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Das PJ, Sagal KM, Blanton KL, Naidu AS, Pavlis W, Goyert JW, Reynolds CW, Schmitzberger F, Ramanathan V, Heisler M. U.S. medical student knowledge and interest in asylum seeker medical care. Educ Prim Care 2022; 33:364-368. [PMID: 36307973 DOI: 10.1080/14739879.2022.2137856] [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: 12/24/2022]
Abstract
CONTEXT Asylum seekers face significant and unique healthcare challenges, requiring healthcare practitioners, specifically in primary care, to be trained to care for this patient population. However, there is limited understanding of medical students' interest in and future ability to care for the population of asylum seekers in the United States. PROJECT AIMS We aim to understand U.S. medical students' interest, experience, and knowledge in providing care for asylum seekers to assess the need for change in the ways in which medical schools introduce asylum seeker care to learners. DESCRIPTION A 23-question survey was administered to U.S. medical students at four institutions with asylum programmes affiliated with Physicians for Human Rights (PHR) from June 2020 to March 2021, querying various aspects of providing care to asylum seekers. OUTCOMES Of the approximately 2846 students who received the survey, 436 students (15%) completed it in its entirety. Most respondents desired training about caring for asylum seekers (91%). Over half (52%) rated their knowledge of asylum issues overall as 'poor' or 'none', and 73% thought their medical school's curriculum on asylum seeker health needed improvement. CONCLUSIONS Medical students at schools with affiliated asylum clinics desire to care for asylum seeker patients but feel unprepared to do so, highlighting an unmet need for formal asylum education in U.S. medical schools.
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Affiliation(s)
- Porag J Das
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Kyra M Sagal
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | | | - Anika S Naidu
- Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, USA
| | - William Pavlis
- School of Medicine, University of Miami Miller, Miami, FL, USA
| | - Joshua W Goyert
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Vidya Ramanathan
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Michele Heisler
- Physicians for Human Rights, Ann Arbor, MI, USA.,Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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Goyert JW, Bell HN, Shah YM. PCL22-188: Reuterin in the Healthy Gut Microbiome Suppresses Colorectal Cancer Growth Through Altering Redox Balance. J Natl Compr Canc Netw 2022. [DOI: 10.6004/jnccn.2021.7207] [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: 11/17/2022]
Affiliation(s)
| | | | - Yatrik M. Shah
- 1 University of Michigan, Ann Arbor, MI
- 2 University of Michigan Rogel Cancer Center, University of Michigan, Ann Arbor, MI
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3
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Schwartz AJ, Goyert JW, Solanki S, Kerk SA, Chen B, Castillo C, Hsu PP, Do BT, Singhal R, Dame MK, Lee HJ, Spence JR, Lakhal-Littleton S, Vander Heiden MG, Lyssiotis CA, Xue X, Shah YM. Hepcidin sequesters iron to sustain nucleotide metabolism and mitochondrial function in colorectal cancer epithelial cells. Nat Metab 2021; 3:969-982. [PMID: 34155415 PMCID: PMC8316354 DOI: 10.1038/s42255-021-00406-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 05/11/2021] [Indexed: 02/05/2023]
Abstract
Colorectal cancer (CRC) requires massive iron stores, but the complete mechanisms by which CRC modulates local iron handling are poorly understood. Here, we demonstrate that hepcidin is activated ectopically in CRC. Mice deficient in hepcidin specifically in the colon tumour epithelium, compared with wild-type littermates, exhibit significantly diminished tumour number, burden and size in a sporadic model of CRC, whereas accumulation of intracellular iron by deletion of the iron exporter ferroportin exacerbates these tumour parameters. Metabolomic analysis of three-dimensional patient-derived CRC tumour enteroids indicates a prioritization of iron in CRC for the production of nucleotides, which is recapitulated in our hepcidin/ferroportin mouse CRC models. Mechanistically, our data suggest that iron chelation decreases mitochondrial function, thereby altering nucleotide synthesis, whereas exogenous supplementation of nucleosides or aspartate partially rescues tumour growth in patient-derived enteroids and CRC cell lines in the presence of an iron chelator. Collectively, these data suggest that ectopic hepcidin in the tumour epithelium establishes an axis to sequester iron in order to maintain the nucleotide pool and sustain proliferation in colorectal tumours.
