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Fernández-Aroca D, García-Flores N, Frost S, Jiménez-Suárez J, Rodríguez-González A, Fernández-Aroca P, Sabater S, Andrés I, Garnés-García C, Belandia B, Cimas F, Villar D, Ruiz-Hidalgo M, Sánchez-Prieto R. MAPK11 (p38β) is a major determinant of cellular radiosensitivity by controlling ionizing radiation-associated senescence: An in vitro study. Clin Transl Radiat Oncol 2023; 41:100649. [PMID: 37346275 PMCID: PMC10279794 DOI: 10.1016/j.ctro.2023.100649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/30/2023] [Accepted: 05/30/2023] [Indexed: 06/23/2023] Open
Abstract
Background and purpose MAPKs are among the most relevant signalling pathways involved in coordinating cell responses to different stimuli. This group includes p38MAPKs, constituted by 4 different proteins with a high sequence homology: MAPK14 (p38α), MAPK11 (p38β), MAPK12 (p38γ) and MAPK13 (p38δ). Despite their high similarity, each member shows unique expression patterns and even exclusive functions. Thus, analysing protein-specific functions of MAPK members is necessary to unequivocally uncover the roles of this signalling pathway. Here, we investigate the possible role of MAPK11 in the cell response to ionizing radiation (IR). Materials and methods We developed MAPK11/14 knockdown through shRNA and CRISPR interference gene perturbation approaches and analysed the downstream effects on cell responses to ionizing radiation in A549, HCT-116 and MCF-7 cancer cell lines. Specifically, we assessed IR toxicity by clonogenic assays; DNA damage response activity by immunocytochemistry; apoptosis and cell cycle by flow cytometry (Annexin V and propidium iodide, respectively); DNA repair by comet assay; and senescence induction by both X-Gal staining and gene expression of senescence-associated genes by RT-qPCR. Results Our findings demonstrate a critical role of MAPK11 in the cellular response to IR by controlling the associated senescent phenotype, and without observable effects on DNA damage response, apoptosis, cell cycle or DNA damage repair. Conclusion Our results highlight MAPK11 as a novel mediator of the cellular response to ionizing radiation through the control exerted onto IR-associated senescence.
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Affiliation(s)
- D.M. Fernández-Aroca
- Laboratorio de Oncología Molecular, Unidad de Medicina Molecular, Centro Regional de Investigaciones Biomédicas, Universidad de Castilla-La Mancha. Unidad Asociada de Biomedicina UCLM, Unidad asociada al CSIC, Albacete, España
| | - N. García-Flores
- Laboratorio de Oncología Molecular, Unidad de Medicina Molecular, Centro Regional de Investigaciones Biomédicas, Universidad de Castilla-La Mancha. Unidad Asociada de Biomedicina UCLM, Unidad asociada al CSIC, Albacete, España
| | - S. Frost
- Centre for Genomics and Child Health, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - J. Jiménez-Suárez
- Laboratorio de Oncología Molecular, Unidad de Medicina Molecular, Centro Regional de Investigaciones Biomédicas, Universidad de Castilla-La Mancha. Unidad Asociada de Biomedicina UCLM, Unidad asociada al CSIC, Albacete, España
| | - A. Rodríguez-González
- Centre for Genomics and Child Health, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - P. Fernández-Aroca
- Laboratorio de Oncología Molecular, Unidad de Medicina Molecular, Centro Regional de Investigaciones Biomédicas, Universidad de Castilla-La Mancha. Unidad Asociada de Biomedicina UCLM, Unidad asociada al CSIC, Albacete, España
| | - S. Sabater
- Servicio de Oncología Radioterápica, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - I. Andrés
- Servicio de Oncología Radioterápica, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - C. Garnés-García
- Laboratorio de Oncología Molecular, Unidad de Medicina Molecular, Centro Regional de Investigaciones Biomédicas, Universidad de Castilla-La Mancha. Unidad Asociada de Biomedicina UCLM, Unidad asociada al CSIC, Albacete, España
| | - B. Belandia
- Departamento de Biología del Cáncer, Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM). Madrid, España. Unidad Asociada de Biomedicina UCLM, Unidad asociada al CSIC, España
| | - F.J. Cimas
- Laboratorio de Oncología Molecular, Unidad de Medicina Molecular, Centro Regional de Investigaciones Biomédicas, Universidad de Castilla-La Mancha. Unidad Asociada de Biomedicina UCLM, Unidad asociada al CSIC, Albacete, España
- Área de Bioquímica y Biología Molecular, Facultad de Medicina, Universidad de Castilla-La Mancha, Albacete, España
| | - D. Villar
- Centre for Genomics and Child Health, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - M.J. Ruiz-Hidalgo
- Laboratorio de Oncología Molecular, Unidad de Medicina Molecular, Centro Regional de Investigaciones Biomédicas, Universidad de Castilla-La Mancha. Unidad Asociada de Biomedicina UCLM, Unidad asociada al CSIC, Albacete, España
- Área de Bioquímica y Biología Molecular, Facultad de Medicina, Universidad de Castilla-La Mancha, Albacete, España
| | - R. Sánchez-Prieto
- Laboratorio de Oncología Molecular, Unidad de Medicina Molecular, Centro Regional de Investigaciones Biomédicas, Universidad de Castilla-La Mancha. Unidad Asociada de Biomedicina UCLM, Unidad asociada al CSIC, Albacete, España
- Departamento de Biología del Cáncer, Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM). Madrid, España. Unidad Asociada de Biomedicina UCLM, Unidad asociada al CSIC, España
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Frost S, Pilley M, Porter C, Agarwal R. Patient perspectives on nipple-areola complex micropigmentation during the COVID-19 pandemic. J Plast Reconstr Aesthet Surg 2022; 75:2831-2870. [PMID: 35780000 PMCID: PMC9225963 DOI: 10.1016/j.bjps.2022.06.032] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/06/2022] [Accepted: 06/07/2022] [Indexed: 11/26/2022]
Abstract
Background Micropigmentation is a well-recognised option for nipple-areola complex reconstruction, as part of the breast reconstruction pathway for patients following mastectomy. As a part of delayed breast reconstruction, this treatment was put on hold during the COVID-19 pandemic. Aims To assess the views of patients regarding micropigmentation in response to the COVID-19 pandemic, and whether their attitudes to seeking out this part of the reconstructive journey had been altered. Methods A questionnaire undertaken with 53 patients between August & September 2020 attending the Micropigmentation clinic. Findings 81.1% of patients reported COVID-19 had not impacted their decision, with a similar proportion happy to proceed with the treatment at the time of questioning. Conclusions The results highlight the importance of nipple-areola complex to our patients’ reconstructive journey.
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Affiliation(s)
- S Frost
- Department of Plastic Surgery, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK.
| | - M Pilley
- Department of Plastic Surgery, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK
| | - C Porter
- Department of Plastic Surgery, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK
| | - R Agarwal
- Department of Plastic Surgery, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK.
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3
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Dyer A, Frost S, Caviezel F, Seymour L. Abstract PR01: Oncolytic adenoviruses expressing metabolic targets can improve viro-immunotherapy with bispecific T cell engagers through reducing acidosis in an in vitro model. Cancer Immunol Res 2022. [DOI: 10.1158/2326-6074.tumimm21-pr01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Oncolytic viro-immunotherapy holds huge promise for cancer treatment. While oncolytic viruses can robustly trigger immune activation, negative feedback is often upregulated in the tumor microenvironment (TME), an issue that is often neglected in early evaluation in vitro. Lactate accumulation and the resulting acidosis are commonly associated with viral infections and has been reported to be a key factor in shaping the immunosuppressive TME through various mechanisms which favor suppressive Tregs and MDSCs whilst polarizing macrophages towards an immunosuppressive state Given that the success of oncolytic viro-immunotherapy is now widely agreed to rely upon the induction of an immune response either from a transgene or from the release of DAMPs and PAMPs as opposed to direct cell lysis, understanding the impact of the increased acidosis upon immune cells and generating oncolytic viruses capable of avoiding or correcting acidosis is very promising. We found that infection with an oncolytic adenovirus led to a significant increase in lactic acid accumulation and acidosis in keeping with prior reports. An immunotherapeutic that shows promising results is the bispecific antibodies known as bispecific T cell engagers (BiTEs). Although BiTEs have particular success in hematological cancers, they have often shown negligible effects in solid tumor models. Here we show that BiTEs can robustly activate T cells resulting in target cell lysis; however, both T cell activation and BiTE-directed cytotoxicity are reduced when lactate concentrations increase or when acid is added to the media in vitro. Using media from virally infected cells, we show that acidosis following infection of tumor cells with an oncolytic adenovirus also negatively impacted T cell stimulation with BiTEs. Building on previously published results which show that inhibiting glycolysis can improve oncolytic viral infection, we have created oncolytic adenoviruses which inhibit acidosis at various stages through the expression of transgenes targeting this pathway. These next-generation oncolytic viruses were able to replicate whilst inhibiting glycolysis, or acidosis, and were able to halt the production of excess lactic acid following infection of tumor cells, ultimately allowing a rescuing of BiTE-mediated T cell activation. These findings provide a rationale for arming oncolytic viruses with anti-acidity agents, alongside those with T cell-activating abilities, which may offer a novel approach to overcome metabolic barriers of the tumor microenvironment and combat immune evasion.
