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Chen Y, Arbuiso S, Qin N, Vernice NA, Black GG, Brown KA, Otterburn D. Proliferation Patterns of MCF-7 Breast Cancer Cells in Lipoaspirate Conditioned Media. Ann Plast Surg 2024; 92:S207-S209. [PMID: 38556675 DOI: 10.1097/sap.0000000000003910] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Autologous fat grafting (AFG) is a common technique used to enhance aesthetic outcomes in postmastectomy breast reconstruction patients. Adipokines are hormones secreted by adipose tissue that play a critical role in regulating metabolic processes and the immune system. However, dysregulated adipokine secretion and signaling can contribute to the development and progression of cancer by promoting angiogenesis, altering the immune response, and inducing the epithelial mesenchymal transition. We aimed to assess how breast cancer cells behave in conditioned media derived from fat grafting lipoaspirates and gain a better understanding of the potential interactions that may occur within the tumor microenvironment. METHODS Patients who were undergoing AFG as a part of breast reconstruction at NY-Presbyterian/Weill Cornell Medical Center between March 2021 and July 2023 were consented and enrolled in the study. This study was approved by the Weill Cornell Medicine Institutional Review Board (#20-10022850-14). Conditioned media is created using 20% of patient lipoaspirate secretome and 80% starving media. The growth of MCF-7, a human ER/PR+ breast cancer cell line, in conditioned media is assessed using CyQUANT. RESULTS The breast cancer cells incubated in conditioned media displayed similar growth trends as those in complete media, which is enriched for cell growth (P > 0.05). MCF-7 cell behavior in conditioned media differed significantly from their proliferation patterns when serum starved in 100% starving media (P < 0.05). DISCUSSION Our results suggest that there may be inherent factors within the lipoaspirate that may promote MCF-7 proliferation. One potential implication is that AFG used for breast reconstruction should be delayed until local-regional disease control has been established. In addition, based on the in vitro proliferation patterns of breast cancer cells in conditioned media, the safety profile of AFG may be enhanced if the procedure is performed after attaining negative margins and the completion breast cancer treatment.
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Affiliation(s)
- Yunchan Chen
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
| | - Sophia Arbuiso
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
| | - Nancy Qin
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
| | | | - Grant G Black
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
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Chen Y, Arbuiso S, Vernice NA, Black GG, Wang ML, Liao MW, Medina SJ, Brown KA, Otterburn D. Assessing Long-Term Volume Retention in Breast Fat Grafting: A Comparative Study of Lipoaspirate Processing Techniques. Ann Plast Surg 2024; 92:S112-S116. [PMID: 38556658 DOI: 10.1097/sap.0000000000003911] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Autologous fat grafting is a method of improving aesthetic outcomes after both breast reconstruction and aesthetic surgery through volume enhancement and tissue contouring. Long-lasting effects are linked to greater patient satisfaction and more optimal augmentation results. Harvesting, processing, and injection techniques may all affect the longevity of deformity filling. Our objective is to evaluate the effect of lipoaspirate processing modality on longitudinal volume retention after surgery. METHODS A prospective, single-institution, randomized control trial placed consented postmastectomy fat grafting patients into 1 of 3 treatment arms (active filtration, low-pressure decantation, and standard decantation) in a 1:1:1 ratio. A preoperative 3-dimensional scan of the upper torso was taken as baseline. At the 3-month postoperative visit, another 3D scan was taken. Audodesk Meshmixer was used to evaluate the volume change. RESULTS The volume of fat injected during the initial procedure did not differ significantly between the treatment arms (P > 0.05). Both active filtration and low-pressure decantation resulted in higher percentage volume retention than traditional decantation (P < 0.05). Active filtration and low-pressure decantation exhibited comparable degrees of fat maintenance at 3 months (P > 0.05). DISCUSSION Compared with using traditional decantation as the lipoaspirate purification technique, active filtration and low-pressure decantation may have led to higher levels of cell viability by way of reduced cellular debris and other inflammatory components that may contribute to tissue resorption and necrosis. Further immunohistochemistry studies are needed to examine whether active filtration and low-pressure decantation lead to lipoaspirates with more concentrated viable adipocytes, progenitor cells, and factors for angiogenesis.
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Affiliation(s)
- Yunchan Chen
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
| | - Sophia Arbuiso
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
| | | | - Grant G Black
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
| | | | - Matthew W Liao
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
| | - Samuel J Medina
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
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Vernice NA, Dong X, Matavosian AA, Corpuz GS, Shin J, Bonassar LJ, Spector JA. Bioengineering Full-scale auricles using 3D-printed external scaffolds and decellularized cartilage xenograft. Acta Biomater 2024:S1742-7061(24)00141-7. [PMID: 38494083 DOI: 10.1016/j.actbio.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/10/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
Reconstruction of the human auricle remains a formidable challenge for plastic surgeons. Autologous costal cartilage grafts and alloplastic implants are technically challenging, and aesthetic and/or tactile outcomes are frequently suboptimal. Using a small animal "bioreactor", we have bioengineered full-scale ears utilizing decellularized cartilage xenograft placed within a 3D-printed external auricular scaffold that mimics the size, shape, and biomechanical properties of the native human auricle. The full-scale polylactic acid ear scaffolds were 3D-printed based upon data acquired from 3D photogrammetry of an adult ear. Ovine costal cartilage was processed either through mincing (1 mm3) or zesting (< 0.5 mm3), and then fully decellularized and sterilized. At explantation, both the minced and zested neoears maintained the size and contour complexities of the scaffold topography with steady tissue ingrowth through 6 months in vivo. A mild inflammatory infiltrate at 3 months was replaced by homogenous fibrovascular tissue ingrowth enveloping individual cartilage pieces at 6 months. All ear constructs were pliable, and the elasticity was confirmed by biomechanical analysis. Longer-term studies of the neoears with faster degrading biomaterials will be warranted for future clinical application. STATEMENT OF SIGNIFICANCE: Accurate reconstruction of the human auricle has always been a formidable challenge to plastic surgeons. In this article, we have bioengineered full-scale ears utilizing decellularized cartilage xenograft placed within a 3D-printed external auricular scaffold that mimic the size, shape, and biomechanical properties of the native human auricle. Longer-term studies of the neoears with faster degrading biomaterials will be warranted for future clinical application.
