1
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Mejia E, Cole J, Soszyn N, Auerbach S, Morgan GJ. Percutaneous Stenting of a Stenotic Berlin Heart Outflow Cannula Graft in a 2 Year Old Child. ASAIO J 2023:00002480-990000000-00365. [PMID: 38039507 DOI: 10.1097/mat.0000000000002112] [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: 12/03/2023] Open
Abstract
Left ventricular assist device (LVAD) outflow obstruction is a rare complication of long-term LVAD support. We present the first case of successful percutaneous stent implantation in a pediatric patient with LVAD outflow obstruction.
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Affiliation(s)
- Ernesto Mejia
- From the Department of Pediatric Cardiology, The Heart Institute, Children's Hospital Colorado, University of Colorado, Aurora, Colorado
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2
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Combs P, Erickson J, Hsieh JH, Guo K, Nolte S, Schmitt C, Auerbach S, Hur J. Corrigendum: Tox21Enricher-Shiny: an R Shiny application for toxicity functional annotation analysis. Front Toxicol 2023; 5:1278066. [PMID: 37692902 PMCID: PMC10484597 DOI: 10.3389/ftox.2023.1278066] [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: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/12/2023] Open
Abstract
[This corrects the article DOI: 10.3389/ftox.2023.1147608.].
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Affiliation(s)
- Parker Combs
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
- National Institute of Environmental Health Sciences (NIH), Durham, NC, United States
| | - Jeremy Erickson
- National Institute of Environmental Health Sciences (NIH), Durham, NC, United States
| | - Jui-Hua Hsieh
- National Institute of Environmental Health Sciences (NIH), Durham, NC, United States
| | - Kai Guo
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
- Michigan Medicine, University of Michigan Health, Ann Arbor, MI, United States
| | - Sue Nolte
- National Institute of Environmental Health Sciences (NIH), Durham, NC, United States
| | - Charles Schmitt
- National Institute of Environmental Health Sciences (NIH), Durham, NC, United States
| | - Scott Auerbach
- National Institute of Environmental Health Sciences (NIH), Durham, NC, United States
| | - Junguk Hur
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
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3
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Law YM, Jacobs-Files E, Auerbach S, Lal AK, Richmond M, Schumacher K, Singh R, Desai A. A multi-site survey of providers on the management of heart failure with dilated cardiomyopathy in children. Cardiol Young 2023; 33:1296-1303. [PMID: 35957582 DOI: 10.1017/s1047951122002517] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We conducted a scientific survey of paediatric practitioners who manage heart failure with dilated cardiomyopathy in children. The survey covered management from diagnosis to treatment to monitoring, totalling 63 questions. There were 54 respondents from 40 institutions and 3 countries. There were diverse selections of management options by the respondents in general, but also unanimity in some management options. Variation in practice is likely due to the relative paucity of scientific data in this field and lack of strong evidence-based recommendations from guidelines, which presents an opportunity for future research and quality improvement efforts as the evidence base continues to grow.
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Affiliation(s)
- Yuk M Law
- Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA
| | | | - Scott Auerbach
- Department of Pediatrics, Children's Hospital of Colorado, Aurora, CO, USA
| | - Ashwin K Lal
- Department of Pediatrics, Primary Children's Hospital, Salt Lake City, UT, USA
| | - Marc Richmond
- Department of Pediatrics, Morgan Stanley Children's Hospital, New York, NY, USA
| | - Kurt Schumacher
- Department of Pediatrics, Mott's Children's Hospital, Ann Arbor, MI, USA
| | - Rakesh Singh
- Department of Pediatrics, New York University Langone Health, New York, NY, USA
| | - Arti Desai
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
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4
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Combs P, Erickson J, Hsieh JH, Guo K, Nolte S, Schmitt C, Auerbach S, Hur J. Tox21Enricher-Shiny: an R Shiny application for toxicity functional annotation analysis. Front Toxicol 2023; 5:1147608. [PMID: 37441091 PMCID: PMC10333489 DOI: 10.3389/ftox.2023.1147608] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
Inference of toxicological and mechanistic properties of untested chemicals through structural or biological similarity is a commonly employed approach for initial chemical characterization and hypothesis generation. We previously developed a web-based application, Tox21Enricher-Grails, on the Grails framework that identifies enriched biological/toxicological properties of chemical sets for the purpose of inferring properties of untested chemicals within the set. It was able to detect significantly overrepresented biological (e.g., receptor binding), toxicological (e.g., carcinogenicity), and chemical (e.g., toxicologically relevant chemical substructures) annotations within sets of chemicals screened in the Tox21 platform. Here, we present an R Shiny application version of Tox21Enricher-Grails, Tox21Enricher-Shiny, with more robust features and updated annotations. Tox21Enricher-Shiny allows users to interact with the web application component (available at http://hurlab.med.und.edu/Tox21Enricher/) through a user-friendly graphical user interface or to directly access the application's functions through an application programming interface. This version now supports InChI strings as input in addition to CASRN and SMILES identifiers. Input chemicals that contain certain reactive functional groups (nitrile, aldehyde, epoxide, and isocyanate groups) may react with proteins in cell-based Tox21 assays: this could cause Tox21Enricher-Shiny to produce spurious enrichment analysis results. Therefore, this version of the application can now automatically detect and ignore such problematic chemicals in a user's input. The application also offers new data visualizations, and the architecture has been greatly simplified to allow for simple deployment, version control, and porting. The application may be deployed onto a Posit Connect or Shiny server, and it uses Postgres for database management. As other Tox21-related tools are being migrated to the R Shiny platform, the development of Tox21Enricher-Shiny is a logical transition to use R's strong data analysis and visualization capacities and to provide aesthetic and developmental consistency with other Tox21 applications developed by the Division of Translational Toxicology (DTT) at the National Institute of Environmental Health Sciences (NIEHS).
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Affiliation(s)
- Parker Combs
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
- National Institute of Environmental Health Sciences, Durham, NC, United States
| | - Jeremy Erickson
- National Institute of Environmental Health Sciences, Durham, NC, United States
| | - Jui-Hua Hsieh
- National Institute of Environmental Health Sciences, Durham, NC, United States
| | - Kai Guo
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
- Michigan Medicine, University of Michigan Health, Ann Arbor, MI, United States
| | - Sue Nolte
- National Institute of Environmental Health Sciences, Durham, NC, United States
| | - Charles Schmitt
- National Institute of Environmental Health Sciences, Durham, NC, United States
| | - Scott Auerbach
- National Institute of Environmental Health Sciences, Durham, NC, United States
| | - Junguk Hur
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
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5
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Almond CS, Sleeper LA, Rossano JW, Bock MJ, Pahl E, Auerbach S, Lal A, Hollander SA, Miyamoto SD, Castleberry C, Lee J, Barkoff LM, Gonzales S, Klein G, Daly KP. The teammate trial: Study design and rationale tacrolimus and everolimus against tacrolimus and MMF in pediatric heart transplantation using the major adverse transplant event (MATE) score. Am Heart J 2023; 260:100-112. [PMID: 36828201 DOI: 10.1016/j.ahj.2023.02.002] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 01/31/2023] [Accepted: 02/05/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Currently there are no immunosuppression regimens FDA-approved to prevent rejection in pediatric heart transplantation (HT). In recent years, everolimus (EVL) has emerged as a potential alternative to standard tacrolimus (TAC) as the primary immunosuppressant to prevent rejection that may also reduce the risk of cardiac allograft vasculopathy (CAV), chronic kidney disease (CKD) and cytomegalovirus (CMV) infection. However, the 2 regimens have never been compared head-to-head in a randomized trial. The study design and rationale are reviewed in light of the challenges inherent in rare disease research. METHODS The TEAMMATE trial (IND 127980) is the first multicenter randomized clinical trial (RCT) in pediatric HT. The primary purpose is to evaluate the safety and efficacy of EVL and low-dose TAC (LD-TAC) compared to standard-dose TAC and mycophenolate mofetil (MMF). Children aged <21 years at HT were randomized (1:1 ratio) at 6 months post-HT to either regimen, and followed for 30 months. Children with recurrent rejection, multi-organ transplant recipients, and those with an estimated glomerular filtration rate (eGFR) <30 mL/min/1.73m2 were excluded. The primary efficacy hypothesis is that, compared to TAC/MMF, EVL/LD-TAC is more effective in preventing 3 MATEs: acute cellular rejection (ACR), CKD and CAV. The primary safety hypothesis is that EVL/LD-TAC does not have a higher cumulative burden of 6 MATEs (antibody mediated rejection [AMR], infection, and post-transplant lymphoproliferative disorder [PTLD] in addition to the 3 above). The primary endpoint is the MATE score, a composite, ordinal surrogate endpoint reflecting the frequency and severity of MATEs that is validated against graft loss. The study had a target sample size of 210 patients across 25 sites and is powered to demonstrate superior efficacy of EVL/LD-TAC. Trial enrollment is complete and participant follow-up will be completed in 2023. CONCLUSION The TEAMMATE trial is the first multicenter RCT in pediatric HT. It is anticipated that the study will provide important information about the safety and efficacy of everolimus vs tacrolimus-based regimens and will provide valuable lessons into the design and conduct of future trials in pediatric HT.
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Affiliation(s)
- Christopher S Almond
- Departments of Pediatrics (Cardiology), Stanford University School of Medicine, Palo Alto, CA.
| | - Lynn A Sleeper
- Department of Cardiology, Boston Children's Hospital and the Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Joseph W Rossano
- Department of Cardiology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Matthew J Bock
- Division of Pediatric Cardiology, Loma Linda University Children's Hospital, Loma Linda University School of Medicine, Loma Linda, CA
| | - Elfriede Pahl
- Department of Pediatrics, Lurie Children's Hospital, Northwestern School of Medicine, Chicago, IL
| | - Scott Auerbach
- Children's Hospital Colorado Heart Institute, University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - Ashwin Lal
- Department of Pediatrics Primary Children's Hospital, University of Utah School of Medicine, Salt Lake City, Utah
| | - Seth A Hollander
- Departments of Pediatrics (Cardiology), Stanford University School of Medicine, Palo Alto, CA
| | - Shelley D Miyamoto
- Children's Hospital Colorado Heart Institute, University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - Chesney Castleberry
- Departments of Pediatrics, St. Louis Children's Hospital, Washington University in Saint Louis, Saint Louis, MO
| | - Joanne Lee
- Departments of Pediatrics (Cardiology), Stanford University School of Medicine, Palo Alto, CA
| | - Lynsey M Barkoff
- Departments of Pediatrics (Cardiology), Stanford University School of Medicine, Palo Alto, CA
| | - Selena Gonzales
- Departments of Pediatrics (Cardiology), Stanford University School of Medicine, Palo Alto, CA
| | - Gloria Klein
- Department of Cardiology, Boston Children's Hospital and the Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Kevin P Daly
- Department of Cardiology, Boston Children's Hospital and the Department of Pediatrics, Harvard Medical School, Boston, MA
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6
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Chan M, Silveira L, Patterson D, Bock M, Pietra B, Everitt M, Simpson K, Miyamoto S, Auerbach S. Predictors of Long-Term Renal Insufficiency in Repeat Pediatric Heart Transplants. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1335] [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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7
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Ramirez CB, Shezad M, VanderPluym C, Bleiweis M, Tunuguntla H, Joong A, Rosenthal D, Lorts A, Auerbach S, Adachi I, Davies R, O'Connor M. Advanced Cardiac Therapies Improving Outcomes Network (ACTION) Outcomes Report. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.025] [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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8
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Hussain S, Aljohani O, Auerbach S, Bearl D, Benvenuto V, Bonura E, Crawford L, Dyal J, Hartje-Dunn C, Jana S, Joong A, Kaushal S, Lynn M, Miller E, Radel L, Raskin A, Rivera-Torpoco D, Spinner J, Wilkens S, Villa C. What to Do with a Squeaky Wheel? Ventricular Assist Device Use in Children with Mechanical Valves in the Action Database. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1248] [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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9
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Amdani S, Conway J, Kleinmahon J, Auerbach S, Hsu D, Cousino MK, Kaufman B, Alejos J, Cruz JH, Lee HY, Rudraraju R, Kirklin JK, Asante-Korang A. Race and Socioeconomic Bias in Pediatric Cardiac Transplantation. JACC Heart Fail 2023; 11:19-26. [PMID: 36599545 DOI: 10.1016/j.jchf.2022.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND To date, no studies evaluated implicit bias among clinicians caring for children with advanced heart failure. OBJECTIVES This study aims to evaluate implicit racial and socioeconomic bias among pediatric heart transplant clinicians. METHODS A cross-sectional survey of transplant clinicians from the Pediatric Heart Transplant Society was conducted between June and August 2021. The survey consisted of demographic questions along with explicit and validated race and socioeconomic status (SES) implicit association tests (IATs). Implicit and explicit biases among survey group members were studied and associations were tested between implicit and explicit measures. RESULTS Of 500 members, 91 (18.2%) individuals completed the race IAT and 70 (14%) completed the SES IAT. Race IAT scores indicated moderate levels of implicit bias (mean = 0.33, d = 0.76; P < 0.001; ie, preference for White individuals). SES IAT scores indicated strong implicit bias (mean = 0.52, d = 1.53; P < 0.001; ie, preference for people from upper SES). There were weak levels of explicit race and wealth bias. There was a strong level of explicit education bias (mean = 5.22, d = 1.19; P < 0.001; ie, preference for educated people). There were nonsignificant correlations between the race and the SES IAT and explicit measures (P > 0.05 for all). CONCLUSIONS As observed across other health care disciplines, among a group of pediatric heart transplant clinicians, there is an implicit preference for individuals who are White and from higher SES, and an explicit preference for educated people. Future studies should evaluate how implicit biases affect clinician behavior and assess the impact of efforts to reduce such biases.
