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Flick ED, Terebelo HR, Fish S, Kitali A, Mahajan V, Nifenecker M, Sullivan K, Thaler P, Ussery S, Grinblatt DL. The Value of Pharmaceutical Industry-Sponsored Patient Registries in Oncology Clinical Research. Oncologist 2023:7191660. [PMID: 37285045 PMCID: PMC10400140 DOI: 10.1093/oncolo/oyad110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/24/2023] [Indexed: 06/08/2023] Open
Abstract
In May 2019, the US Food and Drug Administration (FDA) released the Framework for FDA's Real-World Evidence (RWE) Program, a draft guidance to evaluate the potential use of real-world data in facilitating regulatory decisions. As a result, pharmaceutical companies and medical communities see patient registries, which are large, prospective, noninterventional cohort studies, as becoming increasingly important in providing evidence of treatment effectiveness and safety in clinical practice. Patient registries are designed to collect longitudinal clinical data on a broad population to address critical medical questions over time. With their large sample sizes and broad inclusion criteria, patient registries are often used to generate RWE in the general and underrepresented patient populations that are less likely to be studied in controlled clinical trials. Here, we describe the value of industry-sponsored patient registries in oncology/hematology settings to healthcare stakeholders, in drug development, and in fostering scientific collaboration.
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Affiliation(s)
- E Dawn Flick
- Worldwide Health Economics and Outcomes Research (HEOR), Bristol Myers Squibb, San Francisco, CA, USA
| | | | - Susan Fish
- Worldwide Health Economics and Outcomes Research (HEOR), Bristol Myers Squibb, San Francisco, CA, USA
| | - Amani Kitali
- US Medical Affairs, Bristol Myers Squibb, Summit, NJ, USA
| | - Vrinda Mahajan
- Corporate Medical Affairs, Global Scientific Communications, Bristol Myers Squibb, Summit, NJ, USA
- Legend Biotech, Piscataway, NJ, USA
| | - Melissa Nifenecker
- Research and Early Development Alliances, Bristol Myers Squibb, Summit, NJ, USA
| | - Kristen Sullivan
- Worldwide Health Economics and Outcomes Research (HEOR), Bristol Myers Squibb, San Francisco, CA, USA
| | - Paul Thaler
- US Medical Affairs, Bristol Myers Squibb, Summit, NJ, USA
- ThirdWaveRx, Las Vegas, NV, USA
| | - Sarah Ussery
- US Medical Affairs, Bristol Myers Squibb, Summit, NJ, USA
- BeyondSpring Pharma, Inc., New York, NY, USA
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Biefer HRC, Isker J, Nian Y, El Fatimy R, Camacho V, Emmert MY, Fish S, Loscalzo AJ, Roberts F, Battinelli E, Loscalzo J, Vasudevan A, Abdallah E. Serotonin-Induced Vasoconstriction Mediated by NAD+ as a Therapy for Bleeding Disorders. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725839] [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: 10/21/2022]
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3
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Gerson-Gurwitz A, Goel V, Young N, Eam B, Stumpf C, Barrera M, Sung E, Staunton J, Chen J, Fish S, Chiang G, Thompson P. Dissection of cancer therapy combinations in RTK driven tumors using zotatifin (eFT226), a potent and selective eIF4A inhibitor. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31226-0] [Citation(s) in RCA: 1] [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: 10/23/2022]
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4
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Gerstenberger BS, Ambler C, Arnold EP, Banker ME, Brown MF, Clark JD, Dermenci A, Dowty ME, Fensome A, Fish S, Hayward MM, Hegen M, Hollingshead BD, Knafels JD, Lin DW, Lin TH, Owen DR, Saiah E, Sharma R, Vajdos FF, Xing L, Yang X, Yang X, Wright SW. Discovery of Tyrosine Kinase 2 (TYK2) Inhibitor (PF-06826647) for the Treatment of Autoimmune Diseases. J Med Chem 2020; 63:13561-13577. [PMID: 32787094 DOI: 10.1021/acs.jmedchem.0c00948] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tyrosine kinase 2 (TYK2) is a member of the JAK kinase family that regulates signal transduction downstream of receptors for the IL-23/IL-12 pathways and type I interferon family, where it pairs with JAK2 or JAK1, respectively. On the basis of human genetic and emerging clinical data, a selective TYK2 inhibitor provides an opportunity to treat autoimmune diseases delivering a potentially differentiated clinical profile compared to currently approved JAK inhibitors. The discovery of an ATP-competitive pyrazolopyrazinyl series of TYK2 inhibitors was accomplished through computational and structurally enabled design starting from a known kinase hinge binding motif. With understanding of PK/PD relationships, a target profile balancing TYK2 potency and selectivity over off-target JAK2 was established. Lead optimization involved modulating potency, selectivity, and ADME properties which led to the identification of the clinical candidate PF-06826647 (22).
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Affiliation(s)
| | | | - Eric P Arnold
- Pfizer Inc., Groton, Connecticut 06340, United States
| | | | | | - James D Clark
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | | | - Martin E Dowty
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Andrew Fensome
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Susan Fish
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | | | - Martin Hegen
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | | | | | - David W Lin
- Pfizer Inc., Groton, Connecticut 06340, United States
| | - Tsung H Lin
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Dafydd R Owen
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Eddine Saiah
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Raman Sharma
- Pfizer Inc., Groton, Connecticut 06340, United States
| | | | - Li Xing
- Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Xiaojing Yang
- Pfizer Inc., Groton, Connecticut 06340, United States
| | - Xin Yang
- Pfizer Inc., Groton, Connecticut 06340, United States
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Fish S. Pilot of an advanced practitioner physiotherapist to improve the triage process and assess patients with non-inflammatory conditions in rheumatology. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.048] [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: 10/27/2022]
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Schnute ME, Wennerstål M, Alley J, Bengtsson M, Blinn JR, Bolten CW, Braden T, Bonn T, Carlsson B, Caspers N, Chen M, Choi C, Collis LP, Crouse K, Färnegårdh M, Fennell KF, Fish S, Flick AC, Goos-Nilsson A, Gullberg H, Harris PK, Heasley SE, Hegen M, Hromockyj AE, Hu X, Husman B, Janosik T, Jones P, Kaila N, Kallin E, Kauppi B, Kiefer JR, Knafels J, Koehler K, Kruger L, Kurumbail RG, Kyne RE, Li W, Löfstedt J, Long SA, Menard CA, Mente S, Messing D, Meyers MJ, Napierata L, Nöteberg D, Nuhant P, Pelc MJ, Prinsen MJ, Rhönnstad P, Backström-Rydin E, Sandberg J, Sandström M, Shah F, Sjöberg M, Sundell A, Taylor AP, Thorarensen A, Trujillo JI, Trzupek JD, Unwalla R, Vajdos FF, Weinberg RA, Wood DC, Xing L, Zamaratski E, Zapf CW, Zhao Y, Wilhelmsson A, Berstein G. Discovery of 3-Cyano-N-(3-(1-isobutyrylpiperidin-4-yl)-1-methyl-4-(trifluoromethyl)-1H-pyrrolo[2,3-b]pyridin-5-yl)benzamide: A Potent, Selective, and Orally Bioavailable Retinoic Acid Receptor-Related Orphan Receptor C2 Inverse Agonist. J Med Chem 2018; 61:10415-10439. [DOI: 10.1021/acs.jmedchem.8b00392] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Tomas Bonn
- Karo Bio AB (now Karo Pharma AB), 111 48 Stockholm, Sweden
| | - Bo Carlsson
- Karo Bio AB (now Karo Pharma AB), 111 48 Stockholm, Sweden
| | - Nicole Caspers
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
| | - Ming Chen
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
| | - Chulho Choi
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
| | | | | | | | | | | | - Andrew C. Flick
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
| | | | | | | | - Steven E. Heasley
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
| | | | | | | | - Bolette Husman
- Karo Bio AB (now Karo Pharma AB), 111 48 Stockholm, Sweden
| | - Tomasz Janosik
- Karo Bio AB (now Karo Pharma AB), 111 48 Stockholm, Sweden
| | | | | | | | - Björn Kauppi
- Karo Bio AB (now Karo Pharma AB), 111 48 Stockholm, Sweden
| | | | - John Knafels
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
| | - Konrad Koehler
- Karo Bio AB (now Karo Pharma AB), 111 48 Stockholm, Sweden
| | - Lars Kruger
- Karo Bio AB (now Karo Pharma AB), 111 48 Stockholm, Sweden
| | - Ravi G. Kurumbail
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
| | - Robert E. Kyne
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
| | | | | | | | - Carol A. Menard
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
| | | | | | | | | | | | - Philippe Nuhant
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
| | | | | | | | | | | | | | | | - Maria Sjöberg
- Karo Bio AB (now Karo Pharma AB), 111 48 Stockholm, Sweden
| | - Aron Sundell
- Karo Bio AB (now Karo Pharma AB), 111 48 Stockholm, Sweden
| | | | | | - John I. Trujillo
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
| | | | | | - Felix F. Vajdos
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
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Osorio JC, Ni A, Chaft JE, Pollina R, Kasler MK, Stephens D, Rodriguez C, Cambridge L, Rizvi H, Wolchok JD, Merghoub T, Rudin CM, Fish S, Hellmann MD. Antibody-mediated thyroid dysfunction during T-cell checkpoint blockade in patients with non-small-cell lung cancer. Ann Oncol 2017; 28:583-589. [PMID: 27998967 DOI: 10.1093/annonc/mdw640] [Citation(s) in RCA: 441] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Programmed cell death protein-1 (PD-1) blockade therapies have demonstrated durable responses and prolonged survival in a variety of malignancies. Treatment is generally well tolerated although immune-related adverse events (irAEs) can occur. Autoimmune thyroid dysfunction is among the most common irAE, but an assessment of the clinical, mechanistic, and immunologic features has not been previously described. Patient and methods Patients with advanced non-small-cell lung cancer (NSCLC) treated with pembrolizumab at Memorial Sloan Kettering Cancer Center (n = 51) as part of KEYNOTE-001 (NCT01295827) were included. Thyroid function test and anti-thyroid antibodies were assessed prospectively at each study visit, beginning before the first treatment. Frequency of development of thyroid dysfunction, association with anti-thyroid antibodies, clinical course, and relationship with progression-free survival and overall survival to treatment with pembrolizumab was evaluated. Results Of 51 patients treated, 3 were hypothyroid and 48 were not at baseline. Ten of 48 [21%, 95% confidence interval (CI) 10% to 35%] patients developed thyroid dysfunction requiring thyroid replacement. Anti-thyroid antibodies were present in 8 of 10 patients who developed thyroid dysfunction, compared with 3 of 38 who did not (80% versus 8%, P < 0.0001). Thyroid dysfunction occurred early (median, 42 days) in the pembrolizumab course, and a majority (6 of 10 patients) experienced brief, transient hyperthyroidism preceding the onset of hypothyroidism; no persistent hyperthyroidism occurred. Both hyperthyroidism and hypothyroidism were largely asymptomatic. Overall survival with pembrolizumab was significantly longer in subjects who developed thyroid dysfunction (hazard ratio, 0.29; 95% CI 0.09-0.94; P = 0.04). Conclusions Thyroid dysfunction during pembrolizumab treatment of NSCLC is common and is characterized by early-onset, frequently preceded by transient hyperthyroidism, closely associated with anti-thyroid antibodies, and may be associated with improved outcomes. The presence of antibody-mediated toxicity in T-cell-directed therapy suggests an under-recognized impact of PD-1 biology in modulating humoral immunity.
