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Wilson BE, Booth CM, Patel S, Berry S, Kong W, Merchant SJ. First-line Palliative Chemotherapy for Colorectal Cancer: a Population-based Analysis of Delivery and Outcomes in a Single-payer Health System. Clin Oncol (R Coll Radiol) 2024; 36:211-220. [PMID: 38199907 DOI: 10.1016/j.clon.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/07/2023] [Indexed: 01/12/2024]
Abstract
AIMS Clinical practice guidelines recommend palliative chemotherapy for most patients with metastatic colorectal cancer. However, outcomes observed in the real world compared with patients enrolled in clinical trials have not been sufficiently described. The objective of this study was to evaluate the delivery and outcomes of first-line palliative chemotherapy administered to patients with colorectal cancer in routine clinical practice compared with clinical trials. MATERIALS AND METHODS Using linked health administrative data, we carried out a retrospective population-level cohort study on patients diagnosed with colorectal cancer in Ontario, Canada from 2010 to 2019. Patient, disease and treatment characteristics were summarised. The primary outcome was median overall survival, stratified by treatment prescribed and age. Demographics and outcomes in this real-world population were compared with those from pivotal clinical trials. A multivariable Cox regression model reporting hazard ratios and 95% confidence intervals was used to determine factors associated with survival in patients receiving systemic treatment. RESULTS We identified 70 987 patients with a new diagnosis of colorectal cancer, of which 4613 received first-line chemotherapy for unresectable locally advanced or metastatic disease and formed the study cohort. Fifty-eight per cent were male and the mean age was 63 years. Most had colon cancer (69%), at least one comorbidity (73%) and lived in an urban location (79%). Less than half (47%) had surgery after diagnosis. The most common regimen prescribed was folinic acid, 5-fluorouracil and irinotecan (FOLFIRI) with bevacizumab or epidermal growth factor receptor inhibitors (EGFRi; n = 2784, 60%). Among all treated patients, the median overall survival was 17.1 months, with survival difference by regimen [median overall survival 18.3 for FOLFIRI with bevacizumab or EGFRi, 19.6 for folinic acid, 5-fluorouracil and oxaliplatin (FOLFOX)/capecitabine, oxaliplatin (XELOX) with bevacizumab or EGFRi, 13.6 for FOLFIRI alone and 7.8 for 5-fluorouracil or capecitabine]. Patients aged >80 years were most likely to have received single-agent 5-fluorouracil or capecitabine, and had inferior overall survival compared with their younger counterparts. Compared with pivotal clinical trials, patients in the real world had inferior overall survival outcomes despite similar demographic characteristics (including age and sex). CONCLUSIONS In this real-world population-based analysis of patients receiving first-line chemotherapy for unresectable locally advanced or metastatic colorectal cancer, survival outcomes were inferior to those reported in randomised trials despite similarities in age and sex. This information can be used when counselling patients in routine practice about expected outcomes.
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Affiliation(s)
- B E Wilson
- Department of Oncology, Queen's University, Kingston, Ontario, Canada; Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - C M Booth
- Department of Oncology, Queen's University, Kingston, Ontario, Canada; Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada
| | - S Patel
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada; Department of Surgery, Queen's University, Kingston, Ontario, Canada
| | - S Berry
- Department of Oncology, Queen's University, Kingston, Ontario, Canada
| | - W Kong
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada
| | - S J Merchant
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada; Department of Surgery, Queen's University, Kingston, Ontario, Canada.
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Abu Baker D, Patel S, Charalambous P, Albuloushi N, Rodriguez J. Multi-Modal Digital Impressions For Palatal Defects. Eur J Prosthodont Restor Dent 2024; 32:75-82. [PMID: 37721541 DOI: 10.1922/ejprd_2586abubaker08] [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] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/16/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION This in-vitro study investigated limitations of intra-oral scanners (IOS) in capturing palatal defects at decreased mouth openings. The trueness and precision of composite 3D-printed models from Cone-Beam Computed Tomography (CBCT) and IOS were measured. METHODS A partially dentate palatal defect model was scanned with IOS (3M™TrueDefinition) at various simulated mouth openings. Five silicone impressions were poured in gypsum. Scans were taken using 3M™TrueDefinition; Planmeca Planscan®, n=5 each. Model was scanned on two CBCT (PlanmecaProFace®; Accuitomo170®CBCT, n=5 each). Geomagic®Control2014™ was used to create composite-models merging CBCT with IOS. Thirty composite-models were 3D-printed. Trueness and precision were measured. Pearson Correlation Coefficients measured correlation between mouth opening and data capture. Data analysed using Kruskal-Wallis, Wilcoxon rank-sum, and ANOVA. Statistical significance inferred when p⟨0.05. RESULTS Mouth openings ⟨20mm, IOS didn't capture information of soft tissue. Increased mouth opening positively correlated with increased data capture(r=0.93, p=0.001). AccuitomoCBCT and TrueDefinition IOS composite-models had the highest (trueness) and [precision](median (IQR) 0.172 mm(0.062-0.426)); [mean [SD] 0.080 mm [0.008]]. Casts had the lowest results (median (IQR) 0.289 mm(0.119-1.565));[mean [SD] 0.338 mm [0.089]](p⟨0.001). CONCLUSION Mouth opening ⟨20mm resulted in insufficient data capture by IOS for clinical applications. Composite digital models showed promising trueness and precision results.
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Affiliation(s)
- D Abu Baker
- Assistant Professor, Department of Prosthodontics, University of Jordan, Amman, Jordan
| | - S Patel
- Specialist Registrar in Restorative Dentistry, Guy's and St Thomas's Trust, NHS, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, SE1 9RT
| | - P Charalambous
- Clinical Lecturer, Bristol University, Bristol Dental School, Bristol
| | - N Albuloushi
- Registrar, King's College London, Guy's Campus, London, UK
| | - J Rodriguez
- Consultant in Restorative Dentistry, Honorary Senior Clinical Lecturer, Guy's and St Thomas's Trust, NHS, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, SE1 9RT
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Panchal J, Patel A, Patel S, Goswami D. Understanding mastitis: Microbiome, control strategies, and prevalence - A comprehensive review. Microb Pathog 2024; 187:106533. [PMID: 38171428 DOI: 10.1016/j.micpath.2023.106533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/12/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024]
Abstract
Mastitis significantly affects the udder tissue in dairy cattle, leading to inflammation, discomfort, and a decline in both milk yield and quality. The condition can be attributed to an array of microbial agents that access the mammary gland through multiple pathways. The ramifications of this ailment are not merely confined to animal welfare but extend to the financial viability of the livestock industry. This review offers a historical lens on mastitis, tracing its documentation back to 1851, and examines its global distribution with a focus on regional differences in prevalence and antimicrobial resistance (AMR) patterns. Specific microbial genes and communities implicated in both mastitis and AMR are explored, including Staphylococcus aureus, Streptococcus agalactiae,Streptococcus dysagalactiae, Streptococcus uberis Escherichia coli, Klebsiella pneumoniae, Mycoplasma bovis, Corynebacterium bovis, among others. These microorganisms have evolved diverse strategies to elude host immune responses and neutralize commonly administered antibiotics, complicating management efforts. The review aims a comprehensive overview of the current knowledge and research gaps on mastitis and AMR, and to highlight the need for a One Health approach to address this global health issue. Such an approach entails multi-disciplinary cooperation to foster judicious antibiotic use, enhance preventive measures against mastitis, and bolster surveillance and monitoring of AMR in pathogens responsible for mastitis.
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Affiliation(s)
- Janki Panchal
- Department of Microbiology & Biotechnology, University School of Sciences, Gujarat University, Ahmedabad, 380009, Gujarat, India
| | - Arun Patel
- Department of Veterinary Microbiology, College of Veterinary Sciences & Animal Husbandry, Sardarkrushinagar, 385505, Kamdhenu University, Gujarat, India
| | - Sandip Patel
- Department of Veterinary Microbiology, College of Veterinary Sciences & Animal Husbandry, Sardarkrushinagar, 385505, Kamdhenu University, Gujarat, India
| | - Dweipayan Goswami
- Department of Microbiology & Biotechnology, University School of Sciences, Gujarat University, Ahmedabad, 380009, Gujarat, India.
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Yuan Y, Arige V, Saito R, Mu Q, Brailoiu GC, Pereira GJS, Bolsover SR, Keller M, Bracher F, Grimm C, Brailoiu E, Marchant JS, Yule DI, Patel S. Two-pore channel-2 and inositol trisphosphate receptors coordinate Ca 2+ signals between lysosomes and the endoplasmic reticulum. Cell Rep 2024; 43:113628. [PMID: 38160394 PMCID: PMC10931537 DOI: 10.1016/j.celrep.2023.113628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/13/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024] Open
Abstract
Lysosomes and the endoplasmic reticulum (ER) are Ca2+ stores mobilized by the second messengers NAADP and IP3, respectively. Here, we establish Ca2+ signals between the two sources as fundamental building blocks that couple local release to global changes in Ca2+. Cell-wide Ca2+ signals evoked by activation of endogenous NAADP-sensitive channels on lysosomes comprise both local and global components and exhibit a major dependence on ER Ca2+ despite their lysosomal origin. Knockout of ER IP3 receptor channels delays these signals, whereas expression of lysosomal TPC2 channels accelerates them. High-resolution Ca2+ imaging reveals elementary events upon TPC2 opening and signals coupled to IP3 receptors. Biasing TPC2 activation to a Ca2+-permeable state sensitizes local Ca2+ signals to IP3. This increases the potency of a physiological agonist to evoke global Ca2+ signals and activate a downstream target. Our data provide a conceptual framework to understand how Ca2+ release from physically separated stores is coordinated.
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Affiliation(s)
- Yu Yuan
- Department of Cell and Developmental Biology, University College London, Gower Street, WC1E 6BT London, UK
| | - Vikas Arige
- Department of Pharmacology and Physiology, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA
| | - Ryo Saito
- Department of Cell and Developmental Biology, University College London, Gower Street, WC1E 6BT London, UK; Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Qianru Mu
- Department of Cell and Developmental Biology, University College London, Gower Street, WC1E 6BT London, UK
| | - Gabriela C Brailoiu
- Department of Pharmaceutical Sciences, Jefferson College of Pharmacy, Thomas Jefferson University, 901 Walnut Street, Philadelphia, PA 19107, USA
| | - Gustavo J S Pereira
- Department of Cell and Developmental Biology, University College London, Gower Street, WC1E 6BT London, UK; Department of Pharmacology, Federal University of São Paulo (UNIFESP), São Paulo 04044-020, Brazil
| | - Stephen R Bolsover
- Department of Cell and Developmental Biology, University College London, Gower Street, WC1E 6BT London, UK
| | - Marco Keller
- Department of Pharmacy-Center for Drug Research, Ludwig-Maximilian University, Butenandtstrasse 5-13, 81377 Munich, Germany
| | - Franz Bracher
- Department of Pharmacy-Center for Drug Research, Ludwig-Maximilian University, Butenandtstrasse 5-13, 81377 Munich, Germany
| | - Christian Grimm
- Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, Ludwig-Maximilian University, Nussbaumstrasse 26, 80336 Munich, Germany; Immunology, Infection and Pandemic Research IIP, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, 60596 Frankfurt, Germany
| | - Eugen Brailoiu
- Department of Neural Sciences and Center for Substance Abuse Research, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Jonathan S Marchant
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - David I Yule
- Department of Pharmacology and Physiology, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA.
| | - Sandip Patel
- Department of Cell and Developmental Biology, University College London, Gower Street, WC1E 6BT London, UK.
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Shah U, Patel M, Patel S, Patel S. Investigating the Antioxidant Capacity of Newly Synthesized Flavonoids via DPPH Assay. Curr Drug Discov Technol 2024; 21:CDDT-EPUB-137557. [PMID: 38258778 DOI: 10.2174/0115701638284053240106123407] [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: 10/04/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Numerous naturally occurring and artificially synthesized flavonoids have garnered attention for their impressive ability to combat oxidative stress and scavenge free radicals when evaluated in laboratory settings. The core aim of our investigation revolved around assessing the antioxidant potential of a diverse range of synthesized flavonoids through in vitro experiments. METHOD We crafted 29 distinct flavonoids using the aldol condensation mechanism via a chalcone intermediate to accomplish this. We meticulously characterized these newly formed compounds using a variety of spectroscopic techniques. We employed the widely recognized DPPH free radical method for the crucial antioxidant evaluation, a benchmark in such studies Result: The radical scavenging efficacy of our synthesized flavonoids was then meticulously compared to that of the positive control, ascorbic acid, renowned for its antioxidant prowess, and the IC50 values for each compound were calculated and examined. Surprisingly, our results showed that the flavonoids we tested had a wide range of antioxidant activity, with IC50 values that ranged from 75.8 ± 8.30 to 397 ± 25.10 μg/mL. CONCLUSION Intriguingly, compounds US5, US13, US16, US17, US18, and US21 outshone even ascorbic acid in their antioxidant potential, displaying remarkable scavenging abilities against free radicals. This discovery holds promise for further exploration of these compounds as potential antioxidants with potential applications in health and wellness.
