, phase I dose escalation study enrolled adults with metastatic solid tumours, regardless of NTRK gene fusion status. Key inclusion criteria included evaluable and/or measurable disease, Eastern Cooperative Oncology Group performance status 0-2, and adequate organ function. Larotrectinib was administered orally once or twice daily, on a continuous 28-day schedule, in increasing dose levels according to a standard 3 + 3 dose escalation scheme. The primary end point was the safety of larotrectinib, including dose-limiting toxicity. RESULTS Seventy patients (8 with tumours with NTRK gene fusions; 62 with tumours without a documented NTRK gene fusion) were enrolled to 6 dose cohorts. There were four dose-limiting toxicities; none led to study drug discontinuation. The maximum tolerated dose was not reached. Larotrectinib-related adverse events were predominantly grade 1; none were grade 4 or 5. The most common grade 3 larotrectinib-related adverse event was anaemia [4 (6%) of 70 patients]. A dose of 100 mg twice daily was recommended for phase II studies based on tolerability and antitumour activity. In patients with evaluable TRK fusion cancer, the objective response rate by independent review was 100% (eight of the eight patients). Eight (12%) of the 67 assessable patients overall had an objective response by investigator assessment. Median duration of response was not reached. Larotrectinib had limited activity in tumours with NTRK mutations or amplifications. Pharmacokinetic analysis showed exposure was generally proportional to administered dose. CONCLUSIONS Larotrectinib was well tolerated, demonstrated activity in all patients with tumours harbouring NTRK gene fusions, and represents a new treatment option for such patients. CLINCALTRIALS.GOV NUMBER NCT02122913.
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Affiliation(s)
- D S Hong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA.
| | - T M Bauer
- Medical Oncology, Sarah Cannon Research Institute, Tennessee Oncology, PLLC, Nashville, USA
| | - J J Lee
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - A Dowlati
- Department of Medicine-Hematology and Oncology, UH Cleveland Medical Center, Cleveland, USA
| | - M S Brose
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, USA
| | - A F Farago
- Department of Medicine, Massachusetts General Hospital, Boston, USA
| | - M Taylor
- The Knight Cancer Institute, Oregon Health & Science University, Portland, USA
| | - A T Shaw
- Department of Medicine, Massachusetts General Hospital, Boston, USA
| | - S Montez
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - F Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S Smith
- Loxo Oncology, South San Francisco, USA
| | - B B Tuch
- Loxo Oncology, South San Francisco, USA
| | - K Ebata
- Loxo Oncology, South San Francisco, USA
| | | | - M C Cox
- Loxo Oncology, South San Francisco, USA
| | - H A Burris
- Medical Oncology, Sarah Cannon Research Institute, Tennessee Oncology, PLLC, Nashville, USA
| | - R C Doebele
- Department of Medicine, University of Colorado Cancer Center, Aurora, USA
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Kim DH, Lee JJ, Sung Hyun You J. Effects of instrument-assisted soft tissue mobilization technique on strength, knee joint passive stiffness, and pain threshold in hamstring shortness. J Back Musculoskelet Rehabil 2019; 31:1169-1176. [PMID: 30040707 DOI: 10.3233/bmr-170854] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Hamstring shortness is the most common musculoskeletal condition in sports athletes, which often contributes to hamstring strain injury. To effectively mitigate the hamstring shortness, contemporary HR, SCS, and IASTM soft tissue techniques have been used. The best practical evidence about the therapeutic effects and the biomechanical mechanisms underpinning these manual techniques remain unknown. OBJECTIVE The purpose of this study was to compare the effects of HR, SCS, and IASTM techniques on improving hamstring and quadriceps muscle strength, related ratio, knee joint passive stiffness, and pain threshold. METHODS Forty-five participants (21 males and 24 females) with hamstring shortness participated in this study. The participants were randomly assigned to each of the three soft tissue mobilization technique groups. A Biodex System Isokinetic Dynamometer was used to measure muscle strength and knee joint passive stiffness during knee extension and flexion. Pressure algometry was used to measure hamstring pain threshold. One-way ANOVA were used to determine the statistical significance of the hamstring and quadriceps strength, related ratios, knee joint passive stiffness, and pain threshold in each technique. The significance level was set at α= 0.05. RESULTS The IASTM group showed greater improvement in the peak quadriceps strength (p= 0.000), the peak quadriceps and hamstring (Q:H) strength ratio (p= 0.004), passive knee stiffness (p= 0.000), and pain threshold (p= 0.017) than the HR or SCS groups. CONCLUSION The present comparative study provided first clinical evidence that IASTM technique is a best soft tissue mobilization technique to improve the strength, associated strength ratio, knee joint passive stiffness, and pain threshold among individuals with hamstring shortness.
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Affiliation(s)
- Do-Hyun Kim
- HIP and MAL Laboratory, Department of Rehabilitation Science, Inje University, Gimhae, Korea
| | - Jae Jin Lee
- Institute of Sports Movement Artificial-Intelligence Technology, Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Joshua Sung Hyun You
- Institute of Sports Movement Artificial-Intelligence Technology, Department of Physical Therapy, Yonsei University, Wonju, Korea
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Lee JJ, Hsieh CL, Widman J, Mingala C, Ardeza Villanueva M, Feng H, Divers T, Chang YF. A luminescence-based assay for evaluating bactericidal antibody to Borrelia burgdorferi in vaccinated horses' serum. Equine Vet J 2019; 51:669-673. [PMID: 30648279 DOI: 10.1111/evj.13074] [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: 08/17/2018] [Accepted: 01/01/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Current serological tests cannot discriminate between bactericidal Borrelia burgdorferi antibodies from others that are merely a response to Borrelia antigenic stimulation. OBJECTIVE To develop a sensitive and convenient luminescence-based serum bactericidal assay (L-SBA) to identify serum borreliacidal activity. STUDY DESIGN Prospective validation study and method comparison. METHODS Serum samples were obtained either from archives of the Animal Health Diagnostic Center at Cornell University (N = 7) or from a vaccination trial (N = 238). Endogenous complement-inactivated serum sample was incubated with exogenic complement and B. burgdorferi ML23 pBBE22luc, which is able to process luciferin with luciferase and produce luminescence in viable Borrelia. After incubation, a light signal can be detected by using a luminometer to calculate the borreliacidal antibody titre. RESULTS Components of the reaction mixture including spirochetes and complement from various sources and concentrations were tested to identify a reliable recipe for our complement-mediated L-SBA. We also applied this L-SBA on measuring bactericidal antibody activities and calculated the half inhibitory concentration (IC50 ) of serum samples from clinical collections. Furthermore, we analysed the L-SBA titres and anti-outer surface protein A (OspA) antibody levels from vaccinated horses using the multiplex assays and found that there is a relationship between results generated using these two different assays. The increases of L-SBA titres correlated with increases of anti-OspA antibody titre in sera (r = 0.423). MAIN LIMITATIONS Immunoreactivity of commercial complement may differ from different batches. Clinical protection of borreliacidal antibody levels has not been determined. CONCLUSIONS The L-SBA provided a sensitive and easy-operating platform for the evaluation of bactericidal antibody to B. burgdorferi, and we anticipated L-SBA would function well as an evaluation tool of vaccine efficiency in the future.
