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Henkel E, Hernandez B, Michalek J, Mahalingam D, Arora S. COMBINATION CHEMOTHERAPY FOR PANCREATIC CANCER IN OLDER ADULTS: EFFICACY AND SAFETY ANALYSIS OF PATIENTS AT A HISPANIC-RICH NCI-DESIGNATED CANCER CENTER. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31200-7] [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: 10/25/2022]
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Hrib J, Chylikova Krumbholcova E, Duskova-Smrckova M, Hobzova R, Sirc J, Hruby M, Michalek J, Hodan J, Lesny P, Smucler R. Hydrogel Tissue Expanders for Stomatology. Part II. Poly(styrene-maleic anhydride) Hydrogels. Polymers (Basel) 2019; 11:polym11071087. [PMID: 31247964 PMCID: PMC6680895 DOI: 10.3390/polym11071087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 05/03/2019] [Revised: 06/14/2019] [Accepted: 06/22/2019] [Indexed: 11/16/2022] Open
Abstract
Self-inflating soft tissue expanders represent a valuable modality in reconstructive surgery. For this purpose, particularly synthetic hydrogels that increase their volume by swelling in aqueous environment are used. The current challenge in the field is to deliver a material with a suitable protracted swelling response, ideally with an induction period (for sutured wound healing) followed by a linear increase in volume lasting several days for required tissue reconstruction. Here, we report on synthesis, swelling, thermal, mechanical and biological properties of novel hydrogel tissue expanders based on poly(styrene-alt-maleic anhydride) copolymers covalently crosslinked with p-divinylbenzene. The hydrogels exerted hydrolysis-driven swelling response with induction period over the first two days with minimal volume change and gradual volume growth within 30 days in buffered saline solution. Their final swollen volume reached more than 14 times the dry volume with little dependence on the crosslinker content. The mechanical coherence of samples during swelling and in their fully swollen state was excellent, the compression modulus of elasticity being between 750 and 850 kPa. In vitro cell culture experiments and in vivo evaluation in mice models showed excellent biocompatibility and suitable swelling responses meeting thus the application requirements as soft tissue expanders.
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Affiliation(s)
- Jakub Hrib
- Institute of Macromolecular Chemistry AS CR, Heyrovsky Sq. 2, 162 06 Prague 6, Czech Republic
| | | | | | - Radka Hobzova
- Institute of Macromolecular Chemistry AS CR, Heyrovsky Sq. 2, 162 06 Prague 6, Czech Republic.
| | - Jakub Sirc
- Institute of Macromolecular Chemistry AS CR, Heyrovsky Sq. 2, 162 06 Prague 6, Czech Republic
| | - Martin Hruby
- Institute of Macromolecular Chemistry AS CR, Heyrovsky Sq. 2, 162 06 Prague 6, Czech Republic
| | - Jiri Michalek
- Institute of Macromolecular Chemistry AS CR, Heyrovsky Sq. 2, 162 06 Prague 6, Czech Republic
| | - Jiri Hodan
- Institute of Macromolecular Chemistry AS CR, Heyrovsky Sq. 2, 162 06 Prague 6, Czech Republic
| | - Petr Lesny
- Institute of Hematology and Blood Transfusion, U nemocnice 2094/1, 128 20 Prague 2, Czech Republic
| | - Roman Smucler
- 1st Faculty of Medicine, Charles University in Prague, Katerinska 32, 121 08 Prague 2, Czech Republic
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Laco J, Kovarikova H, Chmelarova M, Vosmikova H, Sieglova K, Bubancova I, Dundr P, Nemejcova K, Michalek J, Celakovsky P, Mottl R, Sirak I, Vosmik M, Marek I, Geryk T, Mejzlik J, Satankova J, Ryska A. Analysis of DNA methylation and microRNA expression in NUT (nuclear protein in testis) midline carcinoma of the sinonasal tract: a clinicopathological, immunohistochemical and molecular genetic study. Neoplasma 2019; 65:113-123. [PMID: 29322795 DOI: 10.4149/neo_2018_161122n581] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of this study was a detailed clinicopathological investigation of sinonasal NUT midline carcinoma (NMC), including analysis of DNA methylation and microRNA (miRNA) expression. Three (5%) cases of NMC were detected among 56 sinonasal carcinomas using immunohistochemical screening and confirmed by fluorescence in situ hybridization. The series comprised 2 males and 1 female, aged 46, 60, and 65 years. Two tumors arose in the nasal cavity and one in the maxillary sinus. The neoplasms were staged pT1, pT3, and pT4a (all cN0M0). All patients were treated by radical resection with adjuvant radiotherapy. Two patients died 3 and 8 months after operation, but one patient (pT1 stage; R0 resection) experienced no evidence of disease at 108 months. Microscopically, all tumors consisted of infiltrating nests of polygonal cells with vesicular nuclei, prominent nucleoli and basophilic cytoplasm. Abrupt keratinization was present in only one case. Immunohistochemically, there was a diffuse expression of cytokeratin (CK) cocktail, CK7, p40, p63, and SMARCB1/INI1. All NMCs tested negative for EBV and HPV infection. Two NMCs showed methylation of RASSF1 gene. All other genes (APC, ATM, BRCA1, BRCA2, CADM1, CASP8, CD44, CDH13, CDKN1B, CDKN2A, CDKN2B, CHFR, DAPK1, ESR1, FHIT, GSTP1, HIC1, KLLN, MLH1a, MLH1b, RARB, TIMP3, and VHL) were unmethylated. All NMCs showed upregulation of miR-9 and downregulation of miR-99a and miR-145 and two cases featured also upregulation of miR-21, miR-143, and miR-484. In summary, we described three cases of sinonasal NMCs with novel findings on DNA methylation and miRNA expression, which might be important for new therapeutic strategies in the future.
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Hobzova R, Hampejsova Z, Cerna T, Hrabeta J, Venclikova K, Jedelska J, Bakowsky U, Bosakova Z, Lhotka M, Vaculin S, Franek M, Steinhart M, Kovarova J, Michalek J, Sirc J. Poly(d,l-lactide)/polyethylene glycol micro/nanofiber mats as paclitaxel-eluting carriers: preparation and characterization of fibers, in vitro drug release, antiangiogenic activity and tumor recurrence prevention. Materials Science and Engineering: C 2019; 98:982-993. [DOI: 10.1016/j.msec.2019.01.046] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 12/11/2018] [Accepted: 01/10/2019] [Indexed: 12/16/2022]
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Kopeckova K, Eckschlager T, Sirc J, Hobzova R, Plch J, Hrabeta J, Michalek J. Nanodrugs used in cancer therapy. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 163:122-131. [PMID: 30967685 DOI: 10.5507/bp.2019.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 03/25/2019] [Indexed: 12/29/2022] Open
Abstract
Cancer despite the introduction of new targeted therapy remains for many patients a fatal disease. Nanotechnology in cancer medicine has emerged as a promising approach to defeat cancer. Targeted delivery of anti-cancer drugs by different nanosystems promises enhanced drug efficacy, selectivity, better safety profile and reduced systemic toxicity. The article presents an overview of recent developments in cancer nanomedicine. We focus on approved anti-cancer medical products and on the results of clinical studies, highlighting that liposomal and micellar cytostatics or albumin-based nanoparticles have less side effects and are more efficient than "free" drugs. In addition, we discuss results of in vitro and in vivo preclinical studies with lipid, inorganic and polymer nanosystems loaded by anticancer drugs which according to our meaning are important for development of new nanodrugs. Pharmacokinetic characteristics of nanodrugs are discussed and characterization of major nanotechnology systems used for cancer nanomedicine is presented.