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Affiliation(s)
- Umang Shah
- Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology, Changa, Gujarat, 388421, India
| | - Mehul Patel
- Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology, Changa, Gujarat, 388421, India
| | - Samir Patel
- Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology, Changa, Gujarat, 388421, India
| | - Sandip Patel
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, Gujarat, India
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Panchal J, Prajapati J, Dabhi M, Patel A, Patel S, Rawal R, Saraf M, Goswami D. Comprehensive computational investigation for ligand recognition and binding dynamics of SdiA: a degenerate LuxR -type receptor in Klebsiella pneumoniae. Mol Divers 2024:10.1007/s11030-023-10785-6. [PMID: 38212453 DOI: 10.1007/s11030-023-10785-6] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/26/2023] [Indexed: 01/13/2024]
Abstract
SdiA is a LuxR-type receptor that controls the virulence of Klebsiella pneumoniae, a Gram-negative bacterium that causes various infections in humans. SdiA senses exogenous acyl-homoserine lactones (AHLs) and autoinducer-2 (AI-2), two types of quorum sensing signals produced by other bacterial species. However, the molecular details of how SdiA recognizes and binds to different ligands and how this affects its function and regulation in K. pneumoniae still need to be better understood. This study uses computational methods to explore the protein-ligand binding dynamics of SdiA with 11 AHLs and 2 AI-2 ligands. The 3D structure of SdiA was predicted through homology modeling, followed by molecular docking with AHLs and AI-2 ligands. Binding affinities were quantified using MM-GBSA, and complex stability was assessed via Molecular Dynamics (MD) simulations. Results demonstrated that SdiA in Klebsiella pneumoniae exhibits a degenerate binding nature, capable of interacting with multiple AHLs and AI-2. Specific ligands, namely C10-HSL, C8-HSL, 3-oxo-C8-HSL, and 3-oxo-C10-HSL, were found to have high binding affinities and formed critical hydrogen bonds with key amino acid residues of SdiA. This finding aligns with the observed preference of SdiA for AHLs having 8 to 10 carbon-length acyl chains and lacking hydroxyl groups. In contrast, THMF and HMF demonstrated poor binding properties. Furthermore, AI-2 exhibited a low affinity, corroborating the inference that SdiA is not the primary receptor for AI-2 in K. pneumoniae. These findings provide insights into the protein-ligand binding dynamics of SdiA and its role in quorum sensing and virulence of K. pneumoniae.
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Affiliation(s)
- Janki Panchal
- Department of Microbiology & Biotechnology, University School of Sciences, Gujarat University, Ahmedabad, 380009, Gujarat, India
| | - Jignesh Prajapati
- Department of Biochemistry & Forensic Science, University School of Sciences, Gujarat University, Ahmedabad, 380009, Gujarat, India
| | - Milan Dabhi
- Department of Microbiology & Biotechnology, University School of Sciences, Gujarat University, Ahmedabad, 380009, Gujarat, India
| | - Arun Patel
- Department of Veterinary Microbiology, College of Veterinary Sciences & Animal Husbandry, Kamdhenu University, Sardarkrushinagar 385505, Gujarat, India
| | - Sandip Patel
- Department of Veterinary Microbiology, College of Veterinary Sciences & Animal Husbandry, Kamdhenu University, Sardarkrushinagar 385505, Gujarat, India
| | - Rakesh Rawal
- Department of Biochemistry & Forensic Science, University School of Sciences, Gujarat University, Ahmedabad, 380009, Gujarat, India
| | - Meenu Saraf
- Department of Microbiology & Biotechnology, University School of Sciences, Gujarat University, Ahmedabad, 380009, Gujarat, India
| | - Dweipayan Goswami
- Department of Microbiology & Biotechnology, University School of Sciences, Gujarat University, Ahmedabad, 380009, Gujarat, India.
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Liu CH, Harrison DC, Patel S, Wilen CD, Rafferty O, Shearrow A, Ballard A, Iaia V, Ku J, Plourde BLT, McDermott R. Quasiparticle Poisoning of Superconducting Qubits from Resonant Absorption of Pair-Breaking Photons. Phys Rev Lett 2024; 132:017001. [PMID: 38242669 DOI: 10.1103/physrevlett.132.017001] [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] [Received: 12/07/2022] [Revised: 11/22/2023] [Accepted: 11/29/2023] [Indexed: 01/21/2024]
Abstract
The ideal superconductor provides a pristine environment for the delicate states of a quantum computer: because there is an energy gap to excitations, there are no spurious modes with which the qubits can interact, causing irreversible decay of the quantum state. As a practical matter, however, there exists a high density of excitations out of the superconducting ground state even at ultralow temperature; these are known as quasiparticles. Observed quasiparticle densities are of order 1 μm^{-3}, tens of orders of magnitude greater than the equilibrium density expected from theory. Nonequilibrium quasiparticles extract energy from the qubit mode and can induce dephasing. Here we show that a dominant mechanism for quasiparticle poisoning is direct absorption of high-energy photons at the qubit junction. We use a Josephson junction-based photon source to controllably dose qubit circuits with millimeter-wave radiation, and we use an interferometric quantum gate sequence to reconstruct the charge parity of the qubit. We find that the structure of the qubit itself acts as a resonant antenna for millimeter-wave radiation, providing an efficient path for photons to generate quasiparticles. A deep understanding of this physics will pave the way to realization of next-generation superconducting qubits that are robust against quasiparticle poisoning.
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Affiliation(s)
- C H Liu
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - D C Harrison
- Intelligence Community Postdoctoral Research Fellowship Program, Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - S Patel
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - C D Wilen
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - O Rafferty
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - A Shearrow
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - A Ballard
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - V Iaia
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - J Ku
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - B L T Plourde
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - R McDermott
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
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Beladiya J, Kumar A, Vasava Y, Parmar K, Patel D, Patel S, Dholakia S, Sheth D, Boddu SHS, Patel C. Safety and efficacy of COVID-19 vaccines: A systematic review and meta-analysis of controlled and randomized clinical trials. Rev Med Virol 2024; 34:e2507. [PMID: 38282394 DOI: 10.1002/rmv.2507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/24/2023] [Accepted: 12/17/2023] [Indexed: 01/30/2024]
Abstract
Vaccines against coronavirus disease 2019 (COVID-19) have been discovered within a very small duration of time as compared to the traditional way for the development of vaccines, which raised the question about the safety and efficacy of the approved vaccines. The purpose of this study is to look at the effectiveness and safety of vaccine platforms against the incidence of COVID-19. The literature search was performed on PubMed/Medline, Cochrane, and clinical trials.gov databases for studies published between 1 January 2020 and 19 February 2022. Preferred Reporting Items for Systemic Review and Meta-Analysis Statement guidelines were followed. Among 284 articles received by keywords, a total of 11 studies were eligible according to the inclusion and exclusion criteria (studies in special populations, e.g., pregnant women, paediatric patients, editorials, case reports, review articles, preclinical and in vitro studies) of the study. A total of 247,186 participants were considered for randomisation at baseline, among them, 129,572 (52.42%) were provided with vaccine (Intervention group) and 117,614 (47.58%) with the placebo (Control group). A pooled fold change estimation of 0.19 (95% CI: 0.12-0.31, p < 0.0001) showed significant protection against the incidence of COVID-19 in the vaccines received group versus the placebo group. mRNA based, inactivated vaccines and non-replicating viral vector-based vaccines showed significantly protection against the incidence of COVID-19 compared to placebo with pooled fold change estimation was 0.08 (95% CI: 0.06-0.10), 0.20 (95% CI: 0.14-0.29) and 0.36 (95% CI: 0.28-0.46), respectively. Injection site discomfort and fatigue were the most common side effect observed in mRNA, non-replicating viral vector, inactivated, and protein subunit-based vaccines. All the approved vaccines were found safe and efficacious but mRNA-based vaccines were found to be more efficacious against SARS-CoV-2 than other platforms.
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Affiliation(s)
- Jayesh Beladiya
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Anup Kumar
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Yogesh Vasava
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Krupanshu Parmar
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Dipanshi Patel
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Sandip Patel
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Sandip Dholakia
- Department of Pharmaceutical Chemistry, L. M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Devang Sheth
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Sai H S Boddu
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, UAE
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, UAE
| | - Chirag Patel
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, Gujarat, India
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Cowan B, Kvale M, Yin J, Patel S, Jorgenson E, Mostaedi R, Choquet H. Risk factors for inguinal hernia repair among US adults. Hernia 2023; 27:1507-1514. [PMID: 37947923 DOI: 10.1007/s10029-023-02913-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/08/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE To investigate demographic, clinical, and behavioral risk factors for undergoing inguinal hernia repair within a large and ethnically diverse cohort. METHODS We conducted a retrospective case-control study from 2007 to 2020 on 302,532 US individuals from a large, integrated healthcare delivery system with electronic health records, who participated in a survey of determinants of health. Participants without diagnosis or procedure record of an inguinal hernia at enrollment were included. We then assessed whether demographic (age, sex, race/ethnicity), clinical, and behavioral factors (obesity status, alcohol use, cigarette smoking and physical activity) were predictors of undergoing inguinal hernia repair using survival analyses. Risk factors showing statistical significance (P < 0.05) in the univariate models were added to a multivariate model. RESULTS We identified 7314 patients who underwent inguinal hernia repair over the study period, with a higher incidence in men (6.31%) compared to women (0.53%). In a multivariate model, a higher incidence of inguinal hernia repair was associated with non-Hispanic white race/ethnicity, older age, male sex (aHR = 13.55 [95% confidence interval 12.70-14.50]), and more vigorous physical activity (aHR = 1.24 [0.045]), and alcohol drinker status (aHR = 1.05 [1.00-1.11]); while African-American (aHR = 0.69 [0.59-0.79]), Hispanic/Latino (aHR = 0.84 [0.75-0.91]), and Asian (aHR = 0.35 [0.31-0.39]) race/ethnicity, obesity (aHR = 0.33 [0.31-0.36]) and overweight (aHR = 0.71 [0.67-0.75]) were associated with a lower incidence. The use of cigarette was significantly associated with a higher incidence of inguinal hernia repair in women (aHR 1.23 [1.09-1.40]), but not in men (aHR 0.96 [0.91-1.02]). CONCLUSION Inguinal hernia repair is positively associated with non-Hispanic white race/ethnicity, older age, male sex, increased physical activity, alcohol consumption and tobacco use (only in women); while negatively associated with obesity and overweight status. Findings from this large and ethnically diverse study may support future prediction tools to identify patients at high risk of this surgery.
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Affiliation(s)
- B Cowan
- UCSF-East Bay General Surgery, Oakland, CA, USA
| | - M Kvale
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, USA
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, USA
| | - J Yin
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, USA
| | - S Patel
- UCSF-East Bay General Surgery, Oakland, CA, USA
| | - E Jorgenson
- Regeneron Genetics Center, Tarrytown, NY, USA
| | - R Mostaedi
- KPNC, Richmond Medical Center, Richmond, CA, USA
| | - H Choquet
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, USA.
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10
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Sagathia V, Patel C, Beladiya J, Patel S, Sheth D, Shah G. Tankyrase: a promising therapeutic target with pleiotropic action. Naunyn Schmiedebergs Arch Pharmacol 2023; 396:3363-3374. [PMID: 37338576 DOI: 10.1007/s00210-023-02576-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023]
Abstract
Tankyrase 1 (TNKS1) and tankyrase 2 (TNKS2) enzymes belong to the poly (ADP-ribose) polymerase (PARP) family participates in process of poly-ADP-ribosylation of different target proteins which leads to ubiquitin-mediated proteasomal degradation. Tankyrases are also involved in the pathophysiology of many diseases, especially cancer. Their functions include cell cycle homeostasis (primarily in mitosis), telomere maintenance, Wnt signaling pathway regulation, and insulin signaling (particularly GLUT4 translocation). Studies have implicated that genetic changes, mutations in the tankyrase coding sequence, or up regulation and down regulation of tankyrase are reflected in the numerous disease conditions. Investigations are pursued to develop putative molecules that target tankyrase in various diseases such as cancer, obesity, osteoarthritis, fibrosis, cherubism, and diabetes, thereby providing a new therapeutic treatment option. In the present review, we described the structure and function of tankyrase along with its role in different disease conditions. Furthermore, we also presented cumulative experimental evidences of different drugs acting on tankyrase.
