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Kasap C, Izgutdina A, Patiño-Escobar B, Kang A, Chilakapati N, Akagi N, Johnson H, Rashid T, Werner J, Barpanda A, Geng H, Lin YHT, Rampersaud S, Gil-Alós D, Sobh A, Dupéré-Richer D, Wicaksono G, Kawehi Kelii K, Dalal R, Ramos E, Vijayanarayanan A, Salangsang F, Phojanakong P, Serrano JAC, Zakraoui O, Tariq I, Steri V, Shanmugam M, Boise LH, Kortemme T, Stieglitz E, Licht JD, Karlon WJ, Barwick BG, Wiita AP. Targeting high-risk multiple myeloma genotypes with optimized anti-CD70 CAR-T cells. bioRxiv 2024:2024.02.24.581875. [PMID: 38463958 PMCID: PMC10925123 DOI: 10.1101/2024.02.24.581875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Despite the success of BCMA-targeting CAR-Ts in multiple myeloma, patients with high-risk cytogenetic features still relapse most quickly and are in urgent need of additional therapeutic options. Here, we identify CD70, widely recognized as a favorable immunotherapy target in other cancers, as a specifically upregulated cell surface antigen in high risk myeloma tumors. We use a structure-guided design to define a CD27-based anti-CD70 CAR-T design that outperforms all tested scFv-based CARs, leading to >80-fold improved CAR-T expansion in vivo. Epigenetic analysis via machine learning predicts key transcription factors and transcriptional networks driving CD70 upregulation in high risk myeloma. Dual-targeting CAR-Ts against either CD70 or BCMA demonstrate a potential strategy to avoid antigen escape-mediated resistance. Together, these findings support the promise of targeting CD70 with optimized CAR-Ts in myeloma as well as future clinical translation of this approach.
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Affiliation(s)
- Corynn Kasap
- Dept. of Medicine, Division of Hematology/Oncology, University of California, San Francisco, CA
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Adila Izgutdina
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | | | - Amrik Kang
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
- Medical Scientist Training Program, University of California, San Francisco, CA
| | - Nikhil Chilakapati
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Naomi Akagi
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Haley Johnson
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Tasfia Rashid
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Juwita Werner
- Dept. of Pediatrics, Division of Oncology, University of California, San Francisco, CA
| | - Abhilash Barpanda
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Huimin Geng
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Yu-Hsiu T. Lin
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Sham Rampersaud
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Daniel Gil-Alós
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
- Dept of Hematology, Hospital 12 de Octubre, Madrid, Spain
| | - Amin Sobh
- University of Florida Health Cancer Center, The University of Florida Cancer and Genetics Research Complex, Gainesville, Florida
- Division of Hematology/Oncology, The University of Florida College of Medicine, Gainesville, Florida
| | - Daphné Dupéré-Richer
- University of Florida Health Cancer Center, The University of Florida Cancer and Genetics Research Complex, Gainesville, Florida
- Division of Hematology/Oncology, The University of Florida College of Medicine, Gainesville, Florida
| | - Gianina Wicaksono
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - K.M. Kawehi Kelii
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Radhika Dalal
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA
| | - Emilio Ramos
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | | | - Fernando Salangsang
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Paul Phojanakong
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | | | - Ons Zakraoui
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Isa Tariq
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Veronica Steri
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Mala Shanmugam
- Department of Hematology and Medical Oncology, Winship Cancer Institute, School of Medicine, Emory University, Atlanta, GA
| | - Lawrence H. Boise
- Department of Hematology and Medical Oncology, Winship Cancer Institute, School of Medicine, Emory University, Atlanta, GA
| | - Tanja Kortemme
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA
- Chan Zuckerberg Biohub San Francisco, San Francisco, CA
| | - Elliot Stieglitz
- Dept. of Pediatrics, Division of Oncology, University of California, San Francisco, CA
| | - Jonathan D. Licht
- University of Florida Health Cancer Center, The University of Florida Cancer and Genetics Research Complex, Gainesville, Florida
- Division of Hematology/Oncology, The University of Florida College of Medicine, Gainesville, Florida
| | - William J. Karlon
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
| | - Benjamin G. Barwick
- Department of Hematology and Medical Oncology, Winship Cancer Institute, School of Medicine, Emory University, Atlanta, GA
| | - Arun P. Wiita
- Dept. of Laboratory Medicine, University of California, San Francisco, CA
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
- Chan Zuckerberg Biohub San Francisco, San Francisco, CA
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2
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Ng DL, Granados AC, Santos YA, Servellita V, Goldgof GM, Meydan C, Sotomayor-Gonzalez A, Levine AG, Balcerek J, Han LM, Akagi N, Truong K, Neumann NM, Nguyen DN, Bapat SP, Cheng J, Martin CSS, Federman S, Foox J, Gopez A, Li T, Chan R, Chu CS, Wabl CA, Gliwa AS, Reyes K, Pan CY, Guevara H, Wadford D, Miller S, Mason CE, Chiu CY. A diagnostic host response biosignature for COVID-19 from RNA profiling of nasal swabs and blood. Sci Adv 2021; 7:eabe5984. [PMID: 33536218 PMCID: PMC7857687 DOI: 10.1126/sciadv.abe5984] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/15/2020] [Indexed: 05/05/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease-19 (COVID-19), has emerged as the cause of a global pandemic. We used RNA sequencing to analyze 286 nasopharyngeal (NP) swab and 53 whole-blood (WB) samples from 333 patients with COVID-19 and controls. Overall, a muted immune response was observed in COVID-19 relative to other infections (influenza, other seasonal coronaviruses, and bacterial sepsis), with paradoxical down-regulation of several key differentially expressed genes. Hospitalized patients and outpatients exhibited up-regulation of interferon-associated pathways, although heightened and more robust inflammatory responses were observed in hospitalized patients with more clinically severe illness. Two-layer machine learning-based host classifiers consisting of complete (>1000 genes), medium (<100), and small (<20) gene biomarker panels identified COVID-19 disease with 85.1-86.5% accuracy when benchmarked using an independent test set. SARS-CoV-2 infection has a distinct biosignature that differs between NP swabs and WB and can be leveraged for COVID-19 diagnosis.
