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Harrison I, Cohen O, Yi L, Singh A, Gradecki S, Zlotoff B, Flowers RH. Neutrophilic eccrine hidradenitis associated with VEXAS syndrome: a case report. Int J Dermatol 2023. [PMID: 38108564 DOI: 10.1111/ijd.16990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/06/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Iris Harrison
- University of Florida College of Medicine, Gainesville, FL, USA
| | - Olivia Cohen
- Department of Dermatology, University of Virginia, Charlottesville, VA, USA
| | - Lauren Yi
- Department of Dermatology, University of Virginia, Charlottesville, VA, USA
| | - Amrit Singh
- Department of Pathology, University of Virginia, Charlottesville, VA, USA
| | - Sarah Gradecki
- Department of Pathology, University of Virginia, Charlottesville, VA, USA
| | - Barrett Zlotoff
- Department of Dermatology, University of Virginia, Charlottesville, VA, USA
| | - Richard H Flowers
- Department of Dermatology, University of Virginia, Charlottesville, VA, USA
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Guémas E, Coppée R, Ménard S, du Manoir M, Nsango S, Makaba Mvumbi D, Nakoune E, Eboumbou Moukoko CE, Bouyou Akotet MK, Mirabeau TY, Manguin S, Malekita Yobi D, Akiana J, Kouna LC, Mawili Mboumba DP, Voumbo-Matoumona DF, Otam AL, Rubbo PA, Lombart JP, Kwanai E, Cohen O, Iriart X, Ayong L, Lekana-Douki JB, Ariey F, Berry A. Evolution and spread of Plasmodium falciparum mutations associated with resistance to sulfadoxine-pyrimethamine in central Africa: a cross-sectional study. Lancet Microbe 2023; 4:e983-e993. [PMID: 37865113 DOI: 10.1016/s2666-5247(23)00211-2] [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] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Efficacy of sulfadoxine-pyrimethamine, the malaria chemoprophylaxis used in pregnant women, and in children when combined with amodiaquine, is threatened by the accumulation of mutations in the Plasmodium falciparum dihydropteroate synthase (pfdhps) and dihydrofolate reductase (pfdhfr) genes. Data on the prevalence of resistant alleles in central Africa and the new pfdhps I431V mutation, particularly associated with other mutations to form the pfdhps vagKgs allele, are scarce. We explored the frequency and geographical distribution of pfdhps and pfdhfr mutations in central Africa in 2014-18, and assessed the evolutionary origin of the vagKgs allele. METHODS Samples were collected at 18 health-care centres in seven countries (Angola, Cameroon, Central African Republic, Democratic Republic of the Congo, Gabon, Nigeria, and Republic of the Congo) from patients who showed possible symptoms of malaria between March 1, 2014, and Oct 31, 2018. Samples that were positive for P falciparum were transported to a laboratory in Toulouse, France, and genotyped. The frequency of pfdhfr and pfdhps mutations was studied in 1749 samples. Microsatellites in pfdhps flanking regions and whole-genome analysis compared with parasite genomes from the data-sharing network MalariaGEN were performed on samples carrying the vagKgs allele. FINDINGS Mapping of the prevalence of single nucleotide polymorphisms and corresponding alleles of pfdhfr and pfdhps showed a substantial spread of alleles associated with sulfadoxine-pyrimethamine resistance in central Africa during the 2014-18 period, especially an increase going west to east in pfdhps alleles carrying the K540E and A581G mutations. A high prevalence of the pfdhps I431V mutation was observed in Cameroon (exceeding 50% in the northern region) and Nigeria. Genomic analysis showed a recent African emergence and a clonal expansion of the most frequent pfdhps vagKgs allele. INTERPRETATION Reduced sulfadoxine-pyrimethamine efficacy due to increased resistance is a worrying situation, especially because the malaria transmission level is high in central Africa. Although the resistance phenotype remains to be confirmed, the emergence and spread of the vagKgs allele in west and central Africa could challenge the use of sulfadoxine-pyrimethamine. FUNDING Toulouse Institute for Infectious and Inflammatory Diseases.
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Affiliation(s)
- Emilie Guémas
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France; Département de Parasitologie et Mycologie, CHU Toulouse, Toulouse, France; LAAS-CNRS, Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Romain Coppée
- Université Paris Cité and Sorbonne Paris Nord, INSERM, IAME, Paris, France
| | - Sandie Ménard
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France
| | - Milena du Manoir
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France
| | - Sandrine Nsango
- Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroon; Malaria Research Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Dieudonné Makaba Mvumbi
- Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo; Institute for Medical Immunology, Université Libre de Bruxelles, Brussells, Belgium
| | | | - Carole Else Eboumbou Moukoko
- Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroon; Malaria Research Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Marielle Karine Bouyou Akotet
- Département de Parasitologie Mycologie Médecine Tropicale, Faculté de Médecine de l'Université des Sciences de la Santé, Libreville, Gabon; Centre de Recherche Biomédicale en Pathogènes Infectieux et Pathologies Associées, CREIPA, Université des Sciences de la Santé, Libreville, Gabon
| | - Tatfeng Youtchou Mirabeau
- Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, College of Health Sciences, Niger Delta University, Wilberforce Island, Nigeria
| | - Sylvie Manguin
- Hydro Sciences Montpellier, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Doudou Malekita Yobi
- Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean Akiana
- Laboratoire National de Santé Publique, Université Marien Ngouabi, Brazzaville, Republic of the Congo
| | - Lady Charlène Kouna
- Unité d'Evolution Epidémiologie et Résistances Parasitaires, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon; Département de Parasitologie-Mycologie, Université des Sciences de la Santé, Libreville, Gabon
| | - Denise Patricia Mawili Mboumba
- Département de Parasitologie Mycologie Médecine Tropicale, Faculté de Médecine de l'Université des Sciences de la Santé, Libreville, Gabon; Centre de Recherche Biomédicale en Pathogènes Infectieux et Pathologies Associées, CREIPA, Université des Sciences de la Santé, Libreville, Gabon
| | - Dominique Fatima Voumbo-Matoumona
- Laboratoire National de Santé Publique, Université Marien Ngouabi, Brazzaville, Republic of the Congo; Unité d'Evolution Epidémiologie et Résistances Parasitaires, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon; Département de Parasitologie-Mycologie, Université des Sciences de la Santé, Libreville, Gabon
| | - Alliance-Laure Otam
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France
| | | | | | - Elisabeth Kwanai
- Coordination diocésaine de la Santé, Diocèse de Maroua-Mokolo, Maroua, Cameroon
| | - Olivia Cohen
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France
| | - Xavier Iriart
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France; Département de Parasitologie et Mycologie, CHU Toulouse, Toulouse, France
| | - Lawrence Ayong
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Jean Bernard Lekana-Douki
- Unité d'Evolution Epidémiologie et Résistances Parasitaires, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon; Département de Parasitologie-Mycologie, Université des Sciences de la Santé, Libreville, Gabon
| | - Frédéric Ariey
- INSERM U1016, Institut Cochin, Laboratoire de Parasitologie-Mycologie, Hôpital Cochin, AP-HP, Université Paris Cité, Paris, France
| | - Antoine Berry
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France; Département de Parasitologie et Mycologie, CHU Toulouse, Toulouse, France.
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Zhou Y, Myrick JG, Farrell EL, Cohen O. Perceived risk, emotions, and stress in response to COVID-19: The interplay of media use and partisanship. Risk Anal 2023; 43:1572-1586. [PMID: 36307383 PMCID: PMC9874794 DOI: 10.1111/risa.14044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/09/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Relationships between risk perceptions, emotions, and stress are well-documented, as are interconnections between stress, emotion, and media use. During the early COVID-19 pandemic, the public responded psychologically to the threat posed by the pandemic, and frequently utilized media for information and entertainment. However, we lack a comprehensive picture of how perceived risk, emotion, stress, and media affected each other longitudinally during this time. Further, although response to the pandemic was highly politicized, research has yet to address how partisan affiliation moderated relationships between risk, emotion, stress, and media use over time. This three-wave (N = 1021) panel study assessed the interplay of risk, emotion, stress, and media use for Americans with different political affiliations between March and May of 2020. Findings indicate that perceived risk, emotion, and stress at Time 1 predicted media use at Time 2, with predictors varying by type of media. Use of entertainment media and social/mobile media predicted later stress (Time 3), but news consumption did not. Later risk perceptions (Time 3) were not influenced by media use at Time 2. The predictors and consequences of different types of media use were notably different for Republicans and Democrats. In particular, risk perceptions predicted greater news use among Democrats but greater entertainment media use among Republicans. Moreover, social/mobile media use resulted in perceiving the risks of COVID-19 as less serious for Republicans while increasing stress over time for Democrats.
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Affiliation(s)
- Yanmengqian Zhou
- Department of Communication StudiesLouisiana State UniversityBaton RougeLouisianaUSA
| | - Jessica Gall Myrick
- Donald P. Bellisario College of CommunicationsPennsylvania State UniversityState College, Centre CountyPennsylvaniaUSA
| | - Erina L. Farrell
- Department of Communication Arts and SciencesPennsylvania State UniversityState College, Centre CountyPennsylvaniaUSA
| | - Olivia Cohen
- Klein College of Media and CommunicationTemple UniversityPhiladelphiaPennsylvaniaUSA
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Cohen O, Guemas E, Menard S, Tsague Kenfack M, Talom Ngassa C, Iriart X, Bidzogo Lebobo M, Ondobo Ekae C, Eboumbou C, Tiyou Kenmeni C, Berry A. Effect of sulfadoxine-pyrimethamine chemoprophylaxis in pregnant women on selection of the new P. falciparum dhps quintuple mutant carrying the I431V mutation. J Antimicrob Chemother 2023; 78:665-668. [PMID: 36611259 DOI: 10.1093/jac/dkac432] [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: 10/13/2022] [Accepted: 12/03/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND A new mutation in the Plasmodium falciparum dihydropteroate synthetase gene (pfdhps), I431V, has been identified in several countries of Central and West Africa. This mutation is mostly found in association with four other SNPs on pfdhps (S436A, A437G, A581G and A613S), forming a quintuple mutant (vagKgs) and almost always associated with the Plasmodium falciparum dihydrofolate reductase gene (pfdhfr) CirnI (C50R, N51I, S108N) triple mutant. To date, nothing is known about the impact of this new pfdhps genotype on sulfadoxine-pyrimethamine (SP) resistance. OBJECTIVES We sought to assess the prevalence of this pfdhps vagKgs quintuple mutant in two groups of pregnant women with malaria, one that took intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and one that did not. METHODS The pfdhfr and pfdhps genes from Plasmodium falciparum isolates collected in Yaoundé (Cameroon) from pregnant women with symptomatic malaria under IPTp-SP or not, were sequenced. RESULTS Of 159 patients evaluated, 70 had already taken SP during pregnancy and 89 had never taken SP. Only the vagKgs allele was significantly overrepresented in the SP+ group (21.4% versus 3.4%; P < 0.001), whereas the ISgKAA mutant, widely distributed in this area and known to be less susceptible to SP, tended to be less abundant in this group (48.6% versus 64.0%; P = 0.0503). CONCLUSIONS We found a strong overrepresentation of the CirnI/vagKgs haplotype in the IPTp-SP pregnant group, suggesting a high level of resistance of this mutant to SP. This could compromise not only the effectiveness of IPTp-SP but also the seasonal malaria chemoprevention of young children, now widely implemented.
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Affiliation(s)
- Olivia Cohen
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France
| | - Emilie Guemas
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France
| | - Sandie Menard
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France
| | | | - Carine Talom Ngassa
- Centre d'Animation Sociale et Sanitaire (CASS) of Nkolndongo, Yaounde, Cameroon
| | - Xavier Iriart
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France
| | | | | | - Carole Eboumbou
- Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroon
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Calvin Tiyou Kenmeni
- Centre d'Animation Sociale et Sanitaire (CASS) of Nkolndongo, Yaounde, Cameroon
- University Hospital of Yaoundé, Yaoundé, Cameroon
| | - Antoine Berry
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France
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Cohen O, Boutrou M, Nacher M, Caumes E, Djossou F, Epelboin L. A severe case of Plasmodium falciparum malaria imported by a French traveler from Cameroon to French Guiana despite regular intake of Artemisia annua herbal tea. Rev Inst Med Trop Sao Paulo 2023; 65:e3. [PMID: 36651464 PMCID: PMC9870253 DOI: 10.1590/s1678-9946202365003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 10/04/2022] [Indexed: 01/19/2023] Open
Abstract
The use of herbal tea with Artemisia annua by travelers and traditional communities in Africa has increased in recent years as a supposed form of malaria prophylaxis, although its use is not recommended due to lack of efficacy. The risk of severe malaria complications that can lead to death is real regarding said behavior, and awareness needs to be raised. We report a case of severe Plasmodium falciparum malaria imported in the Amazon rainforest by a traveler returning from Cameroon who treated himself with Artemisia annua herbal tea.