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Affiliation(s)
- Katerina Kopeckova
- Department of Oncology, 2 nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Tomas Eckschlager
- Department of Pediatric Hematology and Oncology, 2 nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jakub Sirc
- Institute of Macromolecular Chemistry, Academy of Sciences of Czech Republic Corresponding author: Katerina Kopeckova, e-mail
| | - Radka Hobzova
- Institute of Macromolecular Chemistry, Academy of Sciences of Czech Republic Corresponding author: Katerina Kopeckova, e-mail
| | - Johana Plch
- Department of Pediatric Hematology and Oncology, 2 nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jan Hrabeta
- Department of Pediatric Hematology and Oncology, 2 nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jiri Michalek
- Institute of Macromolecular Chemistry, Academy of Sciences of Czech Republic Corresponding author: Katerina Kopeckova, e-mail
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Hrib J, Sirc J, Lesny P, Hobzova R, Duskova-Smrckova M, Michalek J, Smucler R. Hydrogel tissue expanders for stomatology. Part I. Methacrylate-based polymers. J Mater Sci Mater Med 2017; 28:12. [PMID: 27995490 DOI: 10.1007/s10856-016-5818-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 11/24/2016] [Indexed: 06/06/2023]
Abstract
In order to create a soft tissue surplus, implantable volume expanders are often utilized in dental surgery. Implanted tissue expanders should gradually increase their volume, exerting a constant pressure on the surrounding tissue for weeks. Current tissue expanders are based predominantly on externally inflatable balloons or on osmotically active tissue expanders that use soft hydrogels wrapped in perforated plastic coatings, which limit fluid entry and swelling. We have designed and examined tissue expanders based on the controlled rate expansive hydrogels synthesized from copolymers of selected methacrylates and N-vinylpyrrolidone, cross-linked with a combination of non-degradable (glycol dimethacrylates) and hydrolytically degradable (N,O-dimethacryloylhydroxylamine) cross-linkers. These copolymers have close-to-linear volume expansion rates (up to 6-9 times their original volume) and exert an increasing swelling pressure in vitro. The anesthetic benzocaine has been incorporated into the hydrogels, and kinetic release experiments have shown that most of the drug (90%) was released within 48 h. Our proposed hydrogel expanders are homogeneous and have suitable mechanical properties, thus simplifying the surgical manipulations required. Further studies will be needed to completely evaluate their biocompatibility and tissue response to the implants.
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Affiliation(s)
- Jakub Hrib
- Institute of Macromolecular Chemistry AS CR, Heyrovsky Sq. 2, Prague 6, 162 06, Czech Republic
| | - Jakub Sirc
- Institute of Macromolecular Chemistry AS CR, Heyrovsky Sq. 2, Prague 6, 162 06, Czech Republic.
| | - Petr Lesny
- Institute of Hematology and Blood Transfusion, U Nemocnice 2094/1, Prague 2, 128 20, Czech Republic
| | - Radka Hobzova
- Institute of Macromolecular Chemistry AS CR, Heyrovsky Sq. 2, Prague 6, 162 06, Czech Republic
| | | | - Jiri Michalek
- Institute of Macromolecular Chemistry AS CR, Heyrovsky Sq. 2, Prague 6, 162 06, Czech Republic
| | - Roman Smucler
- First Medical Faculty of the Charles University, Katerinska 32, Prague 2, 121 08, Czech Republic
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Hrib J, Sirc J, Hobzova R, Krumbholcova E, Zak A, Stankova B, Slanar O, Hromadka R, Michalek J. The Synthesis and Characterization of the Poly[N-vinylpyrrolidone-co-ethylidene-bis-3-(N-vinyl-2-pyrrolidone)] Hydrogel Matrix for Drug Delivery to the Gastrointestinal Tract. ACTA ACUST UNITED AC 2016. [DOI: 10.1002/masy.201650042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jakub Hrib
- Institute of Macromolecular Chemistry AS CR; Heyrovsky Sq. 2 162 06 Prague 6 Prague Czech Republic
| | - Jakub Sirc
- Institute of Macromolecular Chemistry AS CR; Heyrovsky Sq. 2 162 06 Prague 6 Prague Czech Republic
| | - Radka Hobzova
- Institute of Macromolecular Chemistry AS CR; Heyrovsky Sq. 2 162 06 Prague 6 Prague Czech Republic
| | - Eva Krumbholcova
- Institute of Macromolecular Chemistry AS CR; Heyrovsky Sq. 2 162 06 Prague 6 Prague Czech Republic
| | - Ales Zak
- Fourth Department of Medicine, First Faculty of Medicine; Charles University in Prague; Prague Czech Republic
| | - Barbora Stankova
- Fourth Department of Medicine, First Faculty of Medicine; Charles University in Prague; Prague Czech Republic
| | - Ondrej Slanar
- Institute of Pharmacology, First Faculty of Medicine; Charles University in Prague; Prague Czech Republic
| | - Robert Hromadka
- Research and Development Center; C2P Ltd.; Chlumec nad Cidlinou Czech Republic
| | - Jiri Michalek
- Institute of Macromolecular Chemistry AS CR; Heyrovsky Sq. 2 162 06 Prague 6 Prague Czech Republic
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Sirc J, Hrib J, Vetrik M, Hobzova R, Zak A, Stankova B, Slanar O, Hromadka R, Sandrikova V, Michalek J. The use of a hydrogel matrix for controlled delivery of niacin to the gastrointestinal tract for treatment of hyperlipidemia. Physiol Res 2016; 64:S51-60. [PMID: 26447595 DOI: 10.33549/physiolres.933142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Hyperlipidemia treatment based on niacin requires gastrointestinal administration of relatively high doses. The recommended dietary allowance of niacin as vitamin B3 is 14 to 16 mg daily in adults, while the doses of niacin used in the treatment of hyperlipidemia are generally in the range of 1 to 3 g. Administration of such large doses requires a high concentration of the active compound in the tablet and proper control of the drug release. In this study, a hydrogel matrix based on poly(2-hydroxyethyl methacrylate) and polyvinylpyrrolidone was investigated as delivery vehicle for controlled NA release into the gastrointestinal environment. The prepared hydrogel matrices varied in used monomer and crosslinker types and concentrations. The content of NA in tablets was between 65-80 %. The release profiles of NA from tablets were examined under three different pH values (1, 4.5 and 6.8) over the time period of 30 h. The effects of the monomer ratio, the crosslinking of the polymer network, and the solubility of niacin during drug release under various pH are discussed. The results showed that the release time period can be achieved in a relatively wide range of time and can be adjusted according to the medical requirements.
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Affiliation(s)
- J Sirc
- Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic, Prague, Czech Republic.
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Hrib J, Sirc J, Hobzova R, Hampejsova Z, Bosakova Z, Munzarova M, Michalek J. Nanofibers for drug delivery - incorporation and release of model molecules, influence of molecular weight and polymer structure. Beilstein J Nanotechnol 2015; 6:1939-45. [PMID: 26665065 PMCID: PMC4660903 DOI: 10.3762/bjnano.6.198] [Citation(s) in RCA: 45] [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] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 09/14/2015] [Indexed: 05/23/2023]
Abstract
Nanofibers were prepared from polycaprolactone, polylactide and polyvinyl alcohol using Nanospider(TM) technology. Polyethylene glycols with molecular weights of 2 000, 6 000, 10 000 and 20 000 g/mol, which can be used to moderate the release profile of incorporated pharmacologically active compounds, served as model molecules. They were terminated by aromatic isocyanate and incorporated into the nanofibers. The release of these molecules into an aqueous environment was investigated. The influences of the molecular length and chemical composition of the nanofibers on the release rate and the amount of released polyethylene glycols were evaluated. Longer molecules released faster, as evidenced by a significantly higher amount of released molecules after 72 hours. However, the influence of the chemical composition of nanofibers was even more distinct - the highest amount of polyethylene glycol molecules released from polyvinyl alcohol nanofibers, the lowest amount from polylactide nanofibers.