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Affiliation(s)
- J C Osorio
- Department of Medicine, Weill Cornell Medical College, New York, USA
| | - A Ni
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J E Chaft
- Department of Medicine, Weill Cornell Medical College, New York, USA,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - R Pollina
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M K Kasler
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - D Stephens
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Rodriguez
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - L Cambridge
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - H Rizvi
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J D Wolchok
- Department of Medicine, Weill Cornell Medical College, New York, USA,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA,Parker Institute for Cancer Immunotherapy at Memorial Sloan Kettering, New York, , USA,Ludwig Institute for Cancer Research, New York, USA
| | - T Merghoub
- Department of Medicine, Weill Cornell Medical College, New York, USA,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA,Parker Institute for Cancer Immunotherapy at Memorial Sloan Kettering, New York, , USA,Ludwig Institute for Cancer Research, New York, USA
| | - C M Rudin
- Department of Medicine, Weill Cornell Medical College, New York, USA,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - S Fish
- Department of Medicine, Weill Cornell Medical College, New York, USA,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M D Hellmann
- Department of Medicine, Weill Cornell Medical College, New York, USA,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA,Parker Institute for Cancer Immunotherapy at Memorial Sloan Kettering, New York, , USA
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8
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Krivak G, Woodruff G, Forrest S, Mbungu H, Orcel K, Fish S, Brown-Frase S. A Mixed-Method Multiple Case Study of Three Business Models for Local Healthy Food Delivery Systems in Underprivileged Urban Areas. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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9
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Flick Elizabeth D, Shiansong Li J, Jirau-Lucca G, Ondovik M, Nifenecker M, Fish S, Liu H, Hua Huang J, Swern A, Louis C. Treatment patterns and clinical outcomes in patients with metastatic pancreatic cancer treated with first-line nab-paclitaxel plus gemcitabine: Analysis of US electronic health records from the Flatiron Health Database. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx261.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Gandhi L, Gadgeel S, Shaw A, Barlesi F, Crinò L, Yang JH, Dingemans AM, Kim DW, de Marinis F, Schulz M, Liu S, Fish S, Kotb A, Ou SH. Time to response in patients with ALK+ NSCLC receiving alectinib in the phase II NP28673 and NP28761 studies. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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Leon L, Kosty M, Jahanzeb M, Spigel D, Wozniak AJ, Brahmer J, Fish S, Flick ED, Hazard SJ, Lynch TJ. Effectiveness of bevacizumab exposure beyond disease progression in patients with non-small-cell lung cancer: analyses of the ARIES observational cohort study. Pharmacoepidemiol Drug Saf 2016; 25:569-77. [DOI: 10.1002/pds.3948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 10/14/2015] [Accepted: 11/25/2015] [Indexed: 12/16/2022]
Affiliation(s)
- Larry Leon
- Department of US Medical Affairs; Genentech, Inc.; South San Francisco CA USA
| | - Michael Kosty
- Department of Oncology; Scripps Clinic; La Jolla CA USA
| | - Mohammad Jahanzeb
- Department of Internal Medicine; University of Miami Sylvester Comprehensive Cancer Center; Miami FL USA
| | - David Spigel
- Department of Oncology; Sarah Cannon Research Institute; Nashville TN USA
| | - Antoinette J. Wozniak
- Department of Oncology, Karmanos Cancer Institute; Wayne State University; Detroit MI USA
| | - Julie Brahmer
- Department of Oncology; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Baltimore MD USA
| | - Susan Fish
- Department of US Medical Affairs; Genentech, Inc.; South San Francisco CA USA
| | - E. Dawn Flick
- Department of US Medical Affairs; Genentech, Inc.; South San Francisco CA USA
| | - Sebastien J. Hazard
- Department of US Medical Affairs; Genentech, Inc.; South San Francisco CA USA
| | - Thomas J. Lynch
- Department of Oncology; Yale Cancer Center and Smilow Cancer Hospital; New Haven CT USA
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Giannitti F, Diab S, Mete A, Stanton JB, Fielding L, Crossley B, Sverlow K, Fish S, Mapes S, Scott L, Pusterla N. Necrotizing Enteritis and Hyperammonemic Encephalopathy Associated With Equine Coronavirus Infection in Equids. Vet Pathol 2015; 52:1148-56. [PMID: 25648965 DOI: 10.1177/0300985814568683] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Equine coronavirus (ECoV) is a Betacoronavirus recently associated clinically and epidemiologically with emerging outbreaks of pyrogenic, enteric, and/or neurologic disease in horses in the United States, Japan, and Europe. We describe the pathologic, immunohistochemical, ultrastructural, and molecular findings in 2 horses and 1 donkey that succumbed to natural infection with ECoV. One horse and the donkey (case Nos. 1, 3) had severe diffuse necrotizing enteritis with marked villous attenuation, epithelial cell necrosis at the tips of the villi, neutrophilic and fibrinous extravasation into the small intestinal lumen (pseudomembrane formation), as well as crypt necrosis, microthrombosis, and hemorrhage. The other horse (case No. 2) had hyperammonemic encephalopathy with Alzheimer type II astrocytosis throughout the cerebral cortex. ECoV was detected by quantitative polymerase chain reaction in small intestinal tissue, contents, and/or feces, and coronavirus antigen was detected by immunohistochemistry in the small intestine in all cases. Coronavirus-like particles characterized by spherical, moderately electron lucent, enveloped virions with distinct peplomer-like structures projecting from the surface were detected by negatively stained transmission electron microscopy in small intestine in case No. 1, and transmission electron microscopy of fixed small intestinal tissue from the same case revealed similar 85- to 100-nm intracytoplasmic particles located in vacuoles and free in the cytoplasm of unidentified (presumably epithelial) cells. Sequence comparison showed 97.9% to 99.0% sequence identity with the ECoV-NC99 and Tokachi09 strains. All together, these results indicate that ECoV is associated with necrotizing enteritis and hyperammonemic encephalopathy in equids.
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Affiliation(s)
- F Giannitti
- California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California, Davis, CA, USA Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN, USA
| | - S Diab
- California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - A Mete
- California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - J B Stanton
- Department of Veterinary Microbiology and Pathology and Washington Animal Disease Diagnostic Laboratory, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - L Fielding
- Loomis Basin Equine Medical Center, Loomis, CA, USA
| | - B Crossley
- California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - K Sverlow
- California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - S Fish
- California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - S Mapes
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - L Scott
- Idaho Equine Hospital, Nampa, ID, USA
| | - N Pusterla
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA
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Wozniak AJ, Kosty MP, Jahanzeb M, Brahmer JR, Spigel DR, Leon L, Fish S, Flick ED, Hazard SJ, Lynch TJ. Clinical outcomes in elderly patients with advanced non-small cell lung cancer: results from ARIES, a bevacizumab observational cohort study. Clin Oncol (R Coll Radiol) 2015; 27:187-96. [PMID: 25576353 DOI: 10.1016/j.clon.2014.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 10/01/2014] [Accepted: 12/04/2014] [Indexed: 12/01/2022]
Abstract
AIMS Retrospective analyses from first-line clinical studies in advanced non-small cell lung cancer (NSCLC) have reported conflicting results on progression-free survival (PFS) and overall survival benefits with the addition of bevacizumab to chemotherapy in elderly patients. Here we report effectiveness and safety outcomes by age subgroup for patients with NSCLC in the ARIES observational cohort study. MATERIALS AND METHODS ARIES enrolled patients with advanced non-squamous NSCLC who received first-line bevacizumab-containing treatment per physician's choice. Kaplan-Meier estimates were used to calculate medians and 95% confidence intervals for PFS and overall survival for patients aged <65, ≥65, <75 and ≥75 years. RESULTS In total, 1967 patients receiving first-line treatment with bevacizumab and chemotherapy were enrolled. The median PFS and overall survival values were 6.4 (95% confidence interval = 6.0-6.8) and 14.2 (95% confidence interval = 12.7-15.2) months for patients aged <65 years, respectively, and 6.8 (95% confidence interval = 6.3-7.0) and 12.1 (95% confidence interval = 11.4-13.1) months for patients ≥65 years, respectively. For patients <75 years, the median PFS and overall survival values were 6.6 (95% confidence interval = 6.3-6.9) and 13.5 (95% confidence interval = 12.6-14.5) months, respectively, and 6.6 (95% confidence interval = 5.9-7.1) and 11.6 (95% confidence interval = 10.0-12.5) months, respectively, for patients ≥75 years. Incidence proportions of bevacizumab-associated adverse events were generally similar across all age groups. CONCLUSIONS Data from the ARIES study suggest that treatment with bevacizumab in combination with chemotherapy is a viable first-line treatment option for elderly bevacizumab-eligible patients with advanced non-squamous NSCLC.