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Affiliation(s)
- Olivia Cohen
- Centre Hospitalier de Cayenne Andrée Rosemon, Unité des Maladies Infectieuses et Tropicales, Cayenne, French Guiana
| | - Mathilde Boutrou
- Centre Hospitalier de Cayenne Andrée Rosemon, Unité des Maladies Infectieuses et Tropicales, Cayenne, French Guiana
| | - Mathieu Nacher
- Centre Hospitalier de Cayenne Andrée Rosemon, Centre d’Investigation Clinique Antilles Guyane, Cayenne, French Guiana
| | - Eric Caumes
- Groupe Hospitalier Universitaire Pitié-Salpêtrière, Service des Maladies Infectieuses et Tropicales, Paris, France
| | - Félix Djossou
- Centre Hospitalier de Cayenne Andrée Rosemon, Unité des Maladies Infectieuses et Tropicales, Cayenne, French Guiana
| | - Loïc Epelboin
- Centre Hospitalier de Cayenne Andrée Rosemon, Unité des Maladies Infectieuses et Tropicales, Cayenne, French Guiana,Centre Hospitalier de Cayenne Andrée Rosemon, Centre d’Investigation Clinique Antilles Guyane, Cayenne, French Guiana
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Jendle J, Buompensiere MI, Holm AL, de Portu S, Malkin SJP, Cohen O. A Response to: Letter to the Editor with Regard to the Cost-Effectiveness of an Advanced Hybrid Closed-Loop System in People with Type 1 Diabetes: A Health Economic Analysis in Sweden. Diabetes Ther 2022; 13:1125-1129. [PMID: 35403952 PMCID: PMC9076762 DOI: 10.1007/s13300-022-01252-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 11/03/2022] Open
Affiliation(s)
- J Jendle
- Institute of Medical Sciences, Örebro University, Campus USÖ, 701 82, Örebro, Sweden.
| | | | - A L Holm
- Medtronic Denmark, Copenhagen, Denmark
| | - S de Portu
- Medtronic International Trading Sàrl, Tolechenaz, Switzerland
| | - S J P Malkin
- Ossian Health Economics and Communications, Basel, Switzerland
| | - O Cohen
- Medtronic International Trading Sàrl, Tolechenaz, Switzerland
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7
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Myrick JG, Waldron KA, Cohen O, DiRusso C, Shao R, Cho E, Willoughby JF, Turrisi R. The Effects of Embedded Skin Cancer Interventions on Sun-Safety Attitudes and Attention Paid to Tan Women on Instagram. Front Psychol 2022; 13:838297. [PMID: 35465513 PMCID: PMC9029166 DOI: 10.3389/fpsyg.2022.838297] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives Because of high skin cancer risks for young women, it is vital that effective interventions reach and influence this demographic. Visual social media platforms, like Instagram, are popular with young women and are an appropriate intervention site; yet, they also host competing images idealizing tan skin. The present study tested the ability of digital sun-safety interventions to affect self-control-related emotions and visual attention to subsequent tan-ideal images as well as sun-safety attitudes. Methods Women were recruited from a large public Mid-Atlantic university in the United States. Participants (N = 120) were randomly assigned to view an appearance benefits intervention, a self-control emotions intervention, or a control message, each designed to look like an Instagram sponsored story. After self-reporting self-compassion and anticipated pride, participants then viewed seven pairs of Instagram posts featuring either tan or pale women while an eye tracker assessed visual attention. Finally, participants self-reported their responses to questions assessing sun-safety-related norms, efficacy, and attitudes. Results A mixed design analysis of covariance revealed that women who first viewed the appearance benefits intervention story spent less time visually fixated on Instagram images of tan women than did those who viewed the self-control emotions intervention or control message (p = 0.005, ηp2 = 0.087). Regressions also revealed interactions between the intervention conditions and feelings of anticipated pride on both visual attention and sun-safety attitudes. Conclusion Sponsored stories on Instagram can promote sun-safety attitudes, depending on the emotional responses they generate. Additionally, sponsored interventions can affect subsequent visual attention.
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Affiliation(s)
- Jessica Gall Myrick
- Donald P. Bellisario College of Communications, Pennsylvania State University, University Park, PA, United States
- *Correspondence: Jessica Gall Myrick,
| | - Katja Anne Waldron
- College of Health and Human Development, Pennsylvania State University, University Park, PA, United States
| | - Olivia Cohen
- Donald P. Bellisario College of Communications, Pennsylvania State University, University Park, PA, United States
| | | | - Ruosi Shao
- Donald P. Bellisario College of Communications, Pennsylvania State University, University Park, PA, United States
| | - Eugene Cho
- Department of Communication Studies, The College of New Jersey, Ewing Township, NJ, United States
| | - Jessica Fitts Willoughby
- Edward R. Murrow College of Communication, Washington State University, Pullman, WA, United States
| | - Rob Turrisi
- College of Health and Human Development, Pennsylvania State University, University Park, PA, United States
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8
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Jendle J, Buompensiere MI, Holm AL, de Portu S, Malkin SJP, Cohen O. The Cost-Effectiveness of an Advanced Hybrid Closed-Loop System in People with Type 1 Diabetes: a Health Economic Analysis in Sweden. Diabetes Ther 2021; 12:2977-2991. [PMID: 34596879 PMCID: PMC8519965 DOI: 10.1007/s13300-021-01157-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 09/15/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Swedish National Diabetes Registry data show a correlation of improved glycemic control in people with type 1 diabetes (T1D) with increased use of diabetes technologies over the past 25 years. However, novel technologies are often associated with a high initial outlay. The aim of the present study was to evaluate the long-term cost-effectiveness of the advanced hybrid closed-loop (AHCL) MiniMed 780G system versus intermittently scanned continuous glucose monitoring (isCGM) plus self-injection of multiple daily insulin (MDI) or continuous subcutaneous insulin infusion (CSII) in people with T1D in Sweden. METHODS Outcomes were projected over patients' lifetimes using the IQVIA CORE Diabetes Model (v9.0). Clinical data, including changes in glycated hemoglobin (HbA1c) and hypoglycemia rates, were sourced from observational studies and a randomized crossover trial. Modeled patients were assumed to receive the treatments for their lifetimes, with HbA1c kept constant following the application of treatment effects. Costs were accounted from a societal perspective and expressed in Swedish krona (SEK). Utilities and days off work estimates were taken from published sources. RESULTS The MiniMed 780G system was associated with an improvement in life expectancy of 0.16 years and an improvement in quality-adjusted life expectancy of 1.95 quality-adjusted life years (QALYs) versus isCGM plus MDI or CSII. These clinical benefits were due to a reduced incidence and a delayed time to onset of diabetes-related complications. Combined costs were estimated to be SEK 727,408 (EUR 72,741) higher with MiniMed 780G, with treatment costs partially offset by direct cost savings from the avoidance of diabetes-related complications and indirect cost savings from the avoidance of lost workplace productivity. The MiniMed 780G system was associated with an incremental cost-effectiveness ratio of SEK 373,700 per QALY gained. CONCLUSIONS Based on a willingness-to-pay threshold of SEK 500,000 per QALY gained, the MiniMed 780G system was projected to be cost-effective versus isCGM plus MDI or CSII for the treatment of T1D in Sweden.
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Affiliation(s)
- Johan Jendle
- Institute of Medical Sciences, Campus USÖ, Örebro University, 701 82, Örebro, Sweden.
| | | | - A L Holm
- Medtronic Denmark, Copenhagen, Denmark
| | - S de Portu
- Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - S J P Malkin
- Ossian Health Economics and Communications, Basel, Switzerland
| | - O Cohen
- Medtronic International Trading Sàrl, Tolochenaz, Switzerland
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Nachman D, Eisenkraft A, Maor Y, Constantini K, Goldstein G, Levy R, Halberthal M, Horowitz NA, Golan R, Rosenberg E, Lavon E, Cohen O, Shapira G, Shomron N, Gepner Y. Continuous monitoring of advanced hemodynamic parameters shows early cardiovascular changes in a cohort of 492 COVID-19 hospitalized patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
COVID-19 exerts deleterious cardiopulmonary effects, leading to worse prognosis in the most effected.
Purpose
The aim of this retrospective multi-center observational cohort study was to analyze the trajectories of key advanced hemodynamic parameters amongst hospitalized COVID-19 patients according to different risk populations using a chest-patch wearable providing continuous remote patient monitoring.
Methods
The study was conducted in five COVID-19 isolation units. Patients admitted to the units were connected to a photoplethysmography based noninvasive remote advanced hemodynamic monitor after completing a basic risk factor survey. Physiological parameters were measured every 15 minutes during the hospitalization, including cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), heart rate, blood pressure (BP), respiratory rate, blood oxygen saturation (SpO2), and body temperature.
Results
492 COVID-19 patients (179 females, average age 58.7 years) were included in the final analysis, with more than 3 million measurements collected during an average of 75.3 hours. Overall, within the first five days of hospitalizations we found a significant increase in SVR, and a significant decrease in SpO2, DBP, CO and CI (p<0.01 for all). The changes were more prominent in high risk populations- males, older age and obesity and had a temporal correspondence to changes in respiratory parameters.
Conclusions
This is the first comprehensive continuous advanced hemodynamic profiling of COVID-19 patients. Worse hemodynamic status was prominent in high risk populations.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Nachman
- Hadassah - Hebrew University Medical Center Jerusalem, Jerusalem, Israel
| | - A Eisenkraft
- The Hebrew University Faculty of Medicine, Jerusalem, Israel, and the Israel Defense Force Medical, Institute for Research in Military Medicine, Jerusalem, Israel
| | - Y Maor
- The Edith Wolfson Medical Center, Holon, Israel
| | - K Constantini
- Tel Aviv University, Department of Epidemiology, Preventive Medicine, School of Public Health, Sylvan Adams Sports center, Tel Aviv, Israel
| | - G Goldstein
- Tel Aviv University, Department of Epidemiology, Preventive Medicine, School of Public Health, Sylvan Adams Sports center, Tel Aviv, Israel
| | - R Levy
- Maccabi Healthcare Services, Tel Aviv, Israel
| | | | | | - R Golan
- Baruch Padeh Medical Center, The Faculty of Medicine in Galilee, Bar Ilan University, Tiberias, Israel
| | - E Rosenberg
- Soroka University Medical Center, Beer Sheva, Israel
| | - E Lavon
- Kaplan Medical Center, Rehovot, Israel
| | - O Cohen
- The Edith Wolfson Medical Center, Holon, Israel
| | - G Shapira
- Tel Aviv University, Tel Aviv, Israel
| | - N Shomron
- Tel Aviv University, Tel Aviv, Israel
| | - Y Gepner
- Tel Aviv University, Department of Epidemiology, Preventive Medicine, School of Public Health, Sylvan Adams Sports center, Tel Aviv, Israel
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10
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Cohen O, Aleem M, Wolberink S, Perenyei MA. Giant pedunculated liver mass: primary hepatocellular carcinoma masquerading as hepatic haemangioma. BMJ Case Rep 2021; 14:e242625. [PMID: 34593547 PMCID: PMC8487204 DOI: 10.1136/bcr-2021-242625] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A woman in her mid-60s was referred to surgeons with a 2-week history of worsening right-sided abdominal pain. CT demonstrated a large encapsulated, pedunculated hepatic lesion with active intracapsular bleeding and free fluid but nil further lesions. Findings suggested giant hepatic haemangioma; surgical excision took place the following day. Histopathology however confirmed malignancy. Pedunculated hepatocellular carcinoma (HCC) is rare but characteristically large and encapsulated. Sporadic case reports indicate that diagnosis is typically challenging and delayed with liver metastases at presentation. This case describes a patient with no clear risk factors for HCC found to have a well-defined, encapsulated and pedunculated mass but no detected metastasis or other lesions on initial CT. In this instance, subsequent MRI did identify further lesions in the liver. Such cases are limited in the literature: much remains to be learnt regarding presentation, differential diagnoses, investigation and management.
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Affiliation(s)
- Olivia Cohen
- Department of General Surgery, Jersey General Hospital, Saint Helier, Jersey
| | - Muhammad Aleem
- Department of General Surgery, Jersey General Hospital, Saint Helier, Jersey
| | - Steven Wolberink
- Department of General Surgery, Jersey General Hospital, Saint Helier, Jersey
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11
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Cohen O, Ismail A, Manwani R, Ravichandran S, Foard D, Mahmood S, Sachchithanantham S, Martinez-Naharro A, Fontana M, Lachmann H, Hawkins P, Gillmore J, Whelan C, Wechalekar A. Global longitudinal strain predicts survival and response in patients with systemic AL amyloidosis. analysis of 915 patients from the ALchemy prospective trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0856] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac involvement determines prognosis in systemic AL amyloidosis. The extent is assessed by biomarker-based staging systems. This a prospective report of a large cohort of patients assessing the utility of changes in longitudinal function by 2D strain (GLS%), impairment - a hallmark of amyloidosis.
Purpose
To evaluate the prognostic role of GLS% and other echocardiographic parameters in systemic AL amyloidosis.
Methods
915 newly diagnosed patients seen at the UK National Amyloidosis Centre (February 2010–August 2017) were included. All patients underwent 6-monthly comprehensive assessments inclusive of echocardiogram. The European modification of the Mayo 2004 staging was used with Mayo stage III patients stratified into IIIa (NT-proBNP <8500ng/L) and IIIb (NT-proBNP ≥8500ng/L).
Results
653/915 (71.4%) patients had cardiac involvement. Mayo stage 1, 2, 3a and 3b in 144 (15.7%), 302 (33.0%) 344 (37.6%) and 125 (13.7%) respectively. The median NT-proBNP was 2228ng/L and TNT was 0.54ng/ml. The GLS% significantly worsened with increasing Mayo stage (p<0.0001 between GLS% for each Mayo stage). Poorer baseline GLS% associated with significantly worse OS and stratified patients into three groups: GLS% <−12.8%: OS 69.1 months; GLS% −12.8% to −9%: OS 54.5 months; GLS% >−9%: OS 45.3 months (p<0.0001). On univariate analysis, 11/14 parameters predicted survival (LV wall thickness, LV ejection fraction, systolic velocities of the septal (s'sep) and lateral mitral annulus (s' lat), mitral annulus movement at the lateral corner (e' lat), transmitral early peak flow velocity (E) divided by tissue Doppler mitral annular motion velocity (e') – E/e' and mitral annular plane systolic excursion (MAPSE)). Baseline GLS% >−17% was independent of Mayo stage in predicting survival [Mayo II: Hazard ratio (HR) 2.10 (95% CI: 1.12–3.92) p=0.02, Mayo III: HR 3.94 (95% CI: 2.13–7.32) p<0.0001, Mayo IV: HR 7.49 (95% CI: 3.94–14.21) p<0.0001, GLS <17%: HR 2.14 (95% CI: 1.59–2.88) p<0.0001]. At 12 months, only patients in a haematological complete response (CR) had significant improvement in overall GLS% (p=0.02) as well as baso-lateral (p=0.0004) and baso-septal (p=0.0001) GLS% and MAPSE (p=0.002). The OS was significantly better in patients who achieved a minimum absolute improvement in GLS% of 1.5% improvement (not reached in those with improved GLS% vs. 72 mo in those without) (p=0.034)).