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Affiliation(s)
- J J Lee
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - C L Hsieh
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - J Widman
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - C Mingala
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - M Ardeza Villanueva
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - H Feng
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - T Divers
- Department of Clinical Sciences, Cornell University, Ithaca, New York, USA
| | - Y-F Chang
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA
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Dougoud-Chauvin V, Lee JJ, Santos E, Williams VL, Battisti NML, Ghia K, Sehovic M, Croft C, Kim J, Balducci L, Kish JA, Extermann M. Using Big Data in oncology to prospectively impact clinical patient care: A proof of concept study. J Geriatr Oncol 2018; 9:665-672. [PMID: 29678669 PMCID: PMC6192862 DOI: 10.1016/j.jgo.2018.03.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 01/30/2018] [Accepted: 03/31/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Big Data is widely seen as a major opportunity for progress in the practice of personalized medicine, attracting the attention from medical societies and presidential teams alike as it offers a unique opportunity to enlarge the base of evidence, especially for older patients underrepresented in clinical trials. This study prospectively assessed the real-time availability of clinical cases in the Health & Research Informatics Total Cancer Care™ (TCC) database matching community patients with cancer, and the impact of such a consultation on treatment. MATERIALS AND METHODS Patients aged 70 and older seen at the Lynn Cancer Institute (LCI) with a documented malignancy were eligible. Geriatric screening information and the oncologist's pre-consultation treatment plan were sent to Moffitt. A search for similar patients was done in TCC and additional information retrieved from Electronic Medical Records. A report summarizing the data was sent and the utility of such a consultation was assessed per email after the treatment decision. RESULTS Thirty one patients were included. The geriatric screening was positive in 87.1% (27) of them. The oncogeriatric consultation took on average 2.2 working days. It influenced treatment in 38.7% (12), and modified it in 19.4% (6). The consultation was perceived as "somewhat" to "very useful" in 83.9% (26). CONCLUSION This study establishes a proof of concept of the feasibility of real time use of Big Data for clinical practice. The geriatric screening and the consultation report influenced treatment in 38.7% of cases and modified it in 19.4%, which compares very well with oncogeriatric literature. Additional steps are needed to render it financially and clinically viable.
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Affiliation(s)
| | - Jae Jin Lee
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | | | | | - Kavita Ghia
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Marina Sehovic
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Cortlin Croft
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jongphil Kim
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | - Julie A Kish
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Martine Extermann
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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Lee JJ, Shimony JS, Jafri H, Zazulia AR, Dacey RG, Zipfel GR, Derdeyn CP. Hemodynamic Impairment Measured by Positron-Emission Tomography Is Regionally Associated with Decreased Cortical Thickness in Moyamoya Phenomenon. AJNR Am J Neuroradiol 2018; 39:2037-2044. [PMID: 30361434 DOI: 10.3174/ajnr.a5812] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 08/06/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Impaired cerebrovascular reactivity has been associated with decreased cortical thickness in patients with arterial occlusive diseases. This study tests the hypothesis that severe hemodynamic impairment, indicated by increased oxygen extraction fraction ratios on positron-emission tomography with 15O tracers, is associated with decreased cortical thickness in patients with Moyamoya phenomenon. MATERIALS AND METHODS Patients with unilateral or bilateral idiopathic Moyamoya phenomenon were recruited. Oxygen extraction fraction ratio maps were generated from cerebral images of O[15O] counts divided by H2[15O] counts with normalization by corresponding cerebellar counts. The normal range of the oxygen extraction fraction ratio was estimated from historically available healthy control subjects. Cortical thickness was estimated from T1-weighted MR imaging and FreeSurfer. Regional samples of oxygen extraction fraction ratios and cortical thicknesses were drawn using FreeSurfer parcellations, retaining only parcellations from the vascular territory of the middle cerebral artery. RESULTS Complete MR imaging and PET datasets were available in 35 subjects, including 23 women; the mean age at scanning was 44 years. Patients with Moyamoya phenomenon had a significantly increased regional oxygen extraction fraction ratio compared with 15 healthy control subjects (P < .001). Regional oxygen extraction fraction ratio and age were significant predictors of cortical thickness (P < .001 for each) in a generalized linear mixed-effects model. Using hemisphere averages and patient averages, we found that only age was a significant predictor of cortical thickness (P < .001). CONCLUSIONS Chronic hemodynamic impairment, as indicated by a higher regional oxygen extraction fraction ratio, was significantly predictive of reduced cortical thickness in mixed-effects analysis of FreeSurfer regions. This phenomenon may be related to reversible metabolic down-regulation.