Citation Format: Arthur Dyer, Sally Frost, Flurin Caviezel, Len Seymour. Oncolytic adenoviruses expressing metabolic targets can improve viro-immunotherapy with bispecific T cell engagers through reducing acidosis in an in vitro model [abstract]. In: Abstracts: AACR Virtual Special Conference: Tumor Immunology and Immunotherapy; 2021 Oct 5-6. Philadelphia (PA): AACR; Cancer Immunol Res 2022;10(1 Suppl):Abstract nr PR01.
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Affiliation(s)
- Arthur Dyer
- 1University of Oxford, Oxford, United Kingdom
| | - Sally Frost
- 1University of Oxford, Oxford, United Kingdom
| | | | - Len Seymour
- 1University of Oxford, Oxford, United Kingdom
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Nolde J, Frost S, Kannenkeril D, Lugo-Gavidia L, Chan J, Joyson A, Azzam O, Carnagarin R, Kiuchi M, Vignarajan J, Schlaich M. Capillary vascular density in the retina of hypertensive subjects is associated with a non-dipping pattern independent of mean ambulatory blood pressure. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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5
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Khalique H, Baugh R, Dyer A, Scott EM, Frost S, Larkin S, Lei-Rossmann J, Seymour LW. Oncolytic herpesvirus expressing PD-L1 BiTE for cancer therapy: exploiting tumor immune suppression as an opportunity for targeted immunotherapy. J Immunother Cancer 2021; 9:e001292. [PMID: 33820820 PMCID: PMC8026026 DOI: 10.1136/jitc-2020-001292] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Programmed death-ligand 1 (PD-L1) is an important immune checkpoint protein that can be regarded as a pan-cancer antigen expressed by multiple different cell types within the tumor. While antagonizing PD-L1 is well known to relieve PD-1/PD-L1-mediated T cell suppression, here we have combined this approach with an immunotherapy strategy to target T cell cytotoxicity directly toward PD-L1-expressing cells. We developed a bi-specific T cell engager (BiTE) crosslinking PD-L1 and CD3ε and demonstrated targeted cytotoxicity using a clinically relevant patient-derived ascites model. This approach represents an immunological 'volte-face' whereby a tumor immunological defense mechanism can be instantly transformed into an Achilles' heel for targeted immunotherapy. METHODS The PD-L1 targeting BiTE comprises an anti-PD-L1 single-chain variable fragment (scFv) or nanobody (NB) domain and an anti-CD3 scFv domain in a tandem repeat. The ability to activate T cell cytotoxicity toward PD-L1-expressing cells was established using human carcinoma cells and PD-L1-expressing human ('M2') macrophages in the presence of autologous T cells. Furthermore, we armed oncolytic herpes simplex virus-1 (oHSV-1) with PD-L1 BiTE and demonstrated successful delivery and targeted cytotoxicity in unpurified cultures of malignant ascites derived from different cancer patients. RESULTS PD-L1 BiTE crosslinks PD-L1-positive cells and CD3ε on T cells in a 'pseudo-synapse' and triggers T cell activation and release of proinflammatory cytokines such as interferon-gamma (IFN-γ), interferon gamma-induced protein 10 (IP-10) and tumour necrosis factor-α (TNF-α). Activation of endogenous T cells within ascites samples led to significant lysis of tumor cells and M2-like macrophages (CD11b+CD64+ and CD206+/CD163+). The survival of CD3+ T cells (which can also express PD-L1) was unaffected. Intriguingly, ascites fluid that appeared particularly immunosuppressive led to higher expression of PD-L1 on tumor cells, resulting in improved BiTE-mediated T cell activation. CONCLUSIONS The study reveals that PD-L1 BiTE is an effective immunotherapeutic approach to kill PD-L1-positive tumor cells and macrophages while leaving T cells unharmed. This approach activates endogenous T cells within malignant ascites, generates a proinflammatory response and eliminates cells promoting tumor progression. Using an oncolytic virus for local expression of PD-L1 BiTE also prevents 'on-target off-tumor' systemic toxicities and harnesses immunosuppressive protumor conditions to augment immunotherapy in immunologically 'cold' clinical cancers.
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MESH Headings
- Animals
- Antibodies, Bispecific/genetics
- Antibodies, Bispecific/immunology
- Antibodies, Bispecific/metabolism
- B7-H1 Antigen/immunology
- B7-H1 Antigen/metabolism
- CD3 Complex/immunology
- CD3 Complex/metabolism
- Cell Line, Tumor
- Chlorocebus aethiops
- Coculture Techniques
- Cytokines/metabolism
- Cytotoxicity, Immunologic
- HEK293 Cells
- Herpesvirus 1, Human/genetics
- Herpesvirus 1, Human/immunology
- Herpesvirus 1, Human/metabolism
- Humans
- Lymphocyte Activation
- Lymphocytes, Tumor-Infiltrating/immunology
- Lymphocytes, Tumor-Infiltrating/metabolism
- Neoplasms/immunology
- Neoplasms/metabolism
- Neoplasms/therapy
- Neoplasms/virology
- Oncolytic Virotherapy
- Oncolytic Viruses/genetics
- Oncolytic Viruses/immunology
- Oncolytic Viruses/metabolism
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- Tumor Microenvironment
- Tumor-Associated Macrophages/immunology
- Tumor-Associated Macrophages/metabolism
- Vero Cells
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Affiliation(s)
- Hena Khalique
- Department of Oncology, University of Oxford, Oxford, Oxfordshire, UK
| | - Richard Baugh
- Department of Oncology, University of Oxford, Oxford, Oxfordshire, UK
| | - Arthur Dyer
- Department of Oncology, University of Oxford, Oxford, Oxfordshire, UK
| | - Eleanor M Scott
- Department of Oncology, University of Oxford, Oxford, Oxfordshire, UK
| | - Sally Frost
- Department of Oncology, University of Oxford, Oxford, Oxfordshire, UK
| | - Sarah Larkin
- Department of Oncology, University of Oxford, Oxford, Oxfordshire, UK
| | | | - Leonard W Seymour
- Department of Oncology, University of Oxford, Oxford, Oxfordshire, UK
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6
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Dyer A, Frost S, Fisher KD, Seymour LW. The role of cancer metabolism in defining the success of oncolytic viro-immunotherapy. Cytokine Growth Factor Rev 2020; 56:115-123. [PMID: 32921554 DOI: 10.1016/j.cytogfr.2020.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 07/02/2020] [Indexed: 12/19/2022]
Abstract
Oncolytic viruses infect, replicate in, and kill cancer cells selectively without harming normal cells. The rapidly expanding clinical development of oncolytic virotherapy is an exciting interdisciplinary field that provides insights into virology, oncology, and immunotherapy. Recent years have seen greater focus on rational design of cancer-selective viruses together with strategies to exploit their immunostimulatory capabilities, ultimately to develop powerful oncolytic cancer vaccines. However, despite great interest in the field, many important experiments are still conducted under optimum conditions in vitro, with many nutrients present in excess and with cellular stress kept to a minimum. Whilst this provides a convenient platform for cell culture, it bears little relation to the typical conditions found within a tumour in vivo, where cells are often subject to a range of metabolic and environmental stresses. Viral infection and cancer will both lead to production of metabolites that are also not present in media in vitro. Understanding how oncolytic viruses interact with cells exposed to more representative metabolic conditions in vitro represents an under-explored area of study that could provide valuable insight into the intelligent design of superior oncolytic viruses and help bridge the gap between bench and bedside. This review summarises the major metabolic pathways altered in cancer cells, during viral infection and highlights possible targets for future studies.