Conclusion
These data show that baseline GLS% is an independent predictor of survival in AL amyloidosis. GLS% is the first functional marker that is independent of the Mayo staging in predicting outcomes and should be incorporated in prognostic staging for patients with AL amyloidosis. GLS% shows improvement in patients who achieve a complete haematologic response to treatment and improvement in GLS% of 1.5% is associated with improved outcomes. An absolute improvement in GLS% should be considered as a criterion for cardiac response in AL amyloidosis.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- O Cohen
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - A Ismail
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - R Manwani
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - S Ravichandran
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - D Foard
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - S Mahmood
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - S Sachchithanantham
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - A Martinez-Naharro
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - M Fontana
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - H Lachmann
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - P Hawkins
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - J Gillmore
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - C Whelan
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
| | - A.D Wechalekar
- National Amyloidosis Centre, Royal Free Hospital, Greater London, United Kingdom
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12
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Cohen O, Boumaza X, Alvarez M, Porte L, Lansalot P, Martin-Blondel G, Delobel P. Épidémie d’oreillons en milieu sportif chez des patients correctement vaccinés. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Cohen O, Gabay S, Khafif A. Insertion of a vacuum based drain for post-parotidectomy non-resolving seroma in an outpatient setting. Br J Oral Maxillofac Surg 2020; 59:197-201. [PMID: 33349493 DOI: 10.1016/j.bjoms.2020.08.047] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/10/2020] [Indexed: 02/06/2023]
Abstract
We describe a novel technique for the insertion of a vacuum drain, in an outpatient setting, for persistent seroma post-parotidectomy. This is a retrospective case series of a single academic centre. The complete medical records of all patients who underwent parotidectomy between 2014 and 2019 were reviewed. Data regarding demographics, comorbidities, and intraoperative and postoperative courses were extracted for patients for whom a vacuum drain was inserted due to persistent seroma. A size 8 Fr drain was inserted using a novel approach through the parotidectomy incision using 'Biovac' (Biometrix) 50ml, Trocar kit, that had been adjusted and modified for this purpose. Two hundred and eighteen patients had had parotidectomy during the study period. Eight patients (3.6%) underwent insertion of the drain due to persistent seroma. In three patients (37.5%) no drain was inserted during the initial surgery. The mean (SD) time between surgery and insertion of the outpatient vacuum drain was 10 (5) days. All drain insertions were uneventful and no complications were noted. The mean (SD) time for outpatient vacuum drain removal was 12.75 (4.3) days. A single patient (12.5%) underwent additional needle aspiration of 5cc few days following removal of the drain. Persistent seromas may be managed in an outpatient clinic with good results and a high safety profile.
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Affiliation(s)
- O Cohen
- A.R.M. Center for Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel.
| | - S Gabay
- A.R.M. Center for Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel
| | - A Khafif
- A.R.M. Center for Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel
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14
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Waks AG, Cohen O, Kochupurakkal B, Kim D, Dunn CE, Buendia Buendia J, Wander S, Helvie K, Lloyd MR, Marini L, Hughes ME, Freeman SS, Ivy SP, Geradts J, Isakoff S, LoRusso P, Adalsteinsson VA, Tolaney SM, Matulonis U, Krop IE, D'Andrea AD, Winer EP, Lin NU, Shapiro GI, Wagle N. Reversion and non-reversion mechanisms of resistance to PARP inhibitor or platinum chemotherapy in BRCA1/2-mutant metastatic breast cancer. Ann Oncol 2020; 31:590-598. [PMID: 32245699 DOI: 10.1016/j.annonc.2020.02.008] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/05/2020] [Accepted: 02/12/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Little is known about mechanisms of resistance to poly(adenosine diphosphate-ribose) polymerase inhibitors (PARPi) and platinum chemotherapy in patients with metastatic breast cancer and BRCA1/2 mutations. Further investigation of resistance in clinical cohorts may point to strategies to prevent or overcome treatment failure. PATIENTS AND METHODS We obtained tumor biopsies from metastatic breast cancer patients with BRCA1/2 deficiency before and after acquired resistance to PARPi or platinum chemotherapy. Whole exome sequencing was carried out on each tumor, germline DNA, and circulating tumor DNA. Tumors underwent RNA sequencing, and immunohistochemical staining for RAD51 foci on tumor sections was carried out for functional assessment of intact homologous recombination (HR). RESULTS Pre- and post-resistance tumor samples were sequenced from eight patients (four with BRCA1 and four with BRCA2 mutation; four treated with PARPi and four with platinum). Following disease progression on DNA-damaging therapy, four patients (50%) acquired at least one somatic reversion alteration likely to result in functional BRCA1/2 protein detected by tumor or circulating tumor DNA sequencing. Two patients with germline BRCA1 deficiency acquired genomic alterations anticipated to restore HR through increased DNA end resection: loss of TP53BP1 in one patient and amplification of MRE11A in another. RAD51 foci were acquired post-resistance in all patients with genomic reversion, consistent with reconstitution of HR. All patients whose tumors demonstrated RAD51 foci post-resistance were intrinsically resistant to subsequent lines of DNA-damaging therapy. CONCLUSIONS Genomic reversion in BRCA1/2 was the most commonly observed mechanism of resistance, occurring in four of eight patients. Novel sequence alterations leading to increased DNA end resection were seen in two patients, and may be targetable for therapeutic benefit. The presence of RAD51 foci by immunohistochemistry was consistent with BRCA1/2 protein functional status from genomic data and predicted response to later DNA-damaging therapy, supporting RAD51 focus formation as a clinically useful biomarker.
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Affiliation(s)
- A G Waks
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Boston, USA; Broad Institute of MIT and Harvard, Cambridge, USA; Harvard Medical School, Boston, USA; Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA
| | - O Cohen
- Broad Institute of MIT and Harvard, Cambridge, USA; Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA
| | - B Kochupurakkal
- Center for DNA Damage and Repair, Dana-Farber Cancer Institute, Boston, USA
| | - D Kim
- Broad Institute of MIT and Harvard, Cambridge, USA; Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA
| | - C E Dunn
- Center for DNA Damage and Repair, Dana-Farber Cancer Institute, Boston, USA
| | - J Buendia Buendia
- Broad Institute of MIT and Harvard, Cambridge, USA; Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA
| | - S Wander
- Broad Institute of MIT and Harvard, Cambridge, USA; Harvard Medical School, Boston, USA; Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA; Center for DNA Damage and Repair, Dana-Farber Cancer Institute, Boston, USA
| | - K Helvie
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA
| | - M R Lloyd
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; University of Massachusetts Medical School, Worcester, USA
| | - L Marini
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA
| | - M E Hughes
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - S S Freeman
- Broad Institute of MIT and Harvard, Cambridge, USA
| | - S P Ivy
- Investigational Drug Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, USA
| | - J Geradts
- City of Hope Comprehensive Cancer Center, Duarte, USA
| | - S Isakoff
- Harvard Medical School, Boston, USA; Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, USA
| | | | | | - S M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Boston, USA; Harvard Medical School, Boston, USA
| | - U Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Boston, USA; Harvard Medical School, Boston, USA
| | - I E Krop
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Boston, USA; Harvard Medical School, Boston, USA
| | - A D D'Andrea
- Harvard Medical School, Boston, USA; Center for DNA Damage and Repair, Dana-Farber Cancer Institute, Boston, USA; Department of Radiation Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA
| | - E P Winer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Boston, USA; Harvard Medical School, Boston, USA
| | - N U Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Boston, USA; Harvard Medical School, Boston, USA
| | - G I Shapiro
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Boston, USA; Harvard Medical School, Boston, USA; Center for DNA Damage and Repair, Dana-Farber Cancer Institute, Boston, USA
| | - N Wagle
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Boston, USA; Broad Institute of MIT and Harvard, Cambridge, USA; Harvard Medical School, Boston, USA; Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA.
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15
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Barroso-Sousa R, Jain E, Cohen O, Kim D, Buendia-Buendia J, Winer E, Lin N, Tolaney SM, Wagle N. Prevalence and mutational determinants of high tumor mutation burden in breast cancer. Ann Oncol 2020; 31:387-394. [PMID: 32067680 DOI: 10.1016/j.annonc.2019.11.010] [Citation(s) in RCA: 191] [Impact Index Per Article: 47.8] [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: 05/21/2019] [Revised: 11/14/2019] [Accepted: 11/17/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND High tumor mutation burden (TMB) can benefit immunotherapy for multiple tumor types, but the prevalence of hypermutated breast cancer is not well described. The aim of this study was to evaluate the frequency, mutational patterns, and genomic profile of hypermutated breast cancer. PATIENTS AND METHODS We used de-identified data from individuals with primary or metastatic breast cancer from six different publicly available genomic studies. The prevalence of hypermutated breast cancer was determined among 3969 patients' samples that underwent whole exome sequencing or gene panel sequencing. The samples were classified as having high TMB if they had ≥10 mutations per megabase (mut/Mb). An additional eight patients were identified from a Dana-Farber Cancer Institute cohort for inclusion in the hypermutated cohort. Among the patients with high TMB, the mutational patterns and genomic profiles were determined. A subset of patients was treated with regimens containing PD-1 inhibitors. RESULTS The median TMB was 2.63 mut/Mb. The median TMB significantly varied according to the tumor subtype (HR-/HER2- >HER2+ >HR+/HER2-, P < 0.05) and sample type (metastatic > primary, P = 2.2 × 10-16). Hypermutated tumors were found in 198 patients (5%), with enrichment in metastatic versus primary tumors (8.4% versus 2.9%, P = 6.5 × 10-14). APOBEC activity (59.2%), followed by mismatch repair deficiency (MMRd; 36.4%), were the most common mutational processes among hypermutated tumors. Three patients with hypermutated breast cancer-including two with a dominant APOBEC activity signature and one with a dominant MMRd signature-treated with pembrolizumab-based therapies derived an objective and durable response to therapy. CONCLUSION Hypermutation occurs in 5% of all breast cancers with enrichment in metastatic tumors. Different mutational signatures are present in this population with APOBEC activity being the most common dominant process. Preliminary data suggest that hypermutated breast cancers are more likely to benefit from PD-1 inhibitors.
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Affiliation(s)
- R Barroso-Sousa
- Department of Medical Oncology; Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA
| | - E Jain
- Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA; Broad Institute of MIT and Harvard, Cambridge, USA
| | - O Cohen
- Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA; Broad Institute of MIT and Harvard, Cambridge, USA
| | - D Kim
- Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA; Broad Institute of MIT and Harvard, Cambridge, USA
| | - J Buendia-Buendia
- Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA; Broad Institute of MIT and Harvard, Cambridge, USA
| | - E Winer
- Department of Medical Oncology; Harvard Medical School, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Boston, USA
| | - N Lin
- Department of Medical Oncology; Harvard Medical School, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Boston, USA
| | - S M Tolaney
- Department of Medical Oncology; Harvard Medical School, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Boston, USA
| | - N Wagle
- Department of Medical Oncology; Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, USA; Broad Institute of MIT and Harvard, Cambridge, USA; Harvard Medical School, Boston, USA; Department of Medicine, Brigham and Women's Hospital, Boston, USA.
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16
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Cohen O, Adi M, Shapira-Galitz Y, Halperin D, Warman M. Anatomic variations of the paranasal sinuses in the general pediatric population. Rhinology 2019; 57:206-212. [PMID: 30778427 DOI: 10.4193/rhin18.193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The prevalence of sinuses' anatomic variations in the healthy pediatric population has not been studied. The study describes the prevalence of known anatomic variations with regard to gender and age in this population. METHODS A single academic institute observational cohort study. A total of 200 head CT scans were reviewed, subdivided into five equal age subgroups (0-4.99; 5-7.99; 8-10.99; 11-13.99; 14-17 years), with an equal male to female ratio. Different subgroups were randomly assigned to two senior residents (100 CTs each). A senior rhinologist and radiologist were randomly selected to review 100 CTs each. Consensus was reached after a joint review. Each CT was evaluated for the presence of sinuses and the following variations: deviated septum, frontoethmoidal, infraorbital, posterior-ethmoid cells (Kuhn, Haller, and Onodi cells, respectively) and concha bullosa. Definitions were made according to the European Position on Rhinosinusitis 2012. RESULTS Gender did not affect sinus development or anatomical variations. The frontal and sphenoid sinuses were significantly less developed in the 0-4.99 years group. The point prevalence of concha bullosa and deviated septum significantly increased with age. The point prevalence of Haller cells demonstrated borderline significance among age groups, with children 0-4.99 demonstrating the lowest point prevalence. A significant association was found between the existence of Haller cells to Kuhn and Onodi cells. CONCLUSIONS Anatomical variations should be expected in the pediatric population. Familiarity with their point prevalence and associations may assist pediatric endoscopic sinus surgery planning.
