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Yuan C, Rayasam A, Moe A, Hayward M, Wells C, Szabo A, Mackenzie A, Salzman N, Drobyski WR. Interleukin-9 production by type 2 innate lymphoid cells induces Paneth cell metaplasia and small intestinal remodeling. Nat Commun 2023; 14:7963. [PMID: 38042840 PMCID: PMC10693577 DOI: 10.1038/s41467-023-43248-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/03/2023] [Indexed: 12/04/2023] Open
Abstract
Paneth cell metaplasia (PCM) typically arises in pre-existing gastrointestinal (GI) diseases; however, the mechanistic pathway that induces metaplasia and whether PCM is initiated exclusively by disorders intrinsic to the GI tract is not well known. Here, we describe the development of PCM in a murine model of chronic myelogenous leukemia (CML) that is driven by an inducible bcr-abl oncogene. Mechanistically, CML induces a proinflammatory state within the GI tract that results in the production of epithelial-derived IL-33. The binding of IL-33 to the decoy receptor ST2 leads to IL-9 production by type 2 innate lymphoid cells (ILC2) which is directly responsible for the induction of PCM in the colon and tissue remodeling in the small intestines, characterized by goblet and tuft cell hyperplasia along with expansion of mucosal mast cells. Thus, we demonstrate that an extra-intestinal disease can trigger an ILC2/IL-9 immune circuit, which induces PCM and regulates epithelial cell fate decisions in the GI tract.
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Affiliation(s)
- Chengyin Yuan
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Aditya Rayasam
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alison Moe
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Michael Hayward
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Clive Wells
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Aniko Szabo
- Division of Biostatistics, Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Nita Salzman
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - William R Drobyski
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA.
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2
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Sud S, Kanchi K, Hayward M, Wijetunga A, Corcoran D, Weiner AA. Genomic Characterization of Low and High Grade Cervical Intraepithelial Neoplasia in Comparison to Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e547. [PMID: 37785684 DOI: 10.1016/j.ijrobp.2023.06.1847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Screening reduces incidence of cervical cancer (CC) through identification and treatment of cervical intraepithelial neoplasia (CIN). Triage of CIN must balance between overtreatment versus progression as invasive therapies increase the risk of side effects including obstetric complications. The majority of CIN 1-2 lesions regress and a subset of CIN 3 lesions progress, however, due to inability to differentiate lesions likely to progress, the majority of CIN 2-3 lesions are treated with resection. Improved genomic and molecular identifiers of disease represent an urgent unmet clinical need. MATERIALS/METHODS Using next generation sequencing of a targeted exome panel of 1109 genes (previously validated), we characterized somatic mutations in 36 CIN (14 CIN 1, 11 CIN 2, 11 CIN 3) and 13 CC samples. Sequencing of CIN samples was performed on exfoliated cervical cells. CIN diagnosis and grade was confirmed on biopsy. Mutation profiles between CIN grades and CC were compared to identify genomic patterns that distinguish these groups. RESULTS Across the 49 samples sequenced, we identified a total of 5142 somatic mutations, including 2178 missense, 2522 synonymous, 171 nonsense, 62 splice site, 135 inframe indels, and 74 frameshift mutations. The mutation frequency was significantly higher in CC vs CIN1-3 (Table), p<0.01 (Wilcoxon signed-rank test). The difference in mutation frequency and type (Table) was not significant between CIN grades 1, 2 and 3 (p = 0.07, Kruskal-Wallis test). Cancer related pathway signatures were analyzed for the percentage of CC vs CIN samples with at least one altered variant as follows: RTK-RAS (92% vs 31%), PI3K (92% vs 17%), NOTCH (100% vs 39%), WNT (85% vs 14%) and cell cycle (53% vs 3%). Ninety percent of CC samples versus only 30% of CINs had nonsynonymous variants in the RTK-RAS and NOTCH pathways as well as the PI3K pathway which is implicated as a late event in cervical carcinogenesis. We observed recurrent missense variants in ABL1, IGF1R, TSC2 in the CIN2, CIN3 and CC samples, particularly in genes that belong to the RTK-RAS, PI3K, NOTCH pathway signatures. Potential driver mutations in EGFR, PIK3CA, ERBB4, MTOR, CSF1R genes were exclusive to CC samples. CONCLUSION Our results show that there is a clear distinction of mutational burden and type between cervical cancer and CIN1-3. However, the pathologic grading of CIN is not consistently associated with dynamic changes in overall mutation burden, type, or specific genes with escalating CIN grade. This data supports the hypothesis that late genetic events in CIN accompany a transition to invasive cervical cancer.
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Affiliation(s)
- S Sud
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - K Kanchi
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - M Hayward
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - A Wijetunga
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - D Corcoran
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - A A Weiner
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
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Fung C, Fraser L, Barrón G, Gologorsky M, Atkinson S, Gerrick E, Hayward M, Ziegelbauer J, Li J, Nico K, Tyner M, DeSchepper L, Pan A, Salzman N, Howitt M. Tuft cells mediate commensal remodeling of the small intestinal antimicrobial landscape. Proc Natl Acad Sci U S A 2023; 120:e2216908120. [PMID: 37253002 PMCID: PMC10266004 DOI: 10.1073/pnas.2216908120] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/19/2023] [Indexed: 06/01/2023] Open
Abstract
Succinate produced by the commensal protist Tritrichomonas musculis (T. mu) stimulates chemosensory tuft cells, resulting in intestinal type 2 immunity. Tuft cells express the succinate receptor SUCNR1, yet this receptor does not mediate antihelminth immunity nor alter protist colonization. Here, we report that microbial-derived succinate increases Paneth cell numbers and profoundly alters the antimicrobial peptide (AMP) landscape in the small intestine. Succinate was sufficient to drive this epithelial remodeling, but not in mice lacking tuft cell chemosensory components required to detect this metabolite. Tuft cells respond to succinate by stimulating type 2 immunity, leading to interleukin-13-mediated epithelial and AMP expression changes. Moreover, type 2 immunity decreases the total number of mucosa-associated bacteria and alters the small intestinal microbiota composition. Finally, tuft cells can detect short-term bacterial dysbiosis that leads to a spike in luminal succinate levels and modulate AMP production in response. These findings demonstrate that a single metabolite produced by commensals can markedly shift the intestinal AMP profile and suggest that tuft cells utilize SUCNR1 and succinate sensing to modulate bacterial homeostasis.
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Affiliation(s)
- Connie Fung
- Department of Pathology, Stanford University School of Medicine, Stanford, CA94305
| | - Lisa M. Fraser
- Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI53226
| | - Gabriel M. Barrón
- Department of Pathology, Stanford University School of Medicine, Stanford, CA94305
- Program in Immunology, Stanford University School of Medicine, Stanford, CA94305
| | | | - Samantha N. Atkinson
- Department of Microbiology and Immunology, Center for Microbiome Research, Medical College of Wisconsin, Milwaukee, WI53226
| | - Elias R. Gerrick
- Department of Pathology, Stanford University School of Medicine, Stanford, CA94305
| | - Michael Hayward
- Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI53226
- Department of Microbiology and Immunology, Center for Microbiome Research, Medical College of Wisconsin, Milwaukee, WI53226
| | - Jennifer Ziegelbauer
- Department of Microbiology and Immunology, Center for Microbiome Research, Medical College of Wisconsin, Milwaukee, WI53226
| | - Jessica A. Li
- Department of Pathology, Stanford University School of Medicine, Stanford, CA94305
| | - Katherine F. Nico
- Department of Pathology, Stanford University School of Medicine, Stanford, CA94305
- Program in Immunology, Stanford University School of Medicine, Stanford, CA94305
| | - Miles D. W. Tyner
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA94305
| | - Leila B. DeSchepper
- Department of Pathology, Stanford University School of Medicine, Stanford, CA94305
| | - Amy Pan
- Department of Microbiology and Immunology, Center for Microbiome Research, Medical College of Wisconsin, Milwaukee, WI53226
- Division of Quantitative Health Services, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI53226
| | - Nita H. Salzman
- Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI53226
- Department of Microbiology and Immunology, Center for Microbiome Research, Medical College of Wisconsin, Milwaukee, WI53226
| | - Michael R. Howitt
- Department of Pathology, Stanford University School of Medicine, Stanford, CA94305
- Program in Immunology, Stanford University School of Medicine, Stanford, CA94305
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA94305
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4
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Sadler KE, Atkinson SN, Ehlers VL, Waltz TB, Hayward M, Rodríguez García DM, Salzman NH, Stucky CL, Brandow AM. Gut microbiota and metabolites drive chronic sickle cell disease pain. bioRxiv 2023:2023.04.25.538342. [PMID: 37163080 PMCID: PMC10168372 DOI: 10.1101/2023.04.25.538342] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Pain is a debilitating symptom and leading reason for hospitalization of individuals with sickle cell disease. Chronic sickle cell pain is poorly managed because the biological basis is not fully understood. Using transgenic sickle cell mice and fecal material transplant, we determined that the gut microbiome drives persistent sickle cell pain. In parallel patient and mouse analyses, we identified bilirubin as one metabolite that induces sickle cell pain by altering vagus nerve activity. Furthermore, we determined that decreased abundance of the gut bacteria Akkermansia mucinophila is a critical driver of chronic sickle cell pain. These experiments demonstrate that the sickle cell gut microbiome drives chronic widespread pain and identify bacterial species and metabolites that should be targeted for chronic sickle cell disease pain management.