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Affiliation(s)
- Dianna L Ng
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Andrea C Granados
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Yale A Santos
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Venice Servellita
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Gregory M Goldgof
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Cem Meydan
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
- WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY, USA
| | - Alicia Sotomayor-Gonzalez
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Andrew G Levine
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Joanna Balcerek
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Lucy M Han
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Naomi Akagi
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Kent Truong
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Neil M Neumann
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - David N Nguyen
- Diabetes Center, University of California, San Francisco, San Francisco, CA, USA
| | - Sagar P Bapat
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Diabetes Center, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA
| | - Jing Cheng
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Claudia Sanchez-San Martin
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Scot Federman
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Jonathan Foox
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
- WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY, USA
| | - Allan Gopez
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Tony Li
- Department of Medicine, Division of Hematology and Oncology, University of California, San Francisco, San Francisco, CA, USA
| | - Ray Chan
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Cynthia S Chu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Chiara A Wabl
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Amelia S Gliwa
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Kevin Reyes
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Chao-Yang Pan
- Viral and Rickettsial Disease Laboratory, California Department of Health, Richmond, CA, USA
| | - Hugo Guevara
- Viral and Rickettsial Disease Laboratory, California Department of Health, Richmond, CA, USA
| | - Debra Wadford
- Viral and Rickettsial Disease Laboratory, California Department of Health, Richmond, CA, USA
| | - Steve Miller
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Christopher E Mason
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
- New York Genome Center, New York, NY, USA
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA
| | - Charles Y Chiu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA.
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA
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3
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Ng DL, Goldgof GM, Shy BR, Levine AG, Balcerek J, Bapat SP, Prostko J, Rodgers M, Coller K, Pearce S, Franz S, Du L, Stone M, Pillai SK, Sotomayor-Gonzalez A, Servellita V, Martin CSS, Granados A, Glasner DR, Han LM, Truong K, Akagi N, Nguyen DN, Neumann NM, Qazi D, Hsu E, Gu W, Santos YA, Custer B, Green V, Williamson P, Hills NK, Lu CM, Whitman JD, Stramer SL, Wang C, Reyes K, Hakim JMC, Sujishi K, Alazzeh F, Pham L, Thornborrow E, Oon CY, Miller S, Kurtz T, Simmons G, Hackett J, Busch MP, Chiu CY. SARS-CoV-2 seroprevalence and neutralizing activity in donor and patient blood. Nat Commun 2020; 11:4698. [PMID: 32943630 PMCID: PMC7499171 DOI: 10.1038/s41467-020-18468-8] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/18/2020] [Indexed: 01/08/2023] Open
Abstract
Given the limited availability of serological testing to date, the seroprevalence of SARS-CoV-2-specific antibodies in different populations has remained unclear. Here, we report very low SARS-CoV-2 seroprevalence in two San Francisco Bay Area populations. Seroreactivity was 0.26% in 387 hospitalized patients admitted for non-respiratory indications and 0.1% in 1,000 blood donors in early April 2020. We additionally describe the longitudinal dynamics of immunoglobulin-G (IgG), immunoglobulin-M (IgM), and in vitro neutralizing antibody titers in COVID-19 patients. The median time to seroconversion ranged from 10.3-11.0 days for these 3 assays. Neutralizing antibodies rose in tandem with immunoglobulin titers following symptom onset, and positive percent agreement between detection of IgG and neutralizing titers was >93%. These findings emphasize the importance of using highly accurate tests for surveillance studies in low-prevalence populations, and provide evidence that seroreactivity using SARS-CoV-2 anti-nucleocapsid protein IgG and anti-spike IgM assays are generally predictive of in vitro neutralizing capacity.
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Affiliation(s)
- Dianna L Ng
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Gregory M Goldgof
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Brian R Shy
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Andrew G Levine
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Joanna Balcerek
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sagar P Bapat
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - John Prostko
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Mary Rodgers
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Kelly Coller
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Sandra Pearce
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Sergej Franz
- Vitalant Research Institute, San Francisco, CA, USA
| | - Li Du
- Vitalant Research Institute, San Francisco, CA, USA
| | - Mars Stone
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | | | - Alicia Sotomayor-Gonzalez
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Venice Servellita
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Claudia Sanchez San Martin
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Andrea Granados
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Dustin R Glasner
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Lucy M Han
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Kent Truong
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Naomi Akagi
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - David N Nguyen
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA
| | - Neil M Neumann
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Qazi
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Elaine Hsu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Wei Gu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Yale A Santos
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Brian Custer
- Vitalant Research Institute, San Francisco, CA, USA
| | | | | | - Nancy K Hills
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Chuanyi M Lu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Laboratory Medicine Service, San Francisco VA Health Care System, San Francisco, CA, USA
| | - Jeffrey D Whitman
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Candace Wang
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Kevin Reyes
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Jill M C Hakim
- Department of Medicine at ZSFG, The Division of HIV, ID & Global Medicine, San Francisco, CA, USA
| | - Kirk Sujishi
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Fariba Alazzeh
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Lori Pham
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Edward Thornborrow
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Ching-Ying Oon
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Steve Miller
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Theodore Kurtz
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Graham Simmons
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | - John Hackett
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Michael P Busch
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | - Charles Y Chiu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA.
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA.
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA.
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4
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Burns ST, Damon L, Akagi N, Laszik Z, Ko AH. Rapid Improvement in Gemcitabine-associated Thrombotic Microangiopathy After a Single Dose of Eculizumab: Case Report and Review of the Literature. Anticancer Res 2020; 40:3995-4000. [PMID: 32620643 DOI: 10.21873/anticanres.14393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/02/2020] [Accepted: 06/05/2020] [Indexed: 11/10/2022]
Abstract
We present here the case of a 39-year-old man with metastatic pancreatic carcinoma receiving chemotherapy with the combination of gemcitabine and nab-paclitaxel as part of a clinical trial. Despite an impressive response to therapy, he ultimately developed profound anasarca, renal insufficiency, progressive cytopenias, and malignant hypertension 6 months into his treatment course. The diagnosis of gemcitabine-associated thrombotic microangiopathy (G-TMA) was made based on renal biopsy, and receipt of the anti-C5 monoclonal antibody eculizumab proved successful at reversing his deteriorating clinical course and improving his laboratory parameters. This case illustrates the importance of recognizing this rare but serious complication, and highlights one potential therapeutic option that can be used in the appropriate clinical context.