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Affiliation(s)
- O Cohen
- Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel; Hebrew University- Hadassah Medical School, Jerusalem, Israel
| | - M Adi
- Department of Radiology, Kaplan Medical Center, Rehovot, Israel; Hebrew University- Hadassah Medical School, Jerusalem, Israel
| | - Y Shapira-Galitz
- Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel; Hebrew University- Hadassah Medical School, Jerusalem, Israel
| | - D Halperin
- Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel; Hebrew University- Hadassah Medical School, Jerusalem, Israel
| | - M Warman
- Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel; Hebrew University- Hadassah Medical School, Jerusalem, Israel
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Alrasheed N, Lee L, Ghorani E, Cohen O, Chavda S, Henry J, Furness A, Chin M, Galas-Filipowicz D, Conde L, De-Silva D, Quezada S, Yong K. PF563 MARROW INFILTRATING T-REGULATORY CELLS ASSOCIATE WITH PD-1 EXPRESSING CD4 EFFECTOR CELLS AND INFERIOR OUTCOMES IN PATIENTS UNDERGOING NOVEL-AGENT REGIMENS FOR NEWLY DIAGNOSED MULTIPLE MYELOMA (MM). Hemasphere 2019. [DOI: 10.1097/01.hs9.0000560544.93776.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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18
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Sidorenko P, Dikopoltsev A, Zahavy T, Lahav O, Gazit S, Shechtman Y, Szameit A, Tannor DJ, Eldar YC, Segev M, Cohen O. Improving techniques for diagnostics of laser pulses by compact representations. Opt Express 2019; 27:8920-8934. [PMID: 31052703 DOI: 10.1364/oe.27.008920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 02/09/2019] [Indexed: 06/09/2023]
Abstract
We propose and demonstrate, numerically and experimentally, use of sparsity as prior information for extending the capabilities and performance of techniques and devices for laser pulse diagnostics. We apply the concept of sparsity in three different applications. First, we improve a photodiode-oscilloscope system's resolution for measuring the intensity structure of laser pulses. Second, we demonstrate the intensity profile reconstruction of ultrashort laser pulses from intensity autocorrelation measurements. Finally, we use a sparse representation of pulses (amplitudes and phases) to retrieve measured pulses from incomplete spectrograms of cross-correlation frequency-resolved optical gating traces.
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19
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Cohen O, Buendia-Buendia J, Wander S, Nayar U, Mao P, Waks A, Kim D, Freeman S, Adalsteinsson V, Helvie K, Livitz D, Rosebrock D, Leshchiner I, Dellostritto L, Garrido-Castro A, Jain E, Periyasamy S, Mackichan C, Lloyd M, Marini L, Krop I, Garraway L, Getz G, Winer E, Lin N, Wagle N. Abstract PD9-02: Evolutionary analysis of 462 serial metastatic biopsies from 208 patients with estrogen receptor-positive (ER+) metastatic breast cancer (MBC) using whole exome sequencing (WES). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd9-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: While great strides have been made in the treatment of ER+ MBC, therapeutic resistance is nearly universal. The genomic evolution of ER+ breast cancer in the metastatic setting under the selective pressure of multiple lines of therapies is not well understood. To address this, we analyzed the clonal dynamics of serial metastatic samples (mets) to evaluate how tumors evolve and to identify acquired resistance mechanisms.
Methods: We performed WES on 462 clinically annotated samples from 208 patients (pts) with ER+ MBC, including 67 primary tumor biopsies, 229 metastatic biopsies and 160 blood samples (cfDNA). Pts with multiple mets included cases with temporally concordant metastatic tumor and blood samples (48 pts) and cases with serial mets obtained over the course of treatment in the metastatic setting (69 pts). Treatments given between the serial mets included CDK4/6 inhibitors (23 pts), and selective estrogen receptor degraders (19 pts), among others.
Results: In the temporally-concordant mets, we found that cfDNA mutations (muts) largely overlap with muts found in tumor biopsies, capturing >85% of clonal tumor muts. However, we observed a higher level of heterogeneity in cfDNA compared to biopsies (p.value< 1.05e-19, Welch test) and a subset of high-confidence muts that were only detected in cfDNA, including in clinically important genes such as ESR1, PIK3CA, KRAS, and ERBB2. Analysis of serial mets was used to elucidate the evolutionary dynamics within the metastatic setting under the selective pressure of treatment. The median duration between mets was 112 days and the median number of inter-biopsy unique treatments was two. Most tumors continued to evolve within the metastatic setting, with 50 out of 69 pts (72%) acquiring a meaningful sub-clone (50% increase in relative cancer cell fraction) and 31 out of 69 (45%) acquiring muts in known cancer genes, including a subset acquiring a plausible resistance alteration such as alterations that dysregulate ER (5 out of 69 pts, 7%; ESR1 mut, FOXA1 amplification (amp), NCOR1 bi-allelic deletion (del)), ERBB (4%; ERBB2 amp, ERBB3 mut), RAS (4%; KRAS mut, NRAS amp, NF1 del), FGF/FGFR (12%; FGFR2 mut, FGFR1/2 amp, FGF3 amp), and cell cycle (13%; RB1 del, CDK4 amp, AURKA amp, CDKN2A del). Finally, in pts who had multiple mets, we observed several cases of evolutionary convergence toward equivalent resistance mechanisms including convergent RB1 loss as a mechanism of resistance to a CDK4/6 inhibitor and convergent BRCA2 reversion following resistance to a PARP inhibitor.
Conclusions: This study demonstrates that ER+ MBC continues to evolve under the selective pressure of treatments in the metastatic setting. These findings elucidate the challenge of studying high complexity and heavily treated tumors, while also highlighting some commonalities in the evolutionary trajectories selected by these treatments. The multiplicity of clinically relevant genomic alterations acquired in these advanced stages highlights the need for serial biopsies and the potential to inform post-progression therapeutic choices through targeting the acquired dependencies in post-progression tumors.
Citation Format: Cohen O, Buendia-Buendia J, Wander S, Nayar U, Mao P, Waks A, Kim D, Freeman S, Adalsteinsson V, Helvie K, Livitz D, Rosebrock D, Leshchiner I, Dellostritto L, Garrido-Castro A, Jain E, Periyasamy S, Mackichan C, Lloyd M, Marini L, Krop I, Garraway L, Getz G, Winer E, Lin N, Wagle N. Evolutionary analysis of 462 serial metastatic biopsies from 208 patients with estrogen receptor-positive (ER+) metastatic breast cancer (MBC) using whole exome sequencing (WES) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD9-02.
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Affiliation(s)
- O Cohen
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - J Buendia-Buendia
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - S Wander
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - U Nayar
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - P Mao
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - A Waks
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - D Kim
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - S Freeman
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - V Adalsteinsson
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - K Helvie
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - D Livitz
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - D Rosebrock
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - I Leshchiner
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - L Dellostritto
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - A Garrido-Castro
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - E Jain
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - S Periyasamy
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - C Mackichan
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - M Lloyd
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - L Marini
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - I Krop
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - L Garraway
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - G Getz
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - E Winer
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - N Lin
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
| | - N Wagle
- Broad Institute of MIT and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital Cancer Center, Charlestown, MA
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Jain E, Kim D, Buendia JB, Cohen O, Sousa RB, Anastasio E, Dunphy M, McGillicuddy M, Stoddard R, Balch S, Thomas B, Di Lascio S, Tomson BN, Nguyen C, Painter C, Wagle N. Abstract PD9-03: The genomic landscape of de novo metastatic breast cancer (MBC). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd9-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Approximately 5-10% of newly diagnosed breast cancers (BC) are de novo MBC, which means that metastatic disease was identified at the time of initial diagnosis. Patients with de novo MBC are underrepresented in currently available genomic studies. In The Cancer Genome Atlas (TCGA) dataset, only 15 out of ˜980 BC patients can be classified as having de novo MBC. The objective of this study is to analyze the genomic landscape of de novo MBC and to study the genomic differences of this cohort with early stage BC. To enhance our ability to study de novo MBC, we utilized data from the Metastatic Breast Cancer Project (MBCproject), a patient-partnered research project that aims to generate a large public database of clinical, genomic, and patient reported data (PRD) from patients with MBC.
Methods: We defined de novo MBC as patients diagnosed with metastatic disease less than 4 months after their initial diagnosis with BC.Out of 127 patients in the MBCproject with publicly released whole exome sequencing (WES) data, we identified 33 patients with de novo MBC. We combined this data with 15 de novo MBC patients in TCGA. For patients with de novo MBC with multiple tumor biopsies available, we used WES from breast biopsies to enable appropriate comparison to the early stage biopsies. Somatic mutations were evaluated and significantly recurring genes were identified using MutSig2CV. We compared the mutations found in the de novo cohort with early stage tumors. 10 patients in the de novo MBC cohort had paired simultaneous primary and metastatic biopsies; genomic alterations in these samples were compared. Finally, we used RNA sequencing data to compare cytolytic signatures among the de novo and early stage biopsies.
Results: Among the 48 patients analyzed the receptor subtype distribution was: HR+/HER2-(23), HR+/HER2+(13), HR-/HER2+(2), HR-/HER2-(3), HR+/HER2 unknown(5), and HR-/HER2 unknown(2). Histology subtype distribution was as follows: IDC(39), MDLC(6), ILC(2) and Other (1). Significantly recurrent genes in the de novo MBC cohort (q<0.1) included TP53(27%), PIK3CA(30%), CDH1(8%) and MAP3K1(11%). Mutations in PTEN, EGFR, and MDM4 were significantly enriched (p <0.05) in the de novo cohort when compared to early stage BC Evolutionary analysis of paired primary and metastatic biopsies for de novo MBC patients demonstrated the presence of shared clonal mutations, indicating that these were highly evolutionarily related. RNA-seq immune cytolytic signature was downregulated in de novo MBC as compared to early stage BC (p <0.2).
Gene% Mutation Rate in De Novo MBC (N=48)% Mutation rate in Early Stage BC (N= 997)p-valuePTEN10.403.510.0324EGFR6.250.500.00435MDM44.170.300.0189
Conclusions: Our initial results highlight genomic differences between de novo MBC and early stage BC, including increased frequency of PTEN, EGFR, and MDM4 mutations. Enrichment of PTEN mutations (implicated in tumor immune surveillance), and downregulation of cytolytic signature potentially suggests that de novo MBC may have immunosuppressive tumor microenvironment. To date, ˜1200 patients with self-reported de novo MBC have registered for the MBCproject. We anticipate that additional study of genomic and clinical data from these patients will greatly improve our understanding of de novo MBC.
Citation Format: Jain E, Kim D, Buendia JB, Cohen O, Sousa RB, Anastasio E, Dunphy M, McGillicuddy M, Stoddard R, Balch S, Thomas B, Di Lascio S, Tomson BN, Nguyen C, Painter C, Wagle N. The genomic landscape of de novo metastatic breast cancer (MBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD9-03.
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Affiliation(s)
- E Jain
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - D Kim
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - JB Buendia
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - O Cohen
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - RB Sousa
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - E Anastasio
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - M Dunphy
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - M McGillicuddy
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - R Stoddard
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - S Balch
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - B Thomas
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - S Di Lascio
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - BN Tomson
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - C Nguyen
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - C Painter
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
| | - N Wagle
- The Broad Institute of MIT and Harvard, Cambridge, MA; Dana Farber Cancer Institute, Boston, MA
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Hudry E, Andres-Mateos E, Lerner EP, Volak A, Cohen O, Hyman BT, Maguire CA, Vandenberghe LH. Efficient Gene Transfer to the Central Nervous System by Single-Stranded Anc80L65. Mol Ther Methods Clin Dev 2018; 10:197-209. [PMID: 30109242 PMCID: PMC6083902 DOI: 10.1016/j.omtm.2018.07.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 07/10/2018] [Indexed: 12/27/2022]
Abstract
Adeno-associated viral vectors (AAVs) have demonstrated potential in applications for neurologic disorders, and the discovery that some AAVs can cross the blood-brain barrier (BBB) after intravenous injection has further expanded these opportunities for non-invasive brain delivery. Anc80L65, a novel AAV capsid designed from in silico reconstruction of the viral evolutionary lineage, has previously demonstrated robust transduction capabilities after local delivery in various tissues such as liver, retina, or cochlea, compared with conventional AAVs. Here, we compared the transduction efficacy of Anc80L65 with conventional AAV9 in the CNS after intravenous, intracerebroventricular (i.c.v.), or intraparenchymal injections. Anc80L65 was more potent at targeting the brain and spinal cord after intravenous injection than AAV9, and mostly transduced astrocytes and a wide range of neuronal subpopulations. Although the efficacy of Anc80L65 and AAV9 is similar after direct intraparenchymal injection in the striatum, Anc80L65's diffusion throughout the CNS was more extensive than AAV9 after i.c.v. infusion, leading to widespread EGFP expression in the cerebellum. These findings demonstrate that Anc80L65 is a highly efficient gene transfer vector for the murine CNS. Systemic injection of Anc80L65 leads to notable expression in the CNS that does not rely on a self-complementary genome. These data warrant further testing in larger animal models.
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Affiliation(s)
- Eloise Hudry
- MassGeneral Institute for Neurodegenerative Disease, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Eva Andres-Mateos
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute and Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
- Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - Eli P. Lerner
- MassGeneral Institute for Neurodegenerative Disease, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Adrienn Volak
- Department of Neurology, The Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, MA 02114, USA
| | - Olivia Cohen
- MassGeneral Institute for Neurodegenerative Disease, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Bradley T. Hyman
- MassGeneral Institute for Neurodegenerative Disease, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Casey A. Maguire
- Department of Neurology, The Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, MA 02114, USA
| | - Luk H. Vandenberghe
- Grousbeck Gene Therapy Center, Schepens Eye Research Institute and Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
- Ocular Genomics Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
- Harvard Stem Cell Institute, Harvard University, Cambridge, MA 02138, USA
- The Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
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Cohen O, Gamliel A, Katan J, Kurzbaum E, Riov J, Bar P. Controlling the seed bank of the invasive plant Acacia saligna: comparison of the efficacy of prescribed burning, soil solarization, and their combination. Biol Invasions 2018. [DOI: 10.1007/s10530-018-1738-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
Abstract
Approximately 70% of breast cancers express the estrogen receptor (ER), and estrogen signaling drives breast cancer cell growth and progression. ER-directed therapies are commonly used to treat ER+ breast cancer and have improved survival for patients, yet resistance to those therapies inevitably occurs. Mutations in the estrogen receptor itself occur in ∼25-30% of patients with ER+ metastatic breast cancer that has developed resistance to aromatase inhibitors. Beyond these ER mutations, other resistance mechanisms are not well described. Moreover, clinical mechanisms of resistance to another class of ER-targeted agents, selective estrogen receptor degraders (SERDs), such as fulvestrant have not been clearly identified.