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Affiliation(s)
- Arthur Dyer
- Department of Oncology, University of Oxford, Oxford, UK
| | - Sally Frost
- Department of Oncology, University of Oxford, Oxford, UK
| | - Kerry D Fisher
- Department of Oncology, University of Oxford, Oxford, UK
| | - Len W Seymour
- Department of Oncology, University of Oxford, Oxford, UK; Old Road Campus Research Building, Department of Oncology, University of Oxford, OX37DQ, UK.
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7
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Perrin LD, Harris KA, Reynolds M, Lawes JR, Frost S, Brouwer A, Dale J, Palkopoulou E, Upton PA. Bovine TB infection status in cattle in Great Britain in 2017. Vet Rec 2020; 184:371-378. [PMID: 30902945 DOI: 10.1136/vr.l1321] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | | | | | - J R Lawes
- Department of Epidemiological Sciences
| | - S Frost
- Department of Epidemiological Sciences
| | - A Brouwer
- Department of Epidemiological Sciences
| | | | | | - P A Upton
- Data Systems Workgroup, APHA, Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB
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8
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Yousaf I, Kaeppler J, Frost S, Seymour LW, Jacobus EJ. Attenuation of the Hypoxia Inducible Factor Pathway after Oncolytic Adenovirus Infection Coincides with Decreased Vessel Perfusion. Cancers (Basel) 2020; 12:E851. [PMID: 32244697 PMCID: PMC7225929 DOI: 10.3390/cancers12040851] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/25/2020] [Accepted: 03/30/2020] [Indexed: 12/30/2022] Open
Abstract
The interplay between oncolytic virus infection and tumour hypoxia is particularly unexplored in vivo, although hypoxia is present in virtually all solid carcinomas. In this study, oncolytic adenovirus infection foci were found within pimonidazole-reactive, oxygen-poor areas in a colorectal xenograft tumour, where the expression of VEGF, a target gene of the hypoxia-inducible factor (HIF), was attenuated. We hypothesised that adenovirus infection interferes with the HIF-signalling axis in the hypoxic tumour niche, possibly modifying the local vascular supply. In vitro, enadenotucirev (EnAd), adenovirus 11p and adenovirus 5 decreased the protein expression of HIF-1α only during the late phase of the viral life cycle by transcriptional down-regulation and not post-translational regulation. The decreasing HIF levels resulted in the down-regulation of angiogenic factors such as VEGF, coinciding with reduced endothelial tube formation but also increased T-cell activation in conditioned media transfer experiments. Using intravital microscopy, a decreased perfused vessel volume was observed in infected tumour nodules upon systemic delivery of EnAd, encoding the oxygen-independent fluorescent reporter UnaG to a tumour xenograft grown under an abdominal window chamber. We conclude that the attenuation of the HIF pathway upon adenoviral infection may contribute to anti-vascular and immunostimulatory effects in the periphery of established infection foci in vivo.
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Affiliation(s)
- Iris Yousaf
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (I.Y.); (S.F.)
| | - Jakob Kaeppler
- Mechanisms of Metastasis Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK;
| | - Sally Frost
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (I.Y.); (S.F.)
| | - Len W. Seymour
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (I.Y.); (S.F.)
| | - Egon J. Jacobus
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (I.Y.); (S.F.)
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9
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Pokrovska TD, Jacobus EJ, Puliyadi R, Prevo R, Frost S, Dyer A, Baugh R, Rodriguez-Berriguete G, Fisher K, Granata G, Herbert K, Taverner WK, Champion BR, Higgins GS, Seymour LW, Lei-Rossmann J. External Beam Radiation Therapy and Enadenotucirev: Inhibition of the DDR and Mechanisms of Radiation-Mediated Virus Increase. Cancers (Basel) 2020; 12:E798. [PMID: 32224979 PMCID: PMC7226394 DOI: 10.3390/cancers12040798] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 11/17/2022] Open
Abstract
Ionising radiation causes cell death through the induction of DNA damage, particularly double-stranded DNA (dsDNA) breaks. Evidence suggests that adenoviruses inhibit proteins involved in the DNA damage response (DDR) to prevent recognition of double-stranded viral DNA genomes as cellular dsDNA breaks. We hypothesise that combining adenovirus treatment with radiotherapy has the potential for enhancing tumour-specific cytotoxicity through inhibition of the DDR and augmentation of virus production. We show that EnAd, an Ad3/Ad11p chimeric oncolytic adenovirus currently being trialled in colorectal and other cancers, targets the DDR pathway at a number of junctures. Infection is associated with a decrease in irradiation-induced 53BP1 and Rad51 foci formation, and in total DNA ligase IV levels. We also demonstrate a radiation-associated increase in EnAd production in vitro and in a pilot in vivo experiment. Given the current limitations of in vitro techniques in assessing for synergy between these treatments, we adapted the plaque assay to allow monitoring of viral plaque size and growth and utilised the xCELLigence cell adhesion assay to measure cytotoxicity. Our study provides further evidence on the interaction between adenovirus and radiation in vitro and in vivo and suggests these have at least an additive, and possibly a synergistic, impact on cytotoxicity.
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Affiliation(s)
- Tzveta D. Pokrovska
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (T.D.P.); (E.J.J.); (S.F.); (A.D.); (R.B.); (K.F.); (W.K.T.); (J.L.-R.)
| | - Egon J. Jacobus
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (T.D.P.); (E.J.J.); (S.F.); (A.D.); (R.B.); (K.F.); (W.K.T.); (J.L.-R.)
| | - Rathi Puliyadi
- Tumour Radiosensitivity Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (R.P.); (R.P.); (G.R.-B.); (G.G.); (K.H.); (G.S.H.)
| | - Remko Prevo
- Tumour Radiosensitivity Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (R.P.); (R.P.); (G.R.-B.); (G.G.); (K.H.); (G.S.H.)
| | - Sally Frost
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (T.D.P.); (E.J.J.); (S.F.); (A.D.); (R.B.); (K.F.); (W.K.T.); (J.L.-R.)
| | - Arthur Dyer
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (T.D.P.); (E.J.J.); (S.F.); (A.D.); (R.B.); (K.F.); (W.K.T.); (J.L.-R.)
| | - Richard Baugh
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (T.D.P.); (E.J.J.); (S.F.); (A.D.); (R.B.); (K.F.); (W.K.T.); (J.L.-R.)
| | - Gonzalo Rodriguez-Berriguete
- Tumour Radiosensitivity Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (R.P.); (R.P.); (G.R.-B.); (G.G.); (K.H.); (G.S.H.)
| | - Kerry Fisher
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (T.D.P.); (E.J.J.); (S.F.); (A.D.); (R.B.); (K.F.); (W.K.T.); (J.L.-R.)
- PsiOxus Therapeutics Ltd., Abingdon OX14 3YS, UK;
| | - Giovanna Granata
- Tumour Radiosensitivity Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (R.P.); (R.P.); (G.R.-B.); (G.G.); (K.H.); (G.S.H.)
| | - Katharine Herbert
- Tumour Radiosensitivity Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (R.P.); (R.P.); (G.R.-B.); (G.G.); (K.H.); (G.S.H.)
| | - William K. Taverner
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (T.D.P.); (E.J.J.); (S.F.); (A.D.); (R.B.); (K.F.); (W.K.T.); (J.L.-R.)
| | | | - Geoff S. Higgins
- Tumour Radiosensitivity Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (R.P.); (R.P.); (G.R.-B.); (G.G.); (K.H.); (G.S.H.)
| | - Len W. Seymour
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (T.D.P.); (E.J.J.); (S.F.); (A.D.); (R.B.); (K.F.); (W.K.T.); (J.L.-R.)
| | - Janet Lei-Rossmann
- Anticancer Viruses and Cancer Vaccines Research Group, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (T.D.P.); (E.J.J.); (S.F.); (A.D.); (R.B.); (K.F.); (W.K.T.); (J.L.-R.)