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Affiliation(s)
- Vrunda Sagathia
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, 380009, Gujarat, India
| | - Chirag Patel
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, 380009, Gujarat, India.
| | - Jayesh Beladiya
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, 380009, Gujarat, India
| | - Sandip Patel
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, 380009, Gujarat, India
| | - Devang Sheth
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, 380009, Gujarat, India
| | - Gaurang Shah
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, 380009, Gujarat, India
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11
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Gunaratne GS, Kumar S, Lin-Moshier Y, Slama JT, Brailoiu E, Patel S, Walseth TF, Marchant JS. Progesterone receptor membrane component 1 facilitates Ca 2+ signal amplification between endosomes and the endoplasmic reticulum. J Biol Chem 2023; 299:105378. [PMID: 37866635 PMCID: PMC10685313 DOI: 10.1016/j.jbc.2023.105378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/02/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
Membrane contact sites (MCSs) between endosomes and the endoplasmic reticulum (ER) are thought to act as specialized trigger zones for Ca2+ signaling, where local Ca2+ released via endolysosomal ion channels is amplified by ER Ca2+-sensitive Ca2+ channels into global Ca2+ signals. Such amplification is integral to the action of the second messenger, nicotinic acid adenine dinucleotide phosphate (NAADP). However, functional regulators of inter-organellar Ca2+ crosstalk between endosomes and the ER remain poorly defined. Here, we identify progesterone receptor membrane component 1 (PGRMC1), an ER transmembrane protein that undergoes a unique heme-dependent dimerization, as an interactor of the endosomal two pore channel, TPC1. NAADP-dependent Ca2+ signals were potentiated by PGRMC1 overexpression through enhanced functional coupling between endosomal and ER Ca2+ stores and inhibited upon PGRMC1 knockdown. Point mutants in PGMRC1 or pharmacological manipulations that reduced its interaction with TPC1 were without effect. PGRMC1 therefore serves as a TPC1 interactor that regulates ER-endosomal coupling with functional implications for cellular Ca2+ dynamics and potentially the distribution of heme.
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Affiliation(s)
- Gihan S Gunaratne
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sushil Kumar
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Yaping Lin-Moshier
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - James T Slama
- Department of Medicinal & Biological Chemistry, University of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, Ohio, USA
| | - Eugen Brailoiu
- Center for Substance Abuse Research and Department of Neural Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Sandip Patel
- Department of Cell and Developmental Biology, University College London, London, UK
| | - Timothy F Walseth
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Jonathan S Marchant
- Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
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12
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Patel S, Patel JD. Current and Emerging Treatment Options for Patients with Metastatic EGFR-Mutated Non-small Cell Lung Cancer After Progression on Osimertinib and Platinum-Based Chemotherapy: A Podcast Discussion. Adv Ther 2023; 40:5579-5590. [PMID: 37801233 PMCID: PMC10611612 DOI: 10.1007/s12325-023-02680-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/06/2023] [Indexed: 10/07/2023]
Abstract
Patients with metastatic epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) are widely treated with osimertinib, the preferred first-line treatment option. However, disease progression inevitably occurs, driven by EGFR-dependent or EGFR-independent mechanisms of resistance. Platinum-based chemotherapy is the recommended treatment following progression with osimertinib but responses to platinum-based chemotherapy are transient. Salvage therapies, which are used after progression on platinum-based chemotherapy, have poor clinical outcomes in addition to substantial toxicity. In this podcast, we discuss the current treatment landscape and emerging therapeutic options for patients with metastatic EGFR-mutated NSCLC whose disease has progressed following treatment with osimertinib and platinum-based chemotherapy.Podcast audio available for this article.
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Affiliation(s)
- Sandip Patel
- University of California San Diego, La Jolla, San Diego, CA, 92093, USA.
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13
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Patel S, Awan KH, Freitas CMT, Bhandi S, Licari FW, Patil S. Diode laser targeting red-complex bacteria in periodontitis: a systematic review. Eur Rev Med Pharmacol Sci 2023; 27:11806-11816. [PMID: 38164844 DOI: 10.26355/eurrev_202312_34779] [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: 01/03/2024]
Abstract
OBJECTIVE This systematic review examines the effectiveness of diode laser irradiation in reducing the levels of red complex bacteria as well as periodontal parameters of pocket depth and clinical attachment level. MATERIALS AND METHODS We conducted electronic searches across databases such as Scopus, Embase, Medline, and Web of Science databases in July 2022. Randomized controlled trials that evaluated the reduction of red-complex bacteria in patients with periodontitis using diode lasers were included. The primary focus was the reduction in the microbial count of red complex bacteria, whereas probing depth and attachment level were considered secondary outcomes. Articles in languages other than English were excluded. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions and the ROB2 tool. RESULTS After searching the databases, eight independent studies were included, with a sample size of 210 subjects. The average age group of the study population was 30-60 years, and there was a lack of consensus on the antimicrobial effect of diode lasers. Out of the eight studies, four studies reported no significant difference in the levels of red complex bacteria before and after laser application. Three studies reported significantly lower levels of red complex bacteria in the intergroup comparison. One study reported that laser had no significant effect on intergroup bacterial levels. The combination of diode laser irradiation with scaling reduced the count of red complex bacteria and improved the clinical parameters, although not significantly. CONCLUSIONS Based on the limited evidence available, the adjunctive use of diode laser for scaling and root planning may provide some additional benefit in terms of reduction of red complex bacterial count and clinical parameters. Further well-designed trials and the use of objective measures are necessary before outlining universal guidelines for best practice. The adjunctive use of diode laser in non-surgical periodontal therapy may provide a reduction in the red complex microbial count and improvement in clinical parameters, decreasing the need for periodontal surgery.
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Affiliation(s)
- S Patel
- College of Graduate Studies, Roseman University of Health Sciences, South Jordan, Utah, USA.
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14
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Shah K, Ghosh J, Patel S, Chowdhuri MB, Jadeja KA, Shukla G, Macwan T, Kumar A, Dolui S, Singh K, Tanna RL, Patel KM, Dey R, Manchanda R, Ramaiya N, Kumar R, Aich S, Yadava N, Purohit S, Gupta MK, Nagora UC, Pathak SK, Atrey PK, Mayya KBK. Author Correction: Role of pinch in Argon impurity transport in ohmic discharges of Aditya-U Tokamak. Sci Rep 2023; 13:19969. [PMID: 37968383 PMCID: PMC10651834 DOI: 10.1038/s41598-023-47362-8] [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: 11/17/2023] Open
Affiliation(s)
- K Shah
- Department of Physics, Pandit Deendayal Energy University, Raisan, Gandhinagar, 382 007, India.
| | - J Ghosh
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India.
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India.
| | - S Patel
- Department of Physics, Pandit Deendayal Energy University, Raisan, Gandhinagar, 382 007, India
| | - M B Chowdhuri
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - K A Jadeja
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Department of Nano Science and Advanced Materials, Saurashtra University, Rajkot, 360 005, India
| | - G Shukla
- ITER-India, Institute for Plasma Research, Koteshwar, Ahmedabad, 380 005, India
| | - T Macwan
- University of California, Los Angeles, CA, 90095, USA
| | - A Kumar
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - S Dolui
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - K Singh
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - R L Tanna
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Institute of Science, Nirma University, Ahmedabad, 382 481, India
| | - K M Patel
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - R Dey
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - R Manchanda
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - N Ramaiya
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - R Kumar
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - S Aich
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - N Yadava
- Institute of Science, Nirma University, Ahmedabad, 382 481, India
| | - S Purohit
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - M K Gupta
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - U C Nagora
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - S K Pathak
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - P K Atrey
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - K B K Mayya
- Department of Physics, Pandit Deendayal Energy University, Raisan, Gandhinagar, 382 007, India
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15
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Patel P, Patel S, Chudasama P, Soni S, Raval M. Roflumilast ameliorates diabetic nephropathy in rats through down-regulation of JAK/STAT signaling pathway. Naunyn Schmiedebergs Arch Pharmacol 2023; 396:3285-3297. [PMID: 37318524 DOI: 10.1007/s00210-023-02535-0] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/16/2023] [Indexed: 06/16/2023]
Abstract
Roflumilast is a potent selective inhibitor of the phosphodiesterase-4 enzyme which greatly manifest an anti-inflammatory activity in chronic obstructive pulmonary patients. Inflammation is a prominent factor in the prevalence of diabetic nephropathy, one of the most prevalent microvascular complications of Diabetes Mellitus. The present study was undertaken to assess the potential role of roflumilast in diabetic nephropathy. The model was developed by feeding a high-fat diet for four weeks and following streptozotocin (30 mg/kg) injection intraperitoneally. The rats with > 13.8 mmol/L blood glucose were treated with roflumilast (0.25, 0.5, 1 mg/kg) and standard metformin (100 mg/kg) orally once a day for eight weeks. Roflumilast (1 mg/kg) remarkably improved renal damage, indicated by an increase in 16% albumin, a decrease in 5% serum creatinine, 12% BUN, 19% HbA1c, and 34% blood glucose. It also significantly improves the oxidative stress levels, which was indicated by a decrease in 18% MDA level and an increase in GSH, SOD, and catalase by 6%, 4%, and 5%, respectively. In addition, Roflumilast (1 mg/kg) decreased the HOMA-IR index by 28% and increased the pancreatic β-cells functioning by 30%. Moreover, significant improvement in histopathological abnormalities were observed in roflumilast treatment groups. Roflumilast treatment was shown to down-regulate the gene expressions of TNF-α (2.1-fold), NF-kB (2.3-fold), MCP-1 (2.5-fold), fibronectin (2.7-fold), collagen IV (2.7-fold), STAT 1(1.06-fold), and STAT 3 (1.20-fold) and upregulated the expression of the Nrf2 (1.43-fold) gene. Roflumilast manifested a potential role in diabetic nephropathy as a renoprotective agent. Roflumilast effectively down-regulates the JAK/STAT pathway and restores renal functions.
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Affiliation(s)
- Priyal Patel
- Department of Pharmacology, Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology (CHARUSAT), At and Post: Dist. Anand, Changa, 388421, Gujarat, India
| | - Sandip Patel
- Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, 380009, Gujarat, India.
| | - Piyush Chudasama
- Department of Research and Development, Sat-Kaival Hospital Pvt. Ltd, Anand, 388001, Gujarat, India
| | - Shailesh Soni
- Department of Pathology, Muljibhai Patel Urological Hospital, Nadiad, 387002, Gujarat, India
| | - Manan Raval
- Department of Pharmacognosy and Phytochemistry, Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology (CHARUSAT), At and Post: Dist. Anand, Changa, 388421, Gujarat, India
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16
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Clement D, Szabo EK, Krokeide SZ, Wiiger MT, Vincenti M, Palacios D, Chang YT, Grimm C, Patel S, Stenmark H, Brech A, Majhi RK, Malmberg KJ. The Lysosomal Calcium Channel TRPML1 Maintains Mitochondrial Fitness in NK Cells through Interorganelle Cross-Talk. J Immunol 2023; 211:1348-1358. [PMID: 37737664 PMCID: PMC10579149 DOI: 10.4049/jimmunol.2300406] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/18/2023] [Indexed: 09/23/2023]
Abstract
Cytotoxic lymphocytes eliminate cancer cells through the release of lytic granules, a specialized form of secretory lysosomes. This compartment is part of the pleomorphic endolysosomal system and is distinguished by its highly dynamic Ca2+ signaling machinery. Several transient receptor potential (TRP) calcium channels play essential roles in endolysosomal Ca2+ signaling and ensure the proper function of these organelles. In this study, we examined the role of TRPML1 (TRP cation channel, mucolipin subfamily, member 1) in regulating the homeostasis of secretory lysosomes and their cross-talk with mitochondria in human NK cells. We found that genetic deletion of TRPML1, which localizes to lysosomes in NK cells, led to mitochondrial fragmentation with evidence of collapsed mitochondrial cristae. Consequently, TRPML1-/- NK92 (NK92ML1-/-) displayed loss of mitochondrial membrane potential, increased reactive oxygen species stress, reduced ATP production, and compromised respiratory capacity. Using sensitive organelle-specific probes, we observed that mitochondria in NK92ML1-/- cells exhibited evidence of Ca2+ overload. Moreover, pharmacological activation of the TRPML1 channel in primary NK cells resulted in upregulation of LC3-II, whereas genetic deletion impeded autophagic flux and increased accumulation of dysfunctional mitochondria. Thus, TRPML1 impacts autophagy and clearance of damaged mitochondria. Taken together, these results suggest that an intimate interorganelle communication in NK cells is orchestrated by the lysosomal Ca2+ channel TRPML1.
