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Line J, Ali SE, Grice S, Rao T, Naisbitt DJ. Investigating the Immune Basis of Green Tea Extract Induced Liver Injury in Healthy Donors Expressing HLA-B*35:01. Chem Res Toxicol 2023; 36:1872-1875. [PMID: 38055372 PMCID: PMC10731652 DOI: 10.1021/acs.chemrestox.3c00253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023]
Abstract
Epigallocatechin-3-O-gallate (EGCG) is the major component of green tea extract, commonly found in dietary supplements, and has been associated with immune-mediated liver injury. The purpose of this study was to investigate the immunogenicity of EGCG in healthy donors expressing HLA-B*35:01, and characterize EGCG responsive T-cell clones. We have shown that EGCG can prime peripheral blood mononuclear cells and T-cells from donors with and without the HLA-B*35:01 allele. T-cell clones were CD4+ve and capable of secreting Th1, Th2, and cytolytic molecules. These data demonstrate that EGCG can activate T-cells in vitro, suggesting a significant role in the pathogenesis of green tea extract induced liver injury.
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Affiliation(s)
- James Line
- Department
of Pharmacology and Therapeutics, University
of Liverpool, Sherrington Building, Ashton Street, Liverpool L69 3GE, United
Kingdom
| | - Serat-E Ali
- Department
of Pharmacology and Therapeutics, University
of Liverpool, Sherrington Building, Ashton Street, Liverpool L69 3GE, United
Kingdom
| | - Sophie Grice
- Department
of Pharmacology and Therapeutics, University
of Liverpool, Sherrington Building, Ashton Street, Liverpool L69 3GE, United
Kingdom
| | - Tai Rao
- Department
of Pharmacology and Therapeutics, University
of Liverpool, Sherrington Building, Ashton Street, Liverpool L69 3GE, United
Kingdom
- Department
of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, China
- Hunan
Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha 410008, China
| | - Dean J. Naisbitt
- Department
of Pharmacology and Therapeutics, University
of Liverpool, Sherrington Building, Ashton Street, Liverpool L69 3GE, United
Kingdom
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Zhang Y, Grice S, Wang N, Liu Y, Zhao Q, Liu T, Sun L, Mi Z, Wang J, Yu G, Zhang F, Meng X, Liu H, Naisbitt DJ, Sun Y, Zhang F. HLA-C*15:02 and epidermal growth factor receptor inhibitor-induced erosive pustular dermatosis of the scalp. Clin Exp Dermatol 2023; 48:1260-1265. [PMID: 37710038 DOI: 10.1093/ced/llad282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/30/2023] [Indexed: 09/16/2023]
Abstract
Epidermal growth factor receptor inhibitors (EGFRIs) are widely used to treat various types of malignancies. One of the common adverse reactions is cutaneous toxicity, mostly presenting as acneiform eruptions, paronychia and xerosis. Erosive pustular dermatosis of the scalp (EPDS) is a rare cutaneous adverse reaction that develops during treatment with EGFRIs. The pathogenesis of EGFRI-induced EPDS is poorly understood. Here we present three cases of EPDS induced by EGFRIs. The proteins LTA4H (leukotriene A-4 hydrolase), METAP1 (methionine aminopeptidase 1), BID (BH3-interacting domain death agonist), SMAD1 (mothers against decapentaplegic homologue), PRKRA (interferon-inducible double-stranded RNA-dependent protein kinase activator A), YES1 (tyrosine-protein kinase Yes) and EGFL7 (epidermal growth factor-like protein 7) were significantly upregulated in EGFRI-stimulated peripheral blood mononuclear cell cultures, and validated in the lesions. All of the proteins colocalized with CD4+ and CD8+ T-cell expression. Next-generation-based human leucocyte antigen (HLA) typing showed all patients carried HLA-C*15:02, and modelling studies showed that afatinib and erlotinib bound well within the E/F binding pockets of HLA-C*15:02. Moreover, T cells were preferentially activated by EGFRIs in individuals carrying HLA-C*15:02. The case series revealed that EGFRI-induced EPDS may be mediated by drug-specific T cells.