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Affiliation(s)
- Jakub Hrib
- The Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic, Heyrovsky Sq. 2, 162 06 Prague 6, Czech Republic
| | - Jakub Sirc
- The Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic, Heyrovsky Sq. 2, 162 06 Prague 6, Czech Republic
| | - Radka Hobzova
- The Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic, Heyrovsky Sq. 2, 162 06 Prague 6, Czech Republic
| | - Zuzana Hampejsova
- Department of Analytical Chemistry, Faculty of Science, Charles University in Prague, Albertov 2030, 128 43 Prague 2, Czech Republic
| | - Zuzana Bosakova
- Department of Analytical Chemistry, Faculty of Science, Charles University in Prague, Albertov 2030, 128 43 Prague 2, Czech Republic
| | - Marcela Munzarova
- Nanovia Ltd., Podkrusnohorska 271, 436 03 Litvinov-Chuderin, Czech Republic
| | - Jiri Michalek
- The Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic, Heyrovsky Sq. 2, 162 06 Prague 6, Czech Republic
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Pradny M, Vetrik M, Hruby M, Michalek J. Biodegradable Porous Hydrogels. Adv Healthc Mater 2014. [DOI: 10.1002/9781118774205.ch8] [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: 11/08/2022]
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Michalek J, Kristkova Z, Skopalik J, Dudasova Z, Darinskas A, Moster R. Stem cell therapy of osteoarthritis using stromal vascular fraction cells. Cytotherapy 2013. [DOI: 10.1016/j.jcyt.2013.01.040] [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: 10/27/2022]
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Nanda Kumar H, Van Sickle K, Parikh A, Louden C, Michalek J, Ayon A, Cohn S. Development of an Animal Model to Investigate Optimal Laparoscopic Trocar Site Fascial Closure. J Surg Res 2013. [DOI: 10.1016/j.jss.2012.10.187] [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: 10/27/2022]
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13
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Cejka C, Rosina J, Sirc J, Michalek J, Brunova B, Cejkova J. The Reversibility of UV-B Induced Alterations in Optical Properties of the Rabbit Cornea Depends on Dose of UV Irradiation. Photochem Photobiol 2012; 89:474-82. [DOI: 10.1111/php.12010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 10/08/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Cestmir Cejka
- Laboratory of Eye Histochemistry and Pharmacology; Institute of Experimental Medicine; Center of Excellence; Academy of Sciences of the Czech Republic; Prague; Czech Republic
| | - Josef Rosina
- Department of Medical Biophysics and Informatics; Faculty of Medicine; Charles University in Prague; Prague; Czech Republic
| | - Jakub Sirc
- Institute of Macromolecular Chemistry; Academy of Sciences of the Czech Republic; Prague; Czech Republic
| | - Jiri Michalek
- Institute of Macromolecular Chemistry; Academy of Sciences of the Czech Republic; Prague; Czech Republic
| | - Blanka Brunova
- Eye Clinic for Children and Adults; Faculty of Medicine; Charles University; Prague; Czech Republic
| | - Jitka Cejkova
- Laboratory of Eye Histochemistry and Pharmacology; Institute of Experimental Medicine; Center of Excellence; Academy of Sciences of the Czech Republic; Prague; Czech Republic
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Sirc J, Kubinova S, Hobzova R, Stranska D, Kozlik P, Bosakova Z, Marekova D, Holan V, Sykova E, Michalek J. Controlled gentamicin release from multi-layered electrospun nanofibrous structures of various thicknesses. Int J Nanomedicine 2012; 7:5315-25. [PMID: 23071393 PMCID: PMC3469095 DOI: 10.2147/ijn.s35781] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Polyvinyl alcohol nanofibers incorporating the wide spectrum antibiotic gentamicin were prepared by Nanospider™ needleless technology. A polyvinyl alcohol layer, serving as a drug reservoir, was covered from both sides by polyurethane layers of various thicknesses. The multilayered structure of the nanofibers was observed using scanning electron microscopy, the porosity was characterized by mercury porosimetry, and nitrogen adsorption/desorption measurements were used to determine specific surface areas. The stability of the gentamicin released from the electrospun layers was proved by high-performance liquid chromatography (HPLC) and inhibition of bacterial growth. Drug release was investigated using in vitro experiments with HPLC/MS quantification, while the antimicrobial efficacy was evaluated on Gram-positive Staphylococcus aureus and Gram-negative Pseudomonas aeruginosa. Both experiments proved that the released gentamicin retained its activity and showed that the retention of the drug in the nanofibers was prolonged with the increasing thickness of the covering layers.
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Affiliation(s)
- Jakub Sirc
- Department of Polymer Gels, Institute of Macromolecular Chemistry, Academy of Science of the Czech Republic, Prague, Czech Republic.
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Hobzova R, Duskova-Smrckova M, Michalek J, Karpushkin E, Gatenholm P. Methacrylate hydrogels reinforced with bacterial cellulose. POLYM INT 2012. [DOI: 10.1002/pi.4199] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kumar HN, Corneille M, Michalek J, Louden C, Stewart R, Wolf S. Nonlinear Statistical Algorithms Improve Probability of Survival Prediction Using TRISS Variables. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.412] [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: 11/26/2022]
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Hobzova R, Pradny M, Zhunusbekova NM, Sirc J, Guryca V, Michalek J. Bioactive support for cell cultivation and potential grafting. Part 1: Surface modification of 2-hydroxyethyl methacrylate hydrogels for avidin immobilization. e-Polymers 2011. [DOI: 10.1515/epoly.2011.11.1.474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractSynthetic hydrogels are often used in biomedical applications as many of them are compatible with living tissue and moreover they can meet most criteria for artificial tissue properties. For applications in tissue engineering modification of polymer surface using some bioactive compounds (e.g. saccharides, proteins) for promoting the process of cell adhesion and proliferation is widely used. In this work, a series of modified hydrogels was prepared by three different methods: by copolymerization of 2-hydroxyethyl methacrylate with methacrylic acid, by hydrolysis and oxidation of poly(2-hydroxyethyl methacrylate) to obtain carboxyl-rich supports. The influence of the reaction conditions of the hydrogel surface treatment on the total carboxylic group content and the swelling degree was studied. The modified hydrogels were characterized by attenuated total reflectance FT-IR spectroscopy and refractive index measurements. Obtained carboxylic groups on the hydrogel surface have allowed the immobilization of avidin in two ways: 1) electrostatically through dissociated carboxylic groups and 2) covalently bonded through activated carboxylic groups by Nhydroxysuccinimide. The capacity of hydrogels for avidin immobilization was determined by Bradford spectrophotometric method. The results so far obtained from the preliminary biological tests showed that immobilized avidin on the hydrogel surface provides better adhesion and proliferation of keratinocytes compared to supports without avidin.
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Affiliation(s)
- Radka Hobzova
- 1Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic, Heyrovsky sq. 2, 162 06, Prague 6, Czech Republic
- 2Centre for Cell Therapy and Tissue Repair, 2nd Faculty of Medicine, Charles University in Prague, V Uvalu 84, 150 06, Prague 5, Czech Republic
| | - Martin Pradny
- 1Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic, Heyrovsky sq. 2, 162 06, Prague 6, Czech Republic
- 2Centre for Cell Therapy and Tissue Repair, 2nd Faculty of Medicine, Charles University in Prague, V Uvalu 84, 150 06, Prague 5, Czech Republic
| | - Nazym M. Zhunusbekova
- 3Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic, Heyrovsky sq. 2, 162 06, Prague 6, Czech Republic
| | - Jakub Sirc
- 1Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic, Heyrovsky sq. 2, 162 06, Prague 6, Czech Republic
- 2Centre for Cell Therapy and Tissue Repair, 2nd Faculty of Medicine, Charles University in Prague, V Uvalu 84, 150 06, Prague 5, Czech Republic
| | - Vilem Guryca
- 3Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic, Heyrovsky sq. 2, 162 06, Prague 6, Czech Republic
| | - Jiri Michalek
- 1Institute of Macromolecular Chemistry, Academy of Sciences of the Czech Republic, Heyrovsky sq. 2, 162 06, Prague 6, Czech Republic
- 2Centre for Cell Therapy and Tissue Repair, 2nd Faculty of Medicine, Charles University in Prague, V Uvalu 84, 150 06, Prague 5, Czech Republic
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Izbicka E, Streeper R, Diaz A, Campos D, Michalek J, Louden C, Long T, Baek S, Mussman R. PP 9 Men and women display different proteomic diagnostic profiles in non small cell lung cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72662-4] [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: 10/15/2022]
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Izbicka E, Streeper R, Diaz A, Campos D, Michalek J, Louden C, Long T, Baek S, Mussman R. 1424 POSTER Methods of Identification and Diagnosis of Lung Cancer Using Classification Systems. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70917-0] [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: 11/27/2022]
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Moran EA, Gostout CJ, McConico AL, Michalek J, Huebner M, Bingener J. Assessing the invasiveness of NOTES perforated viscus repair: a comparative study of NOTES and laparoscopy. Surg Endosc 2011; 26:103-9. [PMID: 21792716 DOI: 10.1007/s00464-011-1834-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 06/22/2011] [Indexed: 02/06/2023]
Abstract
BACKGROUND Natural orifice transluminal endoscopic surgery (NOTES) repair of perforated peptic ulcers may decrease surgical invasiveness and improve patient outcomes. METHODS Full thickness gastrotomy was created laparoscopically in swine followed by soilage time. Repair proceeded with a laparoscopic (n = 14) or the NOTES (n = 14) approach. For NOTES repair, the omentum was endoscopically pulled into the gastric lumen and clipped. Intraoperative and postoperative parameters were recorded, including arterial blood gas (ABG) analysis and serum samples for white blood cell (WBC), TNF-α, IL-1, and IL-6 analysis. RESULTS Twenty-four of 28 animals thrived to study completion. NOTES repair could not be accomplished in one animal. At necropsy, all repairs were intact. Blood pressure was equivalent between groups. Pulse examined during the last 30 min of each procedure revealed a slightly higher mean pulse in the animals undergoing NOTES procedures (NOTES, 102 ± 28; laparoscopy, 83 ± 24). ABG obtained at the conclusion of the procedure revealed a pH of 7.47 in NOTES animals and 7.43 in the laparoscopy animals (p = 0.06), a change from baseline in both groups. The final pCO(2) was lower in the NOTES group (NOTES, 40.62; laparoscopy, 47.49, p = 0.03). WBC counts were comparable on postoperative day (POD) 1 (NOTES, 21.1; laparoscopy, 19.0; p = 0.49). Mean TNF-α serum levels were equivalent at all time points between groups; however, TNF-α varied significantly from baseline to POD 7 (p = 0.002). CONCLUSION NOTES omental repair appears comparable to that of laparoscopy. The lower arterial pCO(2) at the conclusion of the NOTES procedure may be advantageous in critically ill patients.