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Affiliation(s)
- Dennis Clement
- Precision Immunotherapy Alliance, Institute for Cancer Research, University of Oslo, Norway
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Edina K. Szabo
- Precision Immunotherapy Alliance, Institute for Cancer Research, University of Oslo, Norway
| | | | - Merete Thune Wiiger
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Marianna Vincenti
- Precision Immunotherapy Alliance, Institute for Cancer Research, University of Oslo, Norway
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Daniel Palacios
- Precision Immunotherapy Alliance, Institute for Cancer Research, University of Oslo, Norway
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Young-Tae Chang
- Department of Chemistry, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Christian Grimm
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Munich, Munich, Germany
| | - Sandip Patel
- Department of Cell and Developmental Biology, University College London, London, United Kingdom
| | - Harald Stenmark
- Department of Molecular Cell Biology, Institute for Cancer Research, Oslo University Hospital, Montebello, Oslo, Norway
| | - Andreas Brech
- Department of Molecular Cell Biology, Institute for Cancer Research, Oslo University Hospital, Montebello, Oslo, Norway
| | - Rakesh Kumar Majhi
- Precision Immunotherapy Alliance, Institute for Cancer Research, University of Oslo, Norway
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
- Tissue Restoration Lab, Department of Biological Sciences and Bioengineering, Mehta Family Center of Engineering and Medicine, Indian Institute of Technology Kanpur, Kanpur, India
| | - Karl-Johan Malmberg
- Precision Immunotherapy Alliance, Institute for Cancer Research, University of Oslo, Norway
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
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17
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Morse R, Beaty B, Moon DH, Green R, Xu V, Weiss J, Sheth S, Patel S, Blumberg J, Hackman T, Lumley C, Patel S, Yarbrough W, Huff SB, Repka MC, Dagan R, Amdur RJ, Chera BS, Shen C, Chen X. Long-Term Outcomes of De-Intensified Chemoradiotherapy for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:S123-S124. [PMID: 37784319 DOI: 10.1016/j.ijrobp.2023.06.464] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To report long-term oncologic outcomes among patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) treated with definitive de-intensified chemoradiotherapy. MATERIALS/METHODS Major criteria for de-intensification were (1) AJCC 7th edition T0-T3, N0-N2c, M0 (AJCC 8th edition T0-T3, N0-N2, M0), (2) pathologically confirmed p16 positive, and (3) no or minimal/remote smoking history (non-mutated p53 if ≥30 pack-years). Treatment was 60 Gy intensity-modulated radiotherapy with first-choice concurrent cisplatin 30 mg/m2 once per week (alternative regimens permissible for cisplatin ineligible patients). Patients with T0-T2 N0-1 (AJCC 7th edition) were recommended 60 Gy radiation alone. Systemic therapy received included: cisplatin 30 mg/m2 (n = 122), cetuximab (n = 15), cisplatin 40 mg/m2 (n = 12), carboplatin/paclitaxel (n = 2), and radiation alone (n = 25). Kaplan Meier estimates for overall survival (OS), progression-free survival (PFS), locoregional control (LRC), and freedom from distant metastasis (FFDM) were calculated. Cox regression models were used for comparisons among subgroups. RESULTS A total 176 patients received de-intensified treatment (n = 153 prospective protocol, n = 23 off-protocol). Median follow-up was 52.6 months (range 5.3 - 102.0, 90.8% with minimum 2-year follow-up); 56.8% (n = 100) were never smokers and 43.2% (n = 76) former smokers; former smokers had median 9 pack-years smoking history (range 0.25 - 50) with 46% ≥10 pack-years. Outcomes were as follows: 2-year OS 99.4% and 5-year OS 91.8%; 2-year PFS 94.1% and 5-year PFS 84.3%; 2-year LRC 98.3% and 5-year LRC 95.8%; 2-year FFDM 95.8% and 5-year FFDM 93.2%. Median time to progression events were 21.1 months (range, 7.2 - 54.1) with 37.5% (6 of 16) of recurrences occurring after 24 months. Six total locoregional events occurred (five recurrences and one site of persistent disease), within the 60 Gy planning target volume. Twenty-three patients with T0-T2 N0-1 disease received radiation alone with 2-year PFS 92.9% (5-year 83.8%) and 2-year LRC 100% (5-year 95.2%). Outcomes for former smokers with ≥10 pack-years were comparable to patients with less or no smoking history (2-year PFS 94.1% vs 94.1%; 5-year PFS 90.6% vs 82.7%; HR 0.58, p = 0.38). Early results suggest similar oncologic outcomes among those treated off-protocol (median follow-up 25.6 months) with 1 of 23 patients experiencing locoregional recurrence. CONCLUSION Dose de-intensification of 60 Gy radiotherapy with weekly cisplatin results in favorable long-term tumor control in patients with HPV-associated OPSCC. De-intensified 60 Gy alone may be efficacious in carefully selected patients with T0-T2 N0-1 (AJCC 7th edition) disease. Inclusion of biologically favorable patients with more extensive former smoking history in de-intensification clinical trials may be warranted.
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Affiliation(s)
- R Morse
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - B Beaty
- Albert Einstein College of Medicine, Bronx, NY
| | - D H Moon
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - R Green
- University of North Carolina Hospitals, Chapel Hill, NC
| | - V Xu
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - J Weiss
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - S Sheth
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - S Patel
- University of North Carolina Hospitals, Chapel Hill, NC
| | | | - T Hackman
- Department of Otolaryngology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - C Lumley
- UNC School of Medicine, Chapel Hill, NC
| | - S Patel
- UNC School of Medicine, Chapel Hill, NC
| | | | - S B Huff
- University of Carolina, Chapel Hill, NC
| | - M C Repka
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - R Dagan
- University of Florida Health Proton Therapy Institute, Jacksonville, FL
| | - R J Amdur
- University of Florida Hospitals, Gainesville, FL
| | - B S Chera
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - C Shen
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - X Chen
- Case Western Reserve University School of Medicine, Cleveland, OH
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18
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Wadi-Ramahi S, Lalonde RJ, Patel S, Conte A, Siddiqui ZA, Olson AC, Huq MSS. Failure Mode and Effects Analysis for Treatment Workflow of a Novel Ring Gantry Linac. Int J Radiat Oncol Biol Phys 2023; 117:S163. [PMID: 37784410 DOI: 10.1016/j.ijrobp.2023.06.258] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) A new ring gantry Linac machine combined with a PET ring is available in the market. It has 3 separate centers, one for laser, one for CT imaging and a 3rd for the Linac. As a first-generation machine of its kind, the workflow heavily depends on user-input. As example, it uses two separate coordinate systems, IEC for lasers and CT localization offsets and DICOM for treatment planning. The planner must manually convert between the two systems. We hypothesize that the unique design of the machine that is heavily dependent on users' input increases the potential of failure of treatment. The present work investigates failure modes for treatment delivery using the methodology of failure modes and effects analysis (FMEA) and proposes solutions to mitigate some of the failure modes (FMs). MATERIALS/METHODS A group of two radiation oncologists, two radiation therapists and three medical physicists was assembled. The process map for treatment delivery on the X1 was created and FMs were identified. Members independently graded each FM on 3 parameters, likelihood of occurrence, detectability of FM and level of severity on patient treatment. A grading scale of 1-5 was used with five representing the worst outcome in each parameter. Each member also identified the origin of each FM to be human, machine or clinical process. Mitigation solutions were proposed. RESULTS The process map of treatment delivery on X1 consists of six major processes and 24 sub-processes. A total of 27 FMs were identified, with many 19/27 (70%) caused by human errors and 7/27 (27%) caused by machine. From all responses, we tallied a median of 11 FMs (40%) that have both S≥ 4 and O or D ≥ 4. To further focus our analysis, we looked at the highest PRN scores from each member and found 7 FMs that were common. 1 FM was in "initiation of Treatment" sub-process and 6 FMs in "Treatment delivery" sub-process. Proposed solutions to these FMs were concerned with software upgrades. Examples are, allow changes in fractionation, allow dose tracking, auto calculation of couch position for various sub processes, allow DICOM image transfer and many more. The current clinical workflow that we adopted for these FMs either puts the burden on the user to confirm/verify parameters or the use of third-party software. In addition to these high-scoring FMs, we adopted changes in clinical workflow to mitigate other FMs, most of them through third-party software. CONCLUSION This study confirmed that the unique design and user-dependent machine environment, human failures are high accounting for 70% of FMs in treatment delivery alone. Our current workflow of the machine depends on direct user input to calculate/confirm certain parameters or the use of third-party software, which also depends on the user for proper completion of the task. Suggested solutions also included proposed improvement to the machine's software and user interface.
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Affiliation(s)
| | - R J Lalonde
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
| | - S Patel
- UPMC Cancer Center, Pittsburgh, PA, United States
| | - A Conte
- UPMC Shadyside Hospital, Pittsburgh, PA
| | - Z A Siddiqui
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - A C Olson
- Department of Radiation Oncology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA
| | - M S S Huq
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
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Patel S, Olatunji EO, Joseph AO, Lasebikan N, Ngoma M, Ngoma TA, Nnko G, Chigbo DC, Ngwa W. An Analysis of Delays in Treatment Time for Prostate Cancer Patients in Sub-Saharan Africa. Int J Radiat Oncol Biol Phys 2023; 117:e610-e611. [PMID: 37785838 DOI: 10.1016/j.ijrobp.2023.06.1984] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Time interval from diagnosis of prostate cancer to treatment is an important predictor of survival outcomes for patients. These time intervals can be prolonged in resource-limited settings, such as those in Sub-Saharan Africa (SSA). The purpose of this project was to analyze the time interval between diagnosis and either hormonal or radiotherapy treatment for prostate cancer patients in Nigeria and Tanzania. The outcomes can inform the implementation of the recent Lancet Oncology Commission recommendations on increasing access to radiotherapy services in SSA to curb the growing cancer burden in the region. MATERIALS/METHODS Data were extracted from electronic patient records at the NSIA-LUTH Cancer Center (NLCC) in Lagos, Nigeria and at the Ocean Road Cancer Institute (ORCI) in Dar Es Salaam, Tanzania. Included patients were prostate cancer patients who received hypofractionated radiotherapy (HFRT) at ORCI between January 6 - June 16, 2022, and either HFRT or conventionally fractionated radiotherapy (CFRT) at NLCC between February 1 - July 27, 2022. Simple descriptive statistics were used to calculate the mean time interval between the patient's date of diagnosis of prostate cancer and the start of hormonal or radiotherapy treatment. RESULTS Time to hormonal therapy was collected for 23 ORCI patients and 28 NLCC patients. The mean time interval from date of diagnosis to start of hormonal therapy was 19.3 weeks for patients in Tanzania and 8.0 weeks for patients in Nigeria. Time to radiotherapy was collected for 23 ORCI patients and 50 NLCC patients. The mean time interval from date of diagnosis to start of radiotherapy was 59.13 weeks for patients in Tanzania and 48.5 weeks for patients in Nigeria. CONCLUSION Prostate cancer patients in Nigeria and Tanzania experience significant delay in receiving hormonal and radiotherapy treatment, especially when compared to wait times in well-resourced countries. For example, a recent assessment of U.S. patients in the National Cancer Database who were diagnosed with prostate cancer between 2004-2015 revealed that the mean interval from diagnosis to definitive therapy (either surgery or some form of radiotherapy) was 11.3 weeks - significantly less than the mean times documented in our study of SSA patients (Cone et al., 2020). Additionally, patients in Tanzania experienced longer treatment delays compared to patients in Nigeria, highlighting potential disparities in access to care between SSA countries. These prolonged delay times are likely to negatively impact survival and represent an intervention opportunity to alleviate the cancer crisis in SSA.