Here we report two FGFR2 mutations identified in patients with resistant ER+ metastatic breast cancer, N550K and M538I. N550K is a well-known activating FGFR2 mutation; M538I stabilizes the active kinase conformation and it has not previously been described in breast cancer. When expressed in ER+ T47D cells, FGFR2 M538I and N550K led to resistance to fulvestrant, and the CDK4/6 inhibitor palbociclib and the combination of the two agents. FGFR2 M538I induced hyperactivity of p-FRS2, p-ERK and p-AKT, which is higher than wildtype FGFR2 and comparable to other known activating mutations N550K and K660N.
In addition, overexpression of M538I mutant reduced sensitivity to FGFR inhibitors PD173074 and dovitinib in T47D cells, suggesting M538I is also functionally activating. Due to the hyperactive downstream signaling elicited by the mutation, cells overexpressing FGFR2 M538I achieved optimal growth in the presence of low dose of FGFR inhibitor. Under such conditions, FGFR2 M538I conferred more potent resistance to fulvestrant as compared to wildtype FGFR2. However, drug resistance resulting from M538I mutant can be fully resensitized to fulvestrant and/or palbociclib with high dose of FGFR inhibitors.
In summary, we have identified activating FGFR2 mutations (M538I and N550K) in ER+ breast cancer patients, which may contribute to the development of resistance to SERDs and CDK4/6 inhibitors. Additional FGFR2 mutations have been recently identified in other cohorts of patients with resistant ER+ metastatic breast cancer, suggesting that this may be a clinical mechanism of resistance in some patients. Patients with activating FGFR2 mutations may benefit from the treatment with an FGFR inhibitor in combination with SERDs and CDK4/6 inhibitors.
Citation Format: Mao P, Kusiel J, Cohen O, Wagle N. The role of FGF/FGFR axis in resistance to SERDs and CDK4/6 inhibitors in ER+ breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD4-01.
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Affiliation(s)
- P Mao
- Dana Farber Cancer Institute; Broad Institute
| | - J Kusiel
- Dana Farber Cancer Institute; Broad Institute
| | - O Cohen
- Dana Farber Cancer Institute; Broad Institute
| | - N Wagle
- Dana Farber Cancer Institute; Broad Institute
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Weinberg A, Granieri M, Cohen O, Bluebond-Langner R, Levine J, Zhao L. 027 Robotic-Assisted Vaginectomy, Mobilization of Vaginal Mucosa for Urethral Lengthening and a Gracilis Muscle Flap for Phalloplasty: A Novel Technique for Female-to-Male Genital Reconstruction. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2017.11.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
Our aim was to examine the influence of BMI on the live-birth rate following IVF/ICSI and evaluate its specific contribution among other factors thus enabling accurate reproductive policy development. All patients that underwent IVF/ICSI at our center during January 2012-July 2015 were included in this retrospective study. A total of 1654 ICSI cycles were divided into four groups according to the patient's BMI (kg/m2): group I (normal weight): <25 (943 cycles); group II (overweight): 25-30 (403 cycles); group III (obese): 30-35 (212 cycles); group IV (morbid obesity): >35 (96 cycles). Comparing the four groups of BMI, mean age and number of previous ART cycles was significantly lower in group I compared to groups II, III and IV. Length of treatment was significantly shorter in group I compared to groups II, III and IV. Ovarian response to COH was comparable in terms of mean estradiol and progesterone levels on the day of hCG administration mean number of oocytes retrieved, fertilized and number of embryos transferred. Endometrial thickness was significantly lower in group IV. Outcome measures, such as implantation rate, clinical pregnancy rate (CPR) per cycle and per ET, as well as live-birth rates did not differ significantly between the groups, although in group IV LBR per cycle and per ET was lower. Multivariate logistic regression stepwise analysis found a significant correlation between age and BMI but did not find correlation between BMI and clinical pregnancy (p = 0.436) or LB (p = 0.206). The results of our relatively large retrospective study did not demonstrate a significant impact of BMI on the ART cycle outcome. Therefore, BMI should not be a basis for IVF treatment denial.
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Affiliation(s)
- S Friedler
- a Infertility and IVF Unit , Barzilai University Medical Center , Ashkelon , Israel
- b Faculty of Health Sciences, Ben Gurion University of the Negev , Beer-Sheva , Israel
| | - O Cohen
- c Research & Development Authority , Barzilai University Medical Center , Ashkelon , Israel
| | - G Liberty
- a Infertility and IVF Unit , Barzilai University Medical Center , Ashkelon , Israel
- b Faculty of Health Sciences, Ben Gurion University of the Negev , Beer-Sheva , Israel
| | - B Saar-Ryss
- a Infertility and IVF Unit , Barzilai University Medical Center , Ashkelon , Israel
- b Faculty of Health Sciences, Ben Gurion University of the Negev , Beer-Sheva , Israel
| | - S Meltzer
- a Infertility and IVF Unit , Barzilai University Medical Center , Ashkelon , Israel
- b Faculty of Health Sciences, Ben Gurion University of the Negev , Beer-Sheva , Israel
| | - T Lazer
- a Infertility and IVF Unit , Barzilai University Medical Center , Ashkelon , Israel
- b Faculty of Health Sciences, Ben Gurion University of the Negev , Beer-Sheva , Israel
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Shoffel-Havakuk H, Cohen O, Slavin M, Haimovich Y, Halperin D, Lahav Y. Intravenous opioid drug abuse as an independent risk factor for supraglottic squamous cell carcinoma-A case-control study. Clin Otolaryngol 2017; 43:456-462. [PMID: 28950046 DOI: 10.1111/coa.12990] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Intravenous opioid drug abuse (IVDA) was previously correlated with laryngeal cancer. However, discrimination of this correlation by anatomical subsites has not yet been described. In this study, we aim to further establish the association between IVDA and laryngeal squamous cell carcinoma (SCC) and to indicate the laryngeal subsites that are predisposed for this correlation. DESIGN A retrospective matched case-control study. SETTING AND PARTICIPANTS Patients diagnosed with supraglottic SCC (SG-SCC) between 1996 and 2016 treated in a tertiary academic referral centre were enrolled to the case group. The control group comprised of matched patients diagnosed with glottis SCC (G-SCC). Matching was based on gender, age and socio-economic rank. MAIN OUTCOME MEASURES Variables studies as risk factors included the following: smoking, alcohol consumption, history of IVDA and infectious diseases. The variables were tested for association with the 2 groups and with each other. RESULTS Forty-eight patients with SG-SCC were matched with 48 patients with G-SCC. IVDA rates significantly increased among patients with SG-SCC. Of the SG-SCC group, 18.8% had a positive history for IVDA compared with 2.1% of the G-SCC (P = .008). A history of IVDA was found to be a risk factor for SG-SCC, independent of smoking, excessive alcohol and socio-economic status. The odds ratio for patients with an IVDA history to have SG-SCC relatively to G-SCC was 10.846 (95% CI: 1.3-89.4). CONCLUSIONS Intravenous opioid drug abuse represents an independent risk factor for SG-SCC. The pathogenesis should be investigated not just as a risk factor, as opioids are commonly used for pain management in oncologic patients.
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Affiliation(s)
- H Shoffel-Havakuk
- Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,Hadassah Medical School, The Hebrew University, Jerusalem, Israel.,Department of Otolaryngology Head and Neck Surgery, USC Voice Center, University of Southern California, Los Angeles, CA, USA
| | - O Cohen
- Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,Hadassah Medical School, The Hebrew University, Jerusalem, Israel
| | - M Slavin
- Department of General Surgery B, Meir Medical Center, Kfar Saba, Israel
| | - Y Haimovich
- Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel
| | - D Halperin
- Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,Hadassah Medical School, The Hebrew University, Jerusalem, Israel
| | - Y Lahav
- Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,Hadassah Medical School, The Hebrew University, Jerusalem, Israel
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27
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Cohen O, Raz Yarkoni T, Lahav Y, Azoulay O, Halperin D, Yehuda M. Surgeon-performed thyroid ultrasound-proving utility and credibility in selecting patients for fine needle aspiration according to the American thyroid association guidelines. A retrospective study of 500 patients. Clin Otolaryngol 2017; 43:267-273. [PMID: 28892590 DOI: 10.1111/coa.12984] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2017] [Indexed: 11/30/2022]
Abstract
DESIGN Case series with chart review. SETTING Single academic centre. PARTICIPANTS The data of all patients who underwent surgeon-performed ultrasound (SUS) between 7/2009 and 9/2012 were retrospectively reviewed. MAIN OUTCOME MEASURES A correlation between sonographic features and a non-benign cytology\malignant pathology. RESULTS Four hundred ninety-eight nodules were included. Solid texture, irregular margins, hypo-echogenicity and intranodular vascularity were significantly associated with malignancy when benign to non-benign cytology was compared, and when compared to malignant pathology. Lack of suspicious features was significantly associated with benign lesions, with a negative predictive value of 94%. Except for taller than wider shape, malignancy odds ratio was significantly higher for known suspicious features, reaching 4.81 for irregular borders (CI 2.42-9.55, P < .001). CONCLUSIONS SUS has proven to be a reliable and consistent tool to assess the thyroid nodule risk stratification. Surgeons should recognise the potential of this tool and its implementation.
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Affiliation(s)
- O Cohen
- Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Hadassah School of Medicine, Hebrew University, Rehovot, Israel
| | - T Raz Yarkoni
- Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Hadassah School of Medicine, Hebrew University, Rehovot, Israel
| | - Y Lahav
- Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Hadassah School of Medicine, Hebrew University, Rehovot, Israel
| | - O Azoulay
- Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Hadassah School of Medicine, Hebrew University, Rehovot, Israel
| | - D Halperin
- Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Hadassah School of Medicine, Hebrew University, Rehovot, Israel
| | - M Yehuda
- Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Hadassah School of Medicine, Hebrew University, Rehovot, Israel.,Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Slutzkey S, Cohen O, Lauritano D, Moses O, Ormianer Z, Tal H, Kolerman R, Carinci F, Matalon S. Temperature changes of one-piece implants during the setting of acrylic resin temporary crown. The effect of implant diameter. An in vitro study. J BIOL REG HOMEOS AG 2017; 31:53-60. [PMID: 28691454] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this work is to evaluate changes in temperature of one-piece titanium implant surface during the setting of acrylic resin temporary crowns and to correlate thermal changes to implant diameter. Thirty-three one-piece implants (ARRP, Alpha-Biotec) were divided into 3 groups according to diameter size (G1=3 mm, G2=3.3 mm, G3=3.6 mm). Implants were mounted on an acrylic glass apparatus. Thermocouples were positioned at the most coronal thread. Lower incisor temporary polycarbonate crowns were filled with 80 μL of self-curing acrylic resin and positioned immediately on the implant abutment. Thermal changes of the implant surface were recorded continuously for 10 min. Data were statistically analyzed using one-way analysis of variance. The mean initial temperature (C0) of groups G1, G2 and G3 was similar (24.79±0.78ºC, 25.26±0.63ºC, 24.97±1.06ºC, respectively). The setting of the acrylic resin temporary crown resulted in a significant increase in the implant surface temperature of all groups. The mean thermal amplitude (ΔC) for groups G1, G2 and G3 were 6.79±1.02ºC, 6.61±0.94ºC, 6.65±1.26ºC, respectively. The mean time to maximum temperature (Tmax) for groups G1, G2 and G3 were 337.38±42.91 sec, 324.69±41.46 sec and 317.98±37.91 sec respectively (P>0.05). Direct application of auto-polymerizing resin to the titanium abutment of one-piece implants significantly increased the cervical implant surface temperature. Implant diameter did not influence the temperature changes.
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Affiliation(s)
- S Slutzkey
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - O Cohen
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - D Lauritano
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - O Moses
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Z Ormianer
- Department of Oral Rehabilitation, School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - H Tal
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - R Kolerman
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - F Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - S Matalon
- Department of Oral Rehabilitation, School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Mao P, Quartey Q, Cohen O, Piccioni F, Wagle N. Abstract P3-03-08: A large-scale functional screen to identify resistance mechanisms to selective estrogen receptor degraders fulvestrant and GDC-810 in ER+ breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-03-08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Therapies that target the estrogen receptor provide clinical benefit and improved survival for patients with estrogen receptor-positive (ER+) breast cancer, yet drug resistance remains a challenging problem, leading to disease relapse and mortality. In recent years, the selective estrogen receptor degrader (SERD) fulvestrant has become an important therapeutic option for patients with resistant ER+ metastatic breast cancer, and newer oral SERDs such as GDC-810 are currently being tested in clinical trials. The mechanisms of intrinsic and acquired resistance to SERDs remain to be fully elucidated.
We conducted a large-scale lentiviral open reading frame (ORF) screen to identify genes whose overexpression confers drug resistance to either fulvestrant or GDC-810 in the ER+ breast cancer cell line T47D. The lentivral ORF expression library used in this study consists of 16,544 barcoded ORFs, including 2,767 ORFs with mutations. The initial screen yielded 72 genes resulting in resistance to fulvestrant and 85 genes resulting in resistance to GDC-0810, with 44 genes overlapping. The top ranked-genes included multiple genes belonging to the PI3K/Akt, ERbB/HER, and FGF/FGFR pathways as well as genes involved in cell cycle progression.
