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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, 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Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Gomez Peña M, Papayannis M, De Martino E, Filardi P, Magri L, Chiarello JM, Figueroa C, De Zuñiga I, Kopcow L, Horton M, Sobral F, Oubiña A, Bisioli C. O-077 The chromosomal constitution of embryos developing from 0PN zygotes. Hum Reprod 2022. [DOI: 10.1093/humrep/deac104.091] [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] Open
Abstract
Abstract
Study question
To compare the ploidy status of embryos originated from zygotes with absence of pronuclei (0PN) with those developing from normal two pronuclei (2PN) fertilization.
Summary answer
We did not find significant differences in euploidy rates between blastocysts from 0PN and 2PN zygotes.
What is known already
Information regarding the ploidy number of 0PN zygotes, even when the pronuclei number is assessed by time-lapse microscope coupled incubators, is still insufficient. Because of this, embryos originating from 0PN zygotes are usually discarded or individualized in order not to include them in first transfers. Even more, abnormal fertilization is considered as a proxy of poor embryo quality.
Study design, size, duration
A retrospective observational study from March 2016 and December 2021 including 80 PGT-A cycles in which at least one of the blastocysts studied developed from oocytes in which pronuclei were not seen at the time of fertilization check.
Participants/materials, setting, methods
307 blastocysts were studied, of which 115 originated from 0PN and 192 from 2PN zygotes. Pronuclear number was assessed 16-20 h after insemination. Zygotes with 0PN were cultured separately from 2PN ones of the same cohort. After extended culture, a biopsy was performed and the material obtained was genetically studied using Next Generation Sequencing. Statistical comparisons were made with Fisher's exact and Chi-square tests. Significance level was set at P<0.05.
Main results and the role of chance
No differences were observed in euploidy rates between the 2PN and 0PN groups [55.2% (106/193) VS 43.5% (50/115)]. In aneuploid embryos originating from 2PN zygotes, a similar amount of trisomies and monosomies was observed (56 and 56 respectively). In contrast, aneuploid embryos from 0PN oocytes showed a greater number of trisomies than monosomies (55 and 35 respectively, P < 0.05). None of the blastocysts resulting from 0PN was haploid, that is, we did not find parthenogenic embryos. Blastocysts derived from 0PN zygotes showed similar quality scoring than those from 2PN ones. To date, 20 euploid blastocysts from the 0PN group have been transferred, producing 12 pregnancies: 6 still ongoing and 4 healthy live births.
Limitations, reasons for caution
Non-visualization of pronuclei in oocytes that later generate normal diploid blastocysts may be due to a faster or slower cell cycle progression. Modifications in the daily fertilization check schedules of busy laboratories should also be considered.
Wider implications of the findings
Contrary to expectations, aneuploid embryos from 0PN oocytes showed a greater number of trisomies than monosomies. A significant fraction of the embryos generated from 0PN zygotes were actually diploid, with similar quality and outcome results than 2PN ones. This makes them perfectly usable in IVF routines.
Trial registration number
Not applicable
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Affiliation(s)
- M Gomez Peña
- Pregna Medicina Reproductiva, ART Laboratory, Buenos Aires , Argentina
| | - M Papayannis
- Pregna Medicina Reproductiva, ART Laboratory, Buenos Aires , Argentina
| | - E De Martino
- Pregna Medicina Reproductiva, ART Laboratory, Buenos Aires , Argentina
| | - P Filardi
- Pregna Medicina Reproductiva, ART Laboratory, Buenos Aires , Argentina
| | - L Magri
- Pregna Medicina Reproductiva, ART Laboratory, Buenos Aires , Argentina
| | - J M Chiarello
- Pregna Medicina Reproductiva, ART Laboratory, Buenos Aires , Argentina
| | - C Figueroa
- Pregna Medicina Reproductiva, ART Laboratory, Buenos Aires , Argentina
| | - I De Zuñiga
- Pregna Medicina Reproductiva, Department of Gynaecology and In Vitro Fertilisation Unit, Buenos Aires , Argentina
| | - L Kopcow
- Pregna Medicina Reproductiva, Department of Gynaecology and In Vitro Fertilisation Unit, Buenos Aires , Argentina
| | - M Horton
- Pregna Medicina Reproductiva, Department of Gynaecology and In Vitro Fertilisation Unit, Buenos Aires , Argentina
| | - F Sobral
- Pregna Medicina Reproductiva, Department of Gynaecology and In Vitro Fertilisation Unit, Buenos Aires , Argentina
| | - A Oubiña
- Pregna Medicina Reproductiva, Department of Gynaecology and In Vitro Fertilisation Unit, Buenos Aires , Argentina
| | - C Bisioli
- Pregna Medicina Reproductiva, ART Laboratory, Buenos Aires , Argentina
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Filardi P, De Martino E, Chiarello Sosa J, Gomez Peña M, Papayannis M, Figueroa C, Magri L, Oubiña A, Horton M, De Zuñiga I, Kopcow L, Sobral F, Bisioli C. P-223 Women aged 40 or older and non-male factor have the same reproductive outcome using intracytoplasmic sperm injection (ICSI) or conventional in vitro fertilization (cIVF). Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.215] [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] Open
Abstract
Abstract
Study question
Do women aged 40 or older have the same reproductive outcome using ICSI or cIVF when male factor infertility is not present?
Summary answer
Women aged 40 or older with non-male factor partners achieved similar reproductive outcomes either with ICSI or cIVF.
What is known already
Although initially proposed to treat couples with severe male factor infertility, ICSI has become the preferred tool to treat patient populations others than initially intended. Many studies and international forums, however, have alerted that its overuse is not free due to its safety, cost and time-consuming concerns. Moreover, it was noted that it does not increase clinical outcomes even in cases of compromised oocyte factor such as poor responder patients or few oocytes retrieved. However, there is still no information regarding its use in the group of patients of advanced reproductive age.
Study design, size, duration
Retrospective cohort study including 412 women aged 40 or older with non-male factor infertility performing ICSI or cIVF between May 2015 and October 2017.
Participants/materials, setting, methods
Patients underwent ICSI (n = 109) or cIVF (n = 303) according to medical indication. The decision to use ICSI in non-male factor patients was merely operational, with the objective of evaluating oocyte maturity.Those cycles with own oocytes, non-male factor and fresh embryo transfers were included. Semen samples were considered normal following the World Health Organization fifth edition sperm parameters values, and prepared by density gradient selection.
Main results and the role of chance
The primary outcome was clinical pregnancy rate. Secondary outcomes included ongoing pregnancy, miscarriage and implantation rates. Statistical significance was denoted by P < 0.05. The mean age of the women were 41.4 in the ICSI group and 41.6 years in the cIVF group, while the mean age for male couple was 43.6 and 41.6 respectively.
No differences between ICSI and cIVF groups were observed regarding clinical pregnancy [16.5% (18/109) vs. 20.8% (63/303)], ongoing pregnancy [9.2% (10/109) vs. 7.9% (24/303)], miscarriage [41.2% (7/17) vs. 46,5% (20/43)], and implantation rates [11.3% (17/151) vs. 9.9% (50/506)].
Limitations, reasons for caution
These results need confirmation with a bigger population size. As with any retrospective study, the potential for residual confounding exists.
Wider implications of the findings
These data suggest that ICSI offers no clinical benefit for women aged 40 and older with non-male factor infertility, beyond oocyte maturation classification.
Trial registration number
not applicable
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Affiliation(s)
- P Filardi
- Pregna Medicina Reproductiva, Embryology Lab , Buenos Aires, Argentina
| | - E De Martino
- Pregna Medicina Reproductiva, Embryology Lab , Buenos Aires, Argentina
| | | | - M Gomez Peña
- Pregna Medicina Reproductiva, Embryology Lab , Buenos Aires, Argentina
| | - M Papayannis
- Pregna Medicina Reproductiva, Embryology Lab , Buenos Aires, Argentina
| | - C Figueroa
- Pregna Medicina Reproductiva, Embryology Lab , Buenos Aires, Argentina
| | - L Magri
- Pregna Medicina Reproductiva, Embryology Lab , Buenos Aires, Argentina
| | - A Oubiña
- Pregna Medicina Reproductiva, Department of Gynaecology and In Vitro Fertilisation Unit , Buenos Aires, Argentina
| | - M Horton
- Pregna Medicina Reproductiva, Department of Gynaecology and In Vitro Fertilisation Unit , Buenos Aires, Argentina
| | - I De Zuñiga
- Pregna Medicina Reproductiva, Department of Gynaecology and In Vitro Fertilisation Unit , Buenos Aires, Argentina
| | - L Kopcow
- Pregna Medicina Reproductiva, Department of Gynaecology and In Vitro Fertilisation Unit , Buenos Aires, Argentina
| | - F Sobral
- Pregna Medicina Reproductiva, Department of Gynaecology and In Vitro Fertilisation Unit , Buenos Aires, Argentina
| | - C Bisioli
- Pregna Medicina Reproductiva, Embryology Lab , Buenos Aires, Argentina
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van Kooten H, Horton M, Wenninger S, Schoser B, Lefeuvre C, Laforêt P, Segovia S, Manera JD, Claeys K, Mongini T, Musumeci O, Toscano A, Hundsberger T, Brusse E, Merkies I, van Doorn P, van der Ploeg A, van der Beek N, R-PAct study group. POMPE DISEASE. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.223] [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: 10/20/2022]
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Calabrese L, Weinblatt ME, Shadick N, Heegaard Brahe C, Østergaard M, Hetland ML, Horton M, Flake D, Sasso E. POS0454 COMPARISON OF MBDA SCORE, PATIENT GLOBAL ASSESSMENT AND EVALUATOR GLOBAL ASSESSMENT FOR PREDICTING RISK OF RADIOGRAPHIC PROGRESSION. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Busy rheumatologists may assess disease activity and risk for radiographic progression (RP) in RA with informal, qualitative versions of evaluator and/or patient global assessments (EGA and PGA). RA patient care may be improved by having a convenient, objective disease activity measure that predicts risk for RP more accurately than EGA or PGA.Objectives:To compare the abilities of MBDA score, patient global assessment and evaluator global assessment to assess risk for radiographic progression (RP), and to assess the ability of MBDA score to predict RP among patients with concordant or discordant PGA and EGA.Methods:Patients were pooled from two RCTs of patients with recent onset RA treated with conventional and biologic DMARDs (OPERA and SWEFOT, N=386) and from a registry of patients with predominantly established RA and diverse treatments (BRASS, N=380). Pearson correlations were determined between MBDA scores (adjusted for the effects of age, sex and adiposity) (scale 1-100), PGA and EGA (each on a scale of 1-10) at baseline. PGA and EGA were considered discordant when they differed by >2.5. Univariable logistic regression assessed ability to predict RP (change in TSS >5 over 1 year) for MBDA score, PGA and EGA as continuous variables; and for discordance of PGA and EGA as 2-level (concordant vs. discordant) or 3-level (PGA>EGA, concordant, EGA>PGA) categorical variables. Multivariable regression considered the main effect and interaction terms of the MBDA score, as a continuous variable, paired with each other variable, to test the ability of each pair to assess risk of RP. All models included a random effect on cohort. Odds ratios were reported for every 10-unit increase in MBDA score. Frequency of RP was determined in subgroups with MBDA score low (<30), moderate (30-44) or high (>44) for patient groups based on PGA/EGA concordance or discordance.Results:The 766 patients studied were 76% female, 76% positive for RF and/or anti-CCP Ab, with mean age 55 years, DAS28-CRP 4.7, CRP 22 mg/L, CDAI 26, SJC 9.1, PGA 4.4, EGA 3.4, MBDA score 53. No interaction was seen between MBDA score and type of cohort (early vs established RA). PGA and EGA were discordant in 294 of 766 (38%) patients and were weakly to moderately correlated (r=0.38). Among discordant patients, PGA was >EGA in 227 cases and EGA was >PGA in 67 cases. Correlations between MBDA score and PGA or EGA were r=0.41 and r=0.34, respectively. In univariable analyses, MBDA score was a statistically significant predictor of radiographic progression (OR=1.53, p=6.3x10-8) whereas PGA, EGA, 2-level discordance and 3-level discordance were not (p=0.38, 0.47, 0.74, 0.83, respectively). In multivariable analyses, significant interactions were observed between MBDA score and discordance (2-level, p=0.0029; 3-level, p=0.0087). The interaction analysis demonstrated, in PGA/EGA-concordant patients, low risk of radiographic progression when MBDA score was low and elevated risk when it was high (OR=1.33 [1.1, 1.59]). A relationship between MBDA score and RP risk was also demonstrated, with heightened trend, among discordant patients with PGA >EGA (OR=2.04 [1.53, 2.81]) and EGA >PGA (OR=3.43 [1.37, 13.8]) (Figure 1).Conclusion:MBDA score was a significant predictor of radiographic progression, whereas PGA and EGA were not. MBDA score predicted progression whether PGA and EGA were concordant or discordant. These results suggest that MBDA score detects joint-damaging disease activity more accurately than PGA and EGA and it does so whether or not PGA and EGA are in agreement.Disclosure of Interests:Leonard Calabrese Grant/research support from: AbbVie, Bristol-Myers Squibb, Cresecendo, Genentech, Gilead, GlaxoSmithKline, Horizon, Janssen, Novartis, and Sanofi., Michael E. Weinblatt Shareholder of: Canfite, Inmedix, Scipher, and Vorso, Consultant of: AbbVie, Aclaris, Amgen, Bayer, Bristol-Myers Squibb, Crescendo Bioscience, Corrona, EqRX, GSK,Genosco, Gilead, Lilly, Novartis, Pfizer, Roche, Set Point, Grant/research support from: Bristol-Myers Squibb, Myriad Genetics, Inc.,Eli Lilly and Sanofi, Nancy Shadick Consultant of: BMS, Grant/research support from: Lilly, mallinckrodt, BMS, Amgen and Sanofi, Cecilie Heegaard Brahe: None declared, Mikkel Østergaard Consultant of: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli-Lilly, Centocor, GSK, Hospira, Janssen, Merck, Novartis, Orion, Pfizer, Regeneron, Roche, Takeda, and UCB, Grant/research support from: AbbVie, BMS, Celgene, Myriad Genetics, Inc., Janssen, and Merck, Merete L. Hetland Speakers bureau: Orion, Grant/research support from: AbbVie, Biogen, BMS, CelltrionRoche, Myriad Genetics, Inc., Eli Lily, MSD, Pfizer, and UCB, Megan Horton Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Darl Flake Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Eric Sasso Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Autoimmune
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Thompson EA, Cascino K, Ordonez AA, Zhou W, Vaghasia A, Hamacher-Brady A, Brady NR, Sun IH, Wang R, Rosenberg AZ, Delannoy M, Rothman R, Fenstermacher K, Sauer L, Shaw-Saliba K, Bloch EM, Redd AD, Tobian AAR, Horton M, Smith K, Pekosz A, D'Alessio FR, Yegnasubramanian S, Ji H, Cox AL, Powell JD. Metabolic programs define dysfunctional immune responses in severe COVID-19 patients. Cell Rep 2021; 34:108863. [PMID: 33691089 PMCID: PMC7908880 DOI: 10.1016/j.celrep.2021.108863] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/17/2020] [Accepted: 02/22/2021] [Indexed: 02/07/2023] Open
Abstract
It is unclear why some SARS-CoV-2 patients readily resolve infection while others develop severe disease. By interrogating metabolic programs of immune cells in severe and recovered coronavirus disease 2019 (COVID-19) patients compared with other viral infections, we identify a unique population of T cells. These T cells express increased Voltage-Dependent Anion Channel 1 (VDAC1), accompanied by gene programs and functional characteristics linked to mitochondrial dysfunction and apoptosis. The percentage of these cells increases in elderly patients and correlates with lymphopenia. Importantly, T cell apoptosis is inhibited in vitro by targeting the oligomerization of VDAC1 or blocking caspase activity. We also observe an expansion of myeloid-derived suppressor cells with unique metabolic phenotypes specific to COVID-19, and their presence distinguishes severe from mild disease. Overall, the identification of these metabolic phenotypes provides insight into the dysfunctional immune response in acutely ill COVID-19 patients and provides a means to predict and track disease severity and/or design metabolic therapeutic regimens. T cells with a unique metabolic profile are expanded in acute COVID-19 These T cells are prone to mitochondrial apoptosis, correlating with lymphopenia Metabolically distinct myeloid-derived suppressor cells increase in acute COVID-19 The presence of these M-MDSCs in acute COVID-19 correlates with disease severity
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Affiliation(s)
- Elizabeth A Thompson
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Katherine Cascino
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Alvaro A Ordonez
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Weiqiang Zhou
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Ajay Vaghasia
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Anne Hamacher-Brady
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Nathan R Brady
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Im-Hong Sun
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Rulin Wang
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Avi Z Rosenberg
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Michael Delannoy
- Department of Cell Biology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Richard Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Katherine Fenstermacher
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Lauren Sauer
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Kathyrn Shaw-Saliba
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Andrew D Redd
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH, Baltimore, MD 21205, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Maureen Horton
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Kellie Smith
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Franco R D'Alessio
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Srinivasan Yegnasubramanian
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Hongkai Ji
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Andrea L Cox
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA.
| | - Jonathan D Powell
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Bloomberg∼Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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Thompson EA, Cascino K, Ordonez AA, Zhou W, Vaghasia A, Hamacher-Brady A, Brady NR, Sun IH, Wang R, Rosenberg AZ, Delannoy M, Rothman R, Fenstermacher K, Sauer L, Shaw-Saliba K, Bloch EM, Redd AD, Tobian AA, Horton M, Smith K, Pekosz A, D'Alessio FR, Yegnasubramanian S, Ji H, Cox AL, Powell JD. Metabolic programs define dysfunctional immune responses in severe COVID-19 patients. medRxiv 2020. [PMID: 32935120 PMCID: PMC7491535 DOI: 10.1101/2020.09.10.20186064] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
It remains unclear why some patients infected with SARS-CoV-2 readily resolve infection while others develop severe disease. To address this question, we employed a novel assay to interrogate immune-metabolic programs of T cells and myeloid cells in severe and recovered COVID-19 patients. Using this approach, we identified a unique population of T cells expressing high H3K27me3 and the mitochondrial membrane protein voltage-dependent anion channel (VDAC), which were expanded in acutely ill COVID-19 patients and distinct from T cells found in patients infected with hepatitis c or influenza and in recovered COVID-19. Increased VDAC was associated with gene programs linked to mitochondrial dysfunction and apoptosis. High-resolution fluorescence and electron microscopy imaging of the cells revealed dysmorphic mitochondria and release of cytochrome c into the cytoplasm, indicative of apoptosis activation. The percentage of these cells was markedly increased in elderly patients and correlated with lymphopenia. Importantly, T cell apoptosis could be inhibited in vitro by targeting the oligomerization of VDAC or blocking caspase activity. In addition to these T cell findings, we also observed a robust population of Hexokinase II+ polymorphonuclear-myeloid derived suppressor cells (PMN-MDSC), exclusively found in the acutely ill COVID-19 patients and not the other viral diseases. Finally, we revealed a unique population of monocytic MDSC (M-MDSC) expressing high levels of carnitine palmitoyltransferase 1a (CPT1a) and VDAC. The metabolic phenotype of these cells was not only highly specific to COVID-19 patients but the presence of these cells was able to distinguish severe from mild disease. Overall, the identification of these novel metabolic phenotypes not only provides insight into the dysfunctional immune response in acutely ill COVID-19 patients but also provide a means to predict and track disease severity as well as an opportunity to design and evaluate novel metabolic therapeutic regimens.