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Affiliation(s)
- Nicholas A Vernice
- Laboratory of Bioregenerative Medicine & Surgery, Department of Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Xue Dong
- Laboratory of Bioregenerative Medicine & Surgery, Department of Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Alicia A Matavosian
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - George S Corpuz
- Laboratory of Bioregenerative Medicine & Surgery, Department of Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, NY, USA
| | - James Shin
- Department of Radiology, Well Cornell Medicine, New York, NY, USA
| | - Lawrence J Bonassar
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA; Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Jason A Spector
- Laboratory of Bioregenerative Medicine & Surgery, Department of Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, NY, USA; Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA; Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY, USA.
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Huang H, Lu Wang M, Chen Y, Chadab TM, Vernice NA, Otterburn DM. A Machine Learning Approach to Predicting Donor Site Complications Following DIEP Flap Harvest. J Reconstr Microsurg 2024; 40:70-77. [PMID: 37040876 DOI: 10.1055/a-2071-3368] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
BACKGROUND The additional donor site incisions in autologous breast reconstruction can predispose to abdominal complications. The purpose of this study is to delineate predictors of donor site morbidity following deep inferior epigastric perforator (DIEP) flap harvest and use those predictors to develop a machine learning model that can identify high-risk patients. METHODS This is a retrospective study of women who underwent DIEP flap reconstruction from 2011 to 2020. Donor site complications included abdominal wound dehiscence, necrosis, infection, seroma, hematoma, and hernia within 90 days postoperatively. Multivariate regression analysis was used to identify predictors for donor site complications. Variables found significant were used to construct machine learning models to predict donor site complications. RESULTS Of 258 patients, 39 patients (15%) developed abdominal donor site complications, which included 19 cases of dehiscence, 12 cases of partial necrosis, 27 cases of infection, and 6 cases of seroma. On univariate regression analysis, age (p = 0.026), body mass index (p = 0.003), mean flap weight (p = 0.006), and surgery time (p = 0.035) were predictors of donor site complications. On multivariate regression analysis, age (p = 0.025), body mass index (p = 0.010), and surgery duration (p = 0.048) remained significant. Radiographic features of obesity, such as abdominal wall thickness and total fascial diastasis, were not significant predictors of complications (p > 0.05). In our machine learning algorithm, the logistic regression model was the most accurate at predicting donor site complications with the accuracy of 82%, specificity of 0.93, and negative predictive value of 0.87. CONCLUSION This study demonstrates that body mass index is superior to radiographic features of obesity in predicting donor site complications following DIEP flap harvest. Other predictors include older age and longer surgery duration. Our logistic regression machine learning model has the potential to quantify the risk of donor site complications.
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Affiliation(s)
- Hao Huang
- NewYork-Presbyterian Hospital-Cornell and Columbia, New York, New York
| | - Marcos Lu Wang
- Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, New York
| | - Yunchan Chen
- Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, New York
| | - Tara M Chadab
- NewYork-Presbyterian Hospital-Cornell and Columbia, New York, New York
| | - Nicholas A Vernice
- Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, New York
| | - David M Otterburn
- Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, New York
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Vernice NA, Jung WF, Black GG, Demetres M, Otterburn DM. Streamlining the Fat: A Systematic Review of Active Closed Wash and Filtration in Autologous Fat Grafting After Breast Reconstruction. Aesthet Surg J 2023; 43:1481-1488. [PMID: 37210472 PMCID: PMC10653348 DOI: 10.1093/asj/sjad153] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/27/2023] [Accepted: 05/01/2023] [Indexed: 05/22/2023] Open
Abstract
Although fat grafting in breast reconstruction continues to grow in popularity, the optimal technique remains elusive and outcomes are varied. This systematic review of available controlled studies utilizing active closed wash and filtration (ACWF) systems sought to examine differences in fat processing efficiency, aesthetic outcomes, and revision rates. A literature search was performed from inception to February 2022 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in Ovid MEDLINE (Wolters Kluwer, Alphen aan den Rijn, the Netherlands), Ovid Embase (Wolters Kluwer), and Cochrane Library (Wiley, Hoboken, NJ). Two independent reviewers screened the studies for eligibility with Covidence software. Bibliographies and citing references from selected articles were screened from Scopus (Elsevier, Amsterdam, the Netherlands). The search identified 3476 citations, with 6 studies included. Three studies demonstrated a significantly higher volume of graftable fat harvested in a significantly lower mean grafting time with ACWF than with their respective controls. With respect to adverse events, 3 studies reported significantly lower incidences of nodule or cyst formation with ACWF with respect to control. Two studies reported a significantly lower incidence of fat necrosis with ACWF vs control, with this trend upheld in 2 additional studies. Three studies reported significantly lower revision rates with ACWF with respect to control. No study reported inferiority with ACWF for any outcome of interest. These data suggest that ACWF systems yield higher fat volumes in less time than other common techniques, with decreased rates of suboptimal outcomes and revisions, thereby supporting active filtration as a safe and efficacious means of fat processing that may reduce operative times. Further large-scale, randomized trials are needed to definitively demonstrate the above trends. LEVEL OF EVIDENCE: 4
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Affiliation(s)
| | | | | | | | - David M Otterburn
- Corresponding Author: Dr David M. Otterburn, 525 East 68th Street, Starr 8, New York, NY 10065, USA. E-mail: ; Instagram: @cornellcolumbiaplasticsurgery
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Shih S, Askinas CA, Vernice NA, Otterburn DM. Applicant Perspective on the Plastic Surgery Common Application (PSCA): A Cross-Sectional Analysis of the 2021-2022 National Residency Matching Program Applicant Pool. J Plast Reconstr Aesthet Surg 2023; 79:30-32. [PMID: 36842285 DOI: 10.1016/j.bjps.2023.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 01/17/2023] [Accepted: 01/29/2023] [Indexed: 02/10/2023]
Affiliation(s)
- Sabrina Shih
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, NY
| | - Carly A Askinas
- Division of Plastic and Reconstructive Surgery, Tulane University School of Medicine, New Orleans, LA 70112
| | - Nicholas A Vernice
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, NY
| | - David M Otterburn
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, NY.
