1
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Abo KM, Merritt C, Basil MC, Lin SM, Cantu E, Morley MP, Bawa P, Gallagher M, Byers DE, Morrisey EE, Wilson AA. Pulmonary Cellular Toxicity in Alpha-1 Antitrypsin Deficiency. Chest 2024:S0012-3692(24)00159-4. [PMID: 38360172 DOI: 10.1016/j.chest.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/09/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024] Open
Affiliation(s)
- Kristine M Abo
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA; The Pulmonary Center and Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Carly Merritt
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA; The Pulmonary Center and Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Maria C Basil
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Penn-CHOP Lung Biology Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Susan M Lin
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Penn-CHOP Lung Biology Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Edward Cantu
- Penn-CHOP Lung Biology Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Division of Cardiovascular Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Michael P Morley
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Penn-CHOP Lung Biology Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Pushpinder Bawa
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA; The Pulmonary Center and Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Marissa Gallagher
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA
| | - Derek E Byers
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO
| | - Edward E Morrisey
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Penn-CHOP Lung Biology Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Andrew A Wilson
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA; The Pulmonary Center and Department of Medicine, Boston University School of Medicine, Boston, MA.
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2
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Werder RB, Berthiaume KA, Merritt C, Gallagher M, Villacorta-Martin C, Wang F, Bawa P, Malik V, Lyons SM, Basil MC, Morrisey EE, Kotton DN, Zhou X, Cho MH, Wilson AA. The COPD GWAS gene ADGRG6 instructs function and injury response in human iPSC-derived type II alveolar epithelial cells. Am J Hum Genet 2023; 110:1735-1749. [PMID: 37734371 PMCID: PMC10577075 DOI: 10.1016/j.ajhg.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/23/2023] Open
Abstract
Emphysema and chronic obstructive pulmonary disease (COPD) most commonly result from the effects of environmental exposures in genetically susceptible individuals. Genome-wide association studies have implicated ADGRG6 in COPD and reduced lung function, and a limited number of studies have examined the role of ADGRG6 in cells representative of the airway. However, the ADGRG6 locus is also associated with DLCO/VA, an indicator of gas exchange efficiency and alveolar function. Here, we sought to evaluate the mechanistic contributions of ADGRG6 to homeostatic function and disease in type 2 alveolar epithelial cells. We applied an inducible CRISPR interference (CRISPRi) human induced pluripotent stem cell (iPSC) platform to explore ADGRG6 function in iPSC-derived AT2s (iAT2s). We demonstrate that ADGRG6 exerts pleiotropic effects on iAT2s including regulation of focal adhesions, cytoskeleton, tight junctions, and proliferation. Moreover, we find that ADGRG6 knockdown in cigarette smoke-exposed iAT2s alters cellular responses to injury, downregulating apical complexes in favor of proliferation. Our work functionally characterizes the COPD GWAS gene ADGRG6 in human alveolar epithelium.
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Affiliation(s)
- Rhiannon B Werder
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA 02118, USA; The Pulmonary Center and Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA; Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
| | - Kayleigh A Berthiaume
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA 02118, USA
| | - Carly Merritt
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA 02118, USA; The Pulmonary Center and Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
| | - Marissa Gallagher
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA 02118, USA
| | - Carlos Villacorta-Martin
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA 02118, USA
| | - Feiya Wang
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA 02118, USA
| | - Pushpinder Bawa
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA 02118, USA
| | - Vidhi Malik
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Shawn M Lyons
- Biochemistry Department, Boston University School of Medicine, Boston, MA 02118, USA
| | - Maria C Basil
- School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Edward E Morrisey
- School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Darrell N Kotton
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA 02118, USA; The Pulmonary Center and Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
| | - Xiaobo Zhou
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Michael H Cho
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Andrew A Wilson
- Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA 02118, USA; The Pulmonary Center and Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA.
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3
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Gallagher M, Ramirez A, Geden CJ, Stoffolano JG. Rescuing the Inhibitory Effect of the Salivary Gland Hypertrophy Virus of Musca domestica on Mating Behavior. Insects 2023; 14:insects14050416. [PMID: 37233044 DOI: 10.3390/insects14050416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023]
Abstract
Infection with salivary gland hypertrophy virus (MdSGHV) of Musca domestica prevents female flies from accepting copulation attempts by healthy or virus-infected males. This study focused on supplemental hormonal rescue therapy for mating behavior in virus-infected female house flies. The inhibitory effect of the virus on mating behavior in females injected with MdSGHV was reversed by hormonal therapy in the form of octopamine injections, topical application of methoprene, or both therapies combined along with 20-hydroxyecdysone. Infected females whose mating responsiveness had been restored continued to have other viral pathologies associated with infection such as hypertrophy of the salivary glands and a lack of ovarian development.
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Affiliation(s)
- Marissa Gallagher
- Neuroscience Department, University of Massachusetts, Amherst, MA 01003, USA
| | - Arianna Ramirez
- Biology Department, University of Massachusetts, Amherst, MA 01003, USA
| | - Christopher J Geden
- Center for Medical, Agricultural and Veterinary Entomology, USDA, Agricultural Research Service, Gainesville, FL 32608, USA
| | - John G Stoffolano
- Stockbridge School of Agriculture, University of Massachusetts, Amherst, MA 01003, USA
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4
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Arshad I, Gallagher M, Ferrè ER. Visuo-vestibular conflicts within the roll plane modulate multisensory verticality perception. Neurosci Lett 2023; 792:136963. [PMID: 36375625 DOI: 10.1016/j.neulet.2022.136963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/19/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
The integration of visuo-vestibular information is crucial when interacting with the external environment. Under normal circumstances, vision and vestibular signals provide corroborating information, for example regarding the direction and speed of self-motion. However, conflicts in visuo-vestibular signalling, such as optic flow presented to a stationary observer, can change subsequent processing in either modality. While previous studies have demonstrated the impact of sensory conflict on unisensory visual or vestibular percepts, here we investigated whether visuo-vestibular conflicts impact sensitivity to multisensory percepts, specifically verticality. Participants were exposed to a visuo-vestibular conflicting or non-conflicting motion adaptor before completing a Vertical Detection Task. Sensitivity to vertical stimuli was reduced following visuo-vestibular conflict. No significant differences in criterion were found. Our findings suggest that visuo-vestibular conflicts not only modulate processing in unimodal channels, but also broader multisensory percepts, which may have implications for higher-level processing dependent on the integration of visual and vestibular signals.
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Affiliation(s)
- I Arshad
- Department of Psychology, Royal Holloway University of London, United Kingdom; Department of Psychological Sciences, Birkbeck University of London, United Kingdom
| | - M Gallagher
- School of Psychology, Cardiff University, United Kingdom; School of Psychology, University of Kent, United Kingdom.
| | - E R Ferrè
- Department of Psychological Sciences, Birkbeck University of London, United Kingdom
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5
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Gallagher M, Romano F, Bockisch CJ, Ferrè ER, Bertolini G. Quantifying virtual self-motion sensations induced by galvanic vestibular stimulation. J Vestib Res 2023; 33:21-30. [PMID: 36591665 DOI: 10.3233/ves-220031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The vestibular system provides a comprehensive estimate of self-motion in 3D space. Widely used to artificially stimulate the vestibular system, binaural-bipolar square-wave Galvanic Vestibular Stimulation (GVS) elicits a virtual sensation of roll rotation. Postural responses to GVS have been clearly delineated, however quantifying the perceived virtual rotation vector has not been fully realised. OBJECTIVE We aimed to quantify the perceived virtual roll rotation vector elicited by GVS using a psychophysical approach on a 3D turntable. METHODS Participants were placed supine on the 3D turntable and rotated around the naso-occipital axis while supine and received square-wave binaural-bipolar GVS or sham stimulation. GVS amplitudes and intensities were systematically manipulated. The turntable motion profile consisted of a velocity step of 20°/s2 until the trial velocity between 0-20°/s was reached, followed by a 1°/s ramp until the end of the trial. In a psychophysical adaptive staircase procedure, we systematically varied the roll velocity to identify the exact velocity that cancelled the perceived roll sensation induced by GVS. RESULTS Participants perceived a virtual roll rotation towards the cathode of approximately 2°/s velocity for 1 mA GVS and 6°/s velocity for 2.5 mA GVS. The observed values were stable across repetitions. CONCLUSIONS Our results quantify for the first time the perceived virtual roll rotations induced by binaural-bipolar square-wave GVS. Importantly, estimates were based on perceptual judgements, in the absence of motor or postural responses and in a head orientation where the GVS-induced roll sensation did not interact with the perceived direction of gravity. This is an important step towards applications of GVS in different settings, including sensory substitution or Virtual Reality.