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Affiliation(s)
- Shahnawaz Amdani
- Department of Pediatric Cardiology, Cleveland Clinic Children's Hospital, Cleveland, Ohio, USA.
| | - Jennifer Conway
- Department of Cardiology, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Jake Kleinmahon
- Department of Cardiology, Ochsner Hospital for Children, New Orleans, Louisiana, USA
| | - Scott Auerbach
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Daphne Hsu
- Department of Pediatrics, Albert Einstein College of Medicine, The Children's Hospital at Montefiore, Bronx, New York, USA
| | - Melissa K Cousino
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Beth Kaufman
- Department of Pediatrics (Cardiology), Stanford University School of Medicine, Stanford, California, USA
| | - Juan Alejos
- Division of Pediatric Cardiology, UCLA Mattel Children's Hospital, Los Angeles, California, USA
| | - Jason Hopper Cruz
- Department of Cardiology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Hannah Y Lee
- Department of Pediatrics, Program for Pediatric Cardiomyopathy, Heart Failure and Transplantation, Columbia University Irving Medical Center, New York, New York, USA
| | - Ramaraju Rudraraju
- Kirklin Institute for Research in Surgical Outcomes, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - James K Kirklin
- Kirklin Institute for Research in Surgical Outcomes, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Alfred Asante-Korang
- Division of Pediatric Cardiology, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA
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Desphpande SR, Bearl DW, Eghtesady P, Henderson HT, Auerbach S, Jeewa A, Bansal N, Amdani S, Richmond ME, Sacks LD, Shih R, Townsend M, Conway J. Clinical approach to vasoplegia in the transplant patient from the Pediatric Heart Transplant Society. Pediatr Transplant 2022; 26:e14392. [PMID: 36377326 DOI: 10.1111/petr.14392] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 08/04/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022]
Abstract
This manuscript outlines a clinical approach to vasoplegia incorporating the current state of knowledge regarding vasoplegia in pediatric patients immediately post-transplant and to identify modifiable factors both pre- and post-transplant that may reduce post-operative morbidity, end-organ dysfunction, and mortality. Centers participating in the Pediatric Heart Transplant Society (PHTS) were asked to provide their internal protocols and rationale for vasoplegia management, and applicable adult and pediatric data were reviewed. The authors synthesized the above protocols and literature into the following description of clinical approaches to vasoplegia highlighting areas of both broad consensus and of significant practice variation.
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Affiliation(s)
- Shriprasad R Desphpande
- Department of Cardiology and Cardiovascular Surgery, Children's National Hospital, The George Washington University, Washington, DC, USA
| | - David W Bearl
- Department of Pediatric Cardiology, Monroe Carell Jr. Children's Hospital, Nashville, Tennessee, USA
| | - Pirooz Eghtesady
- Section of Pediatric Cardiothoracic Surgery, St Louis Children's Hospital and School of Medicine, Washington University, St Louis, Michigan, USA
| | - Heather T Henderson
- Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Scott Auerbach
- Pediatrics, Division of Cardiology, University of Colorado, Denver Anschutz Medical Campus, Children's Hospital Colorado Aurora, Aurora, Colorado, USA
| | - Aamir Jeewa
- Department of Cardiology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Neha Bansal
- Children's Hospital at Montefiore, Bronx, New York, USA
| | | | - Marc E Richmond
- Division of Pediatric Cardiology, Department of Pediatrics, Columbia University College of Physician and Surgeons, Morgan Stanley Children's Hospital, New York, New York, USA
| | - Loren D Sacks
- Pediatric Cardiology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Renata Shih
- Congenital Heart Center, Division of Pediatric Cardiology, University of Florida, Gainesville, Florida, USA
| | | | - Jennifer Conway
- Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
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11
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Aly DM, Nguyen M, Auerbach S, Rausch C, Landeck B, DiMaria MV. Pressure-Strain Loops, a Novel Non-invasive Approach for Assessment of Children with Cardiomyopathy. Pediatr Cardiol 2022; 43:1704-1715. [PMID: 35403889 DOI: 10.1007/s00246-022-02902-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/29/2022] [Indexed: 11/30/2022]
Abstract
Non-invasive myocardial work (MW) by left ventricular (LV) pressure-strain loops (PSL) is a novel method for assessing myocardial function while adjusting for afterload, yet pediatric data remain lacking. The aims of this study were to investigate the different patterns of LV PSL and non-invasive MW in pediatric patients with hypertrophic (HCM) and dilated cardiomyopathy (DCM) and their association with exercise tolerance. We included 110 pediatric subjects (mean age, 13 ± 4 years, 35 DCM, 40 HCM, and 35 healthy controls). Standard and speckle-tracking echocardiography were performed. LV PSLs were generated, and global work index (GWI), MW efficiency (GWE), constructive work (GCW), and wasted work (GWW) were compared between groups. Regression analysis was used to assess the influence of ventricular function, dimensions, wall thickness, and wall stress on MW and to predict the association between MW and VO2 max as a surrogate of exercise capacity. Patients with DCM had significantly lower GWI compared to controls (GWI 479.6 ± 263.0 vs 1610.1 ± 211.0, P < 0.005). GWE was significantly reduced in DCM (79.3 ± 7.9 vs 95.2 ± 1.3, P < 0.005) due to significantly reduced GCW and increased GWW. HCM patients had significant reduction in GWI and GWE from normal (1237.7 ± 449.1 vs 1610.1 ± 211.0, P = 0.001 and 89.6 ± 4.9 vs 95.2 ± 1.3, P < 0.005, respectively), although less severe than with DCM. In a multivariate regression analysis, GWE had the highest association with VO2 max in both cohorts (DCM: β = 0.68, P = 0.001, HCM: β = 0.71, P = 0.007). Non-invasively assessed myocardial work and LV PSLs provide novel insights into the mechanisms of dysfunction in pediatric patients with cardiomyopathy with good prediction of clinical status and thus hold promise to further explore myocardial mechanistic with clinical relevance in different disease entities.
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Affiliation(s)
- Doaa M Aly
- Division of Cardiology, Ward Family Heart Center, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA.
| | - Michael Nguyen
- Division of Cardiology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
| | - Scott Auerbach
- Division of Cardiology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
| | - Christopher Rausch
- Division of Cardiology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
| | - Bruce Landeck
- Johns Hopkins All Children's Hospital, Heart Institute, St. Petersburg, FL, USA
| | - Michael V DiMaria
- Division of Cardiology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
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12
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Conway J, Bansal N, Amdani S, Auerbach S. Learning from each other: The hidden benefit of practice variation. Pediatr Transplant 2022; 26:e14386. [PMID: 36377329 DOI: 10.1111/petr.14386] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 08/04/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022]
Abstract
It has long been recognized that there is significant variation in the way that centers approach clinical management and problems within pediatric transplantation. This has recently been highlighted in two publications by the PHTS showing practice variation in both surveillance for cardiac allograft vasculopathy and diagnosis of acute rejection. These differences in practice are important to recognize and serve as the foundation for collaborative learning, developing research questions, and implementing quality improvement initiatives. To further understand the practice variation within the society, and to begin the process of learning from each other, the society has developed a Clinical Approach Working Group, whose task is to tackle issues seen in transplant and integrate current literature with clinical protocols and experience from the individual sites. The early work of this group has results in the series of Clinical approach articles presented in this issue of Pediatric Transplantation.
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Affiliation(s)
- Jennifer Conway
- Pediatrics, Division of Cardiology, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Neha Bansal
- Pediatrics, Division of Cardiology, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Shahnawaz Amdani
- Pediatrics, Division of Cardiology, Cleveland Clinic Children's, Cleveland, Ohio, USA
| | - Scott Auerbach
- Pediatrics, Division of Cardiology, University of Colorado, Denver Anschutz Medical Campus, Children's Hospital Colorado, Aurora, Colorado, USA
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13
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Christopher Corton J, Mitchell CA, Auerbach S, Bushel JP, Ellinger-Ziegelbauer H, Escobar PA, Froetschl R, Harrill AH, Johnson K, Klaunig JE, Pandiri AR, Podtelezhnikov AA, Rager JE, Tanis KQ, van der Laan JW, Vespa A, Yauk CL, Pettit SD, Sistare FD. A Collaborative Initiative to Establish Genomic Biomarkers for Assessing Tumorigenic Potential to Reduce Reliance on Conventional Rodent Carcinogenicity Studies. Toxicol Sci 2022; 188:4-16. [PMID: 35404422 PMCID: PMC9238304 DOI: 10.1093/toxsci/kfac041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
There is growing recognition across broad sectors of the scientific community that use of genomic biomarkers has the potential to reduce the need for conventional rodent carcinogenicity studies of industrial chemicals, agrochemicals, and pharmaceuticals through a weight-of-evidence approach. These biomarkers fall into 2 major categories: (1) sets of gene transcripts that can identify distinct tumorigenic mechanisms of action; and (2) cancer driver gene mutations indicative of rapidly expanding growth-advantaged clonal cell populations. This call-to-action article describes a collaborative approach launched to develop and qualify biomarker gene expression panels that measure widely accepted molecular pathways linked to tumorigenesis and their activation levels to predict tumorigenic doses of chemicals from short-term exposures. Growing evidence suggests that application of such biomarker panels in short-term exposure rodent studies can identify both tumorigenic hazard and tumorigenic activation levels for chemical-induced carcinogenicity. In the future, this approach will be expanded to include methodologies examining mutations in key cancer driver gene mutation hotspots as biomarkers of both genotoxic and nongenotoxic chemical tumor risk. Analytical, technical, and biological validation studies of these complementary genomic tools are being undertaken by multisector and multidisciplinary collaborative teams within the Health and Environmental Sciences Institute. Success from these efforts will facilitate the transition from current heavy reliance on conventional 2-year rodent carcinogenicity studies to more rapid animal- and resource-sparing approaches for mechanism-based carcinogenicity evaluation supporting internal and regulatory decision-making.