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Affiliation(s)
- E A Moran
- Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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Holan V, Chudickova M, Trosan P, Svobodova E, Krulova M, Kubinova S, Sykova E, Sirc J, Michalek J, Juklickova M, Munzarova M, Zajicova A. Cyclosporine A-loaded and stem cell-seeded electrospun nanofibers for cell-based therapy and local immunosuppression. J Control Release 2011; 156:406-12. [PMID: 21802460 DOI: 10.1016/j.jconrel.2011.07.022] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 07/13/2011] [Accepted: 07/15/2011] [Indexed: 11/25/2022]
Abstract
Cyclosporine A (CsA), a potent immunosuppressive drug with low water solubility, was dissolved in poly(L-lactic acid) (PLA) solution, and nanofibers were fabricated from this mixture by electrospinning technology. The addition of CsA into the PLA solution and the conditions of the electrospinning process did not influence the structure of the nanofibers nor affect the pharmacological activity of CsA. Study of the CsA release behavior in culture medium showed a release for at least 96 h. After the topical application of CsA-loaded nanofibers on skin allografts in vivo, the release was significantly slower and about 35% of the drug was still retained in the nanofibers on day 8. The addition of CsA-loaded nanofibers into cultures of mouse spleen cells stimulated with Concanavalin A selectively inhibited T cell functions; the activity of stimulated macrophages or the growth of non-T-cell populations was not suppressed in the presence of CsA-loaded nanofibers. The covering of skin allografts with CsA-loaded nanofibers significantly attenuated the local production of the proinflammatory cytokines IL-2, IFN-γ and IL-17. These results suggest that CsA-loaded electrospun nanofibers can serve as effective drug carriers for the local/topical suppression of an inflammatory reaction and simultaneously could be used as scaffolds for cell-based therapy.
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Affiliation(s)
- Vladimir Holan
- Institute of Molecular Genetics, Academy of Sciences of the Czech Republic, 142 20 Prague, Czech Republic.
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Mikulkova Z, Praksova P, Stourac P, Bednarik J, Michalek J. Imbalance in T-cell and cytokine profiles in patients with relapsing-remitting multiple sclerosis. J Neurol Sci 2011; 300:135-41. [PMID: 20884014 DOI: 10.1016/j.jns.2010.08.053] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 08/01/2010] [Accepted: 08/25/2010] [Indexed: 01/31/2023]
Abstract
Multiple sclerosis (MS) is characterized by autoimmune attack leading to demyelination of the white matter in the central nervous system with devastating clinical consequences. Several immune-mediated destruction mechanisms were previously proposed including different T-cell subsets but complex view on immune system function in patients with MS is missing. In the present study, T-lymphocyte populations and pro-inflammatory as well as suppressive cytokine profiles were evaluated in detail in previously untreated patients with relapsing-remitting MS (RRMS). CD4(+) and CD8(+) naïve, central memory (Tcm), effector memory (Tem), terminal effector memory (Ttem), CD4(+) regulatory T-cells (Treg) and CD8(+) T-suppressor cells (Ts) were analysed using flow cytometry, and levels of ten plasma cytokines were determined using fluorescent bead-based immunoassay. We evaluated two groups of RRMS with minor (n=33) and major (n=25) clinical impairment and compared them with healthy controls (n=40) in order to detect any correlation between severity of MS clinical symptoms and immune disturbances. Significant differences were noted in CD4(+)CD45RA(+)CCR7(+) naïve T-cells, CD4(+)CD45RO(+)CCR7(-) and CD8(+)CD45RO(+)CCR7(-) Tem cells, while no differences were recognized in Tcm, Ttem, Treg and Ts cells in RRMS patients. Nine out of ten studied cytokines were disturbed in plasma samples of patients with RRMS. In conclusion, we demonstrate complex immune dysbalances in untreated MS patients.
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Affiliation(s)
- Z Mikulkova
- University Cell Immunotherapy Center, Babak Research Institute, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Republic
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Ocadlikova D, Kryukov F, Mollova K, Kovarova L, Buresdova I, Matejkova E, Penka M, Buchler T, Hajek R, Michalek J. Generation of myeloma-specific T cells using dendritic cells loaded with MUC1- and hTERT- drived nonapeptides or myeloma cell apoptotic bodies. Neoplasma 2010; 57:455-64. [PMID: 20568900 DOI: 10.4149/neo_2010_05_455] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Dendritic cells are able to induce anti-tumor immune responses by presenting tumor-specific antigens to T-lymphocytes. Various tumor-associated antigens have been studied in multiple myeloma in an effort to find a strong antigen capable of generating clinically meaningful responses in vaccinated patients. The aim of our study was to generate myeloma-specific cytotoxic T lymphocytes in vitro using dendritic cells loaded with peptide antigens or apoptotic bodies. Peripheral blood mononuclear cells from HLA-A2+ healthy donors were used for isolation and culture of dendritic cells (DCs) and T lymphocytes. DCs were loaded with hTERT- and MUC1-derived nonapeptides or apoptotic bodies from myeloma cells. Repeated stimulation of T lymphocytes led to their activation characterized by interferon-gamma production. Activated T lymphocytes were separated immunomagnetically and expanded in vitro. Specific cytotoxicity of the expanded T lymphocytes was tested against a myeloma cell line. There was evidence of cytotoxicity for all three types of antigens used for T lymphocyte priming and expansion. No statistically significant differences were observed in T lymphocyte cytotoxicity for any of the antigens. We present a method for the priming and expansion of myeloma-specific T lymphocytes using dendritic cells loaded with different types of tumor antigens. Cytotoxic T lymphocytes and/or activated dendritic cells generated by the described methods can be applied for cellular immunotherapy against multiple myeloma and other malignancies.
