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Al Balushi M, Ahmad A, Javaid S, Ahmed L, Al Maskari F, Abdulle A, Ali R. The association between body fat percentage and self-reported depression in the United Arab Emirates. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The United Arab Emirates Healthy Future Study (UAEHFS) is one of the first large prospective cohort studies in the region which examines causes and risk factors for chronic diseases among adult UAE nationals. The aim of this study was to explore the relationship between body fat percentage (BF%) and the eight-item Patient Health Questionnaire (PHQ-8) as a screening instrument for depression among the UAEHFS pilot study participants.
Methods
We analyzed the UAEHFS pilot data to investigate the association between BF% and PHQ-8 adjusted for age and gender. We used multivariate logistic ordinal regression model. To impute missing values, 100 multiple imputations (MI) were performed using multivariate imputation of classification and regression tree. The statistical analysis was performed using R Statistical Software (version 4.2.0)
Results
Out of 517 participants, data from 487 (94.2%) were analyzed after excluding participants who didn't fill out the questionnaires. The median age was 30 years (Interquartile Range: 23 - 38). There were more males (67.8%) than females in the UAEHF pilot data. Approximately, 64 (13.1%) of the participant reported depression. The prevalence of obesity was 35.2% in this study population. The estimated odds ratio of BF% from the fitted multivariate logistic ordinal regression model was OR = 1.046 (95% CI: 1.012-1.08), and OR = 1.03 (95% CI: 1.003-1.057) for the omitted data, and MI (sensitivity analysis) respectively.
Conclusions
High body fat percentage was statistically significantly associated with high risk of reporting depression. Additional research is needed, using the main UAEHFS data (after recruitment is complete), to further investigate the association between body fat percentage and depression.
Key messages
• Our results can help contribute to the knowledge based on current and potential population mental health in the UAE and Gulf Region.
• The main finding of this study that excess body fat is associated with an increased risk of developing depression and vice versa; thus, this could add to the future direction of mental health research.
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Affiliation(s)
- M Al Balushi
- Public Health Research Center, New York University Abu Dhabi , Abu Dhabi, United Arab Emirates
- Institute of Public Health, United Arab Emirates University , Abu Dhabi, United Arab Emirates
| | - A Ahmad
- Public Health Research Center, New York University Abu Dhabi , Abu Dhabi, United Arab Emirates
| | - S Javaid
- Department of Mental Health, United Arab Emirates University , Abu Dhabi, United Arab Emirates
| | - L Ahmed
- Institute of Public Health, United Arab Emirates University , Abu Dhabi, United Arab Emirates
| | - F Al Maskari
- Institute of Public Health, United Arab Emirates University , Abu Dhabi, United Arab Emirates
| | - A Abdulle
- Public Health Research Center, New York University Abu Dhabi , Abu Dhabi, United Arab Emirates
| | - R Ali
- Public Health Research Center, New York University Abu Dhabi , Abu Dhabi, United Arab Emirates
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El Mabrouk Y, Miladi S, Fazaa A, Sallemi M, Souebni L, Kmar O, Selma K, Selma C, Ben A, Ahmed L. Fertilité et morbidités obstétricales chez les femmes suivies pour spondyloarthrite. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.138] [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: 10/18/2022]
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ASMA H, Mariem B, Nouha B, Manel B, Insaf H, Ahmed L, Mouna H, Sabra A, Habib S. POS-929 FOUR CASES OF SEVERE INFECTIONS AFTER RECENT COVID19. Kidney Int Rep 2022. [PMCID: PMC8854940 DOI: 10.1016/j.ekir.2022.01.969] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Fazaa A, Ben Messaoud F, Miladi S, Souabni L, Ouenniche K, Kassab S, Chekili S, Ben Abdelghani K, Ahmed L. Impact de l’arthrite juvénile idiopathique sur la scolarité. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.044] [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: 10/19/2022]
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Ahmed L, El-Mokadem B, Khattab M, El-Abhar H. Quercetin enhances the efficacy of telmisartan in myocardial ischaemia/reperfusion injury in rats. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The clinical outcome of myocardial ischaemia/reperfusion (I/R) injury is still unpredictable and detrimental despite the use of several agents including renin-angiotensin system inhibitors. Quercetin (QN), one of the most prevalent flavonoids, has attracted great attention in the recent years due to its protective role against I/R injury. Interestingly, a recent experimental study showed an important role for β-catenin in the regulation of myocardial I/R injury following heterotopic heart transplantation.
Purpose
The present investigation was directed to estimate the role GSK-3β/β-catenin signaling as a possible mechanistic pathway, through which QN could modulate the therapeutic effect of telmisartan (Tel) in myocardial I/R injury in rats.
Methods
Myocardial I/R was induced by ligation of the left descending coronary artery for 30 min followed by reperfusion for 2 h. Rats were pretreated with Tel (12 mg/kg/day, po), QN (25 mg/kg/day) or a combination of both agents for 3 days before the experiment. Electrocardiographic abnormalities were assessed at the end of ischemic and reperfusion periods. Animals were then sacrificed to assess the cardiac injury surrogate markers; viz., serum CK-MB and cTn-I levels and cardiac energy content (ATP) as well as oxidative stress (ROS, MDA, SOD and TAC), inflammation-related (TNF-α, NF-κB, ICAM-1 and MPO) and apoptotic markers (caspase 3 and Bcl-2). Moreover, the hallmark of fibrosis (TGF-β1) was estimated in addition to GSK-3β/β-catenin signaling. Finally, histological examinations were performed to assess the severity of myocardial damage.
Results
Combined Tel/QN therapy showed an additional improvement compared to each therapy alone (p<0.05) toward reducing myocardial I/R-induced oxidative stress, inflammatory, fibrogenic, and apoptotic markers which subsequently restored Wnt/β-catenin signaling through inhibition of GSK-3β upregulation together with spiking up of β-catenin content. All these changes were associated with restoration of myocardial energy content and prevention of I/R-induced damage in histological examination.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- L Ahmed
- Cairo university, Cairo, Egypt
| | - B El-Mokadem
- Faculty of Pharmacy, Ahram Canadian University, Pharmacology and Toxicology, Giza, Egypt
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Blø M, Nilsson LH, Jackson A, Boniecka A, Toombs J, Ahmed L, Mydel P, Marti H, Brekken R, Gabra H, Lorens J, Micklem D, Gausdal G. Tilvestamab, a novel clinical stage humanized anti-AXL function blocking antibody. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31192-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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7
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Mezhal F, Ahmed L, Jabari A, Alzaabi T, Alblooshi M, Alhosani A, Ali R. The Epidemiology and Burden of Cardiometabolic Risk factors in a Young Emirati Population. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The United Arab Emirates (UAE) has experienced a rapid growth in economy. This growth was paralleled with a drastic rise in non-communicable diseases (NCDs); primarily cardiovascular disease, which accounts for 40% of mortality in UAE. These NCDs are caused by the accumulation of cardiometabolic risk factors (CRFs) such as obesity, dysglycemia, dyslipidemia, hypertension and central obesity. The CRFs are associated with other factors including sociodemography, physical inactivity, tobacco use, and heredity.
Objective
The objective is to investigate the burden of CRFs and their interrelationship, and to estimate the association with other determinants like sociodemographic status, lifestyle and family history.
Methods
Data was drawn from the UAE Healthy Future Study participants aged 18 to 40. Demographic and health data was collected by questionnaires. Measurements, blood pressure, and blood samples were collected. CRFs were analyzed by age and gender.
Results
A total of 5,126 eligible participants were included in the analysis. The age-adjusted prevalence rates were 26.5% for obesity, 11.7% for dysglycemia, 62.7% for dyslipidemia, 22.4% for hypertension and 22.5% for central obesity. Obesity had the strongest relationship with other metabolic factors. Education, employment, smoking and family history had associations with some metabolic markers. Forty percent had ≥2 risk factors. The burden of ≥ 2 CRFs was affected by age (OR 1.1), having lower education (OR 1.37) and having a family history (OR 1.44).
Conclusions
CRFs are highly prevalent in young adults in the UAE. These risk factors are accumulating and are affected by multiple determinants. Obesity is highly associated with having other CRFs simultaneously. This should be taken into account in the design of target-group-specific prevention of NCD development. Further research is needed to investigate how the clustering manifests in young adults to prevent the early rise of NCDs in the UAE.
Key messages
Cardiovascular disease and associated risk factors are highly prevalent in the young population (18-40) of the UAE. The clustering of cardiometabolic risk factors occurs early in young people in UAE.
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Affiliation(s)
- F Mezhal
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - L Ahmed
- Institute of Public Health, United Arab Emirates University, Al Aain, United Arab Emirates
| | - A Jabari
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - T Alzaabi
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - M Alblooshi
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - A Alhosani
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - R Ali
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
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Khan MA, Ahmed L, Mandal PK, Smith R, Haque M. Modelling the dynamics of Pine Wilt Disease with asymptomatic carriers and optimal control. Sci Rep 2020; 10:11412. [PMID: 32651402 PMCID: PMC7351782 DOI: 10.1038/s41598-020-67090-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 05/19/2020] [Indexed: 01/20/2023] Open
Abstract
Pine wilt disease is a lethal tree disease caused by nematodes carried by pine sawyer beetles. Once affected, the trees are destroyed within a few months, resulting in significant environmental and economic losses. The role of asymptomatic carrier trees in the disease dynamics remains unclear. We developed a mathematical model to investigate the effect of asymptomatic carriers on the long-term outcome of the disease. We performed a stability and sensitivity analysis to identify key parameters and used optimal control to examine several intervention options. Our model shows that, with the application of suitable controls, the disease can be eliminated in the vector population and all tree populations except for asymptomatic carriers. Of the possible controls (tree injection, elimination of infected trees, insecticide spraying), we determined that elimination of infected trees is crucial. However, if the costs of insecticide spraying increase, it can be supplemented (although not replaced entirely) by tree injection, so long as some spraying is still undertaken.
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Affiliation(s)
- Muhammad Altaf Khan
- Informetrics Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam
- Faculty of Mathematics and Statistics, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - L Ahmed
- Department of Mathematics, City University of Science and Information Technology, Peshawar, Pakistan
| | | | - Robert Smith
- Department of Mathematics and Faculty of Medicine, The University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Mainul Haque
- Department of Mathematics and Physics University of Portsmouth, Portsmouth, PO1 2UP, UK.