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Affiliation(s)
- M Gallagher
- School of Psychology, University of Kent, Canterbury, UK.,School of Psychology, Royal Holloway, University of London, Egham, UK
| | - F Romano
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - C J Bockisch
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Clinical Neuroscience Center, Zurich, Switzerland.,Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland.,Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland
| | - E R Ferrè
- School of Psychology, Royal Holloway, University of London, Egham, UK.,Department of Psychological Sciences, Birkbeck University of London, London, UK
| | - G Bertolini
- Institute of Optometry, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
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Cronin H, Gallagher M, McGorrian C, Galvin J. The genetic spectrum of hypertrophic cardiomyopathy in an irish cohort. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1711] [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
Hypertrophic cardiomyopathy (HCM) has long been described as the archetypal monogenic cardiac disease. It fulfils the criteria for Mendelian inheritance and painstaking early co-segregation studies by Seidman et al in 1990 lead to the discovery that mutations in MYH7 cause HCM. From here, the genetic architecture of HCM has been gradually assembled and thousands of individual mutations discovered. The complexity of HCM genetics continues to evolve to include the gene-negative cohort and those carrying multiple mutations. We sought to describe the genetic spectrum of HCM in an Irish population.
Methods
A retrospective examination of the proband database of a specialist cardiomyopathy clinic was undertaken to select all patients with gene-positive HCM. Their clinical data and cardiac imaging was reviewed. Mutations classified by the American College of Medical Genetics as Class 4 and 5 were considered pathogenic. Variants of uncertain significance (VUS) in candidate genes were also recorded, though not clinically actionable.
Results
The results of genetic testing for 254 HCM patients were reviewed. 94% of patients (n=238) had a single pathogenic HCM gene mutation. 5% of patients (n=13) had digenic disease. The remaining 1% (n=3) had oligogenic disease. MYBPC3 was the most commonly involved gene with 116 patients (45.6%) carrying a pathogenic variant. The p. Arg502Trp missense mutation is the most common mutation observed within the Irish cohort and has a founder effect in England. MYH7 mutations were found in 51 patients (20%). Troponin mutations were found in 20 patients (6.8%). Although formally classified as a VUS, there was an overrepresentation of FHOD3 mutations with 19 patients (7.4%) carrying a variant. 41 patients (16%) had pathogenic mutations in PRKAG2, LAMP2 and mitochondrial genes collectively.
Discussion
This Irish cohort has a similar genetic profile in sarcomeric HCM to published European registry data. There is an overrepresentation in HCM phenocopy/metabolic conditions such as mitochondrial and PRKAG2-associated cardiomyopathy. This represents a genetically homogenous small population in Ireland but also includes one of the largest Danon disease cohorts in Europe.
The genetic architecture of hypertrophic cardiomyopathy is complex and the concept of monogenic sarcomeric disease is an over-simplification. There is significant phenotypic variability due to gene-gene effects and gene-dose effects, as well as elusive epigenetic modifier effects. Our understanding of the genetic complexities continues to evolve.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Mater Foundation
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Affiliation(s)
- H Cronin
- Mater Misericordiae University Hospital , Dublin , Ireland
| | - M Gallagher
- Mater Misericordiae University Hospital , Dublin , Ireland
| | - C McGorrian
- Mater Misericordiae University Hospital , Dublin , Ireland
| | - J Galvin
- Mater Misericordiae University Hospital , Dublin , Ireland
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7
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Cronin H, Gallagher M, McGorrian C, Galvin J. Promise or peril: the ECG in HCM. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1733] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Hypertrophic cardiomyopathy is a complex disease of the myocardium characterised by left ventricular hypertrophy >15mm in any one segment, in the absence of loading conditions. The phenotypic variability and inhomogeneous nature of the condition have resulted in difficulties with diagnosis. Despite the significant progression in cardiac imaging and genetics, the electrocardiogram (ECG) remains the cornerstone of initial evaluation of patients with HCM and in the screening of families. Moreover, the ECG is in widespread use for pre-participation sports screening.
Purpose
Original and contemporary studies indicate that the ECG is normal in only 6–10% of patients with echocardiographic evidence of HCM. We hypothesised that the ECG may be normal in a significant proportion of HCM patients. This study sought to reassess the ECG as a screening tool in a HCM cohort.
Methods
112 patients were selected randomly from the database of a specialist cardiomyopathy clinic. Their most recent ECG, clinical and imaging data were reviewed. All patients had echocardiographic HCM and were carriers of pathogenic sarcomere gene mutations. Patients with phenocopies were excluded. ECG data for 100 age and sex-matched controls was also analysed. ECG interpretation was performed using international criteria.
Results
18% of patients with a clinical diagnosis of HCM by conventional diagnostic standards (LV wall thickness >15mm) had a normal ECG. A further 7% had a normal ECG with a mild HCM phenotype (LV wall thickness of 13–14mm). The most common abnormality observed was T wave inversion (TWI) in 28%. An additional unexpected finding in the HCM group was isolated TWI in lead aVL. This occurred in 27% of patients in the absence of any other repolarisation abnormalities, compared with 1% of controls. The significance of this finding is unclear. 27% of HCM patients displayed voltage criteria for left ventricular hypertrophy by either Cornell or Sokolow-Lyon criteria, with just 4% meeting criteria for both. 13% of HCM patients had corrected QT prolongation, in the absence of medications responsible for this.
Conclusion
The ECG continues to play a pivotal role in HCM diagnosis but its sensitivity to detect disease has been over-estimated. Up to a quarter of patients with HCM have a normal ECG. This is significantly higher than previously reported. The ECG in isolation therefore is not a reliable tool for screening for HCM in the general population and especially unreliable in at-risk subjects.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The Mater Foundation
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Affiliation(s)
- H Cronin
- Mater Misericordiae University Hospital , Dublin , Ireland
| | - M Gallagher
- Mater Misericordiae University Hospital , Dublin , Ireland
| | - C McGorrian
- Mater Misericordiae University Hospital , Dublin , Ireland
| | - J Galvin
- Mater Misericordiae University Hospital , Dublin , Ireland
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8
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Leung L, Akhtar Z, Bajpai A, Li A, Sohal M, Norman M, Kaba R, Al-Subaie N, Louis-Auguste J, Hayat J, Zuberi Z, Gallagher M. Oesophageal protection during AF ablation: real world registry data and mechanisms behind the therapeutic effect of tissue cooling. Europace 2022. [DOI: 10.1093/europace/euac053.229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Oesophageal protection using a dedicated device to provide controlled active thermal protection of the oesophagus during atrial fibrillation ablation has been shown to be effective at reducing endoscopically detected oesophageal lesions. Real world registry data of this device and established evidence on the effect of cooling on localized tissue after thermal injury have been under review.
Purpose
To determine the safety of an oesophageal temperature control device by a review of real-world registry data on its clinical use during catheter ablation procedures and to clarify basic mechanisms of its therapeutic action by a literature review of scientific studies on cooling in the context of thermal injury.
Methods
The United States Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE), FDA Medical and Radiation Emitting Device Recalls, the Medicines and Healthcare products Regulatory Agency (MHRA) Medical Device Alerts and SwissMedic records of Field Safety Corrective Actions (FSCA) databases were reviewed for any device-related adverse events. A systematic literature review was conducted to clarify the findings from studies investigating the physiological processes behind the therapeutic effect of cooling after tissue thermal injury.