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Affiliation(s)
- J J Lee
- From the Mallinckrodt Institute of Radiology (J.J.L., J.S.S., H.J., A.R.Z.)
| | - J S Shimony
- From the Mallinckrodt Institute of Radiology (J.J.L., J.S.S., H.J., A.R.Z.)
| | - H Jafri
- From the Mallinckrodt Institute of Radiology (J.J.L., J.S.S., H.J., A.R.Z.)
| | - A R Zazulia
- From the Mallinckrodt Institute of Radiology (J.J.L., J.S.S., H.J., A.R.Z.).,Departments of Neurology (A.R.Z., G.R.Z.)
| | - R G Dacey
- Neurosurgery (R.G.D., G.R.Z.), Washington University, St Louis, Missouri
| | - G R Zipfel
- Departments of Neurology (A.R.Z., G.R.Z.).,Neurosurgery (R.G.D., G.R.Z.), Washington University, St Louis, Missouri
| | - C P Derdeyn
- Department of Radiology (C.P.D.), University of Iowa, Iowa City, Iowa
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Cha YJ, Lee JJ, Kim DH, You JSH. The validity and reliability of a dynamic neuromuscular stabilization-heel sliding test for core stability. Technol Health Care 2018; 25:981-988. [PMID: 28759982 DOI: 10.3233/thc-170929] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Core stabilization plays an important role in the regulation of postural stability. To overcome shortcomings associated with pain and severe core instability during conventional core stabilization tests, we recently developed the dynamic neuromuscular stabilization-based heel sliding (DNS-HS) test. OBJECTIVE The purpose of this study was to establish the criterion validity and test-retest reliability of the novel DNS-HS test. METHOD Twenty young adults with core instability completed both the bilateral straight leg lowering test (BSLLT) and DNS-HS test for the criterion validity study and repeated the DNS-HS test for the test-retest reliability study. Criterion validity was determined by comparing hip joint angle data that were obtained from BSLLT and DNS-HS measures. The test-retest reliability was determined by comparing hip joint angle data. RESULTS Criterion validity was (ICC2,3) = 0.700 (p< 0.05), suggesting a good relationship between the two core stability measures. Test-retest reliability was (ICC3,3) = 0.953 (p< 0.05), indicating excellent consistency between the repeated DNS-HS measurements. CONCLUSIONS Criterion validity data demonstrated a good relationship between the gold standard BSLLT and DNS-HS core stability measures. Test-retest reliability data suggests that DNS-HS core stability was a reliable test for core stability. Clinically, the DNS-HS test is useful to objectively quantify core instability and allow early detection and evaluation.
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Lee H, Kim MS, Kim WS, Kim YH, Cho SH, Lee JJ. Life-Threatening Acute on Chronic Pulmonary Thromboembolism Requiring Extracorporeal Membrane Oxygenation. Korean J Thorac Cardiovasc Surg 2018; 51:205-208. [PMID: 29854666 PMCID: PMC5973218 DOI: 10.5090/kjtcs.2018.51.3.205] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 10/23/2017] [Accepted: 10/24/2017] [Indexed: 11/16/2022]
Abstract
A 71-year-old female patient was admitted to the emergency department with sudden aggravation of chest pain and severe dyspnea. Computed tomography showed extensive pulmonary thromboembolism. Venoarterial extracorporeal membrane oxygenation (ECMO) was instituted due to sudden bradycardia and hypotension. An emergency operation was performed. However, chronic pulmonary thromboembolism combined with an acute pulmonary embolism was detected in the operating room. Embolectomy and endarterectomy were performed. ECMO was then discontinued. The patient was discharged on postoperative day 13 with warfarin for anticoagulation. The patient was followed up for 46 months as an outpatient without further thromboembolic events.
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Affiliation(s)
- Heemoon Lee
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Min Soo Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Wook Sung Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Yong Han Kim
- Department of Thoracic and Cardiovascular Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine
| | - Sung Ho Cho
- Department of Thoracic and Cardiovascular Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine
| | - Jae Jin Lee
- Department of Thoracic and Cardiovascular Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine
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Choe JW, Lee JJ, Hyun JJ. Gastrointestinal: Unusual cause of acute cholangitis in a chronic pancreatitis patient. J Gastroenterol Hepatol 2018; 33:1164. [PMID: 29607537 DOI: 10.1111/jgh.14093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- J W Choe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - J J Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - J J Hyun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
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Lee JJ, Lim J, Gao S, Lawson CP, Odell M, Raheem S, Woo J, Kang SH, Kang SS, Jeon BY, Eoh H. Glutamate mediated metabolic neutralization mitigates propionate toxicity in intracellular Mycobacterium tuberculosis. Sci Rep 2018; 8:8506. [PMID: 29855554 PMCID: PMC5981324 DOI: 10.1038/s41598-018-26950-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 11/30/2017] [Accepted: 05/23/2018] [Indexed: 11/09/2022] Open
Abstract
Metabolic networks in biological systems are interconnected, such that malfunctioning parts can be corrected by other parts within the network, a process termed adaptive metabolism. Unlike Bacillus Calmette-Guérin (BCG), Mycobacterium tuberculosis (Mtb) better manages its intracellular lifestyle by executing adaptive metabolism. Here, we used metabolomics and identified glutamate synthase (GltB/D) that converts glutamine to glutamate (Q → E) as a metabolic effort used to neutralize cytoplasmic pH that is acidified while consuming host propionate carbon through the methylcitrate cycle (MCC). Methylisocitrate lyase, the last step of the MCC, is intrinsically downregulated in BCG, leading to obstruction of carbon flux toward central carbon metabolism, accumulation of MCC intermediates, and interference with GltB/D mediated neutralizing activity against propionate toxicity. Indeed, vitamin B12 mediated bypass MCC and additional supplement of glutamate led to selectively correct the phenotypic attenuation in BCG and restore the adaptive capacity of BCG to the similar level of Mtb phenotype. Collectively, a defective crosstalk between MCC and Q → E contributes to attenuation of intracellular BCG. Furthermore, GltB/D inhibition enhances the level of propionate toxicity in Mtb. Thus, these findings revealed a new adaptive metabolism and propose GltB/D as a synergistic target to improve the antimicrobial outcomes of MCC inhibition in Mtb.
