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Aggarwal C, Ahmed H, Sharma P, Reddy ES, Nayak K, Singla M, Maheshwari D, Chawla YM, Panda H, Rai RC, Gunisetty S, Priyamvada L, Bhaumik SK, Ahamed SF, Vivek R, Bhatnagar P, Singh P, Kaur M, Dixit K, Kumar S, Gottimukkala K, Saini K, Bajpai P, Sreekanth GP, Mammen S, Rajan A, Verghese VP, Abraham AM, Shah P, Alagarasu K, Yu T, Davis CW, Wrammert J, Ansari A, Antia R, Kabra SK, Medigeshi GR, Ahmed R, Lodha R, Shet A, Chandele A, Murali-Krishna K. Severe disease during both primary and secondary dengue virus infections in pediatric populations. Nat Med 2024; 30:670-674. [PMID: 38321219 DOI: 10.1038/s41591-024-02798-x] [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: 11/02/2020] [Accepted: 01/02/2024] [Indexed: 02/08/2024]
Abstract
Dengue is a global epidemic causing over 100 million cases annually. The clinical symptoms range from mild fever to severe hemorrhage and shock, including some fatalities. The current paradigm is that these severe dengue cases occur mostly during secondary infections due to antibody-dependent enhancement after infection with a different dengue virus serotype. India has the highest dengue burden worldwide, but little is known about disease severity and its association with primary and secondary dengue infections. To address this issue, we examined 619 children with febrile dengue-confirmed infection from three hospitals in different regions of India. We classified primary and secondary infections based on IgM:IgG ratios using a dengue-specific enzyme-linked immunosorbent assay according to the World Health Organization guidelines. We found that primary dengue infections accounted for more than half of total clinical cases (344 of 619), severe dengue cases (112 of 202) and fatalities (5 of 7). Consistent with the classification based on binding antibody data, dengue neutralizing antibody titers were also significantly lower in primary infections compared to secondary infections (P ≤ 0.0001). Our findings question the currently widely held belief that severe dengue is associated predominantly with secondary infections and emphasizes the importance of developing vaccines or treatments to protect dengue-naive populations.
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Affiliation(s)
- Charu Aggarwal
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Hasan Ahmed
- Department of Biology, Emory University, Atlanta, GA, USA
| | - Pragati Sharma
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Elluri Seetharami Reddy
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
- Kusuma School of Biological Sciences, Indian Institute of Technology, New Delhi, India
| | - Kaustuv Nayak
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Mohit Singla
- Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Maheshwari
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Yadya M Chawla
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Harekrushna Panda
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Ramesh Chandra Rai
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Sivaram Gunisetty
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
- Department of Pediatrics, Division of Infectious Disease, Emory University School of Medicine, Atlanta, GA, USA
| | - Lalita Priyamvada
- Department of Pediatrics, Division of Infectious Disease, Emory University School of Medicine, Atlanta, GA, USA
| | - Siddhartha Kumar Bhaumik
- Department of Pediatrics, Division of Infectious Disease, Emory University School of Medicine, Atlanta, GA, USA
| | - Syed Fazil Ahamed
- Division of Infectious Diseases, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, India
| | - Rosario Vivek
- Division of Infectious Diseases, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, India
- The University of Trans-Disciplinary Health Sciences & Technology, Bengaluru, India
| | - Priya Bhatnagar
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
- TERI school of advanced studies, New Delhi, India
| | - Prabhat Singh
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Manpreet Kaur
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Kritika Dixit
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Sanjeev Kumar
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Kamal Gottimukkala
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Keshav Saini
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Prashant Bajpai
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Gopinathan Pillai Sreekanth
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Shobha Mammen
- Department of Clinical Virology, Christian Medical College, Vellore, India
| | - Anand Rajan
- Department of Clinical Virology, Christian Medical College, Vellore, India
| | - Valsan Philip Verghese
- Pediatric Infectious Diseases, Department of Pediatrics, Christian Medical College, Vellore, India
| | - Asha Mary Abraham
- Department of Clinical Virology, Christian Medical College, Vellore, India
| | - Paresh Shah
- Department of Molecular Virology, National Institute of Virology, Pune, India
| | - Kalichamy Alagarasu
- Department of Molecular Virology, National Institute of Virology, Pune, India
| | - Tianwei Yu
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Shenzhen Research Institute of Big Data, School of Data Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Carl W Davis
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Jens Wrammert
- Department of Pediatrics, Division of Infectious Disease, Emory University School of Medicine, Atlanta, GA, USA
| | - Aftab Ansari
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Rustom Antia
- Department of Biology, Emory University, Atlanta, GA, USA
| | - Sushil Kumar Kabra
- Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Guruprasad R Medigeshi
- Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, India
| | - Rafi Ahmed
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA.
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Rakesh Lodha
- Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
| | - Anita Shet
- Division of Infectious Diseases, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, India.
- International Vaccine Access Centre, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Anmol Chandele
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India.
| | - Kaja Murali-Krishna
- ICGEB Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India.
- Department of Pediatrics, Division of Infectious Disease, Emory University School of Medicine, Atlanta, GA, USA.
- Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA, USA.
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Dobeson CB, Birkbeck M, Bhatnagar P, Hall J, Pearson R, West S, English P, Butteriss D, Perthen J, Lewis J. Perfusion MRI in the evaluation of brain metastases: current practice review and rationale for study of baseline MR perfusion imaging prior to stereotactic radiosurgery (STARBEAM-X). Br J Radiol 2023; 96:20220462. [PMID: 37660364 PMCID: PMC10646666 DOI: 10.1259/bjr.20220462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/04/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023] Open
Abstract
Stereotactic radiosurgery is an established focal treatment for brain metastases with high local control rates. An important side-effect of stereotactic radiosurgery is the development of radionecrosis. On conventional MR imaging, radionecrosis and tumour progression often have similar appearances, but have contrasting management approaches. Perfusion MR imaging is often used in the post-treatment setting in order to help distinguish between the two, but image interpretation can be fraught with challenges.Perfusion MR plays an established role in the baseline and post-treatment evaluation of primary brain tumours and a number of studies have concentrated on the value of perfusion imaging in brain metastases. Of the parameters generated, relative cerebral blood volume is the most widely used variable in terms of its clinical value in differentiating between radionecrosis and tumour progression. Although it has been suggested that the relative cerebral blood volume tends to be elevated in active metastatic disease following treatment with radiosurgery, but not with treatment-related changes, the literature available on interpretation of the ratios provided in the context of defining tumour progression is not consistent.This article aims to provide an overview of the role perfusion MRI plays in the assessment of brain metastases and introduces the rationale for the STARBEAM-X study (Study of assessment of radionecrosis in brain metastases using MR perfusion extra imaging), which will prospectively evaluate baseline perfusion imaging in brain metastases. We hope this will allow insight into the vascular appearance of metastases from different primary sites, and aid in the interpretation of post-treatment perfusion imaging.
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Affiliation(s)
| | - Matthew Birkbeck
- Northern Medical Physics and Clinical Engineering, Freeman Hospital, Newcastle upon Tyne, UK
| | - Priya Bhatnagar
- Department of Neuroradiology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Julie Hall
- Department of Neuroradiology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Rachel Pearson
- Department of Oncology, Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne, UK
| | - Serena West
- Department of Oncology, Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne, UK
| | - Philip English
- Department of Neuroradiology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - David Butteriss
- Department of Neuroradiology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Joanna Perthen
- Department of Neuroradiology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Joanne Lewis
- Department of Oncology, Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne, UK
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Bhatnagar P, Bajpai P, Shrinet J, Kaja MK, Chandele A, Sitaraman R. Prediction of human protein interactome of dengue virus non-structural protein 5 (NS5) and its downstream immunological implications. 3 Biotech 2023; 13:180. [PMID: 37193327 PMCID: PMC10182223 DOI: 10.1007/s13205-023-03569-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/19/2023] [Indexed: 05/18/2023] Open
Abstract
The non-structural protein 5 (NS5) is the most conserved protein among flaviviruses, a family that includes the dengue virus. It functions both as an RNA-dependent RNA polymerase and an RNA-methyltransferase and is therefore essential for the replication of viral RNA. The discovery that dengue virus NS5 protein (DENV-NS5) can also localize to the nucleus has resulted in renewed interest in its potential roles at the host-virus interface. In this study, we have used two complementary computational approaches in parallel - one based on linear motifs (ELM) and another based on tertiary structure of the protein (DALI) - to predict the host proteins that DENV-NS5 might interact with. Of the 42 human proteins predicted by both these methods, 34 are novel. Pathway analysis of these 42 human proteins shows that they are involved in key host cellular processes related to cell cycle regulation, proliferation, protein degradation, apoptosis, and immune responses. A focused analysis of transcription factors that directly interact with the predicted DENV-NS5 interacting proteins was performed, followed by the identification of downstream genes that are differentially expressed after dengue infection using previously published RNA-seq data. Our study provides unique insights into the DENV-NS5 interaction network and delineates mechanisms whereby DENV-NS5 could impact the host-virus interface. The novel interactors identified in this study could be potentially targeted by NS5 to modulate the host cellular environment in general, and the immune response in particular, thereby extending the role of DENV-NS5 beyond its known enzymatic functions. Supplementary Information The online version contains supplementary material available at 10.1007/s13205-023-03569-0.
