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Watts EL, Perez‐Cornago A, Appleby PN, Albanes D, Ardanaz E, Black A, Bueno‐de‐Mesquita HB, Chan JM, Chen C, Chubb SP, Cook MB, Deschasaux M, Donovan JL, English DR, Flicker L, Freedman ND, Galan P, Giles GG, Giovannucci EL, Gunter MJ, Habel LA, Häggström C, Haiman C, Hamdy FC, Hercberg S, Holly JM, Huang J, Huang W, Johansson M, Kaaks R, Kubo T, Lane JA, Layne TM, Le Marchand L, Martin RM, Metter EJ, Mikami K, Milne RL, Morris HA, Mucci LA, Neal DE, Neuhouser ML, Oliver SE, Overvad K, Ozasa K, Pala V, Pernar CH, Pollak M, Rowlands M, Schaefer CA, Schenk JM, Stattin P, Tamakoshi A, Thysell E, Touvier M, Trichopoulou A, Tsilidis KK, Van Den Eeden SK, Weinstein SJ, Wilkens L, Yeap BB, Key TJ, Allen NE, Travis RC. The associations of anthropometric, behavioural and sociodemographic factors with circulating concentrations of IGF-I, IGF-II, IGFBP-1, IGFBP-2 and IGFBP-3 in a pooled analysis of 16,024 men from 22 studies. Int J Cancer 2019; 145:3244-3256. [PMID: 30873591 PMCID: PMC6745281 DOI: 10.1002/ijc.32276] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/28/2019] [Accepted: 02/04/2019] [Indexed: 12/24/2022]
Abstract
Insulin-like growth factors (IGFs) and insulin-like growth factor binding proteins (IGFBPs) have been implicated in the aetiology of several cancers. To better understand whether anthropometric, behavioural and sociodemographic factors may play a role in cancer risk via IGF signalling, we examined the cross-sectional associations of these exposures with circulating concentrations of IGFs (IGF-I and IGF-II) and IGFBPs (IGFBP-1, IGFBP-2 and IGFBP-3). The Endogenous Hormones, Nutritional Biomarkers and Prostate Cancer Collaborative Group dataset includes individual participant data from 16,024 male controls (i.e. without prostate cancer) aged 22-89 years from 22 prospective studies. Geometric means of protein concentrations were estimated using analysis of variance, adjusted for relevant covariates. Older age was associated with higher concentrations of IGFBP-1 and IGFBP-2 and lower concentrations of IGF-I, IGF-II and IGFBP-3. Higher body mass index was associated with lower concentrations of IGFBP-1 and IGFBP-2. Taller height was associated with higher concentrations of IGF-I and IGFBP-3 and lower concentrations of IGFBP-1. Smokers had higher concentrations of IGFBP-1 and IGFBP-2 and lower concentrations of IGFBP-3 than nonsmokers. Higher alcohol consumption was associated with higher concentrations of IGF-II and lower concentrations of IGF-I and IGFBP-2. African Americans had lower concentrations of IGF-II, IGFBP-1, IGFBP-2 and IGFBP-3 and Hispanics had lower IGF-I, IGF-II and IGFBP-3 than non-Hispanic whites. These findings indicate that a range of anthropometric, behavioural and sociodemographic factors are associated with circulating concentrations of IGFs and IGFBPs in men, which will lead to a greater understanding of the mechanisms through which these factors influence cancer risk.