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Affiliation(s)
- Jae Jin Lee
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Juhyeon Lim
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Shengjia Gao
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Christopher P Lawson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, United Kingdom
| | - Mark Odell
- School of Life Sciences, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, United Kingdom.,Department of Life Sciences, Faculty of Science and Technology, University of Westminster, W1W 6UV, London, United Kingdom
| | - Saki Raheem
- Department of Life Sciences, Faculty of Science and Technology, University of Westminster, W1W 6UV, London, United Kingdom
| | - JeongIm Woo
- Department of Biomedical Laboratory Science, College of Health Science, Yonsei University, Wonju, 26493, Korea
| | - Sung-Ho Kang
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Shin-Seok Kang
- Chungbuk Veterinary Service Laboratory, 380-230, Chungju, Republic of Korea
| | - Bo-Young Jeon
- Department of Biomedical Laboratory Science, College of Health Science, Yonsei University, Wonju, 26493, Korea
| | - Hyungjin Eoh
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
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Lee JJ, Koh KN, Park CJ, Jang S, Im HJ, Kim N. The Combination of Flavokawain B and Daunorubicin Induces Apoptosis in Human Myeloid Leukemic Cells by Modifying NF-κB. Anticancer Res 2018; 38:2771-2778. [PMID: 29715098 DOI: 10.21873/anticanres.12520] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 03/21/2018] [Accepted: 03/26/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Flavokawain B (FKB), is a natural chalcone isolated from kava root that induces apoptosis in cancer cells. Herein we investigated the effects of combination of FKB and daunorubicin (DNR) on human leukemic cells. MATERIALS AND METHODS Cell viability and death were assessed by the MTS assay and flow cytometry. NK-κB was detected by western blotting. RESULTS FKB alone and in combination with DNR reduced the viable cell numbers of four leukemic cell lines. FKB itself induced apoptosis of an acute myeloid cell line, HL-60. Because the additive effect of DNR and FKB was most obvious in HL-60 cells, subsequent experiments were performed with HL-60 cells. Combined treatment of the two compounds increased NF-κB activation at 12 h. CONCLUSION A combination treatment of DNR and FKB may improve the anticancer effects of DNR in DNR-resistant acute myeloid leukemia.
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Affiliation(s)
- Jae Jin Lee
- Asan Institute for Life Sciences and Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyung-Nam Koh
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chan-Jeoung Park
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seongsoo Jang
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ho Joon Im
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Nayoung Kim
- Asan Institute for Life Sciences and Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kim DH, Lee JJ, You SJH. Best core stabilization exercise to facilitate subcortical neuroplasticity: A functional MRI neuroimaging study. Technol Health Care 2018; 26:401-407. [PMID: 29614707 DOI: 10.3233/thc-171051] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the effects of conscious (ADIM) and subconscious (DNS) core stabilization exercises on cortical changes in adults with core instability. PARTICIPANTS Five non-symptomatic participants with core instability. METHODS A novel core stabilization task switching paradigm was designed to separate cortical or subcortical neural substrates during a series of DNS or ADIM core stabilization tasks. RESULTS fMRI blood BOLD analysis revealed a distinctive subcortical activation pattern during the performance of the DNS, whereas the cortical motor network was primarily activated during an ADIM. Peak voxel volume values showed significantly greater DNS (11.08 ± 1.51) compared with the ADIM (8.81 ± 0.21) (p= 0.043). CONCLUSION The ADIM exercise activated the cortical PMC-SMC-SMA motor network, whereas the DNS exercise activated both these same cortical areas and the subcortical cerebellum-BG-thalamus-cingulate cortex network.
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Affiliation(s)
- Do Hyun Kim
- HIP and MAL Laboratory, Department of Rehabilitation Science, Inje University, Gimhae, Korea
| | - Jae Jin Lee
- Institute of Sports Movement Artificial-Intelligence Technology, Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Sung Joshua Hyun You
- Institute of Sports Movement Artificial-Intelligence Technology, Department of Physical Therapy, Yonsei University, Wonju, Korea
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Gerber S, Yang SL, Zhu D, Soifer H, Sobota JA, Rebec S, Lee JJ, Jia T, Moritz B, Jia C, Gauthier A, Li Y, Leuenberger D, Zhang Y, Chaix L, Li W, Jang H, Lee JS, Yi M, Dakovski GL, Song S, Glownia JM, Nelson S, Kim KW, Chuang YD, Hussain Z, Moore RG, Devereaux TP, Lee WS, Kirchmann PS, Shen ZX. Femtosecond electron-phonon lock-in by photoemission and x-ray free-electron laser. Science 2018; 357:71-75. [PMID: 28684521 DOI: 10.1126/science.aak9946] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 05/03/2017] [Indexed: 11/02/2022]
Abstract
The interactions that lead to the emergence of superconductivity in iron-based materials remain a subject of debate. It has been suggested that electron-electron correlations enhance electron-phonon coupling in iron selenide (FeSe) and related pnictides, but direct experimental verification has been lacking. Here we show that the electron-phonon coupling strength in FeSe can be quantified by combining two time-domain experiments into a "coherent lock-in" measurement in the terahertz regime. X-ray diffraction tracks the light-induced femtosecond coherent lattice motion at a single phonon frequency, and photoemission monitors the subsequent coherent changes in the electronic band structure. Comparison with theory reveals a strong enhancement of the coupling strength in FeSe owing to correlation effects. Given that the electron-phonon coupling affects superconductivity exponentially, this enhancement highlights the importance of the cooperative interplay between electron-electron and electron-phonon interactions.
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Affiliation(s)
- S Gerber
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA.,SwissFEL and Laboratory for Micro and Nanotechnology, Paul Scherrer Institut, 5232 Villigen PSI, Switzerland
| | - S-L Yang
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA.,Geballe Laboratory for Advanced Materials, Departments of Physics and Applied Physics, Stanford University, Stanford, CA 94305, USA
| | - D Zhu
- Linac Coherent Light Source (LCLS), SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | - H Soifer
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA
| | - J A Sobota
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA.,Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - S Rebec
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA.,Geballe Laboratory for Advanced Materials, Departments of Physics and Applied Physics, Stanford University, Stanford, CA 94305, USA
| | - J J Lee
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA.,Geballe Laboratory for Advanced Materials, Departments of Physics and Applied Physics, Stanford University, Stanford, CA 94305, USA
| | - T Jia
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA.,Geballe Laboratory for Advanced Materials, Departments of Physics and Applied Physics, Stanford University, Stanford, CA 94305, USA
| | - B Moritz
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA
| | - C Jia
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA
| | - A Gauthier
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA.,Geballe Laboratory for Advanced Materials, Departments of Physics and Applied Physics, Stanford University, Stanford, CA 94305, USA
| | - Y Li
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA
| | - D Leuenberger
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA
| | - Y Zhang
- International Center for Quantum Materials, Peking University, Beijing 100871, China
| | - L Chaix
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA
| | - W Li
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA
| | - H Jang
- Stanford Synchrotron Radiation Lightsource, SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | - J-S Lee
- Stanford Synchrotron Radiation Lightsource, SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | - M Yi
- Department of Physics, University of California-Berkeley, Berkeley, CA 94720, USA
| | - G L Dakovski
- Linac Coherent Light Source (LCLS), SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | - S Song
- Linac Coherent Light Source (LCLS), SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | - J M Glownia
- Linac Coherent Light Source (LCLS), SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | - S Nelson
- Linac Coherent Light Source (LCLS), SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | - K W Kim
- Department of Physics, Chungbuk National University, Cheongju 28644, Korea
| | - Y-D Chuang
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Z Hussain
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - R G Moore
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA
| | - T P Devereaux
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA
| | - W-S Lee
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA.
| | - P S Kirchmann
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA.
| | - Z-X Shen
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory and Stanford University, Menlo Park, CA 94025, USA. .,Geballe Laboratory for Advanced Materials, Departments of Physics and Applied Physics, Stanford University, Stanford, CA 94305, USA
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Abstract
This corrects the article DOI: 10.1038/mp.2016.107.