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, McKinstry S, Milligan W, Ooi L, Rafiq NM, Sammut T, Sinclair E, Smith M, Baker C, Boulton APR, Collins J, Copley HC, Fearnhead N, Fox H, Mah T, McKenna J, Naruka V, Nigam N, Nourallah B, Perera S, Qureshi A, Saggar S, Sun L, Wang X, Yang DD, Caroll P, Doyle C, Elangovan S, Falamarzi A, Perai KG, Greenan E, Jain D, Lang-Orsini M, Lim S, O'Byrne L, Ridgway P, Van der Laan S, Wong J, Arthur J, Barclay J, Bradley P, Edwin C, Finch E, Hayashi E, Hopkins M, Kelly D, Kelly M, McCartan N, Ormrod A, Pakenham A, Hayward J, Hitchen C, Kishore A, Martins T, Philomen J, Rao R, Rickards C, Burns N, Copeland M, Durand C, Dyal A, Ghaffar A, Gidwani A, Grant M, Gribbon C, Gruhn A, Leer M, Ahmad K, Beattie G, Beatty M, Campbell G, Donaldson G, Graham S, Holmes D, Kanabar S, Liu H, McCann C, Stewart R, Vara S, Ajibola-Taylor O, Andah EJE, Ani C, Cabdi NMO, Ito G, Jones M, Komoriyama A, Patel P, Titu L, Basra M, Gallogly P, Harinath G, Leong SH, Pradhan A, Siddiqui I, Zaat S, Ali A, Galea M, Looi WL, Ng JCK, Atkin G, Azizi A, Cargill Z, China Z, Elliot J, Jebakumar R, Lam J, Mudalige G, Onyerindu C, Renju M, Babu VS, Hussain M, Joji N, Lovett B, Mownah H, Ali B, Cresswell B, Dhillon AK, Dupaguntla YS, Hungwe C, Lowe-Zinola JD, Tsang JCH, Bevan K, Cardus C, Duggal A, Hossain S, McHugh M, Scott M, Chan F, Evans R, Gurung E, Haughey B, Jacob-Ramsdale B, Kerr M, Lee J, McCann E, O'Boyle K, Reid N, Hayat F, Hodgson S, Johnston R, Jones W, Khan M, Linn T, Long S, Seetharam P, Shaman S, Smart B, Anilkumar A, Davies J, Griffith J, Hughes B, Islam Y, Kidanu D, Mushaini N, Qamar I, Robinson H, Schramm M, Tan CY, Apperley H, Billyard C, Blazeby JM, Cannon SP, Carse S, Göpfert A, Loizidou A, Parkin J, Sanders E, Sharma S, Slade G, Telfer R, Huppatz IW, Worley E, Chandramoorthy L, Friend C, Harris L, Jain P, Karim MJ, Killington K, McGillicuddy J, Rafferty C, Rahunathan N, Rayne T, Varathan Y, Verma N, Zanichelli D, Arneill M, Brown F, Campbell B, Crozier L, Henry J, McCusker C, Prabakaran P, Wilson R, Asif U, Connor M, Dindyal S, Math N, Pagarkar A, Saleem H, Seth I, Sharma S, Standfield N, Swartbol T, Adamson R, Choi JE, El Tokhy O, Ho W, Javaid NR, Kelly M, Mehdi AS, Menon D, Plumptre I, Sturrock S, Turner J, Warren O, Crane E, Ferris B, Gadsby C, Smallwood J, Vipond M, Wilson V, Amarnath T, Doshi A, Gregory C, Kandiah K, Powell B, Spoor H, Toh C, Vizor R, Common M, Dunleavy K, Harris S, Luo C, Mesbah Z, Kumar AP, Redmond A, Skulsky S, Walsh T, Daly D, Deery L, Epanomeritakis E, Harty M, Kane D, Khan K, Mackey R, McConville J, McGinnity K, Nixon G, Ang A, Kee JY, Leung E, Norman S, Palaniappan SV, Sarathy PP, Yeoh T, Frost J, Hazeldine P, Jones L, Karbowiak M, Macdonald C, Mutarambirwa A, Omotade A, Runkel M, Ryan G, Sawers N, Searle C, Suresh S, Vig S, Ahmad A, McGartland R, Sim R, Song A, Wayman J, Brown R, Chang LH, Concannon K, Crilly C, Arnold TJ, Burgin A, Cadden F, Choy CH, Coleman M, Lim D, Luk J, Mahankali-Rao P, Prudence-Taylor AJ, Ramakrishnan D, Russell J, Fawole A, Gohil J, Green B, Hussain A, McMenamin L, McMenamin L, Tang M, Azmi F, Benchetrit S, Cope T, Haque A, Harlinska A, Holdsworth R, Ivo T, Martin J, Nisar T, Patel A, Sasapu K, Trevett J, Vernet G, Aamir A, Bird C, Durham-Hall A, Gibson W, Hartley J, May N, Maynard V, Johnson S, Wood CM, O'Brien M, Orbell J, Stringfellow TD, Tenters F, Tresidder S, Cheung W, Grant A, Tod N, Bews-Hair M, Lim ZH, Lim SW, Vella-Baldacchino M, Auckburally S, Chopada A, Easdon S, Goodson R, McCurdie F, Narouz M, Radford A, Rea E, Taylor O, Yu T, Alfa-Wali M, Amani L, Auluck I, Bruce P, Emberton J, Kumar R, Lagzouli N, Mehta A, Murtaza A, Raja M, Dennahy IS, Frew K, Given A, He YY, Karim MA, MacDonald E, McDonald E, McVinnie D, Ng SK, Pettit A, Sim DPY, Berthaume-Hawkins SD, Charnley R, Fenton K, Jones D, Murphy C, Ng JQ, Reehal R, Robinson H, Seraj SS, Shang E, Tonks A, White P, Yeo A, Chong P, Gabriel R, Patel N, Richardson E, Symons L, Aubrey-Jones D, Dawood S, Dobrzynska M, Faulkner S, Griffiths H, Mahmood F, Patel P, Perry M, Power A, Simpson R, Ali A, Brobbey P, Burrows A, Elder P, Ganyani R, Horseman C, Hurst P, Mann H, Marimuthu K, McBride S, Pilsworth E, Powers N, Stanier P, Innes R, Kersey T, Kopczynska M, Langasco N, Patel N, Rajagopal R, Atkins B, Beasley W, Lim ZC, Gill A, Ang HL, Williams H, Yogeswara T, Carter R, Fam M, Fong J, Latter J, Long M, Mackinnon S, McKenzie C, Osmanska J, Raghuvir V, Shafi A, Tsang K, Walker L, Bountra K, Coldicutt O, Fletcher D, Hudson S, Iqbal S, Bernal TL, Martin JWB, Moss-Lawton F, Smallwood J, Vipond M, Cardwell A, Edgerton K, Laws J, Rai A, Robinson K, Waite K, Ward J, Youssef H, Knight C, Koo PY, Lazarou A, Stanger S, Thorn C, Triniman MC, Botha A, Boyles L, Cumming S, Deepak S, Ezzat A, Fowler AJ, Gwozdz AM, Hussain SF, Khan S, Li H, Morrell BL, Neville J, Nitiahpapand R, Pickering O, Sagoo H, Sharma E, Welsh K, Denley S, Khan S, Agarwal M, Al-Saadi N, Bhambra R, Gupta A, Jawad ZAR, Jiao LR, Khan K, Mahir G, Singagireson S, Thoms BL, Tseu B, Wei R, Yang N, Britton N, Leinhardt D, Mahfooz M, Palkhi A, Price M, Sheikh S, Barker M, Bowley D, Cant M, Datta U, Farooqi M, Lee A, Morley G, Amin MN, Parry A, Patel S, Strang S, Yoganayagam N, Adlan A, Chandramoorthy S, Choudhary Y, Das K, Feldman M, France B, Grace R, Puddy H, Soor P, Ali M, Dhillon P, Faraj A, Gerard L, Glover M, Imran H, Kim S, Patrick Y, Peto J, Prabhudesai A, Smith R, Tang A, Vadgama N, Dhaliwal R, Ecclestone T, Harris A, Ong D, Patel D, Philp C, Stewart E, Wang L, Wong E, Xu Y, Ashaye T, Fozard T, Galloway F, Kaptanis S, Mistry P, Nguyen T, Olagbaiye F, Osman M, Philip Z, Rembacken R, Tayeh S, Theodoropoulou K, Herman A, Lau J, Saha A, Trotter M, Adeleye O, Cave D, Gunwa T, Magalhães J, Makwana S, Mason R, Parish M, Regan H, Renwick P, Roberts G, Salekin D, Sivakumar C, Tariq A, Liew I, McDade A, Stewart D, Hague M, Hudson-Peacock N, Jackson CES, James F, Pitt J, Walker EY, Aftab R, Ang JJ, Anwar S, Battle J, Budd E, Chui J, Crook H, Davies P, Easby S, Hackney E, Ho B, Imam SZ, Rammell J, Andrews H, Perry C, Schinle P, Ahmed P, Aquilina T, Balai E, Church M, Cumber E, Curtis A, Davies G, Dennis Y, Dumann E, Greenhalgh S, Kim P, King S, Metcalfe KHM, Passby L, Redgrave N, Soonawalla Z, Waters S, Zornoza A, Gulzar I, Hole J, Hull K, Ishaq H, Karaj J, Kelkar A, Love E, Patel S, Thakrar D, Vine M, Waterman A, Dib NP, Francis N, Hanson M, Ingleton R, Sadanand KS, Sukirthan N, Arnell S, Ball M, Bassam N, Beghal G, Chang A, Dawe V, George A, Huq T, Hussain A, Ikram B, Kanapeckaite L, Khan M, Ramjas D, Rushd A, Sait S, Serry M, Yardimci E, Capella S, Chenciner L, Episkopos C, Karam E, McCarthy C, Moore-Kelly W, Watson N, Ahluwalia V, Barnfield J, Ben-Gal O, Bloom I, Gharatya A, Khodatars K, Merchant N, Moonan A, Moore M, Patel K, Spiers H, Sundaram K, Turner J, Bath MF, Black J, Chadwick H, Huisman L, Ingram H, Khan S, Martin L, Metcalfe M, Sangal P, Seehra J, Thatcher A, Venturini S, Whitcroft I, Afzal Z, Brown S, Gani A, Gomaa A, Hussein N, Oh SY, Pazhaniappan N, Sharkey E, Sivagnanasithiyar T, Williams C, Yeung J, Cruddas L, Gurjar S, Pau A, Prakash R, Randhawa R, Chen L, Eiben I, Naylor M, Osei-Bordom D, Trenear R, Bannard-Smith J, Griffiths N, Patel BY, Saeed F, Abdikadir H, Bennett M, Church R, Clements SE, Court J, Delvi A, Hubert J, Macdonald B, Mansour F, Patel RR, Perris R, Small S, Betts A, Brown N, Chong A, Croitoru C, Grey A, Hickland P, Ho C, Hollington D, McKie L, Nelson AR, Stewart H, Eiben P, Nedham M, Ali I, Brown T, Cumming S, Hunt C, Joyner C, McAlinden C, Roberts J, Rogers D, Thachettu A, Tyson N, Vaughan R, Verma N, Yasin T, Andrew K, Bhamra N, Leong S, Mistry R, Noble H, Rashed F, Walker NR, Watson L, Worsfold M, Yarham E, Abdikadir H, Arshad A, Barmayehvar B, Cato L, Chan-lam N, Do V, Leong A, Sheikh Z, Zheleniakova T, Coppel J, Hussain ST, Mahmood R, Nourzaie R, Prowle J, Sheik-Ali S, Thomas A, Alagappan A, Ashour R, Bains H, Diamond J, Gordon J, Ibrahim B, Khalil M, Mittapalli D, Neo YN, Patil P, Peck FS, Reza N, Swan I, Whyte M, Chaudhry S, Hernon J, Khawar H, O'Brien J, Pullinger M, Rothnie K, Ujjal S, Bhatte S, Curtis J, Green S, Mayer A, Watkinson G, Chapple K, Hawthorne T, Khaliq M, Majkowski L, Malik TAM, Mclauchlan K, En BNW, Parton S, Robinson SD, Saat MI, Shurovi BN, Varatharasasingam K, Ward AE, Behranwala K, Bertelli M, Cohen J, Duff F, Fafemi O, Gupta R, Manimaran M, Mayhew J, Peprah D, Wong MHY, Farmer N, Houghton C, Kandhari N, Khan K, Ladha D, Mayes J, McLennan F, Panahi P, Seehra H, Agrawal R, Ahmed I, Ali S, Birkinshaw F, Choudhry M, Gokani S, Harrogate S, Jamal S, Nawrozzadeh F, Swaray A, Szczap A, Warusavitarne J, Abdalla M, Asemota N, Cullum R, Hartley M, Maxwell-Armstrong C, Mulvenna C, Phillips J, Yule A, Ahmed L, Clement KD, Craig N, Elseedawy E, Gorman D, Kane L, Livie J, Livie V, Moss E, Naasan A, Ravi F, Shields P, Zhu Y, Archer M, Cobley H, Dennis R, Downes C, Guevel B, Lamptey E, Murray H, Radhakrishnan A, Saravanabavan S, Sardar M, Shaw C, Tilliridou V, Wright R, Ye W, Alturki N, Helliwell R, Jones E, Kelly D, Lambotharan S, Scott K, Sivakumar R, Victor L, Boraluwe-Rallage H, Froggatt P, Haynes S, Hung YMA, Keyte A, Matthews L, Evans E, Haray P, John I, Mathivanan A, Morgan L, Oji O, Okorocha C, Rutherford A, Spiers H, Stageman N, Tsui A, Whitham