Results
Of over 20,000 oesophageal temperature control devices clinically used, 7976 were recorded as having been used for the purpose of oesophageal protection during left atrial catheter ablations. No adverse events occurred related to its use during left atrial catheter ablations. No case of clinically significant oesophageal injury was reported in a patient who had been protected by the oesophageal temperature control device. 208 research articles retrieved from PubMed and MEDLINE that met the search criteria were reviewed. The common finding in all the studies was that cooling had an anti-inflammatory and restorative effect via modulation of several immune-mediated pathways, local cellular function and genetic expression.
Conclusions
There have been no adverse events reported to date in real world clinical use of an oesophageal temperature control device during left atrial catheter ablations, for the purpose of active thermal protection. Literature review data suggests that there are complex biophysical and cellular effects from cooling that leads to its therapeutic effect but further work is required to define the mechanisms of action of thermal protection in this specific context.
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Affiliation(s)
- L Leung
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - Z Akhtar
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - A Bajpai
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - A Li
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - M Sohal
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - M Norman
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - R Kaba
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - N Al-Subaie
- Ahmadi hospital, Anaesthetics, Kuwait, Kuwait
| | - J Louis-Auguste
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - J Hayat
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - Z Zuberi
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - M Gallagher
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
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Gallagher M, Akhtar Z, Gang Y, Gonna H, Li A, Bajpai A, Zuberi Z, Norman M, Sohal M, Leung LWM. Randomised comparison of achieve and traditional circular mapping catheters in cryoballoon ablation: results at up to a decade. Europace 2022. [DOI: 10.1093/europace/euac053.082] [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
Funding Acknowledgements
Type of funding sources: None.
Background
A single-centre trial randomised patients to the use of the Achieve mapping catheter or a traditional circular mapping catheter during cryoballoon procedures for paroxysmal atrial fibrillation (AF) in 2011-2014. Long-term outcomes from the cohort were determined in 2021.
Purpose
To evaluate the determinants of long-term outcome of ablation for paroxysmal AF.
Methods
Patient and study procedure characteristics and clinical outcomes were determined, including mapping catheter assignment, model of cryoballoon used, AF recurrence, repeat ablations required, findings at repeat ablation long term survival of the patient.
Results
Of 102 patients in the original study, 98 had long-term (4.11+/-2.82 years) follow up data available. 35 patients (35.7%) had AF recurrence, giving a long-term success rate at 64.3% after 1 ablation, increasing to 81.6% after repeat ablation. Of the study cohort n=8 (8.16%) died at a median of 4.9 years after ablation (IQR:1.7-5.7). 25/98 (25.5%) patients had a second ablation and 7 (7.1%) had a third or more ablations. Those who had AF recurrence were older, with a higher prevalence of prior ischaemic heart disease and cardiac device implantation (p=0.02-0.03). After multi-variate analysis, a prior implanted cardiac device was the only significant predictor of recurrence (p=0.03).
Conclusion
Long-term outcomes after a 1st time PAF cryoablation were similar regardless of the type of mapping catheter used, the generation of cryoballoon, and traditional procedure endpoints. AF recurrences were more often detected in older patients with a history of ischaemic heart disease and implanted cardiac devices.
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Affiliation(s)
- M Gallagher
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - Z Akhtar
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - Y Gang
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - H Gonna
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - A Li
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - A Bajpai
- Epsom and St Helier University Hospitals NHS Trust, Cardiology, Epsom, United Kingdom of Great Britain & Northern Ireland
| | - Z Zuberi
- Royal Surrey County Hospital, Cardiology, Guildford, United Kingdom of Great Britain & Northern Ireland
| | - M Norman
- Frimley Park Hospital, Cardiology, Frimley, United Kingdom of Great Britain & Northern Ireland
| | - M Sohal
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
| | - LWM Leung
- St George’s Hospital (London), London, United Kingdom of Great Britain & Northern Ireland
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10
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Feng Y, Li Q, Finfer S, Myburgh J, Bellomo R, Perkovic V, Jardine M, Wang A, Gallagher M, Hong D. POS-019 A NOVEL RISK PREDICTION MODEL FOR SERVE ACUTE KIDNEY INJURY IN INTENSIVE CARE UNIT PATIENTS RECEIVING FLUID RESUSCITATION. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.027] [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] Open
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11
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Lam D, Scaria A, Gallagher M, Jun M. POS-254 CLINICAL AND SAFETY OUTCOMES WITH APIXABAN VERSUS WARFARIN BY EGFR IN ADULTS WITH ATRIAL FIBRILLATION. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.273] [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] Open
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12
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McAteer C, Sullivan R, McRory C, O’Domhnaill O, Murphy DE, Rehman MA, Muller T, Gallagher M, Miranda J, Parihar V, Mulpeter K. 95 DOCUMENTATION OF URINARY CATHETER INDICATION AND INSERTION PROCEDURE FOR MEDICAL INPATIENTS AT A UNIVERSITY TEACHING HOSPITAL. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
Approximately 25% of inpatients have urinary catheters at some point during their hospital stay; over half are deemed inappropriate. This is significant as catheter-associated urinary tract infections (CAUTI) increase morbidity, mortality and length of hospitalisation. Lack of medical documentation and clinician awareness of catheters have been identified as risk factors for inappropriate catheterisation. The aim of this audit was to assess inpatient urinary catheter use among medical inpatients to determine if the indication and insertion procedure were clearly documented.
Methods
The audit was conducted over one day and included all medical inpatients aged 18 years and above. Emergency Department and High Dependency patients were excluded. Data was collected using standardised data collection sheets and involved a review of medical/nursing notes. Data was benchmarked against Health Service Executive guidelines.
Results
27 of 132 medical inpatients (20%) had a urinary catheter in situ on the day of audit. 37% (n = 10) had long-term urinary catheters in situ prior to admission and are not considered further. Of the remaining 63% (n = 17), 9 were female (53%), 8 were male (47%), and the average age was 75 years. Indication was documented in nursing notes for 76% and in medical notes for 53%. Indications included monitoring urinary output (29%), urinary retention (24%), sepsis (18%), comfort (6%) and haematuria (6%). Catheter insertion procedure was documented in nursing notes for 59% and in medical notes for 12%.
Conclusion
One fifth of medical inpatients had urinary catheters on the day of audit. 63% of these patients did not have a catheter prior to admission. Overall medical documentation of catheter indication and insertion procedure is poor. Better documentation would likely improve clinician awareness of their patient’s catheters and prompt earlier review of appropriateness. Education sessions, insertion proforma stickers and catheter review reminder systems are suggested to improve documentation.
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Affiliation(s)
- C McAteer
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - R Sullivan
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - C McRory
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - O O’Domhnaill
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - D E Murphy
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - M A Rehman
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - T Muller
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - M Gallagher
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - J Miranda
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - V Parihar
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
| | - K Mulpeter
- Letterkenny University Hospital , Letterkenny, Co. Donegal, Ireland
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Lin J, Ji XJ, Wang AY, Liu JF, Liu P, Zhang M, Qi ZL, Guo DC, Bellomo R, Bagshaw SM, Wald R, Gallagher M, Duan ML. Corrigendum to "Timing of continuous renal replacement therapy in severe acute kidney injury patients with fluid overload: A retrospective cohort study" [J Crit Care. 2021 Aug; 64: 226-236]. J Crit Care 2021; 66:191. [PMID: 34274206 DOI: 10.1016/j.jcrc.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- J Lin
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - X J Ji
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - A Y Wang
- The George Institute for Global Health, Newtown, UNSW, Australia; Concord Clinical School, The University of Sydney, Australia; Department of Renal Medicine, Concord Repatriation General Hospital, Australia.
| | - J F Liu
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - P Liu
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - M Zhang
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - Z L Qi
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - D C Guo
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - R Bellomo
- The George Institute for Global Health, Newtown, UNSW, Australia; Department of Intensive Care, Austin Hospital, Australia
| | - S M Bagshaw
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - R Wald
- Division of Nephrology, St. Michael's Hospital, University of Toronto, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - M Gallagher
- The George Institute for Global Health, Newtown, UNSW, Australia; Concord Clinical School, The University of Sydney, Australia; Department of Renal Medicine, Concord Repatriation General Hospital, Australia
| | - M L Duan
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China.