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Affiliation(s)
- D Ocadlikova
- University Cell Immunotherapy Center, Masaryk University, Brno, Czech Republic
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Mahalingam D, Beeram M, Rodon J, Sankhala K, Mita A, Benjamin D, Michalek J, Tolcher A, Wright J, Sarantopoulos J. 413 Phase II study evaluating the efficacy, safety and pharmacodynamic correlative study of dual anti-angiogenic inhibition using Bevacizumab (B) in combination with Sorafenib (S) in patients (pts) with advanced malignant melanoma. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)72120-0] [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: 11/25/2022] Open
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25
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Cumova J, Kovarova L, Potacova A, Buresova I, Kryukov F, Penka M, Michalek J, Hajek R. Optimization of immunomagnetic selection of myeloma cells from bone marrow using magnetic activated cell sorting. Int J Hematol 2010; 92:314-9. [DOI: 10.1007/s12185-010-0651-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 06/07/2010] [Accepted: 07/14/2010] [Indexed: 11/28/2022]
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Slaby O, Lakomy R, Fadrus P, Hrstka R, Kren L, Lzicarova E, Smrcka M, Svoboda M, Dolezalova H, Novakova J, Valik D, Vyzula R, Michalek J. MicroRNA-181 family predicts response to concomitant chemoradiotherapy with temozolomide in glioblastoma patients. Neoplasma 2010; 57:264-9. [PMID: 20353279 DOI: 10.4149/neo_2010_03_264] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
MicroRNAs are endogenously expressed regulatory noncoding RNAs. Previous studies showed altered expression levels of several microRNAs in glioblastomas. In this study, we examined the expression levels of selected microRNAs in 22 primary glioblastomas and six specimens of adult brain tissue by real-time PCR method. In addition, we examined methylation status of MGMT promoter by methylation-specific real-time PCR, as this has been shown to be a predictive marker in glioblastomas. MGMT methylation status was not correlated with response to concomitant chemoradiotherapy with temozolomide (RT/TMZ). MiR-221 (p=0.016), miR-222 (p=0.038), miR-181b (p=0.036), miR-181c (p=0.043) and miR-128a (p=0.001) were significantly down-regulated in glioblastomas. The most significant change was observed for up-regulation in miR-21 expression in glioblastomas (p<0.001). MiR-181b and miR-181c were significantly down-regulated in patients who responded to RT/TMZ (p=0.016; p=0.047, respectively) in comparison to patients with progredient disease. Our data indicate for the first time that expression levels of miR-181b and miR-181c could serve as a predictive marker of response to RT/TMZ therapy in glioblastoma patients.
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Affiliation(s)
- O Slaby
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
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Zajicova A, Pokorna K, Lencova A, Krulova M, Svobodova E, Kubinova S, Sykova E, Pradny M, Michalek J, Svobodova J, Munzarova M, Holan V. Treatment of ocular surface injuries by limbal and mesenchymal stem cells growing on nanofiber scaffolds. Cell Transplant 2010; 19:1281-90. [PMID: 20573307 DOI: 10.3727/096368910x509040] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Stem cell (SC) therapy represents a promising approach to treat a wide variety of injuries, inherited diseases, or acquired SC deficiencies. One of the major problems associated with SC therapy remains the absence of a suitable matrix for SC growth and transfer. We describe here the growth and metabolic characteristics of mouse limbal stem cells (LSCs) and mesenchymal stem cells (MSCs) growing on 3D nanofiber scaffolds fabricated from polyamide 6/12 (PA6/12). The nanofibers were prepared by the original needleless electrospun Nanospider technology, which enables to create nanofibers of defined diameter, porosity, and a basis weight. Copolymer PA6/12 was selected on the basis of the stability of its nanofibers in aqueous solutions, its biocompatibility, and its superior properties as a matrix for the growth of LSCs, MSCs, and corneal epithelial and endothelial cell lines. The morphology, growth properties, and viability of cells grown on PA6/12 nanofibers were comparable with those grown on plastic. LSCs labeled with the fluorescent dye PKH26 and grown on PA6/12 nanofibers were transferred onto the damaged ocular surface, where their seeding and survival were monitored. Cotransfer of LSCs with MSCs, which have immunosuppressive properties, significantly inhibited local inflammatory reactions and supported the healing process. The results thus show that nanofibers prepared from copolymer PA6/12 represent a convenient scaffold for growth of LSCs and MSCs and transfer to treat SC deficiencies and various ocular surface injuries.
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Affiliation(s)
- Alena Zajicova
- Institute of Molecular Genetics, Academy of Sciences, Prague, Czech Republic
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Jelinek J, Adkins I, Sebo P, Michalek J. In vitro activation of CMV-specific T-cell response using CyaA toxoids delivering peptide antigenic epitopes derived from pp65 protein. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6610] [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: 11/20/2022] Open
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Mahalingam D, Beeram M, Rodon J, Sankhala KK, Mita AC, Benjamin D, Michalek J, Tolcher AW, Wright JJ, Sarantopoulos J. Phase II study evaluating the efficacy, safety, and pharmacodynamic correlative study of dual antiangiogenic inhibition using bevacizumab (B) in combination with sorafenib (S) in patients (pts) with advanced malignant melanoma. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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30
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Malaska J, Kratochvil M, Kyr M, Jabandziev P, Otevrel F, Muriova K, Fedora M, Sramek V, Michalek J, Sevcik P. Cytokine response in severe sepsis: predicting and modelling the course of illness. Crit Care 2010. [PMCID: PMC2934342 DOI: 10.1186/cc8269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Slaby O, Sobkova K, Svoboda M, Garajova I, Fabian P, Hrstka R, Nenutil R, Sachlova M, Kocakova I, Michalek J, Smerdova T, Knoflickova D, Vyzula R. Significant overexpression of Hsp110 gene during colorectal cancer progression. Oncol Rep 2009; 21:1235-41. [PMID: 19360299 DOI: 10.3892/or_00000346] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Colorectal cancer (CRC) is one of the most frequent malignant diseases in the world. Metastatic spread of the cancer to the lymph nodes is a crucial factor for progression and therapeutic management of the disease. We analysed gene expression profiles of CRC patiens by low-density cancer-focused oligonucleotide microarrays to identify new predictive markers of the extent of the disease and for better understanding of CRC progression. Relative expression levels of 440 genes known to be involved in cancer biology were obtained by low-density oligonucleotide microarrays from 20 tumor samples. Statistical analysis of gene expression data identified 3 genes (HSP110, HYOU1 and TCTP) significantly up-regulated in primary tumors of patients who developed lymph node metastasis. We have shown, for the first time, that up-regulation HSP110 and HYOU1 expression is associated with lymph node involvement in CRC. We validated the differences in HSP110 expression in an independent group of 30 patients of all clinical stages by real-time PCR. We identified significant up-regulation of HSP110 expression in colorectal tumors compared to adjacent non-tumoral tissue (p<0.0003). We observed significant differences of HSP110 gene expression between metastatic and localized disease (p=0.031) and negative trend of HSP110 gene expression and overall survival of CRC patients. We suggest that HSP110 gene is a promising molecular predictor in CRC.
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Affiliation(s)
- O Slaby
- Masaryk Memorial Cancer Institute, Department of Oncological and Experimental Pathology, 656 53 Brno, Czech Republic.
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Meis T, Michalek J, Behr J, Leuchte H. Inhalation mit Endothelinrezeptor-Blockern bei artifizieller Pulmonaler Hypertonie – Untersuchungen am Modell der isolierten Kaninchenlunge. Pneumologie 2009. [DOI: 10.1055/s-0029-1214126] [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: 10/21/2022]
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Andel M, Grzeszczak W, Michalek J, Medvescek M, Norkus A, Rasa I, Niewada M, Kamiński B, Kraml P, Madacsy L. A multinational, multi-centre, observational, cross-sectional survey assessing diabetes secondary care in Central and Eastern Europe (DEPAC Survey). Diabet Med 2008; 25:1195-203. [PMID: 19046198 DOI: 10.1111/j.1464-5491.2008.02570.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AIMS The objective of this study was to assess diabetes care in outpatient diabetes clinics in the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia and Slovenia. METHODS Questionnaires for each randomly enrolled patient were completed by an endocrinologist or diabetologist. Data concerning age, sex, diabetes duration, diabetes type, treatment type, glycated haemoglobin (HbA(1c)), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C), blood pressure (BP) and short- and long-term diabetes complications were recorded. Questionnaires were analysed centrally for each country and stratified for Type 1 diabetes (T1D), Type 2 diabetes (T2D) and other types of diabetes. RESULTS Data on 10 950 individuals were analysed (mean population age 56.2 years; females 52%; T1D 22.9%; T2D 75.3%; mean time from diagnosis 11 years). Patients with HbA(1c) within target (< 6.5%): T1D 13.1%, T2D 21.4%; for TC levels (< 4.5 mmol/l): T1D 37%, T2D 20%; for TG levels (< 1.7 mmol/l): T1D 78%, T2D 44%; for HDL-C (> 1.1 mmol/l): T1D 81%, T2D 60%; for LDL-C (< 2.5 mmol/l): T1D 36%, T2D 23%; for BP (< 130/80 mm Hg): T1D 42%, T2D 9%. The prevalence of severe hypoglycaemia (within the last 6 months) was 12% in T1D and 2% in T2D. Prevalence of diabetic ketoacidosis was 0.3-6.6%, blindness 0.15-1.3% and diabetic nephropathy 19-42%. CONCLUSIONS The data show the current quality of care and potential areas for improvement. The quality of care is generally comparable with that in Western Europe.