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Affiliation(s)
- J Christopher Corton
- Center for Computational Toxicology and Exposure, US Environmental Protection Agency, Research Triangle Park, NC, USA
| | | | - Scott Auerbach
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - J Pierre Bushel
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | | | - Patricia A Escobar
- Safety Assessment and Laboratory Animal Resources, Merck Sharp & Dohme Corp, West Point, PA, USA
| | - Roland Froetschl
- BfArM-Bundesinstitut für Arzneimittel und Medizinprodukte, Federal Institute for Drugs and Medical Devices, Kurt-Georg-Kiesinger-Allee 3, Bonn, Germany
| | - Alison H Harrill
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | | | - James E Klaunig
- Laboratory of Investigative Toxicology and Pathology, Department of Environmental and Occupational Health, Indiana School of Public Health, Indiana University, Bloomington, IN, USA
| | - Arun R Pandiri
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | | | - Julia E Rager
- The Institute for Environmental Health Solutions, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Keith Q Tanis
- Safety Assessment and Laboratory Animal Resources, Merck Sharp & Dohme Corp, West Point, PA, USA
| | - Jan Willem van der Laan
- Section on Pharmacology, Toxicology and Kinetics, Medicines Evaluation Board, Utrecht, The Netherlands
| | - Alisa Vespa
- Therapeutic Products Directorate, Health Canada, Ottawa, Canada
| | - Carole L Yauk
- Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Syril D Pettit
- Health and Environmental Sciences Institute, Washington, DC, USA
| | - Frank D Sistare
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
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14
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Bassan A, Alves VM, Amberg A, Anger LT, Auerbach S, Beilke L, Bender A, Cronin MT, Cross KP, Hsieh JH, Greene N, Kemper R, Kim MT, Mumtaz M, Noeske T, Pavan M, Pletz J, Russo DP, Sabnis Y, Schaefer M, Szabo DT, Valentin JP, Wichard J, Williams D, Woolley D, Zwickl C, Myatt GJ. In silico approaches in organ toxicity hazard assessment: current status and future needs in predicting liver toxicity. Comput Toxicol 2021; 20:100187. [PMID: 35340402 PMCID: PMC8955833 DOI: 10.1016/j.comtox.2021.100187] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Hepatotoxicity is one of the most frequently observed adverse effects resulting from exposure to a xenobiotic. For example, in pharmaceutical research and development it is one of the major reasons for drug withdrawals, clinical failures, and discontinuation of drug candidates. The development of faster and cheaper methods to assess hepatotoxicity that are both more sustainable and more informative is critically needed. The biological mechanisms and processes underpinning hepatotoxicity are summarized and experimental approaches to support the prediction of hepatotoxicity are described, including toxicokinetic considerations. The paper describes the increasingly important role of in silico approaches and highlights challenges to the adoption of these methods including the lack of a commonly agreed upon protocol for performing such an assessment and the need for in silico solutions that take dose into consideration. A proposed framework for the integration of in silico and experimental information is provided along with a case study describing how computational methods have been used to successfully respond to a regulatory question concerning non-genotoxic impurities in chemically synthesized pharmaceuticals.
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Affiliation(s)
- Arianna Bassan
- Innovatune srl, Via Giulio Zanon 130/D, 35129 Padova, Italy
| | - Vinicius M. Alves
- The National Institute of Environmental Health Sciences, Division of the National Toxicology, Program, Research Triangle Park, NC 27709, USA
| | - Alexander Amberg
- Sanofi, R&D Preclinical Safety Frankfurt, Industriepark Hoechst, D-65926 Frankfurt am Main, Germany
| | | | - Scott Auerbach
- The National Institute of Environmental Health Sciences, Division of the National Toxicology, Program, Research Triangle Park, NC 27709, USA
| | - Lisa Beilke
- Toxicology Solutions Inc., San Diego, CA, USA
| | - Andreas Bender
- AI and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge, UK
- Centre for Molecular Informatics, Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW
| | - Mark T.D. Cronin
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | | | - Jui-Hua Hsieh
- The National Institute of Environmental Health Sciences, Division of the National Toxicology, Program, Research Triangle Park, NC 27709, USA
| | - Nigel Greene
- Data Science and AI, DSM, IMED Biotech Unit, AstraZeneca, Boston, USA
| | - Raymond Kemper
- Nuvalent, One Broadway, 14th floor, Cambridge, MA, 02142, USA
| | - Marlene T. Kim
- US Food and Drug Administration, Center for Drug Evaluation and Research, Silver Spring, MD, 20993, USA
| | - Moiz Mumtaz
- Office of the Associate Director for Science (OADS), Agency for Toxic Substances and Disease, Registry, US Department of Health and Human Services, Atlanta, GA, USA
| | - Tobias Noeske
- Imaging and Data Analytics, Clinical Pharmacology & Safety Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | - Manuela Pavan
- Innovatune srl, Via Giulio Zanon 130/D, 35129 Padova, Italy
| | - Julia Pletz
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Daniel P. Russo
- Department of Chemistry, Rutgers University, Camden, NJ 08102, USA
- The Rutgers Center for Computational and Integrative Biology, Camden, NJ 08102, USA
| | - Yogesh Sabnis
- UCB Biopharma SRL, Chemin du Foriest – B-1420 Braine-l’Alleud, Belgium
| | - Markus Schaefer
- Sanofi, R&D Preclinical Safety Frankfurt, Industriepark Hoechst, D-65926 Frankfurt am Main, Germany
| | | | | | - Joerg Wichard
- Bayer AG, Genetic Toxicology, Müllerstr. 178, 13353 Berlin, Germany
| | - Dominic Williams
- Functional & Mechanistic Safety, Clinical Pharmacology & Safety Sciences, AstraZeneca, Darwin Building 310, Cambridge Science Park, Milton Rd, Cambridge CB4 0FZ, UK
| | - David Woolley
- ForthTox Limited, PO Box 13550, Linlithgow, EH49 7YU, UK
| | - Craig Zwickl
- Transendix LLC, 1407 Moores Manor, Indianapolis, IN 46229, USA
| | - Glenn J. Myatt
- Instem, 1393 Dublin Road, Columbus, OH 43215. USA
- Corresponding author. (G.J. Myatt)
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15
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Wilkinson D, Lin Y, Everett M, Auerbach S, Morgan G, Mitchell MB. Coronary Artery Reimplantation and Berlin Heart EXCOR Rescue for Left Coronary Artery Atresia With Severe Ischemic Cardiomyopathy. World J Pediatr Congenit Heart Surg 2021; 12:793-795. [PMID: 34264154 DOI: 10.1177/21501351211024662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe a successful bridge to recovery by coronary reimplantation and Berlin Heart EXCOR left ventricular assist device in a child with left main coronary artery ostial atresia and severe ischemic cardiomyopathy.
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Affiliation(s)
- Daniel Wilkinson
- Department of General Surgery, Saint Joseph Hospital, Denver, CO, USA
| | - Yihan Lin
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA
| | - Melanie Everett
- Division of Pediatric Cardiology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO USA
| | - Scott Auerbach
- Division of Pediatric Cardiology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO USA
| | - Gareth Morgan
- Division of Pediatric Cardiology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO USA
| | - Max B Mitchell
- Section of Congenital Cardiac Surgery, Department of Surgery, Children's Hospital Colorado, University of Colorado, Aurora, CO, USA
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16
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Nandi D, Auerbach S, Bansal N, Kaufman B, Lal A, Law S, Lorts A, May L, Mehegan M, Mokshagundam D, O'connor M, Rosenthal D, Shezad M, Simpson K, Sutcliffe D, VanderPluym C, Wittlieb-Weber C, Zafar F, Cripe L, Villa C. Ventricular Assist Device Outcomes in Children and Young Adults with Muscular Dystrophy: An ACTION Analysis. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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17
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Shezad M, Rosenthal D, Larkins C, Heile T, Zafar F, Jeewa A, Barnes A, Lorts A, Joong A, Kwiatkowski D, Sutcliffe D, Sparks J, Simpson K, Ploutz M, Ghanayem N, Niebler R, Davies R, Auerbach S. The Adjudication Process at ACTION - Providing Real-World High-Quality Data. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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18
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Quinlan K, Auerbach S, Bearl DW, Dodd DA, Thurm CW, Hall M, Fuchs DC, Lambert AN, Godown J. The impact of psychiatric disorders on outcomes following heart transplantation in children. Pediatr Transplant 2020; 24:e13847. [PMID: 32997873 DOI: 10.1111/petr.13847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/31/2020] [Accepted: 08/29/2020] [Indexed: 12/31/2022]
Abstract
Psychiatric disorders are common in pediatric HTx recipients. However, the impact of psychiatric comorbidities on patient outcomes is unknown. We aimed to assess the impact of disorders of adjustment, depression, and anxiety on HTx outcomes in children; hypothesizing that the presence of psychiatric disorders during or preceding HTx would negatively impact outcomes. All pediatric HTx recipients ≥8 years of age who survived to hospital discharge were identified from a novel linkage between the PHIS and SRTR databases (2002-2016). Psychiatric disorders were identified using ICD codes during or preceding the HTx admission. Post-transplant graft survival, freedom from readmission, and freedom from rejection were analyzed using the Kaplan-Meier method. Multivariable Cox proportional hazard models were used to adjust for covariates. A total of 1192 patients were included, of which 133 (11.2%) had depression, 197 (16.5%) had anxiety, and 218 (18.3%) had adjustment disorders. The presence of depression was independently associated with higher rates of readmission (60.9% vs 54.1% at 6 months) (AHR 1.63, 95% CI 1.22-2.18, P = .001) and inferior graft survival (70.2% vs 83.4% at 5 years) (AHR 1.62, 95% CI 1.14-2.3, P = .007). Anxiety was independently associated with higher rates of readmission (60.4% vs 53.9% at 6 months) (AHR 1.46, 95% CI 1.09-1.94, P = .01). Anxiety and depression in the pretransplant period are independently associated with outcomes following HTx in children. Evaluation and management of psychiatric comorbidities represents an important component of care in this vulnerable population.
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Affiliation(s)
- Kia Quinlan
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Scott Auerbach
- Pediatrics, Division of Cardiology, Denver Anschutz Medical Campus Children's Hospital of Colorado, University of Colorado, Aurora, CO, USA
| | - David W Bearl
- Pediatric Cardiology, Monroe Carell Jr. Children's Hospital, Nashville, TN, USA
| | - Debra A Dodd
- Pediatric Cardiology, Monroe Carell Jr. Children's Hospital, Nashville, TN, USA
| | - Cary W Thurm
- Children's Hospital Association, Lenexa, KS, USA
| | - Matt Hall
- Children's Hospital Association, Lenexa, KS, USA
| | - Dickey Catherine Fuchs
- Child and Adolescent Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Justin Godown
- Pediatric Cardiology, Monroe Carell Jr. Children's Hospital, Nashville, TN, USA
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19
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Mav D, Phadke DP, Balik-Meisner MR, Merrick BA, Auerbach S, Niemeijer M, Huppelschoten S, Baze A, Parmentier C, Richert L, van de Water B, Shah RR, Paules RS. Utility of Extrapolating Human S1500+ Genes to the Whole Transcriptome: Tunicamycin Case Study. Bioinform Biol Insights 2020; 14:1177932220952742. [PMID: 33088175 PMCID: PMC7545517 DOI: 10.1177/1177932220952742] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 08/04/2020] [Indexed: 01/07/2023] Open
Abstract
The TempO-Seq S1500+ platform(s), now available for human, mouse, rat, and zebrafish, measures a discrete number of genes that are representative of biological and pathway co-regulation across the entire genome in a given species. While measurement of these genes alone provides a direct assessment of gene expression activity, extrapolating expression values to the whole transcriptome (~26 000 genes in humans) can estimate measurements of non-measured genes of interest and increases the power of pathway analysis algorithms by using a larger background gene expression space. Here, we use data from primary hepatocytes of 54 donors that were treated with the endoplasmic reticulum (ER) stress inducer tunicamycin and then measured on the human S1500+ platform containing ~3000 representative genes. Measurements for the S1500+ genes were then used to extrapolate expression values for the remaining human transcriptome. As a case study of the improved downstream analysis achieved by extrapolation, the “measured only” and “whole transcriptome” (measured + extrapolated) gene sets were compared. Extrapolation increased the number of significant genes by 49%, bringing to the forefront many that are known to be associated with tunicamycin exposure. The extrapolation procedure also correctly identified established tunicamycin-related functional pathways reflected by coordinated changes in interrelated genes while maintaining the sample variability observed from the “measured only” genes. Extrapolation improved the gene- and pathway-level biological interpretations for a variety of downstream applications, including differential expression analysis, gene set enrichment pathway analysis, DAVID keyword analysis, Ingenuity Pathway Analysis, and NextBio correlated compound analysis. The extrapolated data highlight the role of metabolism/metabolic pathways, the ER, immune response, and the unfolded protein response, each of which are key activities associated with tunicamycin exposure that were unrepresented or underrepresented in one or more of the analyses of the original “measured only” dataset. Furthermore, the inclusion of the extrapolated genes raised “tunicamycin” from third to first upstream regulator in Ingenuity Pathway Analysis and from sixth to second most correlated compound in NextBio analysis. Therefore, our case study suggests an approach to extend and enhance data from the S1500+ platform for improved insight into biological mechanisms and functional outcomes of diseases, drugs, and other perturbations.