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Affiliation(s)
- Elizabeth A Thompson
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Katherine Cascino
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Alvaro A Ordonez
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Weiqiang Zhou
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Ajay Vaghasia
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Anne Hamacher-Brady
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Nathan R Brady
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Im-Hong Sun
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Rulin Wang
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Avi Z Rosenberg
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Michael Delannoy
- Department of Cell Biology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Richard Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Katherine Fenstermacher
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Lauren Sauer
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Kathyrn Shaw-Saliba
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Andrew D Redd
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH, Baltimore, MD 21205, USA
| | - Aaron Ar Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Maureen Horton
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Kellie Smith
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Franco R D'Alessio
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Srinivasan Yegnasubramanian
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Hongkai Ji
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Andrea L Cox
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Jonathan D Powell
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.,Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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Huizinga T, Weinblatt ME, Shadick N, Heegaard Brahe C, Ǿstergaard M, Hetland ML, Saevarsdottir S, Horton M, Mabey B, Flake D, Ben-Shachar R, Sasso E, Gutin A, Hitraya E, Lanchbury J, Curtis J. AB1243 TRAINING AND VALIDATION OF A MULTIVARIATE PREDICTOR OF RISK OF RADIOGRAPHIC PROGRESSION FOR PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The multi-biomarker disease activity (MBDA) score, adjusted for age, sex and adiposity (MBDAadj), has been shown to be better than several conventional disease activity measures for predicting risk for radiographic progression (RP) in patients with rheumatoid arthritis (RA).1Serologic status and other non-disease activity measures are also predictive of RP risk. Combining them with the MBDAadjshould result in a stronger prognostic test for RP than any one measure alone.Objectives:Develop a multivariate model for predicting risk for RP that includes the adjusted MBDA score and other known predictors of RP.Methods:Four RA cohorts were used, two for training (OPERA and BRASS, n=555) and two for validation (SWEFOT and Leiden, n=397). Each pair of cohorts was heterogeneous in disease duration and treatment history. BMI data were not available for one validation cohort, so a BMI surrogate was modeled using forward selection with the two training cohorts and 3 others (CERTAIN, InFoRM, RACER) (N=1411). An RP risk score was then trained using forward selection in a linear mixed-effects regression, considering disease-related and demographic variables as predictors of change in modified total Sharp score over one year (ΔmTSS), with a random effect on cohort. The RP risk score was validated as a predictor of RP with two cutoffs (ΔmTSS >3 and >5) using logistic mixed-effects regression. Odds ratios (OR) and 95% profile likelihood-based confidence intervals (CI) were calculated from the models and significance was assessed by likelihood ratio tests. Risk curves were generated to show probability of RP as a function of the RP risk score.Results:The BMI surrogate included leptin, sex, age and age2and correlated well with BMI (ρ = 0.76). In training, the most significant independent predictors of RP were MBDAadj(p = 0.00020), seropositivity (p = 9.3 x 10-5), BMI surrogate score (p = 0.013) and use of targeted therapy (p = 0.0026). The final model was: RP risk score = 0.024 x MBDAadj+ 0.093 if seropositive – 0.063 x BMI surrogate score – 0.61 if using a targeted therapy. In validation, the OR (95% CI) of the RP risk score for predicting ΔTSS >3 or >5 were 2.2 (1.6, 3.2) (p = 2.6 × 10-6) and 3.1 (2.0, 5.0) (p = 5.7 × 10-8), respectively (Figure 1). The odds of a patient having RP increases by 50% for each 21-unit or 15-unit increase in MBDAadj, for RP defined as ΔTSS >3 or >5, respectively.Figure 1.Conclusion:A multivariate model containing adjusted MBDA score, seropositivity, a BMI surrogate and use of targeted therapy has been trained and validated as a prognostic test for radiographic progression in RA.References:[1]Curtis, et al.Rheumatology [Oxford].2018;58:874Disclosure of Interests:Thomas Huizinga Grant/research support from: Ablynx, Bristol-Myers Squibb, Roche, Sanofi, Consultant of: Ablynx, Bristol-Myers Squibb, Roche, Sanofi, Michael E. Weinblatt Grant/research support from: BMS, Amgen, Lilly, Crescendo and Sonofi-Regeneron, Consultant of: Horizon Therapeutics, Bristol-Myers Squibb, Amgen, Abbvie, Crescendo, Lilly, Pfizer, Roche, Gilead, Nancy Shadick Grant/research support from: Mallinckrodt, BMS, Lilly, Amgen, Crescendo Biosciences, and Sanofi-Regeneron, Consultant of: BMS, Cecilie Heegaard Brahe: None declared, Mikkel Ǿstergaard Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Merck, and Novartis, Consultant of: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Merete L. Hetland Grant/research support from: BMS, MSD, AbbVie, Roche, Novartis, Biogen and Pfizer, Consultant of: Eli Lilly, Speakers bureau: Orion Pharma, Biogen, Pfizer, CellTrion, Merck and Samsung Bioepis, Saedis Saevarsdottir Employee of: Part-time at deCODE Genetics/Amgen Inc, working on genetic research unrelated to this project, Megan Horton Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Brent Mabey Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Darl Flake Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Rotem Ben-Shachar Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Eric Sasso Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Alexander Gutin Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Elena Hitraya Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Jerry Lanchbury Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Jeffrey Curtis Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB
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Furst D, Lenz L, Horton M, Flake D, Sasso E, Weinblatt ME. AB1239 THE EFFECT OF INFLUENZA VACCINATION ON THE MULTI-BIOMARKER DISEASE ACTIVITY SCORE AND ITS COMPONENT BIOMARKERS IN HEALTHY SUBJECTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The multi-biomarker disease activity (MBDA) blood test measures 12 protein biomarkers (IL-6, CRP, SAA, EGF, VEGF, VCAM, MMP-1, MMP-3, leptin, resistin, TNF-RI and YKL40). It uses a validated algorithm to provide a score on a scale of 1-100 for assessing disease activity in patients with rheumatoid arthritis (RA). The MBDA score reflects several molecular aspects of inflammation, including cytokines, acute phase reactants, growth factors, molecular adhesion, metalloproteinases and hormones. Insights gained by understanding how vaccination affects these biomarkers in healthy subjects - in whom the level of inflammation prior to vaccination should be low and stable - may aid the understanding of how vaccination affects patients with RA.Objectives:The goal of this study was to understand how immunization of healthy subjects with the influenza vaccine affects the assessment of inflammation with the MBDA score and its 12 biomarkers.Methods:A 4-strain influenza virus vaccine (Fluarix Quadrivalent, GlaxoSmithKline) was administered intramuscularly to 22 healthy volunteer subjects on October 24, 2018. Serum samples were obtained immediately prior to vaccination (baseline) and 1, 2 and 3 weeks after vaccination. No restrictions were placed on subject activity. Samples were stored at -80oC until measurement of the 12 MBDA biomarkers for determination of the adjusted MBDA score, hereafter called the MBDA score. (Adjustment accounts for the effects of age, sex and adiposity1). MBDA scores (natural scale) and biomarker concentrations (log scale) were modeled using generalized estimating equations (GEE) that account for correlations between measurements from the same subject at multiple timepoints. Significance of MBDA score change or biomarker concentration change over time was determined by a likelihood ratio test of timepoints.Results:Of the 22 healthy subjects receiving the influenza virus vaccine, 14 (63.6%) were female, with mean (SD) age of 40.0 years (8.9). MBDA scores were low (<30), moderate (30-44) or high (>44) for 15 (68%), 6 (27%) and 1 (5%) subjects at baseline, and this distribution was stable over time (Figure 1). Overall, MBDA scores did not change significantly over time (p=0.48, Figure 2). Mean changes in MBDA score (95% CI) from baseline to weeks 1, 2 and 3 were 0.32 (-3.07, 3.71), 0.82 (-3.03, 4.67) and 2.86 (-1.10, 6.82), respectively (Figure 2); the week 3 value becomes 0.95 (-1.78, 3.68) if the week 3 outlier is removed. Among the 66 post-baseline measurements of change in MBDA score (Figure 2), 3 (5%) exceeded the 95% CI for change in MBDA score in this study (i.e., 14). When assessing the entire cohort across all timepoints, EGF was the only biomarker that demonstrated statistically significant change over time (p=5.6 x 10-7). At weeks 1, 2 and 3, the mean relative concentrations of EGF, compared with baseline, were 0.62 (0.52, 0.74), 0.86 (0.70, 1.06) and 0.62 (0.50, 0.76), respectively.Figure 1Figure 2Conclusion:Immunization of 22 healthy subjects with a quadrivalent influenza vaccine did not have a statistically significant effect on MBDA scores during a 3-week observation, and it had minimal effect on the component biomarkers.References:[1]Curtis et al.Rheumatology [Oxford]2018;58:874Disclosure of Interests:Daniel Furst Grant/research support from: AbbVie, Actelion, Amgen, BMS, Corbus Pharmaceuticals, the National Institutes of Health, Novartis, Pfizer, and Roche/Genentech, Consultant of: AbbVie, Actelion, Amgen, BMS, Cytori Therapeutics, Corbus Pharmaceuticals, the National Institutes of Health, Novartis, Pfizer, and Roche/Genentech, Speakers bureau: CMC Connect (McCann Health Company), Lauren Lenz Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Megan Horton Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Darl Flake Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Eric Sasso Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Michael E. Weinblatt Grant/research support from: BMS, Amgen, Lilly, Crescendo and Sonofi-Regeneron, Consultant of: Horizon Therapeutics, Bristol-Myers Squibb, Amgen, Abbvie, Crescendo, Lilly, Pfizer, Roche, Gilead
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Oh MH, Travers M, Brown S, Zhao L, Sun IM, Sun IH, Arwood M, Xu W, Collins S, Leone R, Prchalova E, Rais R, Slusher B, Horton M, Zahnow C, Powell J. Abstract LB-022: Targeting glutamine metabolism as a mean of treating a murine model of ovarian cancer and ascites development. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-lb-022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Malignant ascites in ovarian cancer develops in the setting of recurrent and advanced metastatic disease and is associated with poor prognosis. Emerging evidence has demonstrated that ovarian cancer patients have altered metabolism and an immunosuppressive environment in the ascites fluid. Inasmuch as the rapid proliferation of ovarian cancer cells and development of ascites is dependent on glutamine metabolism, we hypothesized that targeting the glutamine metabolism can inhibit the development of ascites and enhance anti-tumor immunity in ovarian cancer. To test this hypothesis, we developed a novel small molecule glutamine antagonist (prodrug of 6-Diazo-5-oxo-l-norleucine, JHU-083). By employing JHU-083, we evaluated this hypothesis in mice bearing an aggressive and metastatic ovarian cancer (ID8 cell line with an overexpression of Defb29 and Vegfa). Targeting glutamine metabolism led to markedly reduced progression of ascites along with reduced tumor cell numbers. Furthermore, JHU-083 treatment also led to a marked diminution of the volume of fluid in mice with already established ascites. Inhibition of glutamine metabolism also led to a less suppressive tumor microenvironment by blocking the recruitment of myeloid derived suppressor cells (MDSCs) and tumor-associated macrophages (TAMs) to the ascites fluid. Functionally, both the TAMs and tumor cells from the JHU-083 treated group showed a lower expression of PDL1 compared to the vehicle treated group. Additionally, we also observed reduced regulatory T cell (T regs) percentages and numbers with JHU-083 treatment. These findings are consistent with our previous observations that targeting glutamine metabolism can inhibit the generation and recruitment of MDSC and T regs by targeting both tumor cell and immune cell metabolism. Further, LC-MS based metabolite analysis of the ovarian cancer ascites fluid from JHU-083 treated mice revealed distinct differences in urea-ornithine pathway, nucleotide synthesis, and redox balance related metabolites. In light of these findings, ongoing experiments are examining the efficacy of JHU-083 in combination with epigenetic drugs, VEGF inhibitors, PARP inhibitors, and checkpoint blockade. These studies suggest that targeting glutamine metabolism may represent a novel approach to treating metastatic ovarian cancer and ascites.
Citation Format: Min-Hee Oh, Meghan Travers, Stephen Brown, Liang Zhao, Im-Meng Sun, Im-Hong Sun, Matthew Arwood, Wei Xu, Samuel Collins, Robert Leone, Eva Prchalova, Rana Rais, Barbara Slusher, Maureen Horton, Cynthia Zahnow, Jonathan Powell. Targeting glutamine metabolism as a mean of treating a murine model of ovarian cancer and ascites development [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr LB-022.