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Affiliation(s)
- S Patel
- Johns Hopkins Medicine, Baltimore, MD
| | | | | | - N Lasebikan
- University of Nigeria Teaching Hospital Enugu, Enugu, Nigeria
| | - M Ngoma
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - T A Ngoma
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - G Nnko
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - D C Chigbo
- University of Nigeria Teaching Hospital, Lagos, Nigeria
| | - W Ngwa
- John Hopkins University Hospital, Baltimore, MD
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Kotecha R, McDermott MW, Chen C, Ferreira C, Hanft S, Shen C, Wanebo J, Smith K, Wardak Z, Patel T, Chamoun R, Hoang KB, Choutka O, Rodriguez A, Shah M, Brachman DG, Campbell L, Patel S. Surgically Targeted Radiation Therapy (STaRT) for Brain Metastases: Initial Experience from a Prospective Multi-Institutional Registry. Int J Radiat Oncol Biol Phys 2023; 117:e120. [PMID: 37784668 DOI: 10.1016/j.ijrobp.2023.06.908] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Resection and intraoperative brachytherapy for patients with large, operable brain metastasis allows for both relief of mass effect and the delivery of radiotherapy (RT) to the resection cavity with a favorable dosimetric profile. The objective of this study was to analyze early patterns-of-care and treatment-related toxicity outcomes for brain metastasis patients treated with surgically targeted radiation therapy (STaRT) using a novel brachytherapy carrier. MATERIALS/METHODS Patients with brain metastasis, de novo and recurrent disease, who enrolled onto a prospective multi-institutional observational study (NCT04427384) were the subject of this analysis. Patients underwent resection and immediate implantation of bioresorbable, conformable, 20 mm x 20 mm x 4 mm collagen tile brachytherapy device(s) containing four uniform-intensity Cesium-131 sources. Toxicities were categorized using the CTCAE v5.0 adverse event (AE) criteria. RESULTS From 10/2020 to 01/2023, 13 participating sites enrolled and treated 48 patients with 51 metastases (13 with de novo and 35 patients with recurrent brain metastases), and 3 patients had 2 lesions implanted at the same procedure. Median age was 61 years (range: 28-80), 52% were female, and the most common primary types were lung (56%) and breast (13%). The median maximum pre-operative dimension was 3.4 cm (range: 1.7-5.7) and median pre-operative tumor volume 13.7cm3 (range: 1.7-132). 64% had received prior RT with a median time from last RT to STaRT of 14.6 months range: 3.5-57.3). Median KPS at screening was 80 (range: 50-100), and remained stable at post op visit (80, range: 50-100), and at 3-months following treatment (80, range 50-100), respectively (p>0.05). The median time for implantation was 3 minutes (range: 0.4-30). At a median follow-up of 4 months (range: <1-18), no patient experienced a radiation-attributed AE, and only 1 attributable Gr >3 AE was noted (Gr 5 intracerebral hemorrhage deemed probably related to surgery and unrelated to the implanted device). CONCLUSION Early results from this prospective multi-center trial demonstrate the feasibility and safety of STaRT. The lack of radiation-related AE, even with short follow-up, is intriguing given the relatively large lesion size and proportion of patients treated for recurrent, previously irradiated disease. Additional follow-up will provide data on tumor control outcomes and radiation necrosis rates using this novel technique.
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Affiliation(s)
- R Kotecha
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - M W McDermott
- Department of Neurosurgery, Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL
| | - C Chen
- Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, MN
| | - C Ferreira
- Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN
| | - S Hanft
- Westchester Medical Center, Valhalla, NY
| | - C Shen
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - J Wanebo
- Honor Health Research Institute, Scottsdale, AZ
| | - K Smith
- Barrow Neurological Institute, Phoenix, AZ
| | - Z Wardak
- University of Texas Southwestern Medical Center, Dallas, TX
| | - T Patel
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - R Chamoun
- University of Kansas Medical Center, Kansas City, KS
| | - K B Hoang
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA
| | - O Choutka
- St. Alphonsus Regional Medical Center, Boise, ID
| | - A Rodriguez
- University of Arkansas for Medical Sciences, Director of Neurosurgical Oncology, Little Rock, AR
| | - M Shah
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN; Indiana University Health North Hospital, Indianapolis, IN
| | | | | | - S Patel
- GT Medical Technologies, Tempe, AZ
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21
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Affiliation(s)
- S Patel
- University Dental Hospital Manchester, Manchester, UK.
| | - J Darcey
- University Dental Hospital Manchester, Manchester, UK.
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Olatunji EO, Kisukari JD, Adeneye S, Mkhize T, Patel S, Joseph AO, Studen A, Ajose A, Alabi A, Swanson W, Ngoma TA, Wijesooriya K, Avery SM, Lehmann J, Graef K, Li H, Huq S, Ngwa W, Incrocci L, Mallum AAI. Can Advanced Radiotherapy Clinical Trials be Conducted in Resources Limited Countries? Int J Radiat Oncol Biol Phys 2023; 117:e604-e605. [PMID: 37785822 DOI: 10.1016/j.ijrobp.2023.06.1972] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The Lancet Oncology Commission on Cancer in Sub-Saharan Africa (SSA) highlighted the region's increasing cancer incidence and mortality, and recommended a series of actions to address this growing crisis. One such approach recommended by the Commission to increase access to curative treatment is the use of hypofractionated radiotherapy (HFRT). Here we highlight the barriers and facilitators to launching HFRT in SSA, as identified through the HypoAfrica clinical trial. MATERIALS/METHODS HypoAfrica is a longitudinal multi-center clinical trial that was launched in late 2021 at three centers in Nigeria, Tanzania, and South Africa. The goal of HypoAfrica was to assess the feasibility of implementing HFRT for localized prostate cancer in SSA. To date, 155 of 182 subjects have been enrolled in this study. During the last year, a team of radiation oncology professionals from Africa, Europe, Australia, and USA met once every Saturday and reviewed the sites' data to identify the barriers to the implementation of HFRT and find solutions to overcome these challenges. With the intent to expand HFRT trials and practice to new SSA countries and radiotherapy centers, we also conducted an online survey to elucidate the readiness of radiotherapy centers across SSA to perform HFRT. RESULTS The major challenge identified by this team was securing high-quality data that will yield statistically significant results. Factors that contribute to quality data are: harmonization of machine and patient-specific quality assurance (QA) procedures across the centers, data quality harmonization, and challenges associated with machine maintenance. Immediate solutions implemented included introduction of low-cost QA tools for patient-specific QA measurements, ongoing training of the site's healthcare professionals, implementation of preventative maintenance for Linacs, and data centralization infrastructure. These actions have resulted in the production of a high-quality, standardized dataset. Planned longer-term solutions to HFRT challenges include implementation of ongoing training, telehealth for remote support and QA, and the creation of an Imaging and Radiation Oncology Core for Africa. The online survey indicated that 61% of respondents' institutions perform HFRT for palliative purposes, emphasizing the readiness of sites in SSA to utilize HFRT for curative purposes. CONCLUSION The study serves as a useful guide for increasing access to HFRT treatment in resource-limited settings and for conducting multicenter radiotherapy clinical trials.
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Affiliation(s)
| | - J Dachi Kisukari
- Ocean Road Cancer Institute, Dar Es Salam, United Republic of Tanzania
| | - S Adeneye
- NSIA-LUTH Cancer Center, Lagos, Nigeria
| | - T Mkhize
- Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - S Patel
- Johns Hopkins Medicine, Baltimore, MD
| | | | - A Studen
- University of Ljubljana, Ljubljana, Slovenia
| | - A Ajose
- Lagos University Teaching Hospital, Lagos, Nigeria
| | - A Alabi
- Lagos University Teaching Hospital, Lagos, Nigeria
| | - W Swanson
- Weill Cornell Medicine, New York City, NY
| | - T A Ngoma
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - K Wijesooriya
- Department of Radiation Oncology, University of Virginia, Charlottesville, VA
| | - S M Avery
- University of Pennsylvania, Philadelphia, PA
| | - J Lehmann
- Calvary Mater Newcastle, Newcastle, Australia
| | - K Graef
- BIO Ventures for Global Health, Seattle, WA
| | - H Li
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - S Huq
- UPMC Hillman Cancer Center, Pittsburgh, PA
| | - W Ngwa
- John Hopkins University Hospital, Baltimore, MD
| | - L Incrocci
- Department of Radiotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A A I Mallum
- Inkosi Albert Luthuli Central Hospital, Durban, South Africa; University of KwaZulu Natal, Durban, South Africa
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23
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Patel S, Olatunji EO, Mallum AAI, Benjika B, Joseph AO, Joseph S, Lasebikan N, Mahuna H, Ngoma M, Ngoma TA, Nnko G, Chigbo DC, Vorster M, Ngwa W. Expanding Radiotherapy Access in Sub-Saharan Africa: An Analysis of Travel Burdens and Patient-Related Benefits of Hypofractionation. Int J Radiat Oncol Biol Phys 2023; 117:e613. [PMID: 37785843 DOI: 10.1016/j.ijrobp.2023.06.1989] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The purpose of this project was to examine the travel burdens for radiotherapy patients in Nigeria, Tanzania, and South Africa, and to assess the patient-related benefits of hypofractionated radiotherapy (HFRT) for breast and prostate cancer patients in these countries. The outcomes can inform the implementation of the recent Lancet Oncology Commission recommendations on increasing the adoption of HFRT in Sub-Saharan Africa (SSA) to enhance radiotherapy access in the region. MATERIALS/METHODS Data were extracted from electronic patient records at the NSIA-LUTH Cancer Center (NLCC) in Lagos, Nigeria and the Inkosi Albert Luthuli Central Hospital (IALCH) in Durban, South Africa, from written records at the University of Nigeria Teaching Hospital (UNTH) Oncology Center in Enugu, Nigeria, and from phone interviews at Ocean Road Cancer Institute (ORCI) in Dar Es Salaam, Tanzania. Google Maps was used to calculate the shortest driving distance between a patient's home address and their respective radiotherapy center. QGIS was used to map the straight-line distances to each center. Descriptive statistics were used to compare transportation costs, time expenditures, and lost wages when using HFRT versus conventionally fractionated radiotherapy (CFRT) for breast and prostate cancer. All transportation- and wage-related cost data were contextualized within each country's monthly adjusted net national income (MANNI) per capita, as reported by 2020 data from the World Bank. RESULTS Patients in Nigeria (n = 390) traveled a median distance of 24.0 km (interquartile range (IQR) = 238.5 km) to NLCC and 86.7 km (IQR = 87.3 km) to UNTH, patients in Tanzania (n = 23) traveled a median distance of 537.0 km (IQR = 587.5 km) to ORCI, and patients in South Africa (n = 412) traveled a median distance of 18.0 km (IQR = 15.0 km) to IALCH. Estimated transportation cost savings for breast cancer patients in Lagos and Enugu were 12,895 Naira and 7,369 Naira (20% and 11% of MANNI per capita), respectively, and for prostate cancer patients were 25,329 and 14,276 Naira (38% and 22% of MANNI per capita), respectively. Prostate cancer patients in Tanzania saved a median of 137,765 Shillings (78% of MANNI per capita) in transportation costs. Significant time expenditures - a relevant consideration for patient convenience - were also saved for ORCI patients, including a median of 80.0 hours (includes travel, treatment, and wait times). Mean transportation cost savings for patients in South Africa were 4,777 Rand (72% of MANNI per capita) for breast cancer and 9,486 Rand (143% of MANNI per capita) for prostate cancer. CONCLUSION Cancer patients in SSA travel considerable distances to access radiotherapy services. HFRT decreases patient-related costs and time expenditures, which may increase radiotherapy access and alleviate the growing burden of cancer in the region.