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Affiliation(s)
- Shohei T Burns
- Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco, CA, U.S.A
| | - Lloyd Damon
- Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco, CA, U.S.A
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, U.S.A
| | - Naomi Akagi
- Department of Pathology, University of California, San Francisco, CA, U.S.A
| | - Zoltan Laszik
- Department of Pathology, University of California, San Francisco, CA, U.S.A
| | - Andrew H Ko
- Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco, CA, U.S.A.
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, U.S.A
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5
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Ng DL, Goldgof GM, Shy BR, Levine AG, Balcerek J, Bapat SP, Prostko J, Rodgers M, Coller K, Pearce S, Franz S, Du L, Stone M, Pillai SK, Sotomayor-Gonzalez A, Servellita V, Martin CSS, Granados A, Glasner DR, Han LM, Truong K, Akagi N, Nguyen DN, Neumann NM, Qazi D, Hsu E, Gu W, Santos YA, Custer B, Green V, Williamson P, Hills NK, Lu CM, Whitman JD, Stramer S, Wang C, Reyes K, Hakim JM, Sujishi K, Alazzeh F, Pham L, Oon CY, Miller S, Kurtz T, Hackett J, Simmons G, Busch MP, Chiu CY. SARS-CoV-2 seroprevalence and neutralizing activity in donor and patient blood from the San Francisco Bay Area. medRxiv 2020:2020.05.19.20107482. [PMID: 32511477 PMCID: PMC7273245 DOI: 10.1101/2020.05.19.20107482] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We report very low SARS-CoV-2 seroprevalence in two San Francisco Bay Area populations. Seropositivity was 0.26% in 387 hospitalized patients admitted for non-respiratory indications and 0.1% in 1,000 blood donors. We additionally describe the longitudinal dynamics of immunoglobulin-G, immunoglobulin-M, and in vitro neutralizing antibody titers in COVID-19 patients. Neutralizing antibodies rise in tandem with immunoglobulin levels following symptom onset, exhibiting median time to seroconversion within one day of each other, and there is >93% positive percent agreement between detection of immunoglobulin-G and neutralizing titers.
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Affiliation(s)
- Dianna L. Ng
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Gregory M. Goldgof
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Brian R. Shy
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Andrew G. Levine
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Joanna Balcerek
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sagar P. Bapat
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - John Prostko
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Mary Rodgers
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Kelly Coller
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Sandy Pearce
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Sergej Franz
- Vitalant Research Institute, San Francisco, CA, USA
| | - Li Du
- Vitalant Research Institute, San Francisco, CA, USA
| | - Mars Stone
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | | | - Alicia Sotomayor-Gonzalez
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Venice Servellita
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Claudia Sanchez San Martin
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Andrea Granados
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Dustin R. Glasner
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Lucy M. Han
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Kent Truong
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Naomi Akagi
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - David N. Nguyen
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA
| | - Neil M. Neumann
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Qazi
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA
| | - Elaine Hsu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Wei Gu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Yale A. Santos
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Brian Custer
- Vitalant Research Institute, San Francisco, CA, USA
| | | | | | - Nancy K. Hills
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Chuanyi M. Lu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Lab Medicine Service, San Francisco VA Healthcare System
| | - Jeffrey D. Whitman
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Candace Wang
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Kevin Reyes
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Jill M.C. Hakim
- Department of Medicine at ZSFG, the Division of HIV, ID & Global Medicine
| | - Kirk Sujishi
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Fariba Alazzeh
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Lori Pham
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Ching-Ying Oon
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Steve Miller
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Theodore Kurtz
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - John Hackett
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, USA
| | - Graham Simmons
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | - Michael P. Busch
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | - Charles Y. Chiu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA
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Principe DR, DeCant B, Mascariñas E, Wayne EA, Diaz AM, Akagi N, Hwang R, Pasche B, Dawson DW, Fang D, Bentrem DJ, Munshi HG, Jung B, Grippo PJ. TGFβ Signaling in the Pancreatic Tumor Microenvironment Promotes Fibrosis and Immune Evasion to Facilitate Tumorigenesis. Cancer Res 2016; 76:2525-39. [PMID: 26980767 DOI: 10.1158/0008-5472.can-15-1293] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 02/12/2016] [Indexed: 02/07/2023]
Abstract
In early pancreatic carcinogenesis, TGFβ acts as a tumor suppressor due to its growth-inhibitory effects in epithelial cells. However, in advanced disease, TGFβ appears to promote tumor progression. Therefore, to better understand the contributions of TGFβ signaling to pancreatic carcinogenesis, we generated mouse models of pancreatic cancer with either epithelial or systemic TGFBR deficiency. We found that epithelial suppression of TGFβ signals facilitated pancreatic tumorigenesis, whereas global loss of TGFβ signaling protected against tumor development via inhibition of tumor-associated fibrosis, stromal TGFβ1 production, and the resultant restoration of antitumor immune function. Similarly, TGFBR-deficient T cells resisted TGFβ-induced inactivation ex vivo, and adoptive transfer of TGFBR-deficient CD8(+) T cells led to enhanced infiltration and granzyme B-mediated destruction of developing tumors. These findings paralleled our observations in human patients, where TGFβ expression correlated with increased fibrosis and associated negatively with expression of granzyme B. Collectively, our findings suggest that, despite opposing the proliferation of some epithelial cells, TGFβ may promote pancreatic cancer development by affecting stromal and hematopoietic cell function. Therefore, the use of TGFBR inhibition to target components of the tumor microenvironment warrants consideration as a potential therapy for pancreatic cancer, particularly in patients who have already lost tumor-suppressive TGFβ signals in the epithelium. Cancer Res; 76(9); 2525-39. ©2016 AACR.