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Affiliation(s)
- Katelyn E. Sadler
- Department of Neuroscience, The University of Texas at Dallas; Richardson, TX
- Center for Advanced Pain Studies, The University of Texas at Dallas; Richardson, TX
| | - Samantha N. Atkinson
- Center for Microbiome Research, Medical College of Wisconsin; Milwaukee, WI
- Department of Microbiology and Immunology, Medical College of Wisconsin; Milwaukee, WI
| | - Vanessa L. Ehlers
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin; Milwaukee, WI
| | - Tyler B. Waltz
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin; Milwaukee, WI
| | - Michael Hayward
- Center for Microbiome Research, Medical College of Wisconsin; Milwaukee, WI
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin; Milwaukee, WI
| | | | - Nita H. Salzman
- Center for Microbiome Research, Medical College of Wisconsin; Milwaukee, WI
- Department of Microbiology and Immunology, Medical College of Wisconsin; Milwaukee, WI
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin; Milwaukee, WI
| | - Cheryl L. Stucky
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin; Milwaukee, WI
| | - Amanda M. Brandow
- Department of Pediatrics, Section of Hematology/Oncology/Bone Marrow Transplantation, Medical College of Wisconsin; Milwaukee, WI
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5
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Sadler K, Atkinson SN, Ehlers VL, Waltz TB, Hayward M, Rodriguez-Garcia DM, Salzman NH, Stucky CL, Brandow AM. Gut Microbiota And Metabolites Drive Persistent Pain In Sickle Cell Disease. The Journal of Pain 2023. [DOI: 10.1016/j.jpain.2023.02.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
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6
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Zenga J, Atkinson S, Yen T, Massey B, Stadler M, Bruening J, Peppard W, Reuben M, Hayward M, Mesich B, Buchan B, Ledeboer N, Sanchez JL, Fraser R, Lin CW, Holtz ML, Awan M, Wong SJ, Puram SV, Salzman N. A phase 2 trial of a topical antiseptic bundle in head and neck cancer surgery: Effects on surgical site infection and the oral microbiome. EBioMedicine 2022; 81:104099. [PMID: 35671624 PMCID: PMC9168040 DOI: 10.1016/j.ebiom.2022.104099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 11/27/2022] Open
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7
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de Irujo Labalde XM, Whitnear JM, Booth SG, Zhu B, Hayward M. LiFe 2−x
In
x
SbO 6 oxides as Li ion cathode materials. Acta Crystallogr A Found Adv 2021. [DOI: 10.1107/s0108767321086189] [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: 11/10/2022] Open
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8
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Phyu EE, Than HP, Hayward M. 512 A CASE OF AN IDIOPATHIC ACQUIRED HEMOPHILIA A IN AN ELDERLY WOMAN. Age Ageing 2021. [DOI: 10.1093/ageing/afab119.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Acquired Hemophilia is a bleeding diathesis caused by autoantibodies that interfere with factor VIII (FVIII). Reasons for autoantibodies production are not clear but may be related to gene polymorphisms and/or CD4+ T lymphocytes. 1.3 to 1.5 cases per million population per year are reported in the UK. Half of the cases are secondary to malignancy, pregnancy related conditions, connective tissue disorders or drug reactions while the rest are idiopathic.
Case Report
We report a case of an acquired hemophilia A in an 86-year-old lady with underlying type 2 diabetes, hypertension, and cognitive impairment, being treated as the left lower limb cellulitis with antibiotics. She was found to have a sudden hemoglobin drop and her CT (Abdomen) confirmed a spontaneous intra-abdominal hematoma. Clotting profile showed prolonged APTT to 168.5 seconds, being not corrected at mixing study, with normal PT and INR. The FVIII assay was reduced to 18.4 iU/dL with FVIII inhibitor concentration of 0.7 Bu. Viral and autoimmune screenings were negative. The idiopathic acquired hemophilia A was diagnosed. Red blood cell transfusions, bypassing agents (FEIBA) and oral tranexamic acid were given for acute bleeding episode. Concomitantly, oral prednisolone was used to reduce the inhibitor levels. Repeated FVIII assay showed 121 iU/dL and 199iU/dL on day 6 and 12, respectively. Steroid was continued for the next 4 weeks and then gradually tapered. No further bleeding episode was noted.
Conclusion
The diagnosis of acquired hemophilia should be considered in any elderly patient with prolonged APTT. Mixing study is to measure the presence of inhibitors of coagulation or to detect coagulation factor deficiency. Quantitative coagulation factor assays and Bethesda Assays are performed for definitive diagnosis. Immunosuppressive regimens are the mainstay treatment. However, premorbid conditions and co-morbidities should be taken into consideration before initiating the aggressive immunosuppressive therapy in the elderly patients.
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Affiliation(s)
- E E Phyu
- Dept of Elderly Care, Medway Maritime Hospital
| | - H P Than
- Dept of Elderly Care, Basildon University Hospital
| | - M Hayward
- Dept of Elderly Care, Medway Maritime Hospital
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9
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Frietze KK, Brown AM, Das D, Franks RG, Cunningham JL, Hayward M, Nickels JT. Lipotoxicity reduces DDX58/Rig-1 expression and activity leading to impaired autophagy and cell death. Autophagy 2021; 18:142-160. [PMID: 33966599 DOI: 10.1080/15548627.2021.1920818] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease globally. NAFLD is a consequence of fat accumulation in the liver leading to lipotoxicity. Increasing evidence has demonstrated the critical role of autophagy in NAFLD. This study uncovers the unexpected role of immune surveillance protein DDX58/Rig-1 (DExD/H box helicase 58) in activating macroautophagy/autophagy and protecting from lipotoxicity associated with NAFLD. Here we show for the first time that DDX58 protein is significantly reduced in nonalcoholic steatohepatitis (NASH) mouse model, an aggressive form of NAFLD characterized by inflammation and fibrosis of the liver. In addition to decreased expression of DDX58, we found that DDX58 activity can be attenuated by treatments with palmitic acid (PA), a saturated fatty acid. To investigate whether PA inhibition of DDX58 is harmful to the cell, we characterized DDX58 function in hepatocytes when exposed to high doses of PA in the presence and/or absence of DDX58. We show that siRNA knockdown of DDX58 promotes apoptosis. Importantly, we show that stable overexpression of DDX58 is protective against toxic levels of PA and stimulates autophagy. This study begins to demonstrate the regulation of the autophagy receptor protein SQSTM1/p62 through DDX58. DDX58 expression directly influences SQSTM1 mRNA and protein levels. This work proposes a model in which activating DDX58 increases an autophagic response and this aids in clearing toxic lipid inclusion bodies, which leads to inflammation and apoptosis. Activating a DDX58-induced autophagy response may be a strategy for treating NAFLD.Abbreviations:5'pppdsRNA: 5' triphosphate double-stranded RNA; CDAHFD: choline-deficient, L-amino acid defined high-fat diet; CEBPB: CCAAT/enhancer binding protein (C/EBP), beta; CQ: chloroquine; DDX58/retinoic acid inducible gene 1/Rig-1: DExD/H box helicase 58; h: hours; IFIH1/MDA5: interferon induced with helicase C domain 1; IFNB/IFN-β: interferon beta 1, fibroblast; KO: knockout; MAVS: mitochondrial antiviral signaling protein; NAFLD: nonalcoholic fatty liver disease; NASH: nonalcoholic steatohepatitis; NFKB/NF-κB: nuclear factor of kappa light polypeptide gene enhancer in B cells; PA: palmitic acid; poly:IC: polyinosinic:polycytidylic acid; PRR: pattern recognition receptors; PSR: picrosirus red; RAP: rapamycin; RLR: RIG-I-like receptor; SQSTM1/p62: sequestosome 1; STING1: stimulator of interferon response cGAMP interactor 1; TBK1: TANK-binding kinase 1.