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Affiliation(s)
- Yuan Zhang
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Sophie Grice
- Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - Na Wang
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Yongxia Liu
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Qing Zhao
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Tingting Liu
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Lele Sun
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Zihao Mi
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Jianwen Wang
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Gongqi Yu
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Fan Zhang
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xiaoli Meng
- Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - Hong Liu
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Dean J Naisbitt
- Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - Yonghu Sun
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Furen Zhang
- Shandong Provincial Hospital for Skin Diseases and Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
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Hammond S, Olsson-Brown A, Grice S, Naisbitt DJ. Does immune checkpoint inhibitor therapy increase the frequency of adverse reactions to concomitant medications? Clin Exp Allergy 2022; 52:600-603. [PMID: 35338535 PMCID: PMC9311166 DOI: 10.1111/cea.14134] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 12/03/2022]
Affiliation(s)
- Sean Hammond
- Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK.,ApconiX, Alderley Park, Alderley Edge, UK
| | - Anna Olsson-Brown
- Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - Sophie Grice
- Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - Dean J Naisbitt
- Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
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Hammond S, Olsson-Brown A, Grice S, Gibson A, Gardner J, Castrejón-Flores JL, Jolly C, Fisher BA, Steven N, Betts C, Pirmohamed M, Meng X, Naisbitt DJ. Checkpoint inhibition reduces the threshold for drug-specific T-Cell priming and increases the incidence of sulfasalazine hypersensitivity. Toxicol Sci 2021; 186:58-69. [PMID: 34850240 PMCID: PMC8883351 DOI: 10.1093/toxsci/kfab144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/04/2023] Open
Abstract
An emerging clinical issue associated with immune-oncology agents is the collateral effects on the tolerability of concomitant medications. One report of this phenomenon was the increased incidence of hypersensitivity reactions observed in patients receiving concurrent immune checkpoint inhibitors and sulfasalazine. Thus, the aim of this study was to characterize the T-cells involved in the pathogenesis of such reactions, and recapitulate the effects of inhibitory checkpoint blockade on de-novo priming responses to compounds within in-vitro platforms. A regulatory competent human dendritic cell/T-cell co-culture assay was used to model the effects of immune checkpoint inhibitors on de-novo nitroso sulfamethoxazole- and sulfapyridine (the sulfonamide component of sulfasalazine) hydroxylamine-specific priming responses. The role of T-cells in the pathogenesis of the observed reactions was explored in three patients through phenotypic characterization of sulfapyridine/sulfapyridine hydroxylamine-responsive T-cell clones, and assessment of cross-reactivity and pathways of T-cell activation. Augmentation of the frequency of responding drug-specific T-cells and intensity of the T-cell response was observed with PD-1/PD-L1 blockade. Monoclonal populations of sulfapyridine- and sulfapyridine hydroxylamine-responsive T-cells were isolated from all three patients. A core secretory effector molecule profile (IFN-γ, IL-13, granzyme B and perforin) was identified for sulfapyridine and sulfapyridine hydroxylamine responsive T-cell clones, which proceeded through Pi and hapten mechanisms, respectively. Data presented herein provides evidence that drug-responsive T-cells are effectors of hypersensitivity reactions observed in oncology patients administered immune checkpoint inhibitors and sulfasalazine. Perturbation of drug-specific T-cell priming is a plausible explanation for clinical observations of how an increased incidence of these adverse events is occurring.