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Affiliation(s)
- Eleanor L. Watts
- Cancer Epidemiology UnitNuffield Department of Population Health, University of OxfordOxfordUnited Kingdom
| | - Aurora Perez‐Cornago
- Cancer Epidemiology UnitNuffield Department of Population Health, University of OxfordOxfordUnited Kingdom
| | - Paul N. Appleby
- Cancer Epidemiology UnitNuffield Department of Population Health, University of OxfordOxfordUnited Kingdom
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, Department of Health and Human ServicesNational Cancer Institute, National Institutes of HealthBethesdaMD
| | - Eva Ardanaz
- Navarra Public Health InstitutePamplonaSpain
| | - Amanda Black
- Division of Cancer Epidemiology and Genetics, Department of Health and Human ServicesNational Cancer Institute, National Institutes of HealthBethesdaMD
| | - H. Bas Bueno‐de‐Mesquita
- Department for Determinants of Chronic DiseasesNational Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
- Department of Gastroenterology and HepatologyUniversity Medical CentreUtrechtThe Netherlands
- Department of Epidemiology and BiostatisticsImperial College LondonLondonUnited Kingdom
- Department of Social & Preventive MedicineUniversity of MalayaKuala LumpurMalaysia
| | - June M. Chan
- Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCA
- Department UrologyUniversity of California‐San FranciscoSan FranciscoCA
| | - Chu Chen
- Public Health Sciences Division, Program in EpidemiologyFred Hutchinson Cancer Research CenterSeattleWA
| | - S.A. Paul Chubb
- PathWest Laboratory MedicineFiona Stanley HospitalPerthWAAustralia
- Medical SchoolUniversity of Western AustraliaPerthWAAustralia
| | - Michael B. Cook
- Division of Cancer Epidemiology and Genetics, Department of Health and Human ServicesNational Cancer Institute, National Institutes of HealthBethesdaMD
| | - Mélanie Deschasaux
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS)Nutritional Epidemiology Research Team (EREN), Inserm U1153/Inra U1125/Cnam/Paris 13 UniversityParisFrance
| | - Jenny L. Donovan
- Department of Population Health SciencesBristol Medical School, University of BristolBristolUnited Kingdom
| | - Dallas R. English
- Cancer Epidemiology and Intelligence DivisionCancer Council VictoriaMelbourneVICAustralia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of MelbourneMelbourneVICAustralia
| | - Leon Flicker
- Medical SchoolUniversity of Western AustraliaPerthWAAustralia
- WA Centre for Health & Ageing, Centre for Medical ResearchHarry Perkins Institute of Medical ResearchPerthWAAustralia
- Department of Geriatric MedicineRoyal Perth HospitalPerthWAAustralia
| | - Neal D. Freedman
- Division of Cancer Epidemiology and Genetics, Department of Health and Human ServicesNational Cancer Institute, National Institutes of HealthBethesdaMD
| | - Pilar Galan
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS)Nutritional Epidemiology Research Team (EREN), Inserm U1153/Inra U1125/Cnam/Paris 13 UniversityParisFrance
| | - Graham G. Giles
- Cancer Epidemiology and Intelligence DivisionCancer Council VictoriaMelbourneVICAustralia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of MelbourneMelbourneVICAustralia
| | - Edward L. Giovannucci
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
- Channing Division of Network MedicineBrigham and Women's Hospital and Harvard Medical SchoolBostonMA
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMA
| | - Marc J. Gunter
- Section of Nutrition and MetabolismInternational Agency for Research on CancerLyonFrance
| | - Laurel A. Habel
- Division of ResearchKaiser Permanente Northern CaliforniaOaklandCA
| | | | | | - Freddie C. Hamdy
- Nuffield Department of SurgeryUniversity of OxfordOxfordUnited Kingdom
| | - Serge Hercberg
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS)Nutritional Epidemiology Research Team (EREN), Inserm U1153/Inra U1125/Cnam/Paris 13 UniversityParisFrance
| | - Jeff M. Holly
- IGFs & Metabolic Endocrinology Group, Translational Health SciencesBristol Medical School, Faculty of Health Sciences, University of BristolBristolUnited Kingdom
| | - Jiaqi Huang
- Division of Cancer Epidemiology and Genetics, Department of Health and Human ServicesNational Cancer Institute, National Institutes of HealthBethesdaMD
| | - Wen‐Yi Huang
- Division of Cancer Epidemiology and Genetics, Department of Health and Human ServicesNational Cancer Institute, National Institutes of HealthBethesdaMD
| | - Mattias Johansson
- Genetic Epidemiology GroupInternational Agency for Research on CancerLyonFrance
| | - Rudolf Kaaks
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Tatsuhiko Kubo
- Department of Environmental EpidemiologyUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - J. Athene Lane
- Department of Population Health SciencesBristol Medical School, University of BristolBristolUnited Kingdom
- National Institute for Health Research Bristol Biomedical Research Unit in NutritionBristolUnited Kingdom
| | | | | | - Richard M. Martin
- Department of Population Health SciencesBristol Medical School, University of BristolBristolUnited Kingdom