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Affiliation(s)
- Deepak Mav
- Sciome LLC, Research Triangle Park, NC, USA
| | | | | | - B Alex Merrick
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Scott Auerbach
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Marije Niemeijer
- Division of Toxicology, Leiden Academic Centre for Drug Research (LACDR), Leiden University, Leiden, The Netherlands
| | - Suzanna Huppelschoten
- Division of Toxicology, Leiden Academic Centre for Drug Research (LACDR), Leiden University, Leiden, The Netherlands
| | | | | | | | - Bob van de Water
- Division of Toxicology, Leiden Academic Centre for Drug Research (LACDR), Leiden University, Leiden, The Netherlands
| | | | - Richard S Paules
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
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20
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Bobrowski T, Melo-Filho CC, Korn D, Alves VM, Popov KI, Auerbach S, Schmitt C, Moorman NJ, Muratov EN, Tropsha A. Learning from history: do not flatten the curve of antiviral research! Drug Discov Today 2020; 25:1604-1613. [PMID: 32679173 PMCID: PMC7361119 DOI: 10.1016/j.drudis.2020.07.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/22/2020] [Accepted: 07/08/2020] [Indexed: 01/20/2023]
Abstract
Here, we explore the dynamics of the response of the scientific community to several epidemics, including Coronavirus Disease 2019 (COVID-19), as assessed by the numbers of clinical trials, publications, and level of research funding over time. All six prior epidemics studied [bird flu, severe acute respiratory syndrome (SARS), swine flu, Middle East Respiratory Syndrome (MERS), Ebola, and Zika] were characterized by an initial spike of research response that flattened shortly thereafter. Unfortunately, no antiviral medications have been discovered to date as treatments for any of these diseases. By contrast, the HIV/AIDS pandemic has garnered consistent research investment since it began and resulted in drugs being developed within 7 years of its start date, with many more to follow. We argue that, to develop effective treatments for COVID-19 and be prepared for future epidemics, long-term, consistent investment in antiviral research is needed.
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Affiliation(s)
- Tesia Bobrowski
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Cleber C Melo-Filho
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Daniel Korn
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA; Department of Computer Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Vinicius M Alves
- Office of Data Science, National Toxicology Program, NIEHS, Morrisville, NC 27560, USA
| | - Konstantin I Popov
- Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Scott Auerbach
- Toxicoinformatics Group, National Toxicology Program, NIEHS, Morrisville, NC 27560, USA
| | - Charles Schmitt
- Office of Data Science, National Toxicology Program, NIEHS, Morrisville, NC 27560, USA
| | - Nathaniel J Moorman
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Eugene N Muratov
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA; Department of Pharmaceutical Sciences, Federal University of Paraiba, Joao Pessoa, PB, Brazil.
| | - Alexander Tropsha
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
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21
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Alves VM, Bobrowski T, Melo-Filho CC, Korn D, Auerbach S, Schmitt C, Muratov EN, Tropsha A. QSAR Modeling of SARS-CoV M pro Inhibitors Identifies Sufugolix, Cenicriviroc, Proglumetacin, and other Drugs as Candidates for Repurposing against SARS-CoV-2. Mol Inform 2020; 40:e2000113. [PMID: 33405340 DOI: 10.1002/minf.202000113] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/28/2020] [Indexed: 12/22/2022]
Abstract
The main protease (Mpro) of the SARS-CoV-2 has been proposed as one of the major drug targets for COVID-19. We have identified the experimental data on the inhibitory activity of compounds tested against the closely related (96 % sequence identity, 100 % active site conservation) Mpro of SARS-CoV. We developed QSAR models of these inhibitors and employed these models for virtual screening of all drugs in the DrugBank database. Similarity searching and molecular docking were explored in parallel, but docking failed to correctly discriminate between experimentally active and inactive compounds, so it was not relied upon for prospective virtual screening. Forty-two compounds were identified by our models as consensus computational hits. Subsequent to our computational studies, NCATS reported the results of experimental screening of their drug collection in SARS-CoV-2 cytopathic effect assay (https://opendata.ncats.nih.gov/covid19/). Coincidentally, NCATS tested 11 of our 42 hits, and three of them, cenicriviroc (AC50 of 8.9 μM), proglumetacin (tested twice independently, with AC50 of 8.9 μM and 12.5 μM), and sufugolix (AC50 12.6 μM), were shown to be active. These observations support the value of our modeling approaches and models for guiding the experimental investigations of putative anti-COVID-19 drug candidates. All data and models used in this study are publicly available via Supplementary Materials, GitHub (https://github.com/alvesvm/sars-cov-mpro), and Chembench web portal (https://chembench.mml.unc.edu/).
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Affiliation(s)
- Vinicius M Alves
- Office of Data Science, National Toxicology Program, NIEHS, Morrisville, NC, 27560, USA
| | - Tesia Bobrowski
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Beard Hall, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Cleber C Melo-Filho
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Beard Hall, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Daniel Korn
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Beard Hall, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA.,Department of Computer Science, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Scott Auerbach
- Toxinformatics Group, National Toxicology Program, NIEHS, Morrisville, NC, 27560, USA
| | - Charles Schmitt
- Office of Data Science, National Toxicology Program, NIEHS, Morrisville, NC, 27560, USA
| | - Eugene N Muratov
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Beard Hall, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA.,Department of Pharmaceutical Sciences, Federal University of Paraiba, Joao Pessoa, PB, Brazil
| | - Alexander Tropsha
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Beard Hall, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA
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22
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Bobrowski T, Alves VM, Melo-Filho CC, Korn D, Auerbach S, Schmitt C, Muratov EN, Tropsha A. Computational Models Identify Several FDA Approved or Experimental Drugs as Putative Agents Against SARS-CoV-2. ChemRxiv 2020:12153594. [PMID: 32511287 PMCID: PMC7252448 DOI: 10.26434/chemrxiv.12153594] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Revised: 04/22/2020] [Indexed: 01/09/2023]
Abstract
The outbreak of a novel human coronavirus (SARS-CoV-2) has evolved into global health emergency, infecting hundreds of thousands of people worldwide. We have identified experimental data on the inhibitory activity of compounds tested against closely related (96% sequence identity, 100% active site conservation) protease of SARS-CoV and employed this data to build QSAR models for this dataset. We employed these models for virtual screening of all drugs from DrugBank, including compounds in clinical trials. Molecular docking and similarity search approaches were explored in parallel with QSAR modeling, but molecular docking failed to correctly discriminate between experimentally active and inactive compounds. As a result of our studies, we recommended 41 approved, experimental, or investigational drugs as potential agents against SARS-CoV-2 acting as putative inhibitors of Mpro. Ten compounds with feasible prices were purchased and are awaiting the experimental validation. .
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Affiliation(s)
- Tesia Bobrowski
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Vinicius M. Alves
- Office of Data Science, National Toxicology Program, NIEHS, Morrisville, NC, 27560, USA
| | - Cleber C. Melo-Filho
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Daniel Korn
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Scott Auerbach
- Toxinformatics Group, National Toxicology Program, NIEHS, Morrisville, NC, 27560, USA
| | - Charles Schmitt
- Office of Data Science, National Toxicology Program, NIEHS, Morrisville, NC, 27560, USA
| | - Eugene N. Muratov
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Alexander Tropsha
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA
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23
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Donnellan A, Villa C, Peng D, Auerbach S, Lantz J, Murray J, Smyth L, Krack P, Sutcliffe D. Understanding Pediatric VAD Center Practices for Establishing and Maintaining Optimal Support. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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24
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Townsend M, Karamlou T, Boyle G, Feingold B, Daly K, Deshpande S, Auerbach S, Worley S, Liu W, Saarel E, Amdani S. Brighter Future for Children with Congenital Heart Disease Requiring Heart Transplantation? A UNOS Registry Analysis over the Last Three Decades. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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25
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Diaz I, Thurm C, Hall M, Auerbach S, Bearl DW, Dodd DA, Mettler BA, Smith AH, Fuchs DC, Godown J. Disorders of Adjustment, Mood, and Anxiety in Children and Adolescents Undergoing Heart Transplantation and the Association of Ventricular Assist Device Support. J Pediatr 2020; 217:20-24.e1. [PMID: 31732131 DOI: 10.1016/j.jpeds.2019.10.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/06/2019] [Accepted: 10/10/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To assess the prevalence of psychiatric disorders and associated therapies in children during their heart transplantation admission. STUDY DESIGN All pediatric heart transplant recipients (1999-2016) were included from a linked administrative and clinical registry database. Psychiatric disorders and associated therapies were identified using International Classification of Diseases or billing codes during the transplant admission. Data were analyzed using standard descriptive statistics. Multivariable logistic regression assessed factors independently associated with psychiatric disorders or therapies. RESULTS A total of 3073 pediatric heart transplant recipients were included. Psychiatric disorders were present in 434 (14.1%) patients during the heart transplant admission, with adjustment disorders being the most common. Antidepressant therapy was prescribed to 212 patients (6.9%) and selective serotonin reuptake inhibitors were most commonly used. Psychiatric diagnoses (8.4% vs 18.1%; P < .001) and the use of antidepressants (4.5% vs 8.9%; P < .001) increased over time (era 1, 1999-2009 vs era 2, 2010-2016). Psychiatric disorders were present in 39.8% of patients ≥8 years of age requiring ventricular assist device support at heart transplantation. The need for ventricular assist device support was independently associated with psychiatric diagnoses (aOR, 1.57; 95% CI, 1.18-2.1; P = .002) and antidepressant therapy (aOR, 2.11; 95% CI. 1.43-3.12; P < .001). CONCLUSIONS Psychiatric disorders are common in pediatric heart transplant recipients, especially among those bridged with ventricular assist device support. Psychiatric diagnoses and the use of antidepressants has increased over time, likely representing improved recognition of psychiatric comorbidities in this vulnerable population. Access to psychiatric services represents an important component of the multidisciplinary team caring for pediatric heart transplant recipients.
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Affiliation(s)
- Isaura Diaz
- Pediatric Critical Care, Monroe Carell Jr. Children's Hospital, Nashville, TN
| | - Cary Thurm
- Children's Hospital Association, Lenexa, KS
| | - Matt Hall
- Children's Hospital Association, Lenexa, KS
| | - Scott Auerbach
- Pediatric Cardiology, Children's Hospital of Colorado, Aurora, CO
| | - David W Bearl
- Pediatric Cardiology, Monroe Carell Jr. Children's Hospital, Nashville, TN
| | - Debra A Dodd
- Pediatric Cardiology, Monroe Carell Jr. Children's Hospital, Nashville, TN
| | - Bret A Mettler
- Pediatric Cardiothoracic Surgery, Monroe Carell Jr. Children's Hospital, Nashville, TN
| | - Andrew H Smith
- Pediatric Critical Care, Monroe Carell Jr. Children's Hospital, Nashville, TN
| | - D Catherine Fuchs
- Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Vanderbilt University Medical Center, Nashville, TN
| | - Justin Godown
- Pediatric Cardiology, Monroe Carell Jr. Children's Hospital, Nashville, TN.