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Affiliation(s)
- Priya Bhatnagar
- Department of Biotechnology, TERI School of Advanced Studies, New Delhi, India
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India
| | - Prashant Bajpai
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India
| | - Jatin Shrinet
- Department of Biological Science, Florida State University, Tallahassee, FL 32306 USA
| | - Murali Krishna Kaja
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India
- Department of Pediatrics and Emory Vaccine Centre, Emory University School of Medicine, Atlanta, GA USA
| | - Anmol Chandele
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India
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Dobeson C, Birkbeck M, Bhatnagar P, Hall J, Pearson R, West S, English P, Butteriss D, Lewis J. NIMG-05. DYNAMIC SUSCEPTIBILITY CONTRAST MRI IN THE EVALUATION OF BRAIN METASTASES: CURRENT PRACTICE REVIEW AND RATIONALE FOR STUDY OF BASELINE PERFUSION IMAGING PRIOR TO STEREOTACTIC RADIOSURGERY (STARBEAM-X). Neuro Oncol 2022. [PMCID: PMC9661099 DOI: 10.1093/neuonc/noac209.625] [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] Open
Abstract
Abstract
Stereotactic radiosurgery (SRS) is an established focal treatment for brain metastases with high local control rates. An important side-effect of SRS is the development of radionecrosis. On conventional MR imaging, radionecrosis and tumour progression often have similar appearances, but have contrasting management approaches. Perfusion MR imaging is often used in the post-treatment setting in order to help distinguish between the two, but image interpretation can be fraught with challenges.Perfusion MR plays an established role in the baseline and post-treatment evaluation of primary brain tumours and a number of studies have concentrated on the value of perfusion imaging in brain metastases. Of the parameters generated, relative cerebral blood volume is the most widely used variable in terms of its clinical value in differentiating between radionecrosis and tumour progression.Although it has been suggested that the rCBV tends to be elevated in active metastatic disease following treatment with radiosurgery, but not with treatment-related changes, the literature available on interpretation of the ratios provided in the context of defining tumour progression is not consistent.We provide an overview of the role perfusion MRI plays in the assessment of brain metastases and introduces the rationale for the STARBEAM-X study (Study of assessment of radionecrosis in brain metastases using MR perfusion extra imaging), which will prospectively evaluate baseline perfusion imaging in brain metastases. We present here the results of the first three patients recruited to the feasibility phase of this study. We hope this study will allow insight into the vascular appearance of metastases from different primary sites, and aid in the interpretation of post-treatment perfusion imaging.
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Affiliation(s)
- Caroline Dobeson
- Northern Centre for Cancer Care, Freeman Hospital , Newcastle upon Tyne , United Kingdom
| | - Matthew Birkbeck
- Northern Medical Physics and Clinical Engineering, Freeman Hospital , Newcastle upon Tyne , United Kingdom
| | - Priya Bhatnagar
- Department of Neuroradiology, Royal Victoria Infirmary , Newcastle upon Tyne , United Kingdom
| | - Julie Hall
- Department of Neuroradiology, Royal Victoria Infirmary , Newcastle upon Tyne , United Kingdom
| | - Rachel Pearson
- Northern Centre for Cancer Care, Freeman Hospital , Newcastle upon Tyne , United Kingdom
| | - Serena West
- Northern Centre for Cancer Care, Freeman Hospital , Newcastle upon Tyne , United Kingdom
| | - Philip English
- Department of Neuroradiology, Royal Victoria Infirmary , Newcastle upon Tyne , United Kingdom
| | - David Butteriss
- Department of Neuroradiology, Royal Victoria Infirmary , Newcastle upon Tyne , United Kingdom
| | - Joanne Lewis
- Northern Centre for Cancer Care, Freeman Hospital , Newcastle upon Tyne , United Kingdom
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5
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Maiter A, Butteriss D, English P, Lewis J, Hassani A, Bhatnagar P. Does the rCBV ratio help to differentiate disease progression and treatment-related change in glioblastoma? Clin Radiol 2022. [DOI: 10.1016/j.crad.2022.08.099] [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: 11/26/2022]
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Maiter A, Butteriss D, English P, Lewis J, Hassani A, Bhatnagar P. Assessing the diagnostic accuracy and interobserver agreement of MRI perfusion in differentiating disease progression and pseudoprogression following treatment for glioblastoma in a tertiary UK centre. Clin Radiol 2022; 77:e568-e575. [DOI: 10.1016/j.crad.2022.04.011] [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] [Received: 12/16/2021] [Accepted: 04/12/2022] [Indexed: 11/03/2022]
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Wiegertjes K, Dinsmore L, Drever J, Hutchison A, Stephen J, Valdés Hernández MC, Bhatnagar P, Minks DP, Rodrigues MA, Werring DJ, de Leeuw FE, Klijn CJ, Al-Shahi Salman R, White PM, Wardlaw JM. Diffusion-weighted imaging lesions and risk of recurrent stroke after intracerebral haemorrhage. J Neurol Neurosurg Psychiatry 2021; 92:950-955. [PMID: 34103345 DOI: 10.1136/jnnp-2021-326116] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 01/13/2021] [Accepted: 04/07/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine whether the presence of diffusion-weighted imaging-positive (DWI+) lesions is associated with recurrent stroke after intracerebral haemorrhage (ICH). METHODS The REstart or STop Antithrombotics Randomised Trial (RESTART) assessed the effect of restarting versus avoiding antiplatelet therapy after ICH on major vascular events for up to 5 years. We rated DWI sequences of MRI done before randomisation for DWI+ lesion presence, masked to outcome and antiplatelet use. Cox proportional hazards regression models were used to quantify associations. RESULTS Of 537 participants in RESTART, 247 (median (IQR) age 75.7 (69.6-81.1) years; 170 men (68.8%); 120 started vs 127 avoided antiplatelet therapy) had DWI sequences on brain MRI at a median of 57 days (IQR 19-103) after ICH, of whom 73 (30%) had one or more DWI+ lesion. During a median follow-up of 2 years (1-3), 18 participants had recurrent ICH and 21 had ischaemic stroke. DWI+ lesion presence was associated with all stroke, (adjusted HR 2.2 (95% CI 1.1 to 4.2)) and recurrent ICH (4.8 (95% CI 1.8 to 13.2)), but not ischaemic stroke (0.9 (95% CI 0.3 to 2.5)). DWI+ lesion presence (0.5 (95% CI 0.2 to 1.3)) vs absence (0.6 (95% CI 0.3 to 1.5), pinteraction=0.66) did not modify the effect of antiplatelet therapy on a composite outcome of recurrent stroke. CONCLUSIONS DWI+ lesion presence in ICH survivors is associated with recurrent ICH, but not with ischaemic stroke. We found no evidence of modification of effects of antiplatelet therapy on recurrent stroke after ICH by DWI+ lesion presence. These findings provide a new perspective on the significance of DWI+ lesions, which may be markers of microvascular mechanisms associated with recurrent ICH. TRIAL REGISTRATION NUMBER ISRCTN71907627.
