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Gao C, Shi Q, Pan X, Chen J, Zhang Y, Lang J, Wen S, Liu X, Cheng TL, Lei K. Neuromuscular organoids model spinal neuromuscular pathologies in C9orf72 amyotrophic lateral sclerosis. Cell Rep 2024; 43:113892. [PMID: 38431841 DOI: 10.1016/j.celrep.2024.113892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/04/2023] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
Hexanucleotide repeat expansions in the C9orf72 gene are the most common cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia. Due to the lack of trunk neuromuscular organoids (NMOs) from ALS patients' induced pluripotent stem cells (iPSCs), an organoid system was missing to model the trunk spinal neuromuscular neurodegeneration. With the C9orf72 ALS patient-derived iPSCs and isogenic controls, we used an NMO system containing trunk spinal cord neural and peripheral muscular tissues to show that the ALS NMOs could model peripheral defects in ALS, including contraction weakness, neural denervation, and loss of Schwann cells. The neurons and astrocytes in ALS NMOs manifested the RNA foci and dipeptide repeat proteins. Acute treatment with the unfolded protein response inhibitor GSK2606414 increased the glutamatergic muscular contraction 2-fold and reduced the dipeptide repeat protein aggregation and autophagy. This study provides an organoid system for spinal neuromuscular pathologies in ALS and its application for drug testing.
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Affiliation(s)
- Chong Gao
- Westlake Laboratory of Life Sciences and Biomedicine, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China; Institute of Biology, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China; Key Laboratory of Novel Targets and Drug Study for Neural Repair of Zhejiang Province, Institute of Brain and Cognitive Science, School of Medicine, Hangzhou City University, Hangzhou, Zhejiang, China
| | - Qinghua Shi
- Westlake Laboratory of Life Sciences and Biomedicine, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China; Institute of Biology, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China; Fudan University, Shanghai, China
| | - Xue Pan
- Westlake Laboratory of Life Sciences and Biomedicine, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China; Institute of Biology, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China; College of Life Sciences, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jiajia Chen
- Westlake Laboratory of Life Sciences and Biomedicine, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China; Institute of Biology, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China
| | - Yuhong Zhang
- Westlake Laboratory of Life Sciences and Biomedicine, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China; Institute of Biology, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China
| | - Jiali Lang
- Westlake Laboratory of Life Sciences and Biomedicine, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China; Institute of Biology, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China
| | - Shan Wen
- Westlake Laboratory of Life Sciences and Biomedicine, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China; Institute of Biology, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China; Research Center for Industries of the Future, Westlake University, Hangzhou, Zhejiang, China
| | - Xiaodong Liu
- Westlake Laboratory of Life Sciences and Biomedicine, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China; Institute of Biology, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China; Research Center for Industries of the Future, Westlake University, Hangzhou, Zhejiang, China
| | - Tian-Lin Cheng
- Institute for Translational Brain Research, State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institute of Pediatrics, National Children's Medical Center, Children's Hospital, Fudan University, Shanghai, China
| | - Kai Lei
- Westlake Laboratory of Life Sciences and Biomedicine, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China; Institute of Biology, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China.
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Morris BA, Leal TA, Sethakorn N, Lang J, Schehr J, Zhao SG, Morris ZS, Buehler D, Eickhoff J, Harari PM, Traynor AM, Campbell T, Baschnagel AM, Bassetti MF. Treatment Efficacy Outcomes Combining Dual Checkpoint Immunotherapy with Ablative Radiation to All Sites of Oligometastatic Non-Small Cell Lung Cancer: Survival Analysis of a Phase IB trial. Int J Radiat Oncol Biol Phys 2023; 117:S128-S129. [PMID: 37784329 DOI: 10.1016/j.ijrobp.2023.06.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Aggressivelocal treatment to a limited number of metastatic sites in patients with oligometastatic NSCLC increases progression free survival (PFS) and overall survival (OS). Prior studies have shown the safety of combining high dose stereotactic body radiation therapy (SBRT) with single agent anti-PD1/PD-L1 therapy. Here, we report secondary survival endpoint outcomes from a phase Ib clinical trial investigating the safety of combining ablative, high dose radiation with dual checkpoint, anti-CTLA-4 and anti-PD-L1 immunotherapy for patients with oligometastatic NSCLC. MATERIALS/METHODS Patients with up to 6 sites of extracranial metastatic disease were eligible for trial enrollment. All sites of disease were treated with stereotactic body radiation therapy to a dose of 30 - 50 Gy in 5 fractions. Dual checkpoint immunotherapy was started 7 days following completion of radiation utilizing anti-CTLA-4 (Tremelimumab) and anti-PD-L1 (Durvalumab) immunotherapy for a total of four cycles followed by durvalumab alone until dose limiting toxicity or progression was observed. Primary toxicity outcomes were previously reported. Progression free and overall survival was analyzed using Kaplan Meier statistical methods. RESULTS Fifteen patients were treated with SBRT and received at least one dose of dual agent immunotherapy per protocol. The median follow up was 43 months. The median number of extracranial metastatic sites was 2. Seven patients had 3 or more sites of extracranial disease. The most commonly treated sites were separate metastatic pulmonary lesions or osseous metastatic lesions. Median progression free survival (PFS) was 42 months and median overall survival (OS) was 48 months. Seven patients remain alive without evidence of progressive disease. Prior history of brain metastases was associated with significantly worse PFS (Median PFS 4 months vs 42 months, HR 6.1 (95% CI 1.6 - 37.0) p = 0.0248), but no difference in OS (Median OS 24 vs 42 months, HR 1.9 (95% CI 0.3 - 10.4). CONCLUSION Ablative SBRT radiation to up to 6 sites of disease followed by dual checkpoint immunotherapy in oligometastatic NSCLC resulted in a favorable progression free survival (42 months) and overall survival (48 months) compared to historical controls. These findings suggest potential benefit to patient outcomes compared to immunotherapy or radiation alone in this patient population and warrant further investigation.
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Affiliation(s)
- B A Morris
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI
| | - T A Leal
- Emory University School of Medicine, Atlanta, GA
| | | | - J Lang
- Department of Medical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - J Schehr
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - S G Zhao
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - Z S Morris
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - D Buehler
- Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison, WI
| | - J Eickhoff
- University of Wisconsin Madison, Madison, WI
| | - P M Harari
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - A M Traynor
- Department of Medical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - T Campbell
- Department of Medical Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - A M Baschnagel
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - M F Bassetti
- Department of Human Oncology, University of Wisconsin Hospitals and Clinics, Madison, WI
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Campbell G, Wells S, Huang W, Cooley GM, Jarrard D, Kyriakopoulos C, Cho SY, Lang J, Floberg JM. Disease and Toxicity Outcomes after Salvage Radiotherapy (SRT) for Biochemically Recurrent Prostate Cancer (PC) for Patients Enrolled in a Phase II, Open Label Trial Investigating Neoadjuvant Chemohormonal Therapy Followed by Radical Prostatectomy (RP). Int J Radiat Oncol Biol Phys 2023; 117:e369. [PMID: 37785259 DOI: 10.1016/j.ijrobp.2023.06.2466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Men with metastatic hormone sensitive prostate cancer have improved progression free and overall survival (PFS/OS) when treated with docetaxel and androgen deprivation therapy (ADT). Our institution conducted a phase II trial (UW17009) investigating the addition of three cycles of neoadjuvant docetaxel and ADT to RP in men with high-risk prostate cancer. Here we report toxicity and freedom from biochemical recurrence (FFBCR) for patients treated with SRT following participation in this trial. MATERIALS/METHODS Between January 17, 2018 and August 10, 2021, 28 patients enrolled on UW17009. Patients who had a recurrence and received SRT were identified. Toxicity was assessed using modified LENT (Late Effects of Normal Tissues)/RTOG (Radiation Therapy Oncology Group) criteria, and time to recurrence following SRT was determined for each patient. Additionally, the months of ADT received by each patient was recorded. FFBCR was then determined for this cohort using the method of Kaplan and Meier. RESULTS Of 28 patients enrolled on UW17009, 20 (71%) had BCR after RP. Of these, 19 received SRT, representing 68% of the patients enrolled on the trial. The rates of acute grade 1 and grade 2 GU toxicity with SRT were 37% (7) and 53% (10), respectively. The rates of acute grade 1 and grade 2 GI toxicity with SRT were 32% (6) and 37% (7), respectively. On patient experienced a grade 4 genitourinary toxicity during SRT. There were no acute grade 3 or grade 5 toxicities. The rates of late grade 1 and grade 2 GU toxicity were 16% (3) and 11% (2), respectively. The rates of late grade 1 and grade 2 GI toxicity were 11% (2) and 5% (1), respectively. There was 1 (5%) late grade 3 GU toxicity. There were no late grade 3-5 GI toxicities, or late grade 4-5 GU toxicities. The average duration of ADT after prostatectomy was 15 months (range: 0-37 months). According to the method of Kaplan and Meier, mean FFBCR after SRT was 34.0 months at a median of 37.8 months. Median FFBCR had not yet been reached. At the time of analysis, 13 patients remained free from biochemical recurrence after SRT. CONCLUSION Rates of biochemical recurrence and SRT following neoadjuvant docetaxel and ADT and then RP were consistent with historical data, as was the rate of successful SRT. Toxicities were also consistent with historical data, though there was notably one acute grade 4 GU toxicity.