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Affiliation(s)
- M Andel
- Center for Research of Diabetes, Metabolism and Nutrition and 2nd Department of Internal Medicine, Third Faculty of Medicine, Charles University Prague, Czech Republic.
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Hanak L, Michalek J, Matejkova E, Foltankova V, Lauerova L, Vitetta E. Safe allogeneic hematopoietic stem cell transplantation for renal cell carcinoma: Novel approach using selective depletion of alloreactive donor T cells. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.19509] [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: 11/20/2022] Open
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35
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Vrabelova Z, Hrotekova Z, Hladikova Z, Bohmova K, Stechova K, Michalek J. CD 127−and FoxP3+Expression on CD25+CD4+T Regulatory Cells upon Specific Diabetogeneic Stimulation in High-risk Relatives of Type 1 Diabetes Mellitus Patients. Scand J Immunol 2008; 67:404-10. [DOI: 10.1111/j.1365-3083.2008.02074.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Hejcl A, Urdzikova L, Sedy J, Lesny P, Pradny M, Michalek J, Burian M, Hajek M, Zamecnik J, Jendelova P, Sykova E. Acute and delayed implantation of positively charged 2-hydroxyethyl methacrylate scaffolds in spinal cord injury in the rat. J Neurosurg Spine 2008; 8:67-73. [PMID: 18173349 DOI: 10.3171/spi-08/01/067] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECT Hydrogels are nontoxic, chemically inert synthetic polymers with a high water content and large surface area that provide mechanical support for cells and axons when implanted into spinal cord tissue. METHODS Macroporous hydrogels based on 2-hydroxyethyl methacrylate (HEMA) were prepared by radical copolymerization of monomers in the presence of fractionated NaCl particles. Male Wistar rats underwent complete spinal cord transection at the T-9 level. To bridge the lesion, positively charged HEMA hydrogels were implanted either immediately or 1 week after spinal cord transection; control animals were left untreated. Histological evaluation was performed 3 months after spinal cord transection to measure the volume of the pseudocyst cavities and the ingrowth of tissue elements into the hydrogels. RESULTS The hydrogel implants adhered well to the spinal cord tissue. Histological evaluation showed ingrowth of connective tissue elements, blood vessels, neurofilaments, and Schwann cells into the hydrogels. Morphometric analysis of lesions showed a statistically significant reduction in pseudocyst volume in the treated animals compared with controls and in the delayed treatment group compared with the immediate treatment group (p < 0.001 and p < 0.05, respectively). CONCLUSIONS Positively charged HEMA hydrogels can bridge a posttraumatic spinal cord cavity and provide a scaffold for the ingrowth of regenerating axons. The results indicate that delayed implantation can be more effective than immediate reconstructive surgery.
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Affiliation(s)
- Ales Hejcl
- Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Czech Republic.
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Sirc J, Bosakova Z, Coufal P, Michalek J, Pradny M, Hobzova R, Hradil J. Morphological and chromatographic characterization of molecularly imprinted monolithic columns. e-Polymers 2007. [DOI: 10.1515/epoly.2007.7.1.1356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractThe chromatographic stationary phases based on molecularly imprinted monoliths were prepared by free radical polymerization and subsequently characterized. The mixture of commonly used comonomers of ethylene dimethacrylate/methacrylic acid was polymerized in presence of various porogenic mixtures. Tosyl-L-phenylalanine was selected as a model template. Polymerization steps were carried out in the glass columns (i.d. of 3.3 mm) enabling UV initiation. Difficulties encountered with polymerization in situ, e.g. volume contraction and adhesion of polymer onto the glass inner wall, were successfully solved. The morphology of monoliths was investigated by electron microscopy, mercury porosimetry and surface area measurements. The influence of polymerization conditions on monolith morphology and subsequent chromatographic properties was evaluated. Polymers prepared by UV polymerization showed higher total porosity and the most frequent pore radius compared to the same polymers prepared thermally. The prepared monoliths by UV irradiation were also significantly more permeable for mobile phase during the chromatography tests. Morphology of monoliths prepared in dodecanol/toluene porogenic mixture markedly depended on the temperature of polymerization; the most frequent pore radius decreased with increasing temperature. From chromatographic point of view, monolithic columns were tested by separations of standard hydrophobic solutes. Height equivalent to a theoretical plate reached the values of approx. 25 μm, Walters indices of hydrophobicity laid slightly above 3. Prepared monoliths were compared to the conventional columns, filled with the particles prepared from the polymer of the same composition and preparation. In many cases the monolithic columns showed better chromatographic parameters.
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Affiliation(s)
- Jakub Sirc
- 1Charles University, Faculty of Science, Department of Analytical Chemistry, Albertov 2030, 128 40 Prague 2, Czech Republic
- 2Institute of Macromolecular Chemistry, Academy of Sciences, Heyrovsky sq. 2, 162 06 Prague 6 - Brevnov, Czech Republic
| | - Zuzana Bosakova
- 3Charles University, Faculty of Science, Department of Analytical Chemistry, Albertov 2030, 128 40 Prague 2, Czech Republic
| | - Pavel Coufal
- 3Charles University, Faculty of Science, Department of Analytical Chemistry, Albertov 2030, 128 40 Prague 2, Czech Republic
| | - Jiri Michalek
- 2Institute of Macromolecular Chemistry, Academy of Sciences, Heyrovsky sq. 2, 162 06 Prague 6 - Brevnov, Czech Republic
| | - Martin Pradny
- 2Institute of Macromolecular Chemistry, Academy of Sciences, Heyrovsky sq. 2, 162 06 Prague 6 - Brevnov, Czech Republic
| | - Radka Hobzova
- 2Institute of Macromolecular Chemistry, Academy of Sciences, Heyrovsky sq. 2, 162 06 Prague 6 - Brevnov, Czech Republic
| | - Jiri Hradil
- 2Institute of Macromolecular Chemistry, Academy of Sciences, Heyrovsky sq. 2, 162 06 Prague 6 - Brevnov, Czech Republic
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Dudova S, Kovarova L, Horvath R, Penka M, Hajek R, Michalek J. P134 Amino acid sequences of T cell receptor reacting against multiple myeloma. Blood Rev 2007. [DOI: 10.1016/s0268-960x(07)70212-6] [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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Michalek J, Vrabelova Z, Hrotekova Z, Kyr M, Pejchlova M, Kolouskova S, Faresjö M, Stechova K. Immune Regulatory T Cells in Siblings of Children Suffering from Type 1 Diabetes Mellitus. Scand J Immunol 2006; 64:531-5. [PMID: 17032246 DOI: 10.1111/j.1365-3083.2006.01837.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Patients with type 1 diabetes are suffering from defects in immune regulatory cells. Their siblings may be at increased risk of type 1 diabetes especially if they are carriers of certain human leucocyte antigen (HLA) alleles. In a prospective non-randomized study, we intended to evaluate 31 healthy siblings of paediatric patients with type 1 diabetes and explore immune regulatory populations of CD4+CD25+ T cells and natural killer (NK) T cells. Tested siblings of type 1 diabetes patients were stratified according to the HLA-associated risk of possible diabetes development. Immune regulatory function of CD4+CD25+ T cells was tested in vitro. Significant differences in CD4+CD25+ but not in NK T cells have been identified. Siblings of type 1 diabetes patients carrying high risk HLA alleles (DQA1*05, DQB1*0201, DQB1*0302) had significantly lower number of immune regulatory CD4+CD25+ T cells than the age-matched healthy controls or siblings carrying low-risk HLA alleles (DQB1*0301, DQB1*0603, DQB1*0602). Regulatory function of CD4+CD25+ T cells demonstrated a dose-escalation effect. In siblings of type 1 diabetes patients, the defect in immune regulatory CD4+CD25+ T cells exists in association with genetic HLA-linked risk for type 1 diabetes.