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26
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Hasselgren C, Ahlberg E, Akahori Y, Amberg A, Anger LT, Atienzar F, Auerbach S, Beilke L, Bellion P, Benigni R, Bercu J, Booth ED, Bower D, Brigo A, Cammerer Z, Cronin MTD, Crooks I, Cross KP, Custer L, Dobo K, Doktorova T, Faulkner D, Ford KA, Fortin MC, Frericks M, Gad-McDonald SE, Gellatly N, Gerets H, Gervais V, Glowienke S, Van Gompel J, Harvey JS, Hillegass J, Honma M, Hsieh JH, Hsu CW, Barton-Maclaren TS, Johnson C, Jolly R, Jones D, Kemper R, Kenyon MO, Kruhlak NL, Kulkarni SA, Kümmerer K, Leavitt P, Masten S, Miller S, Moudgal C, Muster W, Paulino A, Lo Piparo E, Powley M, Quigley DP, Reddy MV, Richarz AN, Schilter B, Snyder RD, Stavitskaya L, Stidl R, Szabo DT, Teasdale A, Tice RR, Trejo-Martin A, Vuorinen A, Wall BA, Watts P, White AT, Wichard J, Witt KL, Woolley A, Woolley D, Zwickl C, Myatt GJ. Genetic toxicology in silico protocol. Regul Toxicol Pharmacol 2019; 107:104403. [PMID: 31195068 PMCID: PMC7485926 DOI: 10.1016/j.yrtph.2019.104403] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [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: 02/26/2019] [Revised: 05/20/2019] [Accepted: 06/05/2019] [Indexed: 01/23/2023]
Abstract
In silico toxicology (IST) approaches to rapidly assess chemical hazard, and usage of such methods is increasing in all applications but especially for regulatory submissions, such as for assessing chemicals under REACH as well as the ICH M7 guideline for drug impurities. There are a number of obstacles to performing an IST assessment, including uncertainty in how such an assessment and associated expert review should be performed or what is fit for purpose, as well as a lack of confidence that the results will be accepted by colleagues, collaborators and regulatory authorities. To address this, a project to develop a series of IST protocols for different hazard endpoints has been initiated and this paper describes the genetic toxicity in silico (GIST) protocol. The protocol outlines a hazard assessment framework including key effects/mechanisms and their relationships to endpoints such as gene mutation and clastogenicity. IST models and data are reviewed that support the assessment of these effects/mechanisms along with defined approaches for combining the information and evaluating the confidence in the assessment. This protocol has been developed through a consortium of toxicologists, computational scientists, and regulatory scientists across several industries to support the implementation and acceptance of in silico approaches.
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Affiliation(s)
| | - Ernst Ahlberg
- Predictive Compound ADME & Safety, Drug Safety & Metabolism, AstraZeneca IMED Biotech Unit, Mölndal, Sweden
| | - Yumi Akahori
- Chemicals Evaluation and Research Institute, 1-4-25 Kouraku, Bunkyo-ku, Tokyo, 112-0004, Japan
| | - Alexander Amberg
- Sanofi, R&D Preclinical Safety Frankfurt, Industriepark Hoechst, D-65926, Frankfurt am Main, Germany
| | - Lennart T Anger
- Sanofi, R&D Preclinical Safety Frankfurt, Industriepark Hoechst, D-65926, Frankfurt am Main, Germany
| | - Franck Atienzar
- UCB BioPharma SPRL, Chemin du Foriest, B-1420 Braine-l'Alleud, Belgium
| | - Scott Auerbach
- The National Institute of Environmental Health Sciences, Division of the National Toxicology Program, Research Triangle Park, NC, 27709, USA
| | - Lisa Beilke
- Toxicology Solutions Inc., San Diego, CA, USA
| | | | | | - Joel Bercu
- Gilead Sciences, 333 Lakeside Drive, Foster City, CA, USA
| | - Ewan D Booth
- Syngenta, Product Safety Department, Jealott's Hill International Research Centre, Bracknell, Berkshire, RG42 6EY, UK
| | - Dave Bower
- Leadscope, Inc, 1393 Dublin Rd, Columbus, OH, 43215, USA
| | - Alessandro Brigo
- Roche Pharmaceutical Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - Zoryana Cammerer
- Janssen Research & Development, 1400 McKean Road, Spring House, PA, 19477, USA
| | - Mark T D Cronin
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Ian Crooks
- British American Tobacco, Research and Development, Regents Park Road, Southampton, Hampshire, SO15 8TL, UK
| | - Kevin P Cross
- Leadscope, Inc, 1393 Dublin Rd, Columbus, OH, 43215, USA
| | - Laura Custer
- Bristol-Myers Squibb, Drug Safety Evaluation, 1 Squibb Dr, New Brunswick, NJ, 08903, USA
| | - Krista Dobo
- Pfizer Global Research & Development, 558 Eastern Point Road, Groton, CT, 06340, USA
| | - Tatyana Doktorova
- Douglas Connect GmbH, Technology Park Basel, Hochbergerstrasse 60C, CH-4057, Basel / Basel-Stadt, Switzerland
| | - David Faulkner
- Lawrence Berkeley National Laboratory, One Cyclotron Road, MS 70A-1161A, Berkeley, CA, 947020, USA
| | - Kevin A Ford
- Global Blood Therapeutics, 171 Oyster Point Boulevard, South San Francisco, CA, 94080, USA
| | - Marie C Fortin
- Jazz Pharmaceuticals, Inc., 200 Princeton South Corporate Center, Suite 180, Ewing, NJ, 08628, USA; Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Rutgers University, 170 Frelinghuysen Rd, Piscataway, NJ, 08855, USA
| | | | | | - Nichola Gellatly
- National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs), Gibbs Building, 215 Euston Road, London, NW1 2BE, UK
| | - Helga Gerets
- UCB BioPharma SPRL, Chemin du Foriest, B-1420, Braine-l'Alleud, Belgium
| | | | - Susanne Glowienke
- Novartis Pharma AG, Pre-Clinical Safety, Werk Klybeck, CH, 4057, Basel, Switzerland
| | - Jacky Van Gompel
- Janssen Pharmaceutical Companies of Johnson & Johnson, 2340, Beerse, Belgium
| | - James S Harvey
- GlaxoSmithKline Pre-Clinical Development, Park Road, Ware, Hertfordshire, SG12 0DP, UK
| | - Jedd Hillegass
- Bristol-Myers Squibb, Drug Safety Evaluation, 1 Squibb Dr, New Brunswick, NJ, 08903, USA
| | - Masamitsu Honma
- Division of Genetics and Mutagenesis, National Institute of Health Sciences, Kanagawa, 210-9501, Japan
| | - Jui-Hua Hsieh
- Kelly Government Solutions, Research Triangle Park, NC, 27709, USA
| | - Chia-Wen Hsu
- FDA Center for Drug Evaluation and Research, Silver Spring, MD, USA
| | | | | | - Robert Jolly
- Toxicology Division, Eli Lilly and Company, Indianapolis, IN, USA
| | - David Jones
- Medicines and Healthcare Products Regulatory Agency, 10 South Colonnade, Canary Wharf, London, E14 4PU, UK
| | - Ray Kemper
- Vertex Pharmaceuticals Inc., Predictive and Investigative Safety Assessment, 50 Northern Ave, Boston, MA, USA
| | - Michelle O Kenyon
- Pfizer Global Research & Development, 558 Eastern Point Road, Groton, CT, 06340, USA
| | - Naomi L Kruhlak
- FDA Center for Drug Evaluation and Research, Silver Spring, MD, USA
| | - Sunil A Kulkarni
- Existing Substances Risk Assessment Bureau, Health Canada, Ottawa, ON, K1A 0K9, Canada
| | - Klaus Kümmerer
- Institute for Sustainable and Environmental Chemistry, Leuphana University Lüneburg, Scharnhorststraße 1/C13.311b, 21335, Lüneburg, Germany
| | - Penny Leavitt
- Bristol-Myers Squibb, Drug Safety Evaluation, 1 Squibb Dr, New Brunswick, NJ, 08903, USA
| | - Scott Masten
- The National Institute of Environmental Health Sciences, Division of the National Toxicology Program, Research Triangle Park, NC, 27709, USA
| | - Scott Miller
- Leadscope, Inc, 1393 Dublin Rd, Columbus, OH, 43215, USA
| | | | - Wolfgang Muster
- Roche Pharmaceutical Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | | | | | - Mark Powley
- Merck Research Laboratories, West Point, PA, 19486, USA
| | | | | | | | | | - Ronald D Snyder
- RDS Consulting Services, 2936 Wooded Vista Ct, Mason, OH, 45040, USA
| | | | | | | | | | | | | | | | - Brian A Wall
- Colgate-Palmolive Company, Piscataway, NJ, 08854, USA
| | - Pete Watts
- Bibra, Cantium House, Railway Approach, Wallington, Surrey, SM6 0DZ, UK
| | - Angela T White
- GlaxoSmithKline Pre-Clinical Development, Park Road, Ware, Hertfordshire, SG12 0DP, UK
| | - Joerg Wichard
- Bayer AG, Pharmaceuticals Division, Investigational Toxicology, Muellerstr. 178, D-13353, Berlin, Germany
| | - Kristine L Witt
- The National Institute of Environmental Health Sciences, Division of the National Toxicology Program, Research Triangle Park, NC, 27709, USA
| | - Adam Woolley
- ForthTox Limited, PO Box 13550, Linlithgow, EH49 7YU, UK
| | - David Woolley
- ForthTox Limited, PO Box 13550, Linlithgow, EH49 7YU, UK
| | - Craig Zwickl
- Transendix LLC, 1407 Moores Manor, Indianapolis, IN, 46229, USA
| | - Glenn J Myatt
- Leadscope, Inc, 1393 Dublin Rd, Columbus, OH, 43215, USA
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27
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Harrill J, Shah I, Setzer RW, Haggard D, Auerbach S, Judson R, Thomas RS. Considerations for Strategic Use of High-Throughput Transcriptomics Chemical Screening Data in Regulatory Decisions. Curr Opin Toxicol 2019; 15:64-75. [PMID: 31501805 DOI: 10.1016/j.cotox.2019.05.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Recently, numerous organizations, including governmental regulatory agencies in the U.S. and abroad, have proposed using data from New Approach Methodologies (NAMs) for augmenting and increasing the pace of chemical assessments. NAMs are broadly defined as any technology, methodology, approach or combination thereof that can be used to provide information on chemical hazard and risk assessment that avoids the use of intact animals. High-throughput transcriptomics (HTTr) is a type of NAM that uses gene expression profiling as an endpoint for rapidly evaluating the effects of large numbers of chemicals on in vitro cell culture systems. As compared to targeted high-throughput screening (HTS) approaches that measure the effect of chemical X on target Y, HTTr is a non-targeted approach that allows researchers to more broadly characterize the integrated response of an intact biological system to chemicals that may affect a specific biological target or many biological targets under a defined set of treatment conditions (time, concentration, etc.). HTTr screening performed in concentration-response mode can provide potency estimates for the concentrations of chemicals that produce perturbations in cellular response pathways. Here, we discuss study design considerations for HTTr concentration-response screening and present a framework for the use of HTTr-based biological pathway-altering concentrations (BPACs) in a screening-level, risk-based chemical prioritization approach. The framework involves concentration-response modeling of HTTr data, mapping gene level responses to biological pathways, determination of BPACs, in vitro-to-in vivo extrapolation (IVIVE) and comparison to human exposure predictions.