R, Amoah-Arko A, Cecil E, Dietrich A, Fitzpatrick H, Guy C, Hair J, Hilton J, Jawad L, McAleer E, Taylor Z, Yap J, Akhbari M, Debnath D, Dhir T, Elbuzidi M, Elsaddig M, Glace S, Khawaja H, Koshy R, Lal K, Lobo L, McDermott A, Meredith J, Qamar MA, Vaidya A, Acquaah F, Barfi L, Carter N, Gnanappiragasam D, Ji C, Kaminski F, Lawday S, Mackay K, Sulaiman SK, Webb R, Ananthavarathan P, Dalal F, Farrar E, Hashemi R, Hossain M, Jiang J, Kiandee M, Lex J, Mason L, Matthews JH, McGeorge E, Modhwadia S, Pinkney T, Radotra A, Rickard L, Rodman L, Sales A, Tan KL, Bachi A, Bajwa DS, Battle J, Brown LR, Butler A, Calciu A, Davies E, Gardner I, Girdlestone T, Ikogho O, Keelan G, O'Loughlin P, Tam J, Elias J, Ngaage M, Thompson J, Bristow S, Brock E, Davis H, Pantelidou M, Sathiyakeerthy A, Singh K, Chaudhry A, Dickson G, Glen P, Gregoriou K, Hamid H, Mclean A, Mehtaji P, Neophytou G, Potts S, Belgaid DR, Burke J, Durno J, Ghailan N, Hanson M, Henshaw V, Nazir UR, Omar I, Riley BJ, Roberts J, Smart G, Van Winsen K, Bhatti A, Chan M, D'Auria M, Green S, Keshvala C, Li H, Maxwell-Armstrong C, Michaelidou M, Simmonds L, Smith C, Wimalathasan A, Abbas J, Cairns C, Chin YR, Connelly A, Moug S, Nair A, Svolkinas D, Coe P, Subar D, Wang H, Zaver V, Brayley J, Cookson P, Cunningham L, Gaukroger A, Ho M, Hough A, King J, O'Hagan D, Widdison A, Brown R, Brown B, Chavan A, Francis S, Hare L, Lund J, Malone N, Mavi B, McIlwaine A, Rangarajan S, Abuhussein N, Campbell HS, Daniels J, Fitzgerald I, Mansfield S, Pendrill A, Robertson D, Smart YW, Teng T, Yates J, Belgaumkar A, Katira A, Kossoff J, Kukran S, Laing C, Mathew B, Mohamed T, Myers S, Novell R, Phillips BL, Thomas M, Turlejski T, Turner S, Varcada M, Warren L, Wynell-Mayow W, Church R, Linley-Adams L, Osborn G, Saunders M, Spencer R, Srikanthan M, Tailor S, Tullett A, Ali M, Al-Masri S, Carr G, Ebhogiaye O, Heng S, Manivannan S, Manley J, McMillan LE, Peat C, Phillips B, Thomas S, Whewell H, Williams G, Bienias A, Cope EA, Courquin GR, Day L, Garner C, Gimson A, Harris C, Markham K, Moore T, Nadin T, Phillips C, Subratty SM, Brown K, Dada J, Durbacz M, Filipescu T, Harrison E, Kennedy ED, Khoo E, Kremel D, Lyell I, Pronin S, Tummon R, Ventre C, Walls L, Wootton E, Akhtar A, Davies E, El-Sawy D, Farooq M, Gaddah M, Griffiths H, Katsaiti I, Khadem N, Leong K, Williams I, Chean CS, Chudek D, Desai H, Ellerby N, Hammad A, Malla S, Murphy B, Oshin O, Popova P, Rana S, Ward T, Abbott TEF, Akpenyi O, Edozie F, El Matary R, English W, Jeyabaladevan S, Morgan C, Naidu V, Nicholls K, Peroos S, Prowle J, Sansome S, Torrance HD, Townsend D, Brecher J, Fung H, Kazmi Z, Outlaw P, Pursnani K, Ramanujam N, Razaq A, Sattar M, Sukumar S, Tan TSE, Chohan K, Dhuna S, Haq T, Kirby S, Lacy-Colson J, Logan P, Malik Q, McCann J, Mughal Z, Sadiq S, Sharif I, Shingles C, Simon A, Burnage S, Chan SSN, Craig ARJ, Duffield J, Dutta A, Eastwood M, Iqbal F, Mahmood F, Mahmood W, Patel C, Qadeer A, Robinson A, Rotundo A, Schade A, Slade RD, De Freitas M, Kinnersley H, McDowell E, Moens-Lecumberri S, Ramsden J, Rockall T, Wiffen L, Wright S, Bruce C, Francois V, Hamdan K, Limb C, Lunt AJ, Manley L, Marks M, Phillips CFE, Agnew CJF, Barr CJ, Benons N, Hart SJ, Kandage D, Krysztopik R, Mahalingam P, Mock J, Rajendran S, Stoddart MT, Clements B, Gillespie H, Lee S, McDougall R, Murray C, O'Loane R, Periketi S, Tan S, Amoah R, Bhudia R, Dudley B, Gilbert A, Griffiths B, Khan H, McKigney N, Roberts B, Samuel R, Seelarbokus A, Stubbing-Moore A, Thompson G, Williams P, Ahmed N, Akhtar R, Chandler E, Chappelow I, Gil H, Gower T, Kale A, Lingam G, Rutler L, Sellahewa C, Sheikh A, Stringer H, Taylor R, Aglan H, Ashraf MR, Choo S, Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Landolt L, Furriol J, Babickova J, Ahmed L, Eikrem Ø, Skogstrand T, Scherer A, Suliman S, Leh S, Lorens JB, Gausdal G, Marti HP, Osman T. AXL targeting reduces fibrosis development in experimental unilateral ureteral obstruction. Physiol Rep 2020; 7:e14091. [PMID: 31134766 PMCID: PMC6536582 DOI: 10.14814/phy2.14091] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 12/11/2018] [Revised: 04/16/2019] [Accepted: 04/17/2019] [Indexed: 12/18/2022] Open
Abstract
The AXL receptor tyrosine kinase (RTK) is involved in partial epithelial‐to‐mesenchymal transition (EMT) and inflammation – both main promoters of renal fibrosis development. The study aim was to investigate the role of AXL inhibition in kidney fibrosis due to unilateral ureteral obstruction (UUO). Eight weeks old male C57BL/6 mice underwent UUO and were treated with oral AXL inhibitor bemcentinib (n = 22), Angiotensin‐converting enzyme inhibitor (ACEI, n = 10), ACEI and bemcentinib (n = 10) or vehicle alone (n = 22). Mice were sacrificed after 7 or 15 days and kidney tissues were analyzed by immunohistochemistry (IHC), western blot, ELISA, Sirius Red (SR) staining, and hydroxyproline (Hyp) quantification. RNA was extracted from frozen kidney tissues and sequenced on an Illumina HiSeq4000 platform. After 15 days the ligated bemcentinib‐treated kidneys showed less fibrosis compared to the ligated vehicle‐treated kidneys in SR analyses and Hyp quantification. Reduced IHC staining for Vimentin (VIM) and alpha smooth muscle actin (αSMA), as well as reduced mRNA abundance of key regulators of fibrosis such as transforming growth factor (Tgfβ), matrix metalloproteinase 2 (Mmp2), Smad2, Smad4, myofibroblast activation (Aldh1a2, Crlf1), and EMT (Snai1,2, Twist), in ligated bemcentinib‐treated kidneys was compatible with reduced (partial) EMT induction. Furthermore, less F4/80 positive cells, less activity of pathways related to the immune system and lower abundance of MCP1, MCP3, MCP5, and TARC in ligated bemcentinib‐treated kidneys was compatible with reduction in inflammatory infiltrates by bemcentinib treatment. The AXL RTK pathway represents a promising target for pharmacologic therapy of kidney fibrosis.
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Affiliation(s)
- Lea Landolt
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Jessica Furriol
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Janka Babickova
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | - Øystein Eikrem
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Trude Skogstrand
- Department of Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Andreas Scherer
- Spheromics, Kontiolahti, Finland.,Institute for Molecular Medicine Finland FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Salwa Suliman
- Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen, Bergen, Norway
| | - Sabine Leh
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - James B Lorens
- Department of Biomedicine, Center for Cancer Biomarkers, University of Bergen, Bergen, Norway
| | | | - Hans-Peter Marti
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Tarig Osman
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Ferguson J, Alexander L, Kelly C, Chalmers A, Rahman N, Holme J, Grundy S, Ahmed L, Maskell N, Cowell G, Dick C, Tsim S, Hopkins T, Woodward R, Blyth K. Staging by Thoracoscopy in Potentially Radically Treatable Non-Small Cell Lung Cancer Associated with Minimal Pleural Effusion (STRATIFY) study: a prospective multicentre study. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30245-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Malone ER, Saleh RR, Yu C, Ahmed L, Pugh T, Torchia J, Bartlett J, Virtanen C, Hotte SJ, Hilton J, Welch S, Robinson A, McCready E, Lo B, Sadikovic B, Feilotter H, Hanna TP, Kamel-Reid S, Stockley TL, Siu LL, Bedard PL. OCTANE (Ontario-wide Cancer Targeted Nucleic Acid Evaluation): a platform for intraprovincial, national, and international clinical data-sharing. ACTA ACUST UNITED AC 2019; 26:e618-e623. [PMID: 31708655 DOI: 10.3747/co.26.5235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cancer is a genetic disease resulting from germline or somatic genetic aberrations. Rapid progress in the field of genomics in recent years is allowing for increased characterization and understanding of the various forms of the disease. The Ontario-wide Cancer Targeted Nucleic Acid Evaluation (octane) clinical trial, open at cancer centres across Ontario, aims to increase access to genomic sequencing of tumours and to facilitate the collection of clinical data related to enrolled patients and their clinical outcomes. The study is designed to assess the clinical utility of next-generation sequencing (ngs) in cancer patient care, including enhancement of treatment options available to patients. A core aim of the study is to encourage collaboration between cancer hospitals within Ontario while also increasing international collaboration in terms of sharing the newly generated data. The single-payer provincial health care system in Ontario provides a unique opportunity to develop a province-wide registry of ngs testing and a repository of genomically characterized, clinically annotated samples. It also provides an important opportunity to use province-wide real-world data to evaluate outcomes and the cost of ngs for patients with advanced cancer. The octane study is attempting to translate knowledge to help deliver precision oncology in a Canadian environment. In this article, we discuss the background to the study and its implementation, current status, and future directions.