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Affiliation(s)
- G Campbell
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - S Wells
- Department of Radiology, University of Wisconsin Hospitals & Clinics, Madison, WI
| | - W Huang
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - G M Cooley
- Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, WI
| | - D Jarrard
- Department of Urology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - C Kyriakopoulos
- Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, WI
| | - S Y Cho
- Department of Radiology, University of Wisconsin Hospitals and Clinics, Madison, WI
| | - J Lang
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - J M Floberg
- University of Wisconsin School of Medicine and Public Health, Madison, WI
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Feng M, Tang Y, Fan M, Li L, Wang S, Yin Q, Ai H, Zhao S, Yin Y, Liu D, Ren Y, Li J, Li F, Lang J. Low-Dose Fractionated Radiotherapy Combined with Neoadjuvant Chemotherapy for T3-4 Nasopharyngeal Carcinoma Patients: The Preliminary Results of a Phase II Randomized Controlled Trial. Int J Radiat Oncol Biol Phys 2023; 117:e580-e581. [PMID: 37785764 DOI: 10.1016/j.ijrobp.2023.06.1921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Over 70% of NPC patients were local advanced NPC (LANPC). The 5-year local recurrence-free survival rate is only 70% in T3-4 patients. Neoadjuvant chemotherapy (NACT) followed with concurrent chemoradiotherapy (CCRT) was recommended for LANPC patients. Low-dose fractionated radiotherapy (LDFRT), which is <100cGy, induces enhanced cell killing by the hyper-radiation sensitivity phenomenon and potentiates effects of chemotherapy. The synergy of LDFRT and NACT has not been used in the clinical practice and few studies focused on it. A single arm study found the ORR of primary site was improved to 90% for head and neck squamous carcinoma patients treated with LDFRT and NACT. Our previous study found the ORR of lymph nodes was higher in LDFRT group for high-risk LANPC patients. However, another study showed there was no significant difference between LDFRT and control group for LANPC patients. So, we aimed to investigate the potential efficacy of this novel neoadjuvant therapy for T3-4 NPC patients. MATERIALS/METHODS A total of 60 pathological confirmed T3-4 (UICC/AJCC8th) NPC patients were prospectively enrolled in our study. They were randomly assigned to two groups. For the LDFRT group, the patients received 3 cycles of NACT (docetaxel 75mg/m2 D1, cisplatin 80mg/m2 D1) with LDFRT, and followed with CCRT. LDFRT was delivered as 50cGy per fraction twice a day to primary site on D1,2 for each cycle of NACT. The patients in the control group only received NACT and followed with CCRT. All the patients underwent IGRT. RECIST criteria and CTCAE 5.0 was used to evaluate the ORR and toxicity at post-NACT and the completion of CCRT. RESULTS From February 2022 to December 2022, 60 T3-4 NPC patients were included, and 30 patients for each group. For the primary site, the median volume reduction rate and the ORR after NACT was significantly improved in LDFRT group (69.27% vs 40.10%, p<0.001;93.33% vs 73.33%, p = 0.038). For the median volume reduction rate of primary site and lymph node, it was also obviously improved in LDFRT group (86.59% vs 55.43%, p<0.001). Though there was a tendency of ORR improvement in LDFRT group, but no significant difference (96.67% vs 83.33%, p = 0.195). After the completion of CCRT, the median volume reduction rate of primary site had an increased tendency in LDFRT group (96.16% vs 88.3%, p = 0.065), but the ORR had no statistical significance (LDFRT group: CR 45.8%, PR 54.2%; control group: CR 37.5%, PR 62.5%). For the toxicity, the incidence of grade 3-4 adverse events had no difference between two groups (p = 0.786). No grade 5 adverse events occurred. CONCLUSION LDFRT combined with NACT could obviously improve the median volume reduction rate and ORR of primary tumor for T3-4 NPC patients, and the toxicity was similar and tolerable. This novel treatment could be a promising strategy to improve treatment response and needed to be confirmed further.
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Affiliation(s)
- M Feng
- Sichuan Cancer Hospital, Chengdu, China; Department of Oncology, The Third People's Hospital of Sichuan Province, Chengdu, China
| | - Y Tang
- Sichuan Cancer Hospital, Chengdu, China
| | - M Fan
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - L Li
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - S Wang
- APHP, Hopitaux Universitaires Henri Mondor. Service d'Oncologie-Radiothérapie, Créteil, France
| | - Q Yin
- The Third People's Hospital of Sichuan Province, Chengdu, China
| | - H Ai
- Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China
| | - S Zhao
- Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China
| | - Y Yin
- Sichuan Institute of Brain Science and Brain-like Intelligence, Chengdu, China
| | - D Liu
- Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China
| | - Y Ren
- Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China
| | - J Li
- Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - F Li
- sichuan cancer hospital and institution, Chengdu, China
| | - J Lang
- Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China
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Feng M, Zhao S, Fan M, Li L, Wang S, Ai H, Tang Y, Yin Y, Ren Y, Li J, Li F, Lang J. Long-Term Survival Outcome for Metastatic Nasopharyngeal Carcinoma Patients Receiving Radiation to Primary and Metastatic Sites with Palliative Chemotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e581. [PMID: 37785765 DOI: 10.1016/j.ijrobp.2023.06.1922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) A total of 6% - 8% of NPC patients were initial diagnosed as distant metastatic disease. The median overall survival (OS) is only 10-15 months with palliative chemotherapy for these patients. A phase III study showed that palliative chemotherapy combined with radical radiotherapy to primary site could be a newly effective treatment method for metastatic NPC. Another phase 2, RCT found that the patients who had the solid tumors with 1-5 metastases received standard palliative care plus stereotactic body radiation therapy (SABR), and the 5-year OS were improved to 42.3%. Nevertheless, there was few studies focus on the radiation to both primary site and metastatic lesions. Therefore, we aimed to investigate the potential clinical benefits for initial diagnosed metastatic NPC patients with radiation to both primary site and distant metastatic lesions plus palliative chemotherapy. MATERIALS/METHODS Metastatic NPC patients treated with radiation to both primary site and distant metastatic lesions plus palliative chemotherapy were retrospectively collected in our hospital from May 2008 to May 2022. For treatment group, all patients underwent IGRT according to ICRU reports 50 and 62. The prescribed dose for primary site: GTVT: ≥66Gy, GTVn: ≥66Gy, CTV1: 60-66Gy, CTV2 54-60Gy, CTVln 50-54Gy. And the prescribed dose for distant metastatic lesions was more than 30Gy. For the control group, the patients treated with palliative chemotherapy were selected by propensity score matching from our hospital. The regimen for palliative chemotherapy was cisplatin-based chemotherapy every three weeks (100mg/m2 D1) for both groups. Kaplan-Meier method was used to analyze the OS. Cox regression model was used for multivariate analysis. RESULTS A total of 54 metastatic NPC patients with radiation to both primary site and distant metastatic lesions were retrospectively included in the treatment group, and another 54 patients were selected as the control group. The median follow-up time was 52 months. In the treatment group, the median age was 52 years (37-82), male (68%), female (32%), the main metastatic sites were bone (36 cases, 66%), lung (18 cases, 33%) and liver (10 cases, 18%). There were 23 oligometastasis cases and 31 cases. 3-year and 5-year OS in the treatment group were both dramatically improved than control group (63.2% vs 50.6%, p<0.05; 49.6% vs 38.9%, p<0.05). Multivariate analysis showed that T stage, liver metastatic lesion and oligometastases were the independent prognostic factors for them. CONCLUSION Palliative chemotherapy combined with radiation to primary sites and distant metastatic lesions might improve the OS for initial diagnosed distant metastatic NPC patients. More prospective clinical trials were needed to confirm it further.