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Affiliation(s)
- Andrew J Schwartz
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Joshua W Goyert
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Sumeet Solanki
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Samuel A Kerk
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Brandon Chen
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Cristina Castillo
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Peggy P Hsu
- University of Michigan Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
| | - Brian T Do
- Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, MA, USA
- Koch Institute for Integrative Cancer Research and Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Rashi Singhal
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Michael K Dame
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
| | - Ho-Joon Lee
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Jason R Spence
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
| | | | - Matthew G Vander Heiden
- Koch Institute for Integrative Cancer Research and Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
| | - Costas A Lyssiotis
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
- University of Michigan Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
| | - Xiang Xue
- Department of Biochemistry and Molecular Biology, University of New Mexico, Albuquerque, NM, USA.
| | - Yatrik M Shah
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA.
- University of Michigan Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA.
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Devenport SN, Singhal R, Radyk MD, Taranto JG, Kerk SA, Chen B, Goyert JW, Jain C, Das NK, Oravecz-Wilson K, Zhang L, Greenson JK, Chen YE, Soleimanpour SA, Reddy P, Lyssiotis CA, Shah YM. Colorectal cancer cells utilize autophagy to maintain mitochondrial metabolism for cell proliferation under nutrient stress. JCI Insight 2021; 6:e138835. [PMID: 34138755 PMCID: PMC8328084 DOI: 10.1172/jci.insight.138835] [Citation(s) in RCA: 15] [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: 04/06/2020] [Accepted: 06/16/2021] [Indexed: 12/19/2022] Open
Abstract
Cancer cells reprogram cellular metabolism to maintain adequate nutrient pools to sustain proliferation. Moreover, autophagy is a regulated mechanism to break down dysfunctional cellular components and recycle cellular nutrients. However, the requirement for autophagy and the integration in cancer cell metabolism is not clear in colon cancer. Here, we show a cell-autonomous dependency of autophagy for cell growth in colorectal cancer. Loss of epithelial autophagy inhibits tumor growth in both sporadic and colitis-associated cancer models. Genetic and pharmacological inhibition of autophagy inhibits cell growth in colon cancer–derived cell lines and patient-derived enteroid models. Importantly, normal colon epithelium and patient-derived normal enteroid growth were not decreased following autophagy inhibition. To couple the role of autophagy to cellular metabolism, a cell culture screen in conjunction with metabolomic analysis was performed. We identified a critical role of autophagy to maintain mitochondrial metabolites for growth. Loss of mitochondrial recycling through inhibition of mitophagy hinders colon cancer cell growth. These findings have revealed a cell-autonomous role of autophagy that plays a critical role in regulating nutrient pools in vivo and in cell models, and it provides therapeutic targets for colon cancer.