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Wright BL, Ochkur SI, Olson NS, Shim KP, Jacobsen EA, Rank MA, Dellon ES, Lee JJ. Normalized serum eosinophil peroxidase levels are inversely correlated with esophageal eosinophilia in eosinophilic esophagitis. Dis Esophagus 2017; 31:4714780. [PMID: 29228243 PMCID: PMC7373170 DOI: 10.1093/dote/dox139] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 11/03/2017] [Indexed: 12/11/2022]
Abstract
Eosinophil peroxidase is an eosinophil-specific, cytoplasmic protein stored in the secondary granules of eosinophils. While eosinophil peroxidase deposition is increased in the esophagus in eosinophilic esophagitis (EOE), its potential role as a peripheral marker is unknown. This study aims to examine the relationship between serum eosinophil peroxidase and esophageal eosinophilia in eosinophilic esophagitis. Prospectively collected serum from 19 subjects with incident EoE prior to treatment and 20 non-EoE controls were tested for serum eosinophil peroxidase, eosinophilic cationic protein, and eosinophil derived neurotoxin using ELISA. Matching esophageal tissue sections were stained and assessed for eosinophil peroxidase deposition using a histopathologic scoring algorithm. Mean peripheral blood absolute eosinophil counts in eosinophilic esophagitis subjects were significantly elevated compared to controls (363 vs. 195 cells/μL, P = 0.008). Absolute median serum eosinophil peroxidase, eosinophil cationic protein, and eosinophil derived neurotoxin did not differ between groups; however, when normalized for absolute eosinophil counts, eosinophilic esophagitis subjects had significantly lower median eosinophil peroxidase levels (2.56 vs. 6.96 ng/mL per eos/μL, P = 0.002, AUC 0.79 (0.64, 0.94 95% CI)). Multivariate analysis demonstrated this relationship persisted after controlling for atopy. Esophageal biopsies from eosinophilic esophagitis subjects demonstrated marked eosinophil peroxidase deposition (median score 46 vs. 0, P < 0.0001). Normalized eosinophil peroxidase levels inversely correlated with esophageal eosinophil density (r = -0.41, P = 0.009). In contrast to marked tissue eosinophil degranulation, circulating eosinophils appear to retain their granule proteins in EoE. Investigations of normalized serum eosinophil peroxidase levels as a biomarker of EoE are ongoing.
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Affiliation(s)
- B L Wright
- Division of Allergy, Asthma and Clinical Immunology, Department of Medicine,Division of Pulmonology, Department of Pediatrics, Phoenix Children's Hospital, Phoenix, Arizona,Address correspondence to: Benjamin L. Wright, MD, Assistant Professor, Mayo Clinic Arizona, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA.
| | - S I Ochkur
- Department of Biochemistry and Molecular Biology, Mayo Clinic Arizona, Scottsdale
| | - N S Olson
- Department of Biochemistry and Molecular Biology, Mayo Clinic Arizona, Scottsdale
| | - K P Shim
- Division of Pulmonology, Department of Pediatrics, Phoenix Children's Hospital, Phoenix, Arizona,Department of Biochemistry and Molecular Biology, Mayo Clinic Arizona, Scottsdale
| | - E A Jacobsen
- Department of Biochemistry and Molecular Biology, Mayo Clinic Arizona, Scottsdale
| | - M A Rank
- Division of Allergy, Asthma and Clinical Immunology, Department of Medicine
| | - E S Dellon
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - J J Lee
- Department of Biochemistry and Molecular Biology, Mayo Clinic Arizona, Scottsdale
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Choi HH, Ha EJ, Lee JJ, Yoo DH, Cho WS, Kim JE, Cho YD, Han MH, Kang HS. Comparison of Clinical Outcomes of Intracranial Aneurysms: Procedural Rupture versus Spontaneous Rupture. AJNR Am J Neuroradiol 2017; 38:2126-2130. [PMID: 28860217 DOI: 10.3174/ajnr.a5344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 03/28/2017] [Accepted: 06/09/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Procedural rupture of an intracranial aneurysm is a devastating complication in endovascular treatment. The purpose of this study was to evaluate the clinical outcomes of patients with procedural rupture of unruptured saccular intracranial aneurysms compared with those with spontaneously ruptured aneurysms. MATERIALS AND METHODS A retrospective review was performed for 1340 patients with 1595 unruptured saccular intracranial aneurysms that underwent endovascular coil embolization between February 2010 and December 2014. The clinical outcomes of patients with procedural rupture of unruptured saccular intracranial aneurysms were compared with those of 198 patients presenting with spontaneously ruptured aneurysms. RESULTS In this series, procedural rupture developed in 19 patients (1.4% per patient and 1.2% per aneurysm), and the morbidity related to procedural rupture was 26.3% (95% confidence interval, 8.5%-61.4%) with no mortality. Hunt and Hess scale grades and hospitalization days of patients with procedural rupture were equivalent to those of patients presenting with spontaneous aneurysm rupture. Subsequent treatment procedures after hemorrhage (including lumbar drainage, extraventricular drainage, decompressive craniectomy, and permanent shunt) showed no difference between the 2 groups. The hemorrhage volumes were smaller in the procedural-rupture group (P = .03), and the endovascular vasospasm therapies tended to be more frequently required in the spontaneous aneurysm-rupture group (P = .08). At postictus 6 months, the proportion of modified Rankin Scale scores of ≥2 were lower in the procedural-rupture group (5.3% versus 26.8%, P = .049). In multivariate analysis, spontaneous aneurysm rupture was a significant risk factor for worse clinical outcome (OR = 14.9; 95% CI, 1.2-193.1; P = .039). CONCLUSIONS This study showed better clinical outcomes in the procedural-rupture group. Even though there is a potential chance of aneurysm rupture during treatment, the clinical outcomes after procedural bleeds seem to be more favorable than those of spontaneous rupture.