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Affiliation(s)
- Daniel R Principe
- University of Illinois College of Medicine, Urbana-Champaign, Illinois
| | - Brian DeCant
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Emman Mascariñas
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Elizabeth A Wayne
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois. Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Andrew M Diaz
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Naomi Akagi
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Rosa Hwang
- Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Boris Pasche
- Comprehensive Cancer Center of Wake Forest University, Winston-Salem, North Carolina
| | - David W Dawson
- Department of Pathology and Laboratory Medicine, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Deyu Fang
- Department of Pathology, Northwestern University, Chicago, Illinois
| | - David J Bentrem
- Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Hidayatullah G Munshi
- Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Department of Medicine, Northwestern University, Chicago, Illinois
| | - Barbara Jung
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
| | - Paul J Grippo
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
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7
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Bauer J, Ozden O, Akagi N, Carroll T, Principe DR, Staudacher JJ, Spehlmann ME, Eckmann L, Grippo PJ, Jung B. Activin and TGFβ use diverging mitogenic signaling in advanced colon cancer. Mol Cancer 2015; 14:182. [PMID: 26497569 PMCID: PMC4619565 DOI: 10.1186/s12943-015-0456-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [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: 06/23/2015] [Accepted: 10/16/2015] [Indexed: 02/08/2023] Open
Abstract
Background Understanding cell signaling pathways that contribute to metastatic colon cancer is critical to risk stratification in the era of personalized therapeutics. Here, we dissect the unique involvement of mitogenic pathways in a TGFβ or activin-induced metastatic phenotype of colon cancer. Method Mitogenic signaling/growth factor receptor status and p21 localization were correlated in primary colon cancers and intestinal tumors from either AOM/DSS treated ACVR2A (activin receptor 2) −/− or wild type mice. Colon cancer cell lines (+/− SMAD4) were interrogated for ligand-induced PI3K and MEK/ERK pathway activation and downstream protein/phospho-isoform expression/association after knockdown and pharmacologic inhibition of pathway members. EMT was assessed using epithelial/mesenchymal markers and migration assays. Results In primary colon cancers, loss of nuclear p21 correlated with upstream activation of activin/PI3K while nuclear p21 expression was associated with TGFβ/MEK/ERK pathway activation. Activin, but not TGFβ, led to PI3K activation via interaction of ACVR1B and p85 independent of SMAD4, resulting in p21 downregulation. In contrast, TGFβ increased p21 via MEK/ERK pathway through a SMAD4-dependent mechanism. While activin induced EMT via PI3K, TGFβ induced EMT via MEK/ERK activation. In vivo, loss of ACVR2A resulted in loss of pAkt, consistent with activin-dependent PI3K signaling. Conclusion Although activin and TGFβ share growth suppressive SMAD signaling in colon cancer, they diverge in their SMAD4-independent pro-migratory signaling utilizing distinct mitogenic signaling pathways that affect EMT. p21 localization in colon cancer may determine a dominant activin versus TGFβ ligand signaling phenotype warranting further validation as a therapeutic biomarker prior to targeting TGFβ family receptors. Electronic supplementary material The online version of this article (doi:10.1186/s12943-015-0456-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jessica Bauer
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Illinois at Chicago, 840 South Wood Street, 738A CSB, Chicago, IL, 60612, USA
| | - Ozkan Ozden
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Illinois at Chicago, 840 South Wood Street, 738A CSB, Chicago, IL, 60612, USA
| | - Naomi Akagi
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Illinois at Chicago, 840 South Wood Street, 738A CSB, Chicago, IL, 60612, USA
| | - Timothy Carroll
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Illinois at Chicago, 840 South Wood Street, 738A CSB, Chicago, IL, 60612, USA
| | - Daniel R Principe
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Illinois at Chicago, 840 South Wood Street, 738A CSB, Chicago, IL, 60612, USA
| | - Jonas J Staudacher
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Illinois at Chicago, 840 South Wood Street, 738A CSB, Chicago, IL, 60612, USA
| | - Martina E Spehlmann
- Department of Internal Medicine III, Cardiology and Angiology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Lars Eckmann
- Department of Medicine, University of California, San Diego, CA, USA
| | - Paul J Grippo
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Illinois at Chicago, 840 South Wood Street, 738A CSB, Chicago, IL, 60612, USA
| | - Barbara Jung
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Illinois at Chicago, 840 South Wood Street, 738A CSB, Chicago, IL, 60612, USA.
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Bauer JI, Akagi N, Ozden O, Principe DR, Carroll T, Baik SH, Spehlmann ME, Eckmann L, Grippo PJ, Jung B. Abstract 1438: Opposing influence of activin and TGFβ on PI3K and MEK/ERK signaling in colon cancer. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-1438] [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
Introduction: Colorectal cancer (CRC) is the second deadliest cancer in the US. The overall number of new cases and deaths has decreased, most likely due to increased screening. However, once CRC has metastasized, survival rate drops dramatically. In early stage CRC, the Transforming Growth Factor (TGF) β super family is growth suppressive; in advanced disease, high TGFβ serum levels are associated with poor prognosis. Activin and TGFβ regulate cell growth, apoptosis, and cell migration involving a poorly understood switch from growth suppressive to proinvasive actions. Understanding the switch to metastatic behavior and developing therapeutic strategies and biomarkers to target this process are clinical challenges. We recently observed opposing effects of TGFβ and activin on a downstream target, the cell cycle inhibitor p21. TGFβ induces SMAD4-dependent upregulation of p21, while activin downregulation of p21 is SMAD4-independent. Here, we dissect the unique contributions of mitogenic pathways to a TGFβ or activin-induced metastatic phenotype in colon cancer.
Methods: Colon cancer cell lines (+/- SMAD4) were assessed for ligand-induced PI3K and MEK/ERK pathway activation. Protein/phospho-isoform expression and association were determined following knockdown and pharmacologic inhibition of pathway members. TGFβ and activin influence on cell migration via mitogenic pathways was assessed through use of small molecule inhibitors of signaling members. Epithelial mesenchymal transition (EMT) was assessed by altered expression of epithelial and mesenchymal markers. Pathway activation was compared in intestinal tumors from AOM/DSS treated ACVR2 knockout and ACVR2 wild type mice. Mitogenic signaling/growth factor status and p21 localization were correlated in primary colon cancers.
Results: Activin, but not TGFβ, led to PI3K activation via interaction of ACVR1 and p85 independent of SMAD4, resulting in p21 downregulation. In contrast, TGFβ increased significantly p21 via MEK/ERK/SMAD4 synergy through a SMAD4-dependent mechanism. While activin induced EMT via PI3K, TGFβ induced EMT via MEK/ERK activation. In vivo, loss of ACVR2 resulted in loss of pAkt, consistent with activin-dependent PI3Ksignaling. In primary colon cancers, loss of nuclear p21 correlated with upstream activation of activin/PI3K while nuclear p21 was associated with TGFβ/MEK/ERK pathway activation.