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Affiliation(s)
- Kim Wiegertjes
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Lynn Dinsmore
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Jonathan Drever
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Aidan Hutchison
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Jacqueline Stephen
- Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Maria C Valdés Hernández
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.,Row Fogo Centre for Research into Ageing and the Brain, The University of Edinburgh, Edinburgh, UK.,Edinburgh Imaging, The University of Edinburgh, Edinburgh, UK
| | - Priya Bhatnagar
- Department of Neuroradiology, Newcastle-upon-Tyne Hospitals NHS Trust, Newcastle-upon-Tyne, UK
| | - David P Minks
- Department of Neuroradiology, Newcastle-upon-Tyne Hospitals NHS Trust, Newcastle-upon-Tyne, UK
| | - Mark A Rodrigues
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.,Edinburgh Imaging, The University of Edinburgh, Edinburgh, UK
| | - David J Werring
- Stroke Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Catharina Jm Klijn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Rustam Al-Shahi Salman
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK .,Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Phillip M White
- Translational and Clinical Research Institute, The University of Newcastle, Newcastle-upon-Tyne, UK
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.,Row Fogo Centre for Research into Ageing and the Brain, The University of Edinburgh, Edinburgh, UK.,Edinburgh Imaging, The University of Edinburgh, Edinburgh, UK.,Dementia Research Institute, The University of Edinburgh, Edinburgh, UK
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Bhatnagar P, Tarachandra S, Undaru S. A study on patterns of use of mobile phone and nomophobia in medical undergraduate students during a COVID-19 pandemic lockdown. Eur Psychiatry 2021. [PMCID: PMC9480063 DOI: 10.1192/j.eurpsy.2021.1781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction The governments of various countries enforced a lockdown to contain the COVID -19 pandemic. As the colleges remain closed, the academic teachings for students was conducted online. The mobile phone remained the main source for academics and entertainment during this period. Objectives To assess patterns of use of mobile phone by Medical Undergraduate students prior to and during the COVID-19 lockdown. To assess Nomophobia among same participants. Methods This study was done by an online survey method after obtaining approval from the Institutional Ethics Committee. A validated questionnaire on patterns of mobile phone use and the Nomophobia Questionnaire(NMP-Q) was completed by the medical students (n=187) who consented to participate in the study Results Prior to the pandemic lockdown, 52.9% of the participants used the mobile phones for 2-4 hours per day with 78% of the usage in social media. During lockdown, 89.3% of the participants reported an increase in the usage of mobile phones. 35.65% reported an increase in use by 2-4 hours everyday. About 30.5 % used the mobile phone for 6-8 hours per day. 80.2 % reported a maximum usage for social media. 59.45% reported a maximum usage for online academics. 33.7% frequently checked their phones once in 15 minutes. About 60.43% of the participants were in the moderate and 21.4% in the severe category of nomophobia. Conclusions There is an increase in mobile phone usage during the lockdown with a significant proportion of students in the moderate and severe category of nomophobia. Disclosure No significant relationships.
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Bhatnagar P, Sreekanth GP, Murali-Krishna K, Chandele A, Sitaraman R. Dengue Virus Non-Structural Protein 5 as a Versatile, Multi-Functional Effector in Host-Pathogen Interactions. Front Cell Infect Microbiol 2021; 11:574067. [PMID: 33816326 PMCID: PMC8015806 DOI: 10.3389/fcimb.2021.574067] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 02/19/2021] [Indexed: 12/22/2022] Open
Abstract
Dengue is emerging as one of the most prevalent mosquito-borne viral diseases of humans. The 11kb RNA genome of the dengue virus encodes three structural proteins (envelope, pre-membrane, capsid) and seven non-structural proteins (NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5), all of which are translated as a single polyprotein that is subsequently cleaved by viral and host cellular proteases at specific sites. Non-structural protein 5 (NS5) is the largest of the non-structural proteins, functioning as both an RNA-dependent RNA polymerase (RdRp) that replicates the viral RNA and an RNA methyltransferase enzyme (MTase) that protects the viral genome by RNA capping, facilitating polyprotein translation. Within the human host, NS5 interacts with several proteins such as those in the JAK-STAT pathway, thereby interfering with anti-viral interferon signalling. This mini-review presents annotated, consolidated lists of known and potential NS5 interactors in the human host as determined by experimental and computational approaches respectively. The most significant protein interactors and the biological pathways they participate in are also highlighted and their implications discussed, along with the specific serotype of dengue virus as appropriate. This information can potentially stimulate and inform further research efforts towards providing an integrative understanding of the mechanisms by which NS5 manipulates the human-virus interface in general and the innate and adaptive immune responses in particular.
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Affiliation(s)
- Priya Bhatnagar
- Department of Biotechnology, TERI School of Advanced Studies, New Delhi, India.,ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India
| | - Gopinathan Pillai Sreekanth
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India
| | - Kaja Murali-Krishna
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India.,Department of Paediatrics and Emory Vaccine Centre, Emory University School of Medicine, Atlanta, GA, United States
| | - Anmol Chandele
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India
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NAYAK KAUSTUV, Jain V, Kaur M, Khan N, Rai RC, Dixit K, Sagar R, Gupta S, Islamuddin M, Verma A, Maheshwari D, Aggarwal C, Chawla Y, Reddy ES, Panda H, Sharma P, Bhatnagar P, Singh P, Ratageri VH, Chandele A, Ray P, Muralikrishna K. Human immunity to chikungunya infection. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.249.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Chikungunyna virus is expanding globally and continue to cause major public health threat to Indian populations. Vaccine efforts are underway, and it is hoped that these will eventually progress to human evaluation. However, currently we have little understanding of the phenotypes and functions of the human T cells in chikungunya patients, a knowledge that is essential for improving vaccine design/testing and evaluation efforts. Here, we provide a detailed analysis of the CD8 T cell responses in chikungunya patients from India. We found that CD38+ HLADR+ CD8 T cell subset expanded dramatically in chikungunya febrile patients with frequencies averaging about 20% of the total CD8 T cells, and reaching as high as 50% of the CD8 T cells in some patients. The frequencies of these activated CD8 T cells were substantially low and barely above background levels in afebrile patients reporting to the clinic with persistent arthralgia/arthritis that was lasting for more than 30 days. These massively expanding CD8 T cells observed in the acute febrile patients were highly proliferating (KI67 ), robustly expressing markers indicative strong Th1 differentiation (T-bet), cytotoxic functions (Perforin) and inflammatory/synovial tissue homing characteristics (CX3CR1 and CXCR4). Interestingly, antigen-stimulation mediated IFN-g producing functions of these cells was highly compromized, reminiscent of the “cytokine stunned” phenotype. Taken together, these results suggest that these highly differentiated effector CD8 T cell that were massively expanding during acute chikungunya febrile infection might be involved in protection by homing to infected tissues and eliminating infected targets rather than causing inflammation.
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Affiliation(s)
- KAUSTUV NAYAK
- 1International Centre for Genetic Engineering and Biotechnology, India
| | - Vineet Jain
- 2Hamdard Institute of Medical Sciences and Research, India
| | - Manpreet Kaur
- 1International Centre for Genetic Engineering and Biotechnology, India
| | | | | | - Kritika Dixit
- 1International Centre for Genetic Engineering and Biotechnology, India
| | | | | | | | - Anil Verma
- 4All India Institute of Medical Science, New Delhi, India
| | - Deepti Maheshwari
- 1International Centre for Genetic Engineering and Biotechnology, India
| | - Charu Aggarwal
- 1International Centre for Genetic Engineering and Biotechnology, India
| | - Yadya Chawla
- 1International Centre for Genetic Engineering and Biotechnology, India
| | | | - Harekrushna Panda
- 1International Centre for Genetic Engineering and Biotechnology, India
| | - Pragati Sharma
- 1International Centre for Genetic Engineering and Biotechnology, India
| | - Priya Bhatnagar
- 1International Centre for Genetic Engineering and Biotechnology, India
| | - Prabhat Singh
- 1International Centre for Genetic Engineering and Biotechnology, India
| | | | - Anmol Chandele
- 1International Centre for Genetic Engineering and Biotechnology, India
| | | | - Kaja Muralikrishna
- 1International Centre for Genetic Engineering and Biotechnology, India
- 6Emory Vaccine Center, Emory University School of Medicine
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Nayak K, Jain V, Kaur M, Khan N, Gottimukkala K, Aggarwal C, Sagar R, Gupta S, Rai RC, Dixit K, Islamuddin M, Khan WH, Verma A, Maheshwari D, Chawla YM, Reddy ES, Panda H, Sharma P, Bhatnagar P, Singh P, Raghavendhar B S, Patel AK, Ratageri VH, Chandele A, Ray P, Murali-Krishna K. Antibody response patterns in chikungunya febrile phase predict protection versus progression to chronic arthritis. JCI Insight 2020; 5:130509. [PMID: 32155134 DOI: 10.1172/jci.insight.130509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/24/2019] [Accepted: 03/04/2020] [Indexed: 11/17/2022] Open
Abstract
Chikungunya virus (CHIKV) infection causes acute febrile illness in humans, and some of these individuals develop a debilitating chronic arthritis that can persist for months to years for reasons that remain poorly understood. In this study from India, we characterized antibody response patterns in febrile chikungunya patients and further assessed the association of these initial febrile-phase antibody response patterns with protection versus progression to developing chronic arthritis. We found 5 distinct patterns of the antibody responses in the febrile phase: no CHIKV binding or neutralizing (NT) antibodies but PCR positive, IgM alone with no NT activity, IgM alone with NT activity, IgM and IgG without NT activity, and IgM and IgG with NT activity. A 20-month follow-up showed that appearance of NT activity regardless of antibody isotype or appearance of IgG regardless of NT activity during the initial febrile phase was associated with a robust protection against developing chronic arthritis in the future. These findings, while providing potentially novel insights on correlates of protective immunity against chikungunya-induced chronic arthritis, suggest that qualitative differences in the antibody response patterns that have evolved during the febrile phase can serve as biomarkers that allow prediction of protection or progression to chronic arthritis in the future.