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10
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Scott EM, Frost S, Khalique H, Freedman JD, Seymour LW, Lei-Rossmann J. Use of Liquid Patient Ascites Fluids as a Preclinical Model for Oncolytic Virus Activity. Methods Mol Biol 2020; 2058:261-270. [PMID: 31486044 DOI: 10.1007/978-1-4939-9794-7_17] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The translational success of oncolytic virotherapies would benefit from the widespread use of clinically relevant ex vivo models. Malignant ascites, an accumulation of fluid in the peritoneum due to disseminated cancer, recapitulates many features of the tumor microenvironment, making it a valuable model for studying oncolytic virus activity. Here, we describe a method for the separation and storage of cellular and acellular components of malignant ascites, followed by flow cytometric characterization of the cellular fraction. We then outline a simple experiment using whole ascites to assess the activity of a bispecific T cell engager (BiTE)-expressing oncolytic adenovirus.
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Affiliation(s)
- Eleanor M Scott
- Department of Oncology, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Sally Frost
- Department of Oncology, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Hena Khalique
- Department of Oncology, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Joshua D Freedman
- Department of Oncology, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Len W Seymour
- Department of Oncology, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Janet Lei-Rossmann
- Department of Oncology, University of Oxford, Roosevelt Drive, Oxford, UK.
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11
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Scott EM, Jacobus EJ, Lyons B, Frost S, Freedman JD, Dyer A, Khalique H, Taverner WK, Carr A, Champion BR, Fisher KD, Seymour LW, Duffy MR. Bi- and tri-valent T cell engagers deplete tumour-associated macrophages in cancer patient samples. J Immunother Cancer 2019; 7:320. [PMID: 31753017 PMCID: PMC6873687 DOI: 10.1186/s40425-019-0807-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 11/06/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Tumour-associated macrophages (TAMs) are often implicated in cancer progression but can also exert anti-tumour activities. Selective eradication of cancer-promoting (M2-like) TAM subsets is a highly sought-after goal. Here, we have devised a novel strategy to achieve selective TAM depletion, involving the use of T cell engagers to direct endogenous T cell cytotoxicity towards specific M2-like TAMs. To avoid "on-target off-tumour" toxicities, we have explored localising expression of the T cell engagers to the tumour with enadenotucirev (EnAd), an oncolytic adenovirus in Phase I/II clinical trials. METHOD A panel of bi- and tri-valent T cell engagers (BiTEs/TriTEs) was constructed, recognising CD3ε on T cells and CD206 or folate receptor β (FRβ) on M2-like macrophages. Initial characterisation of BiTE/TriTE activity and specificity was performed with M1- and M2-polarised monocyte-derived macrophages and autologous lymphocytes from healthy human peripheral blood donors. T cell engagers were inserted into the genome of EnAd, and oncolytic activity and BiTE secretion assessed with DLD-1 tumour cells. Clinically-relevant ex vivo models (whole malignant ascites from cancer patients) were employed to assess the efficacies of the free- and virally-encoded T cell engagers. RESULTS T cells activated by the CD206- and FRβ-targeting BiTEs/TriTEs preferentially killed M2- over M1-polarised autologous macrophages, with EC50 values in the nanomolar range. A TriTE with bivalent CD3ε binding - the first of its kind - demonstrated enhanced potency whilst retaining target cell selectivity, whereas a CD28-containing TriTE elicited non-specific T cell activation. In immunosuppressive malignant ascites, both free and EnAd-encoded T cell engagers triggered endogenous T cell activation and IFN-γ production, leading to increased T cell numbers and depletion of CD11b+CD64+ ascites macrophages. Strikingly, surviving macrophages exhibited a general increase in M1 marker expression, suggesting microenvironmental repolarisation towards a pro-inflammatory state. CONCLUSIONS This study is the first to achieve selective depletion of specific M2-like macrophage subsets, opening the possibility of eradicating cancer-supporting TAMs whilst sparing those with anti-tumour potential. Targeted TAM depletion with T cell engager-armed EnAd offers a powerful therapeutic approach combining direct cancer cell cytotoxicity with reversal of immune suppression.
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Affiliation(s)
- Eleanor M. Scott
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ UK
| | - Egon J. Jacobus
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ UK
| | - Brian Lyons
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ UK
| | - Sally Frost
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ UK
| | | | - Arthur Dyer
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ UK
| | - Hena Khalique
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ UK
| | | | - Alison Carr
- Churchill Hospital, Oxford University Hospital NHS Trust, Oxford, OX3 7LE UK
| | | | - Kerry D. Fisher
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ UK
| | - Len W. Seymour
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ UK
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12
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Etaher A, Gibbs O, Saad YM, Frost S, Nguyen T, Ferguson I, Juergens C, Chew D, French JK. P2717Type-II MI and chronic myocardial injury rates, invasive management and 4 year mortality among consecutive patients undergoing high sensitivity troponin T testing in the emergency department. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In emergency departments (EDs), assessment of patients with suspected acute coronary syndromes (ACS) represents a major workload and high sensitivity troponin (HsTn) T and I levels are frequently measured. A minority of patients have final diagnosis of myocardial infarction (MI).
Methods and results
Among 2738 consecutive patients with suspected ACS presenting to ED at Liverpool Hospital, Australia, between March and June 2014, we determined the relative frequencies of 3 patient groups: type-I MI, type-II MI including chronic myocardial injury (CMI), and assessed the use of invasive and pharmacological therapies and 4-year outcomes. Adjudication of MI was according to the 4th universal definition of MI as follows: 1) type-I MI; 2) type-II MI (including acute myocardial injury), and 3) CMI. Of 995 patients (36%) median age 76 years [IQR 65–83]), with at least 2 HsTnT measurements and one >14ng/l, 727 (73%) had chronic myocardial injury, 171 (17%) had type-II MI; and 97 (9.7%) had type-I MI. Patients with type-I MI (mean age 63 years) were younger than those with type-II MI or chronic myocardial injury by 12 and 14 years respectively. The main triggering factors for type-II MI/acute injury included: sepsis (21.1%), acute heart failure (18.3%), tachyarrhythmia (16.9%), anaemia (8.6%) and a combination of factors (16%). In-hospital angiography (62% had PCI) rates were 95% for patients with type-I MI, 24% (7% PCI) for those with type-II MI and 3.4% for CMI. Mortality at 4 years was 55% for type-II MI, 44% for CMI and 18% for type-1 MI (P<0.001; Figure), though after Cox modelling adjusting for age, gender, renal function and COPD, compared to type 1 MI, type-II MI (hazard ratio 1.61 [95% CIs 0.90–2.86]; p=0.106) and CMI (hazard ratio 1.01 [95% CIs 0.59–1.74]; p=0.963) were not independently associated with increased late mortality, largely because patients with type 1 MI were a decade younger.
Conclusion
Among unselected patients undergoing HsTnT testing in EDs, type-II MI including acute myocardial injury was more common than type-I MI. Chronic myocardial injury, which occurred in 3 of 4 patients. While patients with type-II MI acute myocardial injury had higher late mortality rates than type-I MI, though after multivariable analyses mortality rates were not different.
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Affiliation(s)
- A Etaher
- Liverpool Hospital, Cardiology, Sydney, Australia
| | - O Gibbs
- Liverpool Hospital, Cardiology, Sydney, Australia
| | - Y M Saad
- Liverpool Hospital, Cardiology, Sydney, Australia
| | - S Frost
- University of Western Sydney, Sydney, Australia
| | - T Nguyen
- Liverpool Hospital, Cardiology, Sydney, Australia
| | - I Ferguson
- Liverpool Hospital, Liverpool, Australia
| | - C Juergens
- Liverpool Hospital, Cardiology, Sydney, Australia
| | - D Chew
- Flinders Medical Centre and Flinders University, Cardiology, Adelaide, Australia
| | - J K French
- Liverpool Hospital, Liverpool, Australia
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13
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Thompson J, Farmery J, Dobson H, Frost S, Cassidy J, Patel N, Thompson H, Clifford H. OncOS: Scalable and accurate next-generation sequencing analytics for precision oncology and personalized patient care. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz257.031] [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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14
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Dyer A, Baugh R, Chia SL, Frost S, Iris, Jacobus EJ, Khalique H, Pokrovska TD, Scott EM, Taverner WK, Seymour LW, Lei J. Turning cold tumours hot: oncolytic virotherapy gets up close and personal with other therapeutics at the 11th Oncolytic Virus Conference. Cancer Gene Ther 2019; 26:59-73. [PMID: 30177818 DOI: 10.1038/s41417-018-0042-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 05/01/2018] [Revised: 06/28/2018] [Accepted: 07/07/2018] [Indexed: 12/17/2022]
Abstract
The 11th International Oncolytic Virus Conference (IOVC) was held from April 9-12, 2018 in Oxford, UK. This is part of the high-profile academic-led series of meetings that was started back in 2002 by Steve Russell and John Bell, with most of the previous meetings being held in North America (often in Banff). The conference brought together many of the major players in oncolytic virotherapy from all over the world, addressing all stages of research and development-from aspects of basic science and cellular immunology all the way through to early- and late-phase clinical trials. The meeting welcomed 352 delegates from 24 countries. The top seven delegate countries, namely, the UK, US, Canada, The Netherlands, Germany, Japan and South Korea, contributed 291 delegates while smaller numbers coming from Australia, Austria, Bulgaria, China, Finland, France, Iraq, Ireland, Israel, Italy, Latvia, Malaysia, Poland, Slovenia, Spain, Sweden and Switzerland. Academics comprised about half of the attendees, industry 30% and students 20%. The next IOVC is scheduled to be held on Vancouver Island in autumn 2019. Here we share brief summaries of the oral presentations from invited speakers and proffered papers in the different subtopics presented at IOVC 2018.