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Affiliation(s)
- S Patel
- Johns Hopkins Medicine, Baltimore, MD
| | | | - A A I Mallum
- University of KwaZulu-Natal, Durban, South Africa
| | - B Benjika
- ICT University USA, Yaounde, Cameroon
| | | | - S Joseph
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - N Lasebikan
- University of Nigeria Teaching Hospital Enugu, Enugu, Nigeria
| | - H Mahuna
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - M Ngoma
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - T A Ngoma
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - G Nnko
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - D C Chigbo
- University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - M Vorster
- University of KwaZulu-Natal, Durban, South Africa
| | - W Ngwa
- John Hopkins University Hospital, Baltimore, MD
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24
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Thawani N, Lee J, Kirsch C, Pinnaduwage D, Srivastava SP, Patel S, Sorensen SP, Jani S, Ellefson S, Vasireddy S, Riley J, Jennifer M, Diaz AZ, Gagliano R, Patel M. Implementation Science in Radiation Oncology: Case Study for Liver SBRT. Int J Radiat Oncol Biol Phys 2023; 117:e404. [PMID: 37785348 DOI: 10.1016/j.ijrobp.2023.06.1542] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The translation of research into clinical practice is challenging and implementation science is becoming as important as the trial design and development. Implementation science methodologies have been shown to reduce research-to-practice gap in other clinical settings. This is especially true for the field of Radiation Oncology where modern hypofractionated techniques, like Stereotactic Ablative Body Radiotherapy for Liver are at a high risk of over enthusiastic implementation as well as underutilization. We present the results of a multicomponent implementation methodology utilized to develop our Liver SBRT program as a model to safely translate a complex technology into clinical practice. MATERIALS/METHODS After review of literature and market research a setup was created with focus on machine requirements, immobilization devices, motion management techniques and QA techniques. Clinical tools in the form of checklists were developed for patient selection, simulation along with image fusion, target delineation, planning (conformity indices, dose constraint criteria) and treatment delivery. All patients were treated on Truebeam® after Bodyfix® immobilization with plastic wrap. Planning was completed on Eclipse TPS with dose constraints and conformity guidelines defined per the RTOG 1112 and TG 101. Clinical outcomes including clinical and imaging follow-up for tumor control and toxicity were recorded. For this report, all patients treated were reviewed and compared to published data to assess the success of the implementation methodology. RESULTS A total of 64 consecutive Patients treated with liver SBRT at Dignity Health Cancer Institute (DHCI) were eligible for the study. 58 patients treated for primary liver malignancies were included in this analysis to assess outcomes including control of disease and toxicity to compare to the published literature. Median follow up for these patients 6.5 months (4-46mnths). Median GTV volume was 38.7cc (0.1cc-2056.1 cc), median PTV volume was 159.35 cc (21.5cc-2673.5cc). Median SBRT prescription dose was 50 Gy/5 fractions (35-50 Gy). Median Liver- GTV was 1595.8 cc(770.7cc-2983.0cc). Following toxicities were noted- Grade 1- 10.3%, Grade 2 - 1.72%, Grade 3- 3.44%. No Grade 4 toxicity was noted. 1 year LC rate was 96.6%. 8.6% showed out of field liver failure and 6.9% developed distant metastasis. These results were compared to the current published literature and are shown to be comparable. CONCLUSION Strong and well thought out Implementation methodologies can ensure reproducing results in clinical practice, comparable to the controlled environment of trials. These are crucial in translation of clinical trials utilizing advanced technologies to promote the culture of safety in clinical practice of Radiation Oncology. Regular assessment and tracking of clinical outcomes can be used as Quality markers for directing care and reimbursements for future.
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Affiliation(s)
- N Thawani
- Dignity Health Cancer Institute/ CUSOM/ UACC, Phoenix, AZ
| | - J Lee
- Dignity Health Cancer Institute/ CUSOM/ UACC, Phoenix, AZ
| | - C Kirsch
- Creighton School of Medicine- Phoenix, Phoenix, AZ
| | - D Pinnaduwage
- St. Joseph's Hospital and Medical Center, Phoenix, AZ
| | | | - S Patel
- University of Arizona Cancer Center / Dignity Health Saint Joseph Hospital, Phoenix, AZ
| | - S P Sorensen
- University of Arizona Cancer Center / Dignity Health Saint Joseph Hospital, Phoenix, AZ
| | - S Jani
- University of Arizona Cancer Center / Dignity Health Saint Joseph Hospital, Phoenix, AZ
| | - S Ellefson
- Dignity Health Cancer Institute, Phoenix, AZ
| | - S Vasireddy
- University of Arizona Cancer Center, Phoenix, AZ, United States
| | - J Riley
- St. Joseph's Hospital and Medical Center, Phoenix, AZ
| | - M Jennifer
- Dignity Health cancer Institute, Phoenix, AZ
| | - A Z Diaz
- Dignity Health Cancer Institute, Phoenix, AZ
| | - R Gagliano
- Dignity Health Cancer Institute, Phoenix, AZ
| | - M Patel
- Dignity Health Cancer Institute, Phoenix, AZ
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25
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Shah K, Ghosh J, Patel S, Chowdhuri MB, Jadeja KA, Shukla G, Macwan T, Kumar A, Dolui S, Singh K, Tanna RL, Patel KM, Dey R, Manchanda R, Ramaiya N, Kumar R, Aich S, Yadava N, Purohit S, Gupta MK, Nagora UC, Pathak SK, Atrey PK, Mayya KBK. Role of pinch in Argon impurity transport in ohmic discharges of Aditya-U Tokamak. Sci Rep 2023; 13:16087. [PMID: 37752170 PMCID: PMC10522584 DOI: 10.1038/s41598-023-42746-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
We present experimental results of the trace argon impurity puffing in the ohmic plasmas of Aditya-U tokamak performed to study the argon transport behaviour. Argon line emissions in visible and Vacuum Ultra Violet (VUV) spectral ranges arising from the plasma edge and core respectively are measured simultaneously. During the experiments, space resolved brightness profile of Ar1+ line emissions at 472.69 nm (3p44s 2P3/2-3p44p 2D3/2), 473.59 nm (3p44s 4P5/2-3p44p 4P3/2), 476.49 nm (3p44s 2P1/2-3p44p 2P3/2), 480.60 nm (3p44s 4P5/2-3p44p 4P5/2) are recorded using a high resolution visible spectrometer. Also, a VUV spectrometer has been used to simultaneously observe Ar13+ line emission at 18.79 nm (2s22p 2P3/2-2s2p2 2P3/2) and Ar14+ line emission at 22.11 nm (2s2 1S0-2s2p 1P1). The diffusivity and convective velocity of Ar are obtained by comparing the measured radial emissivity profile of Ar1+ emission and the line intensity ratio of Ar13+ and Ar14+ ions, with those simulated using the impurity transport code, STRAHL. Argon diffusivities ~ 12 m2/s and ~ 0.3 m2/s have been observed in the edge (ρ > 0.85) and core region of the Aditya-U, respectively. The diffusivity values both in the edge and core region are found to be higher than the neo-classical values suggesting that the argon impurity transport is mainly anomalous in the Aditya-U tokamak. Also, an inward pinch of ~ 10 m/s mainly driven by Ware pinch is required to match the measured and simulated data. The measured peaked profile of Ar density suggests impurity accumulation in these discharges.
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Affiliation(s)
- K Shah
- Department of Physics, Pandit Deendayal Energy University, Raisan, Gandhinagar, 382 007, India.
| | - J Ghosh
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India.
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India.
| | - S Patel
- Department of Physics, Pandit Deendayal Energy University, Raisan, Gandhinagar, 382 007, India
| | - M B Chowdhuri
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - K A Jadeja
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Department of Nano Science and Advanced Materials, Saurashtra University, Rajkot, 360 005, India
| | - G Shukla
- ITER-India, Institute for Plasma Research, Koteshwar, Ahmedabad, 380 005, India
| | - T Macwan
- University of California, Los Angeles, CA, 90095, USA
| | - A Kumar
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - S Dolui
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - K Singh
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - R L Tanna
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Institute of Science, Nirma University, Ahmedabad, 382 481, India
| | - K M Patel
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - R Dey
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - R Manchanda
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - N Ramaiya
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - R Kumar
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - S Aich
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - N Yadava
- Institute of Science, Nirma University, Ahmedabad, 382 481, India
| | - S Purohit
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - M K Gupta
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - U C Nagora
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - S K Pathak
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - P K Atrey
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - K B K Mayya
- Department of Physics, Pandit Deendayal Energy University, Raisan, Gandhinagar, 382 007, India
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Osman A, Patel S, Gonsalves M, Renani S, Morgan R. Vascular Interventions in Oncology. Clin Oncol (R Coll Radiol) 2023:S0936-6555(23)00311-4. [PMID: 37805354 DOI: 10.1016/j.clon.2023.09.005] [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: 03/06/2023] [Revised: 07/21/2023] [Accepted: 09/13/2023] [Indexed: 10/09/2023]
Abstract
Vascular interventions are an important and established tool in the management of the oncology patient. The goal of these procedures may be curative, palliative or adjunctive in nature. Some of the common vascular interventions used in oncology include transarterial embolisation or chemoembolisation, selective internal radiation therapy, chemosaturation, venous access lines, superior vena cava stenting and portal vein embolisation. We provide an overview of the principles, technology and approach of vascular techniques for tumour therapy in both the arterial and venous systems. Arterial interventions are currently mainly used in the management of hepatocellular carcinoma. Transarterial embolisation, chemoembolisation and selective internal radiation therapy deliver targeted catheter-delivered treatments with the aim of reducing tumour burden, controlling tumour growth or increasing survival in patients not eligible for transplantation. Chemosaturation is a regional chemotherapy technique that delivers high doses of chemotherapy directly to the liver via the hepatic artery, while reducing the risks of systemic effects. Venous interventions are more adjunctive in nature. Venous access lines are used to provide a means of delivering chemotherapy and other medications directly into the bloodstream. Superior vena cava stenting is a palliative procedure that is used to relieve symptoms of superior vena cava obstruction. Portal vein embolisation is a procedure that allows hypertrophy of a healthy portion of the liver in preparation for liver resection. Interventional radiology-led vascular interventions play an essential part of cancer management. These procedures are minimally invasive and provide a safe and effective adjunct to traditional cancer treatment methods. Appropriate work-up and discussion of each patient-specific problem in a multidisciplinary setting with interventional radiology is essential to provide optimum patient-centred care.
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Affiliation(s)
- A Osman
- St George's Hospital University Hospitals NHS Foundation Trust, London, UK.
| | - S Patel
- St George's Hospital University Hospitals NHS Foundation Trust, London, UK
| | - M Gonsalves
- St George's Hospital University Hospitals NHS Foundation Trust, London, UK
| | - S Renani
- St George's Hospital University Hospitals NHS Foundation Trust, London, UK
| | - R Morgan
- St George's Hospital University Hospitals NHS Foundation Trust, London, UK
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Patel S, Jenkins P, Zhong J, Liu W, Harborne K, Modi S, Joy C, Williams R, Haslam P. Better safe than so ray: national survey of radiation protection amongst interventional radiology trainees in the United Kingdom. Br J Radiol 2023; 96:20230071. [PMID: 37493155 PMCID: PMC10461283 DOI: 10.1259/bjr.20230071] [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: 01/12/2023] [Revised: 05/30/2023] [Accepted: 06/14/2023] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVE To establish the provision and use of radiation personal protective equipment (PPE) and dosimetry amongst UK interventional radiology (IR) trainees and highlight areas of improvement in order to enhance the radiation safety. METHODS A survey questionnaire was designed by members of the British Society of Interventional Radiology (BSIR) trainee committee via survey monkey and distributed to UK IR trainees via the BSIR membership mailing list, local representatives and Twitter. The survey was open from 04/01/2021 to 20/02/2021. Only IR trainees in years ST4 and above were included. RESULTS Of the 73 respondents, 62 qualified for analysis. Respondents (81% male) spent a median of 5.5 sessions (half day list) per week in the angiography suite and 58% (n=36) had difficulty finding appropriately sized lead aprons at least once a week. Overall 53% (n=33) had concerns about their radiation PPE. Furthermore 56% of trainees (n=35) experienced back pain among other symptoms attributed to wearing the lead aprons available to them. 77% (n=48) regularly wore lead glasses. For trainees requiring prescription glasses (n=22) overfit goggles were provided however 17 (77%) of these trainees felt the goggles compromised their ability to perform the procedure. Eye and finger dosimeters were used by 50% and 52% of respondents respectively. Compliance with body dosimetry was 99%. CONCLUSION Provision of radiation PPE and dose monitoring for IR trainees is suboptimal, particularly access to adequate eye protection or suitably fitting leads. Based on the findings of this survey, recommendations have been made to promote the safety and radiation awareness of IR trainees. ADVANCES IN KNOWLEDGE Radiation protection practices for IR trainees nationally are poor. Provision of suitable eye protection and well fitting lead body protection is low.