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Lu Wang M, Valenti AB, Qin N, Vernice NA, Huang H, Cohen LE, Otterburn DM. Using Clinical Measurements to Predict Breast Skin Necrosis: A Quantitative Analysis. Ann Plast Surg 2023; 90:163-170. [PMID: 36688860 DOI: 10.1097/sap.0000000000003363] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Breast skin necrosis can lead to poor healing, reoperation, and unaesthetic reconstructive outcomes after mastectomy. Furthermore, the prolonged recovery can delay adjuvant oncologic regimens. This study aims to explore the role of breast surface area as a risk factor for mastectomy skin flap necrosis and to identify predictive clinical measurements. METHODS The authors retrospectively identified patients who underwent immediate breast reconstruction (N = 926 breasts) by 2 surgeons at a single institution between 2011 and 2021. Preoperative breast measurements such as nipple-notch (NN) distance, nipple-inframammary fold (NF) distance, chest width (CW), breast circumference (BC), and breast height (BH) were used to estimate breast surface area. Univariate analysis and receiver operating characteristic curves were used to determine predictive measurements and optimal cutoff values. RESULTS When approximated using either a cone without base or a half ellipsoid, larger surface area was a significant risk factor for mastectomy skin flap necrosis (P = 0.027 and P = 0.022, respectively). Larger NN, NF, CW, BC, and BH measurements were significant predictors of necrosis (P < 0.05). Surface area (cone without base) greater than 212 cm2, surface area (half ellipsoid) greater than 308 cm2, NN distance greater than 27 cm, NF greater than 8.5 cm, CW greater than 15 cm, BC greater than 29 cm, and BH greater than 10.5 cm are all values shown to increase the incidence of necrosis. CONCLUSIONS Larger breast surface area is an independent risk factor for breast skin necrosis. Preoperative breast measurements can be a useful adjunct for predicting necrosis in postmastectomy patients.
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Affiliation(s)
- Marcos Lu Wang
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
| | | | - Nancy Qin
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
| | - Nicholas A Vernice
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
| | - Hao Huang
- NewYork-Presbyterian Hospital, New York, NY
| | - Leslie E Cohen
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
| | - David M Otterburn
- From the Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine
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Bender RJ, Askinas C, Vernice NA, Dong X, Harris J, Shih S, Spector JA. Perfuse and Reuse: A Low-Cost Three-Dimensional-Printed Perfusion Bioreactor for Tissue Engineering. Tissue Eng Part C Methods 2022; 28:623-633. [PMID: 36094108 PMCID: PMC9805868 DOI: 10.1089/ten.tec.2022.0139] [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: 07/22/2022] [Accepted: 09/08/2022] [Indexed: 01/13/2023] Open
Abstract
This article describes fabrication of a customizable bioreactor, which comprises a perfusion system and coverslip-based tissue culture chamber that allow centimeter-scale vascularized or otherwise canalized tissue constructs to be maintained in weeks long static and/or perfusion culture at an exceptionally low cost, with intermittent live imaging and media sampling capabilities. The perfusion system includes a reusable polydimethylsiloxane (PDMS) lid generated from a three-dimensional (3D)-printed poly-lactic acid (PLA) mold and several lengths of perfusion tubing. The coverslip tissue culture chamber includes PDMS components built with 3D-printed PLA molds, as well as 3D-printed PLA frames and glass coverslips that house perfusable hydrogel constructs. As proof of concept, we fabricated a vascularized hydrogel construct, which was subjected to static and perfusion tissue culture, as well as flow studies using fluorescent beads and widefield fluorescent microscopy. This system can be readily reproduced, promoting the advancement of tissue engineering and regenerative medicine research.
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Affiliation(s)
- Ryan J. Bender
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA
- College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Carly Askinas
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Nicholas A. Vernice
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Xue Dong
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Jason Harris
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Sabrina Shih
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Jason A. Spector
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA
- Department of Biomedical Engineering, Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York, USA
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Vernice NA, Askinas CA, Black GG, Truong AY, Reif TJ, Rozbruch SR, Otterburn DM. Osseointegration for Lower-Extremity Amputees: Operative Considerations from the Plastic Surgeon's Perspective. JBJS Rev 2022; 10:01874474-202211000-00003. [PMID: 36574447 PMCID: PMC10979937 DOI: 10.2106/jbjs.rvw.22.00125] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
➢ Osseointegration for lower-extremity amputees, while increasing in frequency, remains in its relative infancy compared with traditional socket-based prostheses. ➢ Ideal candidates for osseointegration have documented failure of a traditional prosthesis and should be skeletally mature, have adequate bone stock, demonstrate an ability to adhere to a longitudinal rehabilitation protocol, and be in an otherwise good state of health. ➢ Lowering the reoperation rate for soft-tissue complications depends heavily on surgical technique and on the implant device itself; the current gold standard involves a smooth implant surface for dermal contact as well as maximal skin resection to prevent skin breakdown against the prosthesis. This may include the need for thighplasty to optimize skin reduction. ➢ Interdisciplinary peripheral nerve management, such as targeted muscle reinnervation, performed in tandem with a plastic surgery team can treat existing and prevent future symptomatic neuromas, ultimately improving pain outcomes.