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14
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Gallagher M, Cooper L, Mata JI. 82 A Case of Recurrent Calcifying Aponeurotic Fibroma of the Hand: Managing a Rare Hand Tumour in an Evolving Healthcare Landscape. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.225] [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: 11/13/2022]
Abstract
Abstract
Introduction
Calcifying Aponeurotic Fibroma (CAF) is a rare benign tumour originating from the aponeuroses of tendons and their bony insertions. Our case illustrates the technical challenges and considerations of removing a large, recurrent CAF of the hand.
Case Report
A 15-year-old student presented to his GP with a one-year history of a progressively enlarging painless swelling on the dorsum of the middle phalanx of the left middle finger. Plain radiographs identified a calcified soft tissue swelling with no bony involvement. The lesion was excised by the local paediatric orthopaedic service and recurred rapidly. Histology confirmed the diagnosis. He was referred to our specialist hand surgery service and the lesion was excised with the overlying skin (which demonstrated histological but not clinical disease). At six months, there was no clinical evidence of recurrence.
Conclusions
CAF may present atypically, and a high index of suspicion is warranted with calcified soft tissue hand lesions. Excision with conservative margins, and we newly suggest, the overlying skin, is recommended to preserve hand function but minimise recurrence (very common). Hand surgery provision in the UK is changing with adoption of the hub and spoke model and hand tumours may be more appropriately managed at specialist centres.
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Affiliation(s)
- M Gallagher
- Department of Plastic Surgery, St Thomas' Hospital, London, United Kingdom
- Imperial College London, London, United Kingdom
| | - L Cooper
- Department of Plastic Surgery, St Thomas' Hospital, London, United Kingdom
| | - J I Mata
- Department of Plastic Surgery, St Thomas' Hospital, London, United Kingdom
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15
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Lin J, Ji XJ, Wang AY, Liu JF, Liu P, Zhang M, Qi ZL, Guo DC, Bellomo R, Bagshaw SM, Wald R, Gallagher M, Duan ML. Timing of continuous renal replacement therapy in severe acute kidney injury patients with fluid overload: A retrospective cohort study. J Crit Care 2021; 64:226-236. [PMID: 34034218 DOI: 10.1016/j.jcrc.2021.04.017] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 01/20/2023]
Abstract
PURPOSE We aimed to evaluate the association of early versus late initiation of Continuous renal replacement therapy (CRRT) with mortality in patients with fluid overload. METHODS This was a retrospective cohort study of patients with fluid overload (FO) treated with CRRT due to severe acute kidney injury (AKI) between January 2015 and December 2017 in a mixed medical intensive care unit of a teaching hospital in Beijing, China. Patients were divided into early (≤15 h) and late (>15 h) groups based on the median time from ICU admission to CRRT initiation. The primary outcome was all-cause mortality at day 60. Multivariable Cox model analysis was used for analysis. RESULTS The study patients were male predominant (84/150) with a mean age of 64.8 ± 16.7 years. The median FO value before CRRT initiation was 10.1% [6.2-16.1%]. The 60-day mortality rates in the early vs the late CRRT groups were 53.9% and 73%, respectively. On multivariable Cox modelling, the late initiation of CRRT was independently associated with an increased risk of death at 60 days (HR 1.75, 95% CI 1.11-2.74, p = 0.015). CONCLUSIONS Early initiation of CRRT was independently associated with survival benefits in severe AKI patients with fluid overload.
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Affiliation(s)
- J Lin
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - X J Ji
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - A Y Wang
- The George Institute for Global Health, Newtown, Australia; Concord Clinical School, The University of Sydney, Australia; Department of Renal Medicine, Concord Repatriation General Hospital, Australia.
| | - J F Liu
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - P Liu
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - M Zhang
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - Z L Qi
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - D C Guo
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China
| | - R Bellomo
- The George Institute for Global Health, Newtown, Australia; Department of Intensive Care, Austin Hospital, Australia
| | - S M Bagshaw
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - R Wald
- Division of Nephrology, St. Michael's Hospital, University of Toronto, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - M Gallagher
- The George Institute for Global Health, Newtown, Australia; Concord Clinical School, The University of Sydney, Australia; Department of Renal Medicine, Concord Repatriation General Hospital, Australia
| | - M L Duan
- Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, China.
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16
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Dahwa R, Rutsito L, Siriwardana A, Kumar N, Gallagher M. POS-254 MORTALITY IN INCIDENT DIALYSIS PATIENTS IN ZIMBABWE. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.269] [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] Open
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17
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Wong J, Gallagher M, Friedt J, Trinder K, McKague M, Stevenson K, Cattell V. Health Science Students as PPE Coaches in the Emergency Department - a Pandemic Pilot Project. Infect Prev Pract 2021; 3:100139. [PMID: 34316578 PMCID: PMC8012167 DOI: 10.1016/j.infpip.2021.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/23/2021] [Indexed: 11/24/2022] Open
Abstract
PPE is an integral part of reducing transmission of COVID-19. We assessed a 5-week pilot project of utilising health science student volunteers as PPE coaches in the adult and paediatric emergency department (ED) during the pandemic. PPE coaches were provided with training, PPE checklist, area for written observations, and feedback surveys. Overall, correct PPE use improved over time. Coaches felt safe, that training was adequate, and part of the team. Factors that contributed to project effectiveness included institutional support, role clarification, and continuous feedback from staff. Our findings support the utilisation of students in IPC projects.
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Affiliation(s)
- J Wong
- University of Saskatchewan, Canada
| | | | - J Friedt
- Saskatchewan Health Authority, Canada
| | | | | | | | - V Cattell
- University of Saskatchewan, Canada.,Saskatchewan Health Authority, Canada
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18
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Lepillier A, Solimene F, De Ruvo E, Scaglione M, Anselmino M, Sebag F, Pecora D, Gallagher M, Rillo M, Stabile G. Reproducibility of pulmonary vein isolation guided by the ablation index: One-year outcome of the AIR registry. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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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19
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Kaba R, Ashry A, Elbadri A, Gukop P, Li A, Sohal M, Bajpay A, Saba M, Sharma R, Gallagher M, Chandrasekaran V, Momin A. 16-month outcomes following hybrid ablation for long-standing persistent atrial fibrillation in patients with dilated atria. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0629] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Although catheter ablation therapy is a well-established treatment for cardiac dysrhythmias, the success rates for longstanding, persistent AF with dilated atria remain unsatisfactory. The minimally invasive hybrid technology is a novel form of therapy.
Methods
A prospective, single-center UK study to evaluate the hybrid ablation technique for patients with longstanding (>1 year) persistent AF and dilated atria. Stage 1 was a minimally invasive epicardial approach for ablation of the posterior wall of left atrium (LA) and pulmonary veins (PVs). Stage 2 was a transcatheter approach via the femoral veins to isolate the endocardial aspect of the PVs +/− posterior wall. Occasionally, the sequence of the stages was reversed.
Results
Forty-one patients were enrolled for the study with a mean follow-up for 16±9 months. Mean age was 65±9 years and the mean BMI was 32±7. Males constituted 75% of the study cohort. Mean LA size was 48±7 mm and mean left ventricular ejection fraction (LVEF) was 51.9%, although 51.6% of patients had impaired LVSF (LVEF below 55%). 87.8% CI (0.7–0.9) of patients remained in sinus rhythm (SR) without repeat ablation, whereas only 12.2% CI (0.04–0.02) had redeveloped persistent AF. Although numerically different, there was no statistically significant difference in maintaining SR between patients with severely dilated LA (>50 mm) and those without (70% vs. 90%, respectively; z=−1.39, p=0.165). Major perioperative complications during stage 1 ablation were low, with IVC injury in 1 patient and a mild stroke in 1 patient. Median LOS was 1 day (1–4 days) and there was no 30-day mortality after stage 1.