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Affiliation(s)
| | | | | | - W Liu
- University Hospitals Coventry and Warwickshire, Coventry, United Kingdom
| | - K Harborne
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | | | - C Joy
- University Hospital Southampton, Southampton, United Kingdom
| | - R Williams
- Freeman Hospital, The Newcastle Upon Tyne Hospitals NHS Foundation, London, United Kingdom
| | - P Haslam
- Freeman Hospital, The Newcastle Upon Tyne Hospitals NHS Foundation, London, United Kingdom
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Gunaratne GS, Brailoiu E, Kumar S, Yuan Y, Slama JT, Walseth TF, Patel S, Marchant JS. Convergent activation of two-pore channels mediated by the NAADP-binding proteins JPT2 and LSM12. Sci Signal 2023; 16:eadg0485. [PMID: 37607218 PMCID: PMC10639087 DOI: 10.1126/scisignal.adg0485] [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: 11/30/2022] [Accepted: 07/27/2023] [Indexed: 08/24/2023]
Abstract
The second messenger nicotinic acid adenine dinucleotide phosphate (NAADP) evokes calcium ion (Ca2+) release from endosomes and lysosomes by activating two-pore channels (TPCs) on these organelles. Rather than directly binding to TPCs, NAADP associates with proteins that indirectly confer NAADP sensitivity to the TPC complex. We investigated whether and how the NAADP-binding proteins Jupiter microtubule-associated homolog 2 (JPT2) and like-Sm protein 12 (LSM12) contributed to NAADP-TPC-Ca2+ signaling in human cells. Biochemical and functional analyses revealed that recombinant JPT2 and LSM12 both bound to NAADP with high affinity and that endogenous JPT2 and LSM12 independently associated with TPC1 and TPC2. On the basis of knockout and rescue analyses, both NAADP-binding proteins were required to support NAADP-evoked Ca2+ signaling and contributed to endolysosomal trafficking of pseudotyped coronavirus particles. These data reveal that the NAADP-binding proteins JPT2 and LSM12 convergently regulate NAADP-evoked Ca2+ release and function through TPCs.
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Affiliation(s)
- Gihan S. Gunaratne
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Eugen Brailoiu
- Center for Substance Abuse Research and Department of Neural Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Sushil Kumar
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Yu Yuan
- Department of Cell and Developmental Biology, University College London, Gower Street, London WC1E 6BT, UK
| | - James T. Slama
- Department of Medicinal and Biological Chemistry, University of Toledo College of Pharmacy and Pharmaceutical Sciences, 3000 Arlington Avenue, Toledo, OH 43614, USA
| | - Timothy F. Walseth
- Department of Pharmacology, University of Minnesota Medical School, 312 Church St., Minneapolis, MN 55455, USA
| | - Sandip Patel
- Department of Cell and Developmental Biology, University College London, Gower Street, London WC1E 6BT, UK
| | - Jonathan S. Marchant
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
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Saito R, Mu Q, Yuan Y, Rubio-Alarcón M, Eznarriaga M, Zhao P, Gunaratne G, Kumar S, Keller M, Bracher F, Grimm C, Brailoiu E, Marchant JS, Rahman T, Patel S. Convergent activation of Ca 2+ permeability in two-pore channel 2 through distinct molecular routes. Sci Signal 2023; 16:eadg0661. [PMID: 37607219 PMCID: PMC10639088 DOI: 10.1126/scisignal.adg0661] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 11/30/2022] [Accepted: 07/27/2023] [Indexed: 08/24/2023]
Abstract
TPC2 is a pathophysiologically relevant lysosomal ion channel that is activated directly by the phosphoinositide PI(3,5)P2 and indirectly by the calcium ion (Ca2+)-mobilizing molecule NAADP through accessory proteins that associate with the channel. TPC2 toggles between PI(3,5)P2-induced, sodium ion (Na+)-selective and NAADP-induced, Ca2+-permeable states in response to these cues. To address the molecular basis of polymodal gating and ion-selectivity switching, we investigated the mechanism by which NAADP and its synthetic functional agonist, TPC2-A1-N, induced Ca2+ release through TPC2 in human cells. Whereas NAADP required the NAADP-binding proteins JPT2 and LSM12 to evoke endogenous calcium ion signals, TPC2-A1-N did not. Residues in TPC2 that bind to PI(3,5)P2 were required for channel activation by NAADP but not for activation by TPC2-A1-N. The cryptic voltage-sensing region of TPC2 was required for the actions of TPC2-A1-N and PI(3,5)P2 but not for those of NAADP. These data mechanistically distinguish natural and synthetic agonist action at TPC2 despite convergent effects on Ca2+ permeability and delineate a route for pharmacologically correcting impaired NAADP-evoked Ca2+ signals.
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Affiliation(s)
- Ryo Saito
- Department of Cell and Developmental Biology, University
College London, Gower Street, London WC1E 6BT, UK
- Department of Dermatology, Graduate School of Biomedical
and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Qianru Mu
- Department of Cell and Developmental Biology, University
College London, Gower Street, London WC1E 6BT, UK
| | - Yu Yuan
- Department of Cell and Developmental Biology, University
College London, Gower Street, London WC1E 6BT, UK
| | | | - Maria Eznarriaga
- Department of Pharmacology, University of Cambridge,
Cambridge, UK
| | - Pingwei Zhao
- Center for Substance Abuse Research, Lewis Katz School of
Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Gihan Gunaratne
- Department of Cell Biology, Neurobiology and Anatomy,
Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226,
USA
| | - Sushil Kumar
- Department of Cell Biology, Neurobiology and Anatomy,
Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226,
USA
| | - Marco Keller
- Department of Pharmacy—Center for Drug Research,
Ludwig-Maximilian University, Munich, Germany
| | - Franz Bracher
- Department of Pharmacy—Center for Drug Research,
Ludwig-Maximilian University, Munich, Germany
| | - Christian Grimm
- Walther Straub Institute of Pharmacology and Toxicology,
Faculty of Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Eugen Brailoiu
- Center for Substance Abuse Research, Lewis Katz School of
Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Jonathan S. Marchant
- Department of Cell Biology, Neurobiology and Anatomy,
Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226,
USA
| | - Taufiq Rahman
- Department of Pharmacology, University of Cambridge,
Cambridge, UK
| | - Sandip Patel
- Department of Cell and Developmental Biology, University
College London, Gower Street, London WC1E 6BT, UK
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Weitz J, Garg B, Martsinkovskiy A, Patel S, Tiriac H, Lowy AM. Pancreatic ductal adenocarcinoma induces neural injury that promotes a transcriptomic and functional repair signature by peripheral neuroglia. Oncogene 2023; 42:2536-2546. [PMID: 37433986 PMCID: PMC10880465 DOI: 10.1038/s41388-023-02775-7] [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: 03/20/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 07/13/2023]
Abstract
Perineural invasion (PNI) is the phenomenon whereby cancer cells invade the space surrounding nerves. PNI occurs frequently in epithelial malignancies, but is especially characteristic of pancreatic ductal adenocarcinoma (PDAC). The presence of PNI portends an increased incidence of local recurrence, metastasis and poorer overall survival. While interactions between tumor cells and nerves have been investigated, the etiology and initiating cues for PNI development is not well understood. Here, we used digital spatial profiling to reveal changes in the transcriptome and to allow for a functional analysis of neural-supportive cell types present within the tumor-nerve microenvironment of PDAC during PNI. We found that hypertrophic tumor-associated nerves within PDAC express transcriptomic signals of nerve damage including programmed cell death, Schwann cell proliferation signaling pathways, as well as macrophage clearance of apoptotic cell debris by phagocytosis. Moreover, we identified that neural hypertrophic regions have increased local neuroglial cell proliferation which was tracked using EdU tumor labeling in KPC mice, as well as frequent TUNEL positivity, suggestive of a high turnover rate. Functional calcium imaging studies using human PDAC organotypic slices confirmed nerve bundles had neuronal activity, as well as contained NGFR+ cells with high sustained calcium levels, which are indicative of apoptosis. This study reveals a common gene expression pattern that characterizes solid tumor-induced damage to local nerves. These data provide new insights into the pathobiology of the tumor-nerve microenvironment during PDAC as well as other gastrointestinal cancers.
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Affiliation(s)
- Jonathan Weitz
- Department of Surgery, University of California, San Diego, La Jolla, CA, CA 92093, USA.
| | - Bharti Garg
- Department of Surgery, University of California, San Diego, La Jolla, CA, CA 92093, USA
| | - Alexei Martsinkovskiy
- Department of Surgery, University of California, San Diego, La Jolla, CA, CA 92093, USA
| | - Sandip Patel
- Division of Hematology-Oncology in the Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Herve Tiriac
- Department of Surgery, University of California, San Diego, La Jolla, CA, CA 92093, USA
| | - Andrew M Lowy
- Department of Surgery, University of California, San Diego, La Jolla, CA, CA 92093, USA.
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Mughal Z, Patel S, Gupta KK, Metcalfe C, Beech T, Jennings C. Evaluating the perceptions of workplace-based assessments in surgical training: a systematic review. Ann R Coll Surg Engl 2023; 105:507-512. [PMID: 36374289 PMCID: PMC10313445 DOI: 10.1308/rcsann.2022.0113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION Workplace-based assessments (WBAs) are intended to maximise learning opportunities in surgical training. There is speculation as to whether mandatory assessments in this form contribute to a tick-box culture. The objective of this review was to investigate surgical trainees' attitudes towards WBAs. METHODS This systematic review of qualitative studies was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement. The literature was searched on the Medline®, Embase™, PubMed and Web of Science™ databases on 22 March 2022. RESULTS Sixteen studies were included in the review, mostly carried out on users of the Intercollegiate Surgical Curriculum Programme portfolio in the UK. Trainees felt that WBAs were educationally useful, providing opportunity for feedback, but this was overshadowed by a pressure to reach a set annual quota for WBAs and achieve high scores. Other themes included inaccurate recording of WBAs, the role of WBAs as formative or summative assessments, engagement and accessibility of trainers, and lack of time to complete WBAs. CONCLUSIONS Negative perceptions about WBAs were widespread among surgical trainees despite a recognition of their capacity to facilitate learning. This review supports the recent removal of the annual quota for WBAs in UK surgical training programmes.
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Affiliation(s)
- Z Mughal
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - S Patel
- Shrewsbury and Telford Hospital NHS Foundation Trust, UK
| | - K Kumar Gupta
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - C Metcalfe
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - T Beech
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - C Jennings
- University Hospitals Birmingham NHS Foundation Trust, UK
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Belfrage SL, Husted M, Fraser S, Patel S, Faulkner JA. A systematic review of the effectiveness of community-based interventions aimed at improving health literacy of parents/carers of children. Perspect Public Health 2023:17579139231180746. [PMID: 37381897 DOI: 10.1177/17579139231180746] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
AIM The aim of this systematic review was to examine the effectiveness of community-based health literacy interventions in improving the health literacy of parents. METHODS A systematic review of six databases - MEDLINE, PsycINFO, CINAHL, Cochrane Library, Embase, and Education Source - was conducted to identify relevant articles. Risk of bias was assessed using version two of the Cochrane risk of bias tool for randomised controlled trials or the Cochrane collaboration risk of bias in non-randomised studies of interventions. The study findings were grouped and synthesised following the synthesis without meta-analysis framework. RESULTS Eleven community-based health literacy interventions for parents were identified. Study design included randomised controlled trials (n = 4), non-randomised studies with comparison group (n = 4), and non-randomised studies without a comparison group (n = 3). Interventions were delivered digitally, in person or a combination of the two. The risk of bias was high in over half the studies (n = 7). The main findings of the studies showed some potential for both in person and digital interventions to increase parental health literacy. Studies were heterogeneous preventing a meta-analysis. CONCLUSION Community-based, health literacy interventions have been identified as potential methods for enhancing parental health literacy. Due to the small number of included studies and their potential for bias, these results must be interpreted with caution. This study emphasises the need for additional theory and evidence-based research on the long-term effects of community interventions.
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Affiliation(s)
- S L Belfrage
- University of Winchester, Winchester SO22 4NR, UK
| | - M Husted
- University of Winchester, Winchester, UK
| | - Sds Fraser
- University of Southampton, Southampton, UK
| | - S Patel
- Southampton Children's Hospital, Southampton, UK
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33
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Pollard AJ, Garner S, Patel S, Jerreat M. A Retrospective Service- Evaluation of Implant Success, Survival, Periimplant Health and Prosthetic Complications in a Cohort of Head and Neck Cancer Patients. Eur J Prosthodont Restor Dent 2023; 31:92-103. [PMID: 35917210 DOI: 10.1922/ejprd_2441pollard12] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To determine the success, survival, peri-implant health and prosthetic complications in head and neck cancer patients receiving oral rehabilitation utilising dental implants between 2008 and the present day. MATERIALS AND METHODS Service evaluation. Survival Group: Retrospective review of records to determine implant survival and prosthetic complications. Success Group: Examination to determine implant success and health. RESULTS Survival Group: 260 implants in 81 individuals, median follow up 49.2 months. 89.3% implant survival at 96 months, no further failures up to 133 months. 40.9% individuals required repair or remake of prosthesis by 72 months - mostly denture re-lines. Success group: 164 implants in 48 individuals, median follow up 56 months. Peri-implant mucositis detected in 22% of fixtures (37.5% individuals); peri-implantitis in 12.8% (25% individuals); 33.3% fixtures exhibiting periimplantitis at 120 months. Previous smoking significantly associated with development of peri-implantitis (HR 2.372, p=0.032, 95CI:1.232, 93.317). Compromised survival (e.g. peri-implantitis), absolute (not in mouth) or clinical failure estimated to occur in 28.1% fixtures at 101 months, mostly due to peri-implantitis. CONCLUSIONS There is a large burden of ongoing care in this cohort, requiring interventions to improve peri-implant health and maintain complex prostheses. Oral rehabilitation and ongoing maintenance in this cohort is complex and multi-disciplinary.