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Affiliation(s)
- Nicholas A Vernice
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY
| | - Carly A Askinas
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY
| | - Grant G Black
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY
| | - Albert Y Truong
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY
| | - Taylor J Reif
- Department of Limb Lengthening and Complex Reconstruction, Hospital for Special Surgery, New York, NY
| | - S Robert Rozbruch
- Department of Limb Lengthening and Complex Reconstruction, Hospital for Special Surgery, New York, NY
| | - David M Otterburn
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY
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Vernice NA, Wingo ME, Walker PB, Demetres M, Stalter LN, Yang Q, de Biasi AR. The great vessel freeze-out: A meta-analysis of conventional versus frozen elephant trunks in aortic arch surgery. J Card Surg 2022; 37:2397-2407. [PMID: 35526122 PMCID: PMC9322650 DOI: 10.1111/jocs.16596] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/16/2022] [Accepted: 03/27/2022] [Indexed: 01/03/2023]
Abstract
Background The optimal treatment strategy for complex aortic arch and proximal descending aortic pathologies remains controversial. Despite the frozen elephant trunk (FET) technique's increasing popularity, its use over the conventional elephant trunk (CET) remains a matter of physician preference and outcomes are varied. Methods This meta‐analysis of available comparative studies of FET versus CET sought to examine differences in survival, reintervention, and adverse events. The following databases were searched from inception—May 2020: Ovid MEDLINE, Ovid EMBASE, and The Cochrane Library. Studies retrieved were then screened for eligibility against predefined inclusion/exclusion criteria with a protocol registered on Open Science Framework at https://osf.io/hrfze/. Results The search identified 1911 citations, with five studies included. The resultant meta‐analysis included 313 CET and 292 FET cases. FET had lower perioperative mortality (risk ratio [RR]: 0.50, 95% confidence interval [CI]: [0.42; 0.60], p < .001) and improved 1‐year survival compared to CET (hazard ratio: 0.63, 95% CI: [0.42; 0.95], p = .03). There were no significant differences in rates of overall or open reinterventions following FET versus CET, but FET did yield a significantly higher rate of endovascular reintervention (RR: 2.32, 95% CI: [1.17; 4.61], p = .03). No significant differences were observed in the incidences of postoperative stroke, spinal cord injury, or renal failure between groups. Conclusions The FET technique yields superior rates of perioperative and medium‐term survival with no significant increase in overall reinterventions. There was no significant difference in the rate of spinal cord injury between groups, providing further large‐scale evidence that the FET is an acceptable, safe alternative to the CET.
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Affiliation(s)
- Nicholas A Vernice
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Matthew E Wingo
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Paul B Walker
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Michelle Demetres
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York, USA
| | - Lily N Stalter
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Qiuyu Yang
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Andreas R de Biasi
- Division of Cardiothoracic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Vernice NA, Caughey S, Berri N, Harris J, Matavosian A, Dong X, Bender RJ, Bonassar L, Spector JA. Off-the-Shelf Nipple Engineering: Neonipple Formation via Implantation of Scaffolded Decellularized Ovine Xenograft. Ann Plast Surg 2022; 88:S302-S308. [PMID: 35513336 PMCID: PMC9097005 DOI: 10.1097/sap.0000000000003184] [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] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nipple reconstruction is widely regarded as the final step in postmastectomy breast reconstruction. While grafts, local flaps, or combination approaches have been used in nipple reconstruction, none has been able to achieve reliable long-term projection preservation. In response, we have sought to bioengineer neonipples in situ via the implantation of processed, decellularized cartilage xenografts placed within 3-dimensional-printed polylactic acid (PLA) scaffolds. MATERIALS AND METHODS External nipple scaffolds were designed in-house and 3-dimensional-printed with PLA filament. Decellularized ovine xenograft infill was prepared and processed by mincing or zesting. All nipple scaffolds were placed subcutaneously on the dorsa of Sprague-Dawley rats and explanted after 1, 3, and 6 months for analysis. RESULTS Explanted nipple scaffolds demonstrated gross maintenance of scaffold shape, diameter, and projection with accompanying increases in tissue volume. Histologic analyses revealed preservation of native cartilage architecture after 6 months without evidence of degradation. Analysis of formed tissue within the scaffolds revealed a progressive invasion of fibrovascular tissue with identifiable vascular channels and adipose tissue after 6 months in vivo. Confined compression testing revealed equilibrium moduli of both minced and zested samples that were within the expected range of previously reported human nipple tissue, while these data revealed no differences in the mechanical properties of the neotissue between time points or processing techniques. CONCLUSIONS These preliminary data support potential use of decellularized allograft to foster healthy tissue ingrowth within a PLA scaffold, thereby offering a novel solution to current limitations in nipple reconstruction.
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Affiliation(s)
- Nicholas A. Vernice
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Sarah Caughey
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Nabih Berri
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Jason Harris
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Alicia Matavosian
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Xue Dong
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Ryan J. Bender
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Lawrence Bonassar
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Jason A. Spector
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY, USA
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
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Vernice NA, Berri N, Bender RJ, Dong X, Spector JA. Production of a Low-Cost, Off-the-Shelf, Decellularized Cartilage Xenograft for Tissue Regeneration. Ann Plast Surg 2022; 88:S296-S301. [PMID: 35513335 PMCID: PMC9097345 DOI: 10.1097/sap.0000000000003185] [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] [Indexed: 11/25/2022]
Abstract
BACKGROUND Reconstruction of cartilaginous deformities is a well-established surgical challenge with high levels of unpredictability and complication. Because of the morbidity associated with autologous cartilage grafting, combined with its limited supply and the significant expense of commercially decellularized allografts, increasing efforts have sought to produce an acellular, nonimmunogenic cartilage xenograft. We have developed and validated a novel protocol for high throughput decellularization of ovine costal cartilage with immediate translational potential for preclinical investigation of novel strategies for cartilaginous reconstruction. METHODS Floating ribs were isolated from freshly slaughtered rack of lamb and after cleaning, the ribs were either minced into 2-mm cubes or zested into 1-mm flakes. Tissue was then decellularized via a protocol consisting of 4 freeze/thaw cycles, digestion with trypsin, incubation in hyperosmolar and hypoosmolar salt solutions, with incubation in 1% Tween following both the hyperosmolar and hypoosmolar steps, a 48-hour incubation in nucleases, DNA elution via EDTA, and 2 terminal sterilization steps. Protocol success was evaluated via histologic analysis with hematoxylin and eosin, DAPI, and safranin-O staining, as well as DNA quantification. RESULTS Histologic analysis of the decellularized tissue revealed a significant reduction in nuclei as evidenced by hematoxylin and eosin and DAPI staining (P < 0.01). Safranin-O staining demonstrated a depletion of glycosaminoglycan content in the decellularized cartilage but with preservation of tissue architecture. Unprocessed lamb cartilage contained 421 ± 60 ng DNA/mg of lyophilized tissue, whereas decellularized zested and minced costal cartilage contained 27 ± 2 ng DNA/mg lyophilized tissue (P < 0.0001) and 24 ± 2.3 ng DNA/mg lyophilized tissue (p < 0.0001), respectively, well below the threshold of 50 ng accepted as evidence of suitable decellularization. In comparison, commercial allograft cartilage contained 17 ± 5 ng DNA/mg of lyophilized tissue. CONCLUSIONS We have developed a novel protocol for the decellularization of xenogeneic cartilage graft. This structurally stable, low immunogenicity decellularized cartilage can be produced at low cost in large quantities for use in preclinical investigation.