Fibroblast growth factor receptor 1 (FGFR1) amplifications are frequently observed in patients with ER+ breast cancer, and have previously been implicated in resistance to endocrine therapies. Several FGFs (FGF3, FGF6, FGF10, and FGF22) were among the top-ranked resistance genes for both fulvestrant and GDC-0810, suggesting that activation of the FGFR signaling pathway may render cells resistant to fulvestrant and GDC-810. In the presence of FGF2, overexpression of FGFR1 in ER+ breast cancer cells resulted in resistance to both fulvestrant and GDC-0810. The ability of an FGFR inhibitor to overcome FGFR-mediated resistance to SERDs is being tested. Additional potential resistance genes identified in the ORF screen are also being validated.
In summary, a whole-genome functional resistance screen has identified several candidate genes and pathways that may cause resistance to fulvestrant and GDC-810. Several of these candidates, such as FGFR1, are also found in patients who develop resistance to SERDs, suggesting rational combination therapies to overcome or preempt SERD resistance.
Citation Format: Mao P, Quartey Q, Cohen O, Piccioni F, Wagle N. A large-scale functional screen to identify resistance mechanisms to selective estrogen receptor degraders fulvestrant and GDC-810 in ER+ breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-03-08.
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Affiliation(s)
- P Mao
- Dana Farber Cancer Institute, Boston, MA; Broad Institute, Cambridge, MA; Brigham and Women's Hospital, Boston, MA
| | - Q Quartey
- Dana Farber Cancer Institute, Boston, MA; Broad Institute, Cambridge, MA; Brigham and Women's Hospital, Boston, MA
| | - O Cohen
- Dana Farber Cancer Institute, Boston, MA; Broad Institute, Cambridge, MA; Brigham and Women's Hospital, Boston, MA
| | - F Piccioni
- Dana Farber Cancer Institute, Boston, MA; Broad Institute, Cambridge, MA; Brigham and Women's Hospital, Boston, MA
| | - N Wagle
- Dana Farber Cancer Institute, Boston, MA; Broad Institute, Cambridge, MA; Brigham and Women's Hospital, Boston, MA
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Cohen O, Kim D, Oh C, Waks A, Oliver N, Helvie K, Marini L, Rotem A, Lloyd M, Stover D, Adalsteinsson V, Freeman S, Ha G, Cibulskis C, Anderka K, Tamayo P, Johannessen C, Krop I, Garraway L, Winer E, Lin N, Wagle N. Abstract S1-01: Whole exome and transcriptome sequencing of resistant ER+ metastatic breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-s1-01] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: While great strides have been made in the treatment of estrogen receptor-positive (ER+) metastatic breast cancer (MBC), therapeutic resistance invariably occurs. A better understanding of the underlying resistance mechanisms is critical to enable durable control of this disease.
Methods: We performed whole exome sequencing (WES) and transcriptome sequencing (RNA-seq) on metastatic tumor biopsies from 88 patients with ER+ MBC who had developed resistance to one or more ER-directed therapies. For 27 of these patients, we sequenced the treatment-naïve primary tumors for comparison to the resistant specimens. Tumors were analyzed for point mutations, insertions/deletions, copy number alterations, translocations, and gene expression. Detailed clinicopathologic data was collected for each patient and linked to the genomic information.
Results: WES of all metastatic samples demonstrated several recurrently altered genes whose incidence differed significantly from primary, treatment-naïve ER+ breast cancers sequenced in the TCGA study (TCGA). These include ESR1 mutations (n=17, 19.3%; 32.86 fold enrichment, q.value<7.5e-12), CCND1 amplification (n=52, 59.1%; 2.3 fold enrichment, q.value<0.0073), and MAP2K4 biallelic inactivation (n=14, 15.9%; 3.04 fold enrichment, q.value< 0.054).
Comparing to matched primary samples from the same patient, many alterations were found to be acquired in several cases, including for ESR1, ERBB2, PIK3CA, PTEN, RB1, AKT1, and others. Initial analysis of RNA-seq data from metastatic samples (n=59) allowed classification of individual resistance mechanisms into broader resistance modes based on the observed transcriptional state.
Conclusions: We present a genomic landscape of resistant ER+ MBC using WES and RNA-seq. Multiple genes were recurrently altered in these tumors at significantly higher rates than in ER+ primary breast cancer. When compared with matched primary tumors from the same patient, alterations in these and other genes were often found to be acquired after treatment, suggesting a role in resistance to ER-directed therapies and/or metastasis. Potential resistance mechanisms appear to fall into several categories; integrating RNA-seq data may enhance the ability to identify these categories even when genomic alterations are not identified. Multiple clinically relevant genomic and molecular alterations are identified in metastatic biopsies– with implications for choice of next therapy, clinical trial eligibility, and novel drug targets.
Citation Format: Cohen O, Kim D, Oh C, Waks A, Oliver N, Helvie K, Marini L, Rotem A, Lloyd M, Stover D, Adalsteinsson V, Freeman S, Ha G, Cibulskis C, Anderka K, Tamayo P, Johannessen C, Krop I, Garraway L, Winer E, Lin N, Wagle N. Whole exome and transcriptome sequencing of resistant ER+ metastatic breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr S1-01.
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Affiliation(s)
- O Cohen
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - D Kim
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - C Oh
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - A Waks
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - N Oliver
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - K Helvie
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - L Marini
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - A Rotem
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - M Lloyd
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - D Stover
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - V Adalsteinsson
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - S Freeman
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - G Ha
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - C Cibulskis
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - K Anderka
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - P Tamayo
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - C Johannessen
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - I Krop
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - L Garraway
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - E Winer
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - N Lin
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
| | - N Wagle
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA; Dana-Farber Cancer Institute, Boston, MA
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Nayar U, Cohen O, Oh C, Wagle N. Abstract P3-04-08: The role of HER2 mutations in resistance to endocrine therapy in ER+ breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-04-08] [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
Resistance to endocrine therapies in estrogen receptor positive (ER+) metastatic breast cancer is widespread, and understanding the mechanisms whereby these tumors acquire resistance is a critical need. Through whole-exome sequencing of metastatic tumor biopsies from patients with endocrine resistant ER+ metastatic breast cancer, we identified 13 different HER2 mutations, including five in the kinase domain, four in the signaling domain, three in the extracellular domain, and one in the transmembrane region of the protein. Two of the kinase domain mutations (L755S and V777L) have been previously described and shown to be activating and resistant to reversible anti-HER2 targeted therapies; the remaining mutations have not been reported. In several of these patients, whole exome sequencing of a pre-treatment primary tumor did not identify the HER2 mutations seen in the corresponding metastatic tumor, suggesting that they were acquired during therapy. To examine the role of HER2 mutations in endocrine resistance, we generated ER+ breast cancer cell lines (MCF7 and T47D) stably expressing the HER2 mutants observed in our clinical data. Several mutants promoted enhanced growth in charcoal dextran-stripped media, which lacks estradiol and mimics treatment with aromatase inhibitor. In addition, several mutants conferred varying degrees of resistance to fulvestrant and tamoxifen. Taken together, these results suggest that HER2 mutations are associated with acquired resistance to endocrine therapies in patients with ER+ breast cancer. The ability of irreversible anti-HER2 agents as well as other agents that target the HER2 pathway to overcome this resistance is being tested for individual HER2 mutations in vitro. The results from these studies may provide a clinical rationale for therapeutic combination strategies in patients with refractory tumors that have acquired endocrine resistance through HER2 mutations.
Citation Format: Nayar U, Cohen O, Oh C, Wagle N. The role of HER2 mutations in resistance to endocrine therapy in ER+ breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-04-08.
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Affiliation(s)
- U Nayar
- Dana-Farber Cancer Institute, Boston, MA; Broad Institute of MIT and Harvard, Cambridge, MA
| | - O Cohen
- Dana-Farber Cancer Institute, Boston, MA; Broad Institute of MIT and Harvard, Cambridge, MA
| | - C Oh
- Dana-Farber Cancer Institute, Boston, MA; Broad Institute of MIT and Harvard, Cambridge, MA
| | - N Wagle
- Dana-Farber Cancer Institute, Boston, MA; Broad Institute of MIT and Harvard, Cambridge, MA
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Schütz-Fuhrmann I, Castañeda J, Reznik Y, Aronson R, Conget I, Liabat S, Runzis S, de Portu S, Cohen O. Factors affecting the benefit of insulin dose intensification in people with Type 2 diabetes: an analysis from the OpT2mise randomized trial. Diabet Med 2017; 34:291-292. [PMID: 27770589 DOI: 10.1111/dme.13279] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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] [Received: 06/08/2016] [Revised: 08/23/2016] [Accepted: 10/19/2016] [Indexed: 11/25/2022]
Affiliation(s)
- I Schütz-Fuhrmann
- Department of Endocrinology, City Hospital Hietzing, Vienna, Austria
| | - J Castañeda
- Medtronic Bakken Research Center, Maastricht, The Netherlands
| | - Y Reznik
- Department of Endocrinology, University of Caen Côte de Nacre Regional Hospital Center, Caen, France
| | - R Aronson
- LMC Diabetes & Endocrinology, Toronto, Ontario, Canada
| | - I Conget
- Diabetes Unit, Endocrinology and Nutrition Department, University Hospital Clinic, Barcelona, Spain
| | - S Liabat
- Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - S Runzis
- Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - S de Portu
- Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - O Cohen
- Institute of Endocrinology, Chaim Sheba Medical Center, Tel Hashomer, Israel
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Maulucci G, Cohen O, Daniel B, Sansone A, Petropoulou PI, Filou S, Spyridonidis A, Pani G, De Spirito M, Chatgilialoglu C, Ferreri C, Kypreos KE, Sasson S. Fatty acid-related modulations of membrane fluidity in cells: detection and implications. Free Radic Res 2016; 50:S40-S50. [PMID: 27593084 DOI: 10.1080/10715762.2016.1231403] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Metabolic homeostasis of fatty acids is complex and well-regulated in all organisms. The biosynthesis of saturated fatty acids (SFA) in mammals provides substrates for β-oxidation and ATP production. Monounsaturated fatty acids (MUFA) are products of desaturases that introduce a methylene group in cis geometry in SFA. Polyunsaturated fatty acids (n-6 and n-3 PUFA) are products of elongation and desaturation of the essential linoleic acid and α-linolenic acid, respectively. The liver processes dietary fatty acids and exports them in lipoproteins for distribution and storage in peripheral tissues. The three types of fatty acids are integrated in membrane phospholipids and determine their biophysical properties and functions. This study was aimed at investigating effects of fatty acids on membrane biophysical properties under varying nutritional and pathological conditions, by integrating lipidomic analysis of membrane phospholipids with functional two-photon microscopy (fTPM) of cellular membranes. This approach was applied to two case studies: first, pancreatic beta-cells, to investigate hormetic and detrimental effects of lipids. Second, red blood cells extracted from a genetic mouse model defective in lipoproteins, to understand the role of lipids in hepatic diseases and metabolic syndrome and their effect on circulating cells.
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Affiliation(s)
- G Maulucci
- a Institute of Physics, Università Cattolica del Sacro Cuore , Roma , Italy
| | - O Cohen
- b Institute for Drug Research, Section of Pharmacology, Diabetes Research Unit, Faculty of Medicine , The Hebrew University , Jerusalem , Israel
| | - B Daniel
- b Institute for Drug Research, Section of Pharmacology, Diabetes Research Unit, Faculty of Medicine , The Hebrew University , Jerusalem , Israel
| | - A Sansone
- c ISOF, BioFreeRadicals Group, Consiglio Nazionale delle Ricerche , Bologna , Italy
| | - P I Petropoulou
- d Department of Pharmacology , University of Patras Medical School , Rio , Greece
| | - S Filou
- d Department of Pharmacology , University of Patras Medical School , Rio , Greece
| | - A Spyridonidis
- e Hematology Department , University of Patras Medical School , Rio , Greece
| | - G Pani
- f Institute of General Pathology, Università Cattolica del Sacro Cuore , Roma , Italy
| | - M De Spirito
- a Institute of Physics, Università Cattolica del Sacro Cuore , Roma , Italy
| | - C Chatgilialoglu
- c ISOF, BioFreeRadicals Group, Consiglio Nazionale delle Ricerche , Bologna , Italy
| | - C Ferreri
- c ISOF, BioFreeRadicals Group, Consiglio Nazionale delle Ricerche , Bologna , Italy
| | - K E Kypreos
- d Department of Pharmacology , University of Patras Medical School , Rio , Greece
| | - S Sasson
- b Institute for Drug Research, Section of Pharmacology, Diabetes Research Unit, Faculty of Medicine , The Hebrew University , Jerusalem , Israel
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Cohen O, Agabria Z, Lysyy L, Ianovitsky Y, Nguyen X, Fung M, Lee S, Wainstein J. Adaptability of structured forms for CSII initiation in patients with type 2 diabetes the Getting2Goal(SM) concept. J Endocrinol Invest 2016; 39:627-33. [PMID: 26746672 PMCID: PMC4869731 DOI: 10.1007/s40618-015-0407-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 10/29/2015] [Indexed: 12/02/2022]
Abstract
BACKGROUND The goal is to assess the usability and satisfaction of implementing the Getting2Goal(SM) protocol by physicians transitioning patients with type 2 diabetes (T2DM) from multiple daily injections (MDI) to continuous subcutaneous insulin infusion (CSII). METHODS T2DM patients from three diabetes clinics were switched from MDI to CSII. Physicians used the Getting2Goal type 2 pumping protocol to prescribe and manage insulin pump therapy for T2DM. Surveys were conducted in which the physicians rated their feedback related to acceptability of the Getting2Goal on a 5-point Likert scale. RESULTS 17 patients with T2DM were switched from MDI to CSII treatment. Mean (±standard deviation) age was 61.2 ± 7.7 (46-77) years, weight was 91.4 ± 21 (66-147) kg, BMI was 31.9 ± 7.6, A1C was 9.2 ± 1.4 % (7.2-12.3) and TDD on MDI was 109.1 ± 53.1 units. Surveys completed by physicians indicated Getting2Goal type 2 pumping protocol to be more efficient, time saving, and structured compared to their current processes. In addition, the primarily prescribed TDD on pump was 98.1 ± 50.0 units and the TDD at first download was 81.4 ± 36.4 units, representing a 25.4 % reduction in TDD At first download. The percentage of all blood glucose readings below 70 mg/dL was also very low. CONCLUSIONS The data indicate Getting2Goal materials as a standard approach that is simple and efficient to initiate pump therapy for T2DM. At the same time, it is safe and a useful tool for physicians that are starting to prescribe pump therapy for T2DM.