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Affiliation(s)
- E R Malone
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - R R Saleh
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - C Yu
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - L Ahmed
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - T Pugh
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - J Torchia
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - J Bartlett
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - C Virtanen
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - S J Hotte
- Hamilton, ON-Laboratory Genetic Services Division, Hamilton Regional Laboratory Medicine Program (McCready); McMaster University (Hotte); Juravinski Cancer Centre (Hotte)
| | - J Hilton
- Ottawa, ON-The Ottawa Hospital Research Institute (Lo); University of Ottawa (Hilton); The Ottawa Hospital Cancer Program (Hilton)
| | - S Welch
- London, ON-Department of Pathology and Laboratory Medicine, Western University, and Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre (Sadikovic); University of Western Ontario (Welch); London Health Sciences Health Centre (Welch)
| | - A Robinson
- Kingston, ON-Department of Pathology and Molecular Medicine, Queen's University (Feilotter); Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University (Hanna, Robinson); Kingston General Hospital (Hanna, Robinson)
| | - E McCready
- Hamilton, ON-Laboratory Genetic Services Division, Hamilton Regional Laboratory Medicine Program (McCready); McMaster University (Hotte); Juravinski Cancer Centre (Hotte)
| | - B Lo
- Ottawa, ON-The Ottawa Hospital Research Institute (Lo); University of Ottawa (Hilton); The Ottawa Hospital Cancer Program (Hilton)
| | - B Sadikovic
- London, ON-Department of Pathology and Laboratory Medicine, Western University, and Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre (Sadikovic); University of Western Ontario (Welch); London Health Sciences Health Centre (Welch)
| | - H Feilotter
- Kingston, ON-Department of Pathology and Molecular Medicine, Queen's University (Feilotter); Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University (Hanna, Robinson); Kingston General Hospital (Hanna, Robinson)
| | - T P Hanna
- Kingston, ON-Department of Pathology and Molecular Medicine, Queen's University (Feilotter); Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University (Hanna, Robinson); Kingston General Hospital (Hanna, Robinson)
| | - S Kamel-Reid
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - T L Stockley
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - L L Siu
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - P L Bedard
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
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Grindell C, Bec R, Tod A, Bhatnagar R, Sivakumar P, Evison M, Morley A, Ahmed M, Ahmed L, Wolstenholme D. P3.15-14 Using Creative Co-Production to Develop a Treatment Decision Support Tool for People with Malignant Pleural Effusion. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1890] [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: 10/28/2022]
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Sivakumar P, Marples L, Breen R, Ahmed L. The diagnostic utility of pleural fluid adenosine deaminase for tuberculosis in a low prevalence area. Int J Tuberc Lung Dis 2018; 21:697-701. [PMID: 28482965 DOI: 10.5588/ijtld.16.0803] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pleural fluid adenosine deaminase (pfADA) is not routinely measured in patients with undiagnosed pleural effusion due to limited evidence of its diagnostic utility in areas of low tuberculosis (TB) prevalence. METHODS We conducted a retrospective consecutive case series analysis of all patients who underwent pfADA testing from 2009 to 2015 at a tertiary service pleural centre in south London. Using receiver operating characteristic (ROC) curve analysis, we identified the optimal threshold at which maximal sensitivity and specificity were achieved. RESULTS Of the 132 patients tested for pfADA, 27 had confirmed pleural TB and 105 did not, with median pfADA levels of respectively 63 IU/l (interquartile range [IQR] 47-88) and 12 IU/l (IQR 7.5-22.5). ROC curve analysis determined the optimal pfADA cut-off to be 30 IU/l, which had positive and negative predictive values of respectively 60.5% and 98.9%, 96.3% sensitivity (95%CI 0.892-1.000) and 83.8% specificity (95%CI 0.768-0.909). The calculated area under the ROC curve was 0.934 (95%CI 0.893-0.975). CONCLUSION A pfADA level <30 IU/l makes a diagnosis of TB highly unlikely in the South London population. Its high sensitivity and negative predictive values make pfADA a valuable screening test for excluding suspected pleural TB.
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Affiliation(s)
- P Sivakumar
- Division of Asthma, Allergy and Lung Biology
| | - L Marples
- School of Medicine, King's College London, Strand, London
| | - R Breen
- Department of Thoracic Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - L Ahmed
- Department of Thoracic Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
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15
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Yule M, Wnuk-Lipinska K, Davidsen K, Blø M, Hodneland L, Engelsen A, Kang J, Lie M, Bougnaud S, Aguilera K, Ahmed L, Rybicka A, Milde Nævdal E, Deyna P, Boniecka A, Straume O, Thiery JP, Chouaib S, Brekken RA, Gausdal G, Lorens JB. Abstract OT1-01-03: A phase II multi-center study of BGB324 in combination with pembrolizumab in patients with previously treated, locally advanced and unresectable or metastatic triple negative breast cancer (TNBC) or triple negative inflammatory breast cancer (TN-IBC). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot1-01-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. The AXL receptor tyrosine kinase is associated with poor overall survival in breast cancer. AXL signaling is an important regulator of tumor plasticity related to epithelial-to-mesenchymal transition (EMT) and stem cell traits that drive metastasis and drug resistance. Upregulation of AXL has been associated with reduced response to anti-PD-1 therapy. Signaling via AXL is also a key suppressor of the anti-tumor innate immune response, and AXL is expressed on several cells associated with the tumor immune microenvironment. Hence AXL signaling contributes uniquely to both tumor cell intrinsic and microenvironmental anti-tumor immune suppression mechanisms. We show that AXL is required for tumor immune evasion in the 4T1/Balb/C mammary adenocarcinoma model and that blocking AXL signaling with BGB324, a selective clinical-stage small molecule AXL kinase inhibitor, enhanced the effect of immune checkpoint blockade. BGB324 + anti-CTLA-4/anti-PD-1 treated tumors displayed enhanced infiltration of cytotoxic T lymphocytes and Natural Killer cells. Importantly, responding animals rejected orthotopic 4T1 tumor cell re-challenge, demonstrating sustained tumor immunity. These data provided a translational rationale for combining AXL targeted therapy with immune checkpoint inhibitors to enhance anti-cancer immune response.
Study Design. BGBC007 (NCT03184558) is an open-label, single arm, multi-center phase II study designed to assess the anti-tumor activity of BGB324 in combination with pembrolizumab in patients with previously treated, locally advanced and unresectable, or metastatic TNBC or TN-IBC. Secondary objectives include safety and pharmacokinetic profile of BGB324 and pembrolizumab in combination. A single arm, extension of Simon's 2-stage design is employed with an interim and final analysis. Up to 56 evaluable patients will be enrolled. Recruitment will be halted once 28 evaluable patients have been entered to determine the Objective Response Rate (ORR, complete response and partial response). If 5 or fewer responses are observed in up to 28 patients, the trial will be terminated in favor of the null for futility. If 11 or more responses are observed, then the trial will be stopped in favor of the alternative for demonstration of activity. If 6 to 10 patients have an observed response then a further 28 patients may be evaluated. This design provides an overall power of 80.6% to test the stated null and alternative hypothesis. BGB324 will be administered orally, once daily, in a fasted state. Days 1, 2 and 3 of BGB324 administration consists of a 'loading' dose of 400 mg followed by a dose of 200 mg daily. A fixed dose of 200 mg pembrolizumab will be given by intravenous infusion over 30 minutes every 3 weeks. BGB324 and pembrolizumab will be given until disease progression, unacceptable dose toxicity, or until 106 weeks (35 cycles). Efficacy endpoints including ORR, Duration of Response, Progression Free Survival are based on tumor imaging evaluation by RECIST 1.1. Tumor specimens will be taken to assess AXL and PD-L1 expression.
Citation Format: Yule M, Wnuk-Lipinska K, Davidsen K, Blø M, Hodneland L, Engelsen A, Kang J, Lie M, Bougnaud S, Aguilera K, Ahmed L, Rybicka A, Milde Nævdal E, Deyna P, Boniecka A, Straume O, Thiery J-P, Chouaib S, Brekken RA, Gausdal G, Lorens JB. A phase II multi-center study of BGB324 in combination with pembrolizumab in patients with previously treated, locally advanced and unresectable or metastatic triple negative breast cancer (TNBC) or triple negative inflammatory breast cancer (TN-IBC) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT1-01-03.
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Affiliation(s)
- M Yule
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - K Wnuk-Lipinska
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - K Davidsen
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - M Blø
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - L Hodneland
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - A Engelsen
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - J Kang
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - M Lie
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - S Bougnaud
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - K Aguilera
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - L Ahmed
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - A Rybicka
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - E Milde Nævdal
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - P Deyna
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - A Boniecka
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - O Straume
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - J-P Thiery
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - S Chouaib
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - RA Brekken
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - G Gausdal
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
| | - JB Lorens
- BerGenBio ASA, Bergen, Norway; University of Bergen, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas
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Yule M, Davidsen K, Bloe M, Hodneland L, Engelsen A, Lie M, Bougnaud S, D'Mello S, Aguilera K, Ahmed L, Rybika A, Milde Naeval E, Boniecka A, Thiery JP, Chouaib S, Brekken RA, Gausdal G, Lorens J. Combination of bemcentinib (BGB324): A first-in-class selective oral AXL inhibitor, with pembrolizumab in patients with triple negative breast cancer and adenocarcinoma of the lung. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.5_suppl.tps43] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS43 Background: Activation of the receptor tyrosine kinase AXL has a profound suppressive effect on the innate immune system. AXL is overexpressed on multiple cell types in the tumour immune microenvironment including dendritic cells, NK cells and tumour-associated macrophages. AXL signalling in immune cells supports tumour immune escape by downregulating dendritic cell activity, modulating efferocytosis as well as favouring an immunosuppressive chemokine profile and M-MDSC expansion. AXL is prevalent in tumours resistant to anti-PD-1 therapy (Hugo, 2016). Axl expression in tumour cells confers resistance to effector T cell cytotoxicity. Bemcentinib (BGB324) is a first-in-class, highly selective and orally bioavailable small molecule AXL inhibitor in phase II clinical development. In pre-clinical models of pancreas, breast and lung cancer, inhibition of AXL signalling with bemcentinib reversed multiple tumour immune suppressive mechanisms as evidenced by increased infiltration of cytotoxic T lymphocytes, NK and NKT cells and decreased infiltration of M-MDSCs (Wnuk-Lipinska, 2017). Bemcentinib enhanced the effect of immune checkpoint blockade via PD-1 or CTLA-4 in lung and mammary adenocarcinoma mouse models and achieved sustained tumour immunity. Methods: BGBC007 (NCT03184558) and BGBC008 (NCT03184571) are open-label, phase II studies designed to assess the anti-tumour activity of bemcentinib in combination with pembrolizumab in patients with previously treated TNBC and adenocarcinoma of the lung respectively. All patients will be treated with bemcentinib in combination with pembrolizumab continuously for up to two years. The primary endpoint is objective response rate, secondary endpoints include duration of response, progression free survival according to RECIST 1.1, pharmacokinetics, safety and tolerability. Pretreatment tumour specimens are scheduled to assess AXL expression/signalling and PD-L1 expression; the levels of circulating immune-related cytokines and soluble AXL receptor will also be measured in longitudinal patient plasma samples. Both studies are open to recruitment. Clinical trial information: NCT03184558.