- National Institute for Health Research Bristol Biomedical Research Unit in NutritionBristolUnited Kingdom
- Medical Research Council/University of Bristol Integrative Epidemiology Unit, University of BristolBristolUnited Kingdom
| | - E. Jeffrey Metter
- Department of NeurologyUniversity of Tennessee Health Science CenterMemphisTN
| | | | - Roger L. Milne
- Cancer Epidemiology and Intelligence DivisionCancer Council VictoriaMelbourneVICAustralia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, The University of MelbourneMelbourneVICAustralia
| | | | - Lorelei A. Mucci
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
- Channing Division of Network MedicineBrigham and Women's Hospital and Harvard Medical SchoolBostonMA
| | - David E. Neal
- Nuffield Department of SurgeryUniversity of OxfordOxfordUnited Kingdom
| | - Marian L. Neuhouser
- Cancer Prevention Program, Public Health Sciences DivisionFred Hutchinson Cancer Research CenterSeattleWA
| | - Steven E. Oliver
- Department of Health SciencesUniversity of York and the Hull York Medical SchoolYorkUK
| | - Kim Overvad
- Department of Public HealthSection for Epidemiology, Aarhus UniversityAarhusDenmark
| | - Kotaro Ozasa
- Radiation Effects Research FoundationHiroshimaJapan
| | - Valeria Pala
- Epidemiology and Prevention UnitFondazione IRCCS Istituto Nazionale dei Tumori di MilanoMilanItaly
| | - Claire H. Pernar
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
| | - Michael Pollak
- Department of Medicine and OncologyMcGill UniversityMontrealQCCanada
- Segal Cancer CentreJewish General HospitalMontrealQCCanada
| | - Mari‐Anne Rowlands
- Department of Population Health SciencesBristol Medical School, University of BristolBristolUnited Kingdom
| | | | - Jeannette M. Schenk
- Cancer Prevention Program, Public Health Sciences DivisionFred Hutchinson Cancer Research CenterSeattleWA
| | - Pär Stattin
- Department of Surgical SciencesUppsala UniversityUppsalaSweden
| | | | - Elin Thysell
- Department of Medical Biosciences and PathologyUmea UniversityUmeaSweden
| | - Mathilde Touvier
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS)Nutritional Epidemiology Research Team (EREN), Inserm U1153/Inra U1125/Cnam/Paris 13 UniversityParisFrance
| | | | - Konstantinos K. Tsilidis
- Department of Epidemiology and BiostatisticsImperial College LondonLondonUnited Kingdom
- Department of Hygiene and Epidemiology, School of MedicineUniversity of IoanninaIoanninaGreece
| | | | - Stephanie J. Weinstein
- Division of Cancer Epidemiology and Genetics, Department of Health and Human ServicesNational Cancer Institute, National Institutes of HealthBethesdaMD
| | | | - Bu B. Yeap
- Medical SchoolUniversity of Western AustraliaPerthWAAustralia
- Department of Endocrinology and DiabetesFiona Stanley HospitalPerthWAAustralia
| | - Timothy J. Key
- Cancer Epidemiology UnitNuffield Department of Population Health, University of OxfordOxfordUnited Kingdom
| | - Naomi E. Allen
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population Health, University of OxfordOxfordUnited Kingdom
| | - Ruth C. Travis
- Cancer Epidemiology UnitNuffield Department of Population Health, University of OxfordOxfordUnited Kingdom
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Moppett IK, Rowlands M, Mannings AM, Marufu TC, Sahota O, Yeung J. The effect of intravenous iron on erythropoiesis in older people with hip fracture. Age Ageing 2019; 48:751-755. [PMID: 31127269 DOI: 10.1093/ageing/afz049] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND anaemia following hip fracture is common and associated with worse outcomes. Intravenous iron is a potential non-transfusion treatment for this anaemia and has been found to reduce transfusion rates in previous observational studies. There is good evidence for its use in elective surgical populations. OBJECTIVE to examine the impact of intravenous iron on erythropoiesis following hip fracture. DESIGN two-centre, assessor-blinded, randomised, controlled trial of patients with primary hip fracture and no contra-indications to intravenous iron. METHOD the intervention group received three doses of 200 mg iron sucrose over 30 min (Venofer, Vifor Pharma, Bagshot Park, UK) on three separate days. Primary outcome was reticulocyte count at day 7 after randomisation. Secondary outcomes included haemoglobin concentration, complications and discharge destination. Eighty participants were randomised. RESULTS there was a statistically significantly greater absolute final reticulocyte count in the iron group (89.4 (78.9-101.3) × 109 cells l-1 (n = 39) vs. the control (72.2 (63.9-86.4)) × 109 cells l-1 (n = 41); P = 0.019; (mean (95% confidence intervals) of log-transformed data). There were no differences in final haemoglobin concentration (99.9 (95.7-104.2) vs. 102.0 (98.7-105.3) P = 0.454) or transfusion requirements in the first week (11 (28%) vs. 12 (29%); P = 0.899). Functional and safety outcomes were not different between the groups. CONCLUSIONS although intravenous iron does stimulate erythropoiesis following hip fracture in older people, the effect is too small and too late to affect transfusion rates. Trial Registry Numbers: ISRCTN:76424792; EuDRACT: 2011-003233-34.