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Affiliation(s)
- Joshua Harrill
- National Center for Computational Toxicology, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Imran Shah
- National Center for Computational Toxicology, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - R Woodrow Setzer
- National Center for Computational Toxicology, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Derik Haggard
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, USA
| | - Scott Auerbach
- National Toxicology Program, National Institute of Environmental Health Sciences, National Institute of Health, Research Triangle Park, NC, USA
| | - Richard Judson
- National Center for Computational Toxicology, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Russell S Thomas
- National Center for Computational Toxicology, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
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28
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VanderPluym C, O'Connor M, Lorts A, Ploutz M, Peng D, Law S, Zinn M, Niebler R, Rosenthal D, Conway J, Auerbach S, Sutcliffe D, Mehegan M. Anti-Coagulation Management in Pediatric Ventricular Assist Device: A Quality Improvement Target. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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29
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Villa C, Peng D, Auerbach S, Kindel S, Law S, Lorts A, Mehegan M, O'Connor M, Ploutz M, Rosenthal D, VanderPluym C, Zinn M, Sutcliffe D. Speaking the Same Language? Assessing Blood Pressure Measurement and Effectiveness in Pediatric VAD Patients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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30
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Li A, Lu X, Natoli T, Bittker J, Sipes NS, Subramanian A, Auerbach S, Sherr DH, Monti S. The Carcinogenome Project: In Vitro Gene Expression Profiling of Chemical Perturbations to Predict Long-Term Carcinogenicity. Environ Health Perspect 2019; 127:47002. [PMID: 30964323 PMCID: PMC6785232 DOI: 10.1289/ehp3986] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Most chemicals in commerce have not been evaluated for their carcinogenic potential. The de facto gold-standard approach to carcinogen testing adopts the 2-y rodent bioassay, a time-consuming and costly procedure. High-throughput in vitro assays are a promising alternative for addressing the limitations in carcinogen screening. OBJECTIVES We developed a screening process for predicting chemical carcinogenicity and genotoxicity and characterizing modes of actions (MoAs) using in vitro gene expression assays. METHODS We generated a large toxicogenomics resource comprising [Formula: see text] expression profiles corresponding to 330 chemicals profiled in HepG2 (human hepatocellular carcinoma cell line) at multiple doses and replicates. Predictive models of carcinogenicity and genotoxicity were built using a random forest classifier. Differential pathway enrichment analysis was performed to identify pathways associated with carcinogen exposure. Signatures of carcinogenicity and genotoxicity were compared with external sources, including Drugmatrix and the Connectivity Map. RESULTS Among profiles with sufficient bioactivity, our classifiers achieved 72.2% Area Under the ROC Curve (AUC) for predicting carcinogenicity and 82.3% AUC for predicting genotoxicity. Chemical bioactivity, as measured by the strength and reproducibility of the transcriptional response, was not significantly associated with long-term carcinogenicity in doses up to [Formula: see text]. However, sufficient bioactivity was necessary for a chemical to be used for prediction of carcinogenicity. Pathway enrichment analysis revealed pathways consistent with known pathways that drive cancer, including DNA damage and repair. The data is available at https://clue.io/CRCGN_ABC , and a portal for query and visualization of the results is accessible at https://carcinogenome.org . DISCUSSION We demonstrated an in vitro screening approach using gene expression profiling to predict carcinogenicity and infer MoAs of chemical perturbations. https://doi.org/10.1289/EHP3986.
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Affiliation(s)
- Amy Li
- Computational Biomedicine, Boston University School of Medicine, Boston, Massachusetts, USA
- Bioinformatics Program, Boston University, Boston, Massachusetts, USA
| | - Xiaodong Lu
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Ted Natoli
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Joshua Bittker
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Nisha S. Sipes
- Toxicoinformatics Group, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Aravind Subramanian
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Scott Auerbach
- Toxicoinformatics Group, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - David H. Sherr
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Stefano Monti
- Computational Biomedicine, Boston University School of Medicine, Boston, Massachusetts, USA
- Bioinformatics Program, Boston University, Boston, Massachusetts, USA
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31
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Auerbach S, Lopez R, Gruss V, Lorenz R. DEMENTIA BIASES AMONG INTERNATIONAL HEALTHCARE PROVIDERS: A LITERATURE REVIEW. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - R Lopez
- MGH Institute of Health Professions
| | - V Gruss
- University of Illinois at Chicago
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32
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Dipchand AI, Kirk R, Naftel DC, Pruitt E, Blume ED, Morrow R, Rosenthal D, Auerbach S, Richmond ME, Kirklin JK. Ventricular Assist Device Support as a Bridge to Transplantation in Pediatric Patients. J Am Coll Cardiol 2018; 72:402-415. [DOI: 10.1016/j.jacc.2018.04.072] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 11/24/2022]
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33
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Auerbach S, Lorenz R, Thomas FP. 1034 Discordance Between Subjective And Objective Measures Of Sleep Among Adults With Multiple Sclerosis. Sleep 2018. [DOI: 10.1093/sleep/zsy061.1033] [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: 11/12/2022] Open
Affiliation(s)
| | - R Lorenz
- University at Buffalo, Buffalo, NY
| | - F P Thomas
- Seton Hall-Hackensack Meridian School of Medicine, South Orange, NJ
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34
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Lorenz RA, Auerbach S, Koedbangkham J, Loux T, Shacham E, Thomas FP. 1035 The Relationship between Actigraphy Measured Sleep and Fatigue among Adults with Multiple Sclerosis. Sleep 2018. [DOI: 10.1093/sleep/zsy061.1034] [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: 11/14/2022] Open
Affiliation(s)
- R A Lorenz
- University at Buffalo, School of Nursing, Buffalo, NY
| | - S Auerbach
- University at Buffalo, School of Nursing, Buffalo, NY
| | - J Koedbangkham
- Saint Louis University, School of Nursing, Saint Louis, MO
| | - T Loux
- Saint Louis University, College of Public Health and Social Justice, Saint Louis, MO
| | - E Shacham
- Saint Louis University, College of Public Health and Social Justice, Saint Louis, MO
| | - F P Thomas
- Department of Neurology, Seton Hall-Hackensack Meridian School of Medicine, MS Center Neuroscience Institute, Hackensack University Medical Center, Hackensack, NJ
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35
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Myatt GJ, Ahlberg E, Akahori Y, Allen D, Amberg A, Anger LT, Aptula A, Auerbach S, Beilke L, Bellion P, Benigni R, Bercu J, Booth ED, Bower D, Brigo A, Burden N, Cammerer Z, Cronin MTD, Cross KP, Custer L, Dettwiler M, Dobo K, Ford KA, Fortin MC, Gad-McDonald SE, Gellatly N, Gervais V, Glover KP, Glowienke S, Van Gompel J, Gutsell S, Hardy B, Harvey JS, Hillegass J, Honma M, Hsieh JH, Hsu CW, Hughes K, Johnson C, Jolly R, Jones D, Kemper R, Kenyon MO, Kim MT, Kruhlak NL, Kulkarni SA, Kümmerer K, Leavitt P, Majer B, Masten S, Miller S, Moser J, Mumtaz M, Muster W, Neilson L, Oprea TI, Patlewicz G, Paulino A, Lo Piparo E, Powley M, Quigley DP, Reddy MV, Richarz AN, Ruiz P, Schilter B, Serafimova R, Simpson W, Stavitskaya L, Stidl R, Suarez-Rodriguez D, Szabo DT, Teasdale A, Trejo-Martin A, Valentin JP, Vuorinen A, Wall BA, Watts P, White AT, Wichard J, Witt KL, Woolley A, Woolley D, Zwickl C, Hasselgren C. In silico toxicology protocols. Regul Toxicol Pharmacol 2018; 96:1-17. [PMID: 29678766 DOI: 10.1016/j.yrtph.2018.04.014] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [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: 12/03/2017] [Revised: 03/16/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
Abstract
The present publication surveys several applications of in silico (i.e., computational) toxicology approaches across different industries and institutions. It highlights the need to develop standardized protocols when conducting toxicity-related predictions. This contribution articulates the information needed for protocols to support in silico predictions for major toxicological endpoints of concern (e.g., genetic toxicity, carcinogenicity, acute toxicity, reproductive toxicity, developmental toxicity) across several industries and regulatory bodies. Such novel in silico toxicology (IST) protocols, when fully developed and implemented, will ensure in silico toxicological assessments are performed and evaluated in a consistent, reproducible, and well-documented manner across industries and regulatory bodies to support wider uptake and acceptance of the approaches. The development of IST protocols is an initiative developed through a collaboration among an international consortium to reflect the state-of-the-art in in silico toxicology for hazard identification and characterization. A general outline for describing the development of such protocols is included and it is based on in silico predictions and/or available experimental data for a defined series of relevant toxicological effects or mechanisms. The publication presents a novel approach for determining the reliability of in silico predictions alongside experimental data. In addition, we discuss how to determine the level of confidence in the assessment based on the relevance and reliability of the information.
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Affiliation(s)
- Glenn J Myatt
- Leadscope, Inc., 1393 Dublin Rd, Columbus, OH 43215, USA.