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Affiliation(s)
- Min-Hee Oh
- 1Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Meghan Travers
- 2Johns Hopkins University School of Medicine, Baltimore, MD
| | - Stephen Brown
- 2Johns Hopkins University School of Medicine, Baltimore, MD
| | - Liang Zhao
- 1Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Im-Meng Sun
- 1Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Im-Hong Sun
- 1Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Matthew Arwood
- 1Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Wei Xu
- 1Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Samuel Collins
- 2Johns Hopkins University School of Medicine, Baltimore, MD
| | - Robert Leone
- 1Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Eva Prchalova
- 1Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rana Rais
- 1Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Barbara Slusher
- 1Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Maureen Horton
- 2Johns Hopkins University School of Medicine, Baltimore, MD
| | - Cynthia Zahnow
- 2Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jonathan Powell
- 1Bloomberg~Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD
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Román LS, Menon BK, Blasco J, Hernández-Pérez M, Dávalos A, Majoie CBLM, Campbell BCV, Guillemin F, Lingsma H, Anxionnat R, Epstein J, Saver JL, Marquering H, Wong JH, Lopes D, Reimann G, Desal H, Dippel DWJ, Coutts S, du Mesnil de Rochemont R, Yavagal D, Ferre JC, Roos YBWEM, Liebeskind DS, Lenthall R, Molina C, Al Ajlan FS, Reddy V, Dowlatshahi D, Sourour NA, Oppenheim C, Mitha AP, Davis SM, Weimar C, van Oostenbrugge RJ, Cobo E, Kleinig TJ, Donnan GA, van der Lugt A, Demchuk AM, Berkhemer OA, Boers AMM, Ford GA, Muir KW, Brown BS, Jovin T, van Zwam WH, Mitchell PJ, Hill MD, White P, Bracard S, Goyal M, Berkhemer OA, Fransen PSS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, Schonewille WJ, Vos JA, Nederkoorn PJ, Wermer MJH, van Walderveen MAA, Staals J, Hofmeijer J, van Oostayen JA, Lycklama à Nijeholt GJ, Boiten J, Brouwer PA, Emmer BJ, de Bruijn SF, van Dijk LC, Kappelle J, Lo RH, van Dijk EJ, de Vries J, de Kort PL, van Rooij WJJ, van den Berg JS, van Hasselt BA, Aerden LA, Dallinga RJ, Visser MC, Bot JC, Vroomen PC, Eshghi O, Schreuder TH, Heijboer RJ, Keizer K, Tielbeek AV, den Hertog HM, Gerrits DG, van den Berg-Vos RM, Karas GB, Steyerberg EW, Flach Z, Marquering HA, Sprengers ME, Jenniskens SF, Beenen LF, Zech M, Kowarik M, Seifert C, Schwaiger B, Puri A, Hou S, Wakhloo A, Moonis M, Henniger N, Goddeau R, van den Berg R, Massari F, Minaeian A, Lozano JD, Ramzan M, Stout C, Patel A, Tunguturi A, Onteddu S, Carandang R, Howk M, Koudstaal PJ, Ribó M, Sanjuan E, Rubiera M, Pagola J, Flores A, Muchada M, Meler P, Huerga E, Gelabert S, Coscojuela P, van Zwam WH, Tomasello A, Rodriguez D, Santamarina E, Maisterra O, Boned S, Seró L, Rovira A, Molina CA, Millán M, Muñoz L, Roos YB, Pérez de la Ossa N, Gomis M, Dorado L, López-Cancio E, Palomeras E, Munuera J, García Bermejo P, Remollo S, Castaño C, García-Sort R, van der Lugt A, Cuadras P, Puyalto P, Hernández-Pérez M, Jiménez M, Martínez-Piñeiro A, Lucente G, Dávalos A, Chamorro A, Urra X, Obach V, van Oostenbrugge RJ, Cervera A, Amaro S, Llull L, Codas J, Balasa M, Navarro J, Ariño H, Aceituno A, Rudilosso S, Renu A, Majoie CB, Macho JM, San Roman L, Blasco J, López A, Macías N, Cardona P, Quesada H, Rubio F, Cano L, Lara B, Dippel DW, de Miquel MA, Aja L, Serena J, Cobo E, Albers GW, Lees KR, Arenillas J, Roberts R, Minhas P, Al-Ajlan F, Brown MM, Salluzzi M, Zimmel L, Patel S, Eesa M, Martí-Fàbregas J, Jankowitz B, Serena J, Salvat-Plana M, López-Cancio E, Bracard S, Liebig T, Ducrocq X, Anxionnat R, Baillot PA, Barbier C, Derelle AL, Lacour JC, Richard S, Samson Y, Sourour N, Baronnet-Chauvet F, Stijnen T, Clarencon F, Crozier S, Deltour S, Di Maria F, Le Bouc R, Leger A, Mutlu G, Rosso C, Szatmary Z, Yger M, Andersson T, Zavanone C, Bakchine S, Pierot L, Caucheteux N, Estrade L, Kadziolka K, Leautaud A, Renkes C, Serre I, Desal H, Mattle H, Guillon B, Boutoleau-Bretonniere C, Daumas-Duport B, De Gaalon S, Derkinderen P, Evain S, Herisson F, Laplaud DA, Lebouvier T, Lintia-Gaultier A, Wahlgren N, Pouclet-Courtemanche H, Rouaud T, Rouaud Jaffrenou V, Schunck A, Sevin-Allouet M, Toulgoat F, Wiertlewski S, Gauvrit JY, Ronziere T, Cahagne V, van der Heijden E, Ferre JC, Pinel JF, Raoult H, Mas JL, Meder JF, Al Najjar-Carpentier AA, Birchenall J, Bodiguel E, Calvet D, Domigo V, Ghannouti N, Godon-Hardy S, Guiraud V, Lamy C, Majhadi L, Morin L, Naggara O, Trystram D, Turc G, Berge J, Sibon I, Fleitour N, Menegon P, Barreau X, Rouanet F, Debruxelles S, Kazadi A, Renou P, Fleury O, Pasco-Papon A, Dubas F, Caroff J, Hooijenga I, Godard Ducceschi S, Hamon MA, Lecluse A, Marc G, Giroud M, Ricolfi F, Bejot Y, Chavent A, Gentil A, Kazemi A, Puppels C, Osseby GV, Voguet C, Mahagne MH, Sedat J, Chau Y, Suissa L, Lachaud S, Houdart E, Stapf C, Buffon Porcher F, Pellikaan W, Chabriat H, Guedin P, Herve D, Jouvent E, Mawet J, Saint-Maurice JP, Schneble HM, Turjman F, Nighoghossian N, Berhoune NN, Geerling A, Bouhour F, Cho TH, Derex L, Felix S, Gervais-Bernard H, 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Vuillier F, Courtheoux P, Viader F, Apoil-Brissard M, Bataille M, Bonnet AL, Cogez J, Kazemi A, Touze E, Licher S, Leclerc X, Leys D, Aggour M, Aguettaz P, Bodenant M, Cordonnier C, Deplanque D, Girot M, Henon H, Kalsoum E, Boodt N, Lucas C, Pruvo JP, Zuniga P, Bonafé A, Arquizan C, Costalat V, Machi P, Mourand I, Riquelme C, Bounolleau P, Ros A, Arteaga C, Faivre A, Bintner M, Tournebize P, Charlin C, Darcel F, Gauthier-Lasalarie P, Jeremenko M, Mouton S, Zerlauth JB, Venema E, Lamy C, Hervé D, Hassan H, Gaston A, Barral FG, Garnier P, Beaujeux R, Wolff V, Herbreteau D, Debiais S, Slokkers I, Murray A, Ford G, Muir KW, White P, Brown MM, Clifton A, Freeman J, Ford I, Markus H, Wardlaw J, Ganpat RJ, Lees KR, Molyneux A, Robinson T, Lewis S, Norrie J, Robertson F, Perry R, Dixit A, Cloud G, Clifton A, Mulder M, Madigan J, Roffe C, Nayak S, Lobotesis K, Smith C, Herwadkar A, Kandasamy N, Goddard T, Bamford J, Subramanian G, Saiedie N, Lenthall R, Littleton E, Lamin S, Storey K, Ghatala R, Banaras A, Aeron-Thomas J, Hazel B, Maguire H, Veraque E, Heshmatollah A, Harrison L, Keshvara R, Cunningham J, Schipperen S, Vinken S, van Boxtel T, Koets J, Boers M, Santos E, Borst J, Jansen I, Kappelhof M, Lucas M, Geuskens R, Barros RS, Dobbe R, Csizmadia M, Hill MD, Goyal M, Demchuk AM, Menon BK, Eesa M, Ryckborst KJ, Wright MR, Kamal NR, Andersen L, Randhawa PA, Stewart T, Patil S, Minhas P, Almekhlafi M, Mishra S, Clement F, Sajobi T, Shuaib A, Montanera WJ, Roy D, Silver FL, Jovin TG, Frei DF, Sapkota B, Rempel JL, Thornton J, Williams D, Tampieri D, Poppe AY, Dowlatshahi D, Wong JH, Mitha AP, Subramaniam S, Hull G, Lowerison MW, Sajobi T, Salluzzi M, Wright MR, Maxwell M, Lacusta S, Drupals E, Armitage K, Barber PA, Smith EE, Morrish WF, Coutts SB, Derdeyn C, Demaerschalk B, Yavagal D, Martin R, Brant R, Yu Y, Willinsky RA, Montanera WJ, Weill A, Kenney C, Aram H, Stewart T, Stys PK, Watson TW, Klein G, Pearson D, Couillard P, Trivedi A, Singh D, Klourfeld E, Imoukhuede O, Nikneshan D, Blayney S, Reddy R, Choi P, Horton M, Musuka T, Dubuc V, Field TS, Desai J, Adatia S, Alseraya A, Nambiar V, van Dijk R, Wong JH, Mitha AP, Morrish WF, Eesa M, Newcommon NJ, Shuaib A, Schwindt B, Butcher KS, Jeerakathil T, Buck B, Khan K, Naik SS, Emery DJ, Owen RJ, Kotylak TB, Ashforth RA, Yeo TA, McNally D, Siddiqui M, Saqqur M, Hussain D, Kalashyan H, Manosalva A, Kate M, Gioia L, Hasan S, Mohammad A, Muratoglu M, Williams D, Thornton J, Cullen A, Brennan P, O'Hare A, Looby S, Hyland D, Duff S, McCusker M, Hallinan B, Lee S, McCormack J, Moore A, O'Connor M, Donegan C, Brewer L, Martin A, Murphy S, O'Rourke K, Smyth S, Kelly P, Lynch T, Daly T, O'Brien P, O'Driscoll A, Martin M, Daly T, Collins R, Coughlan T, McCabe D, Murphy S, O'Neill D, Mulroy M, Lynch O, Walsh T, O'Donnell M, Galvin T, Harbison J, McElwaine P, Mulpeter K, McLoughlin C, Reardon M, Harkin E, Dolan E, Watts M, Cunningham N, Fallon C, Gallagher S, Cotter P, Crowe M, Doyle R, Noone I, Lapierre M, Coté VA, Lanthier S, Odier C, Durocher A, Raymond J, Weill A, Daneault N, Deschaintre Y, Jankowitz B, Baxendell L, Massaro L, Jackson-Graves C, Decesare S, Porter P, Armbruster K, Adams A, Billigan J, Oakley J, Ducruet A, Jadhav A, Giurgiutiu DV, Aghaebrahim A, Reddy V, Hammer M, Starr M, Totoraitis V, Wechsler L, Streib S, Rangaraju S, Campbell D, Rocha M, Gulati D, Silver FL, Krings T, Kalman L, Cayley A, Williams J, Stewart T, Wiegner R, Casaubon LK, Jaigobin C, del Campo JM, Elamin E, Schaafsma JD, Willinsky RA, Agid R, Farb R, ter Brugge K, Sapkoda BL, Baxter BW, Barton K, Knox A, Porter A, Sirelkhatim A, Devlin T, Dellinger C, Pitiyanuvath N, Patterson J, Nichols J, Quarfordt S, Calvert J, Hawk H, Fanale C, Frei DF, Bitner A, Novak A, Huddle D, Bellon R, Loy D, Wagner J, Chang I, Lampe E, Spencer B, Pratt R, Bartt R, Shine S, Dooley G, Nguyen T, Whaley M, McCarthy K, Teitelbaum J, Tampieri D, Poon W, Campbell N, Cortes M, Dowlatshahi D, Lum C, Shamloul R, Robert S, Stotts G, Shamy M, 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Kim BM, Kim YD, Song D, Lee KJ, Yoo J, Bang OY, Rho S, Lee J, Jeon P, Kim KH, Cha J, Kim SJ, Ryoo S, Lee MJ, Sohn SI, Kim CH, Ryu HG, Hong JH, Chang HW, Lee CY, Rha J, Davis SM, Donnan GA, Campbell BCV, Mitchell PJ, Churilov L, Yan B, Dowling R, Yassi N, Oxley TJ, Wu TY, Silver G, McDonald A, McCoy R, Kleinig TJ, Scroop R, Dewey HM, Simpson M, Brooks M, Coulton B, Krause M, Harrington TJ, Steinfort B, Faulder K, Priglinger M, Day S, Phan T, Chong W, Holt M, Chandra RV, Ma H, Young D, Wong K, Wijeratne T, Tu H, Mackay E, Celestino S, Bladin CF, Loh PS, Gilligan A, Ross Z, Coote S, Frost T, Parsons MW, Miteff F, Levi CR, Ang T, Spratt N, Kaauwai L, Badve M, Rice H, de Villiers L, Barber PA, McGuinness B, Hope A, Moriarty M, Bennett P, Wong A, Coulthard A, Lee A, Jannes J, Field D, Sharma G, Salinas S, Cowley E, Snow B, Kolbe J, Stark R, King J, Macdonnell R, Attia J, D'Este C, Saver JL, Goyal M, Diener HC, Levy EI, Bonafé A, Mendes Pereira V, Jahan R, Albers GW, Cognard C, Cohen DJ, Hacke W, Jansen O, Jovin TG, Mattle HP, Nogueira RG, Siddiqui AH, Yavagal DR, von Kummer R, Smith W, Turjman F, Hamilton S, Chiacchierini R, Amar A, Sanossian N, Loh Y, Devlin T, Baxter B, Hawk H, Sapkota B, Quarfordt S, Sirelkhatim A, Dellinger C, Barton K, Reddy VK, Ducruet A, Jadhav A, Horev A, Giurgiutiu DV, Totoraitis V, Hammer M, Jankowitz B, Wechsler L, Rocha M, Gulati D, Campbell D, Star M, Baxendell L, Oakley J, Siddiqui A, Hopkins LN, Snyder K, Sawyer R, Hall S, Costalat V, Riquelme C, Machi P, Omer E, Arquizan C, Mourand I, Charif M, Ayrignac X, Menjot de Champfleur N, Leboucq N, Gascou G, Moynier M, du Mesnil de Rochemont R, Singer O, Berkefeld J, Foerch C, Lorenz M, Pfeilschifer W, Hattingen E, Wagner M, You SJ, Lescher S, Braun H, Dehkharghani S, Belagaje SR, Anderson A, Lima A, Obideen M, Haussen D, Dharia R, Frankel M, Patel V, Owada K, Saad A, Amerson L, Horn C, Doppelheuer S, Schindler K, Lopes DK, Chen M, Moftakhar R, Anton C, Smreczak M, Carpenter JS, Boo S, Rai A, 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M, Belden J, Baker C, Connolly LS, Papanagiotou P, Roth C, Kastrup A, Politi M, Brunner F, Alexandrou M, Merdivan H, Ramsey C, Given II C, Renfrow S, Deshmukh V, Sasadeusz K, Vincent F, Thiesing JT, Putnam J, Bhatt A, Kansara A, Caceves D, Lowenkopf T, Yanase L, Zurasky J, Dancer S, Freeman B, Scheibe-Mirek T, Robison J, Rontal A, Roll J, Clark D, Rodriguez M, Fitzsimmons BFM, Zaidat O, Lynch JR, Lazzaro M, Larson T, Padmore L, Das E, Farrow-Schmidt A, Hassan A, Tekle W, Cate C, Jansen O, Cnyrim C, Wodarg F, Wiese C, Binder A, Riedel C, Rohr A, Lang N, Laufs H, Krieter S, Remonda L, Diepers M, Añon J, Nedeltchev K, Kahles T, Biethahn S, Lindner M, Chang V, Gächter C, Esperon C, Guglielmetti M, Arenillas Lara JF, Martínez Galdámez M, Calleja Sanz AI, Cortijo Garcia E, Garcia Bermejo P, Perez S, Mulero Carrillo P, Crespo Vallejo E, Ruiz Piñero M, Lopez Mesonero L, Reyes Muñoz FJ, Brekenfeld C, Buhk JH, Krützelmann A, Thomalla G, Cheng B, Beck C, Hoppe J, Goebell E, Holst B, Grzyska U, Wortmann G, Starkman S, Duckwiler G, Jahan R, Rao N, Sheth S, Ng K, Noorian A, Szeder V, Nour M, McManus M, Huang J, Tarpley J, Tateshima S, Gonzalez N, Ali L, Liebeskind D, Hinman J, Calderon-Arnulphi M, Liang C, Guzy J, Koch S, DeSousa K, Gordon-Perue G, Haussen D, Elhammady M, Peterson E, Pandey V, Dharmadhikari S, Khandelwal P, Malik A, Pafford R, Gonzalez P, Ramdas K, Andersen G, Damgaard D, Von Weitzel-Mudersbach P, Simonsen C, Ruiz de Morales Ayudarte N, Poulsen M, Sørensen L, Karabegovich S, Hjørringgaard M, Hjort N, Harbo T, Sørensen K, Deshaies E, Padalino D, Swarnkar A, Latorre JG, Elnour E, El-Zammar Z, Villwock M, Farid H, Balgude A, Cross L, Hansen K, Holtmannspötter M, Kondziella D, Hoejgaard J, Taudorf S, Soendergaard H, Wagner A, Cronquist M, Stavngaard T, Cortsen M, Krarup LH, Hyldal T, Haring HP, Guggenberger S, Hamberger M, Trenkler J, Sonnberger M, Nussbaumer K, Dominger C, Bach E, Jagadeesan BD, Taylor R, Kim J, Shea K, Tummala R, Zacharatos H, Sandhu D, Ezzeddine M, Grande A, Hildebrandt D, Miller K, Scherber J, Hendrickson A, Jumaa M, Zaidi S, Hendrickson T, Snyder V, Killer-Oberpfalzer M, Mutzenbach J, Weymayr F, Broussalis E, Stadler K, Jedlitschka A, Malek A, Mueller-Kronast N, Beck P, Martin C, Summers D, Day J, Bettinger I, Holloway W, Olds K, Arkin S, Akhtar N, Boutwell C, Crandall S, Schwartzman M, Weinstein C, Brion B, Prothmann S, Kleine J, Kreiser K, Boeckh-Behrens T, Poppert H, Wunderlich S, Koch ML, Biberacher V, Huberle A, Gora-Stahlberg G, Knier B, Meindl T, Utpadel-Fischler D. Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data. Lancet Neurol 2018; 17:895-904. [DOI: 10.1016/s1474-4422(18)30242-4] [Citation(s) in RCA: 213] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 11/29/2022]