Conclusions: Activin and TGFβ diverge in their pro-migratory, SMAD4-independent signaling in colon cancer and utilize distinct mitogenic signaling to affect p21 localization. p21 localization in colon cancer may warrant further validation as a therapeutic biomarker for targeting TGFβ family receptors.
Citation Format: Jessica I. Bauer, Naomi Akagi, Ozkan Ozden, Daniel R. Principe, Timothy Carroll, Seung Hyun Baik, Martina E. Spehlmann, Lars Eckmann, Paul J. Grippo, Barbara Jung. Opposing influence of activin and TGFβ on PI3K and MEK/ERK signaling in colon cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1438. doi:10.1158/1538-7445.AM2015-1438
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Affiliation(s)
| | - Naomi Akagi
- 1University of Illinois at Chicago, Chicago, IL
| | - Ozkan Ozden
- 1University of Illinois at Chicago, Chicago, IL
| | | | | | | | | | - Lars Eckmann
- 3University of California, San Diego, San Diego, CA
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Bishehsari F, Gach JS, Akagi N, Webber MK, Bauer J, Jung BH. Anti-p21 autoantibodies detected in colorectal cancer patients: A proof of concept study. Oncoimmunology 2014; 3:e952202. [PMID: 25960931 DOI: 10.4161/21624011.2014.952202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 05/10/2014] [Accepted: 06/04/2014] [Indexed: 12/29/2022] Open
Abstract
Whereas the presence of autoantibodies in cancer patients has been acknowledged, their diagnostic or therapeutic significance has yet to be established. This is due, at least in part, to the lack of robust screening techniques to detect and characterize such antibodies for further assessment. In this study, we screened colorectal cancer (CRC) patient sera for antibodies specifically targeting the key cell cycle inhibitory factor p21 encoded by the cyclin-dependent kinase inhibitor 1A (CDKN1A). Anti-p21 antibody titers were higher in CRC patient samples versus controls, correlating with a more advanced disease stage and lymph node involvement. Further, we isolated for the first time a specific human antibody fragment against p21, which could potentially be useful as a tool to study tumorigenicity in CRC patients.
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Key Words
- CDKN1A, cyclin-dependent kinase inhibitor 1
- CRC, colorectal cancer
- ELISA, enzyme-linked immunosorbent assay
- Fab, fragment antigen-binding
- HER2/ERBB2, v-erb-b2 avian erythroblastic leukemia viral oncogene homologue 2
- Ni-NTA, nickel-charged nitrilotriacetic acid
- OD50, half-maximum binding titer
- TAAs, tumor-associated antigens
- TP53, tumor protein p53.
- aAbs, autoantibodies
- autoantibody
- immunofluorescence assay
- olorectal cancer
- p21
- p21/CIP1, CDKN1A protein
- phage display
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Affiliation(s)
- Faraz Bishehsari
- Division of Gastroenterology; Northwestern University ; Chicago, IL USA
| | - Johannes S Gach
- Division of Infectious Diseases; University of California Irvine ; Irvine, CA USA
| | - Naomi Akagi
- Division of Gastroenterology and Hepatology; University of Illinois at Chicago ; Chicago, IL USA
| | - Molly K Webber
- School of Medicine; University of Pittsburgh ; Pittsburgh, PA USA
| | - Jessica Bauer
- Division of Gastroenterology and Hepatology; University of Illinois at Chicago ; Chicago, IL USA
| | - Barbara H Jung
- Division of Gastroenterology and Hepatology; University of Illinois at Chicago ; Chicago, IL USA
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10
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Murakami T, Ono Y, Akagi N, Oshima E, Hamakawa Y, Omori N, Shoji M, Hayashi Y, Abe K, Manabe Y. A case of superior cerebellar artery syndrome with contralateral hearing loss at onset. J Neurol Neurosurg Psychiatry 2005; 76:1744-5. [PMID: 16291913 PMCID: PMC1739460 DOI: 10.1136/jnnp.2004.058735] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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11
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Fukumoto M, Yoshida D, Hayase N, Kurohara A, Akagi N, Yoshida S. Scintigraphic prediction of resistance to radiation and chemotherapy in patients with lung carcinoma: technetium 99m-tetrofosmin and thallium-201 dual single photon emission computed tomography study. Cancer 1999; 86:1470-9. [PMID: 10526275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND Various prognostic markers for lung carcinoma have been proposed, but to the authors' knowledge none is noninvasive and convenient for clinical use. The current study examined the utility of several radiotracers for the prediction of multidrug resistance (MDR) and radioresistance in patients with lung carcinoma. METHODS Thirty patients with untreated lung carcinoma underwent a dual isotope single photon emission computed tomography (SPECT) scan at 10 minutes and 120 minutes after the injection of technetium-99m ((99m)Tc)-tetrofosmin ((99m)Tc-TF) (370 megabecquerels [MBq]) and thallium-201 ((201)TlCl) (111 MBq). Retention of each tracer was evaluated semiquantitatively. Using radiation and chemotherapy (cisplatin plus etoposide), the patients either were treated sequentially (n = 12) or concurrently (n = 18). The relation between therapeutic response and retention of each tracer was analyzed. The detectability of radioresistance was examined. RESULTS In patients treated with sequential therapy, the response to radiation was predicted by (99m)Tc-TF retention, whereas (201)Tl retention was found not to be predictive. Regardless of whether the sequential or concurrent protocol was applied, 14 of 18 tumors with high (99m)Tc-TF retention (>/= 15%) exhibited a favorable response to chemoradiotherapy whereas all 12 tumors with low (99m)Tc-TF retention (</= 15%) did not respond to the therapy. In contrast, (201)Tl retention was not found to be a predictive factor. CONCLUSIONS The employed SPECT method is a useful tool for the in vivo prediction of radioresistance, P-glycoprotein (P-gp), and non-P-gp MDR in lung carcinoma. Low (99m)Tc-TF retention serves as a strong predictor of therapeutic resistance. High (99m)Tc-TF retention implies a favorable response. (201)Tl did not appear to be a predictive factor but is required for localization of the lesion on SPECT imaging.