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Affiliation(s)
- Sean Hammond
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK.,ApconiX, Alderley Park, Alderley Edge, SK10 4TG, U.K
| | - Anna Olsson-Brown
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
| | - Sophie Grice
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
| | - Andrew Gibson
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, WA, 6150
| | - Joshua Gardner
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
| | - Jose Luis Castrejón-Flores
- Instituto Politécnico Nacional, Unidad Profesional Interdisciplinaria de Biotecnología, Mexico City, 07340, México
| | - Carol Jolly
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
| | - Benjamin Alexis Fisher
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,National Institute of Health Research (NIHR) Birmingham Biomedical Research Centre, and Department of Rheumatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Neil Steven
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Cancer Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Catherine Betts
- Pathology Sciences, Drug Safety and Metabolism, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | - Munir Pirmohamed
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
| | - Xiaoli Meng
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
| | - Dean John Naisbitt
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Ashton Street, Liverpool, L69 3GE, UK
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Bowler DM, Gardiner JM, Grice S, Saavalainen P. Memory illusions: false recall and recognition in adults with Asperger's syndrome. J Abnorm Psychol 2001. [PMID: 11195990 DOI: 10.1037//0021-843x.109.4.663] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
As persons on the autistic spectrum are known not to use semantic features of word lists to aid recall, they might show diminished susceptibility to illusory memories that typically occur with lists of associated items. Alternatively, since such individuals also have poor source monitoring, they might show greater susceptibility. The authors found that adults with Asperger's syndrome (n = 10) recalled similar proportions of a nonpresented strong associate of the study list items, compared with controls (n = 15). In Experiment 2, rates of true and false recognition of study list associates did not differ significantly between Asperger (n = 10) and control (n = 10) participants. Moreover, the Asperger participants made fewer remember and more know judgments than controls for veridical but not for false recognitions. Thus, deficits found in some aspects of memory in people with Asperger's syndrome do not affect their susceptibility to memory illusions.
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Affiliation(s)
- D M Bowler
- Department of Psychology, City University, London, Northampton Square, London EC1V 0HB, United Kingdom.
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Bowler DM, Gardiner JM, Grice S, Saavalainen P. Memory illusions: false recall and recognition in adults with Asperger's syndrome. J Abnorm Psychol 2000; 109:663-72. [PMID: 11195990 DOI: 10.1037/0021-843x.109.4.663] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
As persons on the autistic spectrum are known not to use semantic features of word lists to aid recall, they might show diminished susceptibility to illusory memories that typically occur with lists of associated items. Alternatively, since such individuals also have poor source monitoring, they might show greater susceptibility. The authors found that adults with Asperger's syndrome (n = 10) recalled similar proportions of a nonpresented strong associate of the study list items, compared with controls (n = 15). In Experiment 2, rates of true and false recognition of study list associates did not differ significantly between Asperger (n = 10) and control (n = 10) participants. Moreover, the Asperger participants made fewer remember and more know judgments than controls for veridical but not for false recognitions. Thus, deficits found in some aspects of memory in people with Asperger's syndrome do not affect their susceptibility to memory illusions.
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Affiliation(s)
- D M Bowler
- Department of Psychology, City University, London, Northampton Square, London EC1V 0HB, United Kingdom.
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Affiliation(s)
- P A Friedman
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA.
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Abstract
Two experiments were conducted in which a variant of J. McGarrigle and M. Donaldson's (1975) "Naughty Teddy" intervention was applied to children's understanding of false drawings and false beliefs. The results showed that preschool children's understanding of the contents of an out-of-date drawing improved when the drawing was made by a capricious agent ("Naughty Snakey" glove puppet) rather than by the experimenter. The children's performance on a false belief task also improved when the events that set up the false belief were the result of the actions of the glove puppet. The results are discussed in terms of the role of children's sensitivity to the pragmatics of interactions in their development of a theory of mind.
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Affiliation(s)
- D M Bowler
- Department of Psychology, City University, London.