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Campbell BCV, van Zwam WH, Goyal M, Menon BK, Dippel DWJ, Demchuk AM, Bracard S, White P, Dávalos A, Majoie CBLM, van der Lugt A, Ford GA, de la Ossa NP, Kelly M, Bourcier R, Donnan GA, Roos YBWEM, Bang OY, Nogueira RG, Devlin TG, van den Berg LA, Clarençon F, Burns P, Carpenter J, Berkhemer OA, Yavagal DR, Pereira VM, Ducrocq X, Dixit A, Quesada H, Epstein J, Davis SM, Jansen O, Rubiera M, Urra X, Micard E, Lingsma HF, Naggara O, Brown S, Guillemin F, Muir KW, van Oostenbrugge RJ, Saver JL, Jovin TG, Hill MD, Mitchell PJ, Berkhemer OA, Fransen PSS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, Schonewille WJ, Vos JA, Nederkoorn PJ, Wermer MJH, van Walderveen MAA, Staals J, Hofmeijer J, van Oostayen JA, Lycklama à Nijeholt GJ, Boiten J, Brouwer PA, Emmer BJ, de Bruijn SF, van Dijk LC, Kappelle J, Lo RH, van Dijk EJ, de Vries J, de Kort PL, van Rooij WJJ, van den Berg JS, van Hasselt BA, Aerden LA, Dallinga RJ, Visser MC, Bot JC, Vroomen PC, Eshghi O, Schreuder TH, Heijboer RJ, Keizer K, Tielbeek AV, den Hertog HM, Gerrits DG, van den Berg-Vos RM, Karas GB, Steyerberg EW, Flach Z, Marquering HA, Sprengers ME, Jenniskens SF, Beenen LF, van den Berg R, Koudstaal PJ, van Zwam WH, Roos YB, van der Lugt A, van Oostenbrugge RJ, Wakhloo A, Moonis M, Henninger N, Goddeau R, Massari F, Minaeian A, Lozano JD, Ramzan M, Stout C, Patel A, Majoie CB, Tunguturi A, Onteddu S, Carandang R, Howk M, Ribó M, Sanjuan E, Rubiera M, Pagola J, Flores A, Muchada M, Dippel DW, Meler P, Huerga E, Gelabert S, Coscojuela P, Tomasello A, Rodriguez D, Santamarina E, Maisterra O, Boned S, Seró L, Brown MM, Rovira A, Molina CA, Millán M, Muñoz L, Pérez de la Ossa N, Gomis M, Dorado L, López-Cancio E, Palomeras E, Munuera J, Liebig T, García Bermejo P, Remollo S, Castaño C, García-Sort R, Cuadras P, Puyalto P, Hernández-Pérez M, Jiménez M, Martínez-Piñeiro A, Lucente G, Stijnen T, Dávalos A, Chamorro A, Urra X, Obach V, Cervera A, Amaro S, Llull L, Codas J, Balasa M, Navarro J, Andersson T, Ariño H, Aceituno A, Rudilosso S, Renu A, Macho JM, San Roman L, Blasco J, López A, Macías N, Cardona P, Mattle H, Quesada H, Rubio F, Cano L, Lara B, de Miquel MA, Aja L, Serena J, Cobo E, Albers GW, Lees KR, Wahlgren N, Arenillas J, Roberts R, Minhas P, Al-Ajlan F, Salluzzi M, Zimmel L, Patel S, Eesa M, Martí-Fàbregas J, Jankowitz B, van der Heijden E, Serena J, Salvat-Plana M, López-Cancio E, Bracard S, Ducrocq X, Anxionnat R, Baillot PA, Barbier C, Derelle AL, Lacour JC, Ghannouti N, Richard S, Samson Y, Sourour N, Baronnet-Chauvet F, Clarencon F, Crozier S, Deltour S, Di Maria F, Le Bouc R, Leger A, Fleitour N, Mutlu G, Rosso C, Szatmary Z, Yger M, Zavanone C, Bakchine S, Pierot L, Caucheteux N, Estrade L, Kadziolka K, Hooijenga I, Leautaud A, Renkes C, Serre I, Desal H, Guillon B, Boutoleau-Bretonniere C, Daumas-Duport B, De Gaalon S, Derkinderen P, Evain S, Puppels C, Herisson F, Laplaud DA, Lebouvier T, Lintia-Gaultier A, Pouclet-Courtemanche H, Rouaud T, Rouaud Jaffrenou V, Schunck A, Sevin-Allouet M, Toulgoat F, Pellikaan W, Wiertlewski S, Gauvrit JY, Ronziere T, Cahagne V, Ferre JC, Pinel JF, Raoult H, Mas JL, Meder JF, Al Najjar-Carpentier AA, Geerling A, Birchenall J, Bodiguel E, Calvet D, Domigo V, Godon-Hardy S, Guiraud V, Lamy C, Majhadi L, Morin L, Naggara O, Lindl-Velema A, Trystram D, Turc G, Berge J, Sibon I, Menegon P, Barreau X, Rouanet F, Debruxelles S, Kazadi A, Renou P, van Vemde G, Fleury O, Pasco-Papon A, Dubas F, Caroff J, Godard Ducceschi S, Hamon MA, Lecluse A, Marc G, Giroud M, Ricolfi F, de Ridder A, Bejot Y, Chavent A, Gentil A, Kazemi A, Osseby GV, Voguet C, Mahagne MH, Sedat J, Chau Y, Suissa L, Greebe P, Lachaud S, Houdart E, Stapf C, Buffon Porcher F, Chabriat H, Guedin P, Herve D, Jouvent E, Mawet J, Saint-Maurice JP, de Bont-Stikkelbroeck J, Schneble HM, Turjman F, Nighoghossian N, Berhoune NN, Bouhour F, Cho TH, Derex L, Felix S, Gervais-Bernard H, Gory B, de Meris J, Manera L, Mechtouff L, Ritzenthaler T, Riva R, Salaris Silvio F, Tilikete C, Blanc R, Obadia M, Bartolini MB, Gueguen A, Janssen K, Piotin M, Pistocchi S, Redjem H, Drouineau J, Neau JP, Godeneche G, Lamy M, Marsac E, Velasco S, Clavelou P, Struijk W, Chabert E, Bourgois N, Cornut-Chauvinc C, Ferrier A, Gabrillargues J, Jean B, Marques AR, Vitello N, Detante O, Barbieux M, Licher S, Boubagra K, Favre Wiki I, Garambois K, Tahon F, Ashok V, Voguet C, Coskun O, Guedin P, Rodesch G, Lapergue B, Boodt N, Bourdain F, Evrard S, Graveleau P, Decroix JP, Wang A, Sellal F, Ahle G, Carelli G, Dugay MH, Gaultier C, Ros A, Lebedinsky AP, Lita L, Musacchio RM, Renglewicz-Destuynder C, Tournade A, Vuillemet F, Montoro FM, Mounayer C, Faugeras F, Gimenez L, Venema E, Labach C, Lautrette G, Denier C, Saliou G, Chassin O, Dussaule C, Melki E, Ozanne A, Puccinelli F, Sachet M, Slokkers I, Sarov M, Bonneville JF, Moulin T, Biondi A, De Bustos Medeiros E, Vuillier F, Courtheoux P, Viader F, Apoil-Brissard M, Bataille M, Ganpat RJ, Bonnet AL, Cogez J, Kazemi A, Touze E, Leclerc X, Leys D, Aggour M, Aguettaz P, Bodenant M, Cordonnier C, Mulder M, Deplanque D, Girot M, Henon H, Kalsoum E, Lucas C, Pruvo JP, Zuniga P, Bonafé A, Arquizan C, Costalat V, Saiedie N, Machi P, Mourand I, Riquelme C, Bounolleau P, Arteaga C, Faivre A, Bintner M, Tournebize P, Charlin C, Darcel F, Heshmatollah A, Gauthier-Lasalarie P, Jeremenko M, Mouton S, Zerlauth JB, Lamy C, Hervé D, Hassan H, Gaston A, Barral FG, Garnier P, Schipperen S, Beaujeux R, Wolff V, Herbreteau D, Debiais S, Murray A, Ford G, Muir KW, White P, Brown MM, Clifton A, Vinken S, Freeman J, Ford I, Markus H, Wardlaw J, Lees KR, Molyneux A, Robinson T, Lewis S, Norrie J, Robertson F, van Boxtel T, Perry R, Dixit A, Cloud G, Clifton A, Madigan J, Roffe C, Nayak S, Lobotesis K, Smith C, Herwadkar A, Koets J, Kandasamy N, Goddard T, Bamford J, Subramanian G, Lenthall R, Littleton E, Lamin S, Storey K, Ghatala R, Banaras A, Boers M, Aeron-Thomas J, Hazel B, Maguire H, Veraque E, Harrison L, Keshvara R, Cunningham J, Santos E, Borst J, Jansen I, Kappelhof M, Lucas M, Geuskens R, Barros RS, Dobbe R, Csizmadia M, Hill MD, Goyal M, Demchuk AM, Menon BK, Eesa M, Ryckborst KJ, Wright MR, Kamal NR, Andersen L, Randhawa PA, Stewart T, Patil S, Minhas P, Almekhlafi M, Mishra S, Clement F, Sajobi T, Shuaib A, Montanera WJ, Roy D, Silver FL, Jovin TG, Frei DF, Sapkota B, Rempel JL, Thornton J, Williams D, Tampieri D, Poppe AY, Dowlatshahi D, Wong JH, Mitha AP, Subramaniam S, Hull G, Lowerison MW, Sajobi T, Salluzzi M, Wright MR, Maxwell M, Lacusta S, Drupals E, Armitage K, Barber PA, Smith EE, Morrish WF, Coutts SB, Derdeyn C, Demaerschalk B, Yavagal D, Martin R, Brant R, Yu Y, Willinsky RA, Montanera WJ, Weill A, Kenney C, Aram H, Stewart T, Stys PK, Watson TW, Klein G, Pearson D, Couillard P, Trivedi A, Singh D, Klourfeld E, Imoukhuede O, Nikneshan D, Blayney S, Reddy R, Choi P, Horton M, Musuka T, Dubuc V, Field TS, Desai J, Adatia S, Alseraya A, Nambiar V, van Dijk R, Wong JH, Mitha AP, Morrish WF, Eesa M, Newcommon NJ, Shuaib A, Schwindt B, Butcher KS, Jeerakathil T, Buck B, Khan K, Naik SS, Emery DJ, Owen RJ, Kotylak TB, Ashforth RA, Yeo TA, McNally D, Siddiqui M, Saqqur M, Hussain D, Kalashyan H, Manosalva A, Kate M, Gioia L, Hasan S, Mohammad A, Muratoglu M, Williams D, Thornton J, Cullen A, Brennan P, O'Hare A, Looby S, Hyland D, Duff S, McCusker M, Hallinan B, Lee S, McCormack J, Moore A, O'Connor M, Donegan C, Brewer L, Martin A, Murphy S, O'Rourke K, Smyth S, Kelly P, Lynch T, Daly T, O'Brien P, O'Driscoll A, Martin M, Daly T, Collins R, Coughlan T, McCabe D, Murphy S, O'Neill D, Mulroy M, Lynch O, Walsh T, O'Donnell M, Galvin T, Harbison J, McElwaine P, Mulpeter K, McLoughlin C, Reardon M, Harkin E, Dolan E, Watts M, Cunningham N, Fallon C, Gallagher S, Cotter P, Crowe M, Doyle R, Noone I, Lapierre M, Coté VA, Lanthier S, Odier C, Durocher A, Raymond J, Weill A, Daneault N, Deschaintre Y, Jankowitz B, Baxendell L, Massaro L, Jackson-Graves C, Decesare S, Porter P, Armbruster K, Adams A, Billigan J, Oakley J, Ducruet A, Jadhav A, Giurgiutiu DV, Aghaebrahim A, Reddy V, Hammer M, Starr M, Totoraitis V, Wechsler L, Streib S, Rangaraju S, Campbell D, Rocha M, Gulati D, Silver FL, Krings T, Kalman L, Cayley A, Williams J, Stewart T, Wiegner R, Casaubon LK, Jaigobin C, del Campo JM, Elamin E, Schaafsma JD, Willinsky RA, Agid R, Farb R, ter Brugge K, Sapkoda BL, Baxter BW, Barton K, Knox A, Porter A, Sirelkhatim A, Devlin T, Dellinger C, Pitiyanuvath N, Patterson J, Nichols J, Quarfordt S, Calvert J, Hawk H, Fanale C, Frei DF, Bitner A, Novak A, Huddle D, Bellon R, Loy D, Wagner J, Chang I, Lampe E, Spencer B, Pratt R, Bartt R, Shine S, Dooley G, Nguyen T, Whaley M, McCarthy K, Teitelbaum J, Tampieri D, Poon W, Campbell N, Cortes M, Dowlatshahi D, Lum C, Shamloul R, Robert S, Stotts G, Shamy M, Steffenhagen N, Blacquiere D, Hogan M, AlHazzaa M, Basir G, Lesiuk H, Iancu D, Santos M, Choe H, Weisman DC, Jonczak K, Blue-Schaller A, Shah Q, MacKenzie L, Klein B, Kulandaivel K, Kozak O, Gzesh DJ, Harris LJ, Khoury JS, Mandzia J, Pelz D, Crann S, Fleming L, Hesser K, Beauchamp B, Amato-Marzialli B, Boulton M, Lopez- Ojeda P, Sharma M, Lownie S, Chan R, Swartz R, Howard P, Golob D, Gladstone D, Boyle K, Boulos M, Hopyan J, Yang V, Da Costa L, Holmstedt CA, Turk AS, Navarro R, Jauch E, Ozark S, Turner R, Phillips S, Shankar J, Jarrett J, Gubitz G, Maloney W, Vandorpe R, Schmidt M, Heidenreich J, Hunter G, Kelly M, Whelan R, Peeling L, Burns PA, Hunter A, Wiggam I, Kerr E, Watt M, Fulton A, Gordon P, Rennie I, Flynn P, Smyth G, O'Leary S, Gentile N, Linares G, McNelis P, Erkmen K, Katz P, Azizi A, Weaver M, Jungreis C, Faro S, Shah P, Reimer H, Kalugdan V, Saposnik G, Bharatha A, Li Y, Kostyrko P, Santos M, Marotta T, Montanera W, Sarma D, Selchen D, Spears J, Heo JH, Jeong K, Kim DJ, Kim BM, Kim YD, Song D, Lee KJ, Yoo J, Bang OY, Rho S, Lee J, Jeon P, Kim KH, Cha J, Kim SJ, Ryoo S, Lee MJ, Sohn SI, Kim CH, Ryu HG, Hong JH, Chang HW, Lee CY, Rha J, Davis SM, Donnan GA, Campbell BCV, Mitchell PJ, Churilov L, Yan B, Dowling R, Yassi N, Oxley TJ, Wu TY, Silver G, McDonald A, McCoy R, Kleinig TJ, Scroop R, Dewey HM, Simpson M, Brooks M, Coulton B, Krause M, Harrington TJ, Steinfort B, Faulder K, Priglinger M, Day S, Phan T, Chong W, Holt M, Chandra RV, Ma H, Young D, Wong K, Wijeratne T, Tu H, Mackay E, Celestino S, Bladin CF, Loh PS, Gilligan A, Ross Z, Coote S, Frost T, Parsons MW, Miteff F, Levi CR, Ang T, Spratt N, Kaauwai L, Badve M, Rice H, de Villiers L, Barber PA, McGuinness B, Hope A, Moriarty M, Bennett P, Wong A, Coulthard A, Lee A, Jannes J, Field D, Sharma G, Salinas S, Cowley E, Snow B, Kolbe J, Stark R, King J, Macdonnell R, Attia J, D'Este C, Saver JL, Goyal M, Diener HC, Levy EI, Bonafé A, Mendes Pereira V, Jahan R, Albers GW, Cognard C, Cohen DJ, Hacke W, Jansen O, Jovin TG, Mattle HP, Nogueira RG, Siddiqui AH, Yavagal DR, von Kummer R, Smith W, Turjman F, Hamilton S, Chiacchierini R, Amar A, Sanossian N, Loh Y, Devlin T, Baxter B, Hawk H, Sapkota B, Quarfordt S, Sirelkhatim A, Dellinger C, Barton K, Reddy VK, Ducruet A, Jadhav A, Horev A, Giurgiutiu DV, Totoraitis V, Hammer M, Jankowitz B, Wechsler L, Rocha M, Gulati D, Campbell D, Star M, Baxendell L, Oakley J, Siddiqui A, Hopkins LN, Snyder K, Sawyer R, Hall S, Costalat V, Riquelme C, Machi P, Omer E, Arquizan C, Mourand I, Charif M, Ayrignac X, Menjot de Champfleur N, Leboucq N, Gascou G, Moynier M, du Mesnil de Rochemont R, Singer O, Berkefeld J, Foerch C, Lorenz M, Pfeilschifer W, Hattingen E, Wagner M, You SJ, Lescher S, Braun H, Dehkharghani S, Belagaje SR, Anderson A, Lima A, Obideen M, Haussen D, Dharia R, Frankel M, Patel V, Owada K, Saad A, Amerson L, Horn C, Doppelheuer S, Schindler K, Lopes DK, Chen M, Moftakhar R, Anton C, Smreczak M, Carpenter JS, Boo S, Rai A, Roberts T, Tarabishy A, Gutmann L, Brooks C, Brick J, Domico J, Reimann G, Hinrichs K, Becker M, Heiss E, Selle C, Witteler A, Al-Boutros S, Danch MJ, Ranft A, Rohde S, Burg K, Weimar C, Zegarac V, Hartmann C, Schlamann M, Göricke S, Ringlestein A, Wanke I, Mönninghoff C, Dietzold M, Budzik R, Davis T, Eubank G, Hicks WJ, Pema P, Vora N, Mejilla J, Taylor M, Clark W, Rontal A, Fields J, Peterson B, Nesbit G, Lutsep H, Bozorgchami H, Priest R, Ologuntoye O, Barnwell S, Dogan A, Herrick K, Takahasi C, Beadell N, Brown B, Jamieson S, Hussain MS, Russman A, Hui F, Wisco D, Uchino K, Khawaja Z, Katzan I, Toth G, Cheng-Ching E, Bain M, Man S, Farrag A, George P, John S, Shankar L, Drofa A, Dahlgren R, Bauer A, Itreat A, Taqui A, Cerejo R, Richmond A, Ringleb P, Bendszus M, Möhlenbruch M, Reiff T, Amiri H, Purrucker J, Herweh C, Pham M, Menn O, Ludwig I, Acosta I, Villar C, Morgan W, Sombutmai C, Hellinger F, Allen E, Bellew M, Gandhi R, Bonwit E, Aly J, Ecker RD, Seder D, Morris J, Skaletsky M, Belden J, Baker C, Connolly LS, Papanagiotou P, Roth C, Kastrup A, Politi M, Brunner F, Alexandrou M, Merdivan H, Ramsey C, Given II C, Renfrow S, Deshmukh V, Sasadeusz K, Vincent F, Thiesing JT, Putnam J, Bhatt A, Kansara A, Caceves D, Lowenkopf T, Yanase L, Zurasky J, Dancer S, Freeman B, Scheibe-Mirek T, Robison J, Rontal A, Roll J, Clark D, Rodriguez M, Fitzsimmons BFM, Zaidat O, Lynch JR, Lazzaro M, Larson T, Padmore L, Das E, Farrow-Schmidt A, Hassan A, Tekle W, Cate C, Jansen O, Cnyrim C, Wodarg F, Wiese C, Binder A, Riedel C, Rohr A, Lang N, Laufs H, Krieter S, Remonda L, Diepers M, Añon J, Nedeltchev K, Kahles T, Biethahn S, Lindner M, Chang V, Gächter C, Esperon C, Guglielmetti M, Arenillas Lara JF, Martínez Galdámez M, Calleja Sanz AI, Cortijo Garcia E, Garcia Bermejo P, Perez S, Mulero Carrillo P, Crespo Vallejo E, Ruiz Piñero M, Lopez Mesonero L, Reyes Muñoz FJ, Brekenfeld C, Buhk JH, Krützelmann A, Thomalla G, Cheng B, Beck C, Hoppe J, Goebell E, Holst B, Grzyska U, Wortmann G, Starkman S, Duckwiler G, Jahan R, Rao N, Sheth S, Ng K, Noorian A, Szeder V, Nour M, McManus M, Huang J, Tarpley J, Tateshima S, Gonzalez N, Ali L, Liebeskind D, Hinman J, Calderon-Arnulphi M, Liang C, Guzy J, Koch S, DeSousa K, Gordon-Perue G, Haussen D, Elhammady M, Peterson E, Pandey V, Dharmadhikari S, Khandelwal P, Malik A, Pafford R, Gonzalez P, Ramdas K, Andersen G, Damgaard D, Von Weitzel-Mudersbach P, Simonsen C, Ruiz de Morales Ayudarte N, Poulsen M, Sørensen L, Karabegovich S, Hjørringgaard M, Hjort N, Harbo T, Sørensen K, Deshaies E, Padalino D, Swarnkar A, Latorre JG, Elnour E, El-Zammar Z, Villwock M, Farid H, Balgude A, Cross L, Hansen K, Holtmannspötter M, Kondziella D, Hoejgaard J, Taudorf S, Soendergaard H, Wagner A, Cronquist M, Stavngaard T, Cortsen M, Krarup LH, Hyldal T, Haring HP, Guggenberger S, Hamberger M, Trenkler J, Sonnberger M, Nussbaumer K, Dominger C, Bach E, Jagadeesan BD, Taylor R, Kim J, Shea K, Tummala R, Zacharatos H, Sandhu D, Ezzeddine M, Grande A, Hildebrandt D, Miller K, Scherber J, Hendrickson A, Jumaa M, Zaidi S, Hendrickson T, Snyder V, Killer-Oberpfalzer M, Mutzenbach J, Weymayr F, Broussalis E, Stadler K, Jedlitschka A, Malek A, Mueller-Kronast N, Beck P, Martin C, Summers D, Day J, Bettinger I, Holloway W, Olds K, Arkin S, Akhtar N, Boutwell C, Crandall S, Schwartzman M, Weinstein C, Brion B, Prothmann S, Kleine J, Kreiser K, Boeckh-Behrens T, Poppert H, Wunderlich S, Koch ML, Biberacher V, Huberle A, Gora-Stahlberg G, Knier B, Meindl T, Utpadel-Fischler D, Zech M, Kowarik M, Seifert C, Schwaiger B, Puri A, Hou S. Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data. Lancet Neurol 2018; 17:47-53. [DOI: 10.1016/s1474-4422(17)30407-6] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/05/2017] [Accepted: 10/11/2017] [Indexed: 10/18/2022]
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Johnson C, Rosen P, Lloyd T, Horton M, Christopher-Stine L, Oddis CV, Mammen AL, Danoff SK. Exploration of the MUC5B promoter variant and ILD risk in patients with autoimmune myositis. Respir Med 2017; 130:52-54. [PMID: 29206633 DOI: 10.1016/j.rmed.2017.07.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 06/26/2017] [Accepted: 07/15/2017] [Indexed: 02/02/2023]
Abstract
Interstitial lung disease (ILD) is common in patients with autoimmune myositis but factors that determine susceptibility are unknown. Familial and sporadic idiopathic pulmonary fibrosis (IPF) are strongly associated with a single nucleotide polymorphism in the promoter region of MUC5B (rs35705950). We sought to determine the relationship between MUC5B polymorphism expression and myositis-ILD. The MUC5B minor allele frequency (MAF) was examined in 402 European American participants; 60 with idiopathic interstitial pneumonia (IIP), 208 with myositis-ILD, and 134 unaffected controls. The MUC5B minor allele frequency was 26%, 8%, and 7% in those with non-myositis ILD, myositis-ILD, and unaffected controls, respectively. The MUC5B variant was associated with IIP (OR 4.10; p < 0.001). The MUC5B polymorphism was not significantly associated with myositis-ILD (OR 1.08; p = 0.80)]. We found MUC5B MAFs in our IIP cohort similar to published frequencies for subjects with familial and sporadic IPF. Overall, the MUC5B promoter variant does not appear to contribute to ILD risk in myositis patients.