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Affiliation(s)
- J Michalek
- 1st Department of Pediatrics, Masaryk University, Brno, Czech Republic.
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Vaclavkova P, Cao Y, Wu LK, Michalek J, Vitetta ES. A comparison of an anti-CD25 immunotoxin, Ontak and anti-CD25 microbeads for their ability to deplete alloreactive T cells in vitro. Bone Marrow Transplant 2006; 37:559-67. [PMID: 16444279 DOI: 10.1038/sj.bmt.1705286] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Ex vivo depletion of alloreactive CD25(+) T cells from a stem cell transplant (SCT) can reduce the incidence of graft-versus-host disease (GVHD) while preserving antimicrobial and perhaps antileukemia activity. However, the most effective methods for allodepleting T cells prior to transplant have not been determined. In this study, we have compared three agents that deplete CD25(+) activated, alloreactive T cells. These included Ontak (Denileukin Diftitox), an IL-2 fusion toxin, anti-CD25 microbeads (MACS), an anti-CD25 immunotoxin (IT) and a combination of the IT and MACS. Peripheral blood mononuclear cells (PBMCs) activated in a primary mixed lymphocyte reaction (MLR) were allodepleted using optimal amounts of each agent, and the cells were then analyzed by flow cytometry. The treated cells were examined both for remaining alloreactivity and for the preservation of third party reactivity by testing them in a secondary MLR. Our data demonstrate that both the anti-CD25 IT and the anti-CD25 MACS were equally effective in depleting CD4(+)CD25(+) cells and in sparing T cells that were reactive with third party cells. The anti-CD25 IT was, however, superior in depleting alloreactive CD8(+)CD25(+) cells. In contrast, Ontak did not eliminate alloreactive cells and the Ontak-treated cells retained significant reactivity against the original stimulator cells.
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Affiliation(s)
- P Vaclavkova
- The Cancer Immunobiology Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Ocadlikova D, Zahradova L, Kovarova L, Penka M, Zaloudik J, Buchler T, Hajek R, Michalek J. Isolation and Expansion of Allogeneic Myeloma-Specific Interferon-Gamma Producing T Cells for Adoptive Immunotherapy. Med Oncol 2006; 23:377-84. [PMID: 17018895 DOI: 10.1385/mo:23:3:377] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2005] [Revised: 11/30/1999] [Accepted: 01/26/2006] [Indexed: 11/11/2022]
Abstract
Adoptive immunotherapy is a promising approach in the treatment of multiple myeloma. We have tested the identification, separation, and expansion of allogeneic myeloma-specific T cells in vitro. Irradiated myeloma cell line ARH 77 has been used to stimulate allogeneic CD4(+) and CD8(+) T lymphocytes. Activated myeloma-specific T cells that produced interferon-gamma were isolated using immunomagnetic beads and further expanded in vitro to numbers of up to 400 x 106 T cells. Specificity of the T lymphocytes was tested using a 5-(6-)carboxyfluoresceine diacetate succinimidyl ester (CFSE)-based cytotoxicity test. This study demonstrates the feasibility of identification and isolation of tumor-specific T cells from allogeneic donors that can be expanded in vitro to numbers useful for clinical applications.
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Affiliation(s)
- Darina Ocadlikova
- Laboratory of Experimental Hematology and Cell Immunotherapy, Department of Clinical Hematology, University Hospital, Brno, Czech Republic.
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Elbl L, Hrstkova H, Chaloupka V, Novotny J, Michalek J. The evaluation of left ventricular function in childhood cancer survivors by pharmacological stress echocardiography. Neoplasma 2003; 50:191-7. [PMID: 12937852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Late cardiotoxicity after anthracycline chemotherapy for childhood cancer is well recognized sequelae. Many long-term survivors may have subclinical cardiac dysfunction undetectable at a baseline evaluation. Various tests have been utilized for the diagnosis of left ventricular impairment. Recently, low-dose dobutamine stress echocardiography has been proposed as a more sensitive screening test. We have applied low-dose dobutamine stress echocardiography (5-10 microg/kg/min) in 36 asymptomatic survivors (20 male/16 female aged 14.6+/-4.7 years) treated with a cumulative dose of 226+/-106 mg/m2 of doxorubicin. The median follow-up was 5 years. Control group consisted of 20 sex and age matched volunteers (12 male/8 female aged 12.6+/-4.9 years). We found significant differences in mean velocity of circumferential fibre shortening, myocardial performance index (Tei index), left ventricular posterior wall thickening and endsystolic wall stress at a baseline. The stress response was significantly blunted only in a patient group in the following parameters: endsystolic wall stress, isovolumic relaxation time and myocardial performance index. The threshold response was abnormal (0-5% improvement of a variable only) in 45% of subjects from a control group in one or two parameters. On the contrary, 63% of subjects from a patient group responded pathologically (the worsening of a variable) in one or more parameters. We have not found a good correlation between risk factors of late cardiotoxicity and stress changes of left ventricular function parameters. Low-dose dobutamine stress echocardiography is safe and feasible diagnostic tool in children and adolescents. Dobutamine significantly increases the differences in cardiac variables between healthy population and asymptomatic survivors for childhood cancer. In comparison to the controls, most asymptomatic patients revealed subclinical myocardial damage at test. The predictive value for the development of clinical symptoms and cardiac complications need to be assessed in a large prospective study.
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Affiliation(s)
- L Elbl
- Department of Cardiopulmonary Testing, Faculty Hospital Brno, 639 00 Brno, Czech Republic.
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Michalek J, Collins RH, Durrani HP, Vaclavkova P, Ruff LE, Douek DC, Vitetta ES. Definitive separation of graft-versus-leukemia- and graft-versus-host-specific CD4+ T cells by virtue of their receptor beta loci sequences. Proc Natl Acad Sci U S A 2003; 100:1180-4. [PMID: 12531922 PMCID: PMC298747 DOI: 10.1073/pnas.0337543100] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2002] [Indexed: 11/18/2022] Open
Abstract
Although graft-versus-host (GVH) disease (GVHD) is usually associated with graft versus leukemia (GVL), GVL can occur in the absence of clinical GVHD. There is evidence to suggest that GVL and GVH are mediated by different clones of T cells. The objective of this study was to identify the two types of T cells based on their receptor sequences. To this end we used irradiated nonleukemic cells from recipients as stimulator cells in a primary mixed leukocyte reaction (MLR). The activated CD4(+) donor T cells that expressed CD25 were purified by cell sorting. To prepare GVL-specific T cells, alloreactive T cells in the primary MLR were first depleted with an anti-CD25 immunotoxin. The remaining T cells had negligible alloreactivity in a secondary MLR. The allodepleted cells were then stimulated by using purified leukemia cells from the same individual as stimulator cells, and the CD25(+)-activated cells were purified by cell sorting. The GVL- and GVH-specific T cells were analyzed for their T cell receptor (TCR) clonality by using anchored RT-PCR of all the TCRbeta locus complementarity-determining region 3 (CDR3) sequences. By comparing TCRbeta CDR3 sequences from transformed bacterial colonies, we were able to demonstrate that T cells mediating GVH were different from those mediating GVL in each of the eight HLA-mismatched and one HLA-matched donor/recipient pairs. By using the appropriate TCRbeta CDR3-specific primers and probes, the GVH- and GVL-specific clones were monitored in a recipient undergoing an allogeneic stem cell transplant from her HLA-matched related donor.