Conclusions
The hybrid ablation therapy has a conversion rate from longstanding persistent AF to SR of 87.8% at a mean follow-up of 16±9 months, without repeat ablation. LOS was short, with very few complications and no peri-operative mortality. The hybrid approach appears to be very encouraging for a condition with otherwise low success rates by conventional endocardial techniques alone.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R.A Kaba
- St George's Hospital (London), London, United Kingdom
| | - A Ashry
- St George's Hospital (London), London, United Kingdom
| | - A Elbadri
- St George's Hospital (London), London, United Kingdom
| | - P Gukop
- St George's Hospital (London), London, United Kingdom
| | - A Li
- St George's Hospital (London), London, United Kingdom
| | - M Sohal
- St George's Hospital (London), London, United Kingdom
| | - A Bajpay
- St George's Hospital (London), London, United Kingdom
| | - M Saba
- St George's Hospital (London), London, United Kingdom
| | - R.A Sharma
- St George's Hospital (London), London, United Kingdom
| | - M Gallagher
- St George's Hospital (London), London, United Kingdom
| | | | - A Momin
- St George's Hospital (London), London, United Kingdom
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20
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Khadhouri S, Gallagher M, Mackenzie K, Shah T, Gao C, Moore S, Zimmermann E, Edison E, Jefferies M, Nambiar A, Nielsen M, McGrath J, Kasvisvanathan V. Diagnostic test accuracy for USS, CTU and cytology in the detection of bladder cancer: Results from the IDENTIFY study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33492-3] [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] Open
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21
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Carron J, O"brien J, Gallagher M, Mcgorrian C, Galvin J. 1266Novel formin homology 2 domain containing 3 (FHOD3) mutations associated with the pathogenesis of hypertrophic cardiomyopathy (HCM) in an Irish population. Europace 2020. [DOI: 10.1093/europace/euaa162.080] [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: 11/12/2022] Open
Abstract
Abstract
Background
The genetic cause of hypertrophic cardiomyopathy (HCM) remains unexplained in a substantial proportion of cases. Recent large sequencing studies suggest that, though not previously implicated, FHOD3 (a Formin protein responsible for sarcomere assembly) may have a role in the pathogenesis of HCM, particularly variants affecting a conserved small coil-coiled domain (amino acids 622 to 655).
Aim
To investigate the relationship between novel FHOD3 mutations, previously classified as variants of uncertain significance (American College of Medical Genetics ACMG Class III), and the development of HCM.
Methods
A single center review of HCM probands carrying mutations in the FHOD3 gene was conducted. Existing HCM patients from the family heart screening clinic database were retrospectively reviewed. Frequency of FHOD3 mutations, segregation among family members and clinical characteristics of patients were reviewed. All genetic analysis was conducted via the same internationally validated next generation sequencing lab.
Results
Of 367 HCM probands identified in our center, 9 (2.45%) were found to have ACMG Class III mutations affecting the FHOD3 gene. Five of these 9 probands (56%) displayed the same p.Arg637Gln mutation, while the remaining 4 (44%) carry the same p.Ile648Thr residue alteration. Both of these are rare mutations, found to be present in <1% of controls in previous large sequencing studies and not previously reported. Among probands with the p.Ile648Thr mutation, co-segregation was confirmed in one family, another first-degree relative in the same family having suffered a sudden cardiac death (HCM confirmed on autopsy). In those with the p.Arg367Gln mutation, a strong family history was observed in two separate families, 4 first-degree members having a confirmed HCM diagnosis. Carriers of both mutation types displayed varying degrees of disease severity with rates of non-sustained ventricular tachycardia and device implantation similar to other HCM cohorts (∼40%).
Conclusions
FHOD3 is a novel gene, recently implicated in the pathogenesis of HCM, though not previously well described in the literature. Carrier frequency of FHOD3 mutations in the HCM population in our center is similar to that described in recent publication (1-2%), and all carry variants affecting the suspected small coil-coiled domain (amino-acids 622-625).
Abstract Figure.
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Affiliation(s)
- J Carron
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - J O"brien
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - M Gallagher
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - C Mcgorrian
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - J Galvin
- Mater Misericordiae University Hospital, Dublin, Ireland
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22
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Carron J, O"brien J, Heverin K, Gallagher M, Fitzgibbon M, Fabre A, Mcgorrian C, Galvin J. 1269The SADS heart of the matter: a review of the sudden arrhythmic death syndrome (SADS) biobank - the cornerstone of a national strategy. Europace 2020. [DOI: 10.1093/europace/euaa162.081] [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
Sudden cardiac death (SCD) in the young (age 1-35) is commonly attributed to structural and arrhythmogenic syndromes, for which there is often an underlying genetic basis. Expert recommendation emphasises the importance of genetic testing in such cases, however to date this remains the first and only national programme in Europe to facilitate this.
Aim
To review detection rates of genetic variants in samples tested via the SADS BioBank and possibly demonstrate the merits of this novel resource for primary prevention for family members.
Methods
Family screening and consent for genetic testing was carried out in the Family Heart Screening Clinic. Result analysis of samples sent for molecular autopsy via the BioBank from its induction in January 2015 was performed. Genetic analysis was conducted via the same internationally accredited next generation sequencing lab.
Results
From January 2015 to July 2019, 161 samples had been stored in the SADS BioBank following confirmed SADS death on autopsy; 33% female and 67% male. Of these, 24 (14.9%) samples were sent for genetic testing: 21 for a 380 gene molecular autopsy and 3 for a targeted hypertrophic cardiomyopathy panel (173 genes). Of 24 samples tested, 10 (42%) yielded positive genetic variants: 4 American College of Medical Genetics (ACMG) Class IV or V mutations considered pathogenic, and 6 ACMG class III variants of uncertain significance (VUS). Familial cascade screening following confirmed pathogenic mutations resulted in detection of 3 (33.3%) positive genotypes in 9 first-degree relatives. Screening of relatives of Class III positive probands resulted in diagnosis of an Inherited Cardiac Condition (ICC) in 25% of first-degree relatives. 8.2% of first-degree relatives of probands with negative gene testing were given an ICC diagnosis following clinical screening.
Conclusions
This short study demonstrates the unique potential the SADS BioBank has to offer in terms of identifying those most at risk and optimising prevention strategies for relatives, thus highlighting the role for such a resource in terms of preventative screening in the future.
Pathogenic Variant (ACMG Class IV & V) Variant of Uncertain Significance(ACMG Class III) No Gene Variant Identified Number Detected (n = 24) 4 6 14 1st Degree Relatives Screened (n = 86) 17 20 49 2nd Degree Relatives Screened (n = 46) 4 23 19 Genotype Detected (n = 4) 3 1 0 Phenotype Detected (n = 10) 1 5 4 Breakdown of clinical and genetic results of family screening by ACMG class.
Abstract Figure.