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Affiliation(s)
- Cheilonda Johnson
- Johns Hopkins University School of Medicine, Division of Pulmonary & Critical Care Medicine, Baltimore, MD, USA
| | - Paul Rosen
- Princeton University, Department of Chemistry, Princeton, NJ, USA
| | - Thomas Lloyd
- Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD, USA
| | - Maureen Horton
- Johns Hopkins University School of Medicine, Division of Pulmonary & Critical Care Medicine, Baltimore, MD, USA
| | - Lisa Christopher-Stine
- Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, MD, USA
| | - Chester V Oddis
- University of Pittsburgh School of Medicine, Division of Rheumatology and Clinical Immunology, Pittsburgh, PA, USA
| | - Andrew L Mammen
- Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD, USA; National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Expression, Bethesda, MD, USA
| | - Sonye K Danoff
- Johns Hopkins University School of Medicine, Division of Pulmonary & Critical Care Medicine, Baltimore, MD, USA.
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Preston N, Horton M, Levesley M, Mon-Williams M, O'Connor RJ. Development of a parent-reported questionnaire evaluating upper limb activity limitation in children with cerebral palsy. Physiother Res Int 2017; 23. [PMID: 28112465 PMCID: PMC5811897 DOI: 10.1002/pri.1684] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 02/05/2016] [Revised: 07/15/2016] [Accepted: 07/31/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Upper limb activity measures for children with cerebral palsy have a number of limitations, for example, lack of validity and poor responsiveness. To overcome these limitations, we developed the Children's Arm Rehabilitation Measure (ChARM), a parent-reported questionnaire validated for children with cerebral palsy aged 5-16 years. This paper describes both the development of the ChARM items and response categories and its psychometric testing and further refinement using the Rasch measurement model. METHODS To generate valid items for the ChARM, we collected goals of therapy specifically developed by therapists, children with cerebral palsy, and their parents for improving activity limitation of the upper limb. The activities, which were the focus of these goals, formed the basis for the items. Therapists typically break an activity into natural stages for the purpose of improving activity performance, and these natural orders of achievement formed each item's response options. Items underwent face validity testing with health care professionals, parents of children with cerebral palsy, academics, and lay persons. A Rasch analysis was performed on ChARM questionnaires completed by the parents of 170 children with cerebral palsy from 12 hospital paediatric services. The ChARM was amended, and the procedure repeated on 148 ChARMs (from children's mean age: 10 years and 1 month; range: 4 years and 8 months to 16 years and 11 months; 85 males; Manual Ability Classification System Levels I = 9, II = 26, III = 48, IV = 45, and V = 18). RESULTS The final 19-item unidimensional questionnaire displayed fit to the Rasch model (chi-square p = .18), excellent reliability (person separation index = 0.95, α = 0.95), and no floor or ceiling effects. Items showed no response bias for gender, distribution of impairment, age, or learning disability. DISCUSSION The ChARM is a psychometrically sound measure of upper limb activity validated for children with cerebral palsy aged 5-16 years. The ChARM is freely available for use to clinicians and nonprofit organisations.
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Affiliation(s)
- N Preston
- Academic Department of Rehabilitation Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - M Horton
- Academic Department of Rehabilitation Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - M Levesley
- School of Mechanical Engineering, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - M Mon-Williams
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - R J O'Connor
- National Demonstration Centre in Rehabilitation, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom of Great Britain and Northern Ireland.,Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
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Rutherford C, Nixon J, Brown J, Briggs M, Horton M. The Leeds Assessment of Neuropathic Symptoms and Signs Scale (LANSS) is not an adequate outcome measure of pressure ulcer-related neuropathic pain. Eur J Pain 2016; 20:1710-1720. [DOI: 10.1002/ejp.894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2016] [Indexed: 11/10/2022]
Affiliation(s)
- C. Rutherford
- School of Psychology; University of Sydney; Australia
- Leeds Institute of Clinical Trials Research; University of Leeds; Leeds; UK
| | - J.E. Nixon
- Leeds Institute of Clinical Trials Research; University of Leeds; Leeds; UK
| | - J.M. Brown
- Leeds Institute of Clinical Trials Research; University of Leeds; Leeds; UK
| | - M. Briggs
- Institute of Health and Well Being; Leeds Metropolitan University; Leeds; UK
| | - M. Horton
- Psychometric Laboratory for Health Sciences; University of Leeds; Leeds; UK
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Limjunyawong N, Fallica J, Ramakrishnan A, Datta K, Gabrielson M, Horton M, Mitzner W. Phenotyping mouse pulmonary function in vivo with the lung diffusing capacity. J Vis Exp 2015:e52216. [PMID: 25590416 DOI: 10.3791/52216] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The mouse is now the primary animal used to model a variety of lung diseases. To study the mechanisms that underlie such pathologies, phenotypic methods are needed that can quantify the pathologic changes. Furthermore, to provide translational relevance to the mouse models, such measurements should be tests that can easily be done in both humans and mice. Unfortunately, in the present literature few phenotypic measurements of lung function have direct application to humans. One exception is the diffusing capacity for carbon monoxide, which is a measurement that is routinely done in humans. In the present report, we describe a means to quickly and simply measure this diffusing capacity in mice. The procedure involves brief lung inflation with tracer gases in an anesthetized mouse, followed by a 1 min gas analysis time. We have tested the ability of this method to detect several lung pathologies, including emphysema, fibrosis, acute lung injury, and influenza and fungal lung infections, as well as monitoring lung maturation in young pups. Results show significant decreases in all the lung pathologies, as well as an increase in the diffusing capacity with lung maturation. This measurement of lung diffusing capacity thus provides a pulmonary function test that has broad application with its ability to detect phenotypic structural changes with most of the existing pathologic lung models.
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Affiliation(s)
- Nathachit Limjunyawong
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health
| | - Jonathan Fallica
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health
| | - Amritha Ramakrishnan
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health
| | - Kausik Datta
- Department of Medicine, Johns Hopkins University School of Medicine
| | - Matthew Gabrielson
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health
| | - Maureen Horton
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health
| | - Wayne Mitzner
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health;
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Czarnecka M, Trinh E, Lu C, Kuan-Celarier A, Galli S, Hong SH, Tilan JU, Talisman N, Izycka-Swieszewska E, Tsuei J, Yang C, Martin S, Horton M, Christian D, Everhart L, Maheswaran I, Kitlinska J. Neuropeptide Y receptor Y5 as an inducible pro-survival factor in neuroblastoma: implications for tumor chemoresistance. Oncogene 2014; 34:3131-43. [PMID: 25132261 PMCID: PMC4333135 DOI: 10.1038/onc.2014.253] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 05/19/2014] [Accepted: 06/20/2014] [Indexed: 12/14/2022]
Abstract
Neuroblastoma (NB) is a pediatric tumor of neural crest origin with heterogeneous phenotypes. While low stage tumors carry a favorable prognosis, over 50% of high risk NB relapses after treatment with a fatal outcome. Thus, developing therapies targeting refractory NB remains an unsolved clinical problem. Brain-derived neurotrophic factor (BDNF) and its TrkB receptor are known to protect NB cells from chemotherapy-induced cell death, while neuropeptide Y (NPY), acting via its Y2 receptor (Y2R), is an autocrine proliferative and angiogenic factor crucial for maintaining NB tumor growth. Here, we show that in NB cells, BDNF stimulates the synthesis of NPY and induces expression of another one of its receptors, Y5R. In human NB tissues, the expression of NPY and Y5R positively correlated with the expression of BDNF and TrkB. Functionally, BDNF triggered Y5R internalization in NB cells, while Y5R antagonist inhibited BDNF-induced p44/42-MAPK activation and its pro-survival activity. These observations suggested TrkB-Y5R transactivation that resulted in cross-talk between their signaling pathways. Additionally, NPY and Y5R were up-regulated in a BDNF-independent manner in NB cells under pro-apoptotic conditions, such as serum deprivation and chemotherapy, as well as in cell lines and tissues derived from post-treatment NB tumors. Blocking Y5R in chemoresistant NB cells rich in this receptor sensitized them to chemotherapy-induced apoptosis and inhibited their growth in vivo by augmenting cell death. In summary, the NPY/Y5R axis is an inducible survival pathway activated in NB by BDNF or cellular stress. Upon such activation, Y5R augments the pro-survival effect of BDNF via its interactions with TrkB receptor and exerts an additional BDNF-independent anti-apoptotic effect, both of which contribute to NB chemoresistance. Therefore, the NPY/Y5R pathway may become a novel therapeutic target for patients with refractory NB, thus far an incurable form of this disease.
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Affiliation(s)
- M Czarnecka
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Georgetown University, Washington, DC, USA
| | - E Trinh
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Georgetown University, Washington, DC, USA
| | - C Lu
- McGovern Institute, Massachusetts Institute of Technology, Boston, MA, USA
| | - A Kuan-Celarier
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Georgetown University, Washington, DC, USA
| | - S Galli
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Georgetown University, Washington, DC, USA
| | - S-H Hong
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Georgetown University, Washington, DC, USA
| | - J U Tilan
- 1] Department of Nursing, School of Nursing and Health Studies, Georgetown University, Washington, DC, USA [2] Department of Human Science, School of Nursing and Health Studies, Georgetown University, Washington, DC, USA
| | - N Talisman
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Georgetown University, Washington, DC, USA
| | - E Izycka-Swieszewska
- Department of Pathology and Neuropathology, Medical University of Gdańsk, Gdańsk, Poland
| | - J Tsuei
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Georgetown University, Washington, DC, USA
| | - C Yang
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Georgetown University, Washington, DC, USA
| | - S Martin
- Department of Human Science, School of Nursing and Health Studies, Georgetown University, Washington, DC, USA
| | - M Horton
- Department of Human Science, School of Nursing and Health Studies, Georgetown University, Washington, DC, USA
| | - D Christian
- Department of Human Science, School of Nursing and Health Studies, Georgetown University, Washington, DC, USA
| | - L Everhart
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Georgetown University, Washington, DC, USA
| | - I Maheswaran
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Georgetown University, Washington, DC, USA
| | - J Kitlinska
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Georgetown University, Washington, DC, USA
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Hammond A, Prior Y, Horton M, Tennant A, Tyson S. OP0083-HPR Development of the Evaluation of Daily Activities Questionnaire in Musculoskeletal Conditions: Psychometric Testing. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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19
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Sokolowska M, Chen LY, Eberlein M, Martinez-Anton A, Liu Y, Alsaaty S, Qi HY, Logun C, Horton M, Shelhamer JH. Low molecular weight hyaluronan activates cytosolic phospholipase A2α and eicosanoid production in monocytes and macrophages. J Biol Chem 2013; 289:4470-88. [PMID: 24366870 DOI: 10.1074/jbc.m113.515106] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Hyaluronan (HA) is the major glycosaminoglycan in the extracellular matrix. During inflammation, there is an increased breakdown of HA, resulting in the accumulation of low molecular weight (LMW) HA and activation of monocytes and macrophages. Eicosanoids, derived from the cytosolic phospholipase A2 group IVA (cPLA2α) activation, are potent lipid mediators also attributed to acute and chronic inflammation. The aim of this study was to determine the effect of LMW HA on cPLA2α activation, arachidonic acid (AA) release, and subsequent eicosanoid production and to examine the receptors and downstream mechanisms involved in these processes in monocytes and differently polarized macrophages. LMW HA was a potent stimulant of AA release in a time- and dose-dependent manner, induced cPLA2α, ERK1/2, p38, and JNK phosphorylation, as well as activated COX2 expression and prostaglandin (PG) E2 production in primary human monocytes, murine RAW 264.7, and wild-type bone marrow-derived macrophages. Specific cPLA2α inhibitor blocked HA-induced AA release and PGE2 production in all of these cells. Using CD44, TLR4, TLR2, MYD88, RHAMM or STAB2 siRNA-transfected macrophages and monocytes, we found that AA release, cPLA2α, ERK1/2, p38, and JNK phosphorylation, COX2 expression, and PGE2 production were activated by LMW HA through a TLR4/MYD88 pathway. Likewise, PGE2 production and COX2 expression were blocked in Tlr4(-/-) and Myd88(-/-) mice, but not in Cd44(-/-) mice, after LMW HA stimulation. Moreover, we demonstrated that LMW HA activated the M1 macrophage phenotype with the unique cPLA2α/COX2(high) and COX1/ALOX15/ALOX5/LTA4H(low) gene and PGE2/PGD2/15-HETE(high) and LXA4(low) eicosanoid profile. These findings reveal a novel link between HA-mediated inflammation and lipid metabolism.
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Affiliation(s)
- Milena Sokolowska
- From the Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland 20892 and
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Ndosi M, Bremander A, Hamnes B, Horton M, Kukkurainen ML, Machado P, Marques A, Meesters J, Stamm T, Tennant A, Torre-Aboki JDL, Vliet Vlieland T, Zangi H, Hill J. OP0283 Validation of the Educational Needs Assessment Tool as a Generic Instrument for Rheumatic Diseases in 7 European Countries. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Aggarwal NR, D'Alessio FR, Eto Y, Chau E, Avalos C, Waickman AT, Garibaldi BT, Mock JR, Files DC, Sidhaye V, Polotsky VY, Powell J, Horton M, King LS. Macrophage A2A adenosinergic receptor modulates oxygen-induced augmentation of murine lung injury. Am J Respir Cell Mol Biol 2013; 48:635-46. [PMID: 23349051 PMCID: PMC3707379 DOI: 10.1165/rcmb.2012-0351oc] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [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: 09/06/2012] [Accepted: 12/26/2012] [Indexed: 01/16/2023] Open
Abstract
Acute respiratory distress syndrome (ARDS) causes significant morbidity and mortality. Exacerbating factors increasing the risk of ARDS remain unknown. Supplemental oxygen is often necessary in both mild and severe lung disease. The potential effects of supplemental oxygen may include augmentation of lung inflammation by inhibiting anti-inflammatory pathways in alveolar macrophages. We sought to determine oxygen-derived effects on the anti-inflammatory A2A adenosinergic (ADORA2A) receptor in macrophages, and the role of the ADORA2A receptor in lung injury. Wild-type (WT) and ADORA2A(-/-) mice received intratracheal lipopolysaccharide (IT LPS), followed 12 hours later by continuous exposure to 21% oxygen (control mice) or 60% oxygen for 1 to 3 days. We measured the phenotypic endpoints of lung injury and the alveolar macrophage inflammatory state. We tested an ADORA2A-specific agonist, CGS-21680 hydrochloride, in LPS plus oxygen-exposed WT and ADORA2A(-/-) mice. We determined the specific effects of myeloid ADORA2A, using chimera experiments. Compared with WT mice, ADORA2A(-/-) mice exposed to IT LPS and 60% oxygen demonstrated significantly more histologic lung injury, alveolar neutrophils, and protein. Macrophages from ADORA2A(-/-) mice exposed to LPS plus oxygen expressed higher concentrations of proinflammatory cytokines and cosignaling molecules. CGS-21680 prevented the oxygen-induced augmentation of lung injury after LPS only in WT mice. Chimera experiments demonstrated that the transfer of WT but not ADORA2A(-/-) bone marrow cells into irradiated ADORA2A(-/-) mice reduced lung injury after LPS plus oxygen, demonstrating myeloid ADORA2A protection. ADORA2A is protective against lung injury after LPS and oxygen. Oxygen after LPS increases macrophage activation to augment lung injury by inhibiting the ADORA2A pathway.
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Affiliation(s)
- Neil R Aggarwal
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins Asthma and Allergy Center, School of Medicine, Johns Hopkins University, Baltimore, MD 21224, USA.
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22
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Heikamp E, Patel C, Collins S, Waickman A, Scharma A, Naray-Fejes-Toth A, Fejes-Toth G, Sen J, Horton M, Powell J. mTOR regulates CD4 and CD8 effector T cell differentiation via serum- and glucocorticoid-regulated kinase 1 (P1161). The Journal of Immunology 2013. [DOI: 10.4049/jimmunol.190.supp.50.23] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
The mammalian target of rapamycin (mTOR) signaling pathway is a master regulator of T cell differentiation. mTOR integrates various signals in the immune microenvironment, including costimulatory ligands, cytokines, and the availability of nutrients to determine the outcome of T cell differentiation. Recently, we identified the serum- and glucocorticoid-regulated kinase 1 (SGK1) as a downstream target of mTORC2 that is a critical regulator of CD4 effector differentiation into Th1 and Th2 subsets. Specifically, SGK1 promotes Th2 differentiation by negatively regulating the NEDD4-2 E3 ligase mediated destruction of JunB. Simultaneously, SGK1 represses the production of IFN-γ by controlling the expression of the long isoform of TCF-1. Consistent with these functions, mice lacking SGK1 specifically in T cells fail to generate a Th2 response and are resistant to experimentally induced asthma. Likewise, such mice generate robust levels of IFN-γ in response to vaccines and more readily reject tumors. In addition, loss of SGK1 in CD8 T cells promotes memory differentiation by regulating the expression of CD127, CD62L, and eomesodermin. In summary, our findings reveal a novel role for SGK1 as an essential component of the mTOR pathway that guides differentiation of both CD4 and CD8 T cells. Targeting SGK1, therefore, may be a useful strategy for fine-tuning immune responses by manipulating T cell differentiation.