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Affiliation(s)
- M Feng
- Sichuan Cancer Hospital, Chengdu, China; Department of Oncology, The Third People's Hospital of Sichuan Province, Chengdu, China
| | - S Zhao
- Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China
| | - M Fan
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - L Li
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - S Wang
- University of Nebraska Medical Center, Omaha, NE
| | - H Ai
- Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China
| | - Y Tang
- Sichuan Cancer Hospital, Chengdu, China
| | - Y Yin
- Sichuan Institute of Brain Science and Brain-like Intelligence, Chengdu, China
| | - Y Ren
- Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China
| | - J Li
- Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - F Li
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - J Lang
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
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Zou P, Lin R, Fang Z, Chen J, Guan H, Yin J, Xue X, Chen M, Lang J. A Ferroptosis Microneedle Integrated Wireless Implanted Photodynamic Therapy Pellet for Cancer Treatment. Int J Radiat Oncol Biol Phys 2023; 117:e280. [PMID: 37785049 DOI: 10.1016/j.ijrobp.2023.06.1261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Effective, non-toxic, and targeted induction of lung cancer cell death is urgently needed. The goal of this research is to create a new implantable battery-free therapeutic pellet with integrated drug microneedles that allows for wireless photodynamic therapy (PDT) and targeted release of a ferroptosis inducer (Imidazole ketone erastin, IKE) into tumor tissue. MATERIALS/METHODS A wireless power unit, μ-LED illuminant, a flexible control circuit, and an IKE-stored biodegradable microneedle enclosed in polydimethylsiloxane (PDMS) were all built into an integrated therapeutic pellet. Lung cancer cells were used to illustrate the in vitro viability and molecular biological processes of this system. Therapeutic pellet implanted into the LLC xenograft C57BL/6 model. PDT was conducted by 660 nm laser irradiation after injecting a photosensitizer (Chlorin e6, Ce6) and targeted IKE released into the tumor. Systematically analyzing the therapeutic effects on lung cancer and toxic side-effects. RESULTS The PDT-IKE group reduced cellular viability by 90% compared to the control group at the cellular level. In mouse model studies, the PDT-IKE group suppressed tumors at 78.8%, three or four times greater than the PDT (26.6%) or IKE (19.2%) group alone. The PDT-IKE group also controlled IKE release more precisely with heated electrodes, reducing nephrotoxicity and improving safety. Moreover, the combination of PDT and IKE can effectively cause ferroptosis in tumor cells, both in vivo and in vitro. CONCLUSION A new implantable battery-free therapeutic pellet was designed for wireless PDT with integrated IKE microneedles to induce obvious ferroptosis in lung cancer. The proposed pellet would provide a promising strategy for cancer treatment.
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Affiliation(s)
- P Zou
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center University of Electronic Science and Technology of China affiliated Cancer Hospital Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, Sichuan, China
| | - R Lin
- School of Physics, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Z Fang
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center University of Electronic Science and Technology of China affiliated Cancer Hospital Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, Sichuan, China
| | - J Chen
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center University of Electronic Science and Technology of China affiliated Cancer Hospital Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, Sichuan, China; Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - H Guan
- School of Physics, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - J Yin
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center University of Electronic Science and Technology of China affiliated Cancer Hospital Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, Sichuan, China
| | - X Xue
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center University of Electronic Science and Technology of China affiliated Cancer Hospital Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, Sichuan, China; School of Physics, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - M Chen
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center University of Electronic Science and Technology of China affiliated Cancer Hospital Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, Sichuan, China
| | - J Lang
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center University of Electronic Science and Technology of China affiliated Cancer Hospital Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, Sichuan, China; Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
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Lang J, Przybytek M, Lesiuk M, Jeziorski B. Collision-induced three-body polarizability of helium. J Chem Phys 2023; 158:114303. [PMID: 36948830 DOI: 10.1063/5.0137879] [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: 02/23/2023] Open
Abstract
We present the first-principles determination of the three-body polarizability and the third dielectric virial coefficient of helium. Coupled-cluster and full configuration interaction methods were used to perform electronic structure calculations. The mean absolute relative uncertainty of the trace of the polarizability tensor, resulting from the incompleteness of the orbital basis set, was found to be 4.7%. Additional uncertainty due to the approximate treatment of triple and the neglect of higher excitations was estimated at 5.7%. An analytic function was developed to describe the short-range behavior of the polarizability and its asymptotics in all fragmentation channels. We calculated the third dielectric virial coefficient and its uncertainty using the classical and semiclassical Feynman-Hibbs approaches. The results of our calculations were compared with experimental data and with recent Path-Integral Monte Carlo (PIMC) calculations [Garberoglio et al., J. Chem. Phys. 155, 234103 (2021)] employing the so-called superposition approximation of the three-body polarizability. For temperatures above 200 K, we observed a significant discrepancy between the classical results obtained using superposition approximation and the ab initio computed polarizability. For temperatures from 10 K up to 200 K, the differences between PIMC and semiclassical calculations are several times smaller than the uncertainties of our results. Except at low temperatures, our results agree very well with the available experimental data but have much smaller uncertainties. The data reported in this work eliminate the main accuracy bottleneck in the optical pressure standard [Gaiser et al., Ann. Phys. 534, 2200336 (2022)] and facilitate further progress in the field of quantum metrology.
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Affiliation(s)
- J Lang
- Faculty of Chemistry, University of Warsaw, Pasteura 1, 02-093 Warsaw, Poland
| | - M Przybytek
- Faculty of Chemistry, University of Warsaw, Pasteura 1, 02-093 Warsaw, Poland
| | - M Lesiuk
- Faculty of Chemistry, University of Warsaw, Pasteura 1, 02-093 Warsaw, Poland
| | - B Jeziorski
- Faculty of Chemistry, University of Warsaw, Pasteura 1, 02-093 Warsaw, Poland
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Feng M, Du X, Yin Y, Yan L, Wang H, Yin Q, Li L, Fan M, Lai X, Huang Y, Ren J, Lang J. Early Prediction Model of Radiation-Induced Xerostomia Based on Radiomics during Radiotherapy for Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Yin J, Yin W, Zhang S, Lang J, Lu S, Feng M. A One-Arm, Open, Single-Center Exploratory Clinical Study on the Safety and Efficacy of Anlotinib in the Treatment of Relapsed High-Grade Gliomas. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lang J, Cheng L, Yu Z, Wu Y, Wang X. Complete $f$-Moment Convergence for Randomly Weighted Sums of Extended Negatively Dependent Random Variables and Its Statistical Application. Theory Probab Appl 2022. [DOI: 10.1137/s0040585x97t990915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lang J, Jeschke S, Müller RM, Herziger B, Bertsche T, Neininger MP, Bertsche A. Knowledge and attitudes towards epilepsy: A survey of people with epilepsy. Epilepsy Res 2022; 184:106964. [PMID: 35691219 DOI: 10.1016/j.eplepsyres.2022.106964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/18/2022] [Accepted: 06/02/2022] [Indexed: 11/19/2022]
Abstract
PROBLEM Many studies focus on knowledge and attitudes of unaffected people towards epilepsy and people with epilepsy (PWE). The perspective of PWE themselves is much less explored. METHODS We invited PWE in Germany to answer a questionnaire on their knowledge and attitudes towards epilepsy and PWE. RESULTS The questionnaire was completed by 230 PWE (median age: 40 years; min./max.: 19/83; 66 % female). Of PWE, 22 % thought that PWE are more helpful, and 10 % thought that PWE are friendlier than other people. Nevertheless, reservations about relationships and friendships with other PWE existed: of the participants, only 74 % would definitely go on a date with another PWE, and 90 % would definitely include another PWE they liked into their circle of friends. Swimming was judged as more dangerous for PWE than for healthy people by 71 % of PWE. Of PWE, 86 % correctly assumed it was not useful to hold a person having a seizure to the ground. Putting a solid object in the mouth was considered not useful by 85 % of PWE. Of PWE, 20 % would definitely administer an available emergency medication if another PWE had a seizure. For 67 % of PWE, certain preconditions should have to be fulfilled such as an available document with instructions. Of PWE, 11 % stated they would not administer an available emergency medication if another PWE had a seizure. CONCLUSION Although positive attitudes of PWE towards other PWE exist, we also found some reservations calling for psychosocial support. Most PWE had sufficient knowledge about risks of certain activities and about measures to be taken during a seizure. Nevertheless, a small group of PWE showed knowledge gaps. Thus, educational support still seems essential.