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Affiliation(s)
- Kaustuv Nayak
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Vineet Jain
- Department of Medicine, Hamdard Institute of Medical Sciences and Research (HIMSAR), Jamia Hamdard, New Delhi, India
| | - Manpreet Kaur
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Naushad Khan
- Department of Biotechnology, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India
| | - Kamalvishnu Gottimukkala
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Charu Aggarwal
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Rohit Sagar
- Department of Biotechnology, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India
| | - Shipra Gupta
- Department of Biotechnology, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India
| | - Ramesh Chandra Rai
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Kritika Dixit
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Mohammad Islamuddin
- Department of Biotechnology, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India
| | - Wajihul Hasan Khan
- Department of Biotechnology, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India
| | - Anil Verma
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Maheshwari
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Yadya M Chawla
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Elluri Seetharami Reddy
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Harekrushna Panda
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Pragati Sharma
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Priya Bhatnagar
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Prabhat Singh
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Siva Raghavendhar B
- Kusuma School of Biological Sciences, Indian Institute of Technology (IIT), New Delhi, India
| | - Ashok Kumar Patel
- Kusuma School of Biological Sciences, Indian Institute of Technology (IIT), New Delhi, India
| | - Vinod H Ratageri
- Department of Pediatrics, Karnataka Institute of Medical Sciences (KIMS), Hubli, Karnataka, India
| | - Anmol Chandele
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India
| | - Pratima Ray
- Department of Biotechnology, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India
| | - Kaja Murali-Krishna
- ICGEB-Emory Vaccine Centre, International Centre for Genetic Engineering and Biotechnology (ICGEB), Aruna Asaf Ali Marg, New Delhi, India.,Emory Vaccine Center and.,Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
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Mousa AE, Okasha M, Isaacs JD, Price DA, Bhatnagar P, Joshi A, Surash S. Brain pseudotumour secondary to Behçet's disease. Ann R Coll Surg Engl 2019; 101:e164-e168. [PMID: 31537109 PMCID: PMC6818074 DOI: 10.1308/rcsann.2019.0134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Accepted: 10/07/2018] [Indexed: 11/22/2022] Open
Abstract
Neuro-Behçet's disease (NBD) is a serious manifestation of Behçet's disease (BD) and can affect either the central or peripheral nervous systems, or both. It occurs in 10-50% of patients with BD. We report on a patient with an unusual intraparenchymal lesion, initially thought to be a brain tumour. Histological examination revealed vasculitis consistent with BD. Clinicians should include NBD as a differential diagnosis when considering an isolated inflammatory intracranial lesion.
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Affiliation(s)
- AE Mousa
- Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - M Okasha
- Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - JD Isaacs
- Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - DA Price
- Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - P Bhatnagar
- Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - A Joshi
- Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - S Surash
- Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
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Al-Shahi Salman R, Minks DP, Mitra D, Rodrigues MA, Bhatnagar P, du Plessis JC, Joshi Y, Dennis MS, Murray GD, Newby DE, Sandercock PAG, Sprigg N, Stephen J, Sudlow CLM, Werring DJ, Whiteley WN, Wardlaw JM, White PM. Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial. Lancet Neurol 2019; 18:643-652. [PMID: 31129065 PMCID: PMC7645733 DOI: 10.1016/s1474-4422(19)30184-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/04/2019] [Accepted: 04/04/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy. METHODS RESTART was a prospective, randomised, open-label, blinded-endpoint, parallel-group trial at 122 hospitals in the UK that assessed whether starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. For this prespecified subgroup analysis, consultant neuroradiologists masked to treatment allocation reviewed brain CT or MRI scans performed before randomisation to confirm participant eligibility and rate features of the intracerebral haemorrhage and surrounding brain. We followed participants for primary (recurrent symptomatic intracerebral haemorrhage) and secondary (ischaemic stroke) outcomes for up to 5 years (reported elsewhere). For this report, we analysed eligible participants with intracerebral haemorrhage according to their treatment allocation in primary subgroup analyses of cerebral microbleeds on MRI and in exploratory subgroup analyses of other features on CT or MRI. The trial is registered with the ISRCTN registry, number ISRCTN71907627. FINDINGS Between May 22, 2013, and May 31, 2018, 537 participants were enrolled, of whom 525 (98%) had intracerebral haemorrhage: 507 (97%) were diagnosed on CT (252 assigned to start antiplatelet therapy and 255 assigned to avoid antiplatelet therapy, of whom one withdrew and was not analysed) and 254 (48%) underwent the required brain MRI protocol (122 in the start antiplatelet therapy group and 132 in the avoid antiplatelet therapy group). There were no clinically or statistically significant hazards of antiplatelet therapy on recurrent intracerebral haemorrhage in primary subgroup analyses of cerebral microbleed presence (2 or more) versus absence (0 or 1) (adjusted hazard ratio [HR] 0·30 [95% CI 0·08-1·13] vs 0·77 [0·13-4·61]; pinteraction=0·41), cerebral microbleed number 0-1 versus 2-4 versus 5 or more (HR 0·77 [0·13-4·62] vs 0·32 [0·03-3·66] vs 0·33 [0·07-1·60]; pinteraction=0·75), or cerebral microbleed strictly lobar versus other location (HR 0·52 [0·004-6·79] vs 0·37 [0·09-1·28]; pinteraction=0·85). There was no evidence of heterogeneity in the effects of antiplatelet therapy in any exploratory subgroup analyses (all pinteraction>0·05). INTERPRETATION Our findings exclude all but a very modest harmful effect of antiplatelet therapy on recurrent intracerebral haemorrhage in the presence of cerebral microbleeds. Further randomised trials are needed to replicate these findings and investigate them with greater precision. FUNDING British Heart Foundation.
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Affiliation(s)
- Rustam Al-Shahi Salman
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
| | - David P Minks
- Department of Neuroradiology, Newcastle-upon-Tyne Hospitals NHS Trust, Newcastle-upon-Tyne, UK
| | - Dipayan Mitra
- Department of Neuroradiology, Newcastle-upon-Tyne Hospitals NHS Trust, Newcastle-upon-Tyne, UK; Institute of Neuroscience and Newcastle University Institute for Ageing, Newcastle University, Newcastle-upon-Tyne, UK
| | - Mark A Rodrigues
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Priya Bhatnagar
- Department of Neuroradiology, Newcastle-upon-Tyne Hospitals NHS Trust, Newcastle-upon-Tyne, UK
| | | | - Yogish Joshi
- Department of Radiology, Addenbrooke's Hospital, Cambridge, UK
| | - Martin S Dennis
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Gordon D Murray
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - David E Newby
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | | | - Nikola Sprigg
- Division of Clinical Neurosciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Jacqueline Stephen
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Cathie L M Sudlow
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - David J Werring
- Stroke Research Group, Department of Brain Repair and Rehabilitation, University College London Queen Square Institute of Neurology, London, UK
| | - William N Whiteley
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, University of Edinburgh, Edinburgh, UK
| | - Philip M White
- Department of Neuroradiology, Newcastle-upon-Tyne Hospitals NHS Trust, Newcastle-upon-Tyne, UK; Institute of Neuroscience and Newcastle University Institute for Ageing, Newcastle University, Newcastle-upon-Tyne, UK
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Nanapragasam A, Bhatnagar P, Birchall D. Trainee radiologist reports as a source of confirmation bias in radiology. Clin Radiol 2018; 73:1052-1055. [DOI: 10.1016/j.crad.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 08/14/2018] [Indexed: 11/26/2022]
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15
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Gulati RK, Bhatnagar P, Bhatnagar A. Antimicrobial Efficacy of Chemical and Herbal Agents against Streptococcus mutans: An in vitro study. Pesqui bras odontopediatria clín integr 2018. [DOI: 10.4034/pboci.2018.181.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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16
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Pillai S, Duvvuru S, Bhatnagar P, Foster W, Farmen M, Shankar S, Harris C, Bastyr E, Hoogwerf B, Haupt A. The PNPLA3 I148M variant is associated with transaminase elevations in type 2 diabetes patients treated with basal insulin peglispro. Pharmacogenomics J 2017; 18:487-493. [DOI: 10.1038/tpj.2017.45] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/24/2017] [Accepted: 08/04/2017] [Indexed: 12/27/2022]
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17
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Nanapragasam A, Birchall D, Bhatnagar P. In what context are radiologists most prone to error? A systematic review of discrepancies in a tertiary neuroradiology service. Clin Radiol 2017. [DOI: 10.1016/j.crad.2017.06.074] [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: 11/26/2022]
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Bhatnagar P, Townsend N, Shaw A, Foster C. PM010 The Physical Activity Profiles of Adult South Asians in England. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ferguson S, Bhatnagar P, Wright I, Sestric G, Williams S. Effects of Microwave Absorption on Long and Short Single-Walled Carbon Nanotubes at 10 -6 Torr. Int J Nanosci 2015. [DOI: 10.1142/s0219581x15500258] [Citation(s) in RCA: 2] [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: 11/18/2022]
Abstract
Carbon nanotubes have been observed to emit ultraviolet, visible and infrared radiation when exposed to microwaves. We have performed experiments in which both short (0.5 μm–2 μm) and long (5 μm–30 μm) single and double-walled carbon nanotubes were exposed to 2.46 GHz microwaves at a pressure of ~ 10-6 Torr. Structural modifications of the carbon nanotubes due to microwave absorption have been studied using the Raman spectroscopy G-band and D-band intensities, which suggest that microwave irradiation at relatively low pressure results in an increase in nanotube defects, especially in the case of the long nanotubes. Furthermore, a comparison of the spectra of the radiation emitted from the nanotubes suggests that the longer nanotubes emitted radiation of much greater intensity than the shorter nanotubes. Based on the results of the experiments and results described in previous reports, the ultraviolet, visible and infrared radiation emitted as the result of microwave absorption by carbon nanotubes seems to be primarily blackbody radiation emitted due to Joule heating. However, the presence of several broad photopeaks in the spectra of the emitted radiation (which do not seem to be related to gases absorbed by the nanotubes or the presence of catalyst particles) suggest that emissions are not the result of Joule heating alone.