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Affiliation(s)
- I K Moppett
- Anaesthesia and Critical Care Research Group, Division of Clinical Neuroscience, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
| | - M Rowlands
- Department of Anaesthesia, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - A M Mannings
- Department of Anaesthesia, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - T C Marufu
- Department of Healthcare of Older Life, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - O Sahota
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - J Yeung
- Warwick Medical School, University of Warwick, Warwick, UK
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Moppett IK, Rowlands M, Mannings A, Moran CG, Wiles MD. LiDCO-based fluid management in patients undergoing hip fracture surgery under spinal anaesthesia: a randomized trial and systematic review. Br J Anaesth 2015; 114:444-59. [PMID: 25500940 DOI: 10.1093/bja/aeu386] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hip fracture is a condition with high mortality and morbidity in elderly frail patients. Intraoperative fluid optimization may be associated with benefit in this population. We investigated whether intraoperative fluid management using pulse-contour analysis cardiac monitoring, compared with standard care in patients undergoing spinal anaesthesia, would provide benefits in terms of reduced time until medically fit for discharge and postoperative complications. METHODS Patients undergoing surgical repair of fractured neck of femur, aged >60 yr, receiving spinal anaesthesia were enrolled in this single-centre, blinded, randomized, parallel group trial. Patients were allocated to either anaesthetist-directed fluid therapy or a pulse-contour-guided fluid optimization strategy using colloid (Gelofusine) boluses to optimize stroke volume. The primary outcome was time until medically fit for discharge. Secondary outcomes included postoperative complications, mobility, and mortality. We updated a systematic review to include relevant trials to 2014. RESULTS We recruited 130 patients. Time until medically fit for discharge was similar in both groups, mean [95% confidence interval (CI)] 12.2 (11.1-13.5) vs 13.1 (11.9-14.5) days (P=0.31), as was total length of stay 14.2 (12.9-15.8) vs 15.3 (13.8-17.2) days (P=0.32). There were no significant differences in complications, function, or mortality. An updated meta-analysis (four studies, 355 patients) found non-significant reduction in early mortality [relative risk 0.66 (0.24-1.79)] and in-hospital complications [relative risk 0.80 (0.61-1.05)]. CONCLUSIONS Goal-directed fluid therapy during hip fracture repair under spinal anaesthesia does not result in a significant reduction in length of stay or postoperative complications. There is insufficient evidence to either support or discount its routine use. CLINICAL TRIAL REGISTRATION ISRCTN88284896.
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Affiliation(s)
- I K Moppett
- Anaesthesia and Critical Care, Division of Clinical Neuroscience , Queen's Medical Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK
| | - M Rowlands
- Anaesthesia and Critical Care, Division of Clinical Neuroscience , Queen's Medical Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK
| | - A Mannings
- Anaesthesia and Critical Care, Division of Clinical Neuroscience , Queen's Medical Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK
| | - C G Moran
- Department of Trauma and Orthopaedics, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK
| | - M D Wiles
- Department of Anaesthetics, Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield S10 2JF, UK
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Abstract
OBJECTIVE To identify the optimal method of submission of canine and feline urine for bacterial culture. METHODS Cystocentesis samples from 250 animals (200 dogs, 50 cats) suspected of having urinary tract infections were collected. The reference aliquot, without preservative, was processed on site within 2 hours. Two further aliquots (one without preservative, one with boric acid) were stored at room temperature for up to 7 hours and then posted by guaranteed next day delivery to a commercial laboratory for analysis. RESULTS Forty-seven of the samples were positive on culture in the reference test. There was no significant difference between reference test results and those of samples posted without preservative (P=0·39), but samples posted in boric acid were significantly less likely to give a positive result (P=0·01). Samples posted without preservative had a sensitivity of 82% and a specificity of 98%; for boric acid, sensitivity was 73% and specificity 99%. CLINICAL SIGNIFICANCE Postal urine samples should be submitted to the laboratory in a plain sterile tube.
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Affiliation(s)
- M Rowlands
- Small Animal Teaching Hospital, University of Liverpool, Neston, Cheshire CH64 7TE
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Abstract
Oral anticholinergic therapy, used for the treatment of detrusor overactivity (DO), is limited by systemic side-effects and because of failure to respond. Alternative routes of administration include the intravesical route. We reviewed 11 women who were treated with intravesical oxybutynin (IVO). All had idiopathic DO, their symptoms having been unsuccessfully controlled on oral agents. Seven patients had symptomatic improvement. Six out of the eight patients that completed their voiding diaries showed a reduction in voiding frequency. Five patients found the procedure too inconvenient. Seven patients suffered chemical irritation. One patient complained of voiding difficulties. No patient reported systemic side-effects. The mean duration of treatment was 4-5 weeks; two patients continue to use IVO. IVO can be used successfully in the treatment of DO, but its use is limited due to the inconvenience related to catheterisation. With the advent of Botox and oxybutynin patches, IVO probably has a limited role.