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Affiliation(s)
- H H Choi
- From the Departments of Neurosurgery (H.H.C.), Dongguk University College of Medicine, Dongguk University Hospital, Ilsan, Korea
| | - E J Ha
- Departments of Neurosurgery (E.J.H., W.-S.C., J.E.K., H.-S.K.)
| | - J J Lee
- Radiology (J.J.L., D.H.Y., Y.D.C, M.H.H.), Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - D H Yoo
- Radiology (J.J.L., D.H.Y., Y.D.C, M.H.H.), Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - W-S Cho
- Departments of Neurosurgery (E.J.H., W.-S.C., J.E.K., H.-S.K.)
| | - J E Kim
- Departments of Neurosurgery (E.J.H., W.-S.C., J.E.K., H.-S.K.)
| | - Y D Cho
- Radiology (J.J.L., D.H.Y., Y.D.C, M.H.H.), Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - M H Han
- Radiology (J.J.L., D.H.Y., Y.D.C, M.H.H.), Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - H-S Kang
- Departments of Neurosurgery (E.J.H., W.-S.C., J.E.K., H.-S.K.)
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Lee JJ, Kim J, Sehovic M, Chen L, Extermann M. Using heat maps to assess the multidimensional association of comorbidities with survival in older cancer patients treated with chemotherapy. J Geriatr Oncol 2017; 8:336-342. [PMID: 28739160 DOI: 10.1016/j.jgo.2017.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/15/2017] [Accepted: 07/06/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To date, most comorbidity studies have analyzed either a subgroup of frequent diseases, or used summary instruments such as the Charlson score or the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Yet, comorbidity is a multidimensional construct and impacts function, treatment tolerance, and survival. We assessed how heat maps can unveil specific patterns of comorbidities associated with overall survival (OS) in older cancer patients treated with chemotherapy. MATERIAL AND METHODS We reviewed four trials that prospectively evaluated comorbidities using CIRS-G. Eligible patients were 65years or older and had solid tumors with 30 or more patients per tumor site. Heat maps were constructed based on CIRS-G scores and correlated with OS. RESULTS Among 818 patients accrued, 399 were eligible: Median follow-up was 53.4months and median OS was 19.6months (95% CI: 16.5-24.2). In the univariate model for OS, patients with a severe CIRS-G score in 6 organ categories (3-4 in heart, hematopoietic, respiratory, and musculoskeletal-integument and 2-4 in upper GI and liver) had statistically worse OS than those with lower scores. According to a total risk score (TRS) based on hazard ratios for OS, OS of the low risk group (N=309, TRS<2) was significantly higher (24.3m vs. 10.8m, HR=2.05, 95% CI: 1.58-2.66). TRS was a predictor for OS independently from stage, primary site, prior chemotherapy, ECOG performance status, and IADL (HR=1.94, 95% CI: 1.47-2.57). CONCLUSIONS High TRS was a predictor of poor survival. Comorbidity heat maps appear promising to identify diseases most affecting the OS of older cancer patients.
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Affiliation(s)
- Jae Jin Lee
- Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Jongphil Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA; Department of Oncology Sciences, University of South Florida, Tampa, Florida, USA
| | - Marina Sehovic
- Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Lu Chen
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Martine Extermann
- Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA; Department of Oncology Sciences, University of South Florida, Tampa, Florida, USA.
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Eisenblaetter M, Flores-Borja F, Lee JJ, Wefers C, Smith H, Hueting R, Cooper MS, Blower PJ, Patel D, Rodriguez-Justo M, Milewicz H, Vogl T, Roth J, Tutt A, Schaeffter T, Ng T. Visualization of Tumor-Immune Interaction - Target-Specific Imaging of S100A8/A9 Reveals Pre-Metastatic Niche Establishment. Theranostics 2017; 7:2392-2401. [PMID: 28744322 PMCID: PMC5525744 DOI: 10.7150/thno.17138] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 02/20/2017] [Indexed: 11/17/2022] Open
Abstract
Background Systemic cancer spread is preceded by the establishment of a permissive microenvironment in the target tissue of metastasis - the premetastatic niche. As crucial players in establishment of the pre-metastatic niche, myeloid derived suppressor cells (MDSC) release S100A8/A9, an exosomal protein that contributes to metastasis, angiogenesis, and immune suppression. We report the application of antibody-based single-photon emission computed tomography (SPECT) for detection of S100A8/A9 in vivo as an imaging marker for pre-metastatic tissue priming. Methods A syngeneic model system for invasive breast cancer with (4T1.2) or without (67NR) the tendency to form lung metastasis was established in BALB/c mice. A SPECT-probe has been generated and tested for visualization of S100A9 release. Tumor-associated changes in numbers and fuction of immune cells in pre-metastatic tissue were evaluated by flow cytometry and confocal microscopy. Results S100A8/A9 imaging reflected MDSC abundance and the establishment of an immunosuppressive environment in pre-metastatic lung tissue (activity 4T1.2 vs. healthy control: 0.95 vs. 0.45 %ID; p<0.001). The S100A8/A9 imaging signal in the pre-metastatic lung correlated with the subsequent metastatic tumor burden in the same organ (r2=0.788; p<0.0001). CCL2 blockade and the consecutive inhibition of premetastatic niche establishment was clearly depicted by S100A9-SPECT (lung activity untreated vs. treated: 2 vs, 1.4 %ID). Conclusion We report S100A8/A9 as a potent imaging biomarker for tumor-mediated immune remodeling with potential applications in basic research and clinical oncology.