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Affiliation(s)
- J Lang
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
| | - S Jeschke
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
| | - R M Müller
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
| | - B Herziger
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
| | - T Bertsche
- Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, and Drug Safety Center, Leipzig University and Leipzig University Hospital, Bruederstrasse 32, Leipzig 04103, Germany.
| | - M P Neininger
- Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, and Drug Safety Center, Leipzig University and Leipzig University Hospital, Bruederstrasse 32, Leipzig 04103, Germany.
| | - A Bertsche
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
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Knitza J, Grahammer M, Boeltz S, Lang J, Detert M, Bader M, Kleyer A, Simon D, Krönke G, Schett G, Detert J. POS1485-HPR DIGITALLY ENHANCED TREAT-TO-TARGET AND SHARED DECISION-MAKING APPROACH WITH A DIGITAL HEALTH APPLICATION: INTERIM RESULTS FROM A RANDOMIZED CONTROLLED TRIAL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundDigital health applications (DHA) became indispensable patient companions accelerated by the current COVID pandemic [1]. In 2020, for the first time worldwide, a regulatory framework to reimburse DHA was established in Germany. To get listed as a DHA, preliminary evidence needs to be generated – next to fulfilling highest standards in quality and safety. The DHA ABATON RA consists of two parts; 1) digital shared-decision-making (SDM) including choosing an appropriate electronic patient reported outcome (ePRO) instrument and the respective ePRO target for the next visit, 2) remote patient monitoring and ePRO tracking by the patient. Hereby, ABATON RA supports a digitally guided Treat-to-Target (T2T) approach.ObjectivesThe objective of this study is to evaluate a potentially beneficial effect for the patient by using ABATON RA.MethodsThree-armed, partially blinded multicenter trial (RCT) including RA patients who regularly use a smartphone. Patients attend 3 visits, 3 months apart (T0, T3, T6), with one follow-up visit (T9). Intervention group (IG): Patients use ABATON RA. Via SDM patients and rheumatologists choose a specific ePRO and respective treatment target for the next visit in three months, e.g. RAID ≤4. Control group (CG): Standard of care treatment (no DHA). Placebo group (PG): Usage of a placebo version of ABATON RA providing only Regensburger Insomnie Skala (RIS) and Epworth Sleepiness Scale (ESS) as ePROs. No SDM is conducted and ePRO results are not presented to HCP.ResultsThis interim analysis evaluated the first 38 patients that completed T3. IG: 13 patients (Av. age 55.9, 61.5% females); PG: 12 (Av. age 50.7, 66.7% females); CG: 13 (Av. age 56.1, 76.9% females). We observe a significant improvement in the mean over time in a pairwise comparison within the intervention group for the following: Pt-GA mean difference of 2.98 (p = 0.025, partial η2 = 0.353), pain mean difference of 1.46 (p = 0.049, partial η2 = 0.286) whereas all pairwise comparisons for the two parameters were non-significant in PG and CG. The patient reactions assessment (PRA) score, measuring patient perceived quality of the patient-provider relationship, increased by a mean of 4.15 points in IG, compared to a slight decrease of 1.92 for PG and 2.77 for CG.ConclusionThese preliminary findings show beneficial differences among the groups in favor of IG: 1) for quality of life and 2) the physician-patient-relationship. A digitally enhanced therapy is non-inferior to the gold-standard of exclusive in-person treatment. Patients seem willing and able to get involved in an enhanced treat-to-target and shared decision-making approach.References[1]Kernder A, Morf H, Klemm P, Vossen D, Haase I, Mucke J, et al. Digital rheumatology in the era of COVID-19: results of a national patient and physician survey. RMD Open. 2021;7:e001548.Disclosure of InterestsJohannes Knitza Consultant of: ABATON GmbH, Vila Health, Grant/research support from: ABATON GmbH, Manuel Grahammer Shareholder of: ABATON GmbH, Employee of: ABATON GmbH, Sebastian Boeltz: None declared, Judith Lang: None declared, Markus Detert: None declared, Maram Bader Employee of: ABATON GmbH, Arnd Kleyer: None declared, David Simon: None declared, Gerhard Krönke: None declared, Georg Schett: None declared, Jacqueline Detert: None declared
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Ning Y, Roberts NJ, Qi J, Peng Z, Long Z, Zhou S, Gu J, Hou Z, Yang E, Ren Y, Lang J, Liang Z, Zhang M, Ma J, Jiang G. Inbreeding status and implications for Amur tigers. Anim Conserv 2021. [DOI: 10.1111/acv.12761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Y. Ning
- College of Life Science Jilin Agricultural University Changchun China
- Feline Research Center of National Forestry and Grassland Administration College of Wildlife and Protected Area Northeast Forestry University Harbin China
| | - N. J. Roberts
- Feline Research Center of National Forestry and Grassland Administration College of Wildlife and Protected Area Northeast Forestry University Harbin China
| | - J. Qi
- Feline Research Center of National Forestry and Grassland Administration College of Wildlife and Protected Area Northeast Forestry University Harbin China
- School of Forestry Northeast Forestry University Harbin China
| | - Z. Peng
- School of Basic Medical Sciences Nanchang University Nanchang China
| | - Z. Long
- Feline Research Center of National Forestry and Grassland Administration College of Wildlife and Protected Area Northeast Forestry University Harbin China
| | - S. Zhou
- Heilongjiang Research Institute of Wildlife Harbin China
| | - J. Gu
- Feline Research Center of National Forestry and Grassland Administration College of Wildlife and Protected Area Northeast Forestry University Harbin China
| | - Z. Hou
- College of Wildlife and Protected Area Northeast Forestry University Harbin China
| | - E. Yang
- Wildlife Conservation Society Hunchun China
| | - Y. Ren
- Wildlife Conservation Society Hunchun China
| | - J. Lang
- Jilin Hunchun Amur Tiger National Nature Reserve Hunchun China
| | - Z. Liang
- Heilongjiang Laoyeling Amur Tiger National Nature Reserve Dongning China
| | - M. Zhang
- Feline Research Center of National Forestry and Grassland Administration College of Wildlife and Protected Area Northeast Forestry University Harbin China
| | - J. Ma
- Feline Research Center of National Forestry and Grassland Administration College of Wildlife and Protected Area Northeast Forestry University Harbin China
| | - G. Jiang
- Feline Research Center of National Forestry and Grassland Administration College of Wildlife and Protected Area Northeast Forestry University Harbin China
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Fu H, Liu X, Jin L, Lang J, Hu Z, Mao W, Cheng C, Shou Q. Safflower yellow reduces DEN-induced hepatocellular carcinoma by enhancing liver immune infiltration through promotion of collagen degradation and modulation of gut microbiota. Food Funct 2021; 12:10632-10643. [PMID: 34585698 DOI: 10.1039/d1fo01321a] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Safflower yellow (SY) is the main active ingredient isolated from the traditional Chinese medicine Carthamus tinctorius, which is a valuable natural edible pigment that is widely used to treat cerebrovascular and cardiovascular diseases. However, the effect of SY on hepatocellular carcinoma (HCC) remains unclear. In this study, we showed that SY decreased the degree of injury and inhibited the release of inflammatory factors in the liver of a diethylnitrosamine (DEN)-induced HCC mouse model. Flow cytometry and immunoblotting showed that SY increased the infiltration of CD8+ T cells and Gr-1+ macrophages to improve the immune microenvironment by affecting the expression of collagen fibers. Further cellular experiments showed that SY degraded the collagens in the liver cells through the TGF-β/Smad signalling pathway. SY also regulated the gut microbiota which may contribute to the immune microenvironment. In conclusion, SY exhibited a potent effect on the development of HCC by enhancing liver immune infiltration by promoting collagen degradation and modulating the gut microbiota. This study provides novel insights into the mechanism of SY as a candidate for the treatment of HCC in the future.
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Affiliation(s)
- Huiying Fu
- Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China. .,Zhejiang Provincial Key Laboratory of Sexual Function of Integrated Traditional Chinese and Western Medicine, Hangzhou 310053, PR China
| | - Xia Liu
- Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China. .,Zhejiang Provincial Key Laboratory of Sexual Function of Integrated Traditional Chinese and Western Medicine, Hangzhou 310053, PR China
| | - Lu Jin
- Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China. .,Zhejiang Provincial Key Laboratory of Sexual Function of Integrated Traditional Chinese and Western Medicine, Hangzhou 310053, PR China
| | - Jiali Lang
- Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Zhiming Hu
- Department of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Hangzhou, China.