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Affiliation(s)
- Karla K Frietze
- Institute of Metabolic Disorders, Genesis Biotechnology Group, Hamilton, NJ, USA
| | - Alyssa M Brown
- Institute of Metabolic Disorders, Genesis Biotechnology Group, Hamilton, NJ, USA
| | - Dividutta Das
- Institute of Metabolic Disorders, Genesis Biotechnology Group, Hamilton, NJ, USA
| | - Raymond G Franks
- Institute of Metabolic Disorders, Genesis Biotechnology Group, Hamilton, NJ, USA
| | | | | | - Joseph T Nickels
- Institute of Metabolic Disorders, Genesis Biotechnology Group, Hamilton, NJ, USA.,Rutgers Center for Lipid Research, Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ, USA
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10
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Nickels J, Wayne J, Hayward M, Frietze K, Cunningham JL, Liu W, Brown A. Humanized Monoacylglycerol Acyltransferase 2 Mice Develop Non‐alcoholic Steatohepatitis and Fibrosis that Responds to Treatment with Elafibranor. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.05274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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11
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Berry C, Newcombe H, Strauss C, Rammou A, Schlier B, Lincoln T, Hayward M. Validation of the Hamilton Program for Schizophrenia Voices Questionnaire: Associations with emotional distress and wellbeing, and invariance across diagnosis and sex. Schizophr Res 2021; 228:336-343. [PMID: 33540145 DOI: 10.1016/j.schres.2020.12.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/02/2020] [Accepted: 12/31/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Voice-hearing is a transdiagnostic experience with evident negative effects on patients. Good quality measurement is needed to further elucidate the nature, impact and treatment of voice-hearing experiences across patient groups. The Hamilton Program for Schizophrenia Voices Questionnaire (HPSVQ) is a brief self-report measure which requires further psychometric evaluation. METHODS Using data from a transdiagnostic sample of 401 adult UK patients, the fit of a conceptual HPSVQ measurement model, proposing a separation between physical and emotional voice-hearing characteristics, was tested. A structural model was examined to test associations between voice-hearing, general emotional distress (depression, anxiety, stress) and wellbeing. The invariance of model parameters was examined across diagnosis and sex. RESULTS The final measurement model comprised two factors named 'voice severity' and 'voice-related distress'. The former comprised mainly physical voice characteristics and the latter mainly distress and other negative impacts. Structural model results supported voice-related distress as mediating the associations between voice severity and emotional distress and wellbeing. Model parameters were invariant across psychosis versus non-psychosis diagnosis and partially invariant across sex. Females experienced more severe and distressing voices and a more direct association between voice severity and general anxiety was evident. CONCLUSIONS The HPSVQ is a useful self-report measure of voice-hearing with some scope for further exploration and refinement. Voice-related distress appears a key mechanism by which voice severity predicts general distress and wellbeing. Whilst our data broadly support interventions targeting voice-related distress for all patients, females may benefit especially from interventions targeting voice severity and strategies for responding.
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Affiliation(s)
- C Berry
- Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Falmer, Brighton, BN1 9PH, United Kingdom of Great Britain and Northern Ireland; School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland.
| | - H Newcombe
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland
| | - C Strauss
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland; Research & Development, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital, Nevill Avenue, Hove, BN3 7HZ, United Kingdom of Great Britain and Northern Ireland
| | - A Rammou
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland
| | - B Schlier
- Klinische Psychologie und Psychotherapie, Institut für Psychologie, Fakultät für Psychologie und Bewegungswissenschaft, Universität Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany
| | - T Lincoln
- Klinische Psychologie und Psychotherapie, Institut für Psychologie, Fakultät für Psychologie und Bewegungswissenschaft, Universität Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany
| | - M Hayward
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland; Research & Development, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital, Nevill Avenue, Hove, BN3 7HZ, United Kingdom of Great Britain and Northern Ireland
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Dharmaprani D, Jenkins E, Quah J, Lahiri A, Tiver K, Mitchell L, Bradley C, Hayward M, Paterson D, Taggart P, Clayton R, Nash M, Ganesan A. A Governing Equation for Human Ventricular Fibrillation. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.121] [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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13
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Bajaj JS, Salzman N, Acharya C, Takei H, Kakiyama G, Fagan A, White MB, Gavis EA, Holtz ML, Hayward M, Nittono H, Hylemon PB, Cox IJ, Williams R, Taylor-Robinson SD, Sterling RK, Matherly SC, Fuchs M, Lee H, Puri P, Stravitz RT, Sanyal AJ, Ajayi L, Le Guennec A, Atkinson RA, Siddiqui MS, Luketic V, Pandak WM, Sikaroodi M, Gillevet PM. Microbial functional change is linked with clinical outcomes after capsular fecal transplant in cirrhosis. JCI Insight 2019; 4:133410. [PMID: 31751317 PMCID: PMC6975263 DOI: 10.1172/jci.insight.133410] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/13/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUNDHepatic encephalopathy (HE) is associated with poor outcomes. A prior randomized, pilot trial demonstrated safety after oral capsular fecal microbial transplant (FMT) in HE, with favorable changes in microbial composition and cognition. However, microbial functional changes are unclear. The aim of this study was to determine the effect of FMT on the gut-brain axis compared with placebo, using microbial function based on bile acids (BAs), inflammation (serum IL-6, LPS-binding protein [LBP]), and their association with EncephalApp.METHODSTwenty cirrhotic patients were randomized 1:1 into groups that received 1-time FMT capsules from a donor enriched in Lachnospiraceae and Ruminococcaceae or placebo capsules, with 5-month follow-up for safety outcomes. Stool microbiota and BA; serum IL-6, BA, and LBP; and EncephalApp were analyzed at baseline and 4 weeks after FMT/placebo. Correlation networks among microbiota, BAs, EncephalApp, IL-6, and LBP were performed before/after FMT.RESULTSFMT-assigned participants had 1 HE recurrence and 2 unrelated infections. Six placebo-assigned participants developed negative outcomes. FMT, but not placebo, was associated with reduced serum IL-6 and LBP and improved EncephalApp. FMT-assigned participants demonstrated higher deconjugation and secondary BA formation in feces and serum compared with baseline. No change was seen in placebo. Correlation networks showed greater complexity after FMT compared with baseline. Beneficial taxa, such as Ruminococcaceae, Verrucomicrobiaceae, and Lachnospiraceae, were correlated with cognitive improvement and decrease in inflammation after FMT. Fecal/serum secondary/primary ratios and PiCRUST secondary BA pathways did not increase in participants who developed poor outcomes.CONCLUSIONGut microbial function in cirrhosis is beneficially affected by capsular FMT, with improved inflammation and cognition. Lower secondary BAs in FMT recipients could select for participants who develop negative outcomes.TRIAL REGISTRATIONClinicaltrials.gov NCT03152188.FUNDINGNational Center for Advancing Translational Sciences NIH grant R21TR002024, VA Merit Review grant 2I0CX001076, the United Kingdom National Institute for Health Research Biomedical Facility at Imperial College London, the British Heart Foundation, Wellcome Trust, and King's College London.
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Affiliation(s)
- Jasmohan S. Bajaj
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Nita Salzman
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Chathur Acharya
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Hajime Takei
- Junshin Clinic Bile Acid Institute, Meguro-Ku, Tokyo, Japan
| | - Genta Kakiyama
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Andrew Fagan
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Melanie B. White
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Edith A. Gavis
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Mary L. Holtz
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Michael Hayward
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Phillip B. Hylemon
- Department of Microbiology and Immunology, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - I. Jane Cox
- Institute for Hepatology London, Foundation for Liver Research, London, United Kingdom
| | - Roger Williams
- Institute for Hepatology London, Foundation for Liver Research, London, United Kingdom
| | | | - Richard K. Sterling
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Scott C. Matherly
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Michael Fuchs
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Hannah Lee
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Puneet Puri
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - R. Todd Stravitz
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Arun J. Sanyal
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Lola Ajayi
- Institute for Hepatology London, Foundation for Liver Research, London, United Kingdom
| | - Adrien Le Guennec
- Randall Centre for Cell & Molecular Biophysics and Centre for Biomolecular Spectroscopy, King’s College London, London, United Kingdom
| | - R. Andrew Atkinson
- Randall Centre for Cell & Molecular Biophysics and Centre for Biomolecular Spectroscopy, King’s College London, London, United Kingdom
| | - Mohammad S. Siddiqui
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Velimir Luketic
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - William M. Pandak
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA
| | - Masoumeh Sikaroodi
- Microbiome Analysis Center, George Mason University, Manassas, Virginia, USA
| | - Patrick M. Gillevet
- Microbiome Analysis Center, George Mason University, Manassas, Virginia, USA
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Abstract
Objectives: Tissue diagnosis prior to thoracic surgery with curative intent is vital in thoracic lesions concerning for lung cancer. Methods of obtaining tissue diagnosis are variable within the United Kingdom.Methods: We performed a model-based analysis to identify the most efficient method of diagnosis using both a health care perspective. Our analysis concerns adults in the UK presenting with a solitary pulmonary nodule suspicious for a primary lung malignancy, patients with more advanced disease (for example lymph node spread) were not considered. Model assumptions were derived from published sources and expert reviews, cost data were obtained from healthcare research group cost estimates (2016-17). Outcomes were measured in terms of costs experienced to healthcare trusts.Results: Our results show that CT guided percutaneous lung biopsy using an ambulatory approach, is the most cost-effective method of diagnosis. Indeed, using this approach, trust experience approximately half of the cost of an approach of surgical lung biopsy performed at the time of potential resection ('frozen section').Limitations and conclusions: Whilst this analysis is limited to the specific scenario of a solitary pulmonary nodule, these findings have implications for the implementation of lung cancer screening in the UK, which is likely to result in increased numbers of patients with such early disease.