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Affiliation(s)
- Michel Eisenblaetter
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, King's College London, London SE1 1UL, UK
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London SE1 7EH, UK
- Department of Clinical Radiology, University Hospital Muenster, 48149 Muenster, Germany
| | - Fabian Flores-Borja
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, King's College London, London SE1 1UL, UK
- Breast Cancer Now Research Unit, Department of Research Oncology, Guy's Hospital, King's College London, London SE1 9RT, UK
| | - Jae Jin Lee
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, King's College London, London SE1 1UL, UK
- Breast Cancer Now Research Unit, Department of Research Oncology, Guy's Hospital, King's College London, London SE1 9RT, UK
| | - Christina Wefers
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, King's College London, London SE1 1UL, UK
| | - Hannah Smith
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, King's College London, London SE1 1UL, UK
| | - Rebekka Hueting
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London SE1 7EH, UK
| | - Margaret S Cooper
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London SE1 7EH, UK
| | - Philip J Blower
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London SE1 7EH, UK
| | - Dominic Patel
- Department of Histopathology, University College London, London WC1
| | | | - Hanna Milewicz
- UCL Cancer Institute, Paul O'Gorman Building, University College London, London WC1E 6DD, UK
| | - Thomas Vogl
- Institute of Immunology, University Hospital Muenster, 48149 Muenster, Germany
| | - Johannes Roth
- Institute of Immunology, University Hospital Muenster, 48149 Muenster, Germany
| | - Andrew Tutt
- Breast Cancer Now Research Unit, Department of Research Oncology, Guy's Hospital, King's College London, London SE1 9RT, UK
| | - Tobias Schaeffter
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London SE1 7EH, UK
| | - Tony Ng
- Richard Dimbleby Department of Cancer Research, Randall Division & Division of Cancer Studies, King's College London, London SE1 1UL, UK
- Breast Cancer Now Research Unit, Department of Research Oncology, Guy's Hospital, King's College London, London SE1 9RT, UK
- UCL Cancer Institute, Paul O'Gorman Building, University College London, London WC1E 6DD, UK
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Kim KH, Lee JJ, Kim J, Morgado Gomes FR, Sehovic M, Extermann M. Association of multidimensional comorbidities with survival in elderly patients with metastatic colorectal cancer treated with chemotherapy. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e21530] [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
e21530 Background: In geriatric assessments, comorbidity is often assessed with tools such as the Charlson comorbidity index (CCI) and the Cumulative Illness Rating Scale-Geriatrics (CIRS-G). In studies of older patients with colorectal cancer (CRC), comorbidity was mainly measured using the CCI, and inconsistent results about the correlation comorbidity with overall survival (OS) were found. In order to refine our understanding of the impact of comorbidity, we evaluated its correlation with OS using the CIRS-G and heat maps to elicit the subgroups with the highest impact. Methods: We retrospectively reviewed 153 consecutive patients from the Total Cancer Care database, aged ≥65 with stage 4 CRC, who underwent chemotherapy at Moffitt Cancer Center from 2000 to 2015. The association between CIRS-G scores and OS was examined by the Cox proportional hazards regression model. Results: Median age at diagnosis was 71 years. Forty-eight % of patients had an ECOG PS of 0. Median MAX2 score of chemotherapies was 0.119. Median total score of CIRS-G was 8 (1-20) and median severity index was 0.57 (0.07-1.43). The most common comorbidities were vascular, EENT and larynx, and respiratory diseases. Eleven patients had 1 comorbidity and 1 patient had 2 comorbidities at level 4 severity. Median OS of all patients was 25.1 months (95% CI 21.2-27.6). In univariate analysis, the number of CIRS-G level 4 comorbidities was a significant worse prognostic factor for OS (0 vs 1 or 2, HR 2.16, p = 0.017). In multivariate analysis, ECOG PS ≥2, poorly differentiated histology, age at diagnosis and numbers of CIRS-G level 4 comorbidities were significant worse prognostic factors for OS. ECOG PS ≥2 and age at diagnosis were significant worse prognostic factors for unplanned hospitalization. Conclusions: The OS in the elderly metastatic CRC patients was good and similar to the general population with this disease. The number of CIRS-G level 4 comorbidities was associated with worse OS but no specific CIRS-G category was individually associated with OS.
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Affiliation(s)
- Ki Hyang Kim
- Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Jae Jin Lee
- Yonsei Nobel Hospital, Seoul, Republic of Korea
| | - Jongphil Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | - Marina Sehovic
- Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Martine Extermann
- Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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Selzam S, Krapohl E, von Stumm S, O'Reilly PF, Rimfeld K, Kovas Y, Dale PS, Lee JJ, Plomin R. Predicting educational achievement from DNA. Mol Psychiatry 2017; 22:267-272. [PMID: 27431296 PMCID: PMC5285461 DOI: 10.1038/mp.2016.107] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/10/2016] [Accepted: 05/23/2016] [Indexed: 02/06/2023]
Abstract
A genome-wide polygenic score (GPS), derived from a 2013 genome-wide association study (N=127,000), explained 2% of the variance in total years of education (EduYears). In a follow-up study (N=329,000), a new EduYears GPS explains up to 4%. Here, we tested the association between this latest EduYears GPS and educational achievement scores at ages 7, 12 and 16 in an independent sample of 5825 UK individuals. We found that EduYears GPS explained greater amounts of variance in educational achievement over time, up to 9% at age 16, accounting for 15% of the heritable variance. This is the strongest GPS prediction to date for quantitative behavioral traits. Individuals in the highest and lowest GPS septiles differed by a whole school grade at age 16. Furthermore, EduYears GPS was associated with general cognitive ability (~3.5%) and family socioeconomic status (~7%). There was no evidence of an interaction between EduYears GPS and family socioeconomic status on educational achievement or on general cognitive ability. These results are a harbinger of future widespread use of GPS to predict genetic risk and resilience in the social and behavioral sciences.
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Affiliation(s)
- S Selzam
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - E Krapohl
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - S von Stumm
- Department of Psychology, Goldsmiths University of London, London, UK
| | - P F O'Reilly
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - K Rimfeld
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Y Kovas
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Department of Psychology, Goldsmiths University of London, London, UK
- Laboratory for Cognitive Investigations and Behavioural Genetics, Tomsk State University, Tomsk, Russia
| | - P S Dale
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, NM, USA
| | - J J Lee
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - R Plomin
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Lee JA, Choi H, Kim DA, Lee BS, Lee JJ, Bae JH, Lim MH, Kim JJ. Relationship Between Cognitive Perceptual Abilities and Accident and Penalty Histories Among Elderly Korean Drivers. Ann Rehabil Med 2017; 40:1092-1099. [PMID: 28119840 PMCID: PMC5256324 DOI: 10.5535/arm.2016.40.6.1092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 03/16/2016] [Accepted: 05/25/2016] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the relationship between cognitive perceptual abilities of elderly drivers based on the Cognitive Perceptual Assessment for Driving (CPAD) test and their accident and penalty histories. METHODS A total of 168 elderly drivers (aged ≥65 years) participated in the study. Participant data included CPAD scores and incidents of traffic accidents and penalties, attained from the Korea Road Traffic Authority and Korea National Police Agency, respectively. RESULTS Drivers' mean age was 70.25±4.1 years and the mean CPAD score was 52.75±4.72. Elderly drivers' age was negatively related to the CPAD score (p<0.001). The accident history group had marginally lower CPAD scores, as compared to the non-accident group (p=0.051). However, incidence rates for traffic fines did not differ significantly between the two groups. Additionally, the group that passed the CPAD test had experienced fewer traffic accidents (3.6%), as compared to the group that failed (10.6%). The older age group (12.0%) had also experienced more traffic accidents, as compared to the younger group (2.4%). CONCLUSION Overall, elderly drivers who experienced driving accidents had lower CPAD scores than those who did not, without statistical significance. Thus, driving-related cognitive abilities of elderly drivers with insufficient cognitive ability need to be further evaluated to prevent traffic accidents.