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Affiliation(s)
- J Carron
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - J O"brien
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - K Heverin
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - M Gallagher
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - M Fitzgibbon
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - A Fabre
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - C Mcgorrian
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - J Galvin
- Mater Misericordiae University Hospital, Dublin, Ireland
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Bassi A, John MD O, Joshi R, Kotwal S, Angell B, Jan S, Gallagher M, Knight J, Jha V. SUN-180 SOCIO-DEMOGRAPHIC CHARACTERISTICS AND OUTCOMES AT 18 MONTHS OF A COHORT OF ESKD PATIENTS STARTING HEMODIALYSIS IN INDIA. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.713] [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] Open
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24
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Mankuzhy N, Petrescu I, Quinn T, Ye H, Gallagher M, Grills I. Cardiac Function after Definitive Standard Fractionated Radiotherapy for Locally Advanced Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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25
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TALBOT B, Sagar P, Lin R, Jun M, Sen S, Gallagher M. SUN-178 The Impact of Acute Kidney Injury Requiring Haemodialysis on Patient Survival: 10 Years of Prospective Data. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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26
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BASSI A, John O, Joshi R, Kotwal S, Shah K, Angell B, Jan S, Gallagher M, Knight J, Jha V. SAT-039 Socio-Demographic Characteristics, Out of Pocket Expenditure, Quality of Life and Six Months Treatment Outcomes of Haemodialysis Patients in India. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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27
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YEUNG W, Talbot B, Shah N, Palmer S, Mangos G, Gallagher M, Toussaint N, Badve S. SUN-292 BENEFITS AND HARMS OF VITAMIN D COMPOUNDS IN ADULTS WITH CHRONIC KIDNEY DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED CONTROLLED TRIALS. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.797] [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] Open
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TALBOT B, Kumar L, Sen S, Jesudason S, Gallagher M, Krishnan A, Malani J, Wilson D, Ritchie A. SAT-029 Haemodialysis in Fiji. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.051] [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] Open
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29
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TALBOT B, Franca Gois P, Healy H, Gallagher A, Sen S, Chadban S, Gallagher M, Knight J, Barraclough K. SUN-058 Variations in Environmentally Sustainable Practice within Australian Dialysis Units: Time for a Nationwide Approach? Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.454] [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] Open
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30
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Dahwa R, Rutsito L, Gallagher M, Kumar N. SAT-229 DIALYSIS IN ZIMBABWE. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.264] [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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31
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Hughes SJ, Gallagher M. Investigation of anthropometric status among patients on home parenteral nutrition within the Regional Intestinal Failure Service, Northern Ireland. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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32
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Hughes SJ, Warke R, Gallagher M. A review of manganese levels in patients receiving home parenteral nutrition. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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33
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Hughes SJ, Gallagher M. Review of liver parameters among intestinal failure patients within the regional intestinal failure service Northern Ireland when transitioned to SMOF lipid emulsion. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hughes SJ, Warke R, Gallagher M. A review of the prevalence of muscle cramps in patients receiving home parenteral nutrition in Northern Ireland. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Weisbord S, Gallagher M, Jneid H, Garcia S, Cass A, Thwin S, Conner T. Outcomes After Angiography With Sodium Bicarbonate and Acetylcysteine. J Vasc Surg 2018. [DOI: 10.1016/j.jvs.2018.08.140] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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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Roxanas MG, George C, Gallagher M. Comment on 'Continuation of lithium after a diagnosis of chronic kidney disease'. Acta Psychiatr Scand 2018; 138:275. [PMID: 30295936 DOI: 10.1111/acps.12908] [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: 10/28/2022]
Affiliation(s)
- M G Roxanas
- University of Sydney Adventist Hospital Clinical School, Wahroonga, NSW, Australia
| | - C George
- Concord Repatriation General Hospital, Concord, NSW, Australia
| | - M Gallagher
- Concord Repatriation General Hospital, Concord, NSW, Australia
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Leung L, Evranos B, Gonna H, Gomes J, Harding I, Raju H, Angelozzi A, Domenichini G, Zuberi Z, Norman M, Gallagher M. 220Simultaneous multi-catheter cryotherapy for the treatment of accessory pathways refractory to radiofrequency catheter ablation. Europace 2018. [DOI: 10.1093/europace/euy015.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- L Leung
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - B Evranos
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - H Gonna
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - J Gomes
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - I Harding
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - H Raju
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - A Angelozzi
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - G Domenichini
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - Z Zuberi
- Royal Surrey County Hospital, Cardiology Department, Guildford, United Kingdom
| | - M Norman
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - M Gallagher
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
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Gnanenthiran S, Ridley L, Gallagher M, Aitken S, Kritharides L. Chronic Aortic Occlusion: A Novel Cause of Recurrent Pericardial Effusion. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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MacDonagh L, Gray S, Gallagher M, French B, Gasch C, Young V, Ryan R, Nicholson S, Leonard N, Finn S, Cuffe S, O’Byrne K, Barr M. Big applications for a microRNA signature: the diagnostic, prognostic and predictive biomarker potential of a novel 5-miR signature associated with cisplatin resistant NSCLC. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30037-0] [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: 10/18/2022]
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MacDonagh L, Gray S, Gallagher M, French B, Gasch C, Finn S, Cuffe S, O’Byrne K, Barr M. Is miR-34a the micromanager of cancer stemness and resistance in NSCLC? Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30027-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Donagh LM, Gray S, Gallagher M, Ffrench B, Gasch C, Finn S, Cuffe S, O’Byrne K, Barr M. P1.03-048 miR-34a and the Micromanagement of Cancer Stemness and Resistance in NSCLC. Does It Hold Therapeutic Benefit? J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Donagh LM, Gray S, Gallagher M, Ffrench B, Gasch C, Finn S, Cuffe S, O’Byrne K, Barr M. P1.03-041 Exploitation of the Cancer Stem Cell Marker ALDH1 Within the Vitamin a/Retinoic Acid Axis Promotes Re-Sensitization of Cisplatin Resistant NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.845] [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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Donagh LM, Gray S, Gallagher M, Ffrench B, Gasch C, Young V, Ryan R, Nicholson S, Leonard N, Finn S, Cuffe S, O’Byrne K, Barr M. P2.02-064 A Novel 5-miR Signature Shows Potential as a Diagnostic Tool and as a Predictive Biomarker of Cisplatin Response in NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gallagher M, Whitehouse MJ, Kamber BS. The Neoarchaean surficial sulphur cycle: An alternative hypothesis based on analogies with 20th-century atmospheric lead. Geobiology 2017; 15:385-400. [PMID: 28299862 DOI: 10.1111/gbi.12234] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 02/17/2017] [Indexed: 06/06/2023]
Abstract
We revisit the S-isotope systematics of sedimentary pyrite in a shaly limestone from the ca. 2.52 Ga Gamohaan Formation, Upper Campbellrand Subgroup, Transvaal, South Africa. The analysed rock is interpreted to have been deposited in a water depth of ca. 50-100 m, in a restricted sub-basin on a drowning platform. A previous study discovered that the pyrites define a nonzero intercept δ34 SV-CDT -Δ33 S data array. The present study carried out further quadruple S-isotope analyses of pyrite, confirming and expanding the linear δ34 SV-CDT -Δ33 S array with an δ34 S zero intercept at ∆33 S ca. +5. This was previously interpreted to indicate mixing of unrelated S-sources in the sediment environment, involving a combination of recycled sulphur from sulphides that had originally formed by sulphate-reducing bacteria, along with elemental sulphur. Here, we advance an alternative explanation based on the recognition that the Archaean seawater sulphate concentration was likely very low, implying that the Archaean ocean could have been poorly mixed with respect to sulphur. Thus, modern oceanic sulphur systematics provide limited insight into the Archaean sulphur cycle. Instead, we propose that the 20th-century atmospheric lead event may be a useful analogue. Similar to industrial lead, the main oceanic input of Archaean sulphur was through atmospheric raindown, with individual giant point sources capable of temporally dominating atmospheric input. Local atmospheric S-isotope signals, of no global significance, could thus have been transmitted into the localised sediment record. Thus, the nonzero intercept δ34 SV-CDT -Δ33 S data array may alternatively represent a very localised S-isotope signature in the Neoarchaean surface environment. Fallout from local volcanic eruptions could imprint recycled MIF-S signals into pyrite of restricted depositional environments, thereby avoiding attenuation of the signal in the subdued, averaged global open ocean sulphur pool. Thus, the superposition of extreme local S-isotope signals offers an alternative explanation for the large Neoarchaean MIF-S excursions and asymmetry of the Δ33 S rock record.