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Affiliation(s)
- J Barnett
- Department of Radiology, Royal Brompton Hospital, London, UK
| | | | - A N Tavare
- Department of Radiology, Royal Free NHS Foundation Trust, London, UK
| | - A Saini
- Department of Radiology, Royal Free NHS Foundation Trust, London, UK
| | - A Patel
- Department of Respiratory Medicine, Royal Free NHS Foundation Trust, London, UK
| | - M Hayward
- Department of Surgery, University College Hospital NHS Foundation Trust, London, UK
| | - S S Hare
- Department of Radiology, Royal Free NHS Foundation Trust, London, UK
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15
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Bajaj JS, Salzman NH, Acharya C, Sterling RK, White MB, Gavis EA, Fagan A, Hayward M, Holtz ML, Matherly S, Lee H, Osman M, Siddiqui MS, Fuchs M, Puri P, Sikaroodi M, Gillevet PM. Fecal Microbial Transplant Capsules Are Safe in Hepatic Encephalopathy: A Phase 1, Randomized, Placebo-Controlled Trial. Hepatology 2019; 70:1690-1703. [PMID: 31038755 PMCID: PMC6819208 DOI: 10.1002/hep.30690] [Citation(s) in RCA: 163] [Impact Index Per Article: 32.6] [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: 02/12/2019] [Accepted: 04/24/2019] [Indexed: 12/11/2022]
Abstract
Hepatic encephalopathy (HE) can cause major morbidity despite standard of care (SOC; rifaximin/lactulose). Fecal microbial transplant (FMT) enemas postantibiotics are safe, but the effect of FMT without antibiotics using the capsular route requires investigation. The aim of this work was to determine the safety, tolerability, and impact on mucosal/stool microbiota and brain function in HE after capsular FMT in a randomized, single-blind, placebo-controlled clinical trial in Virginia. Patients with cirrhosis with recurrent HE with MELD (Model for End-Stage Liver Disease) <17 on SOC were randomized 1:1 into receiving 15 FMT capsules versus placebo from a single donor enriched in Lachnospiraceae and Ruminococcaceae. Endoscopies with duodenal and sigmoid biopsies, stool analysis, cognition, serum lipopolysaccharide-binding protein (LBP), and duodenal antimicrobial peptide (AMP) expression at baseline were used. Clinical follow-up with SOC maintenance was performed until 5 months. FMT-assigned patients underwent repeat endoscopies 4 weeks postenrollment. Twenty subjects on lactulose/rifaximin were randomized 1:1. MELD score was similar at baseline (9.6 vs. 10.2) and study end (10.2 vs. 10.5). Six patients in the placebo group required hospitalizations compared to 1 in FMT, which was deemed unrelated to FMT. Infection/HE episodes were similar between groups. Baseline microbial diversity was similar in all tissues between groups. Post-FMT, duodenal mucosal diversity (P = 0.01) increased with higher Ruminococcaceae and Bifidobacteriaceae and lower Streptococcaceae and Veillonellaceae. Reduction in Veillonellaceae were noted post-FMT in sigmoid (P = 0.04) and stool (P = 0.05). Duodenal E-cadherin (P = 0.03) and defensin alpha 5 (P = 0.03) increased whereas interleukin-6 (P = 0.02) and serum LBP (P = 0.009) reduced post-FMT. EncephalApp performance improved post-FMT only (P = 0.02). Conclusion: In this phase 1 study, oral FMT capsules are safe and well tolerated in patients with cirrhosis and recurrent HE. FMT was associated with improved duodenal mucosal diversity, dysbiosis, and AMP expression, reduced LBP, and improved EncephalApp performance. Further studies are needed to prove efficacy.
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Affiliation(s)
- Jasmohan S Bajaj
- Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia
| | - Nita H Salzman
- Pediatrics and Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Chathur Acharya
- Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia
| | - Richard K Sterling
- Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia
| | - Melanie B White
- Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia
| | - Edith A Gavis
- Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia
| | - Andrew Fagan
- Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia
| | - Michael Hayward
- Pediatrics and Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Mary L. Holtz
- Pediatrics and Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Scott Matherly
- Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia
| | - Hannah Lee
- Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia
| | | | | | - Michael Fuchs
- Pediatrics and Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Puneet Puri
- Pediatrics and Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin
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16
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Choksi N, Hayward M, Kwon D, Marrazzo J, Mitchell C. Genetic variation of lactobacilllus crispatus strains isolated from a woman during and after bacterial vaginosis. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2018.10.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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17
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Geldart KG, Kommineni S, Forbes M, Hayward M, Dunny GM, Salzman NH, Kaznessis YN. Engineered E. coli Nissle 1917 for the reduction of vancomycin-resistant Enterococcus in the intestinal tract. Bioeng Transl Med 2018; 3:197-208. [PMID: 30377660 PMCID: PMC6195901 DOI: 10.1002/btm2.10107] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/22/2018] [Accepted: 07/09/2018] [Indexed: 12/22/2022] Open
Abstract
Vancomycin-resistant Enterococcus (VRE) poses a serious threat in hospitals where they densely colonize the intestinal tracts of patients. In vulnerable hosts, these pathogens may translocate to the bloodstream and become lethal. The ability to selectively reduce VRE in the intestinal tracts of patients could potentially prevent many of these translocation events and reduce the spread of the pathogen. Herein, we have engineered Escherichia. coli Nissle 1917 to produce and secrete three antimicrobial peptides, Enterocin A, Enterocin B, and Hiracin JM79, to specifically target and kill Enterococcus. These peptides exhibited potent activity against both Enterococcus faecium and Enterococcus faecalis, the two most prominent species responsible for VRE infections. We first discuss the optimization of the system used to express and secrete the peptides. We then show that by simultaneously expressing these peptides, both E. faecium and E. faecalis were drastically inhibited. We then demonstrate a suppression of the development of resistance when supernatant from the E. coli producer strains was used to treat E. faecium. Finally, we tested the efficacy of the probiotic in a VRE colonization model in mice. These studies showed that administration of the engineered probiotic significantly reduced the levels of both E. faecium and E. faecalis in the feces of male Balb/cJ mice.
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Affiliation(s)
- Kathryn G. Geldart
- General Probiotics Inc.St. PaulMN 55114
- Department of Microbiology and ImmunologyUniversity of MinnesotaMinneapolisMN 55455
| | | | | | - Michael Hayward
- Department of PediatricsMedical College of WisconsinMilwaukeeWI 53226
| | - Gary M. Dunny
- Department of Microbiology and ImmunologyUniversity of MinnesotaMinneapolisMN 55455
| | - Nita H. Salzman
- Department of PediatricsMedical College of WisconsinMilwaukeeWI 53226
- Department of Microbiology and ImmunologyMedical College of WisconsinMilwaukeeWI 53226
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18
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Grayson MH, Camarda LE, Hussain SRA, Zemple SJ, Hayward M, Lam V, Hunter DA, Santoro JL, Rohlfing M, Cheung DS, Salzman NH. Intestinal Microbiota Disruption Reduces Regulatory T Cells and Increases Respiratory Viral Infection Mortality Through Increased IFNγ Production. Front Immunol 2018; 9:1587. [PMID: 30042764 PMCID: PMC6048222 DOI: 10.3389/fimmu.2018.01587] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 06/26/2018] [Indexed: 12/20/2022] Open
Abstract
Alterations in gastrointestinal microbiota indirectly modulate the risk of atopic disease, but effects on respiratory viral infections are less clear. Using the murine paramyxoviral virus type 1, Sendai virus (SeV), we examined the effect of altering gastrointestinal microbiota on the pulmonary antiviral immune response. C57BL6 mice were treated with streptomycin before or during infection with SeV and resulting immune response studied. Ingestion of the non-absorbable antibiotic streptomycin led to a marked reduction in intestinal microbial diversity without a significant effect on lung microbiota. Reduction in diversity in the gastrointestinal tract was followed by greatly increased mortality to respiratory viral infection (p < 0.0001). This increase in mortality was associated with a dysregulated immune response characterized by decreased lung (p = 0.01) and intestinal (p = 0.03) regulatory T cells (Tregs), and increased lung IFNγ (p = 0.049), IL-6 (p = 0.015), and CCL2 (p = 0.037). Adoptive transfer of Treg cells or neutralization of IFNγ prevented increased mortality. Furthermore, Lin-CD4+ cells appeared to be a potential source of the increased IFNγ. Together, these results demonstrate gastrointestinal microbiota modulate immune responses at distant mucosal sites and have the ability to significantly impact mortality in response to a respiratory viral infection.