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Affiliation(s)
- O Cohen
- Sackler School of Medicine, Ch. Sheba Medical Center, Institute of Endocrinology, Tel Hashomer, Tel Aviv University, 52621, Tel Aviv, Israel.
| | - Z Agabria
- Cllalit Health Services, Tel Aviv, Israel
| | - L Lysyy
- Diabetes Clinic, Maccabi Health Service, Rehovot, Israel
- Endocrinology and Metabolism Clinic, Kaplan Medical Center, Rehovot, Israel
| | - Y Ianovitsky
- Diabetes Clinic, Maccabi Health Service, Ashkelon, Israel
| | - X Nguyen
- Medtronic, Inc., Northridge, CA, USA
| | - M Fung
- Medtronic, Inc., Northridge, CA, USA
| | - S Lee
- Medtronic, Inc., Northridge, CA, USA
| | - J Wainstein
- Diabetes Unit, E. Wolfson Medical Center, Holon, Israel
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Aronson R, Reznik Y, Conget I, Castañeda JA, Runzis S, Lee SW, Cohen O. Sustained efficacy of insulin pump therapy compared with multiple daily injections in type 2 diabetes: 12-month data from the OpT2mise randomized trial. Diabetes Obes Metab 2016; 18:500-7. [PMID: 26854123 PMCID: PMC5071718 DOI: 10.1111/dom.12642] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/29/2016] [Accepted: 02/08/2016] [Indexed: 11/30/2022]
Abstract
AIMS To compare insulin pump therapy and multiple daily injections (MDI) in patients with type 2 diabetes receiving basal and prandial insulin analogues. METHODS After a 2-month dose-optimization period, 331 patients with glycated haemoglobin (HbA1c) levels ≥8.0% and ≤12% were randomized to pump therapy or continued MDI for 6 months [randomization phase (RP)]. The MDI group was subsequently switched to pump therapy during a 6-month continuation phase (CP). The primary endpoint was the between-group difference in change in mean HbA1c from baseline to the end of the RP. RESULTS The mean HbA1c at baseline was 9% in both groups. At the end of the RP, the reduction in HbA1c was significantly greater with pump therapy than with MDI (-1.1 ± 1.2% vs -0.4 ± 1.1%; p < 0.001). The pump therapy group maintained this improvement to 12 months while the MDI group, which was switched to pump therapy, showed a 0.8% reduction: the final HbA1c level was identical in both arms. In the RP, total daily insulin dose (TDD) was 20.4% lower with pump therapy than with MDI and remained stable in the CP. The MDI-pump group showed a 19% decline in TDD, such that by 12 months TDD was equivalent in both groups. There were no differences in weight gain or ketoacidosis between groups. In the CP, one patient in each group experienced severe hypoglycaemia. CONCLUSIONS Pump therapy has a sustained durable effect on glycaemic control in uncontrolled type 2 diabetes.
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Affiliation(s)
- R. Aronson
- LMC Diabetes and EndocrinologyTorontoONCanada
| | - Y. Reznik
- Department of EndocrinologyUniversity of Caen Côte de Nacre Regional Hospital CenterCaenFrance
| | - I. Conget
- Diabetes Unit, Endocrinology and Nutrition DepartmentUniversity Hospital ClinicBarcelonaSpain
| | | | - S. Runzis
- Medtronic International Trading SàrlTolochenazSwitzerland
| | | | - O. Cohen
- Institute of EndocrinologyChaim Sheba Medical CenterTel HashomerIsrael
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Schütz-Fuhrmann I, Reznik Y, Aronson R, Cohen O, Conget I, Prager R, Liabat S, Runzis S, de Portu S, Castañeda J. Faktoren, die den Erfolg der Insulindosis-Adaptierung bei Patienten mit Diabetes mellitus Typ 2 beeinflussen: eine Analyse aus der OpT2mise Studie. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Levy-Shraga Y, Elisha N, Ben-Ami M, Boyko V, Lerner-Geva L, Ziv T, Konvalina N, Cohen O, Pinhas-Hamiel O. Glycemic control and clinic attendance of emerging adults with type 1 diabetes at a transition care clinic. Acta Diabetol 2016; 53:27-33. [PMID: 25794880 DOI: 10.1007/s00592-015-0734-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 03/05/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Emerging adulthood is a challenging period for diabetes management. Our aim was to determine whether a dedicated transition clinic for emerging adults with type 1 diabetes can improve glycemic control and visit attendance. METHODS An observational study of 53 emerging adults (30 males) treated during 2010-2014 in a newly established transition clinic. The clinic was operated jointly by pediatric and adult endocrinologists and included a transition coordinator. Data collected included the source of referral, HbA1c levels, frequency of visit attendance, and acute complications. For 27 patients who had attended the pediatric clinic at the same medical center, data from up to 2 years preceding the transition were also collected. Patients filled the Diabetes Quality of Life-Youth questionnaire at the transition and 1 year later. RESULTS Mean ± SD age at the transfer to the transition clinic was 22.1 ± 2.7 years; mean disease duration was 8.4 ± 5.0 years. Follow-up duration at the transition clinic was 1.2 ± 1.1 years. Mean HbA1c levels decreased from 67 mmol/mol (95 % CI 63-72) [8.3 % (95 % CI 7.9-8.7)] at transfer to 57 mmol/mol (95 % CI 52-63) [7.4 % (95 % CI 6.9-7.9)] after 1 year (p < 0.001). Thirty-six patients (68 %) attended three or more visits during their first year in the transition clinic. The impact of diabetes on quality of life, disease-related worries, and life satisfaction did not change significantly during 1-year attendance in the transition clinic. CONCLUSIONS A dedicated transition clinic for emerging adults, with tailored support according to the developmental needs of emerging adulthood, showed improved glycemic control and visit attendance.
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Affiliation(s)
- Y Levy-Shraga
- Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621, Tel Hashomer, Israel.
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - N Elisha
- Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621, Tel Hashomer, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - M Ben-Ami
- Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621, Tel Hashomer, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - V Boyko
- The Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer, Israel
| | - L Lerner-Geva
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- The Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer, Israel
| | - T Ziv
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
| | - N Konvalina
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
| | - O Cohen
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
| | - O Pinhas-Hamiel
- Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621, Tel Hashomer, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
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de Breij A, Riool M, Kwakman PHS, de Boer L, Cordfunke RA, Drijfhout JW, Cohen O, Emanuel N, Zaat SAJ, Nibbering PH, Moriarty TF. Prevention of Staphylococcus aureus biomaterial-associated infections using a polymer-lipid coating containing the antimicrobial peptide OP-145. J Control Release 2015; 222:1-8. [PMID: 26658071 DOI: 10.1016/j.jconrel.2015.12.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [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: 10/28/2015] [Revised: 11/27/2015] [Accepted: 12/01/2015] [Indexed: 10/22/2022]
Abstract
The scarcity of current antibiotic-based strategies to prevent biomaterial-associated infections (BAI) and their risk of resistance development prompted us to develop a novel antimicrobial implant-coating to prevent Staphylococcus aureus-induced BAI. We incorporated the antimicrobial peptide OP-145 into a Polymer-Lipid Encapsulation MatriX (PLEX)-coating to obtain high peptide levels for prolonged periods at the implant-tissue interphase. We first confirmed that OP-145 was highly effective in killing S. aureus and inhibiting biofilm formation in vitro. OP-145 injected along S. aureus-inoculated implants in mice significantly reduced the number of culture-positive implants. OP-145 was released from the PLEX coating in a controlled zero-order kinetic rate after an initial 55%-burst release and displayed bactericidal activity in vitro. In a rabbit intramedullary nail-related infection model, 67% of rabbits with PLEX-OP-145-coated nails had culture-negative nails after 28days compared to 29% of rabbits with uncoated nails. In rabbits with PLEX-OP-145-coated nails, bone and soft tissue samples were culture-negative in 67% and 80%, respectively, whereas all bone samples and 71% of the soft tissue samples of rabbits with uncoated nails were infected. Together, PLEX-OP-145 coatings, of which both compounds have already been found safe in man, can prevent implant colonization and S. aureus-induced BAIs.
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Affiliation(s)
- A de Breij
- Dept. of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, P.O. Box 9600, RC Leiden, The Netherlands.
| | - M Riool
- Dept. of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
| | - P H S Kwakman
- Dept. of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
| | - L de Boer
- Dept. of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
| | - R A Cordfunke
- Dept. of Immunohematology and Blood Transfusion, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, P.O. Box 9600 RC Leiden, the Netherlands
| | - J W Drijfhout
- Dept. of Immunohematology and Blood Transfusion, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, P.O. Box 9600 RC Leiden, the Netherlands
| | - O Cohen
- PolyPid Ltd., 18 Hasivim, St. Petach-Tikva 4959376, Israel
| | - N Emanuel
- PolyPid Ltd., 18 Hasivim, St. Petach-Tikva 4959376, Israel
| | - S A J Zaat
- Dept. of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
| | - P H Nibbering
- Dept. of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, P.O. Box 9600, RC Leiden, The Netherlands
| | - T F Moriarty
- AO Research Institute Davos, AO Foundation, Clavadelerstrasse 8 Davos Platz, CH7270 Davos, Switzerland
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Battelino T, Liabat S, Veeze HJ, Castañeda J, Arrieta A, Cohen O. Routine use of continuous glucose monitoring in 10 501 people with diabetes mellitus. Diabet Med 2015; 32:1568-74. [PMID: 26042926 PMCID: PMC4744771 DOI: 10.1111/dme.12825] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/01/2015] [Indexed: 01/04/2023]
Abstract
AIMS To analyse blood glucose control according to continuous glucose monitoring use in data from the CareLink database, and to identify factors associated with continuation of sensor use during sensor-augmented pump therapy. METHODS The analysis used data from 10 501 people with Type 1 and 2 diabetes mellitus, of whom 7916 (61.7%) had used glucose sensors for ≥ 15 days during any 6-month period over a 2-year observation period. Data were analysed according to the extent of sensor use ( < 25%, 25-49%, 50-74% and ≥ 75% of the time). Time to discontinuation of sensor use was also analysed in new users of glucose sensors. RESULTS Compared with patients in the lowest sensor usage group and non-users, the highest glucose sensor usage group had significantly (P < 0.0001) lower mean blood glucose and blood glucose sd, were more likely to achieve a mean blood glucose concentration < 8.6 mmol/l, (odds ratio 1.5, 95% CI 1.3-1.7; P < 0.0001), and had 50% fewer hypoglycaemic (blood glucose concentration < 2.8 mmol/l) episodes. Among new users, sensor use during the first month of therapy was an important predictor of subsequent discontinuation. Lack of full reimbursement was also significantly associated with early discontinuation, whereas measures of glycaemic control were predictive of discontinuation during long-term treatment. CONCLUSIONS The use of continuous glucose monitoring was significantly associated with reductions in hypoglycaemia and improved metabolic control during insulin pump therapy. Sensor use during the first month was strongly associated with long-term adherence; patient education and training may be helpful in achieving this.
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MESH Headings
- Blood Glucose/analysis
- Canada
- Cohort Studies
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 1/drug therapy
- Diabetes Mellitus, Type 1/economics
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/economics
- Drug Resistance
- Europe
- Health Information Exchange
- Humans
- Hyperglycemia/prevention & control
- Hypoglycemia/chemically induced
- Hypoglycemia/prevention & control
- Hypoglycemic Agents/administration & dosage
- Hypoglycemic Agents/adverse effects
- Hypoglycemic Agents/therapeutic use
- Insulin/administration & dosage
- Insulin/adverse effects
- Insulin/therapeutic use
- Insulin Infusion Systems/adverse effects
- Insurance, Health, Reimbursement
- Israel
- Monitoring, Ambulatory/economics
- Patient Compliance
- Practice Patterns, Physicians'
- Time Factors
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Affiliation(s)
- T Battelino
- University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - S Liabat
- Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - H J Veeze
- Diabeter, Centre for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - J Castañeda
- Medtronic Bakken Research Center, Maastricht, The Netherlands
| | - A Arrieta
- Medtronic Bakken Research Center, Maastricht, The Netherlands
| | - O Cohen
- Chaim Sheba Medical Centre, Ramat Gan, Israel
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Ben-Barouch S, Cohen O, Vidal L, Avivi I, Ram R. Busulfan fludarabine vs busulfan cyclophosphamide as a preparative regimen before allogeneic hematopoietic cell transplantation: systematic review and meta-analysis. Bone Marrow Transplant 2015; 51:232-40. [PMID: 26457908 DOI: 10.1038/bmt.2015.238] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 08/27/2015] [Accepted: 08/28/2015] [Indexed: 11/09/2022]
Abstract
We aimed to evaluate the efficacy and toxicity profile of busulfan-fludarabine (Bu-Flu) compared with busulfan-cyclophosphamide (Bu-Cy) as a preparative regimen for patients undergoing allogeneic hematopoietic cell transplantation. We performed a systematic review and meta-analysis of all comparative trials, both randomized controlled trials (RCTs) and non-randomized. Our search yielded 15 trials recruiting 1830 patients. Four trials were RCTs and 11 were either one-arm intervention trials compared with historical controls or retrospective studies. There was a lower risk for non-relapse mortality (NRM) at 100 days in patients given Bu-Flu regimen compared with those given Bu-Cy regimen (relative risk (RR) 0.56; 95% confidence interval (CI) 0.34-0.92, 8 trials); however, there were no differences in all-cause mortality at 100 days (RR 0.85; 95% CI 0.56-1.30, 9 trials) and at the end of study (RR 0.81; 95% CI 0.64-1.02, 13 trials). The risks of sinusoidal obstruction syndrome (SOS) and microbiologically documented infections were lower in patients given Bu-Flu regimen (RR 0.34; 95% CI 0.19-0.62, 8 trials and RR 0.79; 95% CI 0.64-0.97, 2 trials, respectively); however, risk for SOS was no longer lower when performing sensitivity analysis according to RCTs. Engraftment kinetics, risk of grade 3-4 mucositis, GvHD, relapse and NRM at the end of the study were all similar between the two groups. We conclude that both regimens have similar efficacy profiles, whereas toxicity is lower with the Bu-Flu regimen.