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Affiliation(s)
- S. Ferguson
- Department of Physics and Geosciences, Angelo State University, ASU Station 10904, San Angelo, Texas 76909, USA
- Department of Physics, University of Texas at Dallas, 800 West Campbell Rd., Richardson, Texas 75080, USA
| | - P. Bhatnagar
- Department of Physics and Geosciences, Angelo State University, ASU Station 10904, San Angelo, Texas 76909, USA
| | - I. Wright
- Department of Physics and Geosciences, Angelo State University, ASU Station 10904, San Angelo, Texas 76909, USA
| | - G. Sestric
- Department of Physics and Geosciences, Angelo State University, ASU Station 10904, San Angelo, Texas 76909, USA
| | - S. Williams
- Department of Physics and Geosciences, Angelo State University, ASU Station 10904, San Angelo, Texas 76909, USA
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Bhatnagar P, Townsend N, Foster C. The Physical Activity Profiles of Adult Ethnic Groups in England. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sharma P, Mathur N, Singh A, Sogani M, Bhatnagar P, Atri R, Pareek S. Monitoring hospital wastewaters for their probable genotoxicity and mutagenicity. Environ Monit Assess 2015; 187:4180. [PMID: 25487460 DOI: 10.1007/s10661-014-4180-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 11/19/2014] [Indexed: 05/22/2023]
Abstract
Cancer is a leading cause of death worldwide. Excluding the genetic factors, environmental factors, mainly the pollutants, have been implicated in the causation of the majority of cancers. Wastewater originated from health-care sectors such as hospitals may carry vast amounts of carcinogenic and genotoxic chemicals to surface waters or any other source of drinking water, if discharged untreated. Humans get exposed to such contaminants through a variety of ways including drinking water. The aim of the present study was, thus, to monitor the genotoxic and mutagenic potential of wastewaters from three big hospitals located in Jaipur (Rajasthan), India. One of them was operating an effluent treatment plant (ETP) for treatment of its wastewater and therefore both the untreated and treated effluents from this hospital were studied for their genotoxicity. Two short-term bacterial bioassays namely the Salmonella fluctuation assay and the SOS chromotest were used for the purpose. Results of fluctuation assay revealed the highly genotoxic nature of all untreated effluent samples with mutagenicity ratios (MR) up to 23.13 ± 0.18 and 42.25 ± 0.35 as measured with Salmonella typhimurium strains TA98 and TA100, respectively. As determined with the chromotest, all untreated effluents produced significant induction factors (IF) ranging from 3.29 ± 1.11 to 13.35 ± 3.58 at higher concentrations. In contrast, treated effluent samples were found to be slightly genotoxic in fluctuation test only with an MR = 3.75 ± 0.35 for TA100 at 10 % concentration. Overall, the results indicated that proper treatment of hospital wastewaters may render the effluents safe for disposal contrary to the untreated ones, possessing high genotoxic potential.
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Affiliation(s)
- Pratibha Sharma
- Environmental Molecular Microbiology Lab, Department of Zoology, University of Rajasthan, Jaipur, Rajasthan, 302004, India,
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Agrawal S, Flora G, Bhatnagar P, Flora SJS. Comparative oxidative stress, metallothionein induction and organ toxicity following chronic exposure to arsenic, lead and mercury in rats. Cell Mol Biol (Noisy-le-grand) 2014; 60:13-21. [PMID: 24970117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 06/16/2014] [Indexed: 06/03/2023]
Abstract
Globally, arsenic, mercury and lead constitutes as the three most hazardous environmental toxicants perturbing imbalance in pro—oxidant and antioxidant homeostasis. Individual toxicity of these environmental toxicants is well known but there is lack of comparative data on variables indicative of oxidative stress. We thus investigated the effects of chronic exposure to sodium arsenite, mercuric chloride and lead acetate on blood and tissue oxidative stress, metal concentration and metallothionein (MT) contents. Male rats were exposed to sodium arsenite, mercuric chloride and lead acetate (0.05 mg/kg each, orally, once daily) for 6 months. Arsenic, mercury and lead exposure led to a significant inhibition of blood δ—aminolevulinic acid dehydratase (ALAD) activity and glutathione level supported by increased thiobarbituric acid reactive substance (TBARS). The level of inhibition was more pronounced in case of lead followed by mercury and arsenic. These metals/ metalloid significantly increased reactive oxygen species (ROS), thiobarbituric acid reactive substances (TBARS) and glutathione peroxidase (GPx) activity accompanied by a decreased superoxide dismutase (SOD), catalase and reduced and oxidized glutathione (GSH and GSSG) levels in blood and tissues. Mercury alone produced a significant induction of hepatic and renal MT concentrations. Serum transaminases, lactate dehydrogenase and alkaline phosphatase activities increased significantly on exposure to arsenic and mercury exposure suggesting liver injury which was less pronounced in case of lead exposure. These biochemical alterations were supported by increased arsenic, mercury and lead concentrations in blood and soft tissues. The present study suggests that exposure to sodium arsenite and mercuric chloride lead to more pronounced oxidative stress and hepatotoxicity while lead acetate caused significant alterations in haem synthesis pathway compared to two other thiol binding metal/metalloid.
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Affiliation(s)
- S Agrawal
- The IIS University Department of Biotechnology Jaipur India
| | - G Flora
- SBBS College of Engineering and Technology Jalandhar India
| | - P Bhatnagar
- The IIS University Department of Biotechnology Jaipur India
| | - S J S Flora
- Defence Research and Development Establishment Division of Regulatory Toxicology Gwalior India sjsflora@hotmail.com
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Bhatnagar P, Subesinghe M, Patel C, Prestwich R, Scarsbrook AF. Functional Imaging for Radiation Treatment Planning, Response Assessment, and Adaptive Therapy in Head and Neck Cancer. Radiographics 2013; 33:1909-29. [DOI: 10.1148/rg.337125163] [Citation(s) in RCA: 64] [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: 12/21/2022]
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Sunderland G, Hassan F, Bhatnagar P, Mitchell P, Jayakrishnan V, Forster D, Mendelow AD. Development of anterior inferior cerebellar artery pseudoaneurysm after gamma knife surgery for vestibular schwannoma. A case report and review of the literature. Br J Neurosurg 2013; 28:536-8. [PMID: 24111706 DOI: 10.3109/02688697.2013.847168] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [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: 11/13/2022]
Abstract
Gamma knife surgery (GKS) is a well-established modality for controlling the progression of vestibular schwannomas. Adverse effects of this treatment are extremely rare but include cyst formation and malignant transformation. We report a case of anterior inferior cerebellar artery (AICA) pseudoaneurysm development rupture presenting as a poor WFNS grade subarachnoid haemorrhage. This is only the fourth case of aneurysm development (AICA aneurysm) following GKS reported but due to its serious nature we believe this potential complication warrants awareness in those offering this treatment.