| | - Ernst Ahlberg
- Predictive Compound ADME & Safety, Drug Safety & Metabolism, AstraZeneca IMED Biotech Unit, Mölndal, Sweden
| | - Yumi Akahori
- Chemicals Evaluation and Research Institute, 1-4-25 Kouraku, Bunkyo-ku, Tokyo 112-0004 Japan
| | - David Allen
- Integrated Laboratory Systems, Inc., Research Triangle Park, NC, USA
| | - Alexander Amberg
- Sanofi, R&D Preclinical Safety Frankfurt, Industriepark Hoechst, D-65926 Frankfurt am Main, Germany
| | - Lennart T Anger
- Sanofi, R&D Preclinical Safety Frankfurt, Industriepark Hoechst, D-65926 Frankfurt am Main, Germany
| | - Aynur Aptula
- Unilever, Safety and Environmental Assurance Centre, Colworth, Beds, UK
| | - Scott Auerbach
- The National Institute of Environmental Health Sciences, Division of the National Toxicology Program, Research Triangle Park, NC 27709, USA
| | - Lisa Beilke
- Toxicology Solutions Inc., San Diego, CA, USA
| | | | | | - Joel Bercu
- Gilead Sciences, 333 Lakeside Drive, Foster City, CA, USA
| | - Ewan D Booth
- Syngenta, Product Safety Department, Jealott's Hill International Research Centre, Bracknell, Berkshire, RG42 6EY, UK
| | - Dave Bower
- Leadscope, Inc., 1393 Dublin Rd, Columbus, OH 43215, USA
| | - Alessandro Brigo
- Roche Pharmaceutical Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, Switzerland
| | - Natalie Burden
- National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs), Gibbs Building, 215 Euston Road, London NW1 2BE, UK
| | - Zoryana Cammerer
- Janssen Research & Development, 1400 McKean Road, Spring House, PA 19477, USA
| | - Mark T D Cronin
- School of Pharmacy and Chemistry, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Kevin P Cross
- Leadscope, Inc., 1393 Dublin Rd, Columbus, OH 43215, USA
| | - Laura Custer
- Bristol-Myers Squibb, Drug Safety Evaluation, 1 Squibb Dr, New Brunswick, NJ 08903, USA
| | | | - Krista Dobo
- Pfizer Global Research & Development, 558 Eastern Point Road, Groton, CT 06340, USA
| | - Kevin A Ford
- Global Blood Therapeutics, South San Francisco, CA 94080, USA
| | - Marie C Fortin
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, 170 Frelinghuysen Rd, Piscataway, NJ 08855, USA
| | | | - Nichola Gellatly
- National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs), Gibbs Building, 215 Euston Road, London NW1 2BE, UK
| | | | - Kyle P Glover
- Defense Threat Reduction Agency, Edgewood Chemical Biological Center, Aberdeen Proving Ground, MD 21010, USA
| | - Susanne Glowienke
- Novartis Pharma AG, Pre-Clinical Safety, Werk Klybeck, CH-4057, Basel, Switzerland
| | - Jacky Van Gompel
- Janssen Pharmaceutical Companies of Johnson & Johnson, 2340 Beerse, Belgium
| | - Steve Gutsell
- Unilever, Safety and Environmental Assurance Centre, Colworth, Beds, UK
| | - Barry Hardy
- Douglas Connect GmbH, Technology Park Basel, Hochbergerstrasse 60C, CH-4057 Basel / Basel-Stadt, Switzerland
| | - James S Harvey
- GlaxoSmithKline Pre-Clinical Development, Park Road, Ware, Hertfordshire, SG12 0DP, UK
| | - Jedd Hillegass
- Bristol-Myers Squibb, Drug Safety Evaluation, 1 Squibb Dr, New Brunswick, NJ 08903, USA
| | | | - Jui-Hua Hsieh
- Kelly Government Solutions, Research Triangle Park, NC 27709, USA
| | - Chia-Wen Hsu
- FDA Center for Drug Evaluation and Research, Silver Spring, MD 20993, USA
| | - Kathy Hughes
- Existing Substances Risk Assessment Bureau, Health Canada, Ottawa, ON, K1A 0K9, Canada
| | | | - Robert Jolly
- Toxicology Division, Eli Lilly and Company, Indianapolis, IN, USA
| | - David Jones
- Medicines and Healthcare Products Regulatory Agency, 151 Buckingham Palace Road, London, SW1W 9SZ, UK
| | - Ray Kemper
- Vertex Pharmaceuticals Inc., Discovery and Investigative Toxicology, 50 Northern Ave, Boston, MA, USA
| | - Michelle O Kenyon
- Pfizer Global Research & Development, 558 Eastern Point Road, Groton, CT 06340, USA
| | - Marlene T Kim
- FDA Center for Drug Evaluation and Research, Silver Spring, MD 20993, USA
| | - Naomi L Kruhlak
- FDA Center for Drug Evaluation and Research, Silver Spring, MD 20993, USA
| | - Sunil A Kulkarni
- Existing Substances Risk Assessment Bureau, Health Canada, Ottawa, ON, K1A 0K9, Canada
| | - Klaus Kümmerer
- Institute for Sustainable and Environmental Chemistry, Leuphana University Lüneburg, Scharnhorststraße 1/C13.311b, 21335 Lüneburg, Germany
| | - Penny Leavitt
- Bristol-Myers Squibb, Drug Safety Evaluation, 1 Squibb Dr, New Brunswick, NJ 08903, USA
| | | | - Scott Masten
- The National Institute of Environmental Health Sciences, Division of the National Toxicology Program, Research Triangle Park, NC 27709, USA
| | - Scott Miller
- Leadscope, Inc., 1393 Dublin Rd, Columbus, OH 43215, USA
| | - Janet Moser
- Chemical Security Analysis Center, Department of Homeland Security, 3401 Ricketts Point Road, Aberdeen Proving Ground, MD 21010-5405, USA; Battelle Memorial Institute, 505 King Avenue, Columbus, OH 43210, USA
| | - Moiz Mumtaz
- Agency for Toxic Substances and Disease Registry, US Department of Health and Human Services, Atlanta, GA, USA
| | - Wolfgang Muster
- Roche Pharmaceutical Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, Switzerland
| | - Louise Neilson
- British American Tobacco, Research and Development, Regents Park Road, Southampton, Hampshire, SO15 8TL, UK
| | - Tudor I Oprea
- Translational Informatics Division, Department of Internal Medicine, Health Sciences Center, The University of New Mexico, NM, USA
| | - Grace Patlewicz
- U.S. Environmental Protection Agency, National Center for Computational Toxicology, Research Triangle Park, NC 27711, USA
| | - Alexandre Paulino
- SAPEC Agro, S.A., Avenida do Rio Tejo, Herdade das Praias, 2910-440 Setúbal, Portugal
| | - Elena Lo Piparo
- Chemical Food Safety Group, Nestlé Research Center, Lausanne, Switzerland
| | - Mark Powley
- FDA Center for Drug Evaluation and Research, Silver Spring, MD 20993, USA
| | | | | | - Andrea-Nicole Richarz
- European Commission, Joint Research Centre, Directorate for Health, Consumers and Reference Materials, Chemical Safety and Alternative Methods Unit, Via Enrico Fermi 2749, 21027 Ispra, VA, Italy
| | - Patricia Ruiz
- Agency for Toxic Substances and Disease Registry, US Department of Health and Human Services, Atlanta, GA, USA
| | - Benoit Schilter
- Chemical Food Safety Group, Nestlé Research Center, Lausanne, Switzerland
| | | | - Wendy Simpson
- Unilever, Safety and Environmental Assurance Centre, Colworth, Beds, UK
| | - Lidiya Stavitskaya
- FDA Center for Drug Evaluation and Research, Silver Spring, MD 20993, USA
| | | | | | - David T Szabo
- RAI Services Company, 950 Reynolds Blvd., Winston-Salem, NC 27105, USA
| | | | | | | | | | - Brian A Wall
- Colgate-Palmolive Company, Piscataway, NJ 08854, USA
| | - Pete Watts
- Bibra, Cantium House, Railway Approach, Wallington, Surrey, SM6 0DZ, UK
| | - Angela T White
- GlaxoSmithKline Pre-Clinical Development, Park Road, Ware, Hertfordshire, SG12 0DP, UK
| | - Joerg Wichard
- Bayer Pharma AG, Investigational Toxicology, Muellerstr. 178, D-13353 Berlin, Germany
| | - Kristine L Witt
- The National Institute of Environmental Health Sciences, Division of the National Toxicology Program, Research Triangle Park, NC 27709, USA
| | - Adam Woolley
- ForthTox Limited, PO Box 13550, Linlithgow, EH49 7YU, UK
| | - David Woolley
- ForthTox Limited, PO Box 13550, Linlithgow, EH49 7YU, UK
| | - Craig Zwickl
- Transendix LLC, 1407 Moores Manor, Indianapolis, IN 46229, USA
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Dipchand A, Zuckerman W, Auerbach S, Conway J, Cherikh W, Peng D, Barnes A, Kaufman B, Thrush P, Sadavarte A, Almond C, Pahl E, Azeka E, Gajarski R, Law Y, Lorts A, VanderPluym C, Kirk R. The First Analysis of the International Pediatric Heart Failure Registry (iPHFR) - Heart Failure Hospitalizations. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Das BB, Pruitt E, Molina K, Ravekes W, Auerbach S, Savage A, Knox L, Kirklin JK, Naftel DC, Hsu D. The impact of flow PRA on outcome in pediatric heart recipients in modern era: An analysis of the Pediatric Heart Transplant Study database. Pediatr Transplant 2018; 22. [PMID: 29144053 DOI: 10.1111/petr.13087] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2017] [Indexed: 12/20/2022]
Abstract
Data from patients in the Pediatric Heart Transplant Study (PHTS) registry transplanted between 2010 and 2014 were analyzed to determine the association between HLA antibody (PRA) determined by SPA using Luminex or flow cytometry with a positive retrospective cross-match and the post-transplant outcomes of acute rejection and graft survival. A total of 1459 of 1596 (91%) recipients had a PRA reported pretransplant; 26% had a PRA > 20%. Patients with a PRA > 20% were more likely to have CHD, prior cardiac surgery, ECMO support at listing, and waited longer for transplantation than patients with a PRA <20%. Patients with higher PRA% determined by SPA were predictive of a positive retrospective cross-match determined by flow cytometric method (P < .001). A PRA > 50% determined by SPA was independently associated with worse overall graft survival after first month of transplant in both unadjusted and adjusted for all other risk factors. In this large multicenter series of pediatric heart transplant recipients, an elevated PRA determined by SPA remains a significant risk factor in the modern era.
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Affiliation(s)
- B B Das
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - E Pruitt
- Kirklin Institute for Research in Surgical Outcomes, University of Alabama at Birmingham, Birmingham, AL, USA
| | - K Molina
- Department of Pediatrics, Primary Children's Hospital, Salt Lake City, UT, USA
| | - W Ravekes
- Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD, USA
| | - S Auerbach
- Department of Pediatrics, Children's Hospital of Colorado, Aurora, CO, USA
| | - A Savage
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - L Knox
- Children's Health, Dallas, TX, USA
| | - J K Kirklin
- Kirklin Institute for Research in Surgical Outcomes, University of Alabama at Birmingham, Birmingham, AL, USA
| | - D C Naftel
- Kirklin Institute for Research in Surgical Outcomes, University of Alabama at Birmingham, Birmingham, AL, USA
| | - D Hsu
- Department of Pediatrics, The Children's Hospital at Montefiore, Bronx, NY, USA
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Hur J, Danes L, Hsieh JH, McGregor B, Krout D, Auerbach S. Tox21 Enricher: Web-based Chemical/Biological Functional Annotation Analysis Tool Based on Tox21 Toxicity Screening Platform. Mol Inform 2018; 37:e1700129. [PMID: 29377626 DOI: 10.1002/minf.201700129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/12/2018] [Indexed: 11/06/2022]
Abstract
The US Toxicology Testing in the 21st Century (Tox21) program was established to develop more efficient and human-relevant toxicity assessment methods. The Tox21 program screens >10,000 chemicals using quantitative high-throughput screening (qHTS) of assays that measure effects on toxicity pathways. To date, more than 70 assays have yielded >12 million concentration-response curves. The patterns of activity across assays can be used to define similarity between chemicals. Assuming chemicals with similar activity profiles have similar toxicological properties, we may infer toxicological properties based on its neighbourhood. One approach to inference is chemical/biological annotation enrichment analysis. Here, we present Tox21 Enricher, a web-based chemical annotation enrichment tool for the Tox21 toxicity screening platform. Tox21 Enricher identifies over-represented chemical/biological annotations among lists of chemicals (neighbourhoods), facilitating the identification of the toxicological properties and mechanisms in the chemical set.
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Affiliation(s)
- Junguk Hur
- Biomedical Sciences, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, North Dakota, 58202, USA
| | - Larson Danes
- Computer Sciences, University of North Dakota, Grand Forks, North Dakota, 58202, USA
| | - Jui-Hua Hsieh
- National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, North Carolina, 27709, USA
| | - Brett McGregor
- Biomedical Sciences, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, North Dakota, 58202, USA
| | - Dakota Krout
- Computer Sciences, University of North Dakota, Grand Forks, North Dakota, 58202, USA
| | - Scott Auerbach
- National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, North Carolina, 27709, USA
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Conway J, Miera O, Adachi I, Maeda K, Eghtesady P, Henderson HT, Guleserian K, Fan CPS, Kirk R, Canter C, Pac M, VanderPluym C, Eastaugh L, Buchholz H, Zimpfer D, Turek J, Fenton M, Neibler R, Kirklin J, Padalino M, Lorts A, Hassan M, Lytrivi I, Auerbach S, Slaughter M, Schweiger M, Ueno T, Davies R, Lamour J, Schmitto J, Zinn M, Human D, Scheel J, Li Y, Parrino P, Borik Chiger S, Stiller B, Dumfarth J, Morales D. Worldwide Experience of a Durable Centrifugal Flow Pump in Pediatric Patients. Semin Thorac Cardiovasc Surg 2018; 30:327-335. [DOI: 10.1053/j.semtcvs.2018.03.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 11/11/2022]
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40
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Walker N, Auerbach S, Devito M, Ferguson S, Ramaiahgari S, Smith-Roe S, Waidyanatha S, Rider C. New approaches addressing the challenge of evaluating safety of botanical dietary supplements. Toxicol Lett 2017. [DOI: 10.1016/j.toxlet.2017.07.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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41
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Feingold B, Mahle WT, Auerbach S, Clemens P, Domenighetti AA, Jefferies JL, Judge DP, Lal AK, Markham LW, Parks WJ, Tsuda T, Wang PJ, Yoo SJ. Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association. Circulation 2017; 136:e200-e231. [DOI: 10.1161/cir.0000000000000526] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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42
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Castleberry C, Ziniel S, Almond C, Auerbach S, Hollander SA, Lal AK, Fenton M, Pahl E, Rossano JW, Everitt MD, Daly KP. Clinical practice patterns are relatively uniform between pediatric heart transplant centers: A survey-based assessment. Pediatr Transplant 2017; 21. [PMID: 28670871 DOI: 10.1111/petr.13013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 11/29/2022]
Abstract
Clinical practice variations are a barrier to the study of pediatric heart transplants and coordination of multicenter RCTs in this patient population. We surveyed centers to describe practice patterns, understand areas of variation, and willingness to modify protocol. Pediatric heart transplant centers were identified, and one survey was completed per center. Simple descriptive statistics were used. The response rate was 77% (40 responses from 52 contacted centers, 37 with complete responses). Median center volume of respondents was eight transplants/year (IQR 3-19). Most centers reported tacrolimus (36/38, 95%) and mycophenolate mofetil (36/38, 95%) as maintenance immunosuppression. Other immunosuppression agents reported were cyclosporine (7/38, 18%), everolimus or sirolimus (3/38, 8%), and azathioprine (2/38, 5%). Overall, respondents answered similarly for questions regarding clinical practices including induction therapy, maintenance immunosuppression, and rejection treatment threshold (>85% agreement for all). Additionally, willingness to change clinical practices was over 70% for all practices surveyed (35 total respondents), and 97% of centers (36/37) were willing to participate in a RCT of maintenance immunosuppression. In conclusion, we found many similar clinical practice protocols. Most centers are willing to collaborate on a common protocol in order to participate in a RCT and support a trial investigating maintenance immunosuppression.