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Affiliation(s)
- Mitchell H Grayson
- Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee, WI, United States.,Division of Allergy and Immunology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, United States
| | - Lauren E Camarda
- Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee, WI, United States.,Division of Pulmonary and Sleep Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Syed-Rehan A Hussain
- Division of Allergy and Immunology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, United States
| | - Sarah J Zemple
- Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Michael Hayward
- Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Vy Lam
- Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Desiré A Hunter
- Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Jennifer L Santoro
- Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee, WI, United States.,Division of Allergy and Immunology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, United States
| | - Michelle Rohlfing
- Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee, WI, United States.,Division of Allergy and Immunology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, United States
| | - Dorothy S Cheung
- Division of Allergy and Clinical Immunology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Nita H Salzman
- Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
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Berman-Booty LD, Eraslan R, Hanumegowda U, Cantor GH, Bounous DI, Janovitz EB, Jones BK, Buiakova O, Hayward M, Wee S. Systemic Loss of C-terminal Src Kinase Expression Elicits Spontaneous Suppurative Inflammation in Conditional Knockout Mice. Vet Pathol 2018; 55:331-340. [DOI: 10.1177/0300985817747330] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
C-terminal Src kinase (Csk) is one of the critical negative regulators of the Src family of kinases. The Src family of kinases are nonreceptor tyrosine kinases that regulate inflammation, cell proliferation, motility, and adhesion. To investigate potential histologic lesions associated with systemic loss of Csk gene activity in adult mice, conditional Csk-knockout mice were examined. Cre-mediated systemic excision of Csk induced by tamoxifen treatment resulted in multiorgan inflammation. Specifically, induction of Csk gene excision with three days of tamoxifen treatment resulted in greater than 90% gene excision. Strikingly, these mice developed enteritis that ranged from minimal and suppurative to severe, fibrinonecrosuppurative and hemorrhagic. Other inflammatory lesions included suppurative pneumonia, gastritis, and myocarditis, and increased numbers of inflammatory cells within the hepatic parenchyma. When tamoxifen treatment was reduced from three days to one day in an effort to lower the level of Csk gene excision and limit lesion development, the mice developed severe suppurative to pyogranulomatous pneumonia and minimal to mild suppurative enteritis. Lesions observed secondary to Csk gene excision suggest important roles for Csk in downregulating the proinflammatory activity of the Src family of kinases and limiting neutrophil-mediated inflammation.
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Affiliation(s)
| | - Rukiye Eraslan
- Bristol-Myers Squibb, Princeton, NJ, USA
- Invivotek, Hamilton, NJ, USA
| | - Umesh Hanumegowda
- Bristol-Myers Squibb, Princeton, NJ, USA
- ViiV Healthcare, Wallingford, CT, USA
| | | | | | | | | | | | | | - Susan Wee
- Bristol-Myers Squibb, Princeton, NJ, USA
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20
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Mani A, Petko M, Mitsos S, Patrini D, Scarci M, Panagiotopoulos N, Lawrence D, Hayward M, George R. P-116DOES THE MODIFIED FRAILTY INDEX SCORE PREDICT OUTCOME IN PATIENTS UNDERGOING VIDEO-ASSISTED THORACIC SURGERY PLEURODESIS FOR MALIGNANT PLEURAL EFFUSION? Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.116] [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: 11/13/2022] Open
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21
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Mitsos S, Petko M, Patrini D, Hayward M, Scarci M, Lawrence D, Panagiotopoulos N. Is pneumonectomy a justified procedure in patients with persistent N2 nonsmall cell lung cancer disease following induction therapy. Indian J Cancer 2017; 54:73-81. [DOI: 10.4103/ijc.ijc_209_17] [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: 11/04/2022]
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22
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Champney F, Maddock L, Welford J, Kemp J, Allan V, Persidskikh Y, Orini M, Ang R, Workman A, Wong L, Honarbakhsh S, Leong K, Silberbauer J, O'Nunain S, Gomes J, McCready J, Bostock J, Shaw K, McKenna C, Bailey J, Honarbakhsh S, Casas J, Wallace J, Hunter R, Schilling R, Perel P, Morley K, Banerjee A, Hemingway H, Mrochak A, Ilyina T, Goncharik D, Chasnoits A, Plashinskaya L, Taggart P, Hayward M, Lambiase P, Hosford P, Kasparov S, Lambiase P, Tinker A, Gourine A, Kettlewell S, Dempster J, Colman M, Rankin A, Myles R, Smith G, Tester D, Jaye A, FitzPatrick D, Evans M, Fleming P, Jeffrey I, Cohen M, Simpson M, Ackerman M, Behr E, Srinivasan N, Kirkby C, Firman E, Tobin L, Murphy C, Lowe M, Hunter RJ, Finlay M, Schilling RJ, Lambiase PD, Ng F, Tomlinson L, Nuthoo S, Cajilog E, Lefroy D, Qureshi N, Koa-Wing M, Whinnett Z, Linton N, Davies D, Lim P, Peters N, Kanagaratnam P, Varnava A. ORAL ABSTRACTS (1)Allied Professionals7CRYOABLATION FOR PAROXYSMAL ATRIAL FIBRILLATION - IS AN EP LAB REQUIRED?8A PATHWAY TO SAFETY - ANTICOAGULATION COMPLIANCE IN CIED PATIENTS WITH AF9UNDERSTANDING THE WAYS IN WHICH OCCUPATION IS AFFECTED BY POSTURAL TACHYCARDIA SYNDROME: A UK OCCUPATIONAL THERAPY PERSPECTIVE10DEVELOPMENT OF AN INTERGRATED SUPPORT PATHWAY FOR PATIENTS FULFILLING NICE CRITERIA FOR AN INTERNAL CARDIOVASCULAR DEBRIBRILLATOR (ICD) IN A DISTRICT GENERAL HOSPITAL11ARE CARDIOVASCULAR RISK FACTORS ALSO ASSOCIATED WITH THE INCIDENCE OF ATRIAL FIBRILLATION? A SYSTEMATIC REVIEW AND FIELD SYNOPSIS OF 23 FACTORS IN 32 INITIALLY HEALTHY COHORTS OF 20 MILLION PARTICIPANTS12BRAIN MRI FINDINGS IN PATIENTS WITH ATRIAL FIBRILLATION UNDERGOING CARDIOVERSIONBasic Science/Sudden Cardiac Death13PRELIMINARY ASSESSMENT OF THE “RE-ENTRY VULNERABILITY INDEX” AS A MARKER OF CARDIAC INSTABILITY IN THE HUMAN HEART USING WHOLE-HEART CONTACT EPICARDIAL MAPPING14OPTOGENETIC STIMULATION OF BRAINSTEM'S VAGAL PREGANGLIONIC NEURONES IS ASSOCIATED WITH NEURONAL NITRIC OXIDE SYNTHASE-DEPENDENT PROLONGATION OF VENTRICULAR EFFECTIVE REFRACTORY PERIOD15A DYNAMIC-CLAMP STUDY OF L-TYPE Ca2+ CURRENT IN RABBIT AND HUMAN ATRIAL MYOCYTES: THE CONTRIBUTION OF WINDOW ICaL TO EARLY AFTERDEPOLARISATIONS16WHOLE EXOME SEQUENCING IN SUDDEN INFANT DEATH SYNDROME17MEDIUM TERM SURVIVAL AND FAMILY SCREENING OUTCOMES IN AN IDIOPATHIC VENTRICULAR FIBRILLATION COHORT - A MULTICENTRE EXPERIENCE18CLINICAL CHARACTERISTICS OF SCD SURVIVORS WITH BRUGADA SYNDROME:- ARE SPONSANEOUS TYPE I ECG AND PREVIOUS SYNCOPE REALLY ASSOCIATED WITH HIGH RISK? Europace 2016. [DOI: 10.1093/europace/euw270] [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: 11/14/2022] Open
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Mellor G, Orini M, Specterman M, Sawhney V, Merghani A, Claridge S, Laksman Z, Gerull B, Simpson C, Klein G, Champagne J, Talajic M, Gardner M, Steinberg C, Janzen M, Arbour L, Green M, Angaran P, Roberts J, Leather R, Sanatani S, Chauhan V, Healey J, Krahn A, Taggart P, Srinivasan N, Hayward M, Lambiase P, Aziz Q, Finlay M, Nobles M, Anderson N, Ng K, Schilling R, Tinker A, Breitenstein A, Ullah W, Honarbakhsh S, Dhinoja M, Schilling R, Providencia R, Babu G, Chow A, Lambiase P, Panikker S, Kontogeorgis A, Wong T, Hall M, Temple I, Bartoletti S, Kalla M, Cassar M, Rajappan K, Hunter R, Maestrini V, Rosmini S, Cox A, Yeo T, Dhutia H, Narain R, Malhotra A, Behr E, Tome M, Alfakih K, Moon J, Sharma S, Mennuni S, Jackson T, Behar J, Porter B, Sieniewicz B, Webb J, Bostock J, O'Neill M, Murgatroyd F, Carr-White G, Chiribiri A, Razavi R, Chen Z, Rinaldi C. YOUNG INVESTIGATORS COMPETITION1GENETIC ANALYSIS IN THE EVALUATION OF UNEXPLAINED CARDIAC ARREST: FROM THE CARDIAC ARREST SURVIVORS WITH PRESERVED EJECTION FRACTION REGISTRY (CASPER)2IN-VIVO WHOLE HEART CONTACT MAPPING DATA AND A SIMPLE MATHEMATICAL FRAMEWORK TO UNDERSTAND THE INTERACTIONS BETWEEN ACTIVATION AND REPOLARIZATION RESITUTION DYNAMICS IN THE INTACT HUMAN HEART3THE K(ATP) CHANNEL OPENER DIAZOXIDE REDUCES AUTOMATICITY IN AN IN VITRO ATRIAL CELL MODEL - POTENTIAL FOR K(ATP) CHANNELS AS A DRUG TARGET FOR ATRIAL ARRHYTHMIAS4LONG-TERM OUTCOMES AFTER CATHETER ABLATION OF VENTRICULAR TACHYCARDIA IN PATIENTS WITH STRUCTURAL HEART DISEASE: A MULTICENTRE UK STUDY5THE BURDEN OF ARRHYTHMIAS IN LIFE-LONG ENDURANCE ATHLETES6CARDIAC MAGNETIC RESONANCE IMAGING RISK STRATIFICATION USING MARKERS OF REGIONAL AND DIFFUSE FIBROSIS FOR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR THERAPY: THE VALUE OF T1 MAPPING IN NON-ISCHEMIC PATIENTS. Europace 2016. [DOI: 10.1093/europace/euw275] [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: 11/12/2022] Open
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24