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Affiliation(s)
| | - Chirag Patel
- 1Johns Hopkins School of Medicine, Baltimore, MD
| | - Sam Collins
- 1Johns Hopkins School of Medicine, Baltimore, MD
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23
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Johnson C, Rosen P, Lloyd T, McGready J, Horton M, Hall J, Mammen A, Danoff S. MUC5B Promoter Variant Is Not Associated With Myositis-Related Interstitial Lung Disease. Chest 2012. [DOI: 10.1378/chest.1383687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Karasu Y, Dilbaz B, Demir B, Dilbaz S, Secilmis Kerimoglu O, Ercan CM, Keskin U, Korkmaz C, Duru NK, Ergun A, de Zuniga I, Horton M, Oubina A, Scotti L, Abramovich D, Pascuali N, Tesone M, Parborell F, Bouzas N, Yang XH, Chen SL, Chen X, Ye DS, Zheng HY, Nyboe Andersen A, Lauritsen MP, Thuesen LL, Khodadadi M, Shivabasavaiah S, Mozafari R, Ansari Z, Hamdine O, Broekmans F, Eijkemans MJC, Cohlen BJ, Verhoeff A, van Dop PA, Bernardus RE, Lambalk CB, Oosterhuis GJE, Holleboom C, van den Dool-Maasland GC, Verburg HJ, van der Heijden PFM, Blankhart A, Fauser BCJM, Laven JSE, Macklon NS, Agudo D, Lopez C, Alonso M, Huguet E, Bronet F, Garcia-Velasco JA, Requena A, Gonzalez Comadran M, Checa MA, Duran M, Fabregues F, Carreras R, Ersahin A, Kahraman S, Kavrut M, Gorgen B, Acet M, Dokuzeylul N, Aybar F, Lim SY, Park JC, Bae JG, Kim JI, Rhee JH, Mahran A, Abdelmeged A, El-Adawy A, Eissa M, Darne J, Shaw RW, Amer SA, Dai A, Yan G, He Q, Hu Y, Sun H, Ferrero H, Gomez R, Garcia-Pascual CM, Simon C, Gaytan F, Pellicer A, Garcia Pascual CM, Zimmermann RC, Ferrero H, Simon C, Pellicer A, Gomez R, Madani T, Mohammadi Yeganeh L, Khodabakhshi SH, Akhoond MR, Hasani F, Monzo C, Haouzi D, Assou S, Dechaud H, Hamamah S, Amer S, Mahran M, Eissa M, Darne J, Shaw R, Lan V, Nhu G, Tuong H, Mahmoud Youssef MA, Aboulfoutouh I, Al-inany H, Van Der Veen F, Van Wely M, Zhang Q, Fang T, Wu S, Zhang L, Wang B, Li X, Yan G, Sun H, Hu Y, He Q, Ding L, Day A, Wang B, Yan G, Hu Y, Sun H, Zhang L, Fang T, Zhang Q, Wu S, Yan G, Sun H, Hu Y, Fulford B, Boivin J, Alanbay I, Ercan CM, Sakinci M, Coksuer H, Ozturk M, Tapan S, Chung CK, Chung Y, Seo S, Aksoy S, Yakin K, Caliskan S, Salar Z, Ata B, Urman B, Devroey P, Pellicer A, Nyboe Andersen A, Arce JC, Harrison K, Irving J, Osborn J, Harrison M, Fusi F, Arnoldi M, Cappato M, Galbignani E, Galimberti A, Zanga L, Frigerio L, Taghavi SA, Ashrafi M, Karimian L, Mehdizadeh M, Joghataie M, Aflatoonian R, Xu B, Cui YG, Gao LL, Diao FY, Li M, Liu XQ, Liu JY, Jiang F, Li M, Cui YG, Diao FY, Liu JY, Jee BC, Yi G, Kim JY, Suh CS, Kim SH, Liu S, Cui YG, Liu JY, Cai LB, Liu JJ, Ma X, Geenen E, Bots RSGM, Smeenk JMJ, Chang E, Lee W, Seok H, Kim Y, Han J, Yoon T, Lazaros L, Xita N, Zikopoulos K, Makrydimas G, Kaponis A, Sofikitis N, Stefos T, Hatzi E, Georgiou I, Atilgan R, Kumbak B, Sahin L, Ozkan ZS, Simsek M, Sapmaz E, Karacan M, Alwaeely FA, Cebi Z, Berberoglugil M, Ulug M, Camlibel T, Kavrut M, Kahraman S, Ersahin A, Acet M, Yelke H, Kamalak Z, Carlioglu A, Akdeniz D, Uysal S, Inegol Gumus I, Ozturk Turhan N, Regan S, Yovich J, Stanger J, Almahbobi G, Kara M, Aydin T, Turktekin N, Youssef M, Aboulfoutouh I, Al-Inany H, van der Veen F, van Wely M, Hart R, Doherty D, Frederiksen H, Keelan J, Pennell C, Newnham J, Skakkebaek N, Main K, Salem HT, Ismail AA, Viola M, Siebert TI, Steyn DW, Kruger TF, Robin G, Dewailly D, Thomas P, Leroy M, Lefebvre C, soudan B, Pigny P, Decanter C, ElPrince M, Wang F, Zhu Y, Huang H, Valdez Morales F, Vital Reyes V, Mendoza Rodriguez A, Gamboa Dominguez A, Cerbon M, Aizpurua J, Ramos B, Luehr B, Moragues I, Rogel S, Cil AP, Guler ZB, Kisa U, Albu A, Radian S, Grigorescu F, Albu D, Fica S, Al Boghdady L, Ghanem ME, Hassan M, Helal AS, Ozdogan S, Ozdegirmenci O, Dilbaz S, Demir B, Cinar O, Dilbaz B, Goktolga U, Seeber B, Tsybulyak I, Bottcher B, Grubinger T, Czech T, Wildt L, Wojcik J, Howles CM, Destenaves B, Arriagada P, Tavmergen E, Sahin G, Akdogan A, Levi R, Goker ENT, Thuesen LL, Loft A, Smitz J, Nyboe Andersen A, Ricciardi L, Di Florio C, Busacca M, Gagliano D, Immediata V, Selvaggi L, Romualdi D, Guido M, Bouhanna P, Salama S, Kamoud Z, Torre A, Paillusson B, Fuchs F, Bailly M, Wainer R, Tagliaferri V, Busacca M, Gagliano D, Di Florio C, Tartaglia C, Cirella E, Romualdi D, Guido M, Aflatoonian A, Eftekhar M, Mohammadian F, Yousefnejad F, De Cicco S, Gagliano D, Busacca M, Di Florio C, Immediata V, Campagna G, Romualdi D, Guido M, Depalo R, Lippolis C, Vacca M, Nardelli C, Selvaggi L, Cavallini A, Panic T, Mitulovic G, Franz M, Sator K, Tschugguel W, Pietrowski D, Hildebrandt T, Cupisti S, Giltay EJ, Gooren LJ, Oppelt PG, Hackl J, Reissmann C, Schulze C, Heusinger K, Attig M, Hoffmann I, Beckmann MW, Dittrich R, Mueller A, Sharma S, Singh S, Chakravarty A, Sarkar A, Rajani S, Chakravarty BN, Dilbaz S, Ozturk E, Ozdegirmenci O, Demir B, Isikoglu S, Kul S, Dilbaz B, Cinar O, Goktolga U, Eftekhar M, Aflatoonian A, Mohammadian F, Broekmans F, Hillensjo T, Witjes H, Elbers J, Mannaerts B, Gordon K, Krasnopolskaya K, Galaktionova A, Gorskaya O, Kabanova D, Venturella R, Morelli M, Mocciaro R, Capasso S, Cappiello F, Zullo F, Monterde M, Gomez R, Marzal A, Vega O, Rubio-Rubio JM, Diaz-Garcia C, Pellicer A, Gordon K, Kolibianakis E, Griesinger G, Yding Andersen C, Witjes H, Mannaerts B, Ocal P, Guralp O, Aydogan B, Irez T, Cetin M, Senol H, Erol N, Yding Andersen C, Kolibianakis E, Devroey P, Witjes H, Mannaerts B, Gordon K, Griesinger G, Rombauts L, Van Kuijk J, Mannaerts B, Montagut J, Nogueira D, Porcu G, Chomier M, Giorgetti C, Nicollet B, Degoy J, Lehert P, Alviggi C, De Rosa P, Vallone R, Picarelli S, Coppola M, Conforti A, Strina I, Di Carlo C, De Placido G, Hackl J, Cupisti S, Haeberle L, Schulze C, Hildebrandt T, Oppelt PG, Reissmann C, Heusinger K, Attig M, Hoffmann I, Dittrich R, Beckmann MW, Mueller A, Akdogan A, Demirtas O, Sahin G, Tavmergen E, Goker ENT, Fatemi H, Shapiro BS, Griesinger G, Witjes H, Gordon K, Mannaerts BM, Chimote MN, Mehta BN, Chimote NN, Nath NM, Chimote NM, Karia S, Bonifacio M, Bowman M, McArthur S, Jung J, Cho S, Choi Y, Lee B, Seo S, Lee KH, Kim CH, Kwon SK, Kim SH, Kang BM, Jung KS, Basios G, Trakakis E, Hatziagelaki E, Vaggopoulos V, Tsiavou A, Panagopoulos P, Chrelias C, Kassanos D, Sarhan A, Elsamanoudy A, Harira M, Dogan S, Bozdag G, Esinler I, Polat M, Yarali H. REPRODUCTIVE ENDOCRINOLOGY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Waickman AT, Alme A, Senaldi L, Zarek PE, Horton M, Powell JD. Enhancement of tumor immunotherapy by deletion of the A2A adenosine receptor. Cancer Immunol Immunother 2011; 61:917-26. [PMID: 22116345 DOI: 10.1007/s00262-011-1155-7] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 11/03/2011] [Indexed: 01/12/2023]
Abstract
The A(2A) adenosine receptor plays a critical and non-redundant role in suppressing inflammation at sites of hypoxia and tissue damage. The tumor microenvironment has high levels of adenosine as a result of hypoxia and ectopic expression of enzymes responsible for the generation of extracellular adenosine. Thus, we sought to determine the ability of A(2A) receptor null mice to immunologically reject tumors. We observed that mice lacking the A(2A) adenosine receptor showed significantly delayed growth of lymphoma cells when compared to WT mice. Furthermore, when immunized with a low dose of tumor or with an irradiated GM-CSF-secreting tumor vaccine, A(2A) receptor null mice showed significantly enhanced protection from a subsequent high-dose challenge from both immunogenic and poorly immunogenic tumor lines. This increase in protection was accompanied by an increase in the number of tumor-antigen-specific CD8 T cells at the vaccine-site draining lymph node. Finally, we found that A(2A) receptor null mice displayed more robust anti-tumor responses than WT mice when they were treated with a soluble B7-DC/Fc fusion protein designed to antagonize B7-H1-mediated co-inhibition. This combinatorial immunotherapy strategy could also be recapitulated with pharmacological A(2A) receptor blockade paired with B7-DC/Fc administration. In light of these data, we believe that blockade of the A(2A) adenosine receptor is an attractive target for tumor immunotherapy that synergizes with other immunomodulatory approaches currently in clinical trials.
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Affiliation(s)
- Adam T Waickman
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Abstract
In the past decade the mouse has become the primary animal model of a variety of lung diseases. To assess various mechanisms underlying such pathologies, it is essential to make functional measurements that can reflect the developing pathology. In this regard, the diffusing capacity for carbon monoxide is a variable that directly reflects structural changes in the lung. Although measurement of single-breath diffusing capacity of the lung for carbon monoxide (DL(CO)) has also been previously reported in mice by a number of investigators, a number of technical issues have precluded routine and widespread use of this metric in mouse models. In the present report, we describe a means to quickly and simply measure a dimensionless variable closely related to the DL(CO) in mice, termed a diffusion factor for carbon monoxide (DF(CO)). The DF(CO) procedure involves a 9-s lung inflation with tracer gases in an anesthetized mouse, followed by a 1-min gas analysis time. We have tested the approach with two common models of lung pathology, elastase-induced emphysema and bleomycin-induced fibrosis. Results show a significant 15% reduction in DF(CO) in emphysema, and a 41% reduction in the fibrosis model. Repeat measurements within a mouse were found to be highly reproducible. This pulmonary function test can thus be used to detect structural changes with these pathological models. The method can also be used to measure changes in pulmonary blood volume, since the uptake of CO is highly dependent on this variable in addition to the gas exchange surface area.
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Affiliation(s)
- Jon Fallica
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Horton M, Gomez Peña M, Colaci D, de Zuñiga I, Sobral F, Bisioli C. A prospective randomized study comparing performance of day 3 embryos under a physiological low oxygen environment vs. a conventional culture system. Fertil Steril 2010. [DOI: 10.1016/j.fertnstert.2010.07.984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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de Zuñiga I, Colaci D, Horton M, Sobral F, Bisioli C, Motta A. Assessment of oxidative and inflammatory intrafollicular status in tobacco smoking women. Fertil Steril 2010. [DOI: 10.1016/j.fertnstert.2010.07.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Jiang Y, Zhao J, Hua M, Zhen X, Yan G, Hu Y, Sun H, Selvaggi L, Zannoni GF, Tagliaferri V, De Cicco S, Vellone VG, Romualdi D, Lanzone A, Guido M, Fassbender A, Vodolazkaia AV, Bossuyt XB, Kyama MK, Meuleman CM, Peeraer KP, Tomassetti CT, D'Hooghe TM, Lumini A, Nanni L, Manna C, Pappalardo S, Melin A, Lundholm C, Malki N, Swahn ML, Sparen P, Bergqvist A, Manna C, Crescenzi F, Farrag A, Sallam HN, Zou L, Ding G, Zhang R, Sheng J, Huang H, von Kleinsorgen C, Wilson T, Thiel-Moder U, Ebert AD, Reinfandt M, Papadopolous T, Melo AS, Rodrigues JK, Dib LA, Andrade AZ, Donabela FC, Ferriani RA, Navarro PA, Tocci A, Royo P, Lucchini C, Ramos P, Alcazar JL, Habara T, Terada S, Yoshioka N, Hayashi N, Haouzi D, Assou S, Monzo C, Anahory T, Dechaud H, De Vos J, Hamamah S, Gonzalez-Ramos R, Rojas C, Rocco J, Poch A, Sovino H, Kohen P, Munoz A, Devoto L, Aygen MA, Atakul T, Oner G, Ozgun MT, Sahin Y, Ozturk F, Li R, Qiao J, Zhylkova I, Feskov A, Feskova I, Somova O, Chumakova N, Bontekoe S, Blake D, Heineman MJ, Williams EC, Johnson NP, Motta A, Colaci D, Horton M, Faut M, Bisioli C, Kopcow L, de Zuniga I, Wiener-Megnazi Z, Khaytov M, Lahav - Baratz S, Shiloh H, Koifman M, Oslander R, Dirnfeld M, Sundqvist J, Andersson KL, Scarselli G, Gemzell-Danielsson K, Lalitkumar PGL, Tokushige N, Markham R, Crossett B, Ahn S, Nelaturi V, Khan A, Fraser IS, Van Vaerenbergh I, Fatemi HM, Blockeel C, Van Lommel L, In't Veld P, Schuit F, Kolibianakis EM, Devroey P, Bourgain C, Sugino N, Tamura I, Lee R, Maekawa R, Gelbaya T, Gordts S, D'Hooghe TN, Gergolet M, Nardo LG, Yu H, Wang H, Huang H, Lee C, Soong Y, Kremenska Y, Masliy Y, Goncharova Y, Kremenskoy M, Veselovskyy V, Zukin V, Sudoma I, Delgado-Rosas F, Gomez R, Tamarit S, Abad A, Simon C, Pellicer A, Racicot M, Dean NL, Antaki R, Menard S, Kadoch IJ, Garcia-Guzman R, Cabrera Romero L, Hernandez J, Palumbo A, Marshall E, Lowry J, Maybin JA, Collins F, Critchley HOD, Saunders PTK, Chaudhury K, Jana SK, Banerjee P, Mukherjee S, Chakravarty BN, Allegra A, Marino A, Lama A, Santoro A, Agueli C, Mazzola S, Volpes A, Delvoux B, de Graaff AA, D'Hooghe TM, Kyama CM, Dunselman GAJ, Romano A, Caccavo D, Pellegrino NM, Totaro I, Panzarino M, Nardelli C, Depalo R, Flores R, Montanana V, Monzo A, Polo P, Garcia-Gimeno T, Cabo A, Rubio JM, Pellicer A, de Graaff AA, Dunselman GAJ, Beets GL, van Lankveld JJ, Kim HY, Lee BS, Cho SH, Choi YS, Seo SK, Lee KE, Yang HI, Abubakirov A, Vacheyshvili T, Krechetova L, Ziganshina M, Demura T, Nazarenko T, Fulop I, Rucz A, Herczegh SZ, Ujvari A, Takacs SZ, Szakonyi T, Lopez - Muniz A, Zamora L, Serra O, Guix C, Lopez-Teijon M, Benadiva C, Alvarez JG, Goudakou M, Karkanaki A, Kalogeraki A, Mataliotakis I, Kalogiannidis I, Prapas I, Hosie M, Thomson KJ, Penny CB, Thomson KJ, Penny C, Hosie MJ, McKinnon B, Klaeser B, Bersinger N, Mueller MD, Horcajadas JA, Martinez-Conejero JA, Montesinos M, Morgan M, Fortuno S, Simon C, Pellicer A, Yi KW, Shin JH, Park HT, Kim T, Kim SH, Hur JY, Chan RWS, Chan YY, Ng EHY, Yeung WSB, Santulli P, Borghese B, Chopin N, Marcellin L, de Ziegler D, Chapron C, Elnashar A, Badawy A, Mosbah A, Tzioras S, Polyzos NP, Messini CI, Papanikolaou EG, Valachis A, Patavoukas E, Mauri D, Badawy A, Messinis IE, Acar N, Hirota Y, Tranguch S, Daikoku T, Burnum KE, Xie H, Kodama A, Osuga Y, Ustunel I, Friedman DB, Caprioli RM, Dey SK, Mitra A, Sahu R, Pal M, Bhattachrayya AK, Bhattachrya J, Ferrero S, Remorgida V, Rollandi GA, Biscaldi E, Cho S, Choi YS, Kim HY, Seo SK, Yang HI, Lee KE, Shin JH, Lee BS, Arena E, Morando A, Remorgida V, Ferrero S, Tomazevic T, Ban-Frangez H, Virant-Klun I, Verdenik I, Pozlep B, Vrtacnik-Bokal E, Valenzano Menada M, Biscaldi E, Remorgida V, Morotti M, Venturini PL, Rollandi GA, Ferrero S, Dimitriadis E, Salamonsen LA, Hannan N, O'Connor O, Rombauts L, Stoikos C, Mahmoudi M, Shaikh A, Mousavifar N, Rastin M, Baharara J, Tabasi N, Takemura Y, Fujimoto A, Osuga Y, Tsutsumi R, Ooi N, Yano T, Taketani Y, Karkanaki A, Goudakou M, Kalogiannidis I, Panagiotidis I, Prapas Y, Zhang D, Lv PP, Ding GL, Zhang RJ, Zou LB, Xu GF, Gao HJ, Zhu YM, Sheng JZ, Huang HF, Martinez-Conejero JA, Labarta E, Alama P, Pellicer A, Horcajadas JA, Bosch E. Posters * Endometriosis, Endometrium and Implantation. Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fujii R, Fujita S, Waseda T, Oka Y, Takagi H, Tomizawa H, Sasagawa T, Makinoda S, Cavagna M, Braga DPAF, Figueira RCS, Aoki T, Maldonado LGL, Iaconelli A, Borges E, Prabhakar S, Dittrich R, Beckmann MW, Hoffmann I, Mueller A, Kjotrod S, Carlsen SM, Rasmussen PE, Holst-Larsen T, Mellembakken J, Thurin-Kjellberg A, Haapaniemi Kouru K, Morin Papunen L, Humaidan P, Sunde A, von During V, Pappalardo S, Valeri C, Crescenzi F, Manna C, Sallam HN, Polec A, Raki M, Tanbo T, Abyholm T, Fedorcsak P, Tabanelli C, Ferraretti AP, Feliciani E, Magli MC, Fasolino C, Gianaroli L, Wang T, Feng C, Song Y, Dong MY, Sheng JZ, Huang HF, Sayyah Melli M, Kazemi-shishvan M, Snajderova M, Zemkova D, Pechova M, Teslik L, Lanska V, Ketel I, Serne E, Stehouwer C, Korsen T, Hompes P, Smulders Y, Voorstemans L, Homburg R, Lambalk C, Bellver J, Martinez-Conejero JA, Pellicer A, Labarta E, Alama P, Melo MAB, Horcajadas JA, Agirregoitia N, Peralta L, Mendoza R, Exposito A, Matorras R, Agirregoitia E, Ajina M, Chaouache N, Gaddas M, Souissi A, Tabka Z, Saad A, Zaouali-Ajina M, Zbidi A, Eguchi N, Jinno M, Watanabe A, Hirohama J, Hatakeyama N, Choi YM, Kim JJ, Kim DH, Yoon SH, Ku SY, Kim SH, Kim JG, Lee KS, Moon SY, Hirohama J, Jinno M, Watanabe A, Eguchi N, Hatakeyama N, Jinno M, Watanabe A, Hirohama J, Eguchi N, Hatakeyama N, Xiong Y, Liang X, Li Y, Yang X, Wei L, Makinoda S, Tomizawa H, Fujita S, Takagi H, Oka Y, Waseda T, Sasagawa T, Fujii R, Utsunomiya T, Chu S, Li P, Akarsu S, Dirican EK, Akin KO, Kormaz C, Goktolga U, Ceyhan ST, Kara C, Nadamoto K, Tarui S, Ida M, Sugihara K, Haruki A, Hukuda A, Morimoto Y, Albu A, Albu D, Sandu L, Kong G, Cheung L, Lok I, Pinto A, Teixeira L, Figueiredo H, Pires I, Silva Carvalho JL, Pereira ML, Faut M, de Zuniga I, Colaci D, Barrios E, Oubina A, Terrado Gil G, Motta A, Colaci D, de Zuniga I, Horton M, Faut M, Sobral F, Gomez Pena M, Motta A, Gleicher N, Barad DH, Li YP, Zhao HC, Spaczynski RZ, Guzik P, Banaszewska B, Krauze T, Wykretowicz A, Wysocki H, Pawelczyk L, Sarikaya E, Gulerman C, Cicek N, Mollamahmutoglu L, Venetis CA, Kolibianakis EM, Toulis K, Goulis D, Loutradi K, Chatzimeletiou K, Papadimas I, Bontis I, Tarlatzis BC, Schultze-Mosgau A, Griesinger G, Schoepper B, Cordes T, Diedrich K, Al-Hasani S, Gomez R, Jovanovic V, Sauer CM, Shawber CJ, Sauer MV, Kitajewski J, Zimmermann RC, Bungum L, Jacobsson AK, Rosen F, Becker C, Andersen CY, Guner N, Giwercman A, Kiapekou E, Zapanti E, Boukelatou D, Mavreli T, Bletsa R, Stefanidis K, Drakakis P, Mastorakos G, Loutradis D, Malhotra N, Sharma V, Kumar S, Roy KK, Sharma JB, Ferraretti A, Gianaroli L, Magli MC, Crippa A, Stanghellini I, Robles F, Serdynska-Szuster M, Spaczynski RZ, Banaszewska B, Pawelczyk L, Kristensen SL, Ernst E, Toft G, Olsen SF, Bonde JP, Vested A, Ramlau-Hansen CH, Wang FF, Qu F, Ding GL, Huang HF, Gallot V, Genro V, Roux I, Scheffer JB, Frydman R, Fanchin R, Kanta Goswami S, Banerjee S, Chakravarty BN, Kabir SN, Seeber BE, Morandell E, Kurzthaler D, Wildt L, Dieplinger H, Tutuncu L, Bodur S, Dundar O, Ron - El R, Seger R, Komarovsky D, Kasterstein E, Komsky A, Maslansky B, Strassburger D, Ben-Ami I, Zhao XM, Ni RM, Lin L, Dong M, Tu CH, He ZH, Yang DZ, Karamalegos C, Polidoropoulos N, Papanikopoulos C, Stefanis P, Argyrou M, Doriza S, Sisi V, Moschopoulou M, Karagianni T, Mentorou C, Economou K, Davies S, Mastrominas M, Gougeon A, De Los Santos MJ, Garcia-Laez V, Martinez-Conejero JA, Horcajadas JA, Esteban F, Labarta E, Crespo J, Pellicer A, Li HWR, Anderson RA, Yeung WSB, Ho PC, Ng EHY, Yang HI, Lee KE, Seo SK, Kim HY, Cho SH, Choi YS, Lee BS, Park KH, Cho DJ, Hart R, Doherty D, Mori T, Hickey M, Sloboda D, Norman R, Huang RC, Beilin L, Freiesleben N, Lossl K, Johannsen TH, Loft A, Bangsboll S, Hougaard D, Friis-Hansen L, Christiansen M, Nyboe Andersen A, Thum MY, Abdalla H, Martinez-Salazar J, De la Fuente G, Kohls G, Pellicer A, Garcia Velasco JA, Yasmin E, Kukreja S, Barth J, Balen AH, Esra T, Var T, Citil A, Dogan M, Cicek N, Messini CI, Dafopoulos K, Chalvatzas N, Georgoulias P, Anifandis G, Messinis IE, Celik O, Hascalik S, Celik N, Sahin I, Aydin S, Hanna CW, Bretherick KL, Liu CC, Stephenson MD, Robinson WP, Louwers YV, Goodarzi MO, Taylor KD, Jones MR, Cui J, Kwon S, Chen YDI, Guo X, Stolk L, Uitterlinden AG, Laven JSE, Azziz R, Navaratnarajah R, Grun B, Sinclair J, Dafou D, Gayther S, Timms JF, Hardiman PJ, Ye Y, Wu R, Ou J, Kim SD, Jee BC, Lee JY, Suh CS, Kim SH, Jung JH, Moon SY, Opmeer BC, Broeze KA, Coppus SF, Collins JA, Den Hartog JE, Land JA, Van der Linden PJ, Marianowski P, Ng E, Van der Steeg JW, Steures P, Strandell A, Mol BW, Tarlatzi TB, Kyrou D, Mertzanidou A, Fatemi HM, Tarlatzis BC, Devroey P, Batenburg TE, Konig TE, Overbeek A, Hompes P, Schats R, Lambalk CB, Carone D, Vizziello G, Vitti A, Chiappetta R, Topcu HO, Yuksel B, Islimye M, Karakaya J, ozat M, Batioglu S, Kuchenbecker WK, Groen H, Bolster JH, van Asselt S, Wolffenbuettel BH, Land JA, Hoek A, Wu Y, Pan H, Chen X, Wang T, Huang H, Zavos A, Dafopoulos K, Georgoulias P, Messini CI, Verikouki C, Messinis IE, Van Os L, Vink-Ranti CQJ, Rijnders PM, Tucker KE, Jansen CAM, Lucco F, Pozzobon C, Lara E, Galliano D, Pellicer A, Ballesteros A, Ghoshdastidar B, Maity SP, Ghoshdastidar B, Ghoshdastidar S, Luna M, Vela G, Sandler B, Barritt J, Flisser ED, Copperman AB, Nogueira D, Prat L, Degoy J, Bonald F, Montagut J, Ghoshdastidar S, Maity S, Ghoshdastidar B, Chen S, Chen X, Luo C, Zhen H, Shi X, Wu F, Ni Y, Merdassi G, Chaker A, Kacem K, Benmeftah M, Fourati S, Wahabi D, Zhioua F, Zhioua A, Saini P, Saini A, Sugiyama R, Nakagawa K, Nishi Y, Jyuen H, Kuribayashi Y, Sugiyama R, Inoue M, Jancar N, Vrtacnik Bokal E, Virant-Klun I, Lee JH, Kim SG, Cha EM, Park IH, Lee KH, Dahdouh EM, Desrosiers P, St-Michel P, Villeneuve M, Fontaine JY, Granger L, Ramon O, Matorras R, Burgos J, Abanto E, Gonzalez M, Mugica J, Corcostegui B, Exposito A, Tal J, Ziskind G, Ohel G, Paltieli Y, Paz G, Lewit N, Sendel H, Khouri S, Calderon I, van Gelder P, Al-Inany HG, Antaki R, Dean N, Lapensee L, Racicot M, Menard S, Kadoch I, Meylaerts LJ, Dreesen L, Vandersteen M, Neumann C, Zollner U, Kato K, Segawa T, Kawachiya S, Okuno T, Kobayashi T, Takehara Y, Kato O, Jayaprakasan K, Nardo L, Hopkisson J, Campbell B, Raine-Fenning N. Posters * Reproductive Endocrinology (i.e. PCOS, Menarche, Menopause etc.). Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Beamer C, Horton M. 122: Powered Needle Insertion Provides Safe and Effective Vascular Access for Pediatric Emergency Patients. Ann Emerg Med 2007. [DOI: 10.1016/j.annemergmed.2007.06.155] [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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Williams MA, Porter M, Horton M, Guo J, Roman J, Williams D, Breysse P, Georas SN. Ambient particulate matter directs nonclassic dendritic cell activation and a mixed TH1/TH2-like cytokine response by naive CD4+ T cells. J Allergy Clin Immunol 2007; 119:488-97. [DOI: 10.1016/j.jaci.2006.10.022] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Revised: 09/29/2006] [Accepted: 10/11/2006] [Indexed: 11/25/2022]
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Poole J, Kerr A, McGuiness J, Horton M, Poppe K, Poole A, Gilmore J. Nicotine Replacement Therapy in the Coronary Care Unit. Heart Lung Circ 2007. [DOI: 10.1016/j.hlc.2007.06.496] [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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Abstract
There is a long history of drainage of blanket peat but few studies of the long-term hydrological impact of drainage. This paper aims to test differences in runoff production processes between intact and drained blanket peat catchments and determine whether there have been any long-term changes in stream flow since drainage occurred. Hillslope runoff processes and stream discharge were measured in four blanket peat catchments. Two catchments were drained with open-cut ditches in the 1950s. Ditching originally resulted in shorter lag times and flashier storm hydrographs but no change in the annual catchment runoff efficiency. In the period between 2002 and 2004, the hydrographs in the drained catchments, while still flashy, were less sensitive to rainfall than in the 1950s and the runoff efficiency had significantly increased. Drains resulted in a distinctive spatial pattern of runoff production across the slopes. Overland flow was significantly lower in the drained catchments where throughflow was more dominant. In the intact peatlands, matrix throughflow produced by peat layers below 10 cm was rare and produced <1% of the runoff. However, in drained peatlands, matrix throughflow in deeper peat layers was common and provided around 23% of the runoff from gauged plots. Macropore flow, the density of soil piping, and pipeflow were significantly greater in drained peatlands than in intact basins. Gradual changes to peat structure could explain the long-term changes in river flow, which are in addition to those occurring in the immediate aftermath of peatland drainage.
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Affiliation(s)
- J Holden
- School of Geography, University of Leeds, Leeds, LS2 9JT, UK.
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Granger E, Spratt P, Jansz P, Horton M, Glanville A. 411. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.426] [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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Copley MS, Bland HA, Rose P, Horton M, Evershed RP. Gas chromatographic, mass spectrometric and stable carbon isotopic investigations of organic residues of plant oils and animal fats employed as illuminants in archaeological lamps from Egypt. Analyst 2005; 130:860-71. [PMID: 15912234 DOI: 10.1039/b500403a] [Citation(s) in RCA: 134] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Man's use of illuminants in lamps or as torches to extend the working day and range of environments accessible to him would have been a major technological advance in human civilisation. The most obvious evidence for this in the archaeological record comes from pottery and stone vessels showing sooting due to the use of a wick in conjunction with a lipid-based fuel or illuminant. A wide range of potential fuels would have been exploited depending upon availability and burning requirements. Reported herein are the results of chemical investigations of a number of lamps recovered from excavations of the site of Qasr Ibrim, Egypt. Gas chromatographic, mass spectrometric and stable carbon isotopic analyses of both free (solvent extractable) and 'bound'(released from solvent extracted pottery by base treatment) lipids have revealed a wide range of saturated fatty acids, hydroxy fatty acids and alpha, omega-dicarboxylic acids. Examination of the distributions of compounds and comparisons with the fatty acid compositions of modern plant oils have allowed a range of fats and oils to be recognised. Specific illuminants identified include Brassicaceae (Cruciferae) seed oil (most likely radish oil, Raphanus sativus), castor oil (from Ricinus communis), animal fat, with less diagnostic distributions and delta(13)C values being consistent with low stearic acid plant oils, such as linseed (Linum usitatissimum) or sesame (Sesamum indicum) oils. The identifications of the various oils and fats are supported by parallel investigations of illuminant residues produced by burning various oils in replica pottery lamps. The findings are entirely consistent with the classical writers including Strabo, Pliny and Theophrastrus.
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Affiliation(s)
- M S Copley
- Organic Geochemistry Unit, Bristol Biogeochemistry Research Centre, School of Chemistry, University of Bristol, Cantock's Close, Bristol BS8 1TS, UK
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Verrier S, Hogan A, McKie N, Horton M. ADAM gene expression and regulation during human osteoclast formation. Bone 2004; 35:34-46. [PMID: 15207739 DOI: 10.1016/j.bone.2003.12.029] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2003] [Revised: 12/01/2003] [Accepted: 12/24/2003] [Indexed: 11/23/2022]
Abstract
In this study, we identified the expression and the regulation of ADAM members (a disintegrin and metalloprotease) at both gene and protein levels during human osteoclast differentiation and activity. Human peripheral blood monocytes (HPBMC) treated with M-CSF and RANKL were used as an in vitro fusion model. In parallel, we used human osteoclastoma (OCL) tumor as a source of mature osteoclasts, and human osteoblastic cells as a control representing nonfusing and non-resorbing bone cells. RT-PCR using ADAM-specific primers enabled us to identify the expression of ADAM 8, 9, 10, 15, 17, and 28 in both osteoclasts and osteoblasts. Using primers specific for each ADAM 12 isoform (L and S), we observed a strong signal for both forms (ADAM 12L and ADAM 12S) in osteoblastic cells, while only ADAM 12S was detectable in HPBMC-derived osteoclasts and osteoclastoma. Gene regulation was studied using real-time PCR analysis performed during HPBMC differentiation; this showed a progressive increase of ADAM 12 mRNA level from day 1 to 8 of the culture, while at around day 9, ADAM 12 mRNA level decreased 2-fold. We also showed that ADAM 8, ADAM 17, and ADAM 28 decreased according to the stage of HPBMC differentiation or fusion. ADAM 10 was unaltered during cell fusion. However, confocal immunolocalization showed that ADAM 10 protein re-localized from the nuclei and cytoplasm to the plasma membrane during culture and to the ruffled border in resorbing cells. The same re-localization process was observed using an ADAM 12S-specific antibody during HPBMC differentiation. Between days 12 and 14, ADAM 12 co-localized with the F-actin ring, and at day 15, a strong signal was also present in ruffled border or sealing zone area of osteoclasts. Our results describe the expression and regulation of various ADAMs in human bone cells and the selective expression of ADAM 12L in osteoblasts. Our gene regulation and protein localization studies suggest a function for ADAM 10 and ADAM 12S in the formation of osteoclasts from HPBMC and resorption activity.
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Affiliation(s)
- S Verrier
- The Bone and Mineral Centre, Department of Medicine, The Rayne Institute, University College London, WC1E 6JJ UK.
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Lehtolainen P, Wirth T, Taskinen AK, Lehenkari P, Leppänen O, Lappalainen M, Pulkkanen K, Marttila A, Marjomäki V, Airenne KJ, Horton M, Kulomaa MS, Ylä-Herttuala S. Targeting of biotinylated compounds to its target tissue using a low-density lipoprotein receptor–avidin fusion protein. Gene Ther 2003; 10:2090-7. [PMID: 14595382 DOI: 10.1038/sj.gt.3302120] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The very high binding affinity of avidin to biotin is one of the highest to occur in nature. We constructed a fusion protein composed of avidin and the endocytotic LDL receptor in order to target biotinylated molecules to cells of the desired tissues. In addition to the native avidin, charge-mutated and nonglycosylated avidins were utilized as part of the fusion proteins, in order to modify its properties. All of the fusion protein versions retained the biotin-binding capacity. Although the specificity was not increased, however, fusion proteins composed of natural avidin and nonglycosylated avidin bound most efficiently to the biotinylated ligands. Fluorescence microscopy and atomic force microscopy studies revealed the expression of the fusion protein on cell membranes, and demonstrated specific and high-affinity binding of biotin to the low-density lipoprotein receptor (LDLR)-avidin fusion protein in vitro. Additionally, systemically administered biotinylated ligand targeted with high specificity the intracerebral tumors of rats that were expressing fusion protein after the virus-mediated gene transfer. These results suggest that local gene transfer of the fusion protein to target tissues may offer a novel tool for the delivery of biotinylated molecules in vitro and in vivo for therapeutic and imaging purposes.