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Affiliation(s)
| | - Sonja Ziniel
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | | | | | - Ashwin K Lal
- Primary Children's Hospital, Salt Lake City, UT, USA
| | | | - Elfriede Pahl
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | | | | | - Kevin P Daly
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Wu L, Liu Z, Auerbach S, Huang R, Chen M, McEuen K, Xu J, Fang H, Tong W. Integrating Drug's Mode of Action into Quantitative Structure-Activity Relationships for Improved Prediction of Drug-Induced Liver Injury. J Chem Inf Model 2017; 57:1000-1006. [PMID: 28350954 PMCID: PMC6233892 DOI: 10.1021/acs.jcim.6b00719] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Drug-induced liver injury (DILI) is complex in mechanism. Different drugs could undergo different mechanisms but result in the same DILI type, while the same drug could lead to different DILI types via different mechanisms. Therefore, predicting a drug's potential for DILI should take its underlying mechanisms into consideration. To achieve that, we constructed a novel approach by incorporating the drug's Mode of Action (MOA) into Quantitative Structure-Activity Relationship (QSAR) modeling. This MOA-DILI approach was examined using a data set of 333 drugs. The drugs were first grouped according to their MOA profiles (positive or negative in each MOA) based on the Tox21 qHTS assays. QSAR models for individual MOA assays were developed and subsequently combined to obtain the MOA-DILI model. A hold-out testing strategy (222 drugs for training and 111 drugs as a test set) was employed, which yielded a predictive accuracy of 0.711. The MOA-DILI model was directly compared with the standard QSAR approach using the same hold-out strategy, and the QSAR model yielded an accuracy of 0.662. To minimize the random chance in splitting training/test sets, the hold-out testing process was repeated 1000 times, and the observed difference in prediction accuracy between MOA-DILI and QSARs was statistically significant (P value <0.0001). Out of 17 MOAs used, four assays (i.e., antioxidant response elements, PPAR-gamma, estrogen receptor, and thyroid receptor assays) contributed most to the improved prediction of the MOA-DILI model over QSARs. In conclusion, the MOA-DILI approach has the potential to significantly improve predictive outcomes and to reveal complex relationships between MOAs and DILI, all of which would be helpful in developing DILI predictive models in drug screening and for risk assessment of industrial chemicals.
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Affiliation(s)
- Leihong Wu
- National Center for Toxicological Research, US Food and Drug Administration, 3900 NCTR RD, Jefferson, AR 72079, USA
| | - Zhichao Liu
- National Center for Toxicological Research, US Food and Drug Administration, 3900 NCTR RD, Jefferson, AR 72079, USA
| | - Scott Auerbach
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, RTP, NC 27709, USA
| | - Ruili Huang
- National Center for Advancing Translational Sciences, National Institutes of Health, 9800 Medical Center Drive, Rockville, Maryland 20850, USA
| | - Minjun Chen
- National Center for Toxicological Research, US Food and Drug Administration, 3900 NCTR RD, Jefferson, AR 72079, USA
| | - Kristin McEuen
- University of Arkansas at Little Rock, 2801 S University Ave, Little Rock, AR 72204, USA
| | - Joshua Xu
- National Center for Toxicological Research, US Food and Drug Administration, 3900 NCTR RD, Jefferson, AR 72079, USA
| | - Hong Fang
- National Center for Toxicological Research, US Food and Drug Administration, 3900 NCTR RD, Jefferson, AR 72079, USA
| | - Weida Tong
- National Center for Toxicological Research, US Food and Drug Administration, 3900 NCTR RD, Jefferson, AR 72079, USA
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Kleinmahon J, Patel S, Auerbach S, Stehlik J, Rossano J, Everitt M. Hearts Transplanted After Circulatory Death in Children: Analysis of the International Society for Heart and Lung Transplantation Registry. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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45
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Riley CJ, Moore T, Eagelston L, Burkett D, Auerbach S, Ing RJ. Cardiac Failure in a Trisomy 9 Patient Undergoing Anesthesia: A Case Report. Anesth Prog 2017; 64:29-32. [PMID: 28128660 DOI: 10.2344/anpr-63-04-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
A 27-year-old female with Trisomy 9 mosaicism presented to Children's Hospital Colorado for outpatient dental surgery under general anesthesia. The patient's past medical history was also significant for premature birth, gastroesophageal reflux, scoliosis and kyphosis, obesity, and developmental delay. Per her mother's report, the patient had no cardiac issues. She had undergone multiple previous general anesthetics, some of which documented respiratory complications such as laryngospasm, bronchospasm, and possible aspiration. During this anesthetic, the patient became hypotensive on induction, with sluggish response to intravenous fluids, glycopyrrolate, and ephedrine. Her electrocardiogram demonstrated what appeared to be left bundle branch block at baseline, with possible ST segment changes after induction. Due to her abnormal reaction to the induction and subsequent treatment for hypotension, an echocardiogram was performed. The patient was found to have an ejection fraction of 25%-30%. The anesthetic was uneventful for the remainder of the procedure, and following recovery, the patient was admitted by the heart failure team for further care.
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Affiliation(s)
- Cara J Riley
- Department of Anesthesiology, Children's Hospital Colorado, Aurora, Colorado
| | - Timothy Moore
- Department of Anesthesiology, Children's Hospital Colorado, Aurora, Colorado
| | - Lauren Eagelston
- University of Colorado Medical School, Children's Hospital Colorado, Aurora, Colorado
| | - Dale Burkett
- Department of Cardiology, Children's Hospital Colorado, Aurora, Colorado
| | - Scott Auerbach
- Department of Cardiology, Children's Hospital Colorado, Aurora, Colorado
| | - Richard J Ing
- Department of Anesthesiology, Children's Hospital Colorado, Aurora, Colorado
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46
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VanSteenhouse H, Babic M, Shepard P, Auerbach S, Merrick A, Mav D, Shah R, Paules R, Yeakley J, Seligmann B. TempO-Seq surrogate whole transcriptome targeted gene expression profiling of archived rat FFPE. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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47
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Auerbach S, Filer D, Reif D, Walker V, Holloway AC, Schlezinger J, Srinivasan S, Svoboda D, Judson R, Bucher JR, Thayer KA. Prioritizing Environmental Chemicals for Obesity and Diabetes Outcomes Research: A Screening Approach Using ToxCast™ High-Throughput Data. Environ Health Perspect 2016; 124:1141-54. [PMID: 26978842 PMCID: PMC4977057 DOI: 10.1289/ehp.1510456] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/09/2015] [Accepted: 02/08/2016] [Indexed: 05/23/2023]
Abstract
BACKGROUND Diabetes and obesity are major threats to public health in the United States and abroad. Understanding the role that chemicals in our environment play in the development of these conditions is an emerging issue in environmental health, although identifying and prioritizing chemicals for testing beyond those already implicated in the literature is challenging. This review is intended to help researchers generate hypotheses about chemicals that may contribute to diabetes and to obesity-related health outcomes by summarizing relevant findings from the U.S. Environmental Protection Agency (EPA) ToxCast™ high-throughput screening (HTS) program. OBJECTIVES Our aim was to develop new hypotheses around environmental chemicals of potential interest for diabetes- or obesity-related outcomes using high-throughput screening data. METHODS We identified ToxCast™ assay targets relevant to several biological processes related to diabetes and obesity (insulin sensitivity in peripheral tissue, pancreatic islet and β cell function, adipocyte differentiation, and feeding behavior) and presented chemical screening data against those assay targets to identify chemicals of potential interest. DISCUSSION The results of this screening-level analysis suggest that the spectrum of environmental chemicals to consider in research related to diabetes and obesity is much broader than indicated by research papers and reviews published in the peer-reviewed literature. Testing hypotheses based on ToxCast™ data will also help assess the predictive utility of this HTS platform. CONCLUSIONS More research is required to put these screening-level analyses into context, but the information presented in this review should facilitate the development of new hypotheses. CITATION Auerbach S, Filer D, Reif D, Walker V, Holloway AC, Schlezinger J, Srinivasan S, Svoboda D, Judson R, Bucher JR, Thayer KA. 2016. Prioritizing environmental chemicals for obesity and diabetes outcomes research: a screening approach using ToxCast™ high-throughput data. Environ Health Perspect 124:1141-1154; http://dx.doi.org/10.1289/ehp.1510456.
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Affiliation(s)
- Scott Auerbach
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Dayne Filer
- National Center for Computational Toxicology, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - David Reif
- Bioinformatics Research Center, Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Vickie Walker
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Alison C. Holloway
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Schlezinger
- Department of Environmental Health, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Supriya Srinivasan
- Department of Chemical Physiology, The Scripps Research Institute, La Jolla, California, USA
| | - Daniel Svoboda
- SciOme, LLC, Research Triangle Park, North Carolina, USA
| | - Richard Judson
- National Center for Computational Toxicology, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - John R. Bucher
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Kristina A. Thayer
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
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48
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Ali I, Högberg J, Hsieh JH, Auerbach S, Korhonen A, Stenius U, Silins I. Gender differences in cancer susceptibility: role of oxidative stress. Carcinogenesis 2016; 37:985-992. [PMID: 27481070 DOI: 10.1093/carcin/bgw076] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 07/26/2016] [Indexed: 01/07/2023] Open
Abstract
Cancer is a leading cause of death worldwide and environmental factors, including chemicals, have been suggested as major etiological incitements. Cancer statistics indicates that men get more cancer than women. However, differences in the known risk factors including life style or occupational exposure only offer partial explanation. Using a text mining tool, we have investigated the scientific literature concerning male- and female-specific rat carcinogens that induced tumors only in one gender in NTP 2-year cancer bioassay. Our evaluation shows that oxidative stress, although frequently reported for both male- and female-specific rat carcinogens, was mentioned significantly more in literature concerning male-specific rat carcinogens. Literature analysis of testosterone and estradiol showed the same pattern. Tox21 high-throughput assay results, although showing only weak association of oxidative stress-related processes for male- and female-specific rat carcinogens, provide additional support. We also analyzed the literature concerning 26 established human carcinogens (IARC group 1). Oxidative stress was more frequently reported for the majority of these carcinogens, and the Tox21 data resembled that of male-specific rat carcinogens. Thus, our data, based on about 600000 scientific abstracts and Tox21 screening assays, suggest a link between male-specific carcinogens, testosterone and oxidative stress. This implies that a different cellular response to oxidative stress in men and women may be a critical factor in explaining the greater cancer susceptibility observed in men. Although the IARC carcinogens are classified as human carcinogens, their classification largely based on epidemiological evidence from male cohorts, which raises the question whether carcinogen classifications should be gender specific.
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Affiliation(s)
| | | | - Jui-Hua Hsieh
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709, USA and
| | - Scott Auerbach
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709, USA and
| | - Anna Korhonen
- Department of Theoretical and Applied Linguistics, University of Cambridge, Cambridge CB3 9DA, UK
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Donkervoort S, Yang M, Leach M, Medne L, Yum S, Hotchkiss L, Rutkowski A, Chatfield K, Auerbach S, Miyamoto S, Bönnemann C. Cardiomyopathy in patients with ACTA1-myopathy. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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