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Affiliation(s)
| | | | | | | | | | - Maria Lie
- University of Bergen, Bergen, Norway
| | | | | | | | | | | | | | | | | | | | - Rolf A. Brekken
- Division of Surgical Oncology Department of Surgery, Hamon Center for Therapeutic Oncology Research, Dallas, TX
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17
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Landolt L, Eikrem Ø, Strauss P, Scherer A, Lovett DH, Beisland C, Finne K, Osman T, Ibrahim MM, Gausdal G, Ahmed L, Lorens JB, Thiery JP, Tan TZ, Sekulic M, Marti HP. Clear Cell Renal Cell Carcinoma is linked to Epithelial-to-Mesenchymal Transition and to Fibrosis. Physiol Rep 2017; 5:e13305. [PMID: 28596300 PMCID: PMC5471444 DOI: 10.14814/phy2.13305] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 04/27/2017] [Accepted: 05/01/2017] [Indexed: 12/14/2022] Open
Abstract
Clear cell renal cell carcinoma (ccRCC) represents the most common type of kidney cancer with high mortality in its advanced stages. Our study aim was to explore the correlation between tumor epithelial-to-mesenchymal transition (EMT) and patient survival. Renal biopsies of tumorous and adjacent nontumorous tissue were taken with a 16 g needle from our patients (n = 26) undergoing partial or radical nephrectomy due to ccRCC RNA sequencing libraries were generated using Illumina TruSeq® Access library preparation protocol and TruSeq Small RNA library preparation kit. Next generation sequencing (NGS) was performed on Illumina HiSeq2500. Comparative analysis of matched sample pairs was done using the Bioconductor Limma/voom R-package. Liquid chromatography-tandem mass spectrometry and immunohistochemistry were applied to measure and visualize protein abundance. We detected an increased generic EMT transcript score in ccRCC Gene expression analysis showed augmented abundance of AXL and MMP14, as well as down-regulated expression of KL (klotho). Moreover, microRNA analyses demonstrated a positive expression correlation of miR-34a and its targets MMP14 and AXL Survival analysis based on a subset of genes from our list EMT-related genes in a publicly available dataset showed that the EMT genes correlated with ccRCC patient survival. Several of these genes also play a known role in fibrosis. Accordingly, recently published classifiers of solid organ fibrosis correctly identified EMT-affected tumor samples and were correlated with patient survival. EMT in ccRCC linked to fibrosis is associated with worse survival and may represent a target for novel therapeutic interventions.
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Affiliation(s)
- Lea Landolt
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Øystein Eikrem
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Philipp Strauss
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Andreas Scherer
- Spheromics, Kontiolahti, Finland
- Institute for Molecular Medicine Finland (FIMM) University of Helsinki, Helsinki, Finland
| | - David H Lovett
- Department of Medicine, San Francisco VAMC University of California San Francisco, San Francisco, California
| | - Christian Beisland
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Urology, Haukeland University Hospital, Bergen, Norway
| | - Kenneth Finne
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Tarig Osman
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | | | | | - James B Lorens
- BerGenBio AS, Bergen, Norway
- Department of Biomedicine, Center for Cancer Biomarkers University of Bergen, Bergen, Norway
| | - Jean Paul Thiery
- Department of Biomedicine, Center for Cancer Biomarkers University of Bergen, Bergen, Norway
- INSERM UMR 1186, Integrative Tumor Immunology and Genetic Oncology Gustave Roussy EPHE Fac. de médecine-Univ. Paris-Sud Université Paris-Saclay, Villejuif, France
| | - Tuan Zea Tan
- Science Institute of Singapore National University of Singapore, Singapore, Singapore
| | - Miroslav Sekulic
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Hans-Peter Marti
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
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18
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Lorens JB, Lipinska KW, Davidsen K, Blø M, Hodneland L, Engelsen A, Kang J, Lie MK, Bougnaud S, Aguilera K, Ahmed L, Rybicka A, Nævdal EM, Deyna P, Boniecka A, Straume O, Chouaib S, Brekken RA, Gausdal G. Abstract P2-04-08: BGB324, a selective small molecule inhibitor of the receptor tyrosine kinase AXL, enhances immune checkpoint inhibitor efficacy in mammary adenocarcinoma. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-04-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The AXL receptor tyrosine kinase is associated with poor overall survival in breast cancer. Axl signaling is an important regulator of tumor plasticity related to epithelial-to-mesenchymal transition (EMT) and stem cell traits that drive metastasis and drug resistance. Signaling via AXL is also a key suppressor of the anti-tumor innate immune response. AXL is expressed on several cells associated with the tumor immune microenvironment including natural killer cells, dendritic cells and tumor-associated macrophages. AXL is required for tumor immune evasion in mammary adenocarcinoma models and EMT-mediated resistance to cytotoxic T cell and natural killer (NK)-cell mediated cell killing. Hence AXL signaling contributes uniquely to both tumor cell intrinsic and microenvironmental anti-tumor immune suppression mechanisms in breast cancer. We evaluated whether blocking AXL signaling with BGB324, a selective clinical-stage small molecule Axl kinase inhibitor, enhances the effect of immune checkpoint blockade in the aggressive mammary adenocarcinoma (4T1) syngeneic (Balb/C) mouse modelthat display limited immunogenicity.
Immune therapy with anti-CTLA-4/anti-PD-1 increased AXL and EMT-marker expression in 4T1 tumors, and correlated with lack of response to immune therapy. Combination treatment with BGB324 (50 mg/kg bid) significantly enhanced responsiveness to anti-CTLA-4/anti-PD-1 treatment (10 mg/kg of each, 4 doses) in Balb/C mice bearing established 4T1 tumors. The combination of BGB324 + anti-CTLA-4/anti-PD-1 resulted in durable primary tumor clearance in 23 % of treated mice versus 5.6% obtained with anti-CTLA-4/anti-PD-1 alone (p=0.0157). In a separate study, BGB324 + anti-CTLA-4 treated resulted in 22% long-term primary tumor clearance while no response was observed with anti-CTLA4 treatment alone. The extensive metastasis to the lung, liver and spleen characteristic of this model were concomitantly abrogated in the animals responding to the combination treatment. In addition, BGB324 + anti-CTLA-4/anti-PD-1 treated tumors displayed enhanced infiltration of cytotoxic T lymphocytes (CTLs). Enhanced presence of CTLs was also detected in spleens from animals responding to treatment. BGB324 + anti-CTLA-4/anti-PD-1 treatment increased the number of NK cells, macrophages and polymorphonuclear neutrophils, but decreased the number of mMDSC. Importantly, responding animals rejected orthotopic 4T1 tumor cell re-challenge, demonstrating sustained tumor immunity.
Together with recent results in other tumor types that support a prominent role for AXL in resistance to immune therapy and encouraging results from ongoing clinical trials with BGB324, support combining BGB324 with immune checkpoint inhibitors to improve treatment of breast cancer.
Citation Format: Lorens JB, Lipinska KW, Davidsen K, Blø M, Hodneland L, Engelsen A, Kang J, Lie MK, Bougnaud S, Aguilera K, Ahmed L, Rybicka A, Nævdal EM, Deyna P, Boniecka A, Straume O, Chouaib S, Brekken RA, Gausdal G. BGB324, a selective small molecule inhibitor of the receptor tyrosine kinase AXL, enhances immune checkpoint inhibitor efficacy in mammary adenocarcinoma [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-04-08.
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Affiliation(s)
- JB Lorens
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - KW Lipinska
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - K Davidsen
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - M Blø
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - L Hodneland
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - A Engelsen
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - J Kang
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - MK Lie
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - S Bougnaud
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - K Aguilera
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - L Ahmed
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - A Rybicka
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - EM Nævdal
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - P Deyna
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - A Boniecka
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - O Straume
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - S Chouaib
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - RA Brekken
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
| | - G Gausdal
- BerGenBio AS, Bergen, Norway; Biomedicine, Bergen, Norway; Center for Cancer Biomarkers, University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; INSERM Unité 1186, Institut Gustave Roussy, Université Paris-Sud, Villejuif, Paris, France; Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX
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Sivakumar P, Kamalanathan M, Collett A, Ahmed L. P3 Thoracic ultrasound experiences amongst respiratory trainees – a national survey. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.146] [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: 11/03/2022]
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Sivakumar P, Curley D, Rahman NM, Lee YCG, Feller-Kopman D, West A, Ahmed L. P7 Clinicians’ perspectives of health related quality of life and priorities in deciding management for malignant pleural effusion. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Wnuk-Lipinska K, Davidsen K, Blø M, Hodneland L, Engelsen A, Kang J, Lie M, Bougnaud S, Aguilera K, Ahmed L, Rybicka A, Milde E, Deyna P, Boniecka A, Straume O, Chouaib S, Brekken R, Gausdal G, Lorens J. Abstract B027: BGB324, a selective small molecule inhibitor of AXL receptor tyrosine kinase, enhances immune checkpoint inhibitor efficacy. Cancer Immunol Res 2016. [DOI: 10.1158/2326-6066.imm2016-b027] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The AXL receptor tyrosine kinase is expressed by several tumor types and is associated with poor overall survival in patients. AXL signaling is an important regulator of tumor cell plasticity related to epithelial-to-mesenchymal transition (EMT) and stem cell traits that drive metastasis, drug resistance and immune evasion. AXL is also expressed on several cells associated with the inflammatory tumor immune microenvironment including natural killer (NK) cells, dendritic cells and tumor-associated macrophages. Signaling via AXL is a key suppressor of the anti-tumor innate immune response. Hence, AXL signaling contributes uniquely to tumor cell intrinsic and microenvironmental anti-tumor immune suppression mechanisms in cancer. We evaluated whether blocking AXL signaling with BGB324, a selective clinical-stage small molecule AXL kinase inhibitor, enhanced the effect of immune checkpoint blockade in aggressive adenocarcinomas that display limited immunogenicity.
Immune therapy with anti-PD-1/anti-PD-L1 or anti-CTLA-4/anti-PD-1 increased AXL and EMT-marker expression in the murine lung cancer (Lewis lung, LL2) and mammary adenocarcinoma (4T1) syngeneic models, and correlated with a lack of response to immune checkpoint therapy. Combination treatment with BGB324 (50 mg/kg bid) significantly enhanced responsiveness to anti-PD-1/anti-PD-L1 or anti-CTLA-4/anti-PD-1 treatment (10 mg/kg of each, 6 doses for LL2; 4 doses for 4T1) in mice bearing established LL2 or 4T1 tumors respectively. BGB324 in combination with anti-PD-1/anti-PD-L1 or anti-CTLA-4/anti-PD-1 enhanced tumor infiltration of cytotoxic T lymphocytes (CTLs). Increased CTLs were also detected in spleens from animals responding to treatment. BGB324 + anti-CTLA-4/anti-PD-1 combination treatment increased the number of NK cells, macrophages and polymorphonuclear neutrophils, but decreased the number of tumor-associated myeloid-derived suppressor cells (MDSC).
In the 4T1 model, the combination of BGB324 + anti-CTLA-4/anti-PD-1 resulted in durable primary tumor clearance in 23% of treated mice versus 5.6% obtained with anti-CTLA-4/anti-PD-1 alone (p = 0.0157). In a separate study, BGB324 + anti-CTLA-4 therapy treated resulted in 22% long-term primary tumor clearance while no response was observed with anti-CTLA4 treatment alone. The extensive metastasis to the lung, liver and spleen characteristic of this model was concomitantly abrogated in the animals responding to the combination treatment. Importantly, responding animals rejected orthotopic 4T1 tumor cell re-challenge, demonstrating sustained tumor immunity
These findings along with the favorable safety profile and clinical activity of BGB324 in ongoing monotherapy clinical trials, support a rationale for clinical testing of BGB324 in combination with immune checkpoint inhibitors in cancer patients.
Citation Format: Katarzyna Wnuk-Lipinska, Kjersti Davidsen, Magnus Blø, Linn Hodneland, Agnete Engelsen, Jing Kang, Maria Lie, Sebastien Bougnaud, Kristina Aguilera, Lavina Ahmed, Agata Rybicka, Elina Milde, Paulina Deyna, Anna Boniecka, Oddbjørn Straume, Salem Chouaib, Rolf Brekken, Gro Gausdal, James Lorens. BGB324, a selective small molecule inhibitor of AXL receptor tyrosine kinase, enhances immune checkpoint inhibitor efficacy [abstract]. In: Proceedings of the Second CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; 2016 Sept 25-28; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2016;4(11 Suppl):Abstract nr B027.