| | - Wen Mao
- Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Changpei Cheng
- First Clinical Medical College, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Qiyang Shou
- Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China. .,Zhejiang Provincial Key Laboratory of Sexual Function of Integrated Traditional Chinese and Western Medicine, Hangzhou 310053, PR China
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Chen M, Lang J. Combined Stereotactic Ablative Radiotherapy and Fibroblast Activation Protein Based Whole Cell Tumor Vaccine Synergize to Suppress Tumor Growth and Metastasis. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Feng M, Yin Q, Qi Y, Lu L, Lan M, Xin L, Ming F, Jun Z, Fang L, Wang W, Lang J. Low-Dose Ultra-Fractionated Radiotherapy as a Chemosensitizer of Neoadjuvant Chemotherapy for Locally Advanced Nasopharyngeal Carcinoma: A Preliminary Results of the Phase II Trial. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Feng M, Yan L, Du X, Wang H, Ren J, Wang M, Yin Q, Lai X, Li L, Lan M, Lu S, Huang Y, Li F, Xu X, Wang W, Lang J. 873P Early efficacy prediction of nasopharyngeal carcinoma based on 3D-ADC acquired during radiotherapy: A phase II prospective study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Feng M, Wang H, Yin J, Ren J, Lang J. PO-0983 early prediction of parotid gland function based on ADC during radiotherapy for NPC: a phase Ⅱ study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07434-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Feng M, Yin Q, Qi Y, Li L, Lan M, Lai X, Fan M, Zhang J, Li F, Wang W, Lang J. PO-0978 Low-dose radiotherapy as a chemosensitizer of neoadjuvant chemotherapy for LA-NPC: a phase II trial. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07429-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pang H, Zhang L, Han S, Li Z, Gong J, Liu Q, Liu X, Wang J, Xia Z, Lang J, Xu T, Zhu L. A nationwide population-based survey on the prevalence and risk factors of symptomatic pelvic organ prolapse in adult women in China - a pelvic organ prolapse quantification system-based study. BJOG 2021; 128:1313-1323. [PMID: 33619817 PMCID: PMC8252658 DOI: 10.1111/1471-0528.16675] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/19/2021] [Indexed: 01/22/2023]
Abstract
Objective To determine the prevalence, risk factors and burden of symptomatic pelvic organ prolapse (POP) in adult Chinese women. Design A nationwide cross‐sectional study. Setting Six geographic regions of mainland China. Participants Women aged ≥20 years old were included using a multistage, stratified, cluster sampling method from February 2014 through March 2016. Methods We conducted a nationwide epidemiological survey. ‘Symptomatic POP’ was determined by a screening questionnaire and physical examination. Main outcome measurements Prevalence, odds ratio (OR). Results A total of 55 477 women (response rate, 92.5%; mean age, 45.1 years old) were included. The prevalence of symptomatic POP was 9.6% (95% CI 9.3–9.8%) and it increased with age in each stage (P < 0.05). Symptomatic POP‐Q stage II, which mainly involved anterior compartment prolapse, was the most common (7.52%). Minor/moderate burden of symptomatic POP was the most common, with a prevalence of 9.7% (95% CI 9.5–10.0%). The odds for each type of symptomatic POP increased with age (>50 vs 20‐29 years old in symptomatic POP‐Q stage II or higher, OR increased from 1.34 [95% CI 1.32–1.45] to 7.34 [95% CI 4.34–12.41]) and multiple vaginal deliveries (multiparous [≥3] vs nulliparous in symptomatic POP‐Q stage II or higher, OR increased from 1.91 [1.71–2.13] to 2.78 [2.13–3.64]). Conclusions We found a lower prevalence of symptomatic POP than that found in other surveys. The main type of symptomatic POP was anterior compartment prolapse, indicating that it should be considered first. Older age and multiple vaginal deliveries increased the odds of each type of symptomatic POP. Tweetable abstract The prevalence of female symptomatic pelvic organ prolapse (POP) was 9.6% in China. It is related to old age and multiple vaginal deliveries. The prevalence of female symptomatic pelvic organ prolapse (POP) was 9.6% in China. It is related to old age and multiple vaginal deliveries.
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Affiliation(s)
- H Pang
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - L Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - S Han
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Z Li
- Department of Gynecology and Obstetrics, Children's Hospital of Shanxi Province, Shanxi, China
| | - J Gong
- Department of Gynecology and Obstetrics, Maternal and Child Health Hospital of Wuxi, Jiangsu, China
| | - Q Liu
- Department of Gynecology and Obstetrics, Maternal and Child Health Hospital of Gansu Province, Lanzhou, China
| | - X Liu
- Department of Gynecology and Obstetrics, Maternal and Child Health Hospital of Foshan, Guangdong, China
| | - J Wang
- Department of Gynecology and Obstetrics, Maternal and Child Health Hospital of Guiyang, Guizhou, China
| | - Z Xia
- Department of Gynecology and Obstetrics, ShengJing Hospital of China Medical University, Shenyang, China
| | - J Lang
- Department of Gynecology and Obstetrics, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - T Xu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - L Zhu
- Department of Gynecology and Obstetrics, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Stickel S, Eickhoff SB, Habel U, Stickeler E, Goecke TW, Lang J, Chechko N. Endocrine stress response in pregnancy and 12 weeks postpartum - Exploring risk factors for postpartum depression. Psychoneuroendocrinology 2021; 125:105122. [PMID: 33421704 DOI: 10.1016/j.psyneuen.2020.105122] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 08/19/2020] [Revised: 11/13/2020] [Accepted: 12/21/2020] [Indexed: 01/21/2023]
Abstract
Pregnancy and the postpartum period are characterized by physiological alterations in cortisol and cortisone levels. In the present study, we sought to explore the risk factors for postpartum depression (PPD) and self-remitting postpartum adjustment disorder (AD) and whether cortisol/cortisone metabolism might have any bearing on them. Hair samples from 196 participants (mean age = 31.44, SD = 4.71) were collected at two time points (1-6 days after childbirth and 12 weeks postpartum) to determine the cumulative hair cortisol (HCC) and hair cortisone (HCNC) exposure in the third trimester and during the 12 weeks postpartum. Compared to the non-depressed group (ND, n = 141), more women in the AD (n = 28) and PPD (n = 27) groups had a personal or family history of depression and more stressful life events. Compared to ND and PPD, more women in the AD group had birth-related complications with their children being more often transferred to a pediatric ward. The factors associated with PPD were found to include being unmarried and having a lower household income, less support at home, more subjectively perceived stress after childbirth and lower maternal sensitivity. The natural decrease in HCC concentration from the third trimester to 12 weeks postpartum was significant only in the ND and AD groups, but not in PPD. In summary, prolonged subjectively perceived postpartum stress associated with living situations may contribute to the development of PPD while birth- and child-related complications are likely to trigger brief episodes of AD. Only in ND and AD, the pregnancy-related physiological changes in glucocorticoid levels return to the pre-pregnancy baseline after 12 weeks. Our observations point to the difference between the ND and PPD groups in glucocorticoid metabolism-related postpartum adjustment, which may be a factor in the development of PPD.
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Affiliation(s)
- S Stickel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; Institute of Neuroscience and Medicine, JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Wilhelm-Johnen-Strasse, 52428 Jülich, Germany.
| | - S B Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany; Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Wilhelm-Johnen-Strasse, 52428 Jülich, Germany
| | - U Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; Institute of Neuroscience and Medicine, JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Wilhelm-Johnen-Strasse, 52428 Jülich, Germany
| | - E Stickeler
- Department of Gynecology and Obstetrics, Medical Faculty, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - T W Goecke
- Department of Gynecology and Obstetrics, Medical Faculty, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; RoMed Hospital Rosenheim, Department of Obstetrics, Pettenkoferstraße 10, 83022 Rosenheim, Germany
| | - J Lang
- Institute for Occupational, Social and Environmental Medicine, Medical Faculty, Uniklinik RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - N Chechko
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; Institute of Neuroscience and Medicine, JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Wilhelm-Johnen-Strasse, 52428 Jülich, Germany; Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Wilhelm-Johnen-Strasse, 52428 Jülich, Germany.
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Gao Y, Tang R, Li J, Li HJ, Lang J, Liu G, Lin S, Chen R. Generalized headache among Chinese climacteric women: findings from a prospective cohort. Climacteric 2021; 24:289-296. [PMID: 33594921 DOI: 10.1080/13697137.2021.1881058] [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: 10/22/2022]
Abstract
OBJECTIVE This study aimed to prospectively identify the prevalence of generalized headache and associated risk factors in Chinese midlife women. METHODS We identified 411 qualified women from a Chinese urban community, contributing a total of 2544 surveys. The presence of generalized headache was measured. Climacteric symptoms and other risk factors were evaluated by generalized estimating equations. RESULTS The prevalence of headache complaints is associated with menopausal stages. Perimenopausal women have relatively high prevalence of headache symptoms, especially stage +1a women (59.0%) compared to late postmenopausal women (37.8%), although menopause stages were not statistically significant in the multivariate analysis. Women who had headache at baseline and depression were much more likely to have headache during menopause. According to the univariate and multivariate analyses in women without headache at baseline, starting menopausal status, insomnia, sweats, and depression were independently associated with newly developed headache. CONCLUSIONS Symptoms of generalized headache were less prevalent in late postmenopausal women. Our findings highlight the association between headache and climacteric changes.