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Affiliation(s)
- K Guerrero
- Department of Obstetrics and Gynaecology, Singleton Hospital, Swansea SA2 8QA, UK.
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Reynald K, Rowlands M, Hardcastle A, Stimson L, Bannister A, Workman P, Aherne W. 149 POSTER Acetylation of molecular chaperones by histone deactylase inhibitors (HDACI). EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)72081-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Francis NJ, Rowlands M, Travers J, Reynissen J, Hardcastle A, Stimson L, Gamblin S, Jones K, Workman P, Aherne W. 426 POSTER A high throughput screen and secondary assays for the identification and evaluation of histone methyltransferase inhibitors. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)70431-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Turlais F, Hardcastle A, Rowlands M, Newbatt Y, Bannister A, Kouzarides T, Workman P, Aherne GW. High-throughput screening for identification of small molecule inhibitors of histone acetyltransferases using scintillating microplates (FlashPlate). Anal Biochem 2001; 298:62-8. [PMID: 11673896 DOI: 10.1006/abio.2001.5340] [Citation(s) in RCA: 34] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The role of histone acetyltransferases (HATs) in the regulation of crucial cellular functions, e.g., gene transcription, differentiation, and proliferation, has recently been documented and there is increasing evidence that aberrant expression of these enzymes may have a role to play in the development of the malignant phenotype. The availability of potent and selective small molecule inhibitors of HATs would provide useful proof of principle probes for further validation of these enzymes as drug discovery targets and may also provide lead molecules for clinical drug development. We have developed a microplate assay for HAT activity suitable for high-throughput screening. In the assay, following incubation of histone H3, [3H]acetylCoA, and enzyme (recombinant p300/CBP-associated factor expressed as a glutathione S-transferase fusion protein), radiolabeled histone was captured onto the walls of a scintillating microplate (FlashPlate) generating a scintillation signal. The assay was reproducible, amenable to automation, and generated a wide signal to noise ratio. Although antiacetylated histone antibodies were initially used to capture the radiolabeled product, it was subsequently shown that a signal was effectively produced by histone passively binding to the walls of the FlashPlate. This resulted in a simple "mix and measure" assay that is currently being used for the identification of HAT inhibitors.
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Affiliation(s)
- F Turlais
- CRC Centre for Cancer Therapeutics, Institute of Cancer Research, Sutton, Surrey, SM2 5NG, United Kingdom
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Brooker S, Rowlands M, Haller L, Savioli L, Bundy DA. Towards an atlas of human helminth infection in sub-Saharan Africa: the use of geographical information systems (GIS). Parasitol Today 2000; 16:303-7. [PMID: 10858650 DOI: 10.1016/s0169-4758(00)01687-2] [Citation(s) in RCA: 88] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
The value of a geographical perspective to infectious disease epidemiology and control has long been recognized. However, the labour required to produce maps, and keep them up to date, has inhibited the development of this area, and very little is currently known about the spatial distribution of parasitic infections other than malaria, trypanosomiasis and onchocerciasis. A recent initiative by an international group of collaborators is attempting to redress the absence of detailed spatial information on the major helminth infections of humans. In this article, Simon Brooker and colleagues describe progress made by this initiative in mapping helminth infections in sub-Saharan Africa, highlighting the value as well as the limitations of this empirical mapping approach.
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Affiliation(s)
- S Brooker
- WHO Collaborating Centre, Wellcome Trust Centre for the Epidemiology of Infectious Disease, University of Oxford, South Parks Road, Oxford, UK OX1 3FY.