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Affiliation(s)
- M Fukumoto
- Department of Radiology, Kochi Medical School, Kochi, Japan
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12
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Hayase N, Fukumoto M, Yoshida D, Kariya S, Akagi N, Kurohara A, Hisa N, Yoshida S. Extraosseous metastases of hepatocellular carcinoma detection and therapeutic assessment with Tc-99m PMT SPECT. Clin Nucl Med 1999; 24:326-9. [PMID: 10232470 DOI: 10.1097/00003072-199905000-00006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Owing to recent advances in imaging technology and radiologic intervention, survival rates in patients with hepatocellular carcinoma have improved markedly. However, such prolonged survival has resulted in an increase in extrahepatic metastases. Tc-99m (Sn)-N-pyridoxyl-5-methyltryptophan (Tc-99m PMT), developed for hepatobiliary scintigraphy, has been used to visualize extrahepatic metastases, with most related reports limited to osseous metastases. The authors report two cases of hepatocellular cancer presenting as a hypopharyngeal metastasis and intraperitoneal dissemination along the tract of a fine-needle biopsy. Lesions undetectable on planar imaging could be visualized by Tc-99m PMT SPECT.
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Affiliation(s)
- N Hayase
- Department of Radiology, Kochi Medical School, Japan.
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13
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Fukumoto M, Kurohara A, Yoshimura N, Yoshida D, Akagi N, Yoshida S. Relationship between ATP synthesis and 201Tl uptake in transformed and non-transformed cell lines. Nucl Med Commun 1998; 19:1169-75. [PMID: 9885807 DOI: 10.1097/00006231-199812000-00009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
201Tl tumour imaging is an established procedure, but little is known about its biological significance in transformed and non-transformed cells. In investigating the relationship between 201Tl uptake and intracellular ATP, we wished to determine whether the observed difference in delayed uptake is attributable to re-uptake via Na-K ATPase by using transformed (HeLa) and non-transformed (human fibroblast: hFB) cell lines. In each cell line, ATP was measured using the Luciferin-Luciferase method (LLM). The change in 201Tl uptake was assessed under conditions of mitochondrial suppression. Additionally, we assessed whether glycolysis is involved in 201Tl uptake under conditions of mitochondrial suppression and anaerobic incubation. Re-uptake via Na-K ATPase (HeLa vs hFB: 37.3 vs 24.2%) showed a clear difference in delayed uptake between HeLa and hFB. With HeLa, 201Tl uptake decreased biphasically with a reduction in ATP levels, whereas with hFB a linear correlation was evident. Despite the suppression of mitochondrial potential, a 5% glucose loading accelerated glycolysis with HeLa, and increased ATP (10.0 +/- 4.0%) and 201Tl uptake (16.2 +/- 3.0%). Conversely, neither ATP nor 201Tl uptake increased with hFB. Our results provide evidence that 201Tl uptake in transformed cells is related to enhanced glycolysis as well as mitochondrial ATP synthesis.
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Affiliation(s)
- M Fukumoto
- Department of Radiology, Kochi Medical School, Japan
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14
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Kurohara A, Fukumoto M, Akagi N, Yoshimura N, Yoshida S. Diagnosis of lung cancer using two-phase Tl-201 SPECT and modified retention image to view tumor in the collapsed lung: comparison with bolus CT. Clin Nucl Med 1998; 23:657-63. [PMID: 9790039 DOI: 10.1097/00003072-199810000-00003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In this report the usefulness of Tl-201 SPECT and modified retention images in the differentiation of lung cancer and postobstructive collapse was studied. Two-phase Tl-201 SPECT was performed in 20 lung cancer lesions in which postobstructive collapse was suspected on CT. Retention imaging was done afterward. Three types of Tl-201 images were compared with the bolus CT images. Bolus CT differentiated lung cancer from postobstructive collapse in 7 of the 20 lesions (35%). Tl-201 SPECT differentiated the two conditions in 9 of 20 lesions (45%) on early Tl-201 SPECT and in 13 of 20 lesions (65%) on delayed imaging. With modified retention images, differentiation was possible in 13 of 20 lesions (65%). By combining delayed Tl-201 SPECT and modified retention images, lung cancer alone could be demonstrated in 18 of 20 lesions (90%). Combined delayed Tl-201 SPECT and modified retention images were more effective than bolus CT in delineating the extent of lung cancer in the presence of postobstructive collapse.
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Affiliation(s)
- A Kurohara
- Department of Radiology, Kochi Medical School, Kohasu, Japan. kuroharakochi-ms.ac.jp
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15
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Fukumoto M, Osaki Y, Yoshida D, Ogawa Y, Fujiwara M, Miyazaki N, Kurohara A, Akagi N, Yoshida S. Dual-isotope SPECT diagnosis of a skull-base metastasis causing isolated unilateral hypoglossal nerve palsy. Ann Nucl Med 1998; 12:213-6. [PMID: 9795708 DOI: 10.1007/bf03164848] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We describe a 48-year-old female with an isolated unilateral hypoglossal nerve palsy caused by a skull base metastasis from breast cancer. The patient had a medical history of conservative breast therapy for breast cancer. Although the cause of such a neurological deficit includes various pathologies, the reports focusing on metastatic tumor have been limited in number. Radiologic investigation showed a mass involving both the right hypoglossal canal and the clival edge. Swelling of the hypoglossal nerve was observed in views including its canal. Three-dimensional CT images demonstrated the tumor protruding from the enlarged external orifice of the hypoglossal canal. In the present report we mentioned a nuclear medicine procedure to visualize and characterize the small, abnormal tissue in the skull base. Dual-isotope SPECT confirmed an abnormal uptake of 99mTc-HMDP around the hypoglossal canal and a 201Tl-positive elongated lesion running along the hypoglossal nerve.