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Affiliation(s)
- Arthur Dyer
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Richard Baugh
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Suet Lin Chia
- Department of Microbiology, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Sally Frost
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Iris
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Egon J Jacobus
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Hena Khalique
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Tzveta D Pokrovska
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Eleanor M Scott
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - William K Taverner
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Len W Seymour
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Janet Lei
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK.
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15
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Dyer A, Schoeps B, Frost S, Jakeman P, Scott EM, Freedman J, Jacobus EJ, Seymour LW. Antagonism of Glycolysis and Reductive Carboxylation of Glutamine Potentiates Activity of Oncolytic Adenoviruses in Cancer Cells. Cancer Res 2019; 79:331-345. [PMID: 30487139 DOI: 10.1158/0008-5472.can-18-1326] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 05/09/2018] [Revised: 09/08/2018] [Accepted: 11/08/2018] [Indexed: 11/16/2022]
Abstract
Tumor cells exhibiting the Warburg effect rely on aerobic glycolysis for ATP production and have a notable addiction to anaplerotic use of glutamine for macromolecular synthesis. This strategy maximizes cellular biosynthetic potential while avoiding excessive depletion of NAD+ and provides an attractive anabolic environment for viral infection. Here, we evaluate infection of highly permissive and poorly permissive cancer cells with wild-type adenoviruses and the oncolytic chimeric adenovirus enadenotucirev (EnAd). All adenoviruses caused an increase in glucose and glutamine uptake along with increased lactic acid secretion. Counterintuitively, restricting glycolysis using 2-deoxyglucose or by limiting glucose supply strongly improved virus activity in both cell types. Antagonism of glycolysis also boosted EnAd replication and transgene expression within human tumor biopsies and in xenografted tumors in vivo. In contrast, the virus life cycle was critically dependent on exogenous glutamine. Virus activity in glutamine-free cells was rescued with exogenous membrane-permeable α-ketoglutarate, but not pyruvate or oxaloacetate, suggesting an important role for reductive carboxylation in glutamine usage, perhaps for production of biosynthetic intermediates. This overlap between the metabolic phenotypes of adenovirus infection and transformed tumor cells may provide insight into how oncolytic adenoviruses exploit metabolic transformation to augment their selectivity for cancer cells. SIGNIFICANCE: This study describes changes in glucose and glutamine metabolism induced by oncolytic and wild-type adenoviruses in cancer cells, which will be important to consider in the preclinical evaluation of oncolytic viruses.
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Affiliation(s)
- Arthur Dyer
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Benjamin Schoeps
- Institute of Molecular Immunology and Experimental Oncology, Technische Universität München, München, Germany
| | - Sally Frost
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Philip Jakeman
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Eleanor M Scott
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Joshua Freedman
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Egon J Jacobus
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Leonard W Seymour
- Department of Oncology, University of Oxford, Oxford, United Kingdom.
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16
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Etaher A, Gibbs O, Saad Y, Frost S, Nguyen T, Ferguson I, Juergens C, Chew D, French J. Type-II MI and Chronic Myocardial Injury Rates, Invasive Management and 4 Year Mortality Among Consecutive Patients Undergoing High Sensitivity Troponin T Testing in the Emergency Department. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.447] [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: 11/16/2022]
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17
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French J, Etaher A, Gibbs O, Saad Y, Frost S, Ferguson I, Juergens C, Nguyen T. PO159 Mortality at 4 Years In Patients With Type 2 MI Compared to Type 1 MI and Stable High Sensitivity Troponin T Elevations. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.143] [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: 10/28/2022] Open
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18
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French JK, Etaher A, Frost S, Saad Y, Nguyen T, Juergens CP, Ferguson I. P3480High sensitivity Troponin T and late survival of patients at least 80 years with suspected ACS. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J K French
- University of New South Wales, Sydney, Australia
| | - A Etaher
- University of New South Wales, Sydney, Australia
| | - S Frost
- University of Western Sydney, Sydney, Australia
| | - Y Saad
- Liverpool Hospital, Cardiology, Sydney, Australia
| | - T Nguyen
- Liverpool Hospital, Cardiology, Sydney, Australia
| | - C P Juergens
- Liverpool Hospital, Cardiology, Sydney, Australia
| | - I Ferguson
- Liverpool Hospital, Cardiology, Sydney, Australia
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19
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French JK, Etaher A, Gibbs O, Frost S, Saad Y, Ferguson I, Juergens CP. P6428Late mortality rates of patients with type 2 MI compared to type 1 MI and stable high sensitivity troponin T elevations. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J K French
- University of New South Wales, Sydney, Australia
| | - A Etaher
- University of New South Wales, Sydney, Australia
| | - O Gibbs
- University of New South Wales, Sydney, Australia
| | - S Frost
- University of Western Sydney, Sydney, Australia
| | - Y Saad
- Liverpool Hospital, Cardiology, Sydney, Australia
| | - I Ferguson
- Liverpool Hospital, Cardiology, Sydney, Australia
| | - C P Juergens
- Liverpool Hospital, Cardiology, Sydney, Australia
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20
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Frost S, Malone P, Sayed L, Porter C, Agarwal R. “An improvement on burn care” – A full audit cycle on accuracy & appropriateness of burn injury referrals from an emergency department through a burns network. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.425] [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: 10/28/2022]
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21
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Frost S. 1679 The global drive to tackle occupational cancer. Occup Med (Lond) 2018. [DOI: 10.1136/oemed-2018-icohabstracts.1067] [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] Open
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22
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Etaher A, Nguyen T, Saad Y, Frost S, Mussap C, Juergens C, French J. Late Survival Among Patients ≥80 Years with Suspected ACS According to High Sensitivity Troponin T Levels. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.095] [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: 10/19/2022]
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23
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Etaher A, Saad Y, Nguyen T, Frost S, Shugman I, Mussap C, Juergens C, French J. Late Mortality Rates of Patients with Type 2 MI Compared to Type 1 MI and Stable Troponin Elevation. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
The radiographic and scintigraphic appearances in early gonarthrosis were compared in 62 knees. Early femorotibial osteoarthrosis was found to be confined to one compartment (medial or lateral) of the joint. However, concomitant patellofemoral osteoarthrosis was common. 99Tcm-MDP scintigraphy was consistently positive when the joint space (femorotibial and patellofemoral) was reduced by 75 per cent or more. Joint space narrowing by as much as 50 per cent could be observed in a scintigraphically normal knee. The inconsistency between the radiologic and scintigraphic findings in the earliest stages of gonarthrosis points to the importance of appropriate radiographic technique.