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Affiliation(s)
- Y Gao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital (PUMCH), Beijing, China
| | - R Tang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital (PUMCH), Beijing, China
| | - J Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital (PUMCH), Beijing, China
| | - H J Li
- Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - J Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital (PUMCH), Beijing, China
| | - G Liu
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China
| | - S Lin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital (PUMCH), Beijing, China
| | - R Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital (PUMCH), Beijing, China
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Zhang N, Xu FJ, Lang J, Wang LB, Wang JM, Sun YH, Liu BY, Xie N, Fang XZ, Yang XL, Kang XN, Wang XQ, Qin ZX, Ge WK, Shen B. Improved light extraction efficiency of AlGaN deep-ultraviolet light emitting diodes combining Ag-nanodots/Al reflective electrode with highly transparent p-type layer. Opt Express 2021; 29:2394-2401. [PMID: 33726435 DOI: 10.1364/oe.416826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
Enhancement of light extraction efficiency (LEE) of AlGaN-based deep-ultraviolet (DUV) light emitting diodes (LEDs) has been attempted by adopting Ag-nanodots/Al reflective electrodes on a highly transparent complex p-type layer. By thinning the p-GaN to several nm, highly DUV transparent p-type layer is achieved, making it meaningful for the application of reflective electrodes composed of Ag-nanodots and Al film to allow most light emitted upward to be reflected back to the sapphire side. By this approach, the maximum light output power and external quantum efficiency of the DUV-LEDs with optimized Ag nanodots/Al electrodes are severally increased by 52% and 58%, respectively, compared to those with traditional Ni/Au electrodes when the current is below 200 mA.
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Fu H, Tang B, Lang J, Du Y, Cao B, Jin L, Fang M, Hu Z, Cheng C, Liu X, Shou Q. High-Fat Diet Promotes Macrophage-Mediated Hepatic Inflammation and Aggravates Diethylnitrosamine-Induced Hepatocarcinogenesis in Mice. Front Nutr 2020; 7:585306. [PMID: 33304918 PMCID: PMC7701255 DOI: 10.3389/fnut.2020.585306] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 07/20/2020] [Accepted: 10/19/2020] [Indexed: 12/24/2022] Open
Abstract
It has been reported that diet and nutrition play important roles in the occurrence and development of hepatocellular carcinoma (HCC). In this study, we investigated the potential tumor-promoting mechanisms of a high-fat diet (HFD) in mice with dietondiethylnitrosamine (DEN)-induced hepatocarcinogenesis. HFD significantly decreased the survival rate and induced severe liver dysfunction in DEN-induced mice, as indicated by increased serum glutamic-pyruvic transaminase (ALT), glutamic oxalacetic transaminase (AST), and alkaline phosphatase (ALP) levels and increased liver index, liver nodule count, and γ-glutamyltransferase (γ-GT) activity. Moreover, an increased number of fat droplets and HCCs were found in the livers of the HFD mice, who displayed little collagen in and around the liver cancer groove and the infiltration of large number of inflammatory cells, such as macrophages, compared with the control mice. HFD also significantly increased proliferating cell nuclear antigen (PCNA), nuclear factor-κB (NF-κB), cyclin D1, tumor necrosis factor (TNF), and interleukin-1 (IL-1) expression levels in the liver. In vitro, we found that the inducible nitric oxide synthase (iNOS) percentage increased in macrophages after palmitic acid treatment, as well as the secretion of inflammatory factors and cytokines such as interleukin-6(IL-6), interleukin-10(IL-10), CCL2, Interferon γ (IFN-γ), and TNF. Thus, our results demonstrate that an HFD may promote DEN-induced hepatocarcinogenesis in mice by destroying liver function and enhancing the inflammatory response by recruiting and polarizing macrophages in the liver. This study could therefore provide new insights into the tumor promoting effects of an HFD in HCC.
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Affiliation(s)
- Huiying Fu
- The Second Clinical Medical College & Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Biqiang Tang
- Basic Medicine College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiali Lang
- The Second Clinical Medical College & Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yueguang Du
- Basic Medicine College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Beibei Cao
- The Second Clinical Medical College & Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lushuai Jin
- The Second Clinical Medical College & Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Mingsun Fang
- The Second Clinical Medical College & Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhiming Hu
- Department of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Changpei Cheng
- First Clinical Medical College, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Xia Liu
- The Second Clinical Medical College & Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qiyang Shou
- The Second Clinical Medical College & Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
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Boldrini L, Lenkowicz J, Orlandini L, Dinapoli N, Yin G, Cusumano D, Casà C, Peng Q, Chiloiro G, Gambacorta M, Lang J, Valentini V. PH-0716: Radiomics pCR predictive model in rectal cancer: an intercontinental validation on real world data. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00738-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Fan Y, Guan W, Huang X, Zhang P, Lang J. Extranodal Expansion Of The Lymph Nodes Is An Effective Predictor Of Distant Metastasis Of Nasopharyngeal Carcinoma After Radical Radiotherapy And Chemotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Huang Y, Feng M, Zhou J, Yang X, Xu G, Lang J. DW-MRI Guided Dose Escalation Improve Local Control of Locally Advanced Nasopharyngeal Carcinoma treated with Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Liu S, Liao X, Li J, Orlandini L, Lang J. PO-1592: Effect of respiratory motion on lung target volume during 4D-CT and 4D-CBCT imaging. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01610-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chen M, Lang J. Synergistic Effect Of Stereotactic Ablative Radiotherapy And Immunotherapy With A Xenogeneic Fibroblast Activation Protein-Based Whole Cell Tumor Vaccine. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wang Q, Li J, Yao W, Wu L, Li T, Lang J. Radiation to primary lesions in Patients with non-Oligometastatic Non-Small Cell Lung Cancer (NSCLC) with EGFR Mutation who do not Progress after TKI, Results of a Phase II Study. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wang Q, Han Y, Peng L, He W, Li T, Lang J. The Effects of Neoadjuvant Chemoradiation in Locally Advanced Esophageal Squamous Cell Carcinoma—The Impact in Intratumoral Genetic Heterogeneity. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cheng C, Shou Q, Lang J, Jin L, Liu X, Tang D, Yang Z, Fu H. Gehua Jiecheng Decoction Inhibits Diethylnitrosamine-Induced Hepatocellular Carcinoma in Mice by Improving Tumor Immunosuppression Microenvironment. Front Pharmacol 2020; 11:809. [PMID: 32547401 PMCID: PMC7272686 DOI: 10.3389/fphar.2020.00809] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 11/10/2019] [Accepted: 05/18/2020] [Indexed: 12/11/2022] Open
Abstract
Gehua Jiecheng Decoction (GHJCD), a famous traditional Chinese medicine, has been used in the prevention and treatment of precancerous lesion of liver cancer, but its active mechanism has not been reported. This study aimed to evaluate the therapeutic effect of GHJCD on diethylnitrosamine (DEN)-induced hepatocellular carcinoma (HCC) in mice and the mechanism of this effect. We found that GHJCD effectively inhibited the occurrence of liver cancer and reduced the tumor area. The ratio of regulatory cells (Tregs), tumor-associated macrophages (TAMs), and myeloid-derived suppressor cells (MDSCs) in HCC microenvironment was down-regulated, whereas that of CD8 T and effective CD8 T cells was up-regulated. In addition, the expression levels of inflammatory factors IL-6, IL-10, TNF-α, and CCL-2 in the liver were inhibited, whereas those of the angiogenesis related molecules CD31 and VEGF were decreased. Moreover, WNT1, β-catenin, NF-kB, p-MAPK, p-AKT, and p-SRC content in the liver decreased, whereas APC content increased. These results suggested that GHJCD exerted a good inhibitory effect on liver cancer induced by DEN and thus may have a multi-target effect; GHJCD not only antagonized the immunosuppressive effect of the microenvironment of liver cancer but also exerted strong anti-inflammatory and antiangiogenesis effects.