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Affiliation(s)
- S Ben-Barouch
- Institute of Hematology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - O Cohen
- Institute of Hematology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - L Vidal
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikva, Israel
| | - I Avivi
- Institute of Hematology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - R Ram
- Institute of Hematology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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41
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Cohen O, Ma Y, Drake JJ, Glocer A, Garraffo C, Bell JM, Gombosi TI. THE INTERACTION OF VENUS-LIKE, M-DWARF PLANETS WITH THE STELLAR WIND OF THEIR HOST STAR. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/806/1/41] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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42
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Reitblat O, Lerman T, Cohen O, Reitblat T. THU0169 Does Prednisone Really Affect Tuberculin Skin Test Reaction in Patients with Rheumatoid Arthritis? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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43
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Ben-Shachar S, Ayalon I, Reznik-Wolf H, Tenenbaum-Rakover Y, Zuckerman-Levin N, Cohen O, Lifshitz A, Fraenkel M, Toledano Y, Rouach V, Koren I, Modan-Moses D, Hirsch D, Schachter-Davidov A, Israel S, Eyal O, Weintrob N. Correction: Androgen Receptor CAG Repeat Length in Relation to Phenotype Among Females with Nonclassical 21-Hydroxylase Deficiency. Horm Metab Res 2015; 47:e6. [PMID: 29566405 DOI: 10.1055/a-0594-0327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- S Ben-Shachar
- Genetic Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - I Ayalon
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - H Reznik-Wolf
- Genetic Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Y Tenenbaum-Rakover
- Pediatric Endocrine Unit, Ha'Emek Medical Center, Afula, Israel
- The Technion Faculty of Medicine, Haifa, Israel
| | - N Zuckerman-Levin
- The Technion Faculty of Medicine, Haifa, Israel
- Pediatric Diabetes Unit, Meyer Children's Hospital, Haifa, Israel
| | - O Cohen
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Lifshitz
- Endocrinology, Kupat-Holim Clalit, Israel
| | - M Fraenkel
- Endocrine Unit, Soroka Medical Center, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Y Toledano
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - V Rouach
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - I Koren
- Pediatric Endocrinology Clinic, Armon Child Center, Clalit HMO, Haifa, Israel
| | - D Modan-Moses
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - D Hirsch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute for Endocrinology and Diabetes, Rabin Medical Center, Petah Tikva, Israel
| | - A Schachter-Davidov
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - S Israel
- Tissue Typing Unit, Hadassah University Hospital, Jerusalem, Israel
| | - O Eyal
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - N Weintrob
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Ben-Shachar S, Ayalon I, Reznik-Wolf H, Tenenbaum-Rakover Y, Zuckerman-Levin N, Cohen O, Lifshitz A, Fraenkel M, Toledano Y, Roash V, Koren I, Modan-Moses D, Hirsch D, Schachter-Davidov A, Israel S, Eyal O, Weintrob N. Androgen Receptor CAG Repeat Length in Relation to Phenotype Among Females with Nonclassical 21-Hydroxylase Deficiency. Horm Metab Res 2015; 47:491-6. [PMID: 25230321 DOI: 10.1055/s-0034-1389901] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Nonclassical 21-hydroxylase deficiency (NC21OHD) manifests with various degrees of post natal virilization. The length of CAG repeats of the androgen receptor gene (AR) is inversely correlated to activity of the human androgen receptor (AR) and affects phenotype of several androgen-dependent disorders. The aim of the study was to investigate the associations between CAG repeat length and the phenotype of females with NC21OHD. CAG repeat length and AR inactivation were assessed in females with NC21OHD, and related to their clinical presentation. CAG repeat length and AR inactivation were assessed in 119 females with NC21OHD. Biallelic mean (BAM) of the CAG repeat length and the weighted BAM (WBAM) were related to various clinical parameters. Age at diagnosis and age of menarche positively correlated with BAM (r=0.22, p=0.02, and r=0.23, p=0.01, respectively). A shorter (<25) BAM was associated with younger age at diagnosis (14.8 vs. 21.4 years, p<0.01), at adrenarche (8.1 vs. 10.2 years, p<0.01) and gonadarche (9.9 vs. 11.2 years, p<0.01), and higher corrected height standard deviation score at diagnosis (0.77 vs. 0.15, p=0.01). Precocious pubarche and precocious puberty were more frequent in these with the shorter BAM. Results of WBAM were similar. The CAG repeat length of the AR gene contributes to the clinical diversity of the phenotype in females with NC21OHD.
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Affiliation(s)
- S Ben-Shachar
- Genetic Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - I Ayalon
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - H Reznik-Wolf
- Genetic Institute, Sheba Medical Center, Tel Hashomer, Israel
| | | | | | - O Cohen
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
| | - A Lifshitz
- Endocrinology, Kupat-Holim Clalit, Israel
| | - M Fraenkel
- Endocrine Unit, Soroka Medical Center, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Y Toledano
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - V Roash
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - I Koren
- Pediatric Endocrinology Clinic, Armon Child Center, Clalit HMO, Haifa, Israel
| | - D Modan-Moses
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D Hirsch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Schachter-Davidov
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - S Israel
- Tissue Typing Unit, Hadassah University Hospital, Jerusalem, Israel
| | - O Eyal
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - N Weintrob
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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45
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Cohen O, Zhao M, Nevo E, Zurkiya O, Gonzalez R, Yoo A, Ackerman J. Endovascular embolization of aneurysms by interventional MR coagulation. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Mangera Z, Gunasekera C, Kinley J, King J, Walker B, Cohen O, Dilworth P. P113 The Use Of Local Anaesthesia In Improving The Patient Experience Of Arterial Blood Gases: Students And Trainers Are Still Not Getting The Message. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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47
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Cohen O, Mukamel D. Nonequilibrium ensemble inequivalence and large deviations of the density in the ABC model. Phys Rev E Stat Nonlin Soft Matter Phys 2014; 90:012107. [PMID: 25122251 DOI: 10.1103/physreve.90.012107] [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] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Indexed: 06/03/2023]
Abstract
We consider the one-dimensional driven ABC model under particle-conserving and particle-nonconserving processes. Two limiting cases are studied: (a) The rates of the nonconserving processes are vanishingly slow compared with the conserving processes in the thermodynamic limit and (b) the two rates are comparable. For case (a) we provide a detailed analysis of the phase diagram and the large deviations function of the overall density, G(r). The phase diagram of the nonconserving model, derived from G(r), is found to be different from the conserving one. This difference, which stems from the nonconvexity of G(r), is analogous to ensemble inequivalence found in equilibrium systems with long-range interactions. An outline of the analysis of case (a) was given in an earlier letter. For case (b) we show that, unlike the conserving model, the nonconserving model exhibits a moving density profile in the steady state with a velocity that remains finite in the thermodynamic limit. Moreover, in contrast with case (a), the critical lines of the conserving and nonconserving models do not coincide. These are new features which are present only when the rates of the conserving and nonconserving processes are comparable. In addition, we analyze G(r) in case (b) using macroscopic fluctuations theory. Much of the derivation presented in this paper is applicable to any driven-diffusive system coupled to an external particle bath via a slow dynamics.
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Affiliation(s)
- O Cohen
- Department of Physics of Complex Systems, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - D Mukamel
- Department of Physics of Complex Systems, Weizmann Institute of Science, Rehovot 7610001, Israel
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Demongeot J, Hazgui H, Bandiera S, Cohen O, Henrion-Caude A. MitomiRs, chloromiRs and modelling of the microRNA inhibition. Acta Biotheor 2013; 61:367-83. [PMID: 23982306 DOI: 10.1007/s10441-013-9190-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 07/20/2013] [Indexed: 11/26/2022]
Abstract
MicroRNAs are non-coding parts of nuclear and mitochondrial genomes, preventing the weakest part of the genetic regulatory networks from being expressed and preventing the appearance of a too many attractors in these networks. They have also a great influence on the chromatin clock, which ensures the updating of the genetic regulatory networks. The post-transcriptional inhibitory activity by the microRNAs, which is partly unspecific, is due firstly to their possibly direct negative action during translation by hybridizing tRNAs, especially those inside the mitochondrion, hence slowing mitochondrial respiration, and secondly to their action on a large number of putative m-RNA targets like those involved in immunetworks; We show that the circuits in the core of the interaction graphs are responsible for the small number of dedicated attractors that correspond to genetically controlled functions, partly due to a general filtering by the microRNAs. We analyze this influence as well as their impact on important functions like the control by the p53 network over the apoptosis/proliferation system and the homeostasis of the energy metabolism. In this last case, we show the role of two kinds of microRNAs, both involved in the control of the mitochondrial genome: (1) nuclear microRNAs, called mitoMirs, inhibiting mitochondrial genes and (2) putative mitochondrial microRNAs inhibiting the tRNAs functioning.
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Affiliation(s)
- J Demongeot
- AGIM, FRE CNRS 3405, Faculty of Medicine of Grenoble, University J. Fourier, 38 700, La Tronche, France,
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Weiss C, Uziel O, Wolach O, Nordenberg J, Beery E, Bulvick S, Kanfer G, Cohen O, Ram R, Bakhanashvili M, Magen-Nativ H, Shilo N, Lahav M. Differential downregulation of telomerase activity by bortezomib in multiple myeloma cells-multiple regulatory pathways in vitro and ex vivo. Br J Cancer 2012; 107:1844-52. [PMID: 23169337 PMCID: PMC3504947 DOI: 10.1038/bjc.2012.460] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 09/12/2012] [Accepted: 09/12/2012] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The importance of telomerase in multiple myeloma (MM) is well established; however, its response to bortezomib has not been addressed. METHODS The effect of bortezomib on telomerase activity and cell proliferation was evaluated in four MM cell lines and in myeloma cells obtained from eight patients. The mechanism of telomerase regulation on epigenetic, transcriptional, and post-translational levels was further assessed in two selected cell lines: ARP-1 and CAG. Clinical data were correlated with the laboratory findings. RESULTS Bortezomib downregulated telomerase activity and decreased proliferation in all cell lines and cells obtained from patients, albeit in two different patterns of kinetics. ARP-1 cells demonstrated higher and earlier sensitivity than CAG cells due to differential phosphorylation of hTERT by PKCα. Methylation of hTERT promoter was not affected. Transcription of hTERT was similarly inhibited in both lines by decreased binding of SP-1 and not of C-Myc and NFκB. The ex vivo results confirmed the in vitro findings and suggested existence of clinical relevance. CONCLUSION Bortezomib downregulates telomerase activity in MM cells both transcriptionally and post-translationally. MM cells, both in vitro and in patients, exhibit different sensitivity to the drug due to different post-translational response. The effect of bortezomib on telomerase activity may correlate with resistance to bortezomib in patients, suggesting its potential utility as a pre-treatment assessment.
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Affiliation(s)
- C Weiss
- Laniado Medical Center, Netanya, Israel
| | - O Uziel
- Felsenstein Medical Research Center, Tel Aviv University, Tel Aviv, Israel
| | - O Wolach
- Felsenstein Medical Research Center, Tel Aviv University, Tel Aviv, Israel
| | - J Nordenberg
- Felsenstein Medical Research Center, Tel Aviv University, Tel Aviv, Israel
| | - E Beery
- Felsenstein Medical Research Center, Tel Aviv University, Tel Aviv, Israel
| | - S Bulvick
- Laniado Medical Center, Netanya, Israel
| | - G Kanfer
- Felsenstein Medical Research Center, Tel Aviv University, Tel Aviv, Israel
| | - O Cohen
- Felsenstein Medical Research Center, Tel Aviv University, Tel Aviv, Israel
| | - R Ram
- Institute of Hematology, Davidoff Cancer Center, Davidoff, Israel
- Internal Department A, Beilinson Hospital, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Peetah-Tikva 49100, Israel
| | - M Bakhanashvili
- Division of Infectious Diseases, Sheba Medical Center, Tel-Hashomer, Israel
| | - H Magen-Nativ
- Institute of Hematology, Davidoff Cancer Center, Davidoff, Israel
| | - N Shilo
- Internal Department A, Beilinson Hospital, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Peetah-Tikva 49100, Israel
| | - M Lahav
- Felsenstein Medical Research Center, Tel Aviv University, Tel Aviv, Israel
- Internal Department A, Beilinson Hospital, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Peetah-Tikva 49100, Israel
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Kassem R, Liberty Z, Babaev M, Trau H, Cohen O. Harnessing the skin-thyroid connection for wound healing: a prospective controlled trial in guinea pigs. Clin Exp Dermatol 2012; 37:850-6. [DOI: 10.1111/j.1365-2230.2012.04456.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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