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Affiliation(s)
- Nicholas A. Vernice
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY
| | - Nabih Berri
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY
| | - Ryan J. Bender
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY
| | - Xue Dong
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY
| | - Jason A. Spector
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY
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Mencia-Trinchant N, MacKay MJ, Chin C, Afshinnekoo E, Foox J, Meydan C, Butler D, Mozsary C, Vernice NA, Darby C, Schatz MC, Bailey SM, Melnick AM, Guzman ML, Bolton K, Braunstein LZ, Garrett-Bakelman F, Levine RL, Hassane DC, Mason CE. Clonal hematopoiesis before, during, and after human spaceflight. Cell Rep 2021; 34:108740. [PMID: 33567281 DOI: 10.1016/j.celrep.2021.108740] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Karten A, Vernice NA, Renna HA, Carsons SE, DeLeon J, Pinkhasov A, Gomolin IH, Glass DS, Reiss AB, Kasselman LJ. Effect of oxytocin on lipid accumulation under inflammatory conditions in human macrophages. Exp Mol Pathol 2021; 118:104604. [PMID: 33434610 DOI: 10.1016/j.yexmp.2021.104604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/02/2020] [Revised: 12/21/2020] [Accepted: 01/07/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND AIMS Oxytocin (OT) is a neuropeptide hormone secreted by the posterior pituitary gland. Deficits in OT action have been observed in patients with behavioral and mood disorders, some of which correlate with an increased risk of cardiovascular disease (CVD). Recent research has revealed a wider systemic role that OT plays in inflammatory modulation and development of atherosclerotic plaques. This study investigated the role that OT plays in cholesterol transport and foam cell formation in LPS-stimulated THP-1 human macrophages. METHODS THP-1 differentiated macrophages were treated with media, LPS (100 ng/ml), LPS + OT (10 pM), or LPS + OT (100 pM). Changes in gene expression and protein levels of cholesterol transporters were analyzed by real time quantitative PCR (RT-qPCR) and Western blot, while oxLDL uptake and cholesterol efflux capacity were evaluated with fluorometric assays. RESULTS RT-qPCR analysis revealed a significant increase in ABCG1 gene expression upon OT + LPS treatment, compared to LPS alone (p = 0.0081), with Western blotting supporting the increase in expression of the ABCG1 protein. Analysis of oxLDL uptake showed a significantly lower fluorescent value in LPS + OT (100pM) -treated cells when compared to LPS alone (p < 0.0001). While not statistically significant (p = 0.06), cholesterol efflux capacity increased with LPS + OT treatment. CONCLUSION We demonstrate here that OT can attenuate LPS-mediated lipid accumulation in THP-1 macrophages. These findings support the hypothesis that OT could be used to reduce pro-inflammatory and potentially atherogenic changes observed in patients with heightened CVD risk. This study suggests further exploration of OT effects on monocyte and macrophage cholesterol handling in vivo.
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Affiliation(s)
- Ariel Karten
- NYU Langone Hospital - Long Island Biomedical Research Institute and NYU Long Island School of Medicine, Mineola, New York, United States of America
| | - Nicholas A Vernice
- NYU Langone Hospital - Long Island Biomedical Research Institute and NYU Long Island School of Medicine, Mineola, New York, United States of America
| | - Heather A Renna
- NYU Langone Hospital - Long Island Biomedical Research Institute and NYU Long Island School of Medicine, Mineola, New York, United States of America
| | - Steven E Carsons
- NYU Langone Hospital - Long Island Biomedical Research Institute and NYU Long Island School of Medicine, Mineola, New York, United States of America
| | - Joshua DeLeon
- NYU Langone Hospital - Long Island Biomedical Research Institute and NYU Long Island School of Medicine, Mineola, New York, United States of America
| | - Aaron Pinkhasov
- NYU Langone Hospital - Long Island Biomedical Research Institute and NYU Long Island School of Medicine, Mineola, New York, United States of America
| | - Irving H Gomolin
- NYU Langone Hospital - Long Island Biomedical Research Institute and NYU Long Island School of Medicine, Mineola, New York, United States of America
| | - Daniel S Glass
- NYU Langone Hospital - Long Island Biomedical Research Institute and NYU Long Island School of Medicine, Mineola, New York, United States of America
| | - Allison B Reiss
- NYU Langone Hospital - Long Island Biomedical Research Institute and NYU Long Island School of Medicine, Mineola, New York, United States of America
| | - Lora J Kasselman
- NYU Langone Hospital - Long Island Biomedical Research Institute and NYU Long Island School of Medicine, Mineola, New York, United States of America.