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Liu TC, Gurram B, Baldridge MT, Head R, Lam V, Luo C, Cao Y, Simpson P, Hayward M, Holtz ML, Bousounis P, Noe J, Lerner D, Cabrera J, Biank V, Stephens M, Huttenhower C, McGovern DP, Xavier RJ, Stappenbeck TS, Salzman NH. Paneth cell defects in Crohn's disease patients promote dysbiosis. JCI Insight 2016; 1:e86907. [PMID: 27699268 DOI: 10.1172/jci.insight.86907] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Paneth cell dysfunction has been implicated in a subset of Crohn's disease (CD) patients. We previously stratified clinical outcomes of CD patients by using Paneth cell phenotypes, which we defined by the intracellular distribution of antimicrobial proteins. Animal studies suggest that Paneth cells shape the intestinal microbiome. However, it is unclear whether Paneth cell phenotypes alter the microbiome complexity in CD subjects. Therefore, we analyzed the correlation of Paneth cell phenotypes with mucosal microbiome composition and ileal RNA expression in pediatric CD and noninflammatory bowel disease (non-IBD) patients. METHODS Pediatric CD (n = 44) and non-IBD (n = 62) patients aged 4 to 18 were recruited prior to routine endoscopic biopsy. Ileal mucosal samples were analyzed for Paneth cell phenotypes, mucosal microbiome composition, and RNA transcriptome. RESULTS The prevalence of abnormal Paneth cells was higher in pediatric versus adult CD cohorts. For pediatric CD patients, those with abnormal Paneth cells showed significant changes in their ileal mucosal microbiome, highlighted by reduced protective microbes and enriched proinflammatory microbes. Ileal transcriptome profiles showed reduced transcripts for genes that control oxidative phosphorylation in CD patients with abnormal Paneth cells. These transcriptional changes in turn were correlated with specific microbiome alterations. In non-IBD patients, a subset contained abnormal Paneth cells. However, this subset was not associated with alterations in the microbiome or host transcriptome. CONCLUSION Paneth cell abnormalities in human subjects are associated with mucosal dysbiosis in the context of CD, and these changes are associated with alterations in oxidative phosphorylation, potentially in a feedback loop. FUNDING The research was funded by Helmsley Charitable Trust (to T.S. Stappenbeck, R.J. Xavier, and D.P.B. McGovern), Crohn's and Colitis Foundation of America (to N.H. Salzman, T.S. Stappenbeck, R.J. Xavier, and C. Huttenhower), and Doris Duke Charitable Foundation grant 2014103 (to T.C. Liu).
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Affiliation(s)
- Ta-Chiang Liu
- Department of Pathology and Immunology, Washington University, Saint Louis, Missouri, USA
| | - Bhaskar Gurram
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Megan T Baldridge
- Department of Pathology and Immunology, Washington University, Saint Louis, Missouri, USA
| | - Richard Head
- Genome Technology Access Center, Washington University, Saint Louis, Missouri, USA
| | - Vy Lam
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Chengwei Luo
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Yumei Cao
- Department of Pediatrics, Division of Quantitative Health Services, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Pippa Simpson
- Department of Pediatrics, Division of Quantitative Health Services, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Michael Hayward
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Mary L Holtz
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Pavlos Bousounis
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Joshua Noe
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Diana Lerner
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jose Cabrera
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Vincent Biank
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Michael Stephens
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Curtis Huttenhower
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Dermot Pb McGovern
- The F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Ramnik J Xavier
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.,Gastrointestinal Unit and Center for the Study of Inflammatory Bowel Disease, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Thaddeus S Stappenbeck
- Department of Pathology and Immunology, Washington University, Saint Louis, Missouri, USA
| | - Nita H Salzman
- Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Chakraborty R, Kommineni S, Hayward M, Nelson T, Kristich CJ, Salzman NH. Role of the innate immune system in systemic enterococcus dissemination and clearance. The Journal of Immunology 2016. [DOI: 10.4049/jimmunol.196.supp.65.28] [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: 01/05/2023]
Abstract
Abstract
Enterococci are gram-positive commensals of the mammalian intestinal tract and intrinsically resistant to broad-spectrum cephalosporin antibiotics. They proliferate in the gut and disseminate systemically causing infections in immunocompromised individuals and hospitalized patients undergoing cephalosporin therapy. Using a unique mouse model with stable intestinal colonization with a lab strain of Enterococcus faecalis (EF), we investigated the role of the immune system in EF dissemination and clearance from mice treated with cephalosporins. Ceftriaxone mediated depletion of indigenous microbiota was associated with expansion of EF throughout the gut, reduced levels of gut mucosal barrier components and eventually EF dissemination to peripheral organs. We observed that EF was not associated with the FACS sorted populations of lamina propria mononuclear phagocytes suggesting that these immune cells did not actively translocate EF across the intestinal mucosa. Mice cleared EF systemically by 2 weeks post-antibiotic treatment without evidence of adaptive immune response. Studies in Rag1−/− mice suggested that adaptive immune system was not essential in EF clearance or containment. Our observations support that intestinal containment and systemic clearance of EF are mediated by innate immune mechanisms. We predict that this reflects general mechanisms for host containment and management of the intestinal commensal microbiota.
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Panagiotopoulos N, Patrini D, Cabanyes SD, Hayward M, Lawrence D. 103P: Lobectomy for non-small cell lung cancer in octogenarians: A 7-year single center experience. J Thorac Oncol 2016. [DOI: 10.1016/s1556-0864(16)30216-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Grilley-Olsen J, Keith KC, Hayward M, Dees EC, Deal A, Ivanova A, Benbow JM, Parker J, Patel NM, Eberhard D, Mieczkowski P, Weck KE, Hayes DN, Muss H, Jolly T, Reeder-Hayes K, Earp HS, Sharpless N, Carey L, Anders CK. Abstract PD6-07: Genomic sequencing in metastatic breast cancer patients to inform clinical practice at the University of North Carolina at Chapel Hill. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-pd6-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: An increasing number of molecularly-targeted therapies for metastatic breast cancer (MBC) are clinically-available (approved and investigational). These anti-cancer agents target specific molecular abnormalities such as mutated, amplified, deleted, or rearranged genes. Reporting of unique tumor genetic alterations is not included in routine clinical/diagnostic panels. In MBC, knowledge of mutational status may foster efficient transitions in clinical care and trial enrollment at disease progression. We describe the development and implementation of a clinically-integrated genomic sequencing program and report how information regarding targetable genomic aberrations in MBC patients (pts) is used to improve clinical practice in an academic setting.
Methods: Genomic sequencing of investigative biomarkers was prospectively offered to pts with MBC. DNA libraries were prepared separately from a retrieved archival FFPE tumor sample and a matched normal sample from each pt. Relevant targets were enriched by custom Agilent SureSelect hybrid capture baits using standard protocols. Samples were sequenced on Illumina HiSeq 2000/2500 platforms. Mutational findings were reviewed by a molecular tumor board (MTB); variants identified to be potentially actionable underwent confirmatory testing in a CLIA-approved laboratory. Confirmed findings were inserted into the pt's EMR accessible by both the pt and the treating oncologist.
Results: Of the 725 MBC pts seen at UNC since 1/1/2012, 194 (27%) contributed samples for genomic sequencing. Of those whose tumors were sequenced, average age at MBC diagnosis was 54 (25 - 91); 73% were Caucasian, 16% African American. De novo MBC accounted for 39 (20%) sequenced pts. Of sequenced patients, sites of metastatic disease included bone only (7%), visceral only (46%), and both bone and visceral (47%). Approximately 1/3 of pts were consented for sequencing at time of initial MBC diagnosis, 1/4 after 1st line therapy for MBC, and the remaining at or beyond their 2nd line. In total, 131 (68%) pts have sequencing results available of which 43% of pts had reportable mutations deemed actionable by the MTB. Specific mutations and observed frequency by subtype are shown below. Pts (19%) whose tumors were sequenced were more commonly enrolled in a therapeutic clinical trial for MBC, a higher rate than seen in the non-sequenced group (7%) (p<0.001). To date, 27% of pts' tumors harbored an alteration that is an eligibility requirement for a molecularly-targeted therapeutic trial accruing pts at UNC.
Observed Mutation by Clinical Subype Genes Total # (56 pts)HR+/HER2- (25 pts)HER2+ (13 pts)TNBC (18pts)PIK3CA15933TP5315456CCND19531NF-14103FGFR13300PTEN3012KRAS2011MDM22110PIK3R12002ROS12011TSC12011Other*14518TOTAL73281728*Mutations observed only once
Conclusion: Preemptive genomic sequencing can be integrated into the clinical and operational practice of a comprehensive cancer center. Currently this research tool and program provides valuable information that has the potential to foster both clinical trial eligibility and/or enrollment. With longer follow-up, we hope such an approach ultimately will improve patient outcomes.