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Friedman PA, Rasmussen MJ, Grice S, Trusty J, Glikson M, Stanton MS. Defibrillation thresholds are increased by right-sided implantation of totally transvenous implantable cardioverter defibrillators. Pacing Clin Electrophysiol 1999; 22:1186-92. [PMID: 10461295 DOI: 10.1111/j.1540-8159.1999.tb00599.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Whether an ICD is placed via a left- or right-sided approach depends on venous access, the presence of a preexisting pacemaker, and other factors. Since the DFT is affected by lead position, which in turn is determined in part by the side of access, right-sided venous access could adversely affect DFTs. Furthermore, right-sided active can placement directs electric current toward the right hemithorax, which could further increase DFTs. This study sought to determine whether DFTs were increased by right-sided vascular access, and whether active can technology was beneficial or detrimental with right-sided ICD placement. Stepdown to failure DFTs were found in 290 patients receiving transvenous systems at the time of initial ICD implantation. Of these, 271 (93%) received left-sided systems and 19 (7%) received right-sided systems. The mean DFT in systems placed via left-sided vascular access was 11.3 +/- 5.3 J versus 17.0 +/- 4.9 J for right-sided implantation (P < 0.0001); right-sided DFTs were elevated for both active can and cold can systems. Right-sided active can devices had a lower DFT than right-sided cold can systems (15 +/- 4.1 J vs 19 +/- 4.8 J, P = 0.05). The right-sided implantation of implantable defibrillators results in significantly higher DFTs than the left-sided approach. This may be due to the less favorable distribution of the defibrillating field relative to the myocardium with the devices on the right. When right-sided implantation is clinically mandated, active can devices result in lower thresholds and should be used.
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Affiliation(s)
- P A Friedman
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA.
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Brady PA, Friedman PA, Trusty JM, Grice S, Hammill SC, Stanton MS. High failure rate for an epicardial implantable cardioverter-defibrillator lead: implications for long-term follow-up of patients with an implantable cardioverter-defibrillator. J Am Coll Cardiol 1998; 31:616-22. [PMID: 9502644 DOI: 10.1016/s0735-1097(97)00529-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The purpose of this study was to determine the risk of epicardial lead failure during long-term follow-up and its mode of presentation. BACKGROUND Despite the high prevalence of epicardial lead-based implantable cardioverter-defibrillators, their long-term performance is unknown, and appropriate follow-up has not been established. METHODS The study group comprised all patients in whom an epicardial lead system was implanted at the Mayo Clinic between October 31, 1984 and November 3, 1994. The number of lead fractures and leads with fluid within the insulation and the mode of presentation were determined retrospectively by review of patient visits, radiographs of lead systems and data derived from formal lead testing. RESULTS At 4 years, the survival rate free of lead malfunction, using formal lead testing, for 160 Medtronic epicardial patches (models 6897 and 6921) was 72% compared with 92.5% for the 179 Cardiac Pacemaker, Inc. (CPI) patches (models 0040 and 0041) (p = 0.01). In addition, five Medtronic patches in three patients had fluid within the lead insulation but no obvious fracture. No CPI patches had fluid identified within the leads. Of 330 Medtronic epicardial pace/sense leads (model 6917), the 4-year survival rate free of lead malfunction as assessed by lead testing was 96%. In all, 19 presentations of lead malfunction were found in 17 patients (2 patients had more than one lead fracture at different times). In 11 (58%) of these presentations, the patients were asymptomatic despite the presence of obvious lead fracture. CONCLUSIONS Epicardial lead malfunction is common on long-term follow-up, and some leads have a failure rate of 28% at 4 years. Many patients with fractured leads remain asymptomatic, despite involvement of multiple leads in some cases. Therefore, consideration should be given to regular periodic lead testing in addition to routine X-ray examination, as asymptomatic lead malfunction can present with normal chest X-ray findings.
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Affiliation(s)
- P A Brady
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA
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Abstract
The stress management-wellness health care environment is emerging as a distinct facility type in the 1980s. Yet the idea is not a new one, with roots based in the Greek Asklepieon dating from 480 B.C. This and later Western transformations for health promotion embraced the therapeutic amenity inherent in meditation, solace and communality with nature based on the premise that the need for refuge from the stress inherent in one's daily life is deep-rooted in humans. A two-phase study is reported on wellness health care provider priorities, relative to the architectural features of stress-wellness centers. Representatives of 11 health care organizations responded to a telephone survey questionnaire, and 128 respondents completed a user needs questionnaire. Four major issues were addressed: image and appearance, location and setting, services provided and costs, and patterns of use. Convenience to one's place of work, a balanced mixture of clinical and nonclinical programs, a noninstitutional retreat-like environment, and membership cost structures were found to be major user considerations with respect to planning and design concepts for wellness health care environments. Directions for further research are discussed.
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