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Affiliation(s)
- Jung Ah Lee
- Department of Clinical Research on Rehabilitation, National Rehabilitation Research Institute, National Rehabilitation Center, Seoul, Korea
| | - Hyun Choi
- Department of Clinical Research on Rehabilitation, National Rehabilitation Research Institute, National Rehabilitation Center, Seoul, Korea
| | - Dong-A Kim
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea
| | - Bum-Suk Lee
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea
| | - Jae Jin Lee
- Department of Clinical Research on Rehabilitation, National Rehabilitation Research Institute, National Rehabilitation Center, Seoul, Korea
| | - Jae Hyuk Bae
- Department of Clinical Research on Rehabilitation, National Rehabilitation Research Institute, National Rehabilitation Center, Seoul, Korea
| | - Mun Hee Lim
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea
| | - Jin-Ju Kim
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea
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Rodrigues JM, Kim S, Aljunid S, Lee JJ, Ten Napel H, Trombert B. From a Categorical Structure to a Concept Model: The International Classification of Health Interventions (ICHI). Stud Health Technol Inform 2017; 245:1334. [PMID: 29295415] [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
The International Classification of Health Interventions (ICHI) alpha2 2016 Section 1 Interventions on Body Systems and Functions is based on ISO 1828 international standard named categorial Structure (CAST). This is not sufficient to represent the meaning of ICD9-CM Volume 3 labels. We propose to modify it by using the SNOMED CT concept model.
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Affiliation(s)
| | - Sukil Kim
- The Catholic University of Korea, Seoul Korea
| | - Syed Aljunid
- International Centre for Casemix and Clinical Coding, National University of Malaysia
| | - Jae Jin Lee
- The Catholic University of Korea, Seoul Korea
| | - Huib Ten Napel
- WHO Collaborating Center for International Classifications in the Netherlands
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Rodrigues JM, Kim S, Trombert Paviot B, Lee JJ, Aljunid S. How to Link SNOMED CT Procedure and WHO International Classification of Health Interventions (ICHI). Stud Health Technol Inform 2017; 236:40-47. [PMID: 28508777] [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
Among different used healthcare terminology resources there is a need to link them to ease their interoperability. SNOMED CT is the most detailed clinical reference terminology for procedure used in the Electronic Health Record (EHR). WHO developed since 2006 an aggregated classification named ICHI required for statistics and resource allocation. It is based on an ontology framework defined in ISO 1828 named Categorial Structure (CAST) for surgical procedures. We present ICHI coding structure, ISO 1828 CAST standard for surgical procedures and SNOMED CT procedures hierarchy concept model and their relations. We demonstrate the obstacles to align ICHI coding structure with ISO 1828 CAST which can be linked with SNOMED CT procedures hierarchy concept model. We recommend to update ICHI coding structure to decrease the gap with ISO 1828 CAST and SNOMED CT concept model for procedures hierarchy to allow users to share the different terminology resources.
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Affiliation(s)
- Jean Marie Rodrigues
- University of Saint Etienne, CHU, Department of public health and medical informatics, Saint Etienne, France
| | - Sukil Kim
- The Catholic University of Korea, Seoul, Korea
| | - Béatrice Trombert Paviot
- University of Saint Etienne, CHU, Department of public health and medical informatics, Saint Etienne, France
| | - Jae Jin Lee
- The Catholic University of Korea, Seoul, Korea
| | - Syed Aljunid
- Department of Health Policy and Management Kuwait University, Kuwait
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Kim DH, Lee JJ, Han BS, You J. Cortical or Subcortical Neural Networks During Dynamic Neuromuscular Core Stabilization: A fMRI Blood Oxygen-Level Dependent (BOLD) Analysis. j med imaging hlth inform 2016. [DOI: 10.1166/jmihi.2016.1880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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50
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Hall GN, Izumi N, Landen OL, Tommasini R, Holder JP, Hargrove D, Bradley DK, Lumbard A, Cruz JG, Piston K, Lee JJ, Romano E, Bell PM, Carpenter AC, Palmer NE, Felker B, Rekow V, Allen FV. Spatial resolution measurements of the advanced radiographic capability x-ray imaging system at energies relevant to Compton radiography. Rev Sci Instrum 2016; 87:11E310. [PMID: 27910309 DOI: 10.1063/1.4959948] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Compton radiography provides a means to measure the integrity, ρR and symmetry of the DT fuel in an inertial confinement fusion implosion near peak compression. Upcoming experiments at the National Ignition Facility will use the ARC (Advanced Radiography Capability) laser to drive backlighter sources for Compton radiography experiments and will use the newly commissioned AXIS (ARC X-ray Imaging System) instrument as the detector. AXIS uses a dual-MCP (micro-channel plate) to provide gating and high DQE at the 40-200 keV x-ray range required for Compton radiography, but introduces many effects that contribute to the spatial resolution. Experiments were performed at energies relevant to Compton radiography to begin characterization of the spatial resolution of the AXIS diagnostic.
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Affiliation(s)
- G N Hall
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - N Izumi
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - O L Landen
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - R Tommasini
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - J P Holder
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - D Hargrove
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - D K Bradley
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - A Lumbard
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - J G Cruz
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - K Piston
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - J J Lee
- National Security Technologies LLC, 161 S Vasco Rd., Livermore, California 94551, USA
| | - E Romano
- National Security Technologies LLC, 161 S Vasco Rd., Livermore, California 94551, USA
| | - P M Bell
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - A C Carpenter
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - N E Palmer
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - B Felker
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - V Rekow
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
| | - F V Allen
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550, USA
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