Citation Format: Grilley-Olsen J, Keith KC, Hayward M, Dees EC, Deal A, Ivanova A, Benbow JM, Parker J, Patel NM, Eberhard D, Mieczkowski P, Weck KE, Hayes DN, Muss H, Jolly T, Reeder-Hayes K, Earp HS, Sharpless N, Carey L, Anders CK. Genomic sequencing in metastatic breast cancer patients to inform clinical practice at the University of North Carolina at Chapel Hill. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr PD6-07.
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Affiliation(s)
- J Grilley-Olsen
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - KC Keith
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - M Hayward
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - EC Dees
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - A Deal
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - A Ivanova
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - JM Benbow
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - J Parker
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - NM Patel
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - D Eberhard
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - P Mieczkowski
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - KE Weck
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - DN Hayes
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - H Muss
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - T Jolly
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - K Reeder-Hayes
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - HS Earp
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - N Sharpless
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - L Carey
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - CK Anders
- University of North Carolina at Chapel Hill, Chapel Hill, NC
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Le Page PA, Furtado R, Hayward M, Law S, Tan A, Vivian SJ, Van der Wall H, Falk GL. Durability of giant hiatus hernia repair in 455 patients over 20 years. Ann R Coll Surg Engl 2015; 97:188-93. [PMID: 26263802 DOI: 10.1308/003588414x14055925060839] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The surgical management of symptomatic giant hiatus hernia (GHH) aims to improve quality of life (QoL) and reduce the risk of life threatening complications. Previous reports are predominantly those with small sample sizes and short follow-up periods. The present study sought to assess a large cohort of patients for recurrence and QoL over a longer time period. METHODS This was a follow-up study of a prospectively collected database of 455 consecutive patients. Primary repair of GHH was evaluated by endoscopy/barium meal for recurrence and a standardised symptom questionnaire for QoL. Recurrence was assessed for size, elapsed time, oesophagitis and symptoms. RESULTS Objective and subjective review was achieved in 91.9% and 68.6% of patients. The median age was 69 years (range: 15-93 years) and 64% were female. Laparoscopic repair was completed in 95% (mesh in 6% and Collis gastroplasty in 7%). The 30-day mortality rate was 0.9%. The proportion of patients alive at five and ten years were 90% and 75% respectively. Postoperative QoL scores improved from a mean of 95 to 111 (p<0.01) and were stable over time (112 at 10 years). The overall recurrence rate was 35.6% (149/418) at 42 months; this was 11.5% (48/418) for hernias >2cm and 24.2% (101/418) for <2cm. The rate of new recurrence at 0-1 years was 13.7% (>2cm = 3.4%, <2cm = 10.3%), at 1-5 years it was 30.8% (>2cm = 9.5%, <2cm = 21.3%), at 5-10 years it was 40.1% (>2cm = 13.8%, <2cm = 26.3%) and at over 10 years it was 50.0% (>2cm = 25.0%, <2cm = 25.0%). Recurrence was associated with oesophagitis but not decreased QoL. Revision surgery was required in 4.8% of cases (14.8% with recurrence). There were no interval major GHH complications. CONCLUSIONS Surgery has provided sustained QoL improvements irrespective of recurrence. Recurrence occurred progressively over ten years and may predispose to oesophagitis.
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Affiliation(s)
- P A Le Page
- 1 Concord Repatriation General Hospital, NSW , Australia
| | - R Furtado
- 1 Concord Repatriation General Hospital, NSW , Australia
| | - M Hayward
- 2 University of Sydney, NSW , Australia
| | - S Law
- 2 University of Sydney, NSW , Australia
| | - A Tan
- 2 University of Sydney, NSW , Australia
| | - S J Vivian
- 3 Sydney Heartburn Clinic, Lindfield, NSW , Australia
| | | | - G L Falk
- 1 Concord Repatriation General Hospital, NSW , Australia.,2 University of Sydney, NSW , Australia.,3 Sydney Heartburn Clinic, Lindfield, NSW , Australia
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Cunningham S, Hall A, Jackson A, Jarrett-Smith L, Rees P, Brennan C, Saeed Y, Ng F, Kirkwood G, Orini M, Lambiase P, Srinivasan N, Walker N, Wright G, Goodwin J, Reilly J, Connelly D, Mudd P, Wilson C, Rice A, Iglesias A, Taggart S, James S, Thornley A, Turley A, Linker N, Rashid-Fadel T, Bond R, Rosengarten J, Thomas G, Butcher C, Lysitsas D, Wong T, Markides V, Jones D, Hussain W, Gilmore M, Barry J, Srinivasan N, Patel K, Lowe M, Segal O, Temple I, Borbas Z, Atkinson A, Yanni J, Yanni J, Boyett M, Garratt C, Dobrzynski H, Roney C, Debney M, Eichhorn C, Nachiappan A, Qureshi N, Chowdhury R, Kanagaratnam P, Lyon A, Peters N, Lawless M, Pearman C, Radcliffe E, Caldwell J, Trafford A, Taggart P, Hanson B, Hayward M, Lambiase PD, Yanni J, Orini M, Hanson B, Hayward M, Smith A, Zhang H, Dobrzynski H, Boyett M, Taggart P, Orini M, Simon R, Providencia R, Babu G, Vyas S, Khan F, Chow T, Segal O, Lowe M, Lambiase P. Allied Professionals. Europace 2015; 17:v3-v5. [PMCID: PMC4892104 DOI: 10.1093/europace/euv325] [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: 10/20/2023] Open
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30
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Rees PSC, Babu GG, Boston-Griffiths EA, Bognolo G, Hayward M, Kolvekar S, Lawrence D, Yap J, Hausenloy DJ, Yellon DM. 014 Atorvastatin protects human myocardium from lethal ischaemia-reperfusion injury by activating the risk pathway. Heart 2015. [DOI: 10.1136/hrt.2010.195941.14] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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31
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Mangini L, Dong Y, Hayward M, Forman M. Household Food Insecurity and Asthma in the 3rd Grade of the Early Childhood Longitudinal Study‐Kindergarten Cohort. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.261.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L Mangini
- Nutritional SciencesThe University of Texas at AustinUnited States
| | - Y Dong
- Nutritional SciencesThe University of Texas at AustinUnited States
| | - M Hayward
- Population Research Center The University of Texas at AustinUnited States
| | - M Forman
- Nutritional SciencesThe University of Texas at AustinUnited States
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Succony L, Gowers K, Hynds R, Hayward M, Lawrence D, Giangreco A, Janes S. S111 Methods To Isolate Basal Cells From The Respiratory Epithelium. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hayward M. Animal law in Australasia, 2nd edition by P Sankoff, S White and C Black. The Federation Press, Australia, 2013. 416 pages. Price: A$84.95. ISBN 9781862879300. Aust Vet J 2014. [DOI: 10.1111/avj.12201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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34
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Candilio L, Malik A, Ariti C, Barnard M, Wright S, Smith A, Giannaris S, Ashley E, Martin B, Hamilton-Davies C, Cordery R, Hurley R, Bertoja E, Burt C, Di Salvo C, Lawrence D, Hayward M, Yap J, Roberts N, McGregor C, Sheikh A, Kolvekar S, Hausenloy DJ, Yellon DM. 123 THE EFFECTS OF MULTI-LIMB REMOTE ISCHAEMIC PRECONDITIONING IN PATIENTS UNDERGOING CARDIAC BYPASS SURGERY. Heart 2013. [DOI: 10.1136/heartjnl-2013-304019.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Spillane J, Hayward M, Hirsch NP, Taylor C, Kullmann DM, Howard RS. Thymectomy: role in the treatment of myasthenia gravis. J Neurol 2013; 260:1798-801. [PMID: 23508539 DOI: 10.1007/s00415-013-6880-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 02/14/2013] [Accepted: 02/16/2013] [Indexed: 11/26/2022]
Abstract
Thymectomy is a frequently used treatment for myasthenia gravis (MG) and is virtually always indicated in MG patients who have a thymoma. However, the evidence for thymectomy in non-thymomatous MG remains less certain-no randomised controlled trials have been published to date, although one is currently underway. We reviewed the management and clinical outcome of patients with MG who underwent thymectomy over a 12 year period. Eighty-nine patients who underwent transsternal thymectomy were identified. A thymoma was identified on histology in 24 %, whereas 48, 9 and 19 % had hyperplastic, atrophic and normal thymic histology, respectively. One patient developed post operative myasthenic crisis but generally the procedure was well tolerated. Outcome was favourable for the majority of patients, with 34 % achieving complete stable remission (CSR) and an additional 33 % achieving pharmacological remission. Moreover, steroid requirements fell progressively during follow-up. Patients with a hyperplastic gland had a significantly greater chance of achieving CSR compared to other histological subtypes and the incidence of CSR increased with a longer duration of follow-up. Thymectomy for MG is generally safe and well tolerated and is associated with a sustained improvement of symptoms in the majority of patients.
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Affiliation(s)
- J Spillane
- UCL, Institute of Neurology, Queen Square, London, WC1N3BG, UK.