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Affiliation(s)
- Changpei Cheng
- Affiliated First Hospital, Guizhou University of Traditional Chinese Medicine, Guiyang, China.,Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China.,Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qiyang Shou
- Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiali Lang
- Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lu Jin
- Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xia Liu
- Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Dongxin Tang
- Affiliated First Hospital, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Zhu Yang
- Affiliated First Hospital, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Huiying Fu
- Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China
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Sahm J, Baier G, Lang J, Gretser S, Bauer T. [Erratum to: Panton-valentine leukocidin (PVL)-positive Staphylococcus aureus causing necrotizing pneumonia after infection with parainfluenza virus type 2]. Med Klin Intensivmed Notfmed 2020; 116:266. [PMID: 32356042 DOI: 10.1007/s00063-020-00695-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J Sahm
- Medizinische Klinik 1, Klinik für Kardiologie, Internistische Intensivmedizin und Allgemeine Innere Medizin, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland.
| | - G Baier
- Medizinische Klinik 1, Klinik für Kardiologie, Internistische Intensivmedizin und Allgemeine Innere Medizin, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland
| | - J Lang
- Zentralinstitut für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Sana Klinikum Offenbach, Offenbach am Main, Deutschland
| | - S Gretser
- Dr. Senckenbergisches Institut für Pathologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland
| | - T Bauer
- Medizinische Klinik 1, Klinik für Kardiologie, Internistische Intensivmedizin und Allgemeine Innere Medizin, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland
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Sahm J, Baier G, Lang J, Gretser S, Bauer T. [Panton-valentine leukocidin (PVL)-positive Staphylococcus aureus causing necrotizing pneumonia after infection with parainfluenza virus type 2]. Med Klin Intensivmed Notfmed 2020; 116:262-265. [PMID: 32291504 PMCID: PMC7154571 DOI: 10.1007/s00063-020-00679-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/21/2020] [Accepted: 03/13/2020] [Indexed: 12/03/2022]
Affiliation(s)
- J Sahm
- Medizinische Klinik 1, Klinik für Kardiologie, Internistische Intensivmedizin und Allgemeine Innere Medizin, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland.
| | - G Baier
- Medizinische Klinik 1, Klinik für Kardiologie, Internistische Intensivmedizin und Allgemeine Innere Medizin, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland
| | - J Lang
- Zentralinstitut für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Sana Klinikum Offenbach, Offenbach am Main, Deutschland
| | - S Gretser
- Dr. Senckenbergisches Institut für Pathologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Deutschland
| | - T Bauer
- Medizinische Klinik 1, Klinik für Kardiologie, Internistische Intensivmedizin und Allgemeine Innere Medizin, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland
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Pfaller MR, Cruz Varona M, Lang J, Bertoglio C, Wall WA. Using parametric model order reduction for inverse analysis of large nonlinear cardiac simulations. Int J Numer Method Biomed Eng 2020; 36:e3320. [PMID: 32022424 DOI: 10.1002/cnm.3320] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 10/29/2019] [Accepted: 01/25/2020] [Indexed: 06/10/2023]
Abstract
Predictive high-fidelity finite element simulations of human cardiac mechanics commonly require a large number of structural degrees of freedom. Additionally, these models are often coupled with lumped-parameter models of hemodynamics. High computational demands, however, slow down model calibration and therefore limit the use of cardiac simulations in clinical practice. As cardiac models rely on several patient-specific parameters, just one solution corresponding to one specific parameter set does not at all meet clinical demands. Moreover, while solving the nonlinear problem, 90% of the computation time is spent solving linear systems of equations. We propose to reduce the structural dimension of a monolithically coupled structure-Windkessel system by projection onto a lower-dimensional subspace. We obtain a good approximation of the displacement field as well as of key scalar cardiac outputs even with very few reduced degrees of freedom, while achieving considerable speedups. For subspace generation, we use proper orthogonal decomposition of displacement snapshots. Following a brief comparison of subspace interpolation methods, we demonstrate how projection-based model order reduction can be easily integrated into a gradient-based optimization. We demonstrate the performance of our method in a real-world multivariate inverse analysis scenario. Using the presented projection-based model order reduction approach can significantly speed up model personalization and could be used for many-query tasks in a clinical setting.
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Affiliation(s)
- M R Pfaller
- Institute for Computational Mechanics, Technical University of Munich, Garching b. München, Germany
| | - M Cruz Varona
- Chair of Automatic Control, Technical University of Munich, Garching b. München, Germany
| | - J Lang
- Institute for Computational Mechanics, Technical University of Munich, Garching b. München, Germany
| | - C Bertoglio
- Bernoulli Institute, University of Groningen, AG Groningen, The Netherlands
| | - W A Wall
- Institute for Computational Mechanics, Technical University of Munich, Garching b. München, Germany
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Shou Q, Lang J, Jin L, Fang M, Cao B, Cai Y, Ni Z, Qiu F, Li C, Cao G, Fu H. Total glucosides of peony improve ovalbumin-induced allergic asthma by inhibiting mast cell degranulation. J Ethnopharmacol 2019; 244:112136. [PMID: 31377261 DOI: 10.1016/j.jep.2019.112136] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/03/2019] [Accepted: 07/31/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Paeonia lactiflora Pall. (peony) is a medicinal plant used in the Xiaoqinglong decoction, a commonly prescribed traditional Chinese medicine for asthma. The main active ingredients of peony roots-described as the total glucosides of peony (TGP)-have anti-inflammatory, immunomodulatory, and protective effects on endothelial cells, and they are known to improve rheumatoid arthritis. This study explored the underlying mechanism of TGP activity in the treatment of allergic asthma. MATERIALS AND METHODS Allergic asthma was induced in BALB/c mice by administering injections of ovalbumin (OVA) mixed with aluminum hydroxide gel and inhaling nebulized OVA. The OVA-sensitized mice were treated with TGP by oral gavage, and the potentially anti-asthmatic treatment effect was studied by testing airway hyperresponsiveness, classifying and counting of leukocytes, performing cytokine assays, and analyzing the lung histopathology. The β-hexosaminidase activity was assayed as a biomarker to evaluate the effect of TGP on mast cell degranulation. The mechanism of TGP was explored by monitoring the Ca2+ influx level in mast cells (RBL-2H3) using a Ca2+ fluorescent probe technique. RESULTS In mice with OVA-induced allergic asthma, TGP reduced airway hyperresponsiveness and improved lung tissue pathology, which included a decrease in inflammatory cell infiltration and collagen deposition. TGP also significantly lowered BALF leukocyte, eosinophil, and neutrophil counts, along with chemokines and cytokines, such as eotaxin, TNF-α, IL-4, and MIP-1α, in serum and lungs of OVA-challenged mice. These effects were further confirmed with the decrease of β-hexosaminidase release and the inhibition of Ca2+ influx in mast cell degranulation. CONCLUSIONS Our findings suggest that TGP improved OVA-induced allergic asthma in mice mainly by suppressing Ca2+ influx-dependent mast cell degranulation.
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Affiliation(s)
- Qiyang Shou
- Second Clinical Medical College/Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China; School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiali Lang
- Second Clinical Medical College/Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China; School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lu Jin
- Second Clinical Medical College/Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China; School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Mingsun Fang
- Academy of Chinese Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Beibei Cao
- Second Clinical Medical College/Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yueqin Cai
- Academy of Chinese Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhunan Ni
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Fengmei Qiu
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Changyu Li
- Academy of Chinese Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Gang Cao
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Huiying Fu
- Second Clinical Medical College/Affiliated Secondary Hospital, Zhejiang Chinese Medical University, Hangzhou, China.
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Lin H, Ran W, Chen X, Wang B, Yang P, Li Y, Xiao Y, Wang X, Li G, Wang L, Han Y, Peng Y, Lang J, Liang Y, Tian G, Yuan D, Yang J, Deng C, Xing X. Whole-exome sequencing of tumour-only samples reveals the association between somatic alterations and clinical features in pancreatic cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz431.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Marín Jiménez J, Capasso A, Bagby S, Hartman S, Shulman J, Barkow J, Yacob B, Blatchford P, Pitts T, Lang J. Evaluation of immune responses among responders (R) and non-responders (non-R) in a humanized mouse model with colorectal cancer (CRC) xenografts treated with combination immunotherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz268.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Yu H, Lang J, Kern J, Pickard SL, Rudin C, Rivard C, Hirsch F. P1.12-05 Microenvironment Characterization of Small Cell Lung Cancer Xenografts Implanted in Hematopoietic Humanized Mice. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lang J, Xu FJ, Ge WK, Liu BY, Zhang N, Sun YH, Wang JM, Wang MX, Xie N, Fang XZ, Kang XN, Qin ZX, Yang XL, Wang XQ, Shen B. Greatly enhanced performance of AlGaN-based deep ultraviolet light emitting diodes by introducing a polarization modulated electron blocking layer. Opt Express 2019; 27:A1458-A1466. [PMID: 31684498 DOI: 10.1364/oe.27.0a1458] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 08/03/2019] [Indexed: 06/10/2023]
Abstract
Carrier transport in AlGaN-based deep ultraviolet (DUV) light emitting diodes (LEDs) with the wavelength of 273 nm has been investigated by introducing polarization modulated electron blocking layer (EBL) that adopts an Al composition and thickness graded multiple quantum barriers (MQB) structure. The experimental result shows that the maximum light output power and external quantum efficiency for the proposed structure at the current of 250 mA are 9.6 mW and 1.03% respectively, severally increasing by 405% and 249% compared to traditional one, meanwhile, the efficiency droop at 250 mA is also dramatically reduced from 42.2% to 16.6%. Further simulation analysis indicates that this graded MQB-EBL enhances the potential barrier height for electrons and meanwhile reduces that for holes, hence effectively suppresses the electron leakage, and at the same time significantly improves the hole injection efficiency. As a result, the whole performance of the LED with the proposed MQB-EBL is dramatically improved.