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Affiliation(s)
- M Gallagher
- Department of Geology, School of Natural Sciences, Trinity College Dublin, Dublin, Ireland
| | - M J Whitehouse
- Department of Geosciences, Swedish Museum of Natural History, Stockholm, Sweden
| | - B S Kamber
- Department of Geology, School of Natural Sciences, Trinity College Dublin, Dublin, Ireland
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Lo C, Teede H, Fulcher G, Gallagher M, Kerr PG, Ranasinha S, Russell G, Walker R, Zoungas S. Gaps and barriers in health-care provision for co-morbid diabetes and chronic kidney disease: a cross-sectional study. BMC Nephrol 2017; 18:80. [PMID: 28245800 PMCID: PMC5331625 DOI: 10.1186/s12882-017-0493-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 11/16/2016] [Accepted: 02/21/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Patients with diabetes and chronic kidney disease (CKD) are a complex subset of the growing number of patients with diabetes, due to multi-morbidity. Gaps between recommended and received care for diabetes and chronic kidney disease (CKD) are evident despite promulgation of guidelines. Here, we document gaps in tertiary health-care, and the commonest patient-reported barriers to health-care, before exploring the association between these gaps and barriers. METHODS This cross-sectional study recruited patients with diabetes and CKD (eGFR < 60 mL/min/1.73 m2) across 4 large hospitals. For each patient, questionnaires were completed examining clinical data, recommended care, and patient-reported barriers limiting health-care. Descriptive statistics, subgroup analyses by CKD stage and hospital, and analyses examining the relationship between health-care gaps and barriers were performed. RESULTS 308 patients, of mean age 66.9 (SD 11.0) years, and mostly male (69.5%) and having type 2 diabetes (88.0%), participated. 49.1% had stage 3, 24.7% stage 4 and 26.3% stage 5 CKD. Gaps between recommended versus received care were evident: 31.9% of patients had an HbA1c ≥ 8%, and 39.3% had a measured blood pressure ≥ 140/90 mmHg. The commonest barriers were poor continuity of care (49.3%), inadequate understanding/education about CKD (43.5%), and feeling unwell (42.6%). However, barriers associated with a failure to receive items of recommended care were inadequate support from family and friends, conflicting advice from and poor communication amongst specialists, the effect of co-morbidities on self-management and feeling unmotivated (all p < 0.05). CONCLUSIONS Barriers to health-care varied across CKD stages and hospitals. Barriers associated with a deviation from recommended care were different for different items of care, suggesting that specific interventions targeting each item of care are required.
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Affiliation(s)
- C. Lo
- Diabetes and Vascular Research Program, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
- Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria Australia
| | - H. Teede
- Diabetes and Vascular Research Program, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
- Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria Australia
| | - G. Fulcher
- Department of Diabetes and Endocrinology, Royal North Shore Hospital, St Leonards, New South Wales Australia
| | - M. Gallagher
- Department of Nephrology, Concord Hospital, Concord, New South Wales Australia
- The George Institute for Global Health, Sydney, New South Wales Australia
| | - P. G. Kerr
- Department of Nephrology, Monash Health, Clayton, Victoria Australia
| | - S. Ranasinha
- Diabetes and Vascular Research Program, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - G. Russell
- School of Primary Health Care, Monash University, Notting Hill, Victoria Australia
| | - R. Walker
- Department of Renal Medicine, Alfred Health, Prahran, Victoria Australia
| | - S. Zoungas
- Diabetes and Vascular Research Program, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
- Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria Australia
- Department of Diabetes and Endocrinology, Royal North Shore Hospital, St Leonards, New South Wales Australia
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Lakshmanadoss U, Mertens A, Gallagher M, Kutinsky I, Williamson B. Sudden cardiac arrest due to a single sodium channel mutation producing a mixed phenotype of Brugada and Long QT3 syndromes. Indian Pacing Electrophysiol J 2016; 16:66-69. [PMID: 27676163 PMCID: PMC5031864 DOI: 10.1016/j.ipej.2016.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 07/03/2016] [Accepted: 07/12/2016] [Indexed: 11/01/2022] Open
Abstract
Inherited arrhythmia syndromes are a known, albeit rare, cause of sudden cardiac arrest which may present with characteristic electrocardiogram changes in patients with structurally normal heart. There are a variety of distinct arrhythmogenic syndromes that arise from mutations in voltage gated sodium channels, resulting in either gain or loss of function. We describe a patient with a primary inherited arrhythmia syndrome which presented as sudden cardiac arrest. Further workup revealed that her arrest was due to a combination of Brugada syndrome and Long QT3 syndrome secondary to a deleterious mutation of voltage-gated, sodium channel, type V alpha subunit (SCN5A Thr1709Met).
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Affiliation(s)
- U Lakshmanadoss
- Division of Cardiology, LSUHSC Shreveport, LA, United States.
| | - A Mertens
- Department of Medicine, William Beaumont Hospital, Oakland University School of Medicine, Royal Oak, MI, United States
| | - M Gallagher
- Division of Cardiology, William Beaumont Hospital, Oakland University School of Medicine, Royal Oak, MI, United States
| | - I Kutinsky
- Division of Cardiology, William Beaumont Hospital, Oakland University School of Medicine, Royal Oak, MI, United States
| | - B Williamson
- Division of Cardiology, William Beaumont Hospital, Oakland University School of Medicine, Royal Oak, MI, United States
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Delaney K, Gallagher M, Tenaglia P. Bridging the gap from academia to humanitarian project management. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.053] [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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48
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Mays RJ, Goss FL, Nagle EF, Gallagher M, Haile L, Schafer MA, Kim KH, Robertson RJ. Cross-validation of Peak Oxygen Consumption Prediction Models From OMNI Perceived Exertion. Int J Sports Med 2016; 37:831-7. [PMID: 27410768 DOI: 10.1055/s-0042-103029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study cross-validated statistical models for prediction of peak oxygen consumption using ratings of perceived exertion from the Adult OMNI Cycle Scale of Perceived Exertion. 74 participants (men: n=36; women: n=38) completed a graded cycle exercise test. Ratings of perceived exertion for the overall body, legs, and chest/breathing were recorded each test stage and entered into previously developed 3-stage peak oxygen consumption prediction models. There were no significant differences (p>0.05) between measured and predicted peak oxygen consumption from ratings of perceived exertion for the overall body, legs, and chest/breathing within men (mean±standard deviation: 3.16±0.52 vs. 2.92±0.33 vs. 2.90±0.29 vs. 2.90±0.26 L·min(-1)) and women (2.17±0.29 vs. 2.02±0.22 vs. 2.03±0.19 vs. 2.01±0.19 L·min(-1)) participants. Previously developed statistical models for prediction of peak oxygen consumption based on subpeak OMNI ratings of perceived exertion responses were similar to measured peak oxygen consumption in a separate group of participants. These findings provide practical implications for the use of the original statistical models in standard health-fitness settings.
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Affiliation(s)
- R J Mays
- School of Physical Therapy and Rehabilitation Science, University of Montana, Missoula, MT, United States
| | - F L Goss
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA, United States
| | - E F Nagle
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA, United States
| | - M Gallagher
- Department of Kinesiology and Physical Education, University of Central Arkansas, Conway, AR, United States
| | - L Haile
- Department of Health Sciences, Lock Haven University, Lock Haven, PA, United States
| | - M A Schafer
- Department of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, United States
| | - K H Kim
- Department of Psychology in Education, University of Pittsburgh, Pittsburgh, PA, United States
| | - R J Robertson
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA, United States
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Clark AS, O'Dwyer P, Troxel A, Lal P, Feldman M, Gallagher M, Driscoll A, Colameco C, Lewis D, Rosen M, Matro J, Bradbury A, Domchek S, Fox K, DeMichele A. Abstract P6-13-08: Palbociclib and paclitaxel on an alternating schedule for advanced breast cancer: Results of a phase Ib trial. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-13-08] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: Palbociclib (P) is an oral CDK 4/6 inhibitor (CDKi) that was recently FDA approved in combination with endocrine therapy for metastatic breast cancer. We have performed a Phase I trial of P in combination with paclitaxel (T) based on preclinical studies suggesting that P synergizes with T when given on an alternating schedule, enabling cell cycle synchronization in tumor cells. We now present the dose expansion cohort.