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Morley PT, Rees K, Presneill JJ, Rowlands M, Cade JF, Tatoulis J. Beneficial effects of lung recruitment with PEEP after cardiac surgery. Crit Care 2000. [PMCID: PMC3333044 DOI: 10.1186/cc840] [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: 11/25/2022] Open
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Johnston SR, Boeddinghaus IM, Riddler S, Haynes BP, Hardcastle IR, Rowlands M, Grimshaw R, Jarman M, Dowsett M. Idoxifene antagonizes estradiol-dependent MCF-7 breast cancer xenograft growth through sustained induction of apoptosis. Cancer Res 1999; 59:3646-51. [PMID: 10446976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Idoxifene is a novel selective estrogen (E2) receptor (ER) modulator that is currently in clinical development for the treatment of breast cancer. Compared to tamoxifen, idoxifene is metabolically more stable, with a higher relative binding affinity for the ER and reduced agonist activity on breast and uterine cells. Idoxifene also inhibits calmodulin, a calcium-binding protein that is involved in cell signal transduction pathways. In this study, the abilities of idoxifene and tamoxifen to antagonize E2-dependent MCF-7 xenograft growth in oophorectomized athymic mice were compared. The basis for idoxifene's antitumor activity was examined by comparing the effectiveness of the clinically used transisomer (referred to here as idoxifene) with its cis-isomer, which has a 50-fold lower relative binding affinity for ER than idoxifene but similar calmodulin-inhibitory activity. Changes in tumor cell proliferation, apoptosis, and ER-dependent protein expression were studied. Both idoxifene and tamoxifen significantly inhibited E2-dependent tumor growth, whereas cis-idoxifene had little effect. Withdrawal of E2 support induced significant tumor regression due to impaired cell proliferation (Ki-67 score, 9 versus 51% compared to E2 controls) and induction of apoptosis (3.6 versus 0.9% compared to E2 controls). Both anti-E2s inhibited cell proliferation and caused a significant 3-fold induction of apoptosis in E2 supported tumors after 1 week, which was maintained for 3 months with idoxifene (3.1 versus 0.48% compared to E2 controls) but decreased back to baseline in tumors treated with tamoxifen (0.69%). In contrast, cis-idoxifene had no effect on either cell proliferation or apoptosis. Both tamoxifen and idoxifene initially induced ER expression, whereas prolonged therapy with tamoxifen significantly reduced progesterone receptor levels. In conclusion, idoxifene resulted in similar inhibition of E2-dependent MCF-7 xenograft growth compared with tamoxifen, an effect that is mediated via ER rather than through calmodulin. Sustained induction of apoptosis may contribute to prolonged antagonism of E2-dependent growth, and it occurred to a greater extent following 3 months of idoxifene, compared to tamoxifen.
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Affiliation(s)
- S R Johnston
- Department of Medicine, The Royal Marsden NHS Trust, London, England.
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Payne Y, Williams M, Cheadle J, Stott NC, Rowlands M, Shickle D, West G, Meredith L, Goodchild M, Harper PS, Clarke A. Carrier screening for cystic fibrosis in primary care: evaluation of a project in South Wales. The South Wales Cystic Fibrosis Carrier Screening Research Team. Clin Genet 1997; 51:153-63. [PMID: 9137879 DOI: 10.1111/j.1399-0004.1997.tb02445.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Population carrier screening for cystic fibrosis (CF) was offered to all patients aged 16-45 in one general practice in South Wales, excluding those in couples with a current pregnancy. Out of 1553 patients in this group, 481 subjects were tested, giving an overall uptake rate of more than 30%. The rate of uptake varied with the mode of invitation. Twenty-six carriers were identified, giving a prevalence of identified carriers of 5.4% (1 in 18.5) for those with no family history of CF. A further 18 carriers were identified by cascade testing of these 26. We describe the practical difficulties encountered in setting up this programme in primary care in South Wales. Questionnaires were administered or distributed to all subjects before and after testing. The response rate for the pre-test questionnaire was 95%, and 40-50% for the post-test questionnaires. These showed that, at 3 months post-test, 1 in 4 screen-negative subjects did not appreciate that they had a residual risk of being a carrier. At the same time, 15% of this group thought that there was a 1 in 4 chance of a child being affected if one parent was screen-positive (carried an identified mutation) and the other was screen-negative, and 40% thought there was no risk. Anxiety in relation to testing did not appear to be a major problem, although individual patterns of response to carrier status varied widely and more sensitive indicators of psychosocial impact of genetic tests are required. A pilot study of couple screening showed that this approach is unlikely to be useful in primary care, although we did not assess couple testing during pregnancy. For any programme of CF carrier screening to be established in primary care, it will be necessary to involve the primary care team from the earliest planning stage, so that the opportunity costs, training needs and other costs of the programme can be fully resourced.