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Affiliation(s)
| | | | | | | | | | - Jing Kang
- 2University of Bergen, Bergen, Norway
| | - Maria Lie
- 2University of Bergen, Bergen, Norway
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Sivakumar P, Douiri A, West A, Rao D, Warwick G, Chen T, Ahmed L. OPTIMUM: a protocol for a multicentre randomised controlled trial comparing Out Patient Talc slurry via Indwelling pleural catheter for Malignant pleural effusion vs Usual inpatient Management. BMJ Open 2016; 6:e012795. [PMID: 27798020 PMCID: PMC5073842 DOI: 10.1136/bmjopen-2016-012795] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION The development of malignant pleural effusion (MPE) results in disabling breathlessness, pain and reduced physical capability with treatment a palliative strategy. Ambulatory management of MPE has the potential to improve quality of life (QoL). The OPTIMUM trial is designed to determine whether full outpatient management of MPE with an indwelling pleural catheter (IPC) and pleurodesis improves QoL compared with traditional inpatient care with a chest drain and talc pleurodesis. OPTIMUM is currently open for any centres interested in collaborating in this study. METHODS AND ANALYSIS OPTIMUM is a multicentre non-blinded randomised controlled trial. Patients with a diagnosis of MPE will be identified and screened for eligibility. Consenting participants will be randomised 1:1 either to an outpatient ambulatory pathway using IPCs and talc pleurodesis or standard inpatient treatment with chest drain and talc pleurodesis as per British Thoracic Society guidelines. The primary outcome measure is global health-related QoL at 30 days measured using the EORTC QLQ-C30 questionnaire. Secondary outcome measures include breathlessness and pain measured using a 100 mm Visual Analogue Scale and health-related QoL at 60 and 90 days. A sample size of 142 patients is needed to demonstrate a clinically significant difference of 8 points in global health status at 30 days, for an 80% power and a 5% significance level. ETHICS AND DISSEMINATION The study has been approved by the NRES Committee South East Coast-Brighton and Sussex (reference 15/LO/1018). The trial results will be published in peer-reviewed journals and presented at scientific conferences. TRIAL REGISTRATION NUMBERS UKCRN19615 and ISRCTN15503522; Pre-results.
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Affiliation(s)
- P Sivakumar
- St Thomas’ Hospital, London, UK
- King's College London, London, UK
| | - A Douiri
- King's College London, London, UK
| | - A West
- St Thomas’ Hospital, London, UK
| | - D Rao
- Princess Royal University Hospital, Orpington, UK
| | | | - T Chen
- King's College London, London, UK
| | - L Ahmed
- St Thomas’ Hospital, London, UK
- King's College London, London, UK
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Nalwoga H, Ahmed L, Arnes JB, Wabinga H, Akslen LA. Strong Expression of Hypoxia-Inducible Factor-1α (HIF-1α) Is Associated with Axl Expression and Features of Aggressive Tumors in African Breast Cancer. PLoS One 2016; 11:e0146823. [PMID: 26760782 PMCID: PMC4711940 DOI: 10.1371/journal.pone.0146823] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 12/22/2015] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Inhibition of hypoxia-inducible factor (HIF) and Axl receptor tyrosine kinase is being evaluated for targeted therapy in solid tumors. Both HIF-1α and Axl influence tumor growth and metastatic potential, and they have been linked to treatment failure in many cancers. However, there is a lack of reports on HIF-1α expression in African breast cancer, which has a poor prognosis, and novel treatment targets must therefore be established. Here, we aimed to evaluate HIF-1α in relation to Axl expression, angiogenesis markers, and other tumor characteristics in a series of African breast cancer. METHODS Using immunohistochemistry, we examined 261 invasive breast cancers on tissue microarrays for HIF-1α and Axl as well as several other markers, and a subset of 185 cases had information on VEGF (vascular endothelial growth factor) expression, microvessel density (MVD), proliferating microvessel density (pMVD) and vascular proliferation index (VPI) for important comparisons. RESULTS Strong HIF-1α expression was associated with increased Axl (p = 0.007), VEGF (p<0.0005), and p53 (p = 0.032) expression, as well as high tumor cell proliferation by Ki-67 (p = 0.006), and high tumor grade (p = 0.003). Tumors with strong HIF-1α expression had significantly higher MVD (p = 0.019) and higher pMVD (p = 0.027) than tumors with weak expression. CONCLUSIONS High HIF-1α expression is significantly associated with Axl and VEGF expression, and with markers of poor prognosis in this series of breast cancer, suggesting HIF-1α and Axl as potential therapeutic targets in African breast cancer.
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Affiliation(s)
- Hawa Nalwoga
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, University of Bergen, Haukeland University Hospital, Bergen, Norway
- Department of Pathology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Lavina Ahmed
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, University of Bergen, Haukeland University Hospital, Bergen, Norway
- BerGenBio AS, Bergen, Norway
| | - Jarle B. Arnes
- Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - Henry Wabinga
- Department of Pathology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Lars A. Akslen
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, University of Bergen, Haukeland University Hospital, Bergen, Norway
- Department of Pathology, Haukeland University Hospital, Bergen, Norway
- * E-mail:
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Gausdal G, Davidsen K, Wnuk-Lipinska K, Wiertel K, Hellesøy M, Blø M, Ahmed L, Hodneland L, Kiprijanov S, Brekken RA, Lorens JB. Abstract B014: BGB324, a selective small molecule inhibitor of the receptor tyrosine kinase AXL, enhances immune checkpoint inhibitor efficacy. Cancer Immunol Res 2016. [DOI: 10.1158/2326-6074.cricimteatiaacr15-b014] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Signaling via the AXL receptor tyrosine kinase is a key suppressor of anti-tumor innate immune response. AXL is expressed on several cells associated with the suppressive tumor immune microenvironment including natural killer cells, dendritic cells and tumor-associated macrophages. AXL is also an important regulator of tumor plasticity related to epithelial-to-mesenchymal transition (EMT) that contributes to anti-tumor immune evasion. Hence AXL signaling contributes uniquely to tumor intrinsic and microenvironmental immune suppression in tumors. We therefore evaluated whether blocking AXL signaling with BGB324, a selective clinical-stage small molecule Axl kinase inhibitor, enhances the effect of immune checkpoint blockade in syngeneic cancer mouse models that display limited immunogenicity.
We measured the effect of BGB324 in combination with anti-CTLA-4 and anti-PD-1 in the mammary adenocarcinoma 4T1/Balb/C syngeneic mouse model. BGB324 (50 mg/kg bid) significantly enhanced responsiveness to anti-CTLA-4/anti-PD-1 treatment (10 mg/kg of each, 4 doses) in Balb/C mice bearing 4T1 tumors. The combination of BGB324 + anti-CTLA-4/anti-PD-1 resulted in complete tumor clearance in 46.1 % of mice versus complete tumor clearance in 11.7 % of the mice treated with anti-CTLA-4/anti-PD-1 (p = 0.0087). BGB324 + anti-CTLA-4/anti-PD-1 treated tumors displayed enhanced CD8+ T cell tumor infiltration. Combination of BGB324 with immune checkpoint inhibitors is being evaluated in additional models, and detailed interrogation of AXL-dependent immune effector cell activity in tumors is in progress.
In conclusion, AXL inhibition represents a unique opportunity to target anti-tumor immune suppressive mechanisms and supports clinical translation of BGB324 in combination with cancer immunotherapy in human cancer.
Citation Format: Gro Gausdal, Kjersti Davidsen, Katarzyna Wnuk-Lipinska, Kathleen Wiertel, Monica Hellesøy, Magnus Blø, Lavina Ahmed, Linn Hodneland, Sergej Kiprijanov, Rolf A Brekken, James B Lorens. BGB324, a selective small molecule inhibitor of the receptor tyrosine kinase AXL, enhances immune checkpoint inhibitor efficacy. [abstract]. In: Proceedings of the CRI-CIMT-EATI-AACR Inaugural International Cancer Immunotherapy Conference: Translating Science into Survival; September 16-19, 2015; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2016;4(1 Suppl):Abstract nr B014.
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Affiliation(s)
| | - Kjersti Davidsen
- 2Department of Biomedicine, Center for Cancer Biomarkers, University of Bergen, Bergen, Norway,
| | | | - Kathleen Wiertel
- 3Division of Surgical Oncology Department of Surgery, Hamon Center for Therapeutic Oncology Research, Dallas, TX
| | | | | | | | | | | | - Rolf A Brekken
- 3Division of Surgical Oncology Department of Surgery, Hamon Center for Therapeutic Oncology Research, Dallas, TX
| | - James B Lorens
- 2Department of Biomedicine, Center for Cancer Biomarkers, University of Bergen, Bergen, Norway,
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Chan Wah Hak C, Sivakumar P, Ahmed L. P180 5 year retrospective evaluation of indwelling pleural catheter safety in patients undergoing chemotherapy: Abstract P180 Table 1. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Marples L, Sivakumar P, Breen R, Ahmed L. P252 A retrospective evaluation of the diagnostic utility of adenosine deaminase in pleural tuberculosis in a low-prevalence area. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Feriani H, Chaabouni Y, Lobna B, Aguerbi I, Chakib M, Ahmed L, Jarraya F, Mounir B, Zghal K, Kharrat M, Jamil H. Dose de charge de la vancomycine chez les patients hémodialysés. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.142] [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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Ahmed L, Nalwoga H, Arnes JB, Wabinga H, Micklem DR, Akslen LA. Increased tumor cell expression of Axl is a marker of aggressive features in breast cancer among African women. APMIS 2015; 123:688-96. [DOI: 10.1111/apm.12403] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 04/13/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Lavina Ahmed
- Centre for Cancer Biomarkers CCBIO; Department of Clinical Medicine; University of Bergen; Bergen Norway
- BerGenBio AS; Bergen Norway
| | - Hawa Nalwoga
- Centre for Cancer Biomarkers CCBIO; Department of Clinical Medicine; University of Bergen; Bergen Norway
| | - Jarle B. Arnes
- Department of Pathology; Haukeland University Hospital; Bergen Norway
| | - Henry Wabinga
- Department of Pathology; Makerere University College of Health Sciences; Kampala Uganda
| | | | - Lars A. Akslen
- Centre for Cancer Biomarkers CCBIO; Department of Clinical Medicine; University of Bergen; Bergen Norway
- Department of Pathology; Haukeland University Hospital; Bergen Norway
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Engelsen A, Wnup-Lipinska K, Tiron C, Pelissier F, Jokela T, Haaland G, Gausdal G, Sandal T, Frink R, Liang X, Hinz S, Ahmed L, Hellesøy M, Mickelm D, Minna J, LaBarge M, Brekken R, Lorens J. 362 Phenotypic plasticity in epithelial progenitors and mesenchymal carcinoma is regulated by Axl signaling. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70488-5] [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: 11/16/2022]
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Hyde K, Ahmed L. Laboratory Haematology Practice (Kandice Kottke-Marchant with Bruce H. Davis). Int J Lab Hematol 2013. [DOI: 10.1111/ijlh.12085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Esseghir S, Souabni L, Ben Abdelghani K, Salma K, Salma C, Belhadj S, Ahmed L, Leith Z. AB1087 Tuberculosis infections and chronic inflammatory rheumatisms:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nolan RP, Floras JS, Ahmed L, Harvey PJ, Hiscock N, Hendrickx H, Talbot D. Response to comment from Dr. Sloan: 'look what's going down'. J Intern Med 2013; 273:217-8. [PMID: 22998372 DOI: 10.1111/j.1365-2796.2012.02590.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- R. P. Nolan
- University Health Network and University of Toronto; Toronto ON Canada
| | - J. S. Floras
- University Health Network and University of Toronto; Toronto ON Canada
| | - L. Ahmed
- University Health Network and University of Toronto; Toronto ON Canada
| | - P. J. Harvey
- Women's College Hospital; University of Toronto; Toronto ON Canada
| | - N. Hiscock
- Unilever Discover; Colworth Science Park; Bedford UK
| | - H. Hendrickx
- Unilever Discover; Colworth Science Park; Bedford UK
| | - D. Talbot
- Unilever Discover; Colworth Science Park; Bedford UK
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Velazquez M, Salama A, Ahmed L. Incidence, Survival and Mortality of Oral and Oropharyngeal Cancer: A Surveillance, Epidemiology and End Results Program-Based Analysis. J Oral Maxillofac Surg 2012. [DOI: 10.1016/j.joms.2012.06.034] [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: 10/28/2022]
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Ahmed L, Salama A, Velazquez M. Poster 62: Gingival Cancer- Trends in Incidence, Mortality and Survival Rates Among Different Age Groups and Ethnicities. A 35 Years SEER Analysis in US Population. J Oral Maxillofac Surg 2012. [DOI: 10.1016/j.joms.2012.06.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nolan RP, Floras JS, Ahmed L, Harvey PJ, Hiscock N, Hendrickx H, Talbot D. Behavioural modification of the cholinergic anti-inflammatory response to C-reactive protein in patients with hypertension. J Intern Med 2012; 272:161-9. [PMID: 22292421 DOI: 10.1111/j.1365-2796.2012.02523.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES A central hypothesis of the cholinergic anti-inflammatory reflex model is that innate immune activity is inhibited by the efferent vagus. We evaluated whether changes in markers of tonic or reflex vagal heart rate modulation following behavioural intervention were associated inversely with changes in high-sensitivity C-reactive protein (hsCRP) or interleukin-6 (IL-6). DESIGN Subjects diagnosed with hypertension (n = 45, age 35-64 years, 53% women) were randomized to an 8-week protocol of behavioural neurocardiac training (with heart rate variability biofeedback) or autogenic relaxation. Assessments before and after intervention included pro-inflammatory factors (hsCRP, IL-6), markers of vagal heart rate modulation [RR high-frequency (HF) power within 0.15-0.40 Hz, baroreflex sensitivity and RR interval], conventional measures of lipoprotein cholesterol and 24-h ambulatory systolic and diastolic blood pressure. RESULTS Changes in hsCRP and IL-6 were not associated with changes in lipoprotein cholesterol or blood pressure. After adjusting for anti-inflammatory drugs and confounding factors, changes in hsCRP related inversely to changes in HF power (β = -0.25±0.1, P = 0.02), baroreflex sensitivity (β = -0.33±0.7, P = 0.04) and RR interval (β = -0.001 ± 0.0004, P = 0.02). Statistically significant relationships were not observed for IL-6. CONCLUSIONS Changes in hsCRP were consistent with the inhibitory effect of increased vagal efferent activity on pro-inflammatory factors predicted by the cholinergic anti-inflammatory reflex model. Clinical trials for patients with cardiovascular dysfunction are warranted to assess whether behavioural interventions can contribute independently to the chronic regulation of inflammatory activity and to improved clinical outcomes.