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Affiliation(s)
- J Michalek
- Cancer Immunobiology Center and Bone Marrow Transplant Program, Department of Internal Medicine, University of Texas Southwestern Medical Center, 6000 Harry Hines Boulevard, Dallas, TX 75390, USA
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Abstract
OBJECTIVES To reanalyze in a similar manner the two principal studies of TCDD (tetrachlorodibenzo-p-dioxin) and diabetes in an attempt to reconcile disparate results. METHODS Data from 990 United States Air Force veterans (Ranch Hand) and 1275 referents were reanalyzed, and a NIOSH population of 267 chemical workers and 227 referents. The Ranch Hand veterans had lower concentrations of lipid adjusted serum TCDD (median 12 parts per trillion (ppt)) than the NIOSH workers (median 75 ppt) when examined in the late 1980s. An analysis was conducted of the combined data sets, adopting a uniform approach to outcome definition, data analysis, and covariate control. RESULTS The combined exposed groups did not differ markedly from the combined non-exposed groups for prevalence of diabetes (odds ratio (OR) 1.17, 95% confidence interval (95% CI) 0.92 to 1.48), with no evidence of heterogeneity of exposure effect between studies. Also virtually no difference was found between combined exposed and non-exposed groups in mean fasting serum glucose (difference in log serum glucose 0.002, 95% CI -0.006 to 0.010), and there was little evidence in either study of a dose-response trend for fasting serum glucose. An increasing trend was found (p=0.0001) in prevalence of diabetes with increased TCDD (at the time of examination or at time of last exposure) among the Ranch Hand population, with excess risk largely confined to the highest 8% of the exposed group (>78 ppt serum TCDD), which had an OR of 3.21 (95% CI 1.81 to 5.72) versus those with <10 ppt TCDD. However, no such positive dose-response was found in the NIOSH population. CONCLUSIONS There was little overall evidence that the exposed workers were at higher risk than the non-exposed workers of diabetes or abnormal fasting glucose. However, the Ranch Hand subjects showed a positive dose-response for diabetes, whereas the more highly exposed NIOSH subjects did not. The reason for the difference in diabetes dose-response trends between the two studies is unknown.
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Affiliation(s)
- K Steenland
- National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
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Bithoney WG, McJunkin J, Michalek J, Snyder J, Egan H, Epstein D. The effect of a multidisciplinary team approach on weight gain in nonorganic failure-to-thrive children. J Dev Behav Pediatr 1991; 12:254-8. [PMID: 1939681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Failure-to-thrive (FTT) is a chronic symptom accounting for 1% of all patients admitted to pediatric hospitals. FTT, which is traditionally attributed to organic (OFTT) and/or nonorganic (NFTT) causes, results in undernutrition. Undernutrition has potentially serious effects on child development, behavior, and cognitive skills. We undertook a study of children with FTT to determine whether multidisciplinary team treatment resulted in improved weight gain compared with children treated in a primary care setting. Fifty-three children with NFTT referred to our outpatient FTT consultative clinic and 107 children with NFTT identified as comparison subjects from our primary care clinic (PCC) were enrolled in the study. Growth outcomes over a 6-month follow-up were analyzed using growth quotient (GQ) analysis. Children followed in the multidisciplinary team clinic grew better (GQ = 1.75 +/- 0.39 SD) than did children in the PCC (GQ = 1.18 +/- 0.42 SD, p less than .001). The use of a multidisciplinary team offers special advantages in the rapid correction of undernutrition in children with NFTT.
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Affiliation(s)
- W G Bithoney
- Children's Hospital, Boston, Massachusetts 02115
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Bithoney WG, McJunkin J, Michalek J, Egan H, Snyder J, Munier A. Prospective evaluation of weight gain in both nonorganic and organic failure-to-thrive children: an outpatient trial of a multidisciplinary team intervention strategy. J Dev Behav Pediatr 1989; 10:27-31. [PMID: 2925865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Failure-to-thrive (FTT) is categorized as organic (OFTT) or nonorganic (NFTT). Traditionally, it has been taught that children with OFTT are unable to grow well in spite of adequate care (calories, nurturance, medical supervision), whereas NFTT children will grow well when given adequate care. We undertook this study to determine whether NFTT and OFTT children could grow at similar rates when treated by a specialized multidisciplinary team that provided concrete, individualized therapies including psychosocial support, medical care, and hypercaloric diets. Eighty-six children were enrolled on referral to our outpatient FTT consultative clinic; 64 had NFTT and 22 had OFTT. Growth quotient analysis was used to determine growth outcomes over a 6-month follow-up period. Growth at a rate paralleling the growth curve produces a GQ equal to 1. Growth 2 times as rapid as expected gives a GQ = 2. Children in both groups grew extremely well. For NFTT, GQ = 1.67 +/- 0.56 (SD); for OFTT, GQ = 1.81 +/- 0.37 (SD), p = NS. OFTT children grew just as well as NFTT children when given adequate calories for catch-up growth. Our data indicate that weight gain alone cannot reliably differentiate OFTT from NFTT, as has been traditionally taught. They suggest that we make every attempt to maximize caloric intake in FTT children. They also suggest that a multidisciplinary team consisting of a pediatrician, child psychiatrist, nutritionist, nurse clinician, and social worker may be successful in managing FTT children.
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Affiliation(s)
- W G Bithoney
- Comprehensive Child Health Program, Children's Hospital, Boston, MA 02115
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Abstract
Familial, child developmental, and demographic concomitants of serious ingestions in preschool children were measured in 23 hospitalized children and controls matched on age, race, and socioeconomic status. A precoded maternal interview focused on family stress, parental discipline, parental emotional history, as well as childhood temperament and social maturity. A regression analysis was performed on variables that discriminated between ingestion cases and controls. Sixteen variables from the regression equation were entered into a stepwise discriminant function analysis. Significant descriptors of ingestion victims included the following: lack of extended family low Vineland Social Maturity quotient, few maternal opportunities to escape caregiving, good health, a high frequency of physical punishment in the mother's childhood, and increased current advocacy needs. Using these six variables as a screening device, the discriminant function correctly classified 87% of the subjects as either cases or controls. These data suggest that ingestions are symptoms of familial and, especially of maternal, distress. These healthy, active, but delayed children appear to overwhelm their caregivers.
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Abstract
For 1704 patients with large bowel cancer compiled by the Armed Forces Central Medical Registry, selected prognostic factors were related to five-year or longer survival. The majority of late deaths (those occurring after five years) resulted from cancer in the descending colon, sigmoid colon or rectum rather than from cancer in the right or transverse colon. For example, among all patients with cancer of the rectum, 15.4% of those with Dukes' B tumors and 10.9% of those with Dukes' C tumors died of rectal cancer between five and ten years after diagnosis. When late survival rates were compared, patients with right and transverse colon cancer (8 deaths/93 at risk) fared significantly better than those with left colon and rectal cancer (33 deaths/171 at risk; P = 0.01). Among patients with left-sided colon and rectal carcinoma, a further significant difference in late survival was found when stage of disease was considered: patients with Dukes' A cancers (3 deaths/47 at risk after five years) fared better than those with Dukes' C cancers (21 deaths/74 at risk) (P = 0.002). For Dukes' B and C stages of disease, patients with left colon and rectal cancer fared worse than those with right and transverse colon lesions after 60 months. Of all patients who died of large bowel cancer after five years, 69% had a recurrence of cancer by 60 months, and most late recurrences were located in the descending and sigmoid colon and in the rectum. These results show differences in survival after five years with respect to both site of cancer in the colon and stage of initial disease. Our findings indicate that many left-sided large bowel cancers have a slowly progressive natural history.
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Abstract
For 1704 patients with large bowel cancer compiled by the Armed Forces Central Medical Registry, selected prognostic factors were related to five-year or longer survival. The majority of late deaths (those occurring after five years) resulted from cancer in the descending colon, sigmoid colon or rectum rather than from cancer in the right or transverse colon. For example, among all patients with cancer of the rectum, 15.4% of those with Dukes' B tumors and 10.9% of those with Dukes' C tumors died of rectal cancer between five and ten years after diagnosis. When late survival rates were compared, patients with right and transverse colon cancer (8 deaths/93 at risk) fared significantly better than those with left colon and rectal cancer (33 deaths/171 at risk; P = 0.01). Among patients with left-sided colon and rectal carcinoma, a further significant difference in late survival was found when stage of disease was considered: patients with Dukes' A cancers (3 deaths/47 at risk after five years) fared better than those with Dukes' C cancers (21 deaths/74 at risk) (P = 0.002). For Dukes' B and C stages of disease, patients with left colon and rectal cancer fared worse than those with right and transverse colon lesions after 60 months. Of all patients who died of large bowel cancer after five years, 69% had a recurrence of cancer by 60 months, and most late recurrences were located in the descending and sigmoid colon and in the rectum. These results show differences in survival after five years with respect to both site of cancer in the colon and stage of initial disease. Our findings indicate that many left-sided large bowel cancers have a slowly progressive natural history.
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