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Affiliation(s)
- M Fukumoto
- Department of Radiology, Kochi Medical School, Japan
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16
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Fukumoto M, Kurohara A, Akagi N, Yoshida D, Yoshida S. Ga-67 visualization of the coexistence of two mucosa-associated lymphoid tissue (MALT) lymphomas in the thyroid and stomach. Clin Nucl Med 1998; 23:484. [PMID: 9676964 DOI: 10.1097/00003072-199807000-00024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- M Fukumoto
- Department of Radiology, Kochi Medical School, Japan
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17
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Yoshimura N, Fukumoto M, Akagi N, Yoshida S. [Diagnosis of lung cancer using functional image of 201Tl SPECT with parameter of 201Tl retention--evaluation of its applicability to post irradiated lung cancer]. Kaku Igaku 1996; 33:383-90. [PMID: 8683877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Thallium-201 (201Tl) SPECT is a useful method for detecting lung cancer. Moreover, the 201Tl Retention Index (R.I.) reported by Tonami et al is now available for differentiating pulmonary lung cancer from benign lesions. The diagnosis of recurrent tumors is, however, difficult to establish as they are often shaded by radiation pneumonitis or fibrosis. Therefore, we employed functional images (F.I.) obtained using as parameter a modified version of the R.I. First we indicated the statistical value of untreated solitary lung tumor as follows: sensitivity 84.6%, specificity 80.0%, and accuracy 83.3%. In our assessment, the lesions with tumor size over 2.0 cm and R.I. by Tonami et al over 12.7 were detected as positive images. Secondly in assessment of 22 cases (23 lesions) of post irradiated lung cancer, the results obtained were: sensitivity 80.0%, specificity 92.3%, and accuracy 87.0%. 201Tl SPECT functional images seem to be useful for the diagnosis of recurrent lung cancer by shaded radiation pneumonitis and fibrosis.
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Affiliation(s)
- N Yoshimura
- Department of Radiology, Kochi Medical School, Japan
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18
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Shimamura K, Akagi N, Yamamoto K, Sekiguchi F, Sunano S. Neural responses of rat abdominal skin artery. J Smooth Muscle Res 1995; 31:397-9. [PMID: 8867946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- K Shimamura
- Research Institute of Hypertension, Kinki University
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19
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Seo H, Chikamori T, Yabe T, Akagi N, Ozawa T, Doi YL. Determinants of exercise capacity in the hypertensive elderly--a study based on the assessment of cardiac reserve by dipyridamole radionuclide angiography. Jpn Circ J 1995; 59:547-55. [PMID: 7474299 DOI: 10.1253/jcj.59.547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
To evaluate the determinants of exercise capacity in the hypertensive elderly with an assessment of cardiac reserve by dipyridamole radionuclide angiography, 31 elderly subjects (aged 62 to 78 years, 15 hypertensive and 16 normotensive) underwent symptom-limited maximum treadmill exercise with measurement of maximal oxygen consumption along with radionuclide angiography in list mode at rest and after dipyridamole infusion. In the normotensive elderly, maximal oxygen consumption correlated with relative filling volume during the rapid filling period at rest (r = 0.58; p < 0.05), and correlated inversely with the percent change in the peak ejection rate with dipyridamole (r = -0.63; p < 0.01). In contrast, maximal oxygen consumption correlated with atrial contribution at rest (r = 0.69; p < 0.005), and correlated inversely with the percent change in atrial contribution with dipyridamole (r = -0.87; p < 0.0001) in the hypertensive elderly. These results indicate that the mechanisms for maintaining exercise capacity are different in elderly subjects with or without hypertension.
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Affiliation(s)
- H Seo
- Department of Medicine and Geriatrics, Kochi Medical School, Japan
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20
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Yamamoto T, Yoneda K, Osaki T, Yoshimura N, Akagi N. Longer local retention of adoptively transferred T-LAK cells correlates with lesser adhesion molecule expression than NK-LAK cells. Clin Exp Immunol 1995; 100:13-20. [PMID: 7697911 PMCID: PMC1534256 DOI: 10.1111/j.1365-2249.1995.tb03597.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The local retention of adoptively transferred lymphokine (IL-2)-activated killer (LAK) cells was examined in 11 patients with head and neck carcinoma. Unseparated lymphocytes, T and natural killer (NK) cells isolated from patients were cultured with IL-2 for 7 days, labelled with 99mTc-HMPAO, and immediately injected back into the respective donors via the superficial temporal artery or locally into the tumour tissue. The injected LAK cells were periodically traced using a gamma camera, and the LAK cell retention rate was calculated from the radioactivity. One hour after the injection, about 70% of the locally infiltrated LAK cells remained in the tumour tissue, while about half of the LAK cells transferred via the regional artery were dislodged from the tissue. LAK cells induced from T cells (T-LAK) were retained in the tissue for a longer time than LAK cells induced from NK cells (NK-LAK). T-LAK were less chemotactic and less adherent to human umbilical vein endothelial cells (EC), and showed lesser migration through EC. Flow cytometric analysis revealed higher expression of CD11a, CD11b, CD18 and CD49d on NK-LAK compared with T-LAK. MoAbs against these adhesion molecules suppressed adhesion and migration of LAK cells. These results indicate that the rapid disappearance of NK-LAK from the tissue is associated with their greater chemotactic and adhesive as well as migratory activities depending on differing expression of adhesion molecules.
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Affiliation(s)
- T Yamamoto
- Department of Radiology and Nuclear Medicine, Kochi Medical School, Japan
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21
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Chikamori T, Doi YL, Seo H, Kawamoto A, Akagi N, Maeda T, Ozawa T. Effects of dipyridamole on left ventricular systolic and diastolic function in healthy young and elderly subjects as assessed by radionuclide angiography. Am J Cardiol 1994; 73:1024-9. [PMID: 8184844 DOI: 10.1016/0002-9149(94)90166-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- T Chikamori
- Department of Medicine and Geriatrics, Kochi Medical School, Japan
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22
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Shimada M, Akagi N, Goto H, Watanabe H, Nakanishi M, Hirose Y, Watanabe M. Microvessel and astroglial cell densities in the mouse hippocampus. J Anat 1992; 180 ( Pt 1):89-95. [PMID: 1452486 PMCID: PMC1259611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
In order to study the factors responsible for glucose uptake in the mouse hippocampus, microvessel and astroglial cell densities were measured and compared in each laminal region. Microvessel density was examined on histologically prepared sections after injection of Indian ink and measured by means of an image analyser. Astroglial cell density was determined after the cells were stained immunohistochemically. Microvessel and astroglial cell densities were determined in 10 different hippocampal structures. Microvessel and astroglial cell densities were strongly correlated in all layers except the pyramidal cell layers. The highest density of perfused microvessels was found in the stratum lacunosum-moleculare, compared with other regions, and the lowest values were found in the stratum lucidum and dentate granular cell layer. Among pyramidal cell layers, microvessel density in sector CA3a was significantly higher than that in CA1.