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Affiliation(s)
- Y Payne
- Dept. of Medical Genetics, University of Wales College of Medicine, Cardiff, USA
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Dowsett M, Detre S, Rowlands M, Grimshaw R. Oestrogen formation in breast: clinical and biological importance. J Endocrinol 1996; 150 Suppl:S59-63. [PMID: 8943788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
It has been known for many years that many breast carcinomas can synthesize oestrogens from androgens via the action of the enzyme aromatase. There has been widespread speculation on the possibility that this acts as an important intracrine source of growth stimulation. For example, there are data which indicate that clinical response to aromatase inhibitors is far more common in tumours which possess measurable amounts of aromatase. In addition, aromatase activity in the quadrant of the normal breast surrounding breast carcinomas is generally higher than in the other quadrants. However, these data are only suggestive and the case for a significant role for intratumoural aromatase in breast cancer growth remains unproven. We have recently explored this possibility by the transfection of human breast cancer cells with aromatase. By a series of experiments in athymic mice we have demonstrated that growth is supported by this intracrine source in the absence of endocrine oestrogen stimulation.
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Bretti S, Gilleece MH, Kamthan A, Fitzsimmons L, Hicks F, Rowlands M, Bishop P, Picardo AM, Dexter TM, Scarffe JH. An open phase I study to assess the biological effects of a continuous intravenous infusion of Interleukin-3 followed by Granulocyte Macrophage-Colony Stimulating Factor. Eur J Cancer 1996; 32A:1171-8. [PMID: 8758249 DOI: 10.1016/0959-8049(96)00027-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
To assess any synergistic stimulatory effect in vivo of Interleukin 3 (IL-3) and Granulocyte Macrophage-Colony Stimulating Factor (GM-CSF) upon white cell and platelet counts, toxicity and antitumour effect, we conducted this phase I study. IL-3 0.25, 0.5 or 5 micrograms/kg/day for 1, 4 or 7 days was given by continuous intravenous (i.v.) infusion to 35 patients with advanced malignancy. 21 of the 35 patients also received sequential or overlapping treatment with continuous i.v. infusion of GM-CSF 1 or 3 micrograms/kg/day for up to 10 days. Monotherapy with IL-3 producted significant dose related increases in platelets and white cell counts. Combinations of IL-3 and GM-CSF also produced increases in white cell counts, but these were no greater than would be expected following GM-CSF treatment alone. There was a trend for platelets to increase more in patients receiving IL-3 and GM-CSF than those receiving IL-3 alone, but this did not reach statistical significance. In general, IL-3 and combinations of IL-3 and GM-CSF were well tolerated and the most common side-effect was fever. A maximum tolerated dose was not reached and antitumour effects were not seen. Future studies using combinations of IL-3 5 micrograms/kg/day and GM-CSF 3 micrograms/kg/day may help to define the optimal therapeutic regimen.
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Affiliation(s)
- S Bretti
- CRC Department of Medical Oncology, Christie Hospital Trust, Manchester, UK
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Abstract
The existence of aromatase activity in human breast carcinomas has been established for about 20 years but the clinical and biological importance of this remains unclear. A number of studies in clinical material suggest that aromatase activity may be a prerequisite of response to aromatase inhibitors and that aromatase activity may be enhanced in those tumours relapsing during treatment with one such inhibitor, aminoglutethimide. These results would carry more significance, however, if it was demonstrable that the growth of breast carcinomas is affected by the conversion of androgens to oestrogens by intratumoural aromatase. We have tried to address this by establishing model systems with aromatase-transfected MCF7 breast cancer cells. We have demonstrated that these cells can be stimulated mitogenically with androgen and that this proliferation is suppressible with aromatase inhibitors. Similarly the growth of aromatase transfected cells but not wild type cells as xenografts is supported by androstenedione and inhibitable by both the steroidal aromatase inhibitor, 4-hydroxyandrostenedione and non-steroidal inhibitor, CGS 20267. Work with the former of these, which is a suicide inhibitor allowed us to demonstrate that growth can proceed with aromatase activity approximating to the highest level seen in breast carcinomas indicating that at least at this extreme level the intratumoural conversion of androgens to oestrogens may indeed be able to support tumour growth. Further work with this mode system should allow us to define the minimal amount of intratumoural activity which can support tumour growth.