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Affiliation(s)
- R P Nolan
- University Health Network and University of Toronto, ON, Canada.
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Miyazaki N, Matsumoto J, Alberici F, Palmisano A, Maritati F, Oliva E, Buzio C, Vaglio A, Mjoen G, Norby GE, Vikse BE, Svarstad E, Rune B, Knut A, Szymczak M, Kuzniar J, Kopec W, Marchewka Z, Klinger M, Arrizabalaga P, Silvarino R, Sant F, Espinosa G, Sole M, Cervera R, Gude D, Chennamsetty S, Demin A, Kozlov V, Lisukov I, Kotova O, Sizikov A, Sergeevicheva V, Demina L, Borjesson O, Wendt M, Avik A, Qureshi AR, Bratt J, Miller EJ, Gunnarsson I, Bruchfeld A, Sugiyama K, Hasegawa M, Yamamoto K, Hayashi H, Koide S, Murakami K, Tomita M, Yoshida S, Yuzawa Y, Yew S, Jayne D, Westman K, Hoglund P, Flossman O, Mahr A, Luqmani R, Robson J, Thervet E, Levi C, Guiard E, Roland M, Nochy D, Daniliuc C, Guillevin L, Mouthon L, Jacquot C, Karras A, Kimura Y, Morita H, Debiec H, Yamada H, Miura N, Banno S, Ronco P, Imai H, Shin DH, Famee D, Koo HM, Han SH, Choi KH, Yoo TH, Kang SW, Fofi C, Fofi C, Scabbia L, Festuccia F, Stoppacciaro A, Mene' P, Shimizu A, Fukui M, MII A, Kaneko T, Masuda Y, Iino Y, Katayama Y, Fukuda Y, Kuroki A, Matsumoto K, Akizawa T, Jurubita R, Ismail G, Bobeica R, Rusu E, Zilisteanu D, Andronesi A, Motoi O, Ditoiu V, Copaci I, Voiculescu M, Irazabal MV, Eirin A, Lieske JC, Beck LH, Dillon JJ, Nachman PH, Sethi S, Erickson SB, Cattran DC, Fervenza FC, Svobodova B, Hruskova Z, Janatkova I, Jancova E, Tesar V, Seo MS, Kwon SH, Lee EB, You JY, Hyun YK, Woo SA, Park MY, Choi SJ, Jeon JS, Noh H, Kim JG, Han DC, Hwang SD, Choi TY, Jin SY, Kwon SH, Loiacono E, Loiacono E, Defedele D, Puccinelli MP, Camilla R, Gallo R, Peruzzi L, Rollino C, Beltrame G, Ferro M, Vergano L, Campolo F, Amore A, Coppo R, Knoop T, Vikse BE, Svarstad E, Bostad L, Leivestad T, Bjorneklett R, Teranishi J, Yamamoto R, Nagasawa Y, Shoji T, Iwatani H, Okada N, Moriyama T, Yamauchi A, Tsubakihara Y, Imai E, Rakugi H, Isaka Y, Koo HM, Doh FM, Kim SJ, Kang SW, Choi KH, Han DS, Han SH, Suzuki Y, Matsuzaki K, Suzuki H, Okazaki K, Yanagawa H, Maiguma M, Muto M, Sato T, Horikoshi S, Novak J, Hotta O, Tomino Y, Gutierrez* E, Zamora I, Ballarin J, Arce Y, Jimenez S, Quereda C, Olea T, Martinez-Ara J, Segarra A, Bernis C, Garcia A, Goicoechea M, Garcia de Vinuesa S, Rojas J, Praga M, Ristovska V, Petrushevska G, Grcevska L, Knoop T, Vikse BE, Svarstad E, Bostad L, Leivestad T, Bjorneklett R, Satake K, Shimizu Y, Mugitani N, Suzuki H, Suzuki Y, Horikoshi S, Honda S, Shibuya K, Shibuya A, Tomino Y, Papale M, Rocchetti MT, DI Paolo S, Suriano IV, D'apollo A, Vocino G, Montemurno E, Varraso L, Grandaliano G, Gesualdo L, Huerta A, Bomback AS, Canetta PA, Radhakrishnan J, Herlitz L, Stokes B, D'agati V, Markowitz G, Appel GB, Ristovska V, Grcevska L, Mouna H, Nasr BD, Mrabet I, Ahmed L, Sabra A, Mohamed Ammeur F, Mezri E, Habib S, Innocenti M, Pasquariello A, Pasquariello G, Mattei P, Bottai A, Fumagalli G, Bozzoli L, Samoni S, Cupisti A, Caldin B, Hung J, Repizo L, Malheiros DM, Barros R, Woronik V, Giammarresi C, Bono L, Ferrantelli A, Tortorici C, Licavoli G, Rotolo U, Huang X, Wang Q, Shi M, Chen W, Liu Z, Scarpioni R, Cantarini L, Lazzaro A, Ricardi M, Albertazzi V, Melfa L, Concesi C, Vallisa D, Cavanna L, Gungor G, Ataseven H, Demir A, Solak Y, Biyik M, Ozturk B, Polat I, Kiyici A, Ozer Cakir O, Polat H, Martinez-Ara J, Castillo I, Carreno V, Aguilar A, Madero R, Hernandez E, Bernis C, Bartolome J, Gea F, Selgas R, El Aggan HAM, El Banawy HS, Wagdy E, Tchebotareva N, LI O, Bobkova I, Kozlovskaya L, Varshavskiy V, Golicina E, Chen Y, Gong Z, Chen X, Tang L, Zhou J, Cao X, Wei R, Koo EH, Koo EH, Park JH, Kim HK, Kim MS, Jang HR, Lee JE, Huh W, Kim DJ, Oh HY, Kim YG, Tchebotareva N, Bobkova I, Kozlovskaya L, LI O, Eskova O, Shvetsov M, Golytsina E, Varshavskiy V, Popova O, Quaglia M, Monti S, Fenoglio R, Menegotto A, Airoldi A, Izzo C, Rizzo MA, Dianzani U, Stratta P, Vaglio A, Vaglio A, Alberici F, Gianfreda D, Buzio C. Primary and secondary glomerulonephritis I. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jørgensen L, Joakimsen R, Ahmed L, Størmer J, Jacobsen BK. Smoking is a strong risk factor for non-vertebral fractures in women with diabetes: the Tromsø Study. Osteoporos Int 2011; 22:1247-53. [PMID: 20607217 DOI: 10.1007/s00198-010-1340-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Accepted: 05/18/2010] [Indexed: 12/19/2022]
Abstract
UNLABELLED In this longitudinal study of 4,160 postmenopausal women (3,947 without and 213 with self-reported diabetes), smoking was strongly related to fracture risk in those with diabetes. INTRODUCTION Smoking is related to low bone mass and increased risk of fracture risk in postmenopausal women of the general population. The aim of the present longitudinal population-based study was to examine the effect of smoking on the risk of non-vertebral fractures in women ≥ 55 years of age, with specific focus on its relationship with diabetes. METHODS A total of 4,160 women (3,947 without and 213 with self-reported diabetes) from the municipality of Tromsø, Norway, were followed for a mean of 7.6 years. Measurements of height and weight and questionnaire information concerning smoking and alcohol consumption habits, physical activity, prevalent diseases, and use of medication were collected before the start of follow-up. Non-vertebral fractures were registered during follow-up. RESULTS A total of 1,015 without and 66 with diabetes sustained a new non-vertebral fracture. Smoking status (never, past, and current) was significantly associated with an increased risk of fracture both in women with and without diabetes (p values for trend 0.02 and <0.001, respectively, after adjustments for age), but in women without diabetes, the relationship was no longer significant after multiple adjustments. There was a strong interaction between smoking status and diabetes on fracture risk (p= 0.004). Women with diabetes who were current smokers had a 3.47 (95% CI 1.82-6.62) higher risk of non-vertebral fractures than diabetic women who were never smokers (p value for linear trend = 0.001, after multiple adjustments). CONCLUSION We conclude that smoking is strongly related to fracture risk in postmenopausal women with self-reported diabetes.
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Affiliation(s)
- L Jørgensen
- Department of Community Medicine, University of Tromsø, 9037 Tromsø, Norway.