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Affiliation(s)
- Geraint Sunderland
- Department of Neurosurgery, Regional Neurosciences Centre, Newcastle Upon Tyne NHS Foundation Trust , Newcastle Upon Tyne , UK
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Almazedi B, Lyall H, Bhatnagar P, Kessel D, McPherson S, Patel JV, Puppala S. Erratum to: Endovascular Management of Extra-cranial Supra-aortic Vascular Injuries. Cardiovasc Intervent Radiol 2013. [DOI: 10.1007/s00270-013-0612-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sharma P, Kumar M, Mathur N, Singh A, Bhatnagar P, Sogani M. Health care industries: potential generators of genotoxic waste. Environ Sci Pollut Res Int 2013; 20:5160-5167. [PMID: 23361179 DOI: 10.1007/s11356-013-1500-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 01/17/2013] [Indexed: 06/01/2023]
Abstract
Health care waste includes all the waste generated by health care establishments, research facilities, and laboratories. This constitutes a variety of chemical substances, such as pharmaceuticals, radionuclides, solvents, and disinfectants. Recently, scientists and environmentalists have discovered that wastewater produced by hospitals possesses toxic properties due to various toxic chemicals and pharmaceuticals capable of causing environmental impacts and even lethal effects to organisms in aquatic ecosystems. Many of these compounds resist normal wastewater treatment and end up in surface waters. Besides aquatic organisms, humans can be exposed through drinking water produced from contaminated surface water. Indeed, some of the substances found in wastewaters are genotoxic and are suspected to be potential contributors to certain cancers. The aim of this study was to evaluate the genotoxic and cytotoxic potential of wastewaters from two hospitals and three clinical diagnostic centers located in Jaipur (Rajasthan State), India using the prokaryotic Salmonella mutagenicity assay (Ames assay) and the eukaryotic Saccharomyces cerevisiae respiration inhibition assay. In the Ames assay, untreated wastewaters from both of the health care sectors resulted in significantly increased numbers of revertant colonies up to 1,000-4,050 as measured by the Salmonella typhimurium TA98 and TA100 strains (with and without metabolic activation) after exposure to undiluted samples, which indicated the highly genotoxic nature of these wastewaters. Furthermore, both hospital and diagnostic samples were found to be highly cytotoxic. Effective concentrations at which 20 % (EC20) and 50 % (EC50) inhibition of the respiration rate of the cells occurred ranged between ~0.00 and 0.52 % and between 0.005 and 41.30 % (calculated with the help of the MS excel software XLSTAT 2012.1.01; Addinsoft), respectively, as determined by the S. cerevisiae assay. The results indicated that hospital wastewaters contain genotoxic and cytotoxic components. In addition, diagnostic centers also represent small but significant sources of genotoxic and cytotoxic wastes.
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Affiliation(s)
- Pratibha Sharma
- Environmental Molecular Microbiology Laboratory, Department of Zoology, University of Rajasthan, Jaipur, 302004, Rajasthan, India.
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Almazedi B, Lyall H, Bhatnagar P, Kessel D, McPherson S, Patel JV, Puppala S. Endovascular Management of Extra-cranial Supra-aortic Vascular Injuries. Cardiovasc Intervent Radiol 2013; 37:55-68. [DOI: 10.1007/s00270-013-0555-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 12/13/2012] [Indexed: 10/27/2022]
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Yap WW, Belfield JC, Bhatnagar P, Kennish S, Wah TM. Evaluation of the sensitivity of scout radiographs on unenhanced helical CT in identifying ureteric calculi: a large UK tertiary referral centre experience. Br J Radiol 2012; 85:800-6. [PMID: 22665926 DOI: 10.1259/bjr/64356303] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Unenhanced helical CT for kidney, ureter and bladder (CT KUB) has become the standard investigation for renal colic. This study aims to determine the sensitivity of scout radiographs in detecting ureteric calculi using CT KUB as a standard reference. METHODS A retrospective review of consecutive patients who presented with acute flank pain and were investigated using CT KUB. 201 patients with positive ureteric calculi were included. Two radiologists independently reviewed the scout radiographs with access to CT KUB images. Each observer recorded the presence or absence of calculi, location, size and mean Hounsfield units of each calculus. RESULTS 203 ureteric calculi were analysed from 201 patients. The overall sensitivity of scout radiographs for Observer A was 42.3% and for Observer B 52.2%, with an interobserver reliability κ-value of 0.78. The significance of mean Hounsfield units and size between two groups of patients with visible stones and those not visible were tested; the p-value for both variables was <0.0001, which is statistically significant. The study found that calculi in the upper ureter and larger than 4 mm are more likely to be seen on the scout radiograph. CONCLUSIONS Usage of CT scout radiography should be encouraged and reported routinely in conjunction with CT KUB as a baseline for treatment follow-up.
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Affiliation(s)
- W W Yap
- Department of Clinical Radiology, St James University Hospital, Leeds, UK.
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Prestwich RJD, Bhatnagar P, Chowdhury FU, Patel CN, Dyker KE, Coyle C, Sen M, Scarsbrook AF. The Impact of (18)F-FDG PET CT Prior to Chemoradiotherapy for Stage III/IV Head and Neck Squamous Cell Carcinoma. ISRN Oncol 2012; 2012:636379. [PMID: 22548190 PMCID: PMC3324911 DOI: 10.5402/2012/636379] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 01/16/2012] [Indexed: 11/24/2022]
Abstract
Introduction. To determine the value of a FDG-PET-CT scan in patients with locally advanced head and neck squamous cell carcinoma (HNSCC) prior to chemoradiotherapy. Materials and Methods. Consecutive patients with stage III or IV HNSCC who had undergone a staging FDG-PET-CT scan prior to chemoradiotherapy between August 2008 and April 2011 were included. Clinical details and conventional imaging (CT and/or MRI) were, retrospectively, reviewed, a TNM stage was assigned, and levels of cervical lymph node involvement were documented. This process was repeated with the addition of FDG-PET-CT. Radiotherapy plans were reviewed for patients with an alteration identified on TNM staging and/or nodal level identification with FDG-PET-CT and potential alterations in radiotherapy planning were documented. Results. 55 patients were included in the analysis. FDG-PET-CT altered the TNM stage in 17/55 (31%) of patients, upstaging disease in 11 (20%) and downstaging in 6 (11%); distant metastases were identified by FDG-PET-CT in 1 (2%) patient. FDG-PET-CT altered the lymph node levels identified in 22 patients (40%), upclassifying disease in 16 (29%) and downclassifying in 6 (11%). Radiotherapy plans were judged retrospectively to have been altered by FDG-PET-CT in 10 patients (18%). Conclusions. The use of FDG-PET-CT potentially impacts upon both treatment decisions and radiotherapy planning.
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Affiliation(s)
- Robin J D Prestwich
- Departments of Nuclear Medicine, St. James's Institute of Oncology, Leeds LS9 7TF, UK
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Bhatnagar P. The impact of staging 18FDG-PET-CT prior to (chemo-) radiotherapy for stage III/IV head and neck squamous cell carcinoma. Clin Radiol 2011. [DOI: 10.1016/j.crad.2011.07.011] [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: 10/17/2022]
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Wickramasinghe K, Bhatnagar P, Scarborough P. P2-325 Trends in cardiovascular disease treatment in the UK, 1961-2011. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976k.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bhatnagar P, Wickramasinghe K, Scarborough P. SP3-56 Trends in cardiovascular risk factors in the UK, 1961-2011. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976o.56] [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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Abstract
The present study was undertaken to evaluate the teratogenic and behavioral effects of perinatal exposure to cyfluthrin (Synthetic Pyrethroid) on mice offspring. Humans are exposed to this compound as it is widely used in various household insecticide formulations and in public health programmes. Pregnant females were exposed to 16 mg/kg (low dose) and 32 mg/kg (high dose) body weight cyfluthrin daily by oral intubation from gestation day 14 through parturition and lactation up to weaning. On 18th day of gestation, 50% females were euthanized for teratological studies and the remaining were allowed to deliver their pups normally. The fetuses were weighed and observed for gross external malformations and routine teratological examination was done. The neonates were observed for neuromotor reflexes (surface righting, tail hang reflex and pivoting) from day 1 up to day 7 after birth. Movement and exploratory behavior of weanlings were observed using ‘open-field’ and ‘hole-board.’ The fetuses did not show any external malformation. Skeletal aberrations observed included poor ossification of the skull and phalanges and short ribs. Surface righting and pivoting were significantly affected by the high dose. Both doses produced significant changes in the locomotion, exploration, and rearing frequencies in the open-field. The study indicates that cyfluthrin when administered at the above-mentioned doses did not elicit significant teratogenicity but both the doses caused significant difference in behavioral activities.