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Pettengell R, Morgenstern GR, Woll PJ, Chang J, Rowlands M, Young R, Radford JA, Scarffe JH, Testa NG, Crowther D. Peripheral blood progenitor cell transplantation in lymphoma and leukemia using a single apheresis. Blood 1993; 82:3770-7. [PMID: 7505124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Myeloablative treatment and peripheral blood progenitor cell (PBPC) transplantation are increasingly used for lymphomas and leukemias. We have sought to optimize conditions for priming, collection, and engraftment of the leukapheresis product. Fifty-four consecutive adult patients were eligible, 31 with high-grade non-Hodgkin's lymphoma of poor prognosis, 12 with Hodgkin's disease in chemosensitive relapse, and 11 with poor prognosis acute lymphoblastic leukemia. Filgrastim was administered after routine chemotherapy with VAPEC-B or HiCCOM to mobilize PBPC. A rapidly increasing white blood cell count was used to predict the time of peak PBPC release and plan leukapheresis. Forty-five patients underwent leukapheresis. A median of 14 L of blood was processed at a single apheresis. A median of 2.4 x 10(8)/kg mononuclear cells (MNCs), 1.04 x 10(6)/kg granulocyte-macrophage colony-forming cells (GM-CFCs), and 10.6 x 10(6)/kg CD34+ cells were obtained. Slightly fewer MNCs were obtained from the heavily pretreated Hodgkin's disease group. There were no other significant differences in the size or composition of the leukapheresis harvest in the three patient groups. Forty patients underwent high-dose therapy and PBPC transplantation. Filgrastim was administered by daily subcutaneous injection until the absolute neutrophil count was > or = 1 x 10(9)/L for 2 consecutive days. Rapid and sustained hematopoietic engraftment occurred in all patients. The median time to achieve a neutrophil count > or = 0.5 x 10(9)/L was 9 days (range, 8 to 16 days); to achieve a platelet count > or = 20 x 10(9)/L was 10 days (range, 6 to 88 days); and to achieve a platelet count > or = 50 x 10(9)/L was 15.5 days (range, 10 to 100 days). Neutrophil recovery was faster than that of a historical control group treated with autologous bone marrow transplantation and filgrastim, but platelet recovery times were halved in the PBPC group. There was no secondary engraftment failure. Requirements for blood and platelet transfusions, antibiotic use, and parenteral nutrition were similar in the three patient groups. The median number of days in the hospital was 13 (range, 10 to 55) in the PBPC patients, compared with 19 (range, 14 to 51) in the historical controls. Leukapheresis yields (MNC, GM-CFC, and CD34+ cell numbers) were not useful for predicting the times to engraftment. We have shown that sufficient PBPC for transplantation can be obtained at a single leukapheresis after mobilization with routine chemotherapy and filgrastim in patients with non-Hodgkin's lymphoma, Hodgkin's disease, and acute lymphoblastic leukemia, even those heavily pretreated.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- R Pettengell
- CRC Department of Medical Oncology, Christie Hospital NHS Trust, Manchester, UK
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Abstract
AIMS To compare the effectiveness of three computerised systems that are currently used for assisting warfarin control in outpatients with the customary dosing method used by experienced medical staff. METHODS A pilot randomised study of three systems with a follow up independently randomised study of two of these was made on 186 patients receiving long term treatment or who had recently started warfarin treatment and had been discharged from hospital. RESULTS All three computerised systems seemed to give satisfactory control compared with the traditional dosing method. For patients receiving more intensive treatment with an assigned target range of 3.0-4.5 computerised dosage programs achieved significantly better control; the medical staff undertreated such patients almost 50% of the time. CONCLUSION Computer based programs can assist outpatient anticoagulant control with warfarin during both early and long term treatment. For most patients the control achieved is as good as that obtained by the customary method of dosing, by experienced clinic doctors, although the latter tend to be too conservative when dosing patients within the intense target range of 3.0 to 4.5 International Normalised Ratio (INR). The computers were significantly more successful in this higher range.
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Abstract
AIMS To find out which children are treated with oral anticoagulants and how their treatment is controlled in the United Kingdom. METHODS Two questionnaires were used. The first was sent to general haematologists and the other to paediatric cardiologists and cardiac surgeons. RESULTS There were 273 (58%) replies to the first questionnaire. Most children were treated because of artificial cardiac valve replacement. The mean target International Normalised Ratio (INR) used was 2.73 to 4.0 for children with heart valves and 2.1 to 3.25 for children with venous thrombosis. The second questionnaire elicited replies from 11 of 22 cardiac centres. The mean target INR used for children with cardiac valves ranged from 2.59-3.77. Of 68 children covered in the survey, there have been two major bleeds and two thrombotic episodes: 78.8% of children were controlled with a venous prothrombin time and 21.2% with a capillary test. There was no consistency in the dose regimens used for the induction of oral anticoagulant treatment with warfarin. CONCLUSIONS The levels of anticoagulation used for maintenance are similar to those recommended by the British Society for Haematology for adults (3.0 to 4.5). They seem to be safe for children too.
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Affiliation(s)
- D I Evans
- Royal Manchester Children's Hospital
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