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Jørgensen L, Skjelbakken T, Løchen ML, Ahmed L, Bjørnerem A, Joakimsen R, Jacobsen BK. Anemia and the risk of non-vertebral fractures: the Tromsø Study. Osteoporos Int 2010; 21:1761-8. [PMID: 19957163 DOI: 10.1007/s00198-009-1131-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Accepted: 11/02/2009] [Indexed: 10/20/2022]
Abstract
UNLABELLED In this longitudinal study of 5,286 persons, men with anemia had a 2.15 higher risk of non-vertebral fractures than men with high hemoglobin levels. Women with anemia had no increased fracture risk. INTRODUCTION Low hemoglobin levels are associated with several risk factors for fractures such as low physical function, impaired cognition, and low bone mass. The aim of this population-based, prospective study was to examine whether anemia predicts non-vertebral fractures. METHODS A total of 5,286 inhabitants from the municipality of Tromsø, Norway (2,511 men and 2,775 women), 55-74 years old at baseline, were followed for mean 8.3 years. Measurements of hemoglobin, mean corpuscular volume, height, weight, blood pressure, blood lipids, serum creatinine, and bone mineral density and questionnaire information concerning smoking and drinking habits, physical activity, prevalent diseases, and use of medication was collected before start of follow-up. Non-vertebral fractures were registered during follow-up. RESULTS A total of 235 men and 641 women sustained a new non-vertebral fracture. One SD lower value of hemoglobin was associated with a 1.27 higher risk of fracture in men (p < 0.001, after multiple adjustments) and 1.08 (p = 0.07) in women. Men with anemia (hemoglobin levels <13 g/dL) had a 2.15 higher risk of non-vertebral fractures than men with high levels (15.2-18.8, g/dL) whereas women with anemia (hemoglobin levels <12 g/dL) had no increased fracture risk. CONCLUSION Anemia is associated with non-vertebral fractures in men but not in women.
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Affiliation(s)
- L Jørgensen
- Institute of Community Medicine, University of Tromsø, 9037, Tromsø, Norway.
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Plum L, Febres G, Ahmed L, Bessler M, Inabnet W, Korner J. RYGB Surgery in T2DM patients is superior to low calorie diet in improving insulin sensitivity and beta-cell function despite equivalent weight loss. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253958] [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: 10/19/2022]
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Inabnet W, Milone L, Harris P, Durak E, Freeby M, Ahmed L, Sebastian M, Lifante J, Bessler M, Korner J. 158. The Utility of [11C] Dihydrotetrabenazine (DTBZ) PET Scanning in Assessing β-Cell Performance in Non-Obese Type 2 Diabetic Rodents Undergoing Sleeve Gastrectomy and Duodenal-Jejunal Bypass. J Surg Res 2009. [DOI: 10.1016/j.jss.2008.11.193] [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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Dupuis CC, Storr HL, Perry LA, Ho JTF, Ahmed L, Ong KK, Dunger DB, Monson JP, Grossman AB, Besser GM, Savage MO. Abnormal puberty in paediatric Cushing's disease: relationship with adrenal androgen, sex hormone binding globulin and gonadotrophin concentrations. Clin Endocrinol (Oxf) 2007; 66:838-43. [PMID: 17437509 DOI: 10.1111/j.1365-2265.2007.02822.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Paediatric Cushing's disease is frequently associated with abnormal puberty. We addressed the hypothesis that prepubertal patients show excessive virilization and pubertal patients show suppression of LH and FSH secretion. DESIGN AND MEASUREMENTS Serum androstenedione (A4), dehydroepiandrosterone sulphate (DHEAS), testosterone (T), and sex hormone binding globulin (SHBG) were determined at diagnosis and converted to standard deviation scores. LH, FSH concentrations were also determined. Severity of CD was assessed from the sleeping midnight cortisol concentration. Puberty was staged and excessive virilization defined as advance in pubic hair stage for breast stage or testicular volume (TV). PATIENTS Twenty-seven CD patients (17 male, 10 female), median age 13.4 years (range 5.9-17.8) were studied. RESULTS In the CD group as a whole, A4, DHEAS, T standard deviation scores (SDS) values were normal. SHBG SDS values (n = 19) were low (median -1.93, -4.32-0.86) correlating with BMI (r = -0.49). A4, DHEAS, T, SHBG, LH and FSH did not correlate with midnight cortisol, but A4 and T SDS correlated with ACTH at 09.00 h (both r = 0.51). Thirteen patients (11 male, 2 female) had excessive virilization with increased A4 (P = 0.033), DHEAS (P = 0.008), testosterone (P = 0.033) and decreased SHBG (P = 0.004) compared with subjects without excessive virilization. Pubertal boys (TV > or = 4 ml) (n = 7) and girls (breasts > or = stage 2) (n = 8) had low median LH and FSH. Boys had an LH concentration of 1.2 mU/l (0.3-3.5), FSH, 0.9 mU/l (0.2-6.4) and median T SDS, -1.95 (-3.8-4.65), while girls had an LH concentration of 1 mU/l (0.3-7.4). CONCLUSIONS Many patients had abnormal puberty and excessive virilization associated with increased adrenal androgens and decreased SHBG. Pubertal patients had low LH and FSH suggesting impaired pituitary-gonadal axis function.
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Affiliation(s)
- C C Dupuis
- Department of Endocrinology, Barts and the Royal London School of Medicine and Dentistry, London, UK
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Jørgensen L, Joakimsen O, Mathiesen EB, Ahmed L, Berntsen GKR, Fønnebø V, Joakimsen R, Njølstad I, Schirmer H, Jacobsen BK. Carotid plaque echogenicity and risk of nonvertebral fractures in women: a longitudinal population-based study. Calcif Tissue Int 2006; 79:207-13. [PMID: 17048067 DOI: 10.1007/s00223-006-0071-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2006] [Accepted: 07/02/2006] [Indexed: 11/27/2022]
Abstract
Atherosclerosis and osteoporosis appear to be related, but prospective studies on the relationship are sparse. In order to examine whether carotid artery plaques with different morphology predict nonvertebral fractures, we followed 2,733 women, aged 55-74 years (75% of the eligible population in Tromsø, Norway), for 6 years. At baseline, plaque morphology in terms of ultrasound echogenicity was categorized into three groups, ranging from low echogenicity (echolucent plaques with a high content of soft tissue) to strong echogenicity (echogenic plaques with a high content of dense fibrous tissue and calcified material). We found that the age-adjusted relative risk (RR) of fracture was significantly higher among women with echogenic plaques than among women without plaques: 1.7 (95% confidence interval [CI] 1.0-2.7). After adjustment for bone mineral density at baseline in addition to age, the RR was 1.6 (95% CI 1.0-2.6), and further adjustments for body mass index, body height, high-density lipoprotein cholesterol, smoking status, and muscle strength did not influence the association. Subjects with other plaque types were not at an increased risk compared to subjects without plaques: RR < or = 1.1, after multiple adjustments. We conclude that in the general population elderly women with echogenic carotid plaques are at higher risk of nonvertebral fractures than women without plaques.
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Affiliation(s)
- L Jørgensen
- Institute of Community Medicine, University of Tromsø, Breivika, N-9037, Tromsø, Norway.
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Ahmed L, Nazrul Islam S, Khan MNI, Huque S, Ahsan M. Antioxidant micronutrient profile (vitamin E, C, A, copper, zinc, iron) of colostrum: association with maternal characteristics. J Trop Pediatr 2004; 50:357-8. [PMID: 15537722 DOI: 10.1093/tropej/50.6.357] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The study was conducted to investigate the micronutrient profile of human colostrum, and to assess the association of maternal characteristics to the micronutrients. Colostral concentrations of antioxidant vitamins E, C, and A were 21.34 +/- 8.47, 148.92 +/- 43.64, 0.79 +/- 0.42 micromol/l, respectively. The antioxidant minerals copper, zinc, and iron contents were 19.17 +/- 11.73, 63.69 +/- 12.82, 11.44 +/- 1.46 micromol/l, respectively. Maternal characteristics did not have any influence on the colostral micronutrients.
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Affiliation(s)
- L Ahmed
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
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Ahmed L, Castillo J, Morrison JA. Chemistry of tetraboron tetrachloride. Synthesis and characterization of tetraboron tetrabromide (B4Br4) and observation of B4BrCl3, B4Br2Cl2, and B4Br3Cl. Inorg Chem 2002. [DOI: 10.1021/ic00036a025] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ahmed L, Castillo J, Saulys DA, Morrison JA. Reactivity of the diboron tetrahalides. Diboration of ethylene with diboron tetrabromide and thermal decomposition and ligand exchanges of diboron tetrabromide and diboron tetrachloride in carbon tetrabromide and carbon tetrachloride. Inorg Chem 2002. [DOI: 10.1021/ic00030a033] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Farooqui AN, Merchant A, Ahmed L. Klebsiella rhinoscleromatis--an innocent or a deadly organism. J PAK MED ASSOC 2000; 50:395-7. [PMID: 11126819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- A N Farooqui
- Department of Medicine, Karachi Medical and Dental College
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Ahmed L, el-Dib NA, el-Boraey Y, Ibrahim M. Capillaria philippinensis: an emerging parasite causing severe diarrhoea in Egypt. J Egypt Soc Parasitol 1999; 29:483-93. [PMID: 10605499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Four cases with Capillaria philippinensis have been reported from Egypt during 1989-1992. The authors report here four other cases of severe diarrhoea caused by this parasite. A male and three female patients aged 12-45 years presented with severe diarrhoea of 1-7 months duration associated with vomiting and central abdominal colics. Stools were yellowish or greenish and voluminous. Anorexia was profound with loss of weight. Bilateral painless ankle oedema developed early in the course of the disease and two cases had ascites and bilateral pleural effusion at presentation. There was hyponatraemia, hypocalcaemia and marked hypokalaemia and hypoalbulinaemia. Small bowel series showed a rapid transit time in 3 cases and malabsorption pattern in one. Duodenal biopsies showed non-specific chronic inflammation while jejunal biopsies from one case revealed grade II villous atrophy with moderate cellular infiltration of lamina propria. The infection was diagnosed by finding the eggs, larvae and adult worms of C. philippinensis in stool. Patients were treated with mebendazole 400 mg/day in two divided doses for 28 days in addition to high protein diet and correction of electrolyte disturbance. Vomiting stopped on the second day of treatment, appetite improved and diarrhoea regressed by the fourth day. Unfortunately, one case died two days after admission due to marked hypokalaemia. Clinico-pathological and epidemiological aspects of this infection in Egypt are discussed.
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Affiliation(s)
- L Ahmed
- Department of Tropical Medicine, Faculty of Medicine, Cairo University, Egypt
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Staniszewska S, Ahmed L, Jenkinson C. The conceptual validity and appropriateness of using health-related quality of life measures with minority ethnic groups. Ethn Health 1999; 4:51-63. [PMID: 10887462 DOI: 10.1080/13557859998191] [Citation(s) in RCA: 13] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Health-related quality of life measures have become increasingly used in the evaluation of health care to provide a measure of patients' subjective health status. Although studies often include ethnically heterogeneous samples, it is not clear to what extent the use of quality of life measures in this context is valid, because culture can affect the perception and interpretation of health and illness and so may affect the responses to items in a questionnaire. Such use also assumes the appropriateness of using a questionnaire format with individuals from different cultural backgrounds. This paper questions the assumptions of universality of concept and method, and presents the findings of a study which explored the conceptual validity and appropriateness of using the one health-related quality of life measure, the Short Form-36 with a group of Indian cardiac patients. The study identified some differences between a matched control group and Indian patients. The implications of these results and the importance of considering culture in the measurement of health-related quality of life are discussed.
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Affiliation(s)
- S Staniszewska
- Royal College of Nursing Institute, Radcliffe Infirmary, Oxford, UK
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Abstract
The measurement of patient satisfaction has become a common way to elicit patients' views of their health care. However, difficulties arising from the limited theoretical underpinning of satisfaction, the difficulty in defining expectations and satisfaction and the methodological problems associated with their measurement have cast doubt on the validity of studies. This paper reviews the methodological and theoretical difficulties in measuring these concepts and argues that a better understanding of expectations and satisfaction, which is based in patient experience, must first be achieved before theoretical modelling and valid measurement can progress. It presents the findings of a study which attempted to clarify the concepts of expectations and satisfaction by exploring the experience of cardiac patients. The findings are discussed in the context of the key issues in this area.
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Affiliation(s)
- S Staniszewska
- Royal College of Nursing Institute, Radcliffe Infirmary, Oxford, England
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