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Affiliation(s)
- I. Soni
- Environmental Toxicology and Animal Behavior Laboratories, Centre for Advanced Studies, Department of Zoology, University of Rajasthan, Jaipur, Rajasthan, India
| | - F. Syed
- Environmental Toxicology and Animal Behavior Laboratories, Centre for Advanced Studies, Department of Zoology, University of Rajasthan, Jaipur, Rajasthan, India,
| | - P. Bhatnagar
- Environmental Toxicology and Animal Behavior Laboratories, Centre for Advanced Studies, Department of Zoology, University of Rajasthan, Jaipur, Rajasthan, India
| | - R. Mathur
- Environmental Toxicology and Animal Behavior Laboratories, Centre for Advanced Studies, Department of Zoology, University of Rajasthan, Jaipur, Rajasthan, India
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Steele JA, Uchytil TF, Durbin RD, Bhatnagar P, Rich DH. Chloroplast coupling factor 1: A species-specific receptor for tentoxin. Proc Natl Acad Sci U S A 2010; 73:2245-8. [PMID: 16592333 PMCID: PMC430514 DOI: 10.1073/pnas.73.7.2245] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Tentoxin, a cyclic tetrapeptide, induces chlorosis in certain plant species. It inactivated photophosphorylation and coupling factor 1 (CF(1)) ATPase in lettuce, a sensitive species. This effect was due to binding of tentoxin with CF(1) at a single site (affinity constant 1.3 to 20 x 10(7) M(-1)). Neither AMP nor adenyl-5'-yl imidodiphosphate appeared to bind to this site. In radish, an insensitive species, 20 times more tentoxin was required for 50% inhibition of photophosphorylation. In this species CF(1) ATPase was unaffected by tentoxin, and its CF(1) bound tentoxin only weakly (affinity constant less than 1 x 10(4) M(-1)). Sensitivity of photophosphorylation to tentoxin was correlated with chlorosis sensitivity in six other species examined.
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Affiliation(s)
- J A Steele
- Plant Disease Resistance Research Unit, Agricultural Research Service, U.S. Department of Agriculture, Madison, Wisc., 53706
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Bhatnagar P, Schoombee H, Burgess B. Ultrasound scan in the emergency department revealed rare but potentially dangerous internal jugular vein thrombosis. Arch Emerg Med 2010; 27:124. [DOI: 10.1136/emj.2008.067959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rainey JJ, Bhatnagar P, Estivariz CF, Durrani S, Galway M, Sandhu H, Bahl S, Jafari H, Wenger J. Providing monovalent oral polio vaccine type 1 to newborns: findings from a pilot birth-dose project in Moradabad district, India. Bull World Health Organ 2009; 87:955-9. [PMID: 20454487 PMCID: PMC2789365 DOI: 10.2471/blt.08.061556] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [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: 11/18/2008] [Revised: 03/10/2009] [Accepted: 03/11/2009] [Indexed: 11/27/2022] Open
Abstract
PROBLEM Poliovirus transmission remained a public health challenge in western Uttar Pradesh, India in late 2005 and early 2006. In 2006, the India Expert Advisory Group for Polio Eradication concluded that, given the peak incidence of polio among children 6 to 12 months of age, a targeted birth dose of oral polio vaccine may be necessary to interrupt intense poliovirus transmission in high risk areas. APPROACH The Government of Uttar Pradesh, the National Polio Surveillance Project and the United Nations Children's Fund (UNICEF) implemented a pilot birth-dose project aimed at identifying and vaccinating all newborns with a dose of oral polio vaccine within 72 hours of birth in an effort to evaluate operational feasibility and potential impact on population immunity. LOCAL SETTING The project was piloted in Moradabad district: zone 7 in Moradabad City (urban setting), Kunderki block (rural setting) and in select birthing hospitals. RELEVANT CHANGES Between July 2006 and February 2007, 9740 newborns were identified, of which 6369 (65%) were vaccinated by project personnel within 72 hours of birth. Project coverage (for total newborns vaccinated) ranged from 39% (in zone 7) to 76% (in Kunderki block) of the estimated number of newborns vaccinated during previous supplemental immunization activities. LESSONS LEARNED Birth-dose coverage among newborns was lower than expected. Expansion costs were estimated to be high, with marginal impact. The project, however, provided opportunities to strengthen newborn tracking systems which have increased the number of newborns and young infants vaccinated during supplemental immunization activities and enrolled in routine programmes.
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Affiliation(s)
- J J Rainey
- US Centers for Disease Control and Prevention, Global Immunization Division,1600 Clifton Road (MS E-05), Atlanta, GA 30333, United States of America.
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Gupta P, Mathur N, Bhatnagar P, Nagar P, Srivastava S. Genotoxicity evaluation of hospital wastewaters. Ecotoxicol Environ Saf 2009; 72:1925-32. [PMID: 19524298 DOI: 10.1016/j.ecoenv.2009.05.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 04/16/2009] [Accepted: 05/05/2009] [Indexed: 05/17/2023]
Abstract
In hospitals a large variety of substances are in use for medical purposes such as diagnostics and research. After application, diagnostic agents, disinfectants and excreted non-metabolized pharmaceuticals by patients reach the wastewater. Indeed, some of the substances found in wastewaters are genotoxic and are suspected to be a possible cause of the cancers observed in the last decades. Genotoxicity tests are an excellent means to study the toxicity and the risk associated with these releases. This paper points out the areas of concern for hospital wastewater disposal and reports the findings of genotoxicity tests for hospital effluents from 3 major hospitals in Delhi, namely All India Institute of Medical Sciences, Apollo and Escorts. Mutagenicity of hospital wastewaters from effluent treatment plants (before and after treatment) was studied. The results of this study show that the genotoxicity of hospital wastewaters is highly reduced after the treatment process. This study calls for establishment of advanced and effective effluent treatment plants in the hospitals, which are merely dumping the wastewaters in the municipal sewerage system. The results of this study call for further detailed study in this area.
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Affiliation(s)
- Preeti Gupta
- Environmental Toxicology Unit, Department of Zoology, University of Rajasthan, Jaipur 302004, India.
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Hoey ETD, Bhatnagar P, Mankad K, Gopalan D, Darby M, Robertson R. Imaging appearances of congenital thoracic lesions presenting in adulthood. Can Assoc Radiol J 2009; 60:172-81. [PMID: 19631492 DOI: 10.1016/j.carj.2009.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Many congenital lesions of the thorax are detected for the first time in adulthood when they can simulate a wide range of pathologies, including infection and neoplasia. They can be broadly classified into tracheobronchial, parenchymal, vascular, and combined parenchymal/vascular abnormalities. An awareness of their typical imaging features enables a confident diagnosis and helps direct appropriate patient management.
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Soni HI, Bakre PP, Bhatnagar P. Assessment of teratogenecity and embryotoxicity of sludge from textile industries at Pali (India) in Swiss albino mice exposed during organogenetic period. J Environ Biol 2008; 29:965-969. [PMID: 19298001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The present investigation was carried out to assess the teratological effects of in-utero exposure of sludge leachate from textile and dyeing industries located in Pali, Rajasthan. Sludge was collected at the combined effluent treatment plant (CETP). Two groups of 10 pregnant Swiss albino mice each, were given sludge leachate of 1/10 and 1/100 dilutions with water ad libitum from 6th day to 15th day of gestation covering the critical period of organogenesis. Cesarean sections were performed on day 18 of gestation and all foetuses were examined for reproductive and teratological tests. Sludge induced maternal toxicity was evidenced by significant increase in leachate consumption, reduction in body weight gain and reduction in fur of the body. Developmental toxicity was evidenced by a significant decrease in foetal weight per litter increase in the number of resorptions and an increase in total number of foetuses showing bone retardation and skeletal variations (specially of skull, sternebrae and vertebrae). The leachate of the sludge that is being dumped in the open areas of the town Pall seems to elicit teratogenic as well as embryotoxic potential as indicated by the findings of the present investigation.
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Affiliation(s)
- Himani I Soni
- Environmental Toxicology Laboratory, Department of Zoology, University of Rajasthan, Jaipur 302 004, India.
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Kennish SJ, Bhatnagar P, Wah TM, Bush S, Irving HC. Is the KUB radiograph redundant for investigating acute ureteric colic in the non-contrast enhanced computed tomography era? Clin Radiol 2008; 63:1131-5. [PMID: 18774360 DOI: 10.1016/j.crad.2008.04.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2008] [Revised: 04/08/2008] [Accepted: 04/25/2008] [Indexed: 01/28/2023]
Abstract
AIM To establish whether non-contrast enhanced computed tomography (NCCT) renders the kidneys-ureters-bladder (KUB) radiograph redundant as the initial imaging investigation for suspected acute ureteric colic. MATERIALS AND METHODS The imaging investigations for 120 patients consecutively admitted to an emergency department-led clinical decisions unit (CDU) with suspected acute ureteric colic were retrospectively reviewed. A multidisciplinary meeting reviewed the findings and recommended that KUB radiographs should not be routinely performed prior to NCCT. Prospective assessment of 116 consecutive patients admitted over a comparable period was then undertaken. RESULTS In the retrospective group, 61 (50.8%) patients had calculi to account for symptoms (positive NCCT) and 59 (49.2%) patients did not have stone disease (negative NCCT). Ninety (75%) patients had a KUB radiograph prior to NCCT. However, in 46 (38% of total) of these patients the NCCT was negative for stones, and therefore, they had been subjected to an unnecessary radiographic examination. These results prompted a change in practice. In the subsequent and prospectively studied group, preliminary KUB radiographs were performed in only 6% of the patients, with no significant change in the positive NCCT rate (50.8 versus 51.7%) or the total number of examinations performed (120 versus 116). CONCLUSION NCCT should be the initial imaging examination for acute ureteric colic. Up to 50% of patients with clinical suspicion do not have stone disease, and therefore, preliminary KUB radiographs with attendant radiation and cost implications are unjustified. Preliminary KUB radiographs can be omitted from the imaging pathway with no resultant indication creep or increase in demand for NCCT examinations.