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Vernice NA, Pereira NM, Wang A, Demetres M, Adams LV. The adverse health effects of punitive immigrant policies in the United States: A systematic review. PLoS One 2020; 15:e0244054. [PMID: 33326463 PMCID: PMC7744052 DOI: 10.1371/journal.pone.0244054] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/16/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Immigrants in the United States (US) today are facing a dynamic policy landscape. The Trump administration has threatened or curtailed access to basic services for 10.5 million undocumented immigrants currently in the US. We sought to examine the historical effects that punitive laws have had on health outcomes in US immigrant communities. METHODS In this systematic review, we searched the following databases from inception-May 2020 for original research articles with no language restrictions: Ovid MEDLINE, Ovid EMBASE, Cochrane Library (Wiley), Web of Science Core Collection (Clarivate), CINAHL (EBSCO), and Social Work Abstracts (Ovid). This study is registered with PROSPERO, CRD42019138817. Articles with cohort sizes >10 that directly evaluated the health-related effects of a punitive immigrant law or policy within the US were included. FINDINGS 6,357 studies were screened for eligibility. Of these, 32 studies were selected for inclusion and qualitatively synthesized based upon four themes that appeared throughout our analysis: (1) impact on healthcare utilization, (2) impact on women's and children's health, (3) impact on mental health services, and (4) impact on public health. The impact of each law, policy, mandate, and directive since 1990 is briefly discussed, as are the limitations and risk of bias of each study. INTERPRETATION Many punitive immigrant policies have decreased immigrant access to and utilization of basic healthcare services, while instilling fear, confusion, and anxiety in these communities. The federal government should preserve and expand access for undocumented individuals without threat of deportation to improve health outcomes for US citizens and noncitizens.
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Affiliation(s)
- Nicholas A. Vernice
- Center for Global Health Equity, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America
- Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
- * E-mail:
| | - Nicola M. Pereira
- Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Anson Wang
- Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Michelle Demetres
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York, United States of America
| | - Lisa V. Adams
- Center for Global Health Equity, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America
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Mencia-Trinchant N, MacKay MJ, Chin C, Afshinnekoo E, Foox J, Meydan C, Butler D, Mozsary C, Vernice NA, Darby C, Schatz MC, Bailey SM, Melnick AM, Guzman ML, Bolton K, Braunstein LZ, Garrett-Bakelman F, Levine RL, Hassane DC, Mason CE. Clonal Hematopoiesis Before, During, and After Human Spaceflight. Cell Rep 2020; 33:108458. [PMID: 33242405 PMCID: PMC9398182 DOI: 10.1016/j.celrep.2020.108458] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 10/29/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022] Open
Abstract
Clonal hematopoiesis (CH) occurs when blood cells harboring an advantageous mutation propagate faster than others. These mutations confer a risk for hematological cancers and cardiovascular disease. Here, we analyze CH in blood samples from a pair of twin astronauts over 4 years in bulk and fractionated cell populations using a targeted CH panel, linked-read whole-genome sequencing, and deep RNA sequencing. We show CH with distinct mutational profiles and increasing allelic fraction that includes a high-risk, TET2 clone in one subject and two DNMT3A mutations on distinct alleles in the other twin. These astronauts exhibit CH almost two decades prior to the mean age at which it is typically detected and show larger shifts in clone size than age-matched controls or radiotherapy patients, based on a longitudinal cohort of 157 cancer patients. As such, longitudinal monitoring of CH may serve as an important metric for overall cancer and cardiovascular risk in astronauts. Trinchant et al. examined twin astronauts for clonal hematopoiesis (CH). Some high-risk CH clones (TET2 and DNMT3A) were observed two decades before expected, with TET2 decreasing in spaceflight and elevating later post flight. Thus, CH is an important metric for overall cancer and cardiovascular risk in astronauts.
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17
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Vernice NA, Meydan C, Afshinnekoo E, Mason CE. Long-term spaceflight and the cardiovascular system. Precis Clin Med 2020; 3:284-291. [PMID: 33391848 PMCID: PMC7757439 DOI: 10.1093/pcmedi/pbaa022] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [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: 05/07/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 02/01/2023] Open
Abstract
While early investigations into the physiological effects of spaceflight suggest the body's ability to reversibly adapt, the corresponding effects of long-term spaceflight (>6 months) are much less conclusive. Prolonged exposure to microgravity and radiation yields profound effects on the cardiovascular system, including a massive cephalad fluid translocation and altered arterial pressure, which attenuate blood pressure regulatory mechanisms and increase cardiac output. Also, central venous pressure decreases as a result of the loss of venous compression. The stimulation of baroreceptors by the cephalad shift results in an approximately 10%–15% reduction in plasma volume, with fluid translocating from the vascular lumen to the interstitium. Despite possible increases in cardiac workload, myocyte atrophy and notable, yet unexplained, alterations in hematocrit have been observed. Atrophy is postulated to result from shunting of protein synthesis from the endoplasmic reticulum to the mitochondria via mortalin-mediated action. While data are scarce regarding their causative agents, arrhythmias have been frequently reported, albeit sublethal, during both Russian and American expeditions, with QT interval prolongation observed in long, but not short duration, spaceflight. Exposure of the heart to the proton and heavy ion radiation of deep space has also been shown to result in coronary artery degeneration, aortic stiffness, carotid intima thickening via collagen-mediated action, accelerated atherosclerosis, and induction of a pro-inflammatory state. Upon return, long-term spaceflight frequently results in orthostatic intolerance and altered sympathetic responses, which can prove hazardous should any rapid mobilization or evacuation be required, and indicates that these cardiac risks should be especially monitored for future missions.