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Affiliation(s)
- A J Pollard
- University of Bristol Dental Hospital, Bristol
- Musgrove Park Hospital, Taunton
- Peninsula Dental School, University of Plymouth, Plymouth
| | - S Garner
- University of Bristol Dental Hospital, Bristol
- Musgrove Park Hospital, Taunton
| | - S Patel
- Musgrove Park Hospital, Taunton
| | - M Jerreat
- Musgrove Park Hospital, Taunton
- Peninsula Dental School, University of Plymouth, Plymouth
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Alonso MT, Torres-Vidal P, Calvo B, Rodriguez C, Delrio-Lorenzo A, Rojo-Ruiz J, Garcia-Sancho J, Patel S. Use of aequorin-based indicators for monitoring Ca 2+ in acidic organelles. Biochim Biophys Acta Mol Cell Res 2023; 1870:119481. [PMID: 37142127 DOI: 10.1016/j.bbamcr.2023.119481] [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] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/22/2023] [Accepted: 04/26/2023] [Indexed: 05/06/2023]
Abstract
Over the last years, there is accumulating evidence that acidic organelles can accumulate and release Ca2+ upon cell activation. Hence, reliable recording of Ca2+ dynamics in these compartments is essential for understanding the physiopathological aspects of acidic organelles. Genetically encoded Ca2+ indicators (GECIs) are valuable tools to monitor Ca2+ in specific locations, although their use in acidic compartments is challenging due to the pH sensitivity of most available fluorescent GECIs. By contrast, bioluminescent GECIs have a combination of features (marginal pH sensitivity, low background, no phototoxicity, no photobleaching, high dynamic range and tunable affinity) that render them advantageous to achieve an enhanced signal-to-noise ratio in acidic compartments. This article reviews the use of bioluminescent aequorin-based GECIs targeted to acidic compartments. A need for more measurements in highly acidic compartments is identified.
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Affiliation(s)
- M T Alonso
- Unidad de Excelencia, Instituto de Biomedicina y Genética Molecular de Valladolid (IBGM), Universidad de Valladolid y Consejo Superior de Investigaciones Científicas (CSIC), c/ Sanz y Forés 3, 47003 Valladolid, Spain.
| | - P Torres-Vidal
- Unidad de Excelencia, Instituto de Biomedicina y Genética Molecular de Valladolid (IBGM), Universidad de Valladolid y Consejo Superior de Investigaciones Científicas (CSIC), c/ Sanz y Forés 3, 47003 Valladolid, Spain
| | - B Calvo
- Unidad de Excelencia, Instituto de Biomedicina y Genética Molecular de Valladolid (IBGM), Universidad de Valladolid y Consejo Superior de Investigaciones Científicas (CSIC), c/ Sanz y Forés 3, 47003 Valladolid, Spain
| | - C Rodriguez
- Unidad de Excelencia, Instituto de Biomedicina y Genética Molecular de Valladolid (IBGM), Universidad de Valladolid y Consejo Superior de Investigaciones Científicas (CSIC), c/ Sanz y Forés 3, 47003 Valladolid, Spain
| | - A Delrio-Lorenzo
- Universidad Alfonso X el Sabio, Madrid, Avenida Universidad, 1, 28691 Villanueva de la Cañada, Madrid, Spain
| | - J Rojo-Ruiz
- Unidad de Excelencia, Instituto de Biomedicina y Genética Molecular de Valladolid (IBGM), Universidad de Valladolid y Consejo Superior de Investigaciones Científicas (CSIC), c/ Sanz y Forés 3, 47003 Valladolid, Spain
| | - J Garcia-Sancho
- Unidad de Excelencia, Instituto de Biomedicina y Genética Molecular de Valladolid (IBGM), Universidad de Valladolid y Consejo Superior de Investigaciones Científicas (CSIC), c/ Sanz y Forés 3, 47003 Valladolid, Spain
| | - S Patel
- Department of Cell and Developmental Biology, University College London, Gower Street, London WC1E 6BT, UK
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Patel P, Patel S, Chudasama P, Soni S, Raval M. Roflumilast alleviates adenine-induced chronic kidney disease by regulating inflammatory biomarkers. Eur J Pharmacol 2023; 949:175731. [PMID: 37075855 DOI: 10.1016/j.ejphar.2023.175731] [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: 04/19/2022] [Revised: 01/09/2023] [Accepted: 04/17/2023] [Indexed: 04/21/2023]
Abstract
The present investigation was carried out to explore the role of roflumilast, a PDE4 inhibitor, as a potential treatment option for chronic kidney disease. Forty-six male Wistar rats were divided into five groups: Control, Disease control (50 mg/kg Adenine p.o.), Adenine + Roflumilast (0.5, 1 and 1.5 mg/kg, p.o.). Various urinary and serum biomarkers, antioxidant status, histopathology, and protein expression of inflammatory markers were measured to investigate the effects of roflumilast on kidney functions. Adenine was found to elevate the levels of serum creatinine, urea, uric acid, sodium, potassium, chloride, magnesium, and phosphorus and reduce the level of serum calcium. Further, adenine significantly increased the serum TGF-β levels and reduced the anti-oxidant indices. Significant elevation was observed in protein expression of IL-1β, TNF-α, MCP-1, ICAM-1, and Fibronectin. Histopathologically, adenine caused thickening of the glomerular basement membrane, inflammatory cells infiltration, atrophy, and glomeruli deterioration. However, Roflumilast administration (1 mg/kg) remarkably decrease serum creatinine, urea, uric acid, sodium, potassium, chloride, magnesium, phosphorus by 61%, 40%, 44%, 41%, 49%, 58%, 59% and 42% respectively, and increase in calcium by 158%. Moreover, Roflumilast (1 mg/kg) significantly reduced serum TGF-β levels by 50% and elevated anti-oxidant indices by 257%, 112%, and 60%, respectively. The protein expression was significantly reduced by 5.5-fold, 7-fold, 5.7-fold, 6.2-fold, and 5.1-fold individually. Roflumilast noticeably improved the structure of glomeruli, tubules, and cellular functioning. The study confirmed that Roflumilast has the potential to ameliorate renal injury by reducing and regulating inflammatory responses.
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Affiliation(s)
- Priyal Patel
- Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology (CHARUSAT), At and Post: Changa-388421, Dist. Anand, Gujarat, India.
| | - Sandip Patel
- L.M. College of Pharmacy, Ahmedabad, 380009, Gujarat, India.
| | - Piyush Chudasama
- R&D Unit, Sat-Kaival Hospital Pvt. Ltd, Anand, 388001, Gujarat, India.
| | - Shailesh Soni
- Department of Pathology, Muljibhai Patel Urological Hospital, Nadiad, 387002, Gujarat, India
| | - Manan Raval
- Ramanbhai Patel College of Pharmacy, Charotar University of Science and Technology (CHARUSAT), At and Post: Changa-388421, Dist. Anand, Gujarat, India.
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Jaślan D, Patel S, Grimm C. New insights into gating mechanisms in TPCs: Relevance for drug discovery. Cell Calcium 2023; 112:102732. [PMID: 37031661 DOI: 10.1016/j.ceca.2023.102732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/11/2023]
Affiliation(s)
- Dawid Jaślan
- Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, Ludwig-Maximilians-Universität, Munich, Germany
| | - Sandip Patel
- Department of Cell and Developmental Biology, University College London, Gower Street, London WC1E 6BT, UK; Department of Pharmacology, Cambridge University, Tennis Court Road, Cambridge CB2 1QJ, UK
| | - Christian Grimm
- Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, Ludwig-Maximilians-Universität, Munich, Germany.
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Zou Y, Laothamatas K, Sonett J, Lemaitre P, Stanifer B, Magda G, Grewal H, Shah L, Robbins H, Patel S, Miller A, Anderson M, Costa J, D'Ovidio F, Arcasoy S, Benvenuto L. Effect of Age and Transplant Type on Survival and Hospital-Free Days in COPD Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1462] [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: 04/05/2023] Open
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38
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Alexy T, Patel S, Rochlani Y, Saeed O, Gjelaj C, Madan S, Shin J, Maharaj V, Goldstein D, Jorde U, Vukelic S. Risk of Acute Rejection in Heart Transplant Patients Treated with M-TOR Inhibitors. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.177] [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: 04/05/2023] Open
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Patel S, Uriel N, Nguyen A, Silvia B, Wolf-Doty T, Tian W, Qu K, Pinney S. Relationship Between Absolute Quantification of Donor-Derived Cell-Free DNA and Donor-Derived Cell-Free DNA Fraction for Detection of Allograft Rejection in Heart Transplant Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1107] [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: 04/05/2023] Open
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40
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Takahashi T, Kobayashi Y, Saeed O, Vukelic S, Jorde U, Shin J, Patel S. Optical Coherence Tomography Evaluation of Donor Transmitted Coronary Atherosclerosis and Risk of Cardiac Allograft Vasculopathy. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.170] [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: 04/05/2023] Open
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41
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Milwidsky A, Chan M, Travin M, Gjelaj C, Saeed O, Vukelic S, Rochlani Y, Madan S, Shin J, Sims D, Murthy S, Chavez P, Jorde U, Patel S. PET-CT Defined Micro-Vascular Dysfunction and Cardiac Allograft Vasculopathy Risk Factors in Heart Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.172] [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: 04/05/2023] Open
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42
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Balgobind A, Patel S, Varrias D, Safiriyu I, Villela MA. Left Ventricular Assist Device Therapy in “Cold and Dry” Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1639] [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: 04/05/2023] Open
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43
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Hirsch E, Nnani D, Patel S, Rochlani Y, Vukelic S, Shin J, Chavez P, Madan S, Sims D, Jorde U, Saeed O. Tolerability and Effectiveness of Intensified Statin after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.465] [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: 04/05/2023] Open
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44
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Greissman S, Laothamatas K, Costa J, D'Ovidio F, Grewal H, Lemaitre P, Magda G, Miller A, Patel S, Robbins H, Shah L, Sonnett J, Stanifer B, Arcasoy S, Benvenuto L. Comparison of Post-Transplant Survival Between Lung-Kidney and Lung Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1463] [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: 04/05/2023] Open
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45
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Teuteberg J, Pinney S, Khush K, Fei M, Yue J, Shen L, Patel S, Kanwar M, Shah P, Uriel N. A “Negative” Endomyocardial Biopsy after an Elevated Donor-Derived Cell Free DNA is Associated with Worse Survival after Heart Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1522] [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: 04/05/2023] Open
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46
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Saeed O, Farooq M, Chinnadurai T, Ramos J, Patel S, Chavez P, Rochlani Y, Murthy S, Shin J, Vukelic S, Sims D, Goldstein D, Jorde U. Platelet Function and Sildenafil Use During Left Ventricular Assist Device Support. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.152] [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: 04/05/2023] Open
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47
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Han J, Nguyen A, Tian W, Nguyen A, Zeng J, Shen L, DePasquale E, Patel S. Effect of Pre-Transplant Sensitization on Gene Expression Profiling and Donor Derived Cell Free DNA Results. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.572] [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: 04/05/2023] Open
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48
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Greissman S, Laothamatas K, Costa J, D'Ovidio F, Grewal H, Lemaitre P, Magda G, Miller A, Patel S, Robbins H, Shah L, Sonett J, Stanifer B, Arcasoy S, Benvenuto L. Lung Transplant Waitlist Outcomes Before and after 2021 LAS Revision. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1445] [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: 04/05/2023] Open
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49
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Novakovic M, Nnani D, Saeed O, Vukelic S, Rochlani Y, Madan S, Sims D, Shin J, Murthy S, Bazarbachi A, Chavez P, Jorde U, Patel S. Does Switching from Bactrim to Atovaquone Result in Less Hyperkalemia? A Single-Center Retrospective Analysis in Heart Transplant Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1252] [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: 04/05/2023] Open
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50
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Chauhan D, Patel S, Cohen S, Madan S, Goldstein D, Jorde U, Rochlani Y, Vukelic S, Shin J, Murthy S, Sims D, Forest S, Saeed O. Diminishing Effect of Blood Type on Waitlist and Heart Transplantation Outcomes in the Contemporary UNOS Allocation System. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1669] [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: 04/05/2023] Open
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