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25
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Younossi ZM, Stepanova M, Saab S, Kalwaney S, Clement S, Henry L, Frost S, Hunt S. The impact of type 2 diabetes and obesity on the long-term outcomes of more than 85 000 liver transplant recipients in the US. Aliment Pharmacol Ther 2014; 40:686-94. [PMID: 25040315 DOI: 10.1111/apt.12881] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [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: 05/27/2014] [Revised: 06/25/2014] [Accepted: 06/27/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Type 2 diabetes is known to negatively impact the outcome of chronic liver disease. AIM To evaluate the impact of diabetes on the outcomes of liver transplants (LT). METHODS Study cohort included adults (>18 years) who received LT in the US between 1994 and 2013 (The Scientific Registry of Transplant Recipients). Pre- and post-transplant diabetes was recorded in patients with mortality follow-up. RESULTS We included 85 194 liver transplant recipients. Of those, 11.2% had history of pre-transplant diabetes. The most common indications for liver transplant were hepatitis C (36.4%), alcohol-related liver disease (20.6%), primary liver malignancy of unspecified aetiology (14.7%), cryptogenic cirrhosis (8.0%), hepatitis B (4.6%) and non-alcoholic steatohepatitis (3.9%). A total of 96.5% transplants were from deceased donors, and 7.9% donors had history of diabetes. During an average 6.5 years of follow-up, 31.3% recipients died and 8.8% had a graft failure. In multivariate survival analysis [at least 5 years of cohort follow-up (N = 35 870)], after adjustment for age, ethnicity, insurance type, history of chronic diseases, HCV infection and noncompliance, independent predictors of recipient mortality included the presence of pre-transplant diabetes [adjusted hazard ratio (95%CI) = 1.21 (1.12-1.30)] and developing diabetes post-transplant [1.06 (1.02-1.11)]. Donor's history of diabetes was also independently associated with higher mortality [1.10 (1.02-1.19)]. Furthermore, donor's history of diabetes was also associated with an increased the risk of liver graft failure [1.35 (1.24-1.47)]. CONCLUSIONS Presence of type 2 diabetes pre- and post-transplant, as well as presence of type 2 diabetes in the donors, are all associated with an increased risk of adverse post-transplant outcomes.
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Affiliation(s)
- Z M Younossi
- Department of Medicine, Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, USA; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA
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Bonevski B, O'Brien J, Frost S, Yiow L, Oakes W, Barker D. Novel setting for addressing tobacco-related disparities: a survey of community welfare organization smoking policies, practices and attitudes. Health Educ Res 2013; 28:46-57. [PMID: 22798564 PMCID: PMC3549586 DOI: 10.1093/her/cys077] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 05/30/2012] [Indexed: 06/01/2023]
Abstract
Research in the United States and Australia acknowledges the potential of non-government social and community service organizations (SCSOs) for reaching socially disadvantaged smokers. This study aimed to describe SCSO smoking policies and practices, and attitudes of senior staff towards smoking and cessation. It also investigated factors associated with positive tobacco control attitudes. In 2009, a cross-sectional telephone survey was undertaken of senior staff in Australian SCSOs, 149 respondents representing 93 organizations completed the survey (response rate=65%; 93/142). Most service clients (60%) remained in programs for 6 months plus, and 77% attended at least weekly. Although 93% of respondents indicated they had an organizational smoking policy, it often did not include the provision of smoking cessation support. Most respondents indicated that client smoking status was not recorded on case notes (78%). Attitudes were mostly positive towards tobacco control in SCSOs, with a mean (standard deviation) score of 8.3 (2.9) of a possible 13. The practice of assessing clients' interest in quitting was the only statistically significant factor associated with high tobacco control attitude scores. The results suggest that SCSOs are appropriate settings for reaching socially disadvantaged smokers with cessation support. Although generally receptive to tobacco control, organizations require further support to integrate smoking cessation support into usual care. In particular, education, training and support for staff to enable them to help their clients quit smoking is important.
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Affiliation(s)
- B Bonevski
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia.
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27
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Rao S, Barrett L, Frost S. P1 Omalizumab in Paediatric Asthma: Importance of Multi-Disciplinary Assessment to Identify Eligible Patients. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.142] [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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28
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Frost S. S13.1 Respondent-driven sampling: uses, assumptions, limits and prospects. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050102.52] [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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29
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McCreesh N, Frost S, Seeley J, Katongole J, Tarsh MN, Ndungutse R, Jichi F, Maher D, Sonnenberg P, Copas A, Hayes RJ, White RG. S13.3 An empirical evaluation of respondent-driven sampling. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050102.54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Drumright L, Weir S, Frost S. P1-S2.58 The role of venues in structuring STI and risk networks among men who have sex with men. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.115] [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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Morton CO, Loeffler J, De Luca A, Frost S, Kenny C, Duval S, Romani L, Rogers TR. Dynamics of extracellular release of Aspergillus fumigatus DNAand galactomannan during growth in blood and serum. J Med Microbiol 2010; 59:408-413. [DOI: 10.1099/jmm.0.017418-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Aspergillus fumigatus is the major cause of invasive aspergillosis (IA),a disease associated with high rates of morbidity and mortality in patientsundergoing treatment for haematological malignancies. This study investigated A. fumigatus growth in vitro and in a murine model of IA inorder to provide insights into the dynamics of extracellular DNA and galactomannan (GM)release and their relevance to early diagnosis of IA. Following inoculationof whole blood with 20 A. fumigatus conidia ml−1,DNA that corresponded to the inoculum could be detected by PCR but GM wasnot detected in plasma separated from the blood sample, indicating that thefungus did not grow in whole blood. The quantities of DNA detected by PCR,and GM, were proportional to the amount of fungal biomass present in vitro. Fungal DNA could be detected in the sera of mice experimentally infectedwith A. fumigatus with maximum detection in cyclophosphamide-treatedmice.
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Affiliation(s)
- C. O. Morton
- Department of Clinical Microbiology, Sir PatrickDun Research Laboratory, Trinity College Dublin, St James's Hospital,Dublin 8, Ireland
| | - J. Loeffler
- Universität Würzburg, Medizinische Klinik &Poliklinik II, 97070 Würzburg, Germany
| | - A. De Luca
- Department of Experimental Medicine, University ofPerugia, 06126 Perugia, Italy
| | - S. Frost
- Department of Clinical Microbiology, Sir PatrickDun Research Laboratory, Trinity College Dublin, St James's Hospital,Dublin 8, Ireland
| | - C. Kenny
- Department of Clinical Microbiology, Sir PatrickDun Research Laboratory, Trinity College Dublin, St James's Hospital,Dublin 8, Ireland
| | - S. Duval
- Department of Clinical Microbiology, Sir PatrickDun Research Laboratory, Trinity College Dublin, St James's Hospital,Dublin 8, Ireland
| | - L. Romani
- Department of Experimental Medicine, University ofPerugia, 06126 Perugia, Italy
| | - T. R. Rogers
- Department of Clinical Microbiology, Sir PatrickDun Research Laboratory, Trinity College Dublin, St James's Hospital,Dublin 8, Ireland
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Krüger K, Frost S, Most E, Völker K, Pallauf J, Mooren FC. Exercise affects tissue lymphocyte apoptosis via redox-sensitive and Fas-dependent signaling pathways. Am J Physiol Regul Integr Comp Physiol 2009; 296:R1518-27. [PMID: 19261913 DOI: 10.1152/ajpregu.90994.2008] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Intensive and exhaustive exercise induces an activation of blood T-lymphocytes, which seems to be terminated by apoptotic processes in the postexercise period. Here, we report that exercise-induced T-lymphocyte apoptosis is a systemic phenomenon occurring in various lymphoid and nonlymphoid tissues. The apoptosis rate could be related to exercise intensity and type. Although in some tissues, such as the spleen and Peyer's patches, an early start of apoptosis (1-3 h postexercise) could be detected, a delayed apoptosis (24 h postexercise) was observed in lung, bone marrow, and lymph nodes. Further analysis showed a similar apoptosis distribution among lymphocyte subpopulations. We tested whether components of the extrinsic or the intrinsic apoptotic pathways or both were involved in these processes. Elevated levels of lipid peroxidation-product malondialdehyde (MDA), indicating an increased production of reactive oxygen species (ROS), were found after exercise in Peyer's patches, lung, and spleen, but not in lymph nodes. Application of N-acetyl-cysteine (NAC) prevented exercise-induced T-cell apoptosis completely in spleen and bone marrow, partially in lung and Peyer's patches, while it was ineffective in lymph nodes. Additionally, exercise addressed the Fas-mediated apoptosis. The percentage of Fas-receptor (Fas+) and Fas-ligand positive (FasL+) lymphocytes was enhanced in Peyer's patches after exercise. Moreover, FasL+ T cells were increased in the lung, while in lymph nodes Fas+ cells were increased. The critical role of Fas signaling in exercise-induced apoptosis was supported by using Fas-deficient MRL/lpr-mice. In Fas-deficient mice, exercise-induced T-lymphocyte apoptosis was prevented in spleen, lung, bone marrow, and lymph nodes, but not in Peyer's patches. These data demonstrate that exercise-induced lymphocyte apoptosis is a transient systemic process with tissue-type specific apoptosis-inducing mechanisms, whose relevance for the adaptive immune competence remains to be shown.