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Lu S, Deng S, Zhang H, Lang J. Salicylic Acid Increase the Radiosensitivity of CaSki Cells by Regulating AMPK/TSC2/mTOR Pathway. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Zhang H, Lu S, Lang J. Analysis of Local Control Rate and Toxicity of Radiotherapy Dose of Cervical Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Zhang P, Li Z, Yang F, Lang J, Huang X, Kang L, Xie K, Guan W. A Phase II Prospective, Single Arm, Multicenter Clinic Study of Pulsed Low-Dose-Rate IMRT for Local Recurrence Head and Neck Cancer after Radical Radiotherapy and Chemotherapy: Preliminary Reports. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Chen Y, Chen X, Hall W, Prior P, Zhang Y, Paulson E, Lang J, Erickson B, Li A. A Preferred Patient Decubitus Positioning for MRI-guided Online Adaptive Radiation Therapy of Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Li Y, Lan M, Peng X, Zhang Z, Lang J. Weighted Gene Co-Expression Network Analysis Combined with Machine Learning to Identify Prognostic Biomarkers for Cervical Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sun C, Lu S, Lang J. Prognostic Value of Tumor Parameters Measured By MRI in Cervical Cancer Patients Receiving CCRT. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Chen M, Lang J, Li T. A Whole Cell Tumor Vaccine Expressing Human Fibroblast Activation Protein α Targets Cancer Cells and Cancer-Associated Fibroblasts. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bentley E, Ved R, Amato-Watkins A, Lang J, Zilani G, Bhatti I, Leach P. P104 One year failure rates for de novo ventriculo-peritonealshunts in under 3- month-old children. J Neurol Neurosurg Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.161] [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: 11/03/2022]
Abstract
ObjectivesHistorically VPS failure and infection rates are higher for neonates than for older children. We compared our one year VPS failure and infection rates in under 3-month-olds with those of older children.DesignA retrospective, single centre study comparing 1 year survival and infection rates of VPS in under 3-month-olds verses older children.Subjects58 children under 3 months of age underwent VPS insertion between January 2007 and December 2016.MethodsData was collected by three independent reviewers from electronic files and case notes. Data was analysed using descriptive statistics and one year shunt survival curves were produced.ResultsFor children under 3 months there was a 29.3% one-year shunt failure rate, of which 2 were shunt infections (3.4%). In patients greater than 3 months, the shunt malfunction rate was 23.4% and the infection rate was 4.3%. There were no shunt-related mortalities in either group.ConclusionsChildren under 3-months-old undergoing VPS insertion should not automatically expect an increased 1 year failure or infection rate compared with older children. Reasons for this may be increased sub-specialisation, improved neonatal care and use of antibiotic impregnated catheters.
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Stickel S, Eickhoff S, Goecke TW, Schneider F, Quinete NS, Lang J, Habel U, Chechko N. Cumulative cortisol exposure in the third trimester correlates with postpartum mothers' neural response to emotional interference. Biol Psychol 2019; 143:53-61. [PMID: 30797948 DOI: 10.1016/j.biopsycho.2019.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 02/09/2019] [Accepted: 02/15/2019] [Indexed: 12/23/2022]
Abstract
Prolonged stress affects the central nervous system, rendering individuals vulnerable to a wide range of mental health disorders. 76 healthy postpartum mothers were studied by means of functional magnetic resonance imaging within 6 days of childbirth. The subjects were required to perform the emotional Stroop task involving happy and anxious word-face combinations. Hair samples were collected to determine cumulative hair cortisol concentration (HCC) in the third trimester. HCC was found to be negatively correlated with the recruitment of the dorsal anterior cingulate cortex (ACC) and the midcingulate cortex (MCC). In response to the emotional interference of only anxious target faces, a negative correlation was seen between HCC and the bilateral orbitofrontal cortex, extending to the rostral ACC and the MCC. Women with lower HCC recruited brain areas relevant to emotional cognitive control, indicating that lower HCC helps preserve conflict monitoring and resolution capacities and thus benefits mental health in pregnancy.
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Affiliation(s)
- S Stickel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen, Aachen, Germany; Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany.
| | - S Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - T W Goecke
- RoMed Hospital Rosenheim, Department of Obstetrics, Rosenheim, Germany
| | - F Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen, Aachen, Germany; University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - N S Quinete
- Institute for Occupational, Social and Environmental Medicine, Medical Faculty, Uniklinik RWTH Aachen University, Aachen, Germany; Southeast Environmental Research Center, Florida International University, FL, USA
| | - J Lang
- Institute for Occupational, Social and Environmental Medicine, Medical Faculty, Uniklinik RWTH Aachen University, Aachen, Germany
| | - U Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen, Aachen, Germany; Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
| | - N Chechko
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Uniklinik RWTH Aachen, Aachen, Germany; Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
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Caswell-Jin JL, McNamara K, Reiter JG, Sun R, Hu Z, Ma Z, Suarez CJ, Tilk S, Raghavendra A, Forte V, Chin SF, Bardwell H, Provenzano E, Caldas C, Lang J, West R, Tripathy D, Press MF, Curtis C. Abstract P3-06-01: Clonal evolution and heterogeneity in breast tumors treated with neoadjuvant HER2-targeted therapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-06-01] [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: Understanding to what extent a breast tumor's genetic composition may change over the course of a few months of neoadjuvant therapy has implications for optimal therapeutic approach. However, genomic changes observed across treatment may result from either treatment-induced clonal evolution or geographically disparate sampling of a heterogeneous tumor. We sought to characterize the geographic heterogeneity in primary breast tumors, and to incorporate this information into analysis of clonal evolution with neoadjuvant therapy.
Methods: We assembled the largest cohort to date of multi-region (n=2-3) whole-exome sequenced (WES) or whole-genome sequenced untreated primary breast tumors with matched normal and adequate tumor purity for analysis: four tumors with data generated for this study and five tumors compiled from three previous studies. We also generated the first cohort of multi-region (n=2-6) WES breast tumors post-neoadjuvant HER2-targeted therapy and chemotherapy, sequencing one region from a pre-treatment diagnostic specimen, multiple regions from the post-treatment surgical specimen, and matched normal for five HER2+ breast tumors that did not achieve a pathologic complete response. We used an agent-based model of spatial tumor growth to investigate whether the mutational patterns we observed with treatment were consistent with pre-existing heterogeneity or treatment-induced selection.
Results: In untreated primary breast tumors, on average 30% (range 1-70%) of apparently clonal mutations from a single region were absent or rare in a second, spatially disparate region (high-frequency regional, or HFR). Intra-tumor heterogeneity was similar post-treatment (HFR 28%, range 10-54%), and was higher in breast tumors than in previously analyzed colon, brain, lung, and esophageal tumors. Simulation studies confirmed that with high heterogeneity as observed in breast tumors, analysis of one pre-treatment and one post-treatment region could not distinguish treatment-induced clonal evolution from pre-existing heterogeneity; however, obtaining at least two post-treatment regions allowed for detection of clonal shifts with treatment. Analysis of multi-region data revealed that clonal replacement occurred with neoadjuvant therapy in two of the five tumors. Candidate causes of therapeutic resistance included amplifications in CCND1, ERBB4, and MYC in one subclone, and functional protein-altering mutations in ERCC2, SMO, and WT1 in another. Mathematical modeling suggested that these putative resistant subclones comprised 0.02-12.5% of the overall pre-treatment cell population, substantially larger than previous estimates of resistant tumor clone size.
Conclusions: WES data from multiple regions of untreated and treated primary breast tumors revealed considerable heterogeneity that remained present throughout treatment with chemotherapy and HER2-targeted therapy, even while major clonal sweeps took place in a minority of tumors. Obtaining at least two samples for analysis from breast tumors post-neoadjuvant therapy may reveal the tumor's evolutionary path and, especially as increasing numbers of molecular and immune therapeutic targets are identified, inform new clinical strategies.
Citation Format: Caswell-Jin JL, McNamara K, Reiter JG, Sun R, Hu Z, Ma Z, Suarez CJ, Tilk S, Raghavendra A, Forte V, Chin S-F, Bardwell H, Provenzano E, Caldas C, Lang J, West R, Tripathy D, Press MF, Curtis C. Clonal evolution and heterogeneity in breast tumors treated with neoadjuvant HER2-targeted therapy [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 P3-06-01.
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Affiliation(s)
- JL Caswell-Jin
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - K McNamara
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - JG Reiter
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - R Sun
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Z Hu
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Z Ma
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - CJ Suarez
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - S Tilk
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - A Raghavendra
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - V Forte
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - S-F Chin
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - H Bardwell
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - E Provenzano
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - C Caldas
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - J Lang
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - R West
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - D Tripathy
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - MF Press
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - C Curtis
- Stanford University School of Medicine, Stanford, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Norris Comprehensive Cancer Center, Los Angeles, CA; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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