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Affiliation(s)
- Samantha N Devenport
- Cellular and Molecular Biology.,Departments of Molecular & Integrative Physiology
| | | | | | | | | | - Brandon Chen
- Cellular and Molecular Biology.,Departments of Molecular & Integrative Physiology
| | | | - Chesta Jain
- Departments of Molecular & Integrative Physiology
| | - Nupur K Das
- Departments of Molecular & Integrative Physiology
| | | | - Li Zhang
- Departments of Molecular & Integrative Physiology
| | | | | | | | - Pavan Reddy
- Hematology & Oncology.,Rogel Cancer Center, and
| | - Costas A Lyssiotis
- Departments of Molecular & Integrative Physiology.,Rogel Cancer Center, and.,Internal Medicine, Division of Gastroenterology, University of Michigan Medical School, Ann Arbor Michigan, USA
| | - Yatrik M Shah
- Cellular and Molecular Biology.,Departments of Molecular & Integrative Physiology.,Rogel Cancer Center, and.,Internal Medicine, Division of Gastroenterology, University of Michigan Medical School, Ann Arbor Michigan, USA
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Huang B, Faucette AN, Pawlitz MD, Pei B, Goyert JW, Zhou JZ, El-Hage NG, Deng J, Lin J, Yao F, Dewar RS, Jassal JS, Sandberg ML, Dai J, Cols M, Shen C, Polin LA, Nichols RA, Jones TB, Bluth MH, Puder KS, Gonik B, Nayak NR, Puscheck E, Wei WZ, Cerutti A, Colonna M, Chen K. Interleukin-33-induced expression of PIBF1 by decidual B cells protects against preterm labor. Nat Med 2017; 23:128-135. [PMID: 27918564 PMCID: PMC5512431 DOI: 10.1038/nm.4244] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/03/2016] [Indexed: 12/12/2022]
Abstract
Preterm birth (PTB) is a leading cause of neonatal death worldwide. Intrauterine and systemic infection and inflammation cause 30-40% of spontaneous preterm labor (PTL), which precedes PTB. Although antibody production is a major immune defense mechanism against infection, and B cell dysfunction has been implicated in pregnancy complications associated with PTL, the functions of B cells in pregnancy are not well known. We found that choriodecidua of women undergoing spontaneous PTL harbored functionally altered B cell populations. B cell-deficient mice were markedly more susceptible than wild-type (WT) mice to PTL after inflammation, but B cells conferred interleukin (IL)-10-independent protection against PTL. B cell deficiency in mice resulted in a lower uterine level of active progesterone-induced blocking factor 1 (PIBF1), and therapeutic administration of PIBF1 mitigated PTL and uterine inflammation in B cell-deficient mice. B cells are a significant producer of PIBF1 in human choriodecidua and mouse uterus in late gestation. PIBF1 expression by B cells is induced by the mucosal alarmin IL-33 (ref. 9). Human PTL was associated with diminished expression of the α-chain of IL-33 receptor on choriodecidual B cells and a lower level of active PIBF1 in late gestation choriodecidua. These results define a vital regulatory cascade involving IL-33, decidual B cells and PIBF1 in safeguarding term pregnancy and suggest new therapeutic approaches based on IL-33 and PIBF1 to prevent human PTL.
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Affiliation(s)
- Bihui Huang
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Azure N Faucette
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Michael D Pawlitz
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Bo Pei
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Joshua W Goyert
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Jordan Zheng Zhou
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Nadim G El-Hage
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Jie Deng
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jason Lin
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Fayi Yao
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Robert S Dewar
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Japnam S Jassal
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Maxwell L Sandberg
- Leadership in Medicine Program, Union College, Schenectady, New York, USA
| | - Jing Dai
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Montserrat Cols
- Immunology Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Cong Shen
- Immunology Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lisa A Polin
- Department of Oncology, Wayne State University, Detroit, Michigan, USA
| | - Ronald A Nichols
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
- Department of Obstetrics and Gynecology-Med Ed, Beaumont Dearborn Hospital, Dearborn, Michigan, USA
| | - Theodore B Jones
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
- Department of Obstetrics and Gynecology-Med Ed, Beaumont Dearborn Hospital, Dearborn, Michigan, USA
| | - Martin H Bluth
- Department of Pathology, Wayne State University, Detroit, Michigan, USA
| | - Karoline S Puder
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Bernard Gonik
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Nihar R Nayak
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Elizabeth Puscheck
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
| | - Wei-Zen Wei
- Department of Oncology, Wayne State University, Detroit, Michigan, USA
| | - Andrea Cerutti
- Catalan Institute for Research and Advanced Studies, Barcelona Biomedical Research Park, Barcelona, Spain
- Program for Inflammatory and Cardiovascular Disorders, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Mucosal Immunology Studies Team, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Marco Colonna
- Mucosal Immunology Studies Team, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kang Chen
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
- Department of Oncology, Wayne State University, Detroit, Michigan, USA
- Mucosal Immunology Studies Team, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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