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Affiliation(s)
- K Krüger
- Department of Sports Medicine, Institute of Sports Sciences, Justus-Liebig-University, Giessen, Germany.
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Saulino M, Burton AW, Danyo DA, Frost S, Glanzer J, Solanki DR. Intrathecal ziconotide and baclofen provide pain relief in seven patients with neuropathic pain and spasticity: case reports. Eur J Phys Rehabil Med 2009; 45:61-67. [PMID: 19156022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Seven cases of combination of intrathecal (IT) ziconotide and baclofen therapy in patients with refractory neuropathic pain and spasticity were reviewed. Five of the seven adult patients were receiving IT baclofen treatment when ziconotide was initiated. All five patients had experienced at least one previous failed IT treatment regimen. Pain intensity scores improved by a mean of 50.3% with the use of ziconotide-baclofen therapy. Mean time to onset of pain relief was 15 weeks, at a mean ziconotide dose of 3.7 microg/day. Within this group of patients, adverse events were observed in one patient, but they were not considered to be ziconotide related and subsequently resolved. The remaining two patients were receiving ziconotide treatment when baclofen was initiated. Pain intensity scores improved by 75% and 30%, respectively. Pain relief was evident at two weeks and one week, with corresponding ziconotide doses of 2.4 microg/day and 14.4 microg/day, respectively. One patient in this group reported adverse events, but all resolved during continued treatment with the study drugs. Treatment regimens varied between patients in these case series; each regimen used a different titration strategy and different concentrations of ziconotide and baclofen. Combination IT ziconotide and baclofen therapy may be a treatment option for patients with neuropathic pain and spasticity. Future studies are warranted to determine the optimal dosing and titration schedules for ziconotide-baclofen usage.
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Affiliation(s)
- M Saulino
- MossRehab, Thomas Jefferson University Elkins Park, PA, USA.
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Perkins S, Schmidt U, Eisler I, Treasure J, Berelowitz M, Dodge E, Frost S, Jenkins M, Johnson-Sabine E, Keville S, Murphy R, Robinson P, Winn S, Yi I. Motivation to change in recent onset and long-standing bulimia nervosa: are there differences? Eat Weight Disord 2007; 12:61-9. [PMID: 17615490 DOI: 10.1007/bf03327580] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
UNLABELLED REASON FOR THE STUDY: Little is known about how motivation to change evolves over the course of an eating disorder. The present study compared 'stage of change' and motivation, confidence and readiness to change in two groups of patients with bulimia nervosa (BN), adolescents with a short duration of illness and adults with a long duration of illness. METHOD Patients completed the Severity of eating disorder symptomatology scale, Hospital Anxiety and Depression Scale and measures of stage of change and motivation, readiness and confidence to change their bulimic symptomatology at pre-treatment. MAIN FINDINGS Short- and long duration groups did not differ in illness severity, comorbidity, stage of change, motivation, readiness, and confidence to change. There were, however, some differences between groups in terms of the relationship between motivational measures, illness severity, duration and comorbidity. CONCLUSIONS There seem to be more similarities than differences between adolescents with short duration of illness and those with well-established BN in terms of their motivation to change.
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Affiliation(s)
- S Perkins
- Section of Eating Disorders, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
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Al-Uzri MM, Reveley MA, Owen L, Bruce J, Frost S, Mackintosh D, Moran PM. Measuring memory impairment in community-based patients with schizophrenia. Case-control study. Br J Psychiatry 2006; 189:132-6. [PMID: 16880482 DOI: 10.1192/bjp.bp.105.013631] [Citation(s) in RCA: 19] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The majority of memory impairment studies in schizophrenia are cohort studies using laboratory-based tests, which make it difficult to estimate the true extent and relevance of memory impairment in patients with schizophrenia in the community. AIMS To examine the extent of memory impairment in community-based patients with schizophrenia using a clinically relevant test. METHOD All patients with schizophrenia (n=190) in one catchment area were identified, of whom 133 were potentially eligible for the study; 73 patients volunteered to take part. They were assessed using the Rivermead Behavioural Memory Test (RBMT), the National Adult Reading Test, the Positive and Negative Syndrome Scale, the Health of the Nation Outcome Scales and the Scales and the Office for National Statistics Classification of Occupation. Their performance on the memory test was compared with that of matched controls (n=71). RESULTS Patients as a group performed significantly worse (P<0.001) than controls on the RBMT. Using the RBMT normative scores, 81% of patients were found to have impaired memory compared with 28% of controls. CONCLUSIONS Using a clinically relevant test, the majority of community-based patients with schizophrenia may have memory impairment.
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Affiliation(s)
- M M Al-Uzri
- Department of Health Sciences, University of Leicester and Leicestershire Partnership NHS Trust, Leicester, UK.
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Lane R, Frost S, Ashmore P, Howe G, Zablotska L, Chambers D, Stager R, McLaughlin J, Smith L. 323: Saskatchewan Uranium Miners’ Cohort (SUMC) Study. 1). Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s81b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R Lane
- The Canadian Nuclear Safety Commission, Ottawa, Ontario, K1P 5S9
| | - S Frost
- The Canadian Nuclear Safety Commission, Ottawa, Ontario, K1P 5S9
| | - P Ashmore
- The Canadian Nuclear Safety Commission, Ottawa, Ontario, K1P 5S9
| | - G Howe
- The Canadian Nuclear Safety Commission, Ottawa, Ontario, K1P 5S9
| | - L Zablotska
- The Canadian Nuclear Safety Commission, Ottawa, Ontario, K1P 5S9
| | - D Chambers
- The Canadian Nuclear Safety Commission, Ottawa, Ontario, K1P 5S9
| | - R Stager
- The Canadian Nuclear Safety Commission, Ottawa, Ontario, K1P 5S9
| | - J McLaughlin
- The Canadian Nuclear Safety Commission, Ottawa, Ontario, K1P 5S9
| | - L Smith
- The Canadian Nuclear Safety Commission, Ottawa, Ontario, K1P 5S9
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Tyrer P, Thompson S, Schmidt U, Jones V, Knapp M, Davidson K, Catalan J, Airlie J, Baxter S, Byford S, Byrne G, Cameron S, Caplan R, Cooper S, Ferguson B, Freeman C, Frost S, Godley J, Greenshields J, Henderson J, Holden N, Keech P, Kim L, Logan K, Manley C, MacLeod A, Murphy R, Patience L, Ramsay L, De Munroz S, Scott J, Seivewright H, Sivakumar K, Tata P, Thornton S, Ukoumunne OC, Wessely S. Randomized controlled trial of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm: the POPMACT study. Psychol Med 2003; 33:969-976. [PMID: 12946081 DOI: 10.1017/s0033291703008171] [Citation(s) in RCA: 137] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND We carried out a large randomized trial of a brief form of cognitive therapy, manual-assisted cognitive behaviour therapy (MACT) versus treatment as usual (TAU) for deliberate self-harm. METHOD Patients presenting with recurrent deliberate self-harm in five centres were randomized to either MACT or (TAU) and followed up over 1 year. MACT patients received a booklet based on cognitive behaviour therapy (CBT) principles and were offered up to five plus two booster sessions of CBT from a therapist in the first 3 months of the study. Ratings of parasuicide risk, anxiety, depression, social functioning and global function, positive and negative thinking, and quality of life were measured at baseline and after 6 and 12 months. RESULTS Four hundred and eighty patients were randomized. Sixty per cent of the MACT group had both the booklet and CBT sessions. There were seven suicides, five in the TAU group. The main outcome measure, the proportion of those repeating deliberate self-harm in the 12 months of the study, showed no significant difference between those treated with MACT (39%) and treatment as usual (46%) (OR 0.78, 95% CI 0.53 to 1.14, P=0.20). CONCLUSION Brief cognitive behaviour therapy is of limited efficacy in reducing self-harm repetition, but the findings taken in conjunctin with the economic evaluation (Byford et al. 2003) indicate superiority of MACT over TAU in terms of cost and effectiveness combined.