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Affiliation(s)
- S J Kennish
- Department of Radiology, St James' University Hospital, Leeds, UK
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Bhatnagar S, Carey-Smith R, Darrah C, Bhatnagar P, Glasgow MM. Evidence-based practice in the utilization of knee radiographs--a survey of all members of the British Orthopaedic Association. Int Orthop 2006; 30:409-11. [PMID: 16642345 PMCID: PMC3172767 DOI: 10.1007/s00264-006-0099-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Accepted: 01/24/2006] [Indexed: 10/24/2022]
Abstract
There has been a debate amongst orthopaedic surgeons about which plain radiographs are required in common knee conditions and this is a 5-year review assessing the influence of recent publications on the use of radiographs. A postal survey of all members of the British Orthopaedic Association was performed. The response rate was 60% (990/1,650). There was a broad agreement on the use of anteroposterior and lateral radiographs. The use of the posteroanterior (PA) weight-bearing radiograph has increased from 82 to 86%. The use of skyline view for suspected arthritis and after knee replacement has increased from 23 to 41%. There is still disparity amongst orthopaedic surgeons regarding the knee flexion angle for skyline and weight-bearing views. After review of the literature we recommend that a single skyline view in 30 degrees flexion is adequate and should be a standard investigation in knee disorders. We also stress the importance of weight-bearing PA radiograph in 30 degrees knee flexion for adequate assessment in all patients with suspected arthritis.
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Affiliation(s)
- S Bhatnagar
- Norfollk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
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Abstract
BACKGROUND First described in 1988, attenuated familial adenomatous polyposis (AFAP) is a rare autosomal dominant precancerous condition of the gastrointestinal tract. Few reports have described adenocarcinomatous change in the gastroduodenal region thus far. CASE OUTLINE We report a case of AFAP presenting with extensive gastric polyposis and ampullary adenocarcinoma in absence of a positive family history of gastrointestinal cancer and a novel mutation.
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Affiliation(s)
- P. Bhatnagar
- Institute of Liver Studies, King's College HospitalLondonUK
| | - H. Tetzlaff
- Institute of Liver Studies, King's College HospitalLondonUK
| | - L. Izatt
- Department of Clinical Genetics, Guy's HospitalLondonUK
| | - J. Devlin
- Institute of Liver Studies, King's College HospitalLondonUK
| | - N. D. Heaton
- Institute of Liver Studies, King's College HospitalLondonUK
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Valle JW, Bhatnagar P, Young E, Levine E, Swindell R, Saunders MP. Irinotecan with bolus and infusional 5-flurouracil and folinic acid for patients with advanced or metastatic colorectal cancer previously treated with 5-flurouracil: a possible alternative to single-agent irinotecan in a 'real-life' setting. Clin Oncol (R Coll Radiol) 2005; 17:666. [PMID: 16372501 DOI: 10.1016/j.clon.2005.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bhatnagar P, Rawat H, Kishan S, Bhatnagar A, Kashyap R. Radionuclide detection of accessory reticuloendothelial thoracic masses, coupled with congenital hepatic abnormality. Indian J Radiol Imaging 2005. [DOI: 10.4103/0971-3026.28739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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John PJ, Bakore N, Bhatnagar P. Assessment of organochlorine pesticide residue levels in dairy milk and buffalo milk from Jaipur City, Rajasthan, India. Environ Int 2001; 26:231-236. [PMID: 11341290 DOI: 10.1016/s0160-4120(00)00111-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The widespread application of pesticides in agriculture, public health, and industry and in and around the home can result in the accumulation of pesticides in the environment. Therefore, a survey has been conducted during 1993-1996 to investigate the magnitude of contamination of bovine milk with organochlorine pesticide (OCP) residues from Jaipur City, Rajasthan, India. Milk samples, i.e., dairy (toned and whole) and buffalo milk, were collected seasonally, and pesticide residues were assessed using a gas chromatograph (GC) with an electron capture detector (ECD). The results indicate that all the milk samples were contaminated with dichlorodiphenyltrichloroethane (DDT) and its metabolites (DDE and p,p'-dichlorodiphenyldichloroethane [DDD]), isomers of hexachlorocyclohexane (HCH; alpha, beta, and gamma), heptachlor and its epoxide, and aldrin. Seasonal variations of these pesticide residue levels were also observed in all the milk samples. Samples collected during winter season were found to contain higher residue levels as compared to other seasons.
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Affiliation(s)
- P J John
- Department of Zoology, University of Rajasthan, Jaipur, India.
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Bhatnagar P, Glasheen BM, Bains SK, Long SL, Minocha R, Walter C, Minocha SC. Transgenic manipulation of the metabolism of polyamines in poplar cells. Plant Physiol 2001; 125:2139-53. [PMID: 11299393 PMCID: PMC88869 DOI: 10.1104/pp.125.4.2139] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2000] [Revised: 11/15/2000] [Accepted: 01/10/2001] [Indexed: 05/18/2023]
Abstract
The metabolism of polyamines (putrescine, spermidine, and spermine) has become the target of genetic manipulation because of their significance in plant development and possibly stress tolerance. We studied the polyamine metabolism in non-transgenic (NT) and transgenic cells of poplar (Populus nigra x maximowiczii) expressing a mouse Orn decarboxylase (odc) cDNA. The transgenic cells showed elevated levels of mouse ODC enzyme activity, severalfold higher amounts of putrescine, a small increase in spermidine, and a small reduction in spermine as compared with NT cells. The conversion of labeled ornithine (Orn) into putrescine was significantly higher in the transgenic than the NT cells. Whereas exogenously supplied Orn caused an increase in cellular putrescine in both cell lines, arginine at high concentrations was inhibitory to putrescine accumulation. The addition of urea and glutamine had no effect on polyamines in either of the cell lines. Inhibition of glutamine synthetase by methionine sulfoximine led to a substantial reduction in putrescine and spermidine in both cell lines. The results show that: (a) Transgenic expression of a heterologous odc gene can be used to modulate putrescine metabolism in plant cells, (b) accumulation of putrescine in high amounts does not affect the native arginine decarboxylase activity, (c) Orn biosynthesis occurs primarily from glutamine/glutamate and not from catabolic breakdown of arginine, (d) Orn biosynthesis may become a limiting factor for putrescine production in the odc transgenic cells, and (e) assimilation of nitrogen into glutamine keeps pace with an increased demand for its use for putrescine production.
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Affiliation(s)
- P Bhatnagar
- Department of Plant Biology, University of New Hampshire, Durham, New Hampshire 03824, USA
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50
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Abstract
Replacement of the labile sulfhydryl group (-SH) of the hemoregulatory peptide monomer pyroGluGluAspCysLys (HP5b) with an isosteric methylene group yields a chemically stable compound, SK&F108636. In this study, we describe the effects of SK&F108636 on highly enriched Lin-Sca1+ hematopoietic stem cells. SK&F108636 significantly reduced the fraction of cycling progenitor cells, granulocyte macrophage colony-forming cells (GM-CFC), in vitro and in vivo. There was no effect on GM-CFC or Mix-CFC colony formation. SK&F108636 significantly inhibited proliferation of high proliferative potential (HPP)-CFC in semisolid agar cultures stimulated by stem cell factor + interleukin 3 (IL-3) + IL-1, but had no effect in cultures stimulated with M-CSF + IL-3 + IL-1. SK&F108636 was shown to act directly on the stem cells since SK&F108636 inhibited proliferation of Lin-Sca1+ cells in single cell assays. Administration of SK&F108636 to lethally irradiated mice transplanted with 2000 Lin-Sca1+ cells significantly inhibited proliferation/differentiation of cells developing into colony forming units-spleen (CFU-S) (preCFU-S) and the reconstitution of HPP-CFC and GM-CFC. There was no effect of SK&F108636 on CFU-S colony formation or mature cell regeneration in bone marrow, spleen and blood. Hence, the hemoregulatory peptide monomer SK&F108636 is a potent primitive stem cell inhibitor in vivo and in vitro. Inhibition of stem cell proliferation by small specific inhibitors may protect hematopoiesis from myelotoxic side effects during chemotherapy treatment.
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Affiliation(s)
- O P Veiby
- Nycomed Pharma AS, Diagnostica and Exploratory Therapy R&D, Olso, Norway
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