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Affiliation(s)
- Nicholas A Vernice
- The Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, 1305 York Avenue, New York, NY 10021, USA
| | - Cem Meydan
- The Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, 1305 York Avenue, New York, NY 10021, USA
| | - Ebrahim Afshinnekoo
- The Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, 1305 York Avenue, New York, NY 10021, USA
| | - Christopher E Mason
- The Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, 1305 York Avenue, New York, NY 10021, USA
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18
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Duval KEA, Vernice NA, Wagner RJ, Fiering SN, Petryk JD, Lowry GJ, Tau SS, Yin J, Houde GR, Chaudhry AS, Hoopes PJ. Immunogenetic effects of low dose (CEM43 30) magnetic nanoparticle hyperthermia and radiation in melanoma cells. Int J Hyperthermia 2020; 36:37-46. [PMID: 31795829 PMCID: PMC6943912 DOI: 10.1080/02656736.2019.1627433] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Indexed: 02/08/2023] Open
Abstract
Objective: In this in vitro study we have used an RNA quantification technique, nanoString, and a conventional protein analysis technique (Western Blot) to assess the genetic and protein expression of B16 murine melanoma cells following a modest magnetic nanoparticle hyperthermia (mNPH) dose equivalent to 30 minutes @ 43°C (CEM43 30) and/or a clinically relevant 8 Gy radiation dose. Methods: Melanoma cells with mNPs(2.5 μg Fe/106 cells) were pelleted and exposed to an alternating magnetic field (AMF) to generate the targeted thermal dose. Thermal dose was accurately monitored by a fiber optic probe and automatically maintained at CEM43 30. All cells were harvested 24 hours after treatment. Results: The mNPH dose demonstrated notable elevations in the thermotolerance/immunogenic HSP70 gene and a number of chemoattractant and toll-like receptor gene pathways. The 8 Gy dose also upregulated a number of important immune and cytotoxic genetic and protein pathways. However, the mNPH/radiation combination was the most effective stimulator of a wide variety of immune and cytotoxic genes including HSP70, cancer regulating chemokines CXCL10, CXCL11, the T-cell trafficking chemokine CXCR3, innate immune activators TLR3, TLR4, the MDM2 and mTOR negative regulator of p53, the pro-apoptotic protein PUMA, and the cell death receptor Fas. Importantly a number of the genetic changes were accurately validated by protein expression changes, i.e., HSP70, p-mTOR, p-MDM2. Conclusion: These results not only show that low dose mNPH and radiation independently increase the expression of important immune and cytotoxic genes but that the effect is greatly enhanced when they are used in combination.
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Affiliation(s)
- Kayla E A Duval
- Thayer School of Engineering, Dartmouth College, Hanover, NH, USA
| | | | - Robert J Wagner
- Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | | | - James D Petryk
- Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | | | - Steven S Tau
- Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - John Yin
- Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Georgia R Houde
- Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | | | - P Jack Hoopes
- Thayer School of Engineering, Dartmouth College, Hanover, NH, USA.,Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
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Shipman WD, Vernice NA, Demetres M, Jorizzo JL. An update on the use of hydroxychloroquine in cutaneous lupus erythematosus: A systematic review. J Am Acad Dermatol 2020; 82:709-722. [DOI: 10.1016/j.jaad.2019.07.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/10/2019] [Accepted: 07/03/2019] [Indexed: 01/03/2023]
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Vernice NA, Shah N, Lam E, Herd P, Reiss AB, Kasselman LJ. The gut microbiome and psycho-cognitive traits. Prog Mol Biol Transl Sci 2020; 176:123-140. [PMID: 33814113 DOI: 10.1016/bs.pmbts.2020.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The idea that trillions of bacteria inhabit our gut is somewhat unnerving, yet these bacteria may have a greater influence on our behavior than previously thought. Accumulating data strongly suggest that these gut commensal organisms have a strong inter-relationship with our brain and behavior, including cognitive function, mood, and personality. In this chapter, we discuss the role of the gut microbiome in the development of human personality, mood and mood disorders, and cognition, with a particular emphasis on the current consensus and controversies in the literature surrounding the behavioral effects of bioactive metabolites, microbial ratio shifts, and neurotransmitter synthesis facilitated by the microbiome.
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Affiliation(s)
| | - Neal Shah
- NYU Winthrop Hospital, Mineola, NY, United States
| | - Eric Lam
- Nassau University Medical Center, East Meadow, NY, United States
| | - Pamela Herd
- McCourt School of Public Policy, Georgetown University, Washington, DC, United States
| | - Allison B Reiss
- NYU Winthrop Hospital, Mineola, NY, United States; NYU Long Island School of Medicine, Mineola, NY, United States
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21
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Reiss AB, Grossfeld D, Kasselman LJ, Renna HA, Vernice NA, Drewes W, Konig J, Carsons SE, DeLeon J. Adenosine and the Cardiovascular System. Am J Cardiovasc Drugs 2019; 19:449-464. [PMID: 30972618 PMCID: PMC6773474 DOI: 10.1007/s40256-019-00345-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Adenosine is an endogenous nucleoside with a short half-life that regulates many physiological functions involving the heart and cardiovascular system. Among the cardioprotective properties of adenosine are its ability to improve cholesterol homeostasis, impact platelet aggregation and inhibit the inflammatory response. Through modulation of forward and reverse cholesterol transport pathways, adenosine can improve cholesterol balance and thereby protect macrophages from lipid overload and foam cell transformation. The function of adenosine is controlled through four G-protein coupled receptors: A1, A2A, A2B and A3. Of these four, it is the A2A receptor that is in a large part responsible for the anti-inflammatory effects of adenosine as well as defense against excess cholesterol accumulation. A2A receptor agonists are the focus of efforts by the pharmaceutical industry to develop new cardiovascular therapies, and pharmacological actions of the atheroprotective and anti-inflammatory drug methotrexate are mediated via release of adenosine and activation of the A2A receptor. Also relevant are anti-platelet agents that decrease platelet activation and adhesion and reduce thrombotic occlusion of atherosclerotic arteries by antagonizing adenosine diphosphate-mediated effects on the P2Y12 receptor. The purpose of this review is to discuss the effects of adenosine on cell types found in the arterial wall that are involved in atherosclerosis, to describe use of adenosine and its receptor ligands to limit excess cholesterol accumulation and to explore clinically applied anti-platelet effects. Its impact on electrophysiology and use as a clinical treatment for myocardial preservation during infarct will also be covered. Results of cell culture studies, animal experiments and human clinical trials are presented. Finally, we highlight future directions of research in the application of adenosine as an approach to improving outcomes in persons with cardiovascular disease.