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Affiliation(s)
- P Tyrer
- Department of Psychological Medicine, Imperial College, King's College and Maudsley Hospitals, Center for the Economics of Mental Health, Institute of Psychiatry, London
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Abstract
The authors investigated factors that predict intention to take a genetic test for Alzheimer's disease (AD). The 449 men and women were surveyed in two groups: (a) those told that a positive result meant a 90% chance of developing AD (increased certainty) and (b) those told that a positive result meant a 50% chance of developing AD (decreased certainty). Participants completed measures of the Theory of Planned Behavior (TPB), anticipated regret, risk perception, likelihood of taking a genetic test for cancer, and AD risk factors. Just over 50% of the variance in intentions was related to TPB variables, likelihood of taking a genetic test for cancer, number of people the participants knew who had AD, experimental condition, and anticipated regret. The subjective norm was the strongest predictor of intention in the increased certainty group, whereas positive belief was the strongest predictor in the decreased certainty group.
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Affiliation(s)
- S Frost
- Department of Psychiatry and Behavioral Sciences, Royal Free University College Medical School in London, United Kingdom
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Dawson J, Fitzpatrick R, Frost S, Gundle R, McLardy-Smith P, Murray D. Evidence for the validity of a patient-based instrument for assessment of outcome after revision hip replacement. J Bone Joint Surg Br 2001; 83:1125-9. [PMID: 11764424 DOI: 10.1302/0301-620x.83b8.11643] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The Oxford hip score (OHS) is a patient-based instrument for assessment of outcome which is often used after total hip replacement, and the EuroQol 5D (EQ5D) is a patient-based generic questionnaire for health assessment. In an analysis of the outcome at one year of 609 revision hip replacements (RHRs), we compared the OHS and EQ5D scores, postoperative patient satisfaction and change in pain. About 25% of the operations were repeat RHRs. At one year, 57% of patients were very pleased with their operation. The correlation between preoperative and postoperative scores and change scores for the OHS and EQ5D was high. For both instruments the effect sizes were large, but the greater effect size of the OHS suggests that it is particularly sensitive to improvements after RHR. The effect scores of the OHS declined with the number of previous RHRs, while those for the EQ5D seemed less sensitive. Our results confirm the value of the OHS in assessing outcome after RHR.
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Affiliation(s)
- J Dawson
- Institute of Health Sciences, University of Oxford and the Nuffield Orthopaedic Centre, Headington, England
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Dawson J, Fitzpatrick R, Frost S, Gundle R, McLardy-Smith P, Murray D. Evidence for the validity of a patient-based instrument for assessment of outcome after revision hip replacement. ACTA ACUST UNITED AC 2001. [DOI: 10.1302/0301-620x.83b8.0831125] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The Oxford hip score (OHS) is a patient-based instrument for assessment of outcome which is often used after total hip replacement, and the EuroQol 5D (EQ5D) is a patient-based generic questionnaire for health assessment. In an analysis of the outcome at one year of 609 revision hip replacements (RHRs), we compared the OHS and EQ5D scores, postoperative patient satisfaction and change in pain. About 25% of the operations were repeat RHRs. At one year, 57% of patients were very pleased with their operation. The correlation between preoperative and postoperative scores and change scores for the OHS and EQ5D was high. For both instruments the effect sizes were large, but the greater effect size of the OHS suggests that it is particularly sensitive to improvements after RHR. The effect scores of the OHS declined with the number of previous RHRs, while those for the EQ5D seemed less sensitive. Our results confirm the value of the OHS in assessing outcome after RHR.
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Affiliation(s)
- J. Dawson
- Oxford Centre for Health Care Research and Development, School of Health Care, Oxford Brookes University, 44 London Road, Headington, Oxford OX3 7PD, UK
| | - R. Fitzpatrick
- Department of Public Health, Institute of Health Sciences, University of Oxford, Old Road, Headington, Oxford OX3 7LD, UK
| | - S. Frost
- Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK
| | - R. Gundle
- Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK
| | - P. McLardy-Smith
- Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK
| | - D. Murray
- Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK
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Frost S. It takes an alliance to save a child. J Ky Med Assoc 2001; 99:455-6. [PMID: 11668905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Frost S. "That there child has a green gall upon its liver". J Ky Med Assoc 2001; 99:407-8. [PMID: 11573311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Frost S. Santa Clara auditors verify GPO savings. Hosp Mater Manage 2001; 26:2, 14-5. [PMID: 11499227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- S Frost
- Contract Support Services, La Crescenta, Calif., USA
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Frost S. Buying in: IDN reaps GPO benefits. Hosp Mater Manage 2001; 26:11-3. [PMID: 11547464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The impact of switching to group purchasing contracts on a hospital's supply expenses is often a subject of speculation, but is rarely actually measured. Scott Frost relates how one hospital system isolated the financial impact of joining a national GPO.
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Ruiz L, Carcelain G, Martínez-Picado J, Frost S, Marfil S, Paredes R, Romeu J, Ferrer E, Morales-Lopetegi K, Autran B, Clotet B. HIV dynamics and T-cell immunity after three structured treatment interruptions in chronic HIV-1 infection. AIDS 2001; 15:F19-27. [PMID: 11416734 DOI: 10.1097/00002030-200106150-00001] [Citation(s) in RCA: 121] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate whether controlled re-exposures to autologous HIV-1 could boost HIV-specific immunity and limit virus replication in patients with chronic HIV-1 infection. PATIENTS AND DESIGN Subjects with at least 2 years virus suppression during antiretroviral therapy and a CD4 : CD8 ratio > 1 were randomly assigned to interrupt highly active antiretroviral treatment (HAART) three times (n = 12) or to continue their previous HAART (n = 14). RESULTS In 10/12 interrupter patients a rebound of HIV-1 RNA was detected in all three structured treatment interruptions (STI). Plasma virus doubling time was shorter during the first STI than in the second and third STI, corresponding to an average 13% reduction in viral basic reproductive rate. However, the mean time before plasma viral load rose to > 50 copies/ml was significantly shorter in the second and third STI. The average frequency of HIV-specific CD8 T cells in the interrupter patients at the end of the third STI cycle was significantly higher compared with the baseline and the end of the first STI. A substantial increase in HIV-specific CD8 T cell frequencies was found in four interrupter patients, whereas there were no changes in all 14 non-interrupter individuals. A weak p24-specific T helper response developed in 5/12 interrupter patients compared with no response in non-interruptors, but these responses were transient and disappeared rapidly. CONCLUSION The increase in the control of viral replication, and positive effects of STI on immune responses in this population should encourage the further development of HIV-specific immune-based therapeutic strategies.
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Affiliation(s)
- L Ruiz
- Retrovirology Laboratory, IrsiCaixa Foundation and HIV Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
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Frost S. Slip, slop, slap, and wrap. J Ky Med Assoc 2001; 99:251-2. [PMID: 11449603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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Horne R, Mailey E, Frost S, Lea R. Shared care: a qualitative study of GPs' and hospital doctors' views on prescribing specialist medicines. Br J Gen Pract 2001; 51:187-93. [PMID: 11255899 PMCID: PMC1313949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Shared care schemes have mainly centred on chronic diseases, such as asthma and diabetes. However, with increasing government emphasis on primary and secondary care integration and the effects of budget restraints, general practitioners (GPs) have been asked to take on the prescribing of specialist medicines. AIM To elicit the views and experiences of GPs and hospital doctors about existing arrangements for shared care applied to the prescribing of specialist medicines. To identify a set of quality indicators for prescribing specialist medicines at the interface between primary and secondary care. DESIGN OF STUDY A qualitative study based on semi-structured interviews. SETTING Forty-eight GPs and 13 hospital doctors in the former South Thames region. METHOD The interviews focused on how far experiences with shared care compare with the arrangements currently in place for prescribing specialist medicines and identified the barriers to facilitators of effective shared care. RESULTS A number of key themes were identified and these formed the basis for eight quality indicators relating to the prescribing of specialist medicines where treatment is shared between primary and secondary care. The themes centred around issues of clinical responsibility, 'cost-shifting', availability of medicines, GP satisfaction, and the nature of the prescribing relationship. CONCLUSION Overall, GPs appeared dissatisfied with arrangements for prescribing specialist medicines, while hospital doctors were generally satisfied. The quality indicators will form the basis of a more extensive quantitative survey of GPs' perceptions of the arrangements for prescribing specialist medicines.
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Affiliation(s)
- R Horne
- Centre for Health Care Research, University of Brighton, 1 Great Wilkins, Falmer Campus, Brighton, BN1 9PH
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