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Hodges LA, Connolly SM, Winter J, Schmidt T, Stevens HNE, Hayward M, Wilson CG. Modulation of gastric pH by a buffered soluble effervescent formulation: A possible means of improving gastric tolerability of alendronate. Int J Pharm 2012; 432:57-62. [PMID: 22564778 DOI: 10.1016/j.ijpharm.2012.04.073] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 04/25/2012] [Accepted: 04/26/2012] [Indexed: 11/27/2022]
Abstract
Gastrointestinal side-effects of alendronate (ALN) are believed to be associated with oesophageal lodging of tablets and perhaps reflux of gastric contents with alendronate under strongly acidic pH conditions. This leads to unfavourable posture restrictions when dosing. This clinical study evaluated gastric emptying and gastric pH after administration of Fosamax(®) tablets and a novel effervescent ALN formulation with a high buffering capacity. This novel formulation, EX101, was developed to potentially improve gastric tolerance. Gastric pH was monitored by nasogastric probes. Gastric emptying was determined simultaneously by scintigraphic imaging of (99m)Tc-DTPA labelled formulations. Both formulations tested rapidly cleared the oesophagus and there were no statistically significant or physiologically relevant differences in gastric emptying times. Mean pH at time to 50% gastric emptying of the radiolabel was significantly higher in EX101-treated subjects compared to those treated with Fosamax(®). At time to 90% gastric emptying of the radiolabel, mean pH values were comparable. Mucosal exposure to ALN at pH less than 3 is irritating to gastro-oesophageal tissue. Ingestion of Fosamax(®) resulted in ALN being present in the stomach at a pH below 3 within minutes. EX101 minimised the possibility of exposing the oesophagus (in case of reflux) to acidified ALN.
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Affiliation(s)
- L A Hodges
- Bio-Images Research Ltd., Within Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK.
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Diaz A, Di Salvo C, Lawrence D, Hayward M. Left atrial and right ventricular myxoma: an uncommon presentation of a rare tumour. Interact Cardiovasc Thorac Surg 2011; 12:622-3. [DOI: 10.1510/icvts.2010.255661] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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38
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Naqvi J, Navani N, Saeed S, Shastry M, Groves A, Shaw P, Lawrence D, Kolvekar S, Hayward M, Janes S. P222 A retrospective study of disease recurrence post thoracotomy for non-small cell lung cancer. Thorax 2010. [DOI: 10.1136/thx.2010.151068.23] [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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41
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Berry C, Gerry L, Hayward M, Chandler R. Expectations and illusions: a position paper on the relationship between mental health practitioners and social exclusion. J Psychiatr Ment Health Nurs 2010; 17:411-21. [PMID: 20584238 DOI: 10.1111/j.1365-2850.2009.01538.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Over the last 10 years, the social inclusion agenda has been gaining momentum as a policy driver in mental health services. Prior to the seminal Social Exclusion Unit (SEU) report, Mental Health and Social Exclusion, there was a lack of awareness concerning the pervasive links between social exclusion and mental health problems. In the report, the SEU suggested that mental health practitioners themselves may actually be contributing to this social exclusion. This finding has been given limited coverage in both social inclusion literature and research. The current paper is a positioned commentary further exploring the relationship between practitioners and the social exclusion of mental health service users. A literature review was conducted in order to identify themes among factors which appear to moderate and contribute to this relationship. These factors are presented and implications for inclusive practice are explored.
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Affiliation(s)
- C Berry
- Sussex Partnership NHS Foundation Trust, Worthing, West Sussex, UK.
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42
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Ang M, Zhao N, Hayward M, Patel M, Yin X, Wilkerson MD, Funkhouser WK, Fritchie K, Olshan A, Hayes DN. Expression and prognostic significance of X-ray crosscomplementation group 1 (XRCC1) in head and neck squamous cell carcinoma patients undergoing concurrent chemoradiation. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5541] [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] Open
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43
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Salzman NH, Hung K, Haribhai D, Chu H, Karlsson-Sjöberg J, Amir E, Teggatz P, Barman M, Hayward M, Eastwood D, Stoel M, Zhou Y, Sodergren E, Weinstock GM, Bevins CL, Williams CB, Bos NA. Enteric defensins are essential regulators of intestinal microbial ecology. Nat Immunol 2009; 11:76-83. [PMID: 19855381 PMCID: PMC2795796 DOI: 10.1038/ni.1825] [Citation(s) in RCA: 859] [Impact Index Per Article: 57.3] [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: 08/24/2009] [Accepted: 10/16/2009] [Indexed: 12/12/2022]
Abstract
Antimicrobial peptides are important effectors of innate immunity throughout the plant and animal kingdoms. In the mammalian small intestine, Paneth cell alpha-defensins are antimicrobial peptides that contribute to host defense against enteric pathogens. To determine if alpha-defensins also govern intestinal microbial ecology, we analyzed the intestinal microbiota of mice expressing a human alpha-defensin gene (DEFA5) and in mice lacking an enzyme required for the processing of mouse alpha-defensins. In these complementary models, we detected significant alpha-defensin-dependent changes in microbiota composition, but not in total bacterial numbers. Furthermore, DEFA5-expressing mice had striking losses of segmented filamentous bacteria and fewer interleukin 17 (IL-17)-producing lamina propria T cells. Our data ascribe a new homeostatic role to alpha-defensins in regulating the makeup of the commensal microbiota.
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Affiliation(s)
- Nita H Salzman
- Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
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Carter KN, Cronin M, Blakely T, Hayward M, Richardson K. Cohort Profile: Survey of Families, Income and Employment (SoFIE) and Health Extension (SoFIE-health). Int J Epidemiol 2009; 39:653-9. [PMID: 19478042 DOI: 10.1093/ije/dyp215] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kristie N Carter
- Health Inequalities Research Program, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.
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45
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ten Tusscher KHWJ, Mourad A, Nash MP, Clayton RH, Bradley CP, Paterson DJ, Hren R, Hayward M, Panfilov AV, Taggart P. Organization of ventricular fibrillation in the human heart: experiments and models. Exp Physiol 2009; 94:553-62. [PMID: 19168541 DOI: 10.1113/expphysiol.2008.044065] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sudden cardiac death is a major health problem in the industrialized world. The lethal event is typically ventricular fibrillation (VF), during which the co-ordinated regular contraction of the heart is overthrown by a state of mechanical and electrical anarchy. Understanding the excitation patterns that sustain VF is important in order to identify potential therapeutic targets. In this paper, we studied the organization of human VF by combining clinical recordings of electrical excitation patterns on the epicardial surface during in vivo human VF with simulations of VF in an anatomically and electrophysiologically detailed computational model of the human ventricles. We find both in the computational studies and in the clinical recordings that epicardial surface excitation patterns during VF contain around six rotors. Based on results from the simulated three-dimensional excitation patterns during VF, which show that the total number of electrical sources is 1.4 +/- 0.12 times greater than the number of epicardial rotors, we estimate that the total number of sources present during clinically recorded VF is 9.0 +/- 2.6. This number is approximately fivefold fewer compared with that observed during VF in dog and pig hearts, which are of comparable size to human hearts. We explain this difference by considering differences in action potential duration dynamics across these species. The simpler spatial organization of human VF has important implications for treatment and prevention of this dangerous arrhythmia. Moreover, our findings underline the need for integrated research, in which human-based clinical and computational studies complement animal research.
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Affiliation(s)
- K H W J ten Tusscher
- Department of Scientific Computing, Simula Research Laboratory, Lysaker, Norway.
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Grilley-Olson JE, Hayes DN, Miller RD, Socinski MA, Stinchcombe TE, Hayward M, Qaqish BF, Moore DT, Funkhouser WK. Inter-observer reliability for the diagnosis of lung cancer in a clinical cohort using the WHO classification system, version. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.22020] [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: 11/20/2022] Open
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Hayes DN, Lee CB, Hayward M, Socinski MA, Stinchcombe TE, Roberts P, Thorne L, Bernard PS, Yin X, Parsons A, Funkhouser WK. Molecular markers distinguish patients at differential risk of brain metastases in lung cancer by immunohistochemistry. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8083] [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] Open
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Abstract
Alkaptonuria (endogenous ochronosis) is a rare metabolic disorder caused by a deficiency of homogentisic acid oxidase, an enzyme responsible for the metabolic degradation of tyrosine. Patients with alkaptonuria commonly present with joint pain owing to degenerative arthritis. Other affected patients may present with pigmentation of the ear cartilage and sclera. This article reports a case of aortic stenosis associated with ochronosis in a 48-year-old man who presented with severe cardiac failure. He had no previous diagnosis of alkaptonuria, which was confirmed by mass spectrometry analysis of urine. The pathogenesis of cardiovascular ochronosis is unclear, but is probably related to the extensive extracellular deposits of ochronotic pigment in the cardiac tissue.
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Affiliation(s)
- L V Ffolkes
- Department of Histopathology, University College London Hospitals NHS Trust, London, UK
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Merkin SS, Karlarnangla A, Crimmins E, Hayward M, Seeman T. Education Differentials by Race in the Diagnosis. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s1-b] [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: 11/12/2022] Open
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