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Affiliation(s)
- M Shimada
- Department of Anatomy, Osaka Medical College, Japan
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23
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Shimada M, Akagi N, Nakai Y, Goto H, Watanabe M, Watanabe H, Nakanishi M, Yoshimatsu S, Ono C. Free radical production by the red tide alga, Chattonella antiqua. Histochem J 1991; 23:361-5. [PMID: 1655681 DOI: 10.1007/bf01042181] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The red tide alga, Chattonella antiqua, was found to show a strong chemiluminescence, using luminol as the reagent, when exposed to ultraviolet irradiation. This luminescence was completely inhibited by ascorbate or catalase, suggesting that hydrogen peroxide was generated by the plankton. Red tide cells exposed to fish gill mucus from young yellowtail resulted in the release of a large number of mucocysts and a weak luminosity, and showed a strong reduction of cytochrome c in the medium. Therefore, the discharge of mucocysts from the red tide, induced by the presence of gill mucus, may be accompanied by the release of active oxygen species. The active oxygen may be involved in depolymerization of mucus glycoproteins from the gill lamellae.
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Affiliation(s)
- M Shimada
- Department of Anatomy, Osaka Medical College, Japan
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24
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Yonezawa Y, Hamashige N, Doi Y, Ozawa T, Odawara H, Takata J, Yamada M, Akagi N, Maeda T, Yoshida S. [Significance of diffuse slow washout in dipyridamole loading thallium-201 myocardial perfusion scintigraphy]. Kaku Igaku 1991; 28:355-60. [PMID: 1880969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
To assess the significance of diffuse slow washout (DSW) in dipyridamole loading thallium-201 myocardial perfusion scintigraphy, 382 patients were studied. DSW were observed in 69 (24%) of 285 patients with perfusion defects, 5 (5%) of 97 patients without perfusion defects. There was significant relation between DSW and perfusion defects (p less than 0.01). Coronary angiography showed multivessel disease in 84% single vessel disease in 12% of patients with DSW and multivessel disease in 28%, single vessel disease in 50% of patients without DSW. During a mean follow up period of 29 months, initial CABG or PTCA were done in 41%, cardiac death occurred in 12%, nonfatal cardiac events occurred in 7% of patients with DSW and perfusion defects. In patients without DSW, initial CABG or PTCA were done in 11%, cardiac death occurred in 7%, nonfatal cardiac events occurred in 5%. Patients without perfusion defects had good prognosis regardless of the presence or absence of DSW. In conclusion, DSW indicates serious cardiac ischemia in patients with perfusion defects. DSW does not indicate cardiac ischemia in patients without perfusion defects.
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Affiliation(s)
- Y Yonezawa
- Department of Internal Medicine and Geriatrics, Kochi Medical School
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25
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Yamamoto Y, Yoshida S, Sawada A, Kamiike O, Morita M, Inomata T, Ohara S, Ogawa Y, Akagi N, Kubo Y. [The analysis of Tc-99m RBCs time activity curve on liver tumor--differentiation between hemangioma and hepatocellular carcinoma]. Kaku Igaku 1989; 26:1567-73. [PMID: 2560090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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26
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Kuzume O, Hamashige N, Yonezawa Y, Doi Y, Odawara H, Chikamori T, Ozawa T, Akagi N, Yoshida S, Maeda T. [Clinical significance of negative dipyridamole perfusion scintigram]. Kaku Igaku 1989; 26:753-62. [PMID: 2796002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Six hundred seventy-one patients who had dipyridamole perfusion scintigraphy were classified into two groups; ie, 242 patients without perfusion defect (Group A) and 429 patients with perfusion defect (Group B). Clinical significance of negative scintigram was then assessed and correlated with coronary angiographic findings and prevalence of cardiac events. 1) Significant coronary artery disease (greater than 50% luminar narrowing) was present in 7 of 92 patients (8%) in Group A and in 235 of 285 patients (82%) in Group B. Multi-vessel coronary artery disease was found only in 2 patients (2%) in Group A and in 119 patients (42%) in Group B. 2) During a mean follow-up period of 29 months, 48 cardiac death (8%) and 19 nonfatal cardiac events (3%) occurred in 619 medically treated patients. These cardiac complications were observed in 7 of 242 patients (3%) in Group A and in 60 of 377 patients (16%) in Group B, including 4 (2%) and 44 (12%) cardiac deaths, respectively. In conclusion, it is rare to see severe organic coronary artery disease and future cardiac event in patients with negative dipyridamole perfusion scintigram. It may be, therefore, stated that it is unnecessary to perform coronary angiography in these patients, unless they have symptoms which cannot be controlled medically.
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27
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Nishimoto H, Yamamoto Y, Yoshida S, Akagi N, Ohara S, Kamiike O, Maeda T. [Tc-99m-HMPAO brain scintigraphy: a comparative study with I-123-IMP]. Kaku Igaku 1989; 26:545-50. [PMID: 2788761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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28
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Akagi N, Morimoto T, Watanabe M. The Harderian gland and the porphyrins. Bull Osaka Med Sch 1987; 33:97-115. [PMID: 3334132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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29
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Hamashige N, Doi Y, Yonezawa Y, Odawara H, Ozawa T, Akagi N, Yoshida S, Maeda T. [Dipyridamole-loading myocardial scintigraphy for the evaluation of patients after aortocoronary bypass surgery]. Kaku Igaku 1986; 23:1683-91. [PMID: 3494143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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30
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Yoshida S, Sawada A, Ogawa Y, Morita S, Morita M, Yamamoto Y, Ogawa Y, Maeda T, Akagi N, Kubo Y. [Hepatobiliary scintigraphy with Tc-99m-PMT in a case of Rotor's disease. Comparison with the image of Tc-99m E-HIDA]. Kaku Igaku 1985; 22:1823-7. [PMID: 3831485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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31
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Akagi N, Kato K, Abe S, Hanaya Y. [2 cases of measles with central nervous system complications]. Nihon Shonika Gakkai Zasshi 1968; 72:537-540. [PMID: 5748782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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32
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Gebauer PW, Akagi N, Mason CB, Chun AK. Experimental aortic reconstruction. Int Surg 1966; 45:450-7. [PMID: 5324423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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