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Affiliation(s)
- A J Wozniak
- Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA.
| | | | - M Jahanzeb
- UM Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - J R Brahmer
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - D R Spigel
- Sarah Cannon Research Institute, Nashville, TN, USA
| | - L Leon
- Genentech, Inc., South San Francisco, CA, USA
| | - S Fish
- Genentech, Inc., South San Francisco, CA, USA
| | - E D Flick
- Genentech, Inc., South San Francisco, CA, USA
| | - S J Hazard
- Genentech, Inc., South San Francisco, CA, USA
| | - T J Lynch
- Yale Cancer Center and Smilow Cancer Hospital, New Haven, CT, USA
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14
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Kosty MP, Wozniak AJ, Jahanzeb M, Leon L, Fish S, Hazard SJ, Lynch TJ. Effectiveness and safety of post-induction phase bevacizumab treatment for patients with non-small-cell lung cancer: results from the ARIES observational cohort study. Target Oncol 2015; 10:509-16. [PMID: 25559289 DOI: 10.1007/s11523-014-0355-4] [Citation(s) in RCA: 6] [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: 08/22/2014] [Accepted: 12/18/2014] [Indexed: 11/29/2022]
Abstract
Data from randomized, controlled trials suggest that post-induction phase (IP) treatment with bevacizumab may benefit patients with advanced non-small-cell lung cancer (NSCLC). Real-world clinical practice, however, can involve variable use and patterns of treatment in broader patient populations. To assess the effect of bevacizumab on post-IP overall survival (OS) following IP chemotherapy + bevacizumab, analyses were conducted in patients enrolled in the Avastin(®) Registry--Investigation of Effectiveness and Safety (ARIES) observational cohort study (OCS) who received post-IP bevacizumab. ARIES was a large, prospective OCS of patients who received chemotherapy in combination with bevacizumab for the first-line treatment of NSCLC. This unplanned, post hoc analysis included patients who received chemotherapy and bevacizumab and who did not have progressive disease through the completion of IP treatment. A dichotomous analysis compared outcomes in patients who did and did not receive bevacizumab before a landmark date of day 30 post IP. A cumulative exposure analysis used a time-dependent Cox regression model to assess the effect of cumulative post-IP bevacizumab exposure on post-IP OS. In the dichotomous analysis, the duration of post-IP OS was significantly longer in patients who received post-IP bevacizumab; median post-IP OS was 15.6 vs. 11.3 months, respectively (hazard ratio [HR] = 0.80; 95 % confidence interval 0.71-0.91; P < 0.001). The cumulative exposure analysis observed that each additional cycle of cumulative bevacizumab exposure decreased the HR for post-IP OS by 2.7 %, on average. In conclusion, post-IP bevacizumab exposure was associated with improved post-IP OS in patients with advanced NSCLC who were enrolled in the ARIES OCS.
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Affiliation(s)
- Michael P Kosty
- Scripps Clinic, 10666 N Torrey Pines Rd - MS217, La Jolla, CA, 92037, USA.
| | | | - Mohammad Jahanzeb
- The University of Miami Sylvester Cancer Center, Deerfield Beach, FL, USA
| | - Larry Leon
- Genentech, Inc., South San Francisco, CA, USA
| | - Susan Fish
- Genentech, Inc., South San Francisco, CA, USA
| | | | - Thomas J Lynch
- Yale Cancer Center and Smilow Cancer Hospital, New Haven, CT, USA
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15
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Kasaian MT, Page KM, Fish S, Brennan A, Cook TA, Moreira K, Zhang M, Jesson M, Marquette K, Agostinelli R, Lee J, Williams CMM, Tchistiakova L, Thakker P. Therapeutic activity of an interleukin-4/interleukin-13 dual antagonist on oxazolone-induced colitis in mice. Immunology 2014; 143:416-27. [PMID: 24831554 DOI: 10.1111/imm.12319] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 05/08/2014] [Accepted: 05/12/2014] [Indexed: 02/06/2023] Open
Abstract
Interleukin-4 (IL-4) and IL-13 are critical drivers of immune activation and inflammation in ulcerative colitis, asthma and other diseases. Because these cytokines may have redundant function, dual targeting holds promise for achieving greater efficacy. We have recently described a bifunctional therapeutic targeting IL-4 and IL-13 developed on a novel protein scaffold, generated by combining specific binding domains in an optimal configuration using appropriate linker regions. In the current study, the bifunctional IL-4/IL-13 antagonist was evaluated in the murine oxazolone-induced colitis model, which produces disease with features of ulcerative colitis. The bifunctional IL-4/IL-13 antagonist reduced body weight loss throughout the 7-day course of the model, and ameliorated the increased colon weight and decreased colon length that accompany disease. Colon tissue gene expression was modulated in accordance with the treatment effect. Concentrations of serum amyloid P were elevated in proportion to disease severity, making it an effective biomarker. Serum concentrations of the bifunctional IL-4/IL-13 antagonist were inversely proportional to disease severity, colon tissue expression of pro-inflammatory genes, and serum amyloid P concentration. Taken together, these results define a panel of biomarkers signifying engagement of the IL-4/IL-13 pathway, confirm the T helper type 2 nature of disease in this model, and demonstrate the effectiveness of dual cytokine blockade.
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Gaynor AM, Fish S, Duerr RS, Cruz FND, Pesavento PA. Identification of a novel papillomavirus in a Northern Fulmar (Fulmarus glacialis) with viral production in cartilage. Vet Pathol 2014; 52:553-61. [PMID: 25034110 DOI: 10.1177/0300985814542812] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report the identification of a novel papillomavirus, Fulmarus glacialis papillomavirus 1 (FgPV1), present within an interdigital foot mass of a Northern Fulmar (Fulmarus glacialis). The mass of interest was composed of normal stratified and keratinized epithelium and dense mesenchymal cells with central cartilaginous islands. Within the nuclei of many chondrocytes were loose aggregates or paracrystalline arrays of virions approximately 50 nm in size. Degenerate polymerase chain reaction was used to identify the virus as a putative papillomavirus, and the entire viral genome of 8132 base pairs was subsequently amplified and sequenced. Analysis revealed canonical papillomavirus architecture, including the early open reading frames E6, E7, E1, and E2 and the 2 late proteins L1 and L2. FgPV1 is most closely related to a cluster of avian and reptilian papillomaviruses as visualized by phylogenetic trees. This observation suggests that papillomavirus virion production can occur in mesenchymal cells.
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Affiliation(s)
- A M Gaynor
- Department of Pathology, Microbiology, Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - S Fish
- California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - R S Duerr
- International Bird Rescue, San Francisco Bay Center, Fairfield, CA, USA
| | - F N Dela Cruz
- Department of Pathology, Microbiology, Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - P A Pesavento
- Department of Pathology, Microbiology, Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA
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Bendell J, Cohn A, Mun Y, Fish S, Sommer N, Grothey A. Clinical Outcomes with First-Line Bevacizumab and Chemotherapy for Patients with Metastatic Colorectal Cancer and a History of Diabetes: Results From the Aries Observational Cohort Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu164.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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18
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Grothey A, Flick ED, Cohn AL, Bekaii-Saab TS, Bendell JC, Kozloff M, Roach N, Mun Y, Fish S, Hurwitz HI. Bevacizumab exposure beyond first disease progression in patients with metastatic colorectal cancer: analyses of the ARIES observational cohort study. Pharmacoepidemiol Drug Saf 2014; 23:726-34. [PMID: 24830357 DOI: 10.1002/pds.3633] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [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: 11/21/2013] [Revised: 03/14/2014] [Accepted: 04/02/2014] [Indexed: 12/31/2022]
Abstract
PURPOSE This analysis from Avastin® Registries: Investigation of Effectiveness and Safety (ARIES) examined the association between exposure to bevacizumab after disease progression (PD) and postprogression survival (PPS) in bevacizumab-exposed metastatic colorectal cancer (mCRC) through the application of time-dependent and time-fixed analytical methods. METHODS Patients with mCRC who were treated with first-line bevacizumab and who survived first PD (PD1) were included. A time-dependent Cox regression model was fitted to assess the effect of cumulative bevacizumab exposure on PPS, while controlling for potential confounders. In addition to support findings from previous studies, a modified intent-to-treat (mITT) analysis compared PPS in patients who received bevacizumab beyond disease progression (BBP) with those who did not (No-BBP). RESULTS Of 1550 patients, 1199 survived PD1 and had a median PPS of 13.4 months. Cumulative bevacizumab exposure was associated with improved PPS (p = 0.0040). After adjusting for confounders, the hazard ratios (HRs) for PPS decreased, on average, by 1.2% (range, 1.1-1.3%) with each additional dose of bevacizumab. In the mITT analysis, the median PPS for BBP (n = 438) was 14.4 months vs 10.6 months with for No-BBP (n = 667). BBP was found to be independently associated with longer PPS in a multivariable Cox regression analysis (HR, 0.84; 95% confidence interval, 0.73-0.97). Protocol-specified adverse events suspected to be associated with bevacizumab occurred in 13.0% of patients with BBP. CONCLUSION This analysis supports the observation that bevacizumab exposure after PD1 is associated with longer PPS in mCRC.
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Affiliation(s)
- Axel Grothey
- Mayo Clinic, Medical Oncology, Rochester, MN, USA
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Hurwitz HI, Bekaii-Saab TS, Bendell JC, Cohn AL, Kozloff M, Roach N, Mun Y, Fish S, Flick ED, Grothey A. Safety and effectiveness of bevacizumab treatment for metastatic colorectal cancer: final results from the Avastin(®) Registry - Investigation of Effectiveness and Safety (ARIES) observational cohort study. Clin Oncol (R Coll Radiol) 2014; 26:323-32. [PMID: 24686090 DOI: 10.1016/j.clon.2014.03.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [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: 10/15/2013] [Revised: 01/27/2014] [Accepted: 01/30/2014] [Indexed: 02/07/2023]
Abstract
AIMS The Avastin(®) Registry - Investigation of Effectiveness and Safety (ARIES) observational cohort study (OCS) was designed to prospectively examine outcomes associated with bevacizumab-containing treatment for metastatic colorectal cancer (mCRC) in a community-based setting, where patient populations are less restricted than those in randomised trials. MATERIALS AND METHODS Patients with mCRC who were eligible for bevacizumab in combination with chemotherapy in first- or second-line treatment were enrolled from November 2006 to September 2008. There were no protocol-specified treatment regimens; the dose and schedule of bevacizumab and chemotherapy were at the treating physician's discretion. The objectives in the ARIES OCS included analyses of progression-free survival (PFS), overall survival, treatment patterns and safety in each of the first- and second-line treatment cohorts. RESULTS ARIES enrolled 1550 patients with mCRC receiving first-line therapy with bevacizumab. The median follow-up time was 20.6 months. The median PFS in this cohort was 10.2 months (95% confidence interval 9.8-10.6) and the median overall survival was 23.2 months (95% confidence interval 21.2-24.8). In a separate cohort of 482 patients with second-line mCRC, the median follow-up time was 16.9 months, the median PFS and overall survival from the start of second-line treatment to the end of follow-up was 7.9 months (95% confidence interval 7.2-8.3) and 17.8 months (95% confidence interval 16.5-20.7), respectively. Incidences of known bevacizumab-associated adverse events in ARIES were generally consistent with those previously reported in OCSs and randomised trials. CONCLUSION Results from the prospective ARIES OCS add further evidence to support the effectiveness and safety of bevacizumab when added to first- and second-line treatment regimens for patients with mCRC in community treatment settings.
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Affiliation(s)
- H I Hurwitz
- Division of Hematology and Oncology, Duke University Medical Center, Durham, NC, USA.
| | - T S Bekaii-Saab
- Department of Internal Medicine, The Ohio State University Medical Center, Columbus, OH, USA
| | - J C Bendell
- Department of Gastrointestinal Oncology, Sarah Cannon Research Institute, Nashville, TN, USA
| | - A L Cohn
- Department of Medical Oncology, Rocky Mountain Cancer Center, Denver, CO, USA
| | - M Kozloff
- Department of Hematology & Oncology, Ingalls Hospital and University of Chicago, Harvey, IL, USA
| | - N Roach
- Patient Advocacy, FightColorectalCancer.org, Alexandria, VA, USA
| | - Y Mun
- U.S. Medical Affairs, Genentech, Inc., South San Francisco, CA, USA
| | - S Fish
- U.S. Medical Affairs, Genentech, Inc., South San Francisco, CA, USA
| | - E D Flick
- U.S. Medical Affairs, Genentech, Inc., South San Francisco, CA, USA
| | - A Grothey
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
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20
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Kaila N, Follows B, Leung L, Thomason J, Huang A, Moretto A, Janz K, Lowe M, Mansour TS, Hubeau C, Page K, Morgan P, Fish S, Xu X, Williams C, Saiah E. Discovery of Isoquinolinone Indole Acetic Acids as Antagonists of Chemoattractant Receptor Homologous Molecule Expressed on Th2 Cells (CRTH2) for the Treatment of Allergic Inflammatory Diseases. J Med Chem 2014; 57:1299-322. [DOI: 10.1021/jm401509e] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Neelu Kaila
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Bruce Follows
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Louis Leung
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Jennifer Thomason
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Adrian Huang
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Alessandro Moretto
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Kristin Janz
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Michael Lowe
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Tarek S. Mansour
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Cedric Hubeau
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Karen Page
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Paul Morgan
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Susan Fish
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Xin Xu
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Cara Williams
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
| | - Eddine Saiah
- Pfizer Research and Development, Cambridge, Massachusetts 02140, United States
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21
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Kasaian MT, Marquette K, Fish S, DeClercq C, Agostinelli R, Cook TA, Brennan A, Lee J, Fitz L, Brooks J, Vugmeyster Y, Williams CMM, Lofquist A, Tchistiakova L. An IL-4/IL-13 dual antagonist reduces lung inflammation, airway hyperresponsiveness, and IgE production in mice. Am J Respir Cell Mol Biol 2013; 49:37-46. [PMID: 23449738 DOI: 10.1165/rcmb.2012-0500oc] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IL-4 and IL-13 comprise promising targets for therapeutic interventions in asthma and other Th2-associated diseases, but agents targeting either IL-4 or IL-13 alone have shown limited efficacy in human clinical studies. Because these cytokines may involve redundant function, dual targeting holds promise for achieving greater efficacy. We describe a bifunctional therapeutic targeting IL-4 and IL-13, developed by a combination of specific binding domains. IL-4-targeted and IL-13-targeted single chain variable fragments were joined in an optimal configuration, using appropriate linker regions on a novel protein scaffold. The bifunctional IL-4/IL-13 antagonist displayed high affinity for both cytokines. It was a potent and efficient neutralizer of both murine IL-4 and murine IL-13 bioactivity in cytokine-responsive Ba/F3 cells, and exhibited a half-life of approximately 4.7 days in mice. In a murine model of ovalbumin-induced ear swelling, the bifunctional molecule blocked both the IL-4/IL-13-dependent early-phase response and the IL-4-dependent late-phase response. In the ovalbumin-induced lung inflammation model, the bifunctional IL-4/IL-13 antagonist reduced the IL-4-dependent rise in serum IgE titers, and reduced IL-13-dependent airway hyperresponsiveness, lung inflammation, mucin gene expression, and serum chitinase responses. Taken together, these findings demonstrate the effective dual blockade of IL-4 and IL-13 with a single agent, which resulted in the modulation of a more extensive range of endpoints than could be achieved by targeting either cytokine alone.
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22
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Cohn AL, Hurwitz H, Bekaii-Saab TS, Bendell JC, Kozloff M, Tezcan H, Flick ED, Mun Y, Fish S, Dalal D, Grothey A. Effectiveness of bevacizumab (BV) beyond disease progression in metastatic colorectal cancer (mCRC): Analyses by sex in the ARIES observational cohort study (OCS). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.4_suppl.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
514 Background: Randomized trials and OCSs have demonstrated that BV treatment in 1st-line (1L), in 2L, and across multiple lines is associated with longer survival in patients (pts) with mCRC. This analysis was aimed at comparing the effectiveness of BV after 1st disease progression (PD) between male and female mCRC pts who received 1L BV-containing therapy in a real-world setting. Methods: ARIES is a large, prospective OCS that enrolled pts who received BV and chemotherapy (CT) for 1L mCRC. Post-PD effectiveness was assessed for men and women characterizing BV use by cumulative and dichotomous approaches. The primary analysis treated BV exposure as cumulative BV doses after 1st PD and post-progression overall survival (ppOS) as the time from 1st PD to death. A time-dependent Cox regression model was fitted to assess the effect of cumulative BV exposure on ppOS, while controlling for potential confounders. A dichotomous secondary analysis characterized BV exposure as receipt of CT + BV (BBP) or CT alone (No BBP) within 2 months after PD and ppOS as time from 1st PD + 2 months to death. Results: Among the 1,550 1L mCRC pts enrolled, 1,199 (532 women) had PD. In the primary analysis, hazard ratios (HRs) for ppOS decreased, on average, by 1.2% with each additional BV dose. When stratified by sex, the average risk reduction per BV dose over 15 doses was 1.8% in women and 0.7% in men. In the secondary analysis that included 331 women (BBP, 180; No BBP, 151) and 417 men (BBP, 245, No BBP, 172) who received BV ± CT within 2 months post-PD, the HRs for ppOS with BBP treatment were 0.46 (95% CI, 0.35–0.59) in women and 0.52 (95% CI, 0.41–0.67) in men. Statistical interaction tests for differences in the effectiveness of BV between men and women were negative for primary and secondary analyses (P of 0.58 and 0.77). Protocol-specified adverse events occurred in 17.8% of women and 10.2% of men in the BBP population; this difference was largely related to rates of hypertension (8.3% vs 2.4%, respectively). Conclusions: In ARIES, the effectiveness of BV after first PD was not statistically different between women and men with mCRC. Clinical trial information: NCT00388206.
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Affiliation(s)
| | | | | | | | - Mark Kozloff
- Ingalls Hospital and University of Chicago, Harvey, IL
| | | | | | - Yong Mun
- Genentech, South San Francisco, CA
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Abstract
Over a period of 6 months, dozens of moon jelly ( Aurelia aurita) medusae from a single-species exhibit at the California Science Center (CSC) developed exumbrellar ulcers. Ulcers were progressive, causing umbrellar creases that expanded radially to the bell rim and occasional adoral erosions that extended into gastrovascular cavities. Husbandry interventions, including addition of ultraviolet light sterilizers, repopulation with fresh cultures, and enclosure disinfection, did not arrest the recurrence of lesions. Biopsies or whole specimens representing 17 medusae (15 affected and 2 grossly unaffected) from CSC and 2 control medusae from Aquarium of the Pacific were submitted to a private diagnostic laboratory and processed for light and electron microscopy. Microscopic lesions were present in all CSC medusae and were not observed or negligible in control medusae. Lesions included ulceration, necrosis, and hyperplasia in all umbrellar layers, with most severe lesions in the exumbrella and amoebocyte infiltration in the underlying mesoglea. Special stains, electron microscopy, and fungal culture did not associate microorganisms with the lesions. Bacterial cultures from the CSC population consistently grew Shewanella and Vibrio spp, both of which were considered commensal. Trauma and environmental stress are proposed as possible causes for the ulcers.
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Affiliation(s)
| | | | - J. Wynne
- California Science Center, Los Angeles, California
| | - S. Fish
- California Animal Health and Food Safety Lab, Davis, California
| | - L. Adams
- Aquarium of the Pacific, Long Beach, California
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24
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Bendell JC, Bekaii-Saab TS, Cohn AL, Hurwitz HI, Kozloff M, Tezcan H, Roach N, Mun Y, Fish S, Flick ED, Dalal D, Grothey A. Treatment patterns and clinical outcomes in patients with metastatic colorectal cancer initially treated with FOLFOX-bevacizumab or FOLFIRI-bevacizumab: results from ARIES, a bevacizumab observational cohort study. Oncologist 2012; 17:1486-95. [PMID: 23015662 DOI: 10.1634/theoncologist.2012-0190] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [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: 12/21/2022] Open
Abstract
BACKGROUND The Avastin Registry: Investigation of Effectiveness and Safety (ARIES) study is a prospective, community-based observational cohort study that evaluated the effectiveness and safety of first-line treatment patterns, assessing the impact of chemotherapy choice and treatment duration. METHODS The ARIES study enrolled patients with metastatic colorectal cancer (mCRC) receiving first-line chemotherapy with bevacizumab and followed them longitudinally. The protocol did not specify treatment regimens or assessments. Analyses included all patients who initiated bevacizumab in combination with either first-line oxaliplatin with infusional 5-fluorouracil and leucovorin (FOLFOX) or irinotecan with infusional 5-fluorouracil and leucovorin (FOLFIRI). Progression-free survival (PFS) and overall survival (OS) times were estimated using Kaplan-Meier methods. Hazard ratios (HRs) were estimated with multivariate Cox regression analysis, adjusting for potential confounding factors. RESULTS In total, 1,550 patients with first-line mCRC were enrolled (median follow-up, 21 months) and most received FOLFOX-bevacizumab (n = 968) or FOLFIRI-bevacizumab (n = 243) as first-line therapy. The baseline characteristics and median treatment duration were generally similar between subgroups. There were no significant differences in the median PFS (10.3 months vs. 10.2 months) or OS (23.7 months vs. 25.5 months) time between the FOLFOX-bevacizumab and FOLFIRI-bevacizumab subgroups, respectively, by unadjusted analyses. Multivariate analyses showed FOLFIRI-bevacizumab resulted in a similar PFS (HR, 1.03; 95% confidence interval [CI], 0.88-1.21) and OS (HR, 0.95; 95% CI, 0.78-1.16) outcome as with FOLFOX-bevacizumab. The incidence proportions of bevacizumab-associated adverse events were similar for FOLFOX- and FOLFIRI-based therapies. CONCLUSIONS In first-line mCRC patients, the FOLFOX-bevacizumab and FOLFIRI-bevacizumab regimens were associated with similar treatment patterns and clinical outcomes.
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Affiliation(s)
- Johanna C Bendell
- GI Oncology Research and Drug Development Unit, Sarah Cannon Research Institute, 250 25th Avenue N, Suite 100, Nashville, Tennessee 37203, USA.
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25
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Robenshtok E, Fish S, Bach A, Domínguez JM, Shaha A, Tuttle RM. Suspicious cervical lymph nodes detected after thyroidectomy for papillary thyroid cancer usually remain stable over years in properly selected patients. J Clin Endocrinol Metab 2012; 97:2706-13. [PMID: 22639292 DOI: 10.1210/jc.2012-1553] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The risk of loco-regional recurrence in papillary thyroid cancer (PTC) patients ranges from 15-30%. However, the clinical significance of small-volume loco-regional recurrence detected by highly sensitive ultrasonography is unclear. OBJECTIVE Our objective was to describe the natural history of abnormal cervical lymph nodes (LN) diagnosed after initial treatment. DESIGN We conducted a retrospective cohort study. PATIENTS 166 PTC with patients who had at least one abnormal LN outside the thyroid be on ultrasound and selected for active surveillance were included. MAIN OUTCOME MEASURE LN growth during a period of active surveillance was the primary outcome. RESULTS Most patients had classical PTC (85%) and an intermediate risk of recurrence (77%). The median LN size at the start of the observation period was 1.3 cm (range, 0.5-2.7 cm) in largest diameter, with all nodes having at least one abnormal sonographic characteristic (70% of patients had LN with at least two abnormal features). In almost all patients, the LN were in the lateral neck, primarily in levels 3 (43%) and 4 (58%). After a median follow-up of 3.5 yr, only 20% (33 of 166) grew at least 3 mm, 9% (15 of 166) grew at least 5 mm, and 14% (23 of 166) resolved. None of the clinical or sonographic features were predictive of LN growth (positive predictive value range = 0.21-0.57). There were no local complications (nerve damage or local invasion) related to the abnormal nodes and no disease-related mortality. CONCLUSIONS Suspicious cervical LN in the lateral neck usually remain stable for long periods of time in properly selected PTC patients and can be safely followed with serial ultrasounds.
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Affiliation(s)
- E Robenshtok
- Endocrinology Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA
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Silverstein M, Banks M, Fish S, Bauchner H. Variability in institutional approaches to ethics review of community-based research conducted in collaboration with unaffiliated organizations. J Empir Res Hum Res Ethics 2012; 3:69-76. [PMID: 19385746 DOI: 10.1525/jer.2008.3.2.69] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Academic institutions' requirements FOR ethics committee (IRB) review of research conducted by investigators from unaffiliated organizations engaged in collaborative, community-based research (CBR) may be highly variable. The present study examined the extent of this variability through a national survey of 196 IRB directors from US academic institutions. Fifty-three percent of respondents reported a formal policy or standardized approach to reviewing this type of CBR, with high volume IRBs more likely than low volume IRBs to do so (aOR 2.11, 95% CI 1.02, 4.35). The most common policy (40%) was to require that unaffiliated community organizations obtain a Federalwide Assurance on which they delegate responsibility for IRB review to their own (i.e., the academic institution's) IRB. Among IRBs without formal policies, 56% reported that human subject risk was their foremost consideration when reviewing CBR. Universities (71%) were more likely than medical schools (33%) to report subject risk as their foremost consideration (aOR 4.68, 95% CI 1.43, 15.28).
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Kaila N, Huang A, Moretto A, Follows B, Janz K, Lowe M, Thomason J, Mansour TS, Hubeau C, Page K, Morgan P, Fish S, Xu X, Williams C, Saiah E. Diazine indole acetic acids as potent, selective, and orally bioavailable antagonists of chemoattractant receptor homologous molecule expressed on Th2 cells (CRTH2) for the treatment of allergic inflammatory diseases. J Med Chem 2012; 55:5088-109. [PMID: 22651823 DOI: 10.1021/jm300007n] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
New classes of CRTH2 antagonists, the pyridazine linker containing indole acetic acids, are described. The initial hit 1 had good potency but poor permeability, metabolic stability, and PK. Initial optimization led to compounds of type 2 with low oxidative metabolism but poor oral bioavailability. Poor permeability was identified as a liability for these compounds. Addition of a linker between the indole and diazine moieties afforded a series with good potency, low rates of metabolism, moderate permeability, and good oral bioavailability in rodents. 32 was identified as the development track candidate. It was potent in cell based, binding, and whole blood assays and exhibited good PK profile. It was efficacious in mouse models of contact hypersensitivity (1 mg/kg b.i.d.) and house dust (20 mg/kg q.d.) when dosed orally. In sheep asthma, administration at 1 mg/kg iv completely blocked the LAR and AHR and attenuated the EAR phase.
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Affiliation(s)
- Neelu Kaila
- BioTherapeutics Chemistry, Pfizer Worldwide Medicinal Chemistry, 200 Cambridgepark Drive, Cambridge, Massachusetts 02140, United States.
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Bekaii-Saab TS, Grothey A, Bendell JC, Kozloff M, Cohn AL, Mun Y, Fish S, Flick ED, Dalal D, Hurwitz H. Effectiveness and safety of second-line (2L) irinotecan- and oxaliplatin-based regimens after first-line (1L) bevacizumab (BV)-containing treatment (tx) for metastatic colorectal cancer (mCRC): Results from the ARIES observational cohort study. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.4_suppl.535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
535 Background: Prior ARIES analyses showed that BV-treated mCRC patients (pts) receiving chemotherapy (CT)/biologics + BV within 2 months (mo) after 1st progressive disease (PD) had longer post-progression survival (PPS) than pts receiving only CT/biologics. The present analysis evaluated whether this effect of BV was consistent when used with common 2L CT regimens— irinotecan- (iri-) and oxaliplatin- (ox-) based—in mCRC pts exposed to 1L BV in ARIES. Methods: ARIES enrolled mCRC pts receiving 1L CT + BV. No tx regimens or assessments were protocol specified. This analysis evaluated 1L BV-treated mCRC pts who had PD, survived ≥2 mo after PD, and received 2L iri- or ox-based tx. PPS was estimated by Kaplan-Meier methods. Cox regression was used to estimate hazard ratios (HRs), while adjusting for covariates (eg, 1L time to progression). Results: Of 1550 1L pts in ARIES, 1074 had 1st PD and survived ≥2 mo after PD. Of these 1074, 390 and 114 received 2L iri- and ox-based tx, respectively, ± BV ( table ). Baseline characteristics were generally similar between groups. The incidence of targeted adverse events (TAEs) was as expected and similar between the BV and No BV groups over time. In pts receiving 2L iri- or ox-based CT tx, PPS in BV-treated pts was longer compared to those not on BV. Analyses may be limited by small pt numbers in some groups. Conclusions: Consistent with prior ARIES analyses, the continued use of BV after 1st PD was associated with prolonged PPS regardless of the 2L CT backbone used. [Table: see text]
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Affiliation(s)
- Tanios S. Bekaii-Saab
- The Ohio State University Medical Center, Columbus, OH; Mayo Clinic, Rochester, MN; Sarah Cannon Research Institute, Nashville, TN; Ingalls Hospital and University of Chicago, Harvey, IL; Rocky Mountain Cancer Center, Denver, CO; Genentech, South San Francisco, CA; Duke University Medical Center, Durham, NC
| | - Axel Grothey
- The Ohio State University Medical Center, Columbus, OH; Mayo Clinic, Rochester, MN; Sarah Cannon Research Institute, Nashville, TN; Ingalls Hospital and University of Chicago, Harvey, IL; Rocky Mountain Cancer Center, Denver, CO; Genentech, South San Francisco, CA; Duke University Medical Center, Durham, NC
| | - Johanna C. Bendell
- The Ohio State University Medical Center, Columbus, OH; Mayo Clinic, Rochester, MN; Sarah Cannon Research Institute, Nashville, TN; Ingalls Hospital and University of Chicago, Harvey, IL; Rocky Mountain Cancer Center, Denver, CO; Genentech, South San Francisco, CA; Duke University Medical Center, Durham, NC
| | - Mark Kozloff
- The Ohio State University Medical Center, Columbus, OH; Mayo Clinic, Rochester, MN; Sarah Cannon Research Institute, Nashville, TN; Ingalls Hospital and University of Chicago, Harvey, IL; Rocky Mountain Cancer Center, Denver, CO; Genentech, South San Francisco, CA; Duke University Medical Center, Durham, NC
| | - Allen Lee Cohn
- The Ohio State University Medical Center, Columbus, OH; Mayo Clinic, Rochester, MN; Sarah Cannon Research Institute, Nashville, TN; Ingalls Hospital and University of Chicago, Harvey, IL; Rocky Mountain Cancer Center, Denver, CO; Genentech, South San Francisco, CA; Duke University Medical Center, Durham, NC
| | - Yong Mun
- The Ohio State University Medical Center, Columbus, OH; Mayo Clinic, Rochester, MN; Sarah Cannon Research Institute, Nashville, TN; Ingalls Hospital and University of Chicago, Harvey, IL; Rocky Mountain Cancer Center, Denver, CO; Genentech, South San Francisco, CA; Duke University Medical Center, Durham, NC
| | - Susan Fish
- The Ohio State University Medical Center, Columbus, OH; Mayo Clinic, Rochester, MN; Sarah Cannon Research Institute, Nashville, TN; Ingalls Hospital and University of Chicago, Harvey, IL; Rocky Mountain Cancer Center, Denver, CO; Genentech, South San Francisco, CA; Duke University Medical Center, Durham, NC
| | - Elizabeth Dawn Flick
- The Ohio State University Medical Center, Columbus, OH; Mayo Clinic, Rochester, MN; Sarah Cannon Research Institute, Nashville, TN; Ingalls Hospital and University of Chicago, Harvey, IL; Rocky Mountain Cancer Center, Denver, CO; Genentech, South San Francisco, CA; Duke University Medical Center, Durham, NC
| | - Darshan Dalal
- The Ohio State University Medical Center, Columbus, OH; Mayo Clinic, Rochester, MN; Sarah Cannon Research Institute, Nashville, TN; Ingalls Hospital and University of Chicago, Harvey, IL; Rocky Mountain Cancer Center, Denver, CO; Genentech, South San Francisco, CA; Duke University Medical Center, Durham, NC
| | - Herbert Hurwitz
- The Ohio State University Medical Center, Columbus, OH; Mayo Clinic, Rochester, MN; Sarah Cannon Research Institute, Nashville, TN; Ingalls Hospital and University of Chicago, Harvey, IL; Rocky Mountain Cancer Center, Denver, CO; Genentech, South San Francisco, CA; Duke University Medical Center, Durham, NC
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Wu Y, Li J, Wu J, Morgan P, Xu X, Rancati F, Vallese S, Raveglia L, Hotchandani R, Fuller N, Bard J, Cunningham K, Fish S, Krykbaev R, Tam S, Goldman SJ, Williams C, Mansour TS, Saiah E, Sypek J, Li W. Discovery of potent and selective matrix metalloprotease 12 inhibitors for the potential treatment of chronic obstructive pulmonary disease (COPD). Bioorg Med Chem Lett 2011; 22:138-43. [PMID: 22153340 DOI: 10.1016/j.bmcl.2011.11.046] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Revised: 11/09/2011] [Accepted: 11/14/2011] [Indexed: 11/24/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease associated with irreversible progressive airflow limitation. Matrix metalloproteinase-12 (MMP-12) has been characterized to be one of the major proteolytic enzymes to induce airway remodeling, destruction of elastin and the aberrant remodeling of damaged alveoli in COPD and asthma. The goal of this project is to develop and identify an orally potent and selective small molecule inhibitor of MMP-12 for treatment of COPD and asthma. Syntheses and structure-activity relationship (SAR) studies of a series of dibenzofuran (DBF) sulfonamides as MMP-12 inhibitors are described. Potent inhibitors of MMP-12 with excellent selectivity against other MMPs were identified. Compound 26 (MMP118), which exhibits excellent oral efficacy in the MMP-12 induced ear-swelling inflammation and lung inflammation mouse models, had been successfully advanced into Development Track status.
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Affiliation(s)
- Yuchuan Wu
- Pfizer Global Research & Development, 200 CambridgePark Drive, Cambridge, MA 02140, USA.
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Vaisman F, Shaha A, Fish S, Michael Tuttle R. Initial therapy with either thyroid lobectomy or total thyroidectomy without radioactive iodine remnant ablation is associated with very low rates of structural disease recurrence in properly selected patients with differentiated thyroid cancer. Clin Endocrinol (Oxf) 2011; 75:112-9. [PMID: 21521273 DOI: 10.1111/j.1365-2265.2011.04002.x] [Citation(s) in RCA: 147] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the risk of structural disease recurrence in a cohort of patients with differentiated thyroid cancer selected for treatment with either thyroid lobectomy or total thyroidectomy without radioactive iodine remnant ablation (RRA). DESIGN Retrospective review. PATIENTS A total of 289 patients were selected for either thyroid lobectomy (n = 72) or total thyroidectomy (n = 217) without RRA and followed with modern disease detection tools in a tertiary referral centre. Most patients had papillary thyroid cancer (89%) without clinically evident lymph node metastases (91%). However, 55% (156/289) of patients had primary tumours that were >1 cm and 10% (28/289) had minor extrathyroidal extension. MEASUREMENTS The primary endpoint was detection of recurrent/persistent structural disease. RESULTS After a 5-year median follow-up, structural disease recurrence was detected in 2·3% (5/217) of patients treated with total thyroidectomy without RRA, and in 4·2% (3/72) of patients treated with thyroid lobectomy. Size of the primary tumour, the presence of cervical lymph node metastases and American Thyroid Association risk category were all statistically significant predictors of recurrence. Changes in serum thyroglobulin were not helpful in identifying the presence of persistent/recurrent structural disease. Importantly, 88% (7/8) of the patients that had recurrent disease were rendered clinically disease free with additional therapies. CONCLUSIONS Initial risk stratification is able to identify a cohort of patients with differentiated thyroid cancer with a very low risk of structural disease recurrence following treatment with either thyroid lobectomy or total thyroidectomy without RRA. Our data strongly support a selective approach to the initial management of thyroid cancer.
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Affiliation(s)
- F Vaisman
- Endocrinology Service, Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USAEndocrinology Service, Universidade Federal do Rio de Janeiro and Instituto Nacional do Cancer, Rio de Janeiro, Brazil
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Kozloff M, Bekaii-Saab TS, Bendell JC, Cohn AL, Hurwitz H, Roach N, Tezcan H, Fish S, Flick ED, Mun Y, Dalal D, Grothey A. Effectiveness of first- or second-line bevacizumab (BV) treatment (tx) in elderly patients (pts) with metastatic colorectal cancer (mCRC) in ARIES, an observational cohort study (OCS). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3625] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Li W, Li J, Wu Y, Rancati F, Vallese S, Raveglia L, Wu J, Hotchandani R, Fuller N, Cunningham K, Morgan P, Fish S, Krykbaev R, Xu X, Tam S, Goldman SJ, Abraham W, Williams C, Sypek J, Mansour TS. Identification of an orally efficacious matrix metalloprotease 12 inhibitor for potential treatment of asthma. J Med Chem 2009; 52:5408-19. [PMID: 19725580 DOI: 10.1021/jm900809r] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
MMP-12 plays a significant role in airway inflammation and remodeling. Increased expression and production of MMP-12 have been observed in the lungs of asthmatic patients. Compound 27 was identified as a potent and selective MMP-12 inhibitor possessing good physicochemical properties. In pharmacological studies, the compound was orally efficacious in an MMP-12 induced ear-swelling inflammation model in the mouse with a good dose response. This compound also exhibited oral efficacy in a naturally Ascaris-sensitized sheep asthma model showing significant inhibition of the late phase response to allergen challenge. This compound has been considered for further development as a treatment therapy for asthma.
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Affiliation(s)
- Wei Li
- Chemical Sciences, Wyeth Research, Cambridge, Massachusetts 02140, USA.
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DeClercq C, Demers D, Bree A, Fish S, Wei SQ, Brennan A, Kasaian M, Chen J, Wang D, Boschelli D, Chaudhary D, Williams C. Specific blockade of protein kinase C (PKC)-theta with a small molecule antagonist attenuates lung inflammation in a mouse model of established allergic airway disease (140.21). The Journal of Immunology 2009. [DOI: 10.4049/jimmunol.182.supp.140.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
PKCθ is primarily expressed in T cells and is recruited to the immunological synapse upon T cell receptor signaling. PKCθ deficient mice display a diminished pulmonary inflammatory response following allergen challenge. We investigated the allergic airway response in mice when PKCθ is specifically blocked with a small molecule inhibitor (compound A). Mice were sensitized with ovalbumin (OVA) in alum on days 0 and 14, then challenged with OVA on days 26, 27, and 28 (primary challenges). Four weeks later mice were aerosolized once with OVA (rechallenge). Airway inflammation was monitored after both primary challenges and rechallenge. Compound A was dosed 30 mg/kg intraperitoneally twice daily in 3 dosing regimens: for 4 days concurrent with and after the primary challenges only; for 3 days starting before the OVA rechallenge only; and both of the above regimens. Administration of compound A significantly inhibited the influx of eosinophils, lymphocytes and neutrophils into the airways. Ex vivo antigen induced Th2 cytokine production by splenocytes was also reduced in cells obtained from mice treated with Compound A in either the primary challenge phase, or both primary and rechallenge phases, but not the rechallenge phase alone. We conclude that blocking T cell activation with a PKCθ inhibitor may attenuate airway inflammation in established allergic disease and may be beneficial in treating chronic allergic asthma.
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Affiliation(s)
| | | | | | - Susan Fish
- 1Respiratory Disease, Wyeth, Cambridge, MA
| | | | | | | | - Joan Chen
- 2Chemical Sciences, Wyeth, Pearl River, NY
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Ernst AA, Fish S. Exception from informed consent: viewpoint of institutional review boards--balancing risks to subjects, community consultation, and future directions. Acad Emerg Med 2005; 12:1050-5. [PMID: 16264073 DOI: 10.1197/j.aem.2005.06.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Differences in interpretation of the Final Rule for exception from informed consent (EFIC) requirements for emergency research result in inconsistencies in implementation and difficulties for some institutional review boards (IRBs) to approve such research. During a consensus workshop organized by the editorial board of Academic Emergency Medicine, participants discussed how IRBs balance the risks to human subjects in EFIC research, the conduct of community consultation and its role in IRB decision making, and future directions to improve and research EFIC effects. Areas of consensus and diversity of opinion were identified. During the workshop, the National Institutes of Health model of consensus building was used to develop statements pertaining to specific questions of the effects, directions, implementation, and ultimate goals for emergency research using EFIC. The program was composed of an overview of the history and issues related to EFIC or Final Rule research and presentations of viewpoints of experts in this area of research. A final consensus was developed regarding the major topics, including IRB perspective, effective community consultation (often considered the main difficulty in implementing EFIC research), and goals for future directions and research on the topic. Roundtable discussions and breakout sessions involving interested parties were used as a format. In regard to how IRBs balance risks, by consensus it was agreed the regulations stipulate that EFIC studies must involve treatment that is unproven or unsatisfactory. The committee agreed that resuscitation rates are currently unsatisfactory, and thus current treatments are unsatisfactory. Many treatments currently used as standard care have never been proven to be effective. IRBs and the public need education that resuscitation research is needed. The same can be said for other conditions to which this rule applies. Because IRB expertise differs across the country, a group of peer reviewers to act as consultants should be available to help IRBs determine if current treatment for a condition is unproven or unsatisfactory. In regard to community consultation, the experiences of others are important and helpful as guidance. The amount and formats of community consultation should correspond to the amount of risk involved in the study proposed. In regard to future directions, communities should be asked how they define "success" of community consultation and public disclosure. Research on community attitudes is critical. Ways to continue/add to research include the following: research including major National Institutes of Health/Centers for Disease Control and Prevention funding acquisition for evaluation of the clinical impact of EFIC research; education for research funding agencies about emergency research, including current outcomes (e.g., survival rates); participation of emergency medicine researchers in meetings of research ethicists/IRB members (Public Responsibility in Medicine and Research/Applied Research Ethics National Association); publication of experiences and of the effects of EFIC research; future update meetings such as this one at the Society for Academic Emergency Medicine meeting; and more membership on IRBs of emergency physicians. While IRBs must approve EFIC research based on their own local environment, additional guidelines from regulatory agencies may be helpful. In general, current treatments for EFIC conditions are unsatisfactory and many are unproven. A group of peer reviewers can act as consultants to IRBs that do not have this expertise.
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Affiliation(s)
- Amy A Ernst
- Department of Emergency Medicine, University of New Mexico, Albuquerque, NM 87131-0001, USA.
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Ernst AA, Fish S. Exception from Informed Consent: Viewpoint of Institutional Review Boards—Balancing Risks to Subjects, Community Consultation, and Future Directions. Acad Emerg Med 2005. [DOI: 10.1111/j.1553-2712.2005.tb00828.x] [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: 11/29/2022]
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Bembenek ME, Jain S, Prack A, Li P, Chee L, Cao W, Spurling H, Roy R, Fish S, Rokas M, Parsons T, Meyers R. Development of a high-throughput assay for two inositol-specific phospholipase Cs using a scintillation proximity format. Assay Drug Dev Technol 2004; 1:435-43. [PMID: 15090180 DOI: 10.1089/154065803322163740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Inositol-specific PLCs comprise a family of enzymes that utilize phosphoinositide substrates, e.g., PIP(2), to generate intracellular second messengers for the regulation of cellular responses. In the past, monitoring this reaction has been difficult due to the need for radiolabeled substrates, separation of the reaction products by organic-phase extraction, and finally radiometric measurements of the segregated products. In this report, we have studied the enzymatic characteristics of two novel PLCs that were derived from functional genomic analyses using a phospholipid-modified solid scintillating support. This method allows for the hydrophobic capture of the [(3)H]phosphoinositide substrate on a well defined scintillation surface and the homogenous measurement of the enzymatic hydrolysis of the substrate by proximity effects. Our results show that the assay format is robust and well suited for this class of lipid-metabolizing enzymes.
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von Stechow D, Fish S, Yahalom D, Bab I, Chorev M, Müller R, Alexander JM. Does simvastatin stimulate bone formation in vivo? BMC Musculoskelet Disord 2003; 4:8. [PMID: 12718758 PMCID: PMC156891 DOI: 10.1186/1471-2474-4-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2002] [Accepted: 04/28/2003] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Statins, potent compounds that inhibit cholesterol synthesis in the liver have been reported to induce bone formation, both in tissue culture and in rats and mice. To re-examine potential anabolic effects of statins on bone formation, we compared the activity of simvastatin (SVS) to the known anabolic effects of PTH in an established model of ovariectomized (OVX) Swiss-Webster mice. METHODS Mice were ovariectomized at 12 weeks of age (T0), remained untreated for 5 weeks to allow development of osteopenia (T5), followed by treatment for 8 weeks (T13). Whole, trabecular and cortical femoral bone was analyzed by micro-computed tomography (micro CT). Liquid chromatography/mass spectrometry (LC/MS) was used to detect the presence of SVS and its active metabolite, simvastatin beta-hydroxy acid (SVS-OH) in the mouse serum. RESULTS Trabecular BV/TV at T13 was 4.2 fold higher in animals treated with PTH (80 micro-g/kg/day) compared to the OVX-vehicle treated group (p < 0.001). However, the same comparison for the SVS-treated group (10 mg/kg/day administered by gavage) showed no significant difference (p = NS). LC/MS detected SVS and SVS-OH in mouse serum 20 minutes after gavage of 100 mg SVS. A serum osteocalcin assay (OC) demonstrated that neither bone formation nor osteoblast activity is significantly enhanced by SVS treatment in this in vivo study. CONCLUSIONS While PTH demonstrated the expected anabolic effect on bone, SVS failed to stimulate bone formation, despite our verification by LC/MS of the active SVS-OH metabolite in mouse serum. While statins have clear effects on bone formation in vitro, the formulation of existing 'liver-targeted' statins requires further refinement for efficacy in vivo.
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Affiliation(s)
- Dietrich von Stechow
- Orthopedic Biomechanics Laboratory, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Susan Fish
- Bone and Mineral Metabolism Unit, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Dror Yahalom
- Bone and Mineral Metabolism Unit, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Itai Bab
- Bone and Mineral Metabolism Unit, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
- Bone Laboratory, Institute for Dental Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Michael Chorev
- Bone and Mineral Metabolism Unit, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Ralph Müller
- Institute for Biomedical Engineering, ETH and University Zürich, Switzerland
| | - Joseph M Alexander
- Bone and Mineral Metabolism Unit, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
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Abstract
The tylosin-biosynthetic (tyl) gene cluster occupies about 1% of the genome of Streptomycesfradiae and includes at least 43 open reading frames. In addition to structural genes required for tylosin production, the tyl cluster contains three resistance determinants and several regulatory genes. Tylosin production is evidently controlled by pathway-specific and pleiotropic regulators with the likely involvement of y-butyrolactone signalling factors. Accumulation of the polyketide aglycone is controlled by glycosylated macrolides and optimal performance of the complex polyketide synthase enzyme requires the activity of an editing thioesterase.
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Affiliation(s)
- E Cundliffe
- Department of Biochemistry, University of Leicester, UK.
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Alexander JM, Bab I, Fish S, Müller R, Uchiyama T, Gronowicz G, Nahounou M, Zhao Q, White DW, Chorev M, Gazit D, Rosenblatt M. Human parathyroid hormone 1-34 reverses bone loss in ovariectomized mice. J Bone Miner Res 2001; 16:1665-73. [PMID: 11547836 DOI: 10.1359/jbmr.2001.16.9.1665] [Citation(s) in RCA: 123] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The experimental work characterizing the anabolic effect of parathyroid hormone (PTH) in bone has been performed in nonmurine ovariectomized (OVX) animals, mainly rats. A major drawback of these animal models is their inaccessibility to genetic manipulations such as gene knockout and overexpression. Therefore, this study on PTH anabolic activity was carried out in OVX mice that can be manipulated genetically in future studies. Adult Swiss-Webster mice were OVX, and after the fifth postoperative week were treated intermittently with human PTH(1-34) [hPTH(1-34)] or vehicle for 4 weeks. Femoral bones were evaluated by microcomputed tomography (microCT) followed by histomorphometry. A tight correlation was observed between trabecular density (BV/TV) determinations made by both methods. The BV/TV showed >60% loss in the distal metaphysis in 5-week and 9-week post-OVX, non-PTH-treated animals. PTH induced a approximately 35% recovery of this loss and a approximately 40% reversal of the associated decreases in trabecular number (Tb.N) and connectivity. PTH also caused a shift from single to double calcein-labeled trabecular surfaces, a significant enhancement in the mineralizing perimeter and a respective 2- and 3-fold stimulation of the mineral appositional rate (MAR) and bone formation rate (BFR). Diaphyseal endosteal cortical MAR and thickness also were increased with a high correlation between these parameters. These data show that OVX osteoporotic mice respond to PTH by increased osteoblast activity and the consequent restoration of trabecular network. The Swiss-Webster mouse model will be useful in future studies investigating molecular mechanisms involved in the pathogenesis and treatment of osteoporosis, including the mechanisms of action of known and future bone antiresorptive and anabolic agents.
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Affiliation(s)
- J M Alexander
- Division of Bone and Mineral Metabolism, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02115, USA
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Abstract
AIMS In this study we aimed to determine local recurrence, mortality an d amputation rates in patients presenting with limb and limb girdle soft tissue sarcomas. METHOD A review of all 439 patients presenting with p rimary or recurrent soft tissue sarcomas of limb and limb girdle to the Royal Marsden Hospital between 1989 and 1995 was carried out. RESULTS The local recurrence rate was 15.5% and the mortality rate was 30%, with a median follow up of 3.2 years and an overall amputation rate of 4.8%. CONCLUSION The outcome of limb and limb girdle sarcomas in this study i s comparable to those reported elsewhere.
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Affiliation(s)
- M E Pitcher
- Sarcoma Unit, Royal Marsden Hospital, London, UK
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Summers RL, Fish S, Blanda M, Terndrup T. Assessment of the "scholarly project" requirement for emergency medicine residents: report of the SAEM Research Directors' workshop. SAEM Research Directors' Interest Group. Acad Emerg Med 1999; 6:1160-5. [PMID: 10569390 DOI: 10.1111/j.1553-2712.1999.tb00120.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Differences in interpretation of the residency review committee (RRC) directive concerning resident scholarly activity have resulted in inconsistencies in the practical fulfillment of this responsibility among the various training programs in emergency medicine. During a workshop organized by the SAEM Research Directors' Interest Group (RDIG), a consensus statement was developed regarding the scope, definition, and purpose of the scholarly project requirement. METHODS During the workshop, the NIH model of consensus building was used to develop statements pertaining to specific questions of the goals, definition, and endpoints of the scholarly project. The program consisted of an overview of the history and issues related to the scholarly project and presentations of varying viewpoints from interested parties. A final consensus of answers to the defined questions was then developed by the workshop participants during roundtable discussions and further refined through interactive debate using the RDIG e-mail list server. RESULTS By consensus it was agreed that the primary role of the scholarly project is to instruct residents in the process of scientific inquiry, to teach problem-solving skills, and to expose the resident to the mechanics of research. To realize these goals, the project should include the general elements of hypothesis formulation, data collection, analytic thinking, and interpretation of results. It was also thought that these elements should be documented in some written form with a literature review. CONCLUSIONS While each residency program must implement the RRC residency requirements in a manner that best suits the needs and culture of its individual environment, a concurrence of definition and approach to satisfying the scholarly project requirement would provide better consistency in resident training. Guidelines developed by consensus during the SAEM RDIG workshop may serve as a general recipe that can be used to fulfill the goals of the scholarly project and the spirit of the RRC directive.
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Affiliation(s)
- R L Summers
- Department of Emergency Medicine, University of Mississippi Medical Center, Jackson 39216, USA.
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Abstract
STUDY OBJECTIVES We sought to measure plasma cocaine and benzoylecgonine levels in children after application of a solution of a topical anesthetic containing tetracaine 0.5%, epinephrine 1:2, 000, and viscous cocaine 5.9% (TAC) to lacerations requiring suture repair. Previous reports demonstrating cocaine absorption used aqueous cocaine. The purpose of this study is to determine whether systemic absorption occurs with viscous cocaine. METHODS We used a convenience sample of children in a pediatric emergency department during the summer months of 1994 and 1995. Participants were pediatric patients less than 15 years of age with simple lacerations requiring suturing. RESULTS Twenty-five patients were enrolled in the study. The mean age of the patients was 8.5 years (range, 3 to 13 years). Lacerations tended to be small, with a mean length of 2.2 cm (range, 1 to 8 cm). Plasma cocaine and benzoylecgonine levels were measured by means of high-performance liquid chromatography. The mean time for obtaining the plasma sample for cocaine analysis was 67.2+/-23.9 minutes (range, 28 to 130 minutes) after application of the viscous cocaine-containing TAC solution. Qualitative assay results, which were accurate to 50 ng/mL, were negative in all 25 patients for both plasma cocaine and benzoylecgonine. No child demonstrated any signs or symptoms suggestive of cocaine toxicity. CONCLUSION In our study, application of viscous cocaine-containing TAC solutions to small lacerations did not produce clinically important cocaine absorption.
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Affiliation(s)
- R J Vinci
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.
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Feldman J, Wallace E, Berty C, Mitchell P, Fish S. What does “risk of MI” mean to the emergency physician? results of an observational study. Ann Emerg Med 1999. [DOI: 10.1016/s0196-0644(99)80414-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fish S. A brief history of theosophy. J Christ Nurs 1997; 13:12-3. [PMID: 9362808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Affiliation(s)
- S Fish
- University of Rochester, New York, USA
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Fish S. A new age for nursing. J Christ Nurs 1997; 13:11. [PMID: 9362807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Pernodet JL, Fish S, Blondelet-Rouault MH, Cundliffe E. The macrolide-lincosamide-streptogramin B resistance phenotypes characterized by using a specifically deleted, antibiotic-sensitive strain of Streptomyces lividans. Antimicrob Agents Chemother 1996; 40:581-5. [PMID: 8851574 PMCID: PMC163161 DOI: 10.1128/aac.40.3.581] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [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: 02/02/2023] Open
Abstract
Genes conferring resistance to macrolide, lincosamide, and streptogramin B (MLS) antibiotics via ribosomal modification are widespread in bacteria, including clinical isolates and MLS-producing actinomycetes. Such erm-type genes encode enzymes that mono- or dimethylate residue A-2058 of 23S rRNA. The different phenotypes resulting from monomethylation (MLS-I phenotype, conferred by erm type I genes) or dimethylation (MLS-II phenotype due to erm type II genes) have been characterized by introducing tlrD or ermE, respectively, into an MLS-sensitive derivative of Streptomyces lividans TK21. This strain (designated OS456) was generated by specific replacement of the endogenous resistance genes lrm and mgt. The MLS-I phenotype is characterized by high-level resistance to lincomycin with only marginal resistance to macrolides such as chalcomycin or tylosin, whereas the MLS-II phenotype involves high-level resistance to all MLS drugs. Mono- and dimethylated ribosomes were introduced into a cell-free protein-synthesizing system prepared from S. lividans and compared with unmodified particles in their response to antibiotics. There was no simple correlation between the relative potencies of MLS drugs at the level of the target site (i.e., the ribosome) and their antibacterial activities expressed as MICs.
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Affiliation(s)
- J L Pernodet
- Laboratoire de Biologie et Génétique Moléculaire, Université Paris-Sud XI, Orsay, France
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