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22
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Reiss AB, Silverman A, Khalfan M, Vernice NA, Kasselman LJ, Carsons SE, De Leon J. Accelerated Atherosclerosis in Rheumatoid Arthritis: Mechanisms and Treatment. Curr Pharm Des 2019; 25:969-986. [DOI: 10.2174/1381612825666190430113212] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 04/14/2019] [Indexed: 12/11/2022]
Abstract
Background:Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disorder that increases the risk of developing cardiovascular disease. There is accumulating evidence that the RA disease state accelerates the formation of atherosclerotic plaques. Treatments for RA improve joint symptomatology and may reduce inflammation, but consideration of their effects on the cardiovascular system is generally low priority.Objective:Since cardiovascular disease is the leading cause of mortality in RA patients, the impact of RA therapies on atherosclerosis is an area in need of attention and the focus of this review.Results:The drugs used to treat RA may be analgesics, conventional disease-modifying anti-rheumatic drugs, and/or biologics, including antibodies against the cytokine tumor necrosis factor-α. Pain relievers such as nonselective non-steroidal anti-inflammatory drugs and cyclooxygenase inhibitors may adversely affect lipid metabolism and cyclooxygenase inhibitors have been associated with increased adverse cardiovascular events, such as myocardial infarction and stroke. Methotrexate, the anchor disease-modifying anti-rheumatic drug in RA treatment has multiple atheroprotective advantages and is often combined with other therapies. Biologic inhibitors of tumor necrosis factor-α may be beneficial in preventing cardiovascular disease because tumor necrosis factor-α promotes the initiation and progression of atherosclerosis. However, some studies show a worsening of the lipid profile in RA with blockade of this cytokine, leading to higher total cholesterol and triglycerides.Conclusion:Greater understanding of the pharmacologic activity of RA treatments on the atherosclerotic process may lead to improved care, addressing both damages to the joints and heart.
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Affiliation(s)
- Allison B. Reiss
- Winthrop Research Institute, Department of Medicine, NYU Winthrop Hospital, 101 Mineola Boulevard, Suite 4-004, Mineola, NY 11501, United States
| | - Andrew Silverman
- Winthrop Research Institute, Department of Medicine, NYU Winthrop Hospital, 101 Mineola Boulevard, Suite 4-004, Mineola, NY 11501, United States
| | - Muhammed Khalfan
- Winthrop Research Institute, Department of Medicine, NYU Winthrop Hospital, 101 Mineola Boulevard, Suite 4-004, Mineola, NY 11501, United States
| | - Nicholas A. Vernice
- Winthrop Research Institute, Department of Medicine, NYU Winthrop Hospital, 101 Mineola Boulevard, Suite 4-004, Mineola, NY 11501, United States
| | - Lora J. Kasselman
- Winthrop Research Institute, Department of Medicine, NYU Winthrop Hospital, 101 Mineola Boulevard, Suite 4-004, Mineola, NY 11501, United States
| | - Steven E. Carsons
- Winthrop Research Institute, Department of Medicine, NYU Winthrop Hospital, 101 Mineola Boulevard, Suite 4-004, Mineola, NY 11501, United States
| | - Joshua De Leon
- Winthrop Research Institute, Department of Medicine, NYU Winthrop Hospital, 101 Mineola Boulevard, Suite 4-004, Mineola, NY 11501, United States
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23
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Karten A, Kasselman L, Renna HA, Lam E, Glass DS, Vernice NA, DeLeon J, Reiss A. ATHEROPROTECTIVE ACTIONS OF OXYTOCIN IN HUMAN MACROPHAGES: REDUCED LIPID ACCUMULATION UNDER INFLAMMATORY CONDITIONS. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)32666-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Reiss AB, Vernice NA, Siegart NM, De Leon J, Kasselman LJ. Exosomes in Cholesterol Metabolism and Atherosclerosis. Cardiovasc Hematol Disord Drug Targets 2017; 17:185-194. [PMID: 29299993 DOI: 10.2174/1871529x18666180103124443] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 08/14/2017] [Revised: 10/26/2017] [Accepted: 10/28/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Exosomes are small secreted membrane vesicles formed in the late endocytic compartments by inward budding. Interest in these extracellular vesicles and their role in atherosclerosis is growing, as they can affect multiple cellular processes that lead to lipid overload, cytokine secretion and cellular adhesion. Exosomes protect and transport lipids, proteins, and RNAs, fostering intercellular communication among different cell types involved in atherogenesis such as macrophages, endothelium and smooth muscle. Their molecular composition reflects their cell type of origin, but they share attributes because they are enriched in proteins of their endosomal source. CONCLUSION This review will describe the current state of our knowledge of exosome involvement in the development of atherosclerosis. The transfer of signaling molecules, lipids, mRNAs, and microRNAs via exosomes with effects on monocyte and macrophage cholesterol metabolism, endothelial cell and platelet activation and smooth muscle proliferation will be discussed. Finally, therapeutic potential of exosomes and clinical application will be explored.
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Affiliation(s)
- Allison B Reiss
- Winthrop Research Institute and Department of Medicine, NYU Winthrop Hospital, Mineola, NY 11501, United States
| | - Nicholas A Vernice
- Winthrop Research Institute and Department of Medicine, NYU Winthrop Hospital, Mineola, NY 11501, United States
| | - Nicolle M Siegart
- Winthrop Research Institute and Department of Medicine, NYU Winthrop Hospital, Mineola, NY 11501, United States
| | - Joshua De Leon
- Winthrop Research Institute and Department of Medicine, NYU Winthrop Hospital, Mineola, NY 11501, United States
| | - Lora J Kasselman
- Winthrop Research Institute and Department of Medicine, NYU Winthrop Hospital, Mineola, NY 11501, United States
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