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Affiliation(s)
- P Lehtolainen
- A.I. Virtanen Institute, University of Kuopio, Kuopio, Finland
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Horton M, Harris RV, Ireland RS. The development and use of a triage protocol for patients with dental problems contacting an out-of-hours general medical practitioner cooperative. Prim Dent Care 2001; 8:93-7. [PMID: 11490705 DOI: 10.1308/135576101322561886] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE OF THE STUDY The number of patients contacting general medical practitioner (GMP) out-of-hours services with dental problems is perceived to be a significant problem by the medical profession. This study was undertaken to design and pilot a triage protocol that could be used by non-dental staff to refer callers with dental complaints for appropriate treatment. BASIC PROCEDURES A triage protocol was designed to address the patient conditions considered to be relevant to emergency dental care. The triage protocol was piloted for three months at a GMP cooperative in North Wales, which provided an out-of-hours service for 61 GMPs. Baseline data were collected for three months prior to the introduction of the triage protocol. MAIN FINDINGS The study showed that the number of dental callers contacting the out-of-hours service was not as great as GMPs imagined, and was similar to other studies. The introduction of the triage protocol resulted in a rise in the number of callers asked to call the general dental practitioner (GDP) support line. The number of unregistered patients given the name of a dentist also increased. The need to make a second telephone call seemed not to affect patient satisfaction since when patients were later questioned on their experience, those who had used the service since the introduction of the triage protocol were more likely to be satisfied with the service. PRINCIPAL CONCLUSIONS This study provides some evidence that a triage protocol can be used successfully by non-dental staff to sift requests for out-of-hours emergency dental care.
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Abstract
Osteoblasts and bone lining cells form a near continuous layer covering the bone surface and interactions between these cells and the organic matrix of bone are important determinants of osteoblast proliferation and differentiation. In addition, cells of the osteoblast-lineage form functional communications with each other, with the extra-cellular matrix and with osteocytes through cytoplasmic processes extending through canaliculi in the bone. Together, these cells form a network of putative importance in the regulation of skeletal homeostasis. Cell-cell and cell-matrix interactions are mediated by members of several families of cell adhesion molecules, and knowledge of their interactions will be of fundamental importance in understanding the role of osteoblast in skeletal turnover. Here, the expression pattern of members of the major families of cell adhesion molecules by cells of the osteoblast lineage is reviewed. Special emphasis has been placed on human tissues. In addition, the possibility that cells at progressive stages of the osteoblast lineage have different profiles of cell adhesion molecule expression is explored, and the putative significance of cell-matrix interactions in human skeletal disease briefly discussed.
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Affiliation(s)
- J H Bennett
- Department of Oral Pathology, Eastman Dental Institute, University College London, UK.
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Chico TJ, Chamberlain J, Gunn J, Arnold N, Bullens SL, Gadek TR, Francis SE, Bunting S, Horton M, Shepherd L, Lipari MT, Quan C, Knolle J, Stilz HU, Peyman A, Crossman DC. Effect of selective or combined inhibition of integrins alpha(IIb)beta(3) and alpha(v)beta(3) on thrombosis and neointima after oversized porcine coronary angioplasty. Circulation 2001; 103:1135-41. [PMID: 11222478 DOI: 10.1161/01.cir.103.8.1135] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Thrombosis and neointima formation limit the efficacy of coronary angioplasty (PTCA). Clinical trials have implicated the adhesion molecules integrin alpha(IIb)beta(3) and integrin alpha(v)beta(3) in these processes. The roles of these molecules in vascular smooth muscle cell adhesion, platelet aggregation, and the thrombotic and neointimal response to oversize porcine PTCA was investigated by use of a selective alpha(IIb)beta(3) antagonist (lamifiban), a selective alpha(v)beta(3) antagonist (VO514), and a combined alpha(IIb)beta(3)/alpha(v)beta(3) antagonist (G3580). METHODS AND RESULTS In vitro, both alpha(v)beta(3) inhibitors caused dose-dependent inhibition of porcine vascular smooth muscle cell adhesion to vitronectin but not to collagen type IV, fibronectin, or laminin, whereas selective alpha(IIb)beta(3) inhibition had no effect. Intravenous infusions of either alpha(IIb)beta(3) inhibitor in swine profoundly inhibited ex vivo platelet aggregation to ADP, whereas selective alpha(v)beta(3) inhibition had no effect. In a porcine PTCA model, intravenous infusions of the integrin antagonists were administered for 14 days after oversized balloon angioplasty injury. After PTCA, there was regional upregulation of integrin alpha(v)beta(3) in the developing neointima, as assessed by immunohistochemistry. Six hours after PTCA, obstruction of lumen by thrombus was reduced significantly by alpha(IIb)beta(3) inhibition compared with either control or alpha(v)beta(3) inhibition (mean control, 18.7%; VO514, 18.5%; lamifiban, 6.4%; G3580, 7.9%). Twenty-eight days after PTCA, there was a significant reduction of neointima with inhibitors of either integrin (mean intima/media ratio: control, 3.08; VO514, 1.33; lamifiban, 0.97; G3580, 1.32). CONCLUSIONS We conclude that both integrin alpha(IIb)beta(3) and integrin alpha(v)beta(3) participate in neointima development after experimental angioplasty.
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Affiliation(s)
- T J Chico
- Cardiovascular Research Group, Division of Clinical Sciences (NGHT), University of Sheffield, Clinical Sciences Centre, Northern General Hospital, Sheffield, UK.
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Taylor JC, Sterkel B, Utley M, Shipley M, Newman S, Horton M, Fitz-Clarence H. Opinions and experiences in general practice on osteoporosis prevention, diagnosis and management. Osteoporos Int 2001; 12:844-8. [PMID: 11716187 DOI: 10.1007/s001980170035] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We determined to survey the general practice population regarding their attitudes to and knowledge of osteoporosis as a baseline prior to publication of national guidelines for the management of osteoporosis. All 2515 general practitioners registered in the 10 Health Authorities of the North Thames region, London, UK were surveyed by a postal questionnaire. Responses relating to epidemiology, public health and education on osteoporosis were analyzed. The overall response was 1153 (46%). General practitioners who responded were younger, predominantly female and in group practice. There is considerable awareness of the importance of preventing osteoporosis. General practitioners are active in identifying groups at risk, particularly those who are aged 40 years and older. A prevention strategy for osteoporosis is viewed as effective. However, two thirds of general practitioners remain unconvinced about the efficacy of drug therapy. Education on osteoporosis is considered inadequate. General practitioners would welcome further information on management issues and access to osteoporosis services. In conclusion, educational initiatives will be important both at undergraduate and postgraduate levels to increase awareness and knowledge of osteoporosis. General practitioners are aware of the public health impact of this condition and express a preference for educational material of direct relevance to the care of their patients. Therefore better cooperation between primary and secondary care should lead to ways of breaking down barriers to change in clinical practice and promoting fully integrated care of patients with osteoporosis.
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Affiliation(s)
- J C Taylor
- Centre for Rheumatology, UCLH, London, UK.
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43
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Huang W, Ray F, Ura M, Fermanis G, Horton M, Horton D, Hambly B, Barden J. P2X (purinergic) receptor distribution in coronary artery bypass conduits: Implications for graft behavior. Heart Lung Circ 2000. [DOI: 10.1046/j.1443-9506.2000.09326.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
BACKGROUND Bioprostheses (BPs) are used to avoid anticoagulation after aortic valve replacement (AVR) in patients over 65 years of age. Stentless BPs offer established hemodynamic benefits. We sought to determine whether these advantages translate into improved survival. METHODS Between 1993 and 1997, follow-up data (for Food and Drug Administration submission) were collected prospectively for 160 consecutive, unselected hospital survivors who received the Freestyle valve (FS). Equivalent data were collected for 247 Carpentier-Edwards (CE) porcine xenograft patients. Detailed comparative statistical analysis was used to compare events and survival between the groups. Follow-up was 100% complete for the FS (5.2 years maximum; mean 3.2+/-1.0 years) group and 98% (7.2 years maximum; mean 3.8+/-2.0 years) for CE. RESULTS The groups were well matched in age (FS, 73+/-6 years; CE, 74+/-6 years), gender (FS, 58% male; CE, 62% male), ventricular function, and number of patients requiring coronary grafts (FS, 41%; CE, 37%). Actuarial survival at 5 years was 84% for FS versus 69% for CE (p = 0.023 Kaplan Meier, p = 0.009 Cox). Annual mortality rates were 3.6% for FS versus 7.1% for CE (p = 0.001). Thromboembolic rate was 0.8% per year for FS and 2.4% for CE (p = 0.024) without a difference in cardiac rhythm. Incidence of nonstructural dysfunction (paravalvular leak) was 0.2% for FS versus 1.3% for CE (p = 0.020). CONCLUSIONS By 5 years, the stentless valve patients had improved survival and reduced adverse events. Though differences in durability are yet to be proved, our findings support the use of stentless bioprostheses in this age group.
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Affiliation(s)
- S Westaby
- Department of Cardiac Surgery, Oxford Heart Centre, John Radcliffe Hospital, Headington, United Kingdom.
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Abstract
A patient with acute fulminant lymphocytic myocarditis and cardiogenic shock was successfully treated by mechanical off loading of the left ventricle. A nonpulsatile left-heart bypass was undertaken with an implantable centrifugal blood pump. Careful weaning resulted in device removal on the seventh day. Left and right ventricular function is sustained at 7 months. Widespread application of this method depends on the availability of an inexpensive user friendly blood pump, appropriate weaning protocols and emerging strategies to promote sustainable myocardial recovery.
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Affiliation(s)
- S Westaby
- Department of Cardiac Surgery, John Radcliffe Hospital Oxford, England.
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Bendeck MP, Irvin C, Reidy M, Smith L, Mulholland D, Horton M, Giachelli CM. Smooth muscle cell matrix metalloproteinase production is stimulated via alpha(v)beta(3) integrin. Arterioscler Thromb Vasc Biol 2000; 20:1467-72. [PMID: 10845859 DOI: 10.1161/01.atv.20.6.1467] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study tests the hypothesis that alpha(v)beta(3) integrin receptors play a critical role in smooth muscle cell (SMC) migration after arterial injury and facilitate migration through the upregulation of matrix metalloproteinase (MMP) activity. We showed that beta(3) integrin mRNA was upregulated by SMCs in the balloon-injured rat carotid artery in coincidence with MMP-1 expression and early SMC migration. Treatment with the beta(3) integrin-blocking antibody F11 significantly decreased SMC migration into the intima at 4 days after injury, from 110.8+/-30.8 cells/mm(2) in control rats to 10.29+/-7.03 cells/mm(2) in F11-treated rats (P=0.008). By contrast, there was no effect on medial SMC proliferation or on medial SMC number in the carotid artery at 4 days. In vitro, we found that human newborn SMCs produced MMP-1 but that adult SMCs did not. This was possibly due to the fact that newborn SMCs expressed alpha(v)beta(3) integrin receptors, whereas adult SMCs did not. Stimulation of newborn (alpha(v)beta(3)+) SMCs with osteopontin, a matrix ligand for alpha(v)beta(3), increased MMP-1 production from 114.4+/-35.8 ng/mL at 0 nmol/L osteopontin to 232.5+/-57.5 ng/mL at 100 nmol/L osteopontin. Finally, we showed that stimulation of newborn SMCs with platelet-derived growth factor-BB and osteopontin together increased the SMC production of MMP-9. Thus, our results support the hypothesis that SMC alpha(v)beta(3) integrin receptors play an important role in regulating migration by stimulating SMC MMP production.
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MESH Headings
- Animals
- Becaplermin
- Blood Platelets/physiology
- Carotid Artery Injuries/metabolism
- Catheterization
- Cell Movement
- Cells, Cultured
- Gene Expression Regulation
- Humans
- Infant, Newborn
- Male
- Matrix Metalloproteinase 1/biosynthesis
- Mice
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/enzymology
- Osteopontin
- Platelet-Derived Growth Factor/pharmacology
- Proto-Oncogene Proteins c-sis
- RNA, Messenger/metabolism
- Rats
- Rats, Sprague-Dawley
- Receptors, Vitronectin/genetics
- Receptors, Vitronectin/physiology
- Sialoglycoproteins/pharmacology
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Affiliation(s)
- M P Bendeck
- Terrence Donnelly Research Laboratories, Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
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Abstract
UNLABELLED In order to determine the amount of Chlamydia trachomatis that is diagnosed outside genitourinary medicine (GUM) clinics in a large university city, a review of all positive chlamydial infections diagnosed on specimens received from hospitals (non-GUM) and community sources in 1996 was performed. It was also ascertained whether these patients subsequently attended at GUM. Eight hundred and nine cases of C. trachomatis were diagnosed during the study period. Three hundred and ninety-seven (49%) were initially diagnosed outside GUM of which 264 (66.5%) were referred, giving an overall involvement of GUM in 667 (83.6%) of all cases. The proportion of cases referred varied according to service: Family Planning Clinics 94.5%, Obstetrics and Gynaecology 73%, General Practice 52.5%. Referral rates also showed within service variation, with University Health Services referring 19% vs 73% (P < 0.001). High levels of referral to GUM of patients diagnosed with C. trachomatis are achievable, but referrals show inter- and intra-service variations. Efforts should be made to improve referral rates from those services with the lowest rates. IN CONCLUSION (1) The proportion of cases of C. trachomatis diagnosed in the community who are referred to a GUM clinic, varies according to service type. (2) Referral rates vary within services and (3) Distance of services from a GUM clinic does not appear to influence referral rates.
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Affiliation(s)
- K E Rogstad
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield, UK
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Aweeka F, Jayesekara D, Horton M, Swan S, Lambrecht L, Wilner KD, Sherwood J, Anziano RJ, Smolarek TA, Turncliff RZ. The pharmacokinetics of ziprasidone in subjects with normal and impaired renal function. Br J Clin Pharmacol 2000; 49 Suppl 1:27S-33S. [PMID: 10771451 PMCID: PMC2015058 DOI: 10.1046/j.1365-2125.2000.00150.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AIMS To assess whether renal impairment influences the pharmacokinetics of ziprasidone, and to determine whether ziprasidone is cleared via haemodialysis. METHODS Thirty-nine subjects with varying degrees of renal impairment were enrolled into an open-label, multicentre, multiple-dose study and assigned to four groups according to their renal function: normal (group 1, creatinine clearance > 70 ml min(-1); mildly impaired (group 2, creatinine clearance 30-60 ml min(-1); moderately impaired (group 3, creatinine clearance 10-29 ml min(-1), and severely impaired (group 4, requiring haemodialysis three times-a-week). Subjects received ziprasidone 40 mg day(-1), given orally with food, as two divided daily doses for 7 days and a single 20 mg dose on the morning of day 8. Pharmacokinetic variables were determined from multiple venous blood samples collected on days 1 and 8 (haemodialysis day for subjects with severe renal impairment). Additional samples were collected from subjects with severe renal impairment on day 7 (nonhaemodialysis day). RESULTS On day 1 there were no statistically significant differences in the pharmacokinetics (AUC(0, 12 h), Cmax, tmax) of ziprasidone among subjects with normal renal function and those with mild, moderate and severe renal impairment. The AUC(0,12 h) and Cmax in subjects with mildly impaired renal function were statistically significantly greater than in those with moderately impaired renal function (P = 0.0163-0.0385). The mean AUC(0,12 h) was 272, 370, 250 and 297 ng ml(-1) h in groups 1, 2, 3 and 4, respectively. Corresponding mean Cmax values were 47, 61, 41 and 50 ng ml(-1) and corresponding mean tmax values were 5, 6, 5 and 5 h. On day 8 there were no statistically significant differences in the pharmacokinetics (AUC(0,12 h), Cmax, tmax, lambda(z), Fb) of ziprasidone among subjects with normal renal function and those with moderate or severe renal impairment. The AUC(0,12 h) in subjects with mild renal impairment was statistically significantly greater than those in the other three groups (P = 0.0025-0.0221), but this was not considered clinically significant. The mean AUC(0,12 h) were 446, 650, 389 and 427 ng ml(-1) h in groups 1, 2, 3 and 4, respectively. Corresponding mean Cmax values were 68, 93, 54 and 70 ng ml(-1), corresponding mean tmax values were 4, 5, 4 and 5 h and corresponding mean lambda(z) were 0.14, 0.11, 0.14 and 0.17 h(-1). The mean percentage Fb was 99.84-99.88% across all groups and the mean t(1/2),z ranged from 4.2 to 6.4 h. Comparison of the mean AUC(0,12 h) and Cmax values in subjects with severe renal impairment on day 7 with those on day 8 suggested that haemodialysis does not have a clinically significant effect on the pharmacokinetics of ziprasidone. CONCLUSIONS The findings of this study indicate that mild-to-moderate impairment of renal function does not result in clinically significant alteration of ziprasidone pharmacokinetics and therefore does not necessitate dose adjustment.
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Affiliation(s)
- F Aweeka
- San Francisco General Hospital, CA 94110, USA
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50
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Dimmitt DC, Shah AK, Arumugham T, Cramer MB, Halstenson C, Horton M, Weir SJ. Pharmacokinetics of oral and intravenous dolasetron mesylate in patients with renal impairment. J Clin Pharmacol 1998; 38:798-806. [PMID: 9753207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In an open-label, randomized, two-way complete crossover study, the influence of renal impairment on the pharmacokinetics of dolasetron and its primary active metabolite, hydrodolasetron, were evaluated. Patients with renal impairment were stratified into three groups of 12 based on their 24-hour creatinine clearance (Cl(cr)): group 1, mild impairment (Cl(cr) between 41 and 80 mL/min); group 2, moderate impairment (Cl(cr) between 11 and 40 mL/min); and group 3, endstage renal impairment (Cl(cr) < or = 10 mL/min). Twenty-four healthy volunteers from a previous study served as the control group. Each participant received a single intravenous or oral 200-mg dose of dolasetron mesylate on separate occasions. Serial blood samples were collected up to 60 hours after dose for determination of dolasetron and hydrodolasetron, and urine samples were collected in intervals up to 72 hours for determination of dolasetron, hydrodolasetron, and the 5' and 6'-hydroxy metabolites of hydrodolasetron. Because plasma concentrations were low and sporadic, pharmacokinetic parameters of dolasetron were not calculated after oral administration. Although some significant differences in area under the concentration-time curve (AUC0-infinity), volume of distribution (Vd), systemic clearance (Cl), and elimination half-life (t1/2) of the parent drug were observed between control subjects and patients with renal impairment, there were no systematic findings related to degree of renal dysfunction. The elimination pathways of hydrodolasetron include both hepatic metabolism and renal excretion. Consistent increases in mean Cmax, AUC0-infinity, and t1/2 and decreases in renal and total apparent clearance of hydrodolasetron were seen with diminishing renal function after intravenous administration of dolasetron mesylate. No consistent changes were found after oral administration. Urinary excretion of hydrodolasetron and its metabolites decreased with decreasing renal function, but the profile of metabolites remained constant. Dolasetron was well tolerated in all three groups of patients. Based on these findings, no dosage adjustment for dolasetron is recommended in patients with renal impairment.
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Affiliation(s)
- D C Dimmitt
- Hoechst Marion Roussel, Kansas City, Missouri 64134, USA
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