Methods: Patients (Pts) enrolled on the trial had Rb-expressing tumors of any estrogen/progesterone/HER2 receptor type, adequate organ function, and ≤3 prior chemotherapy regimens for metastatic breast cancer (mBC). Prior adjuvant or metastatic taxane was allowed. Dose escalation led to expansion at P100mg or 75mg, starting with 3 days of P (run-in) and reduction of P dosing from 5-day to 3-day intervals (days 2-4, 9-11, 16-18 of each 28 day cycle). T at 80mg/m2 was given weekly for 3 cycles; thereafter, T was administered days 1, 8 and 15 of 28 day cycle. Weekly toxicity assessments were performed; RECIST 1.0 response was assessed every 2 cycles as partial response (PR), stable disease (SD) or progressive disease (PD). Pts had the option to discontinue T and continue on P alone (3 on/1 off schedule) if they attained SD after cycle 6.
Results: 27 pts enrolled on study (15- dose escalation, 12- dose expansion). Results are shown in the Table. 21 pts had received prior taxane; pts had received a median of 2 chemotherapy regimens for mBC. DLTs were grade 3 AST/ALT (n=1, at 125 mg) and febrile neutropenia (FN) (n=1, at 100 mg). Uncomplicated grade 3/4 NTP was common and frequently led to dose reduction or dose interruption during the first cycle of therapy. Frequency of NTP did not change with reducing the days of P. Among 24 evaluable patients, 14 (58%), had PR or SD ≥ 6 months across all dose levels. Of 14 pts who responded, 10 (71%) had received prior taxane. 20 pts are off study; 19 for PD, and 2 for toxicity (NTP in cycle 17 and FN in cycle 1); 7 pts remain on study. Prolonged tumor responses were seen.
Conclusions: P and T can be safely combined on an alternating dosing schedule; the optimal combination dose is 75 mg of P and 80mg/m2 of weekly T. The high response rate warrants a randomized trial to determine the incremental benefit over T alone. Additional mechanistic studies are in progress to understand the in vivo effects of the alternating dosing schedule on cell cycle activity and tumor proliferation.
Starting Dose Level P (mg)Number (Total 27)DLTGrade 3/4 NTP (n)Final Dose P mg (n)Dose Interruption (n)Best Response (n)5030050 (1) 50 (1) 50 (1)No (2) Yes (1)PR (1) SD (1) PD (1)7530275 (1) 50 (1) 25 (1)No (1) Yes (2)PR (2) SD (1)100605100 (2) 75 (3) 25 (1)No (1) Yes (5)PR (2) SD (1) PD (3)12531- LFT375 (1) 50 (2)No (0) Yes (3)PR (1) SD (2)75 (Run-In)60175 (5) 50 (1)No (4) Yes (2)PR (1) SD (2) PD (1) N/A (2)*100 (Run-In)61- FN5100 (1) 75 (4) 25(1)No (1) Yes (5)PR (4) SD (1) N/A (1)^*2 pts not yet evaluable. ^1 pt went off study due to FN after cycle 1.
Citation Format: Clark AS, O'Dwyer P, Troxel A, Lal P, Feldman M, Gallagher M, Driscoll A, Colameco C, Lewis D, Rosen M, Matro J, Bradbury A, Domchek S, Fox K, DeMichele A. Palbociclib and paclitaxel on an alternating schedule for advanced breast cancer: Results of a phase Ib trial. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-13-08.
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Affiliation(s)
- AS Clark
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - P O'Dwyer
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - A Troxel
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - P Lal
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - M Feldman
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - M Gallagher
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - A Driscoll
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - C Colameco
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - D Lewis
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - M Rosen
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - J Matro
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - A Bradbury
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - S Domchek
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - K Fox
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - A DeMichele
- Perelman School of Medicine, University of Pennsylvania; Division of Hematology/Oncology, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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DeMichele A, Shih NNC, Koehler M, Huang Bartlett C, Jiang Y, Harwick J, Huang D, Zheng X, Clark AS, Colameco C, Feldman MD, Gallagher M, Goodman N, O'Dwyer P, Rejto P. Abstract P4-13-04: Upregulation of cell cycle pathway genes without loss of RB1 contributes to acquired resistance to single-agent treatment with palbociclib in breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-13-04] [Citation(s) in RCA: 2] [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: 11/16/2022]
Abstract
Abstract
Background: The oral cdk4/6 inhibitor, Palbociclib (Palbo), has been shown to prolong progression-free survival when combined with anti-estrogen therapy and have single-agent activity in metastatic breast cancer (MBC). Progressive disease (PD) on therapy does occur, however, and little is known about resistance mechanisms. Preclinical data have suggested that cell cycle gene expression changes are a potential mechanism of resistance. We performed comprehensive genomic analyses on serial tumor samples from an exceptional responder to single-agent Palbo to determine whether such changes occur in vivo.
Methods: Serial biopsies were obtained from a 67 year old patient with MBC treated on a phase II trial of single-agent Palbo at the University of Pennsylvania. Tissue was obtained from the primary lesion (1999, Stage 3, ER-/PR+/Her2+) and first recurrence (2005, contralateral breast, bone, lung; ER+/PR-/Her2+, treated with Herceptin/letrozole). At PD (2010), pt received single-agent P, 50 mg daily for 21 days each 28-day cycle, with PR for 33 months. A sample from metastatic skin lesion at PD on P (2013) was obtained. Next generation targeted sequencing was performed at Foundation Medicine using the Heme Panel. RNA was profiled using a 784-gene custom Nanostring array including cell cycle genes and ER pathway genes. Determination of pathway enrichment was performed using GSEA and the statistical significance of network neighborhood over-representation was calculated using cumulative hypergeometric distribution.
Results: There was no genetic evidence suggesting loss of RB1, or alterations in p16, cyclin D1, cdk4, PIK3CA or ESR1, and the genomic profile did not change between the primary and recurrent tissue samples. As expected, amplification of ERRB2 was present in all samples. In contrast, expression of cell cycle-regulated genes (PLK1, TOP2A, CDK1, BUB1, CDC20, CCNA2, CCNE2, CCNB1 BIRC5) increased more than two-fold at PD on Palbo compared to pre-Palbo, along with evidence of activation of the FOXM1 network.
Conclusion: Gene expression changes associated with cell cycle activation and FOXM1 activation may lead to acquired resistance to Palbociclib, despite wild-type RB1. These data demonstrate the importance of pre-/post-treatment biopsies and the feasibility of high-level genomic assessment in archival tissues to elucidate resistance mechanisms of novel therapies.
Citation Format: DeMichele A, Shih NNC, Koehler M, Huang Bartlett C, Jiang Y, Harwick J, Huang D, Zheng X, Clark AS, Colameco C, Feldman MD, Gallagher M, Goodman N, O'Dwyer P, Rejto P. Upregulation of cell cycle pathway genes without loss of RB1 contributes to acquired resistance to single-agent treatment with palbociclib in breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-04.
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Affiliation(s)
- A DeMichele
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - NNC Shih
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - M Koehler
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - C Huang Bartlett
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - Y Jiang
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - J Harwick
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - D Huang
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - X Zheng
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - AS Clark
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - C Colameco
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - MD Feldman
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - M Gallagher
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - N Goodman
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - P O'Dwyer
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
| | - P Rejto
- University of Pennsylvania School of Medicine, Philadelphia, PA; Abramson Cancer Center, Philadelphia, PA; Pfizer Oncology, NY, NY; Pfizer Oncology Research, San Diego, CA
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