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Berry W, D'Arcy C, Welsh B, Orchard D, Bekhor PS, Robertson SJ. Naevoid miliaria profunda, successfully treated with botulinum toxin. Australas J Dermatol 2024. [PMID: 38530143 DOI: 10.1111/ajd.14256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024]
Affiliation(s)
- William Berry
- Department of Dermatology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Colleen D'Arcy
- Department of Pathology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Belinda Welsh
- Department of Dermatology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - David Orchard
- Department of Dermatology, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Philip S Bekhor
- Department of Dermatology, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Susan J Robertson
- Department of Dermatology, Royal Children's Hospital, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- The Royal Melbourne Hospital, Parkville, Victoria, Australia
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2
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Mahar PD, Robertson SJ, Orchard D, Baker C, Foley P. Paediatric indications and dosing guidance for advanced targeted treatments in Australia. Australas J Dermatol 2024. [PMID: 38445760 DOI: 10.1111/ajd.14230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 02/08/2024] [Indexed: 03/07/2024]
Abstract
As with adults, paediatric patients may benefit from a number of advanced targeted therapies for inflammatory skin disease. This brief report aims to be an accessible reference tool with respect to regulatory approval and reimbursement of these treatments within Australia.
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Affiliation(s)
- Patrick D Mahar
- Skin Health Institute, Melbourne, Victoria, Australia
- Department of Dermatology, The Royal Children's Hospital, Melbourne, Victoria, Australia
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Susan J Robertson
- Department of Dermatology, The Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Dermatology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - David Orchard
- Department of Dermatology, The Royal Children's Hospital, Melbourne, Victoria, Australia
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher Baker
- Skin Health Institute, Melbourne, Victoria, Australia
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Dermatology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Peter Foley
- Skin Health Institute, Melbourne, Victoria, Australia
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Dermatology, St Vincent's Hospital, Melbourne, Victoria, Australia
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3
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Chan OB, Willems A, Simpson K, Gopinathan LP, Robertson SJ, Mahar P. Toxic epidermal necrolysis: A rare and life-threatening condition. Aust J Gen Pract 2024; 53:138-140. [PMID: 38437657 DOI: 10.31128/ajgp-05-23-6831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Affiliation(s)
- On Bon Chan
- BAppSc (Physio), MBBS (Hons), DCH, MPH, FRACGP, Dermatology Registrar, Department of Dermatology, The Royal Children@s Hospital, Melbourne, Vic
| | - Anneliese Willems
- BMedSci, MBBS, FRACGP, General Practitioner, Yarra Medical Clinic, Melbourne, Vic; Honorary Dermatology Fellow, Western Health, St Albans, Vic; Honorary Fellow, Department of Medicine, University of Melbourne, Melbourne, Vic; Honorary Dermatology Fellow, The Royal Children@s Hospital, Melbourne, Vic
| | - Kate Simpson
- MBBS, Dermatology Registrar, The Royal Children@s Hospital, Melbourne, Vic
| | - Lalitha Pillay Gopinathan
- MD (Ind), MRCPCH (UK), Subspecialty in Paediatric Dermatology, Paediatric Dermatology Fellow, The Royal Children@s Hospital, Melbourne, Vic; Paediatrician and Paediatric Dermatologist, Ministry of Health, Malaysia
| | - Susan J Robertson
- MBBS, FACD, Director of Dermatology and@Consultant Dermatologist, The Royal Children@s Hospital, Melbourne, Vic; Consultant Dermatologist, Laser Dermatology, Melbourne, Vic
| | - Patrick Mahar
- OAM MBBS (Hons), LLB (Hons), MBA (Melb), PhD, DMedSc, GAICD, FACLM, FACD, Consultant Dermatologist, Department of Dermatology and Laser Unit, Burns Unit, Trauma Service, The Royal Children@s Hospital, Melbourne, Vic;@Consultant Dermatologist, The Skin Health Institute, Melbourne, Vic
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4
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Vos A, Ringin S, Chong AH, Robertson SJ. Delayed linear lipoatrophy following corticosteroid injection of a hypertrophic scar: Successfully reversed by isotonic saline injection. Australas J Dermatol 2023; 64:e374-e376. [PMID: 37461806 DOI: 10.1111/ajd.14135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/07/2023] [Indexed: 11/10/2023]
Affiliation(s)
- Ayesha Vos
- Department of Medicine, Eastern Health, Box Hill, Victoria, Australia
| | - Sarah Ringin
- Department of Dermatology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Alvin H Chong
- Department of Medicine and Dermatology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Susan J Robertson
- Department of Dermatology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Dermatology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
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5
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Mellerio JE, Pillay EI, Ledwaba-Chapman L, Bisquera A, Robertson SJ, Papanikolaou M, McGrath JA, Wang Y, Martinez AE, Jeffs E. Itch in recessive dystrophic epidermolysis bullosa: findings of PEBLES, a prospective register study. Orphanet J Rare Dis 2023; 18:235. [PMID: 37559055 PMCID: PMC10410928 DOI: 10.1186/s13023-023-02817-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 07/08/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Itch is common and distressing in epidermolysis bullosa (EB) but has not previously been studied in depth in different recessive dystrophic EB (RDEB) subtypes. OBJECTIVES As part of a prospective register study of the natural history of RDEB we explored features of itch, medications used, and correlation with disease severity and quality of life. METHODS Fifty individuals with RDEB aged 8 years and above completed the Leuven Itch Scale (LIS) (total 243 reviews over a 7-year period). Data included itch frequency, severity, duration, distress, circumstances, consequences, itch surface area and medications for itch. The iscorEB disease severity score and the validated EB quality of life tool, QOLEB, were compared to LIS domains and analysed by RDEB subtype. RESULTS Itch was frequent, present in the preceding month in 93% of reviews. Itch severity and distress were significantly greater in severe (RDEB-S) and pruriginosa (RDEB-Pru) subtypes compared to intermediate RDEB (RDEB-I). Itch medications were reported in just over half of reviews including emollients, topical corticosteroids and antihistamines; the proportion of participants not using medication despite frequent pruritus suggests limited efficacy. In inversa RDEB (RDEB-Inv) and RDEB-I, LIS domains correlated with iscorEB and QOLEB. In contrast to previous studies, correlations were lacking in RDEB-S suggesting that global disease burden relatively reduces the contribution of itch. CONCLUSIONS This comprehensive study of RDEB-associated itch highlights differences between RDEB subtypes, suggests an unmet need for effective treatments and could serve as control data for future clinical trials incorporating itch as an endpoint.
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Affiliation(s)
- Jemima E Mellerio
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
- Genetic Skin Disease Group, King's College London, London, UK.
| | - Elizabeth I Pillay
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | | | | | - Susan J Robertson
- Departments of Dermatology, The Royal Children's Hospital, The Royal Melbourne Hospital and Monash Health, Melbourne, Australia
| | | | - John A McGrath
- Genetic Skin Disease Group, King's College London, London, UK
| | - Yanzhong Wang
- Department of Population Health Sciences, King's College London, London, UK
| | - Anna E Martinez
- Department of Dermatology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Eunice Jeffs
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
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6
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Yadav J, Liang T, Qin T, Nathan N, Schwenger KJP, Pickel L, Xie L, Lei H, Winer DA, Maughan H, Robertson SJ, Woo M, Lou W, Banks K, Jackson T, Okrainec A, Hota SS, Poutanen SM, Sung HK, Allard JP, Philpott DJ, Gaisano HY. Gut microbiome modified by bariatric surgery improves insulin sensitivity and correlates with increased brown fat activity and energy expenditure. Cell Rep Med 2023; 4:101051. [PMID: 37196633 PMCID: PMC10213984 DOI: 10.1016/j.xcrm.2023.101051] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/20/2022] [Accepted: 04/21/2023] [Indexed: 05/19/2023]
Abstract
Alterations in the microbiome correlate with improved metabolism in patients following bariatric surgery. While fecal microbiota transplantation (FMT) from obese patients into germ-free (GF) mice has suggested a significant role of the gut microbiome in metabolic improvements following bariatric surgery, causality remains to be confirmed. Here, we perform paired FMT from the same obese patients (BMI > 40; four patients), pre- and 1 or 6 months post-Roux-en-Y gastric bypass (RYGB) surgery, into Western diet-fed GF mice. Mice colonized by FMT from patients' post-surgery stool exhibit significant changes in microbiota composition and metabolomic profiles and, most importantly, improved insulin sensitivity compared with pre-RYGB FMT mice. Mechanistically, mice harboring the post-RYGB microbiome show increased brown fat mass and activity and exhibit increased energy expenditure. Moreover, improvements in immune homeostasis within the white adipose tissue are also observed. Altogether, these findings point to a direct role for the gut microbiome in mediating improved metabolic health post-RYGB surgery.
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Affiliation(s)
- Jitender Yadav
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Tao Liang
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tairan Qin
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nayanan Nathan
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | | | - Lauren Pickel
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada
| | - Li Xie
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Helena Lei
- Division of Cellular and Molecular Biology, Diabetes Research Group, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Daniel A Winer
- Department of Immunology, University of Toronto, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Division of Cellular and Molecular Biology, Diabetes Research Group, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Buck Institute for Research on Aging, Novato, CA, USA
| | | | - Susan J Robertson
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Minna Woo
- Department of Immunology, University of Toronto, Toronto, ON, Canada; Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Toronto General Hospital, University Health Network, Toronto, ON, Canada; Division of Cellular and Molecular Biology, Diabetes Research Group, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Kate Banks
- Department of Comparative Medicine, University of Toronto, Toronto, ON, Canada
| | - Timothy Jackson
- Division of General Surgery, University of Toronto, Toronto, Canada; Division of General Surgery, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Allan Okrainec
- Division of General Surgery, University of Toronto, Toronto, Canada; Division of General Surgery, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Susy S Hota
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Infection Prevention and Control, University Health Network, Toronto, ON, Canada
| | - Susan M Poutanen
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Department of Microbiology & Division of Infectious Diseases, University Health Network and Sinai Health, Toronto, ON, Canada
| | - Hoon-Ki Sung
- Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Johane P Allard
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Toronto General Hospital, University Health Network, Toronto, ON, Canada.
| | - Dana J Philpott
- Department of Immunology, University of Toronto, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
| | - Herbert Y Gaisano
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada.
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7
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Foerster EG, Tsang DKL, Goyal S, Robertson SJ, Robert LM, Maughan H, Streutker CJ, Girardin SE, Philpott DJ. ATG16L1 protects from interferon-γ-induced cell death in the small intestinal crypt. Mucosal Immunol 2023; 16:135-152. [PMID: 36792009 DOI: 10.1016/j.mucimm.2023.02.001] [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] [Received: 01/10/2023] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/15/2023]
Abstract
The breakdown of the intestinal mucosal barrier is thought to underlie the progression to Crohn disease (CD), whereby numerous risk factors contribute. For example, a genetic polymorphism of the autophagy gene ATG16L1, associated with an increased risk of developing CD, contributes to the perturbation of the intestinal epithelium. We examined the role of Atg16l1 in protecting the murine small intestinal epithelium from T-cell-mediated damage using the anti-CD3 model of enteropathy. Our work showed that mice specifically deleted for Atg16l1 in intestinal epithelial cells (IECs) (Atg16l1ΔIEC) had exacerbated intestinal damage, characterized by crypt epithelial cell death, heightened inflammation, and decreased survival. Moreover, Atg16l1 deficiency delayed the recovery of the intestinal epithelium, and Atg16l1-deficient IECs were impaired in their proliferative response. Pathology was largely driven by interferon (IFN)-γ signaling in Atg16l1ΔIEC mice. Mechanistically, although survival was rescued by blocking tumor necrosis factor or IFN-γ independently, only anti-IFN-γ treatment abrogated IEC death in Atg16l1ΔIEC mice, thereby decoupling IEC death and survival. In summary, our findings suggest differential roles for IFN-γ and tumor necrosis factor in acute enteropathy and IEC death in the context of autophagy deficiency and suggest that IFN-γ-targeted therapy may be appropriate for patients with CD with variants in ATG16L1.
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Affiliation(s)
| | - Derek K L Tsang
- Department of Immunology, University of Toronto, Toronto, Canada
| | - Shawn Goyal
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | | | - Lukian M Robert
- Department of Immunology, University of Toronto, Toronto, Canada
| | | | - Catherine J Streutker
- Department of Laboratory Medicine, St. Michael's Hospital, Unity Health, Toronto, Canada
| | - Stephen E Girardin
- Department of Immunology, University of Toronto, Toronto, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Dana J Philpott
- Department of Immunology, University of Toronto, Toronto, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
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8
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McWhirter S, Wong N, Morgan V, Hardy T, Robertson SJ. Gold weight implants for cicatricial lagophthalmos in epidermolysis bullosa. Clin Exp Dermatol 2023; 48:543-544. [PMID: 36655515 DOI: 10.1093/ced/llad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/26/2023] [Indexed: 01/20/2023]
Affiliation(s)
- Seamus McWhirter
- Dermatology Department, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Nathan Wong
- Ophthalmology Department, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Vanessa Morgan
- Dermatology Department, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Dermatology Department, The Royal Children's Hospital, Parkville, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Tom Hardy
- Ophthalmology Department, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Susan J Robertson
- Dermatology Department, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Dermatology Department, The Royal Children's Hospital, Parkville, Victoria, Australia
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9
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Willems A, Ma E, Scardamaglia L, Robertson SJ. A red scaly rash to the groin. Aust J Gen Pract 2023; 52:58-61. [PMID: 36796774 DOI: 10.31128/ajgp-03-22-6372] [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: 02/18/2023]
Affiliation(s)
- Anneliese Willems
- B Med Sci, MBBS, FRACGP, General Practitioner, Yarra Medical Clinic, Richmond, Vic; Honorary Dermatology Fellow, Western Health, St Albans, Vic; Honorary Fellow, Department of Medicine, University of Melbourne, Parkville, Vic; Honorary Dermatology Fellow, The Royal Children@s Hospital, Parkville, Vic
| | - Ellen Ma
- MBBS, FACD, Consultant Dermatologist, Austin Hospital, Heidelberg, Vic; Dermatologist, Laser Dermatology, Mont Albert, Vic
| | - Laura Scardamaglia
- MBBS, FACD, Head of Dermatology, Western Health, St Albans, Vic; Honorary Clinical Associate Professor, Department of Medicine, University of Melbourne, Parkville, Vic; Consultant Dermatologist, The Royal Children@s Hospital, Parkville, Vic; Head of Clinical Services, The Royal Melbourne Hospital, Parkville, Vic
| | - Susan J Robertson
- MBBS, FACD, Acting Director of Dermatology, Consultant Dermatologist, The Royal Children@s Hospital, Parkville, Vic; Consultant Dermatologist, Laser Dermatology, Mont Albert, Vic
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10
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Langbroek GB, Wolkerstorfer A, Horbach SE, Spuls PI, Kelly KM, Robertson SJ, van Raath MI, Al‐Niaimi F, Kono T, Boixeda P, Laubach HJ, Badawi AM, Rubin AT, Haedersdal M, Manuskiatti W, van der Horst CM, Ubbink D. A core outcome domain set for clinical research on capillary malformations (the COSCAM project): an e-Delphi process and consensus meeting. Br J Dermatol 2022; 187:730-742. [PMID: 35762296 PMCID: PMC9796083 DOI: 10.1111/bjd.21723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 06/16/2022] [Accepted: 06/26/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND There is limited evidence on the best available treatment options for capillary malformations (CMs), mainly due to the absence of uniform outcome measures in trials on therapies. A core outcome set (COS) enables standard reporting of trial outcomes, which facilitates comparison of treatment results. OBJECTIVES To develop a core outcome domain set (CDS), as part of a core outcome set (COS), for clinical research on CMs. METHODS Sixty-seven potentially relevant outcome subdomains were recognized based on the literature, focus group sessions, and input from the COSCAM working group. These outcome subdomains were presented in an online Delphi study to CM experts (medical specialists and authors of relevant literature) and (parents of) patients with CM (international patient associations). During three e-Delphi study rounds, the participants repeatedly scored the importance of these outcome subdomains on a seven-point Likert scale. Participants could also propose other relevant outcome subdomains. Consensus was defined as ≥ 80% agreement as to the importance of an outcome subdomain among both stakeholder groups. The CDS was finalized during an online consensus meeting. RESULTS In total 269 participants from 45 countries participated in the first e-Delphi study round. Of these, 106 were CM experts from 32 countries, made up predominantly of dermatologists (59%) and plastic surgeons (18%). Moreover, 163 (parents of) patients with CM from 28 countries participated, of whom 58% had Sturge-Weber syndrome. During the two subsequent e-Delphi study rounds, 189 and 148 participants participated, respectively. After the entire consensus process, consensus was reached on 11 outcome subdomains: colour/redness, thickness, noticeability, distortion of anatomical structures, glaucoma, overall health-related quality of life, emotional functioning, social functioning, tolerability of intervention, patient satisfaction with treatment results, and recurrence. CONCLUSIONS We recommend the CDS to be used as a minimum reporting standard in all future trials of CM therapy. Our next step will be to select suitable outcome measurement instruments to score the core outcome subdomains. What is already known about this topic? Besides physical and functional sequelae, capillary malformations (CMs) often cause emotional and social burden. The lack of uniform outcome measures obstructs proper evaluation and comparison of treatment strategies. As a result, there is limited evidence on the best available treatment options. The development of a core outcome set (COS) may improve standardized reporting of trial outcomes. What does this study add? A core outcome domain set (CDS), as part of a COS, was developed for clinical research on CMs. International consensus was reached on the recommended core outcome subdomains to be measured in CM trials: colour/redness, thickness, noticeability, distortion of anatomical structures, glaucoma, overall health-related quality of life, emotional functioning, social functioning, tolerability of intervention, patient satisfaction with treatment results, and recurrence. This CDS enables the next step in the development of a COS, namely to reach consensus on the core outcome measurement instruments to score the core outcome subdomains. What are the clinical implications of this work? The obtained CDS will facilitate standardized reporting of treatment outcomes, thereby enabling proper comparison of treatment results. This comparison is likely to provide more reliable information for patients about the best available treatment options.
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Affiliation(s)
- Ginger Beau Langbroek
- Department of SurgeryAmsterdam University Medical Centers, location AMC, University of AmsterdamAmsterdamthe Netherlands,Department of Plastic, Reconstructive and Hand SurgeryAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
| | - Albert Wolkerstorfer
- Department of DermatologyAmsterdam University Medical Centers, Amsterdam Public Health, Immunity and Infections, University of AmsterdamAmsterdamthe Netherlands
| | - Sophie E.R. Horbach
- Department of Plastic, Reconstructive and Hand SurgeryAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
| | - Phyllis I. Spuls
- Department of DermatologyAmsterdam University Medical Centers, Amsterdam Public Health, Immunity and Infections, University of AmsterdamAmsterdamthe Netherlands
| | - Kristen M. Kelly
- Department of DermatologyUniversity of California IrvineIrvineCAUSA
| | - Susan J. Robertson
- Department of DermatologyMurdoch Children’s Research Institute, The Royal Children’s HospitalMelbourneVICAustralia
| | - M. Ingmar van Raath
- Department of Plastic, Reconstructive, and Hand SurgeryMaastricht University Medical Center, Maastricht UniversityMaastrichtthe Netherlands
| | - Firas Al‐Niaimi
- Private dermatological practiceLondonUK,Department of DermatologyUniversity of AalborgAalborgDenmark
| | - Taro Kono
- Department of Plastic SurgeryTokai University School of MedicineShimokasuyaIseharaKanagawaJapan
| | - Pablo Boixeda
- Department of DermatologyHospital Ramon y CajalMadridSpain
| | - Hans J. Laubach
- Department of DermatologyGeneva University Hospitals (HUG)GenevaSwitzerland
| | - Ashraf M. Badawi
- Department of DermatologySzeged UniversitySzegedHungary,Department of Medical Laser ApplicationsNational Institute of Laser Enhanced Sciences, Cairo UniversityGizaEgypt
| | | | - Merete Haedersdal
- Department of DermatologyUniversity of Copenhagen, Bispebjerg HospitalCopenhagenNVDenmark
| | - Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Chantal M.A.M. van der Horst
- Department of Plastic, Reconstructive and Hand SurgeryAmsterdam University Medical Centers, University of AmsterdamAmsterdamthe Netherlands
| | - D.T. Ubbink
- Department of SurgeryAmsterdam University Medical Centers, location AMC, University of AmsterdamAmsterdamthe Netherlands
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11
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Davenport R, Su JC, Nathalie J, Richmond CM, Yang Tan T, Robertson SJ. Clinical overlap of PHACE and LUMBAR syndromes. Pediatr Dermatol 2022; 39:752-756. [PMID: 35896169 DOI: 10.1111/pde.15031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 04/26/2022] [Indexed: 11/28/2022]
Abstract
Segmental infantile hemangiomas affecting the upper body are associated with PHACE(S) (Posterior fossa anomalies, Hemangioma, Arterial anomalies, Cardiac anomalies, Eye anomalies, and Sternal defects) syndrome, whereas segmental infantile hemangiomas affecting the lower body are the cutaneous hallmark of LUMBAR (Lower body hemangioma and other skin defects, Urogenital anomalies and Ulceration, Myelopathy, Bony deformities, Anorectal malformations and Arterial anomalies, and Renal anomalies) syndrome. We present two individuals with concurrent features of both PHACE and LUMBAR syndromes demonstrating an overlap phenotype. The overlapping features seen in our patients suggest that these syndromes occur on the same phenotypic spectrum and derive from a common embryonic pathophysiology.
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Affiliation(s)
- Rachael Davenport
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - John C Su
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of Dermatology, Monash University, Eastern Health, Melbourne, Victoria, Australia
| | - Janice Nathalie
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia.,Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Christopher M Richmond
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Tiong Yang Tan
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Susan J Robertson
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia
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12
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Lin Q, Kuypers M, Liu Z, Copeland JK, Chan D, Robertson SJ, Kontogiannis J, Guttman DS, Banks EK, Philpott DJ, Mallevaey T. Invariant natural killer T cells minimally influence gut microbiota composition in mice. Gut Microbes 2022; 14:2104087. [PMID: 35912530 PMCID: PMC9348128 DOI: 10.1080/19490976.2022.2104087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Invariant Natural Killer T (iNKT) cells are unconventional T cells that respond to glycolipid antigens found in microbes in a CD1d-dependent manner. iNKT cells exert innate-like functions and produce copious amounts of cytokines, chemokines and cytotoxic molecules within only minutes of activation. As such, iNKT cells can fuel or dampen inflammation in a context-dependent manner. In addition, iNKT cells provide potent immunity against bacteria, viruses, parasites and fungi. Although microbiota-iNKT cell interactions are not well-characterized, mounting evidence suggests that microbiota colonization early in life impacts iNKT cell homeostasis and functions in disease. In this study, we showed that CD1d-/- and Vα14 Tg mice, which lack and have increased numbers of iNKT cells, respectively, had no significant alterations in gut microbiota composition compared to their littermate controls. Furthermore, specific iNKT cell activation by glycolipid antigens only resulted in a transient and minimal shift in microbiota composition when compared to the natural drift found in our colony. Our findings demonstrate that iNKT cells have little to no influence in regulating commensal bacteria at steady state.Abbreviations: iNKT: invariant Natural Killer T cell; αGC: α-galactosylceramide.
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Affiliation(s)
- Qiaochu Lin
- Department of Immunology, University of Toronto, Toronto, ON, Canada,CONTACT Thierry Mallevaey University of Toronto, Department of Immunology, Medical Sciences Building, Room 7334,1 King’s College Circle, Toronto, OntarioM5S 1A8, Canada
| | - Meggie Kuypers
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Zhewei Liu
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Julia K Copeland
- Centre for the Analysis of Genome Evolution & Function, University of Toronto, Toronto, Ontario, Canada
| | - Donny Chan
- Centre for the Analysis of Genome Evolution & Function, University of Toronto, Toronto, Ontario, Canada
| | - Susan J Robertson
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Jean Kontogiannis
- Division of Comparative Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - David S Guttman
- Centre for the Analysis of Genome Evolution & Function, University of Toronto, Toronto, Ontario, Canada,Department of Cell and Systems Biology, University of Toronto, Toronto, ON, Canada
| | - E. Kate Banks
- Division of Comparative Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Dana J Philpott
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Thierry Mallevaey
- Department of Immunology, University of Toronto, Toronto, ON, Canada,Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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13
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Robertson SJ, Prodinger C, Liu L, Skilbeck C, Petrof G, Martinez AE, Mellerio JE, Greenblatt DT. Otological complications in inversa type recessive dystrophic epidermolysis bullosa. Clin Exp Dermatol 2021; 47:717-723. [PMID: 34826142 DOI: 10.1111/ced.15029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/16/2021] [Accepted: 11/19/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The rare inversa subtype of recessive dystrophic epidermolysis bullosa (RDEB-I) is characterized by predominant intertriginous skin blistering and marked mucosal involvement. Specific recessive missense mutations in the collagen VII triple helix are implicated. To date, otological complications have infrequently been reported in this patient group. METHODS We conducted an observational, retrospective, double institution case record review of RDEB-I patients who presented with otological complications between January 2000 and June 2020. Diagnosis was established on the basis of clinical features, family history and mutation analysis of COL7A1. RESULTS Forty-four percent (11/25) of RDEB-I patients in our database (2 paediatric, 9 adult; mean age 40.9 years, range 8-72 years) experienced otological complications. Ten of 11 individuals (90.9%) had recurrent otitis externa, 7/11 (63.6%) had meatal stenosis and 7/11 (63.6%) had recurrent blistering of external auditory canals. All 11 patients reported hearing difficulties, with conductive hearing loss confirmed by audiology testing in 6/11 (54.5%). Three of 11 (27.3%) patients had implantable hearing aids fitted with favourable outcome; 2 bone-anchored hearing aids (BAHA) and 1 middle ear implant (MEI). One paediatric patient presented with a cholesteatoma that was surgically managed. DISCUSSION We observed a higher prevalence of otological morbidity in RDEB-I than previously reported and present the first case of cholesteatoma in EB. Our data indicate that BAHA and MEI are safe and effective treatment options for hearing loss in EB. Clinicians should be vigilant in screening for ear symptoms in RDEB-I and consider early referral to an ENT specialist.
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Affiliation(s)
- S J Robertson
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, United Kingdom
| | - C Prodinger
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, United Kingdom
| | - L Liu
- Viapath, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - C Skilbeck
- Department of Otorhinolaryngology-Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - G Petrof
- Department of Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom
| | - A E Martinez
- Department of Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom
| | - J E Mellerio
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, United Kingdom
| | - D T Greenblatt
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, United Kingdom
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14
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Robertson SJ, Elder JE, Bekhor PS. Infantile hemangioma affecting the iris. Pediatr Dermatol 2021; 38:1579-1580. [PMID: 34632621 DOI: 10.1111/pde.14833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An infant girl developed a hemangioma affecting her left iris concurrently with diffuse cutaneous infantile hemangiomas from day 2 of life. Intraocular hemangiomas are rarely reported and are usually associated with neonatal hemangiomatosis, the presence of which indicates a high risk for visceral lesions. This striking case highlights the unusual clinical presentation of iris hemangioma and demonstrates the importance of conducting visceral screening when faced with these lesions. Oral propranolol was commenced and resulted in rapid improvement of all lesions without complication.
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Affiliation(s)
- Susan J Robertson
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - James E Elder
- Department of Ophthalmology, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Philip S Bekhor
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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15
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Robertson SJ, Orrin E, Lakhan MK, O'Sullivan G, Felton J, Robson A, Greenblatt DT, Bernardis C, McGrath JA, Martinez AE, Mellerio JE. Cutaneous Squamous Cell Carcinoma in Epidermolysis Bullosa: a 28-year Retrospective Study. Acta Derm Venereol 2021; 101:adv00523. [PMID: 34230977 PMCID: PMC9413672 DOI: 10.2340/00015555-3875] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Epidermolysis bullosa (EB), notably severe recessive dystrophic EB (RDEB-S), is associated with increased risk of aggressive mucocutaneous squamous cell carcinomas, the major cause of mortality in early adulthood. This observational, retrospective case review describes a series of EB patients with cutaneous squamous cell carcinomas over a 28-year period. Forty-four EB patients with squamous cell carcinomas were identified with a total of 221 primary tumours. They comprised: 31 (70%) with RDEB-S, 4 (9%) with other RDEB subtypes, 5 (11.4%) with dominant dystrophic EB, 3 (6.8%) with intermediate junctional EB and 1 (2.3%) with Kindler EB. Squamous cell carcinomas occurred earlier in RDEB-S (median age 29.5 years; age range 13–52 years) than other groups collectively (median age 47.1 years; age range 30–89 years) and most had multiple tumours (mean 5.8; range 1–44). Squamous cell carcinoma-associated mortality was high in RDEB-S (64.5%), with median survival after first squamous cell carcinoma of 2.4 years (range 0.5–12.6 years), significantly lower than previous reports, highlighting the need for early surveillance and better treatments.
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Affiliation(s)
- Susan J Robertson
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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16
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Langbroek GB, Wolkerstorfer A, Horbach SER, Spuls PI, Kelly KM, Robertson SJ, van Raath MI, Al-Niaimi F, Kono T, Boixeda P, Laubach HJ, Badawi AM, Troilius Rubin A, Haedersdal M, Manuskiatti W, van der Horst CMAM, Ubbink DT. Development of a core outcome domain set for clinical research on capillary malformations (the COSCAM project). J Eur Acad Dermatol Venereol 2021; 35:1888-1895. [PMID: 34014582 PMCID: PMC8453952 DOI: 10.1111/jdv.17376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/21/2021] [Indexed: 01/19/2023]
Abstract
Background Due to a large variety in treatment outcomes reported in therapeutic trials and lacking patient‐relevant outcomes, it is hard to adequately compare and improve current therapies for patients with capillary malformations (CMs). The Core Outcome Set for Capillary Malformations (COSCAM) project aims to develop a core outcome set (COS) for use in future CM trials, in which we will first develop a core outcome (sub)domain set (CDS). Here, we describe the methods for the development of a CDS and present the results of the first development stage. Methods The COSCAM project is carried out according to the recommendations of the Cochrane Skin Core OUtcomes Set INitiative (CS‐COUSIN) and the Core Outcome Measures in Effectiveness Trials (COMET) initiative. During the first stage, we identified all potentially relevant outcome subdomains based on a systematic review, two focus group sessions and input from patient representatives of Dutch patient organizations and the COSCAM‐founding group. In stage two, we will present the subdomains in a three‐round e‐Delphi study and online consensus meeting, in which CM patients, parents/caregivers and CM experts worldwide rate the importance of the proposed subdomains, hereby finalizing the core outcome (sub)domains of the CDS. Results A total of 67 potential outcome subdomains were included; sixteen were previously used in the literature, 20 were proposed by Dutch patients and their parents/caregivers (n = 13) in focus group sessions and 38 were suggested by the experts of the COSCAM‐founding group. Seven were excluded because of overlap. Conclusion The final CDS may serve as a minimum standard in future CM trials, thereby facilitating adequate comparison of treatment outcomes. After this CDS development, we will select appropriate outcome measurement instruments to measure the core outcome subdomains.
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Affiliation(s)
- G B Langbroek
- Department of Surgery, Amsterdam University Medical Center (UMC) Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - A Wolkerstorfer
- Department of Dermatology, Amsterdam University Medical Center UMC, Amsterdam Public Health, Immunity and Infections, University of Amsterdam, Amsterdam, The Netherlands
| | - S E R Horbach
- Department of Plastic-, Reconstructive- and Hand Surgery, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam, The Netherlands
| | - P I Spuls
- Department of Dermatology, Amsterdam University Medical Center UMC, Amsterdam Public Health, Immunity and Infections, University of Amsterdam, Amsterdam, The Netherlands
| | - K M Kelly
- Department of Dermatology, University of California Irvine, Irvine, CA, USA
| | - S J Robertson
- Department of Dermatology and Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - M I van Raath
- Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
| | - F Al-Niaimi
- Private Dermatological Practice, London, UK.,Department of Dermatology, University of Aalborg, Aalborg, Denmark
| | - T Kono
- Department of Plastic Surgery, Tokai University School of Medicine, Shimokasuya Isehara Kanagawa, Kanagawa, Japan
| | - P Boixeda
- Department of Dermatology, Hospital Ramon y Cajal, Madrid, Spain
| | - H J Laubach
- Department of Dermatology, Geneva University Hospitals (HUG), Geneva, Switzerland
| | - A M Badawi
- Department of Dermatology, Szeged University, Szeged, Hungary.,Department of Medical Laser Applications, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
| | - A Troilius Rubin
- Department of Dermatology, Skåne University Hospital, Malmö, Sweden
| | - M Haedersdal
- Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, Copenhagen NV, Denmark
| | - W Manuskiatti
- Department of Dermatology, Siriraj Skin Laser Center Department of Dermatology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
| | - C M A M van der Horst
- Department of Plastic-, Reconstructive- and Hand Surgery, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam, The Netherlands
| | - D T Ubbink
- Department of Surgery, Amsterdam University Medical Center (UMC) Location AMC, University of Amsterdam, Amsterdam, The Netherlands
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17
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Robertson SJ, Orme L, Teixeira R, Shamassi M, Newell F, Patch AM, Yeh I, Gard G, Wilmott J, Jackett L, LeBoit P, Fellowes A, MacArthur G, Fox S, Hayward NK, Bastian B, Scolyer R, Waddell N, Penington A, Shackleton M. Evaluation of Crizotinib Treatment in a Patient With Unresectable GOPC-ROS1 Fusion Agminated Spitz Nevi. JAMA Dermatol 2021; 157:836-841. [PMID: 34076666 DOI: 10.1001/jamadermatol.2021.0025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Spitz nevi are benign melanocytic neoplasms that classically present in childhood. Isolated Spitz nevi have been associated with oncogenic gene fusions in approximately 50% of cases. The rare agminated variant of Spitz nevi, thought to arise from cutaneous genetic mosaicism, is characterized by development of clusters of multiple lesions in a segmental distribution, which can complicate surgical removal. Somatic single-nucleotide variants in the HRAS oncogene have been described in agminated Spitz nevi, most of which were associated with an underlying nevus spilus. The use of targeted medical therapy for agminated Spitz nevi is not well understood. Observations A girl aged 30 months presented with facial agminated Spitz nevi that recurred rapidly and extensively after surgery. Owing to the morbidity of further surgery, referral was made to a molecular tumor board. The patient's archival nevus tissue was submitted for extended immunohistochemical analysis and genetic sequencing. Strong ROS1 protein expression was identified by immunohistochemistry. Consistent with this, analysis of whole-genome sequencing data revealed GOPC-ROS1 fusions. These results indicated likely benefit from the oral tyrosine kinase inhibitor crizotinib, which was administered at a dosage of 280 mg/m2 twice daily. An excellent response was observed in all lesions within 5 weeks, with complete flattening after 20 weeks. Conclusions and Relevance Given the response following crizotinib treatment observed in this case, the kinase fusion was believed to be functionally consequential in the patient's agminated Spitz nevi and likely the driver mutational event for growth of her nevi. The repurposing of crizotinib for GOPC-ROS1 Spitz nevi defines a new treatment option for these lesions, particularly in cases for which surgery is relatively contraindicated.
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Affiliation(s)
- Susan J Robertson
- Department of Dermatology, The Royal Children's Hospital, The Royal Melbourne Hospital and Monash Medical Centre, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Lisa Orme
- Department of Oncology, The Royal Children's Hospital, Melbourne, Australia.,Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Rodrigo Teixeira
- Department of Plastic Surgery, The Royal Children's Hospital, Melbourne, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Maryam Shamassi
- Department of Anatomical Pathology, The Royal Children's Hospital, Melbourne, Australia
| | - Felicity Newell
- Department of Genetics and Computational Biology, QIMR (Queensland Institute of Medical Research) Berghofer Medical Research Institute, Brisbane, Australia
| | - Ann-Marie Patch
- Department of Genetics and Computational Biology, QIMR (Queensland Institute of Medical Research) Berghofer Medical Research Institute, Brisbane, Australia
| | - Iwei Yeh
- Helen Diller Family Comprehensive Cancer Center, Departments of Dermatology and Pathology, University of California, San Francisco
| | - Grace Gard
- Department of Medical Oncology, Alfred Health, Melbourne, Australia
| | - James Wilmott
- Melanoma Institute Australia, University of Sydney, Sydney, Australia
| | - Louise Jackett
- Melanoma Institute Australia, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Camperdown, Australia
| | - Philip LeBoit
- Helen Diller Family Comprehensive Cancer Center, Departments of Dermatology and Pathology, University of California, San Francisco
| | | | | | - Stephen Fox
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nicholas K Hayward
- Department of Genetics and Computational Biology, QIMR (Queensland Institute of Medical Research) Berghofer Medical Research Institute, Brisbane, Australia
| | - Boris Bastian
- Helen Diller Family Comprehensive Cancer Center, Departments of Dermatology and Pathology, University of California, San Francisco
| | - Richard Scolyer
- Melanoma Institute Australia, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Camperdown, Australia
| | - Nicola Waddell
- Department of Genetics and Computational Biology, QIMR (Queensland Institute of Medical Research) Berghofer Medical Research Institute, Brisbane, Australia
| | - Anthony Penington
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Plastic Surgery, The Royal Children's Hospital, Melbourne, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Mark Shackleton
- Peter MacCallum Cancer Centre, Melbourne, Australia.,Department of Medical Oncology, Alfred Health, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
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18
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Smith BRC, Nyström A, Nowell CJ, Hausser I, Gretzmeier C, Robertson SJ, Varigos GA, Has C, Kern JS, Pang KC. Mouse models for dominant dystrophic epidermolysis bullosa carrying common human point mutations recapitulate the human disease. Dis Model Mech 2021; 14:dmm048082. [PMID: 34085701 PMCID: PMC8214732 DOI: 10.1242/dmm.048082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/27/2021] [Indexed: 12/13/2022] Open
Abstract
Heterozygous missense mutations in the human COL7A1 gene - coding for collagen VII - lead to the rare, dominantly inherited skin disorder dominant dystrophic epidermolysis bullosa (DDEB), which is characterised by skin fragility, blistering, scarring and nail dystrophy. To better understand the pathophysiology of DDEB and develop more effective treatments, suitable mouse models for DDEB are required but to date none have existed. We identified the two most common COL7A1 mutations in DDEB patients (p.G2034R and p.G2043R) and used CRISPR-Cas9 to introduce the corresponding mutations into mouse Col7a1 (p.G2028R and p.G2037R). Dominant inheritance of either of these two alleles results in a phenotype that closely resembles that seen in DDEB patients. Specifically, mice carrying these alleles show recurrent blistering that is first observed transiently around the mouth and paws in the early neonatal period and then again around the digits from 5-10 weeks of age. Histologically, the mice show micro-blistering and reduced collagen VII immunostaining. Biochemically, collagen VII from these mice displays reduced thermal stability, which we also observed to be the case for DDEB patients carrying the analogous mutations. Unlike previous rodent models of epidermolysis bullosa, which frequently show early lethality and severe disease, these mouse models, which to our knowledge are the first for DDEB, show no reduction in growth and survival, and - together with a relatively mild phenotype - represent a practically and ethically tractable tool for better understanding and treating epidermolysis bullosa. This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Blake R. C. Smith
- Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia
| | - Alexander Nyström
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79104, Germany
| | - Cameron J. Nowell
- Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Ingrid Hausser
- Institute of Pathology, University Hospital Heidelberg, Heidelberg 69120, Germany
| | - Christine Gretzmeier
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79104, Germany
| | - Susan J. Robertson
- Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Dermatology Department, Faculty of Medicine, Dentistry and Health Sciences, The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC 3050, Australia
- Royal Children's Hospital, Parkville, VIC 3052, Australia
| | - George A. Varigos
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia
- Dermatology Department, Faculty of Medicine, Dentistry and Health Sciences, The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC 3050, Australia
| | - Cristina Has
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79104, Germany
| | - Johannes S. Kern
- Dermatology Department, Faculty of Medicine, Dentistry and Health Sciences, The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC 3050, Australia
| | - Ken C. Pang
- Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia
- Royal Children's Hospital, Parkville, VIC 3052, Australia
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19
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Rogers CL, Gibson M, Kern JS, Martin LK, Robertson SJ, Daniel BS, Su JC, Murrell OGC, Feng G, Murrell DF. A comparison study of outcome measures for epidermolysis bullosa: Epidermolysis Bullosa Disease Activity and Scarring Index (EBDASI) and the Instrument for Scoring Clinical Outcomes of Research for Epidermolysis Bullosa (iscorEB). JAAD Int 2021; 2:134-152. [PMID: 34409361 PMCID: PMC8362226 DOI: 10.1016/j.jdin.2020.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2020] [Indexed: 12/19/2022] Open
Abstract
Background The success of clinical trials in Epidermolysis Bullosa (EB) is dependent upon the availability of a valid and reliable scoring tool that can accurately assess and monitor disease severity. The Epidermolysis Bullosa Disease Activity and Scarring Index (EBDASI) and Instrument for Scoring Clinical Outcomes of Research for Epidermolysis Bullosa (iscorEB) were independently developed and validated against the Birmingham Epidermolysis Bullosa Severity Score but have never been directly compared. Objective To compare the reliability, convergent validity, and discriminant validity of the EBDASI and iscorEB scoring tools. Methods An observational cohort study was conducted in 15 patients with EB. Each patient was evaluated using the EBDASI and iscorEB-clinician scoring tools by 6 dermatologists with expertise in EB. Quality of life was assessed using the iscorEB-patient and Quality of Life in EB measures. Results The intraclass correlation coefficients for interrater reliability were 0.942 for the EBDASI and 0.852 for the iscorEB-clinician. The intraclass correlation coefficients for intrarater reliability was 0.99 for both scores. The two tools demonstrated strong convergent validity with each other. Conclusion Both scoring tools demonstrate excellent reliability. The EBDASI appears to better discriminate between EB types and disease severities.
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Key Words
- BEBS, Birmingham Epidermolysis Bullosa Severity Score
- BMD, bone mineral densitometry
- DDEB, dominant dystrophic epidermolysis bullosa
- EB, epidermolysis bullosa
- EBDASI, Epidermolysis Bullosa Disease Activity and Scarring Index
- EBS, epidermolysis bullosa simplex
- Epidermolysis Bullosa Disease Activity and Scarring Index
- ICC, intraclass correlation coefficient
- Instrument for Scoring Clinical Outcomes of Research for Epidermolysis Bullosa
- JEB, junctional epidermolysis bullosa
- QOLEB, Quality of Life in Epidermolysis Bullosa score
- QoL, quality of life
- RDEB, recessive dystrophic epidermolysis bullosa
- blistering skin disease
- dermatology
- epidermolysis bullosa
- iscorEB, Instrument for Scoring Clinical Outcomes of Research for Epidermolysis Bullosa
- outcome measure
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Affiliation(s)
- Clare L Rogers
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia.,Premier Specialists, Dermatology Trials Australia, Kogarah, New South Wales, Australia
| | - Matthew Gibson
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia.,Premier Specialists, Dermatology Trials Australia, Kogarah, New South Wales, Australia
| | - Johannes S Kern
- Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Linda K Martin
- Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Susan J Robertson
- Department of Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Dermatology, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Dermatology, Monash Health, Melbourne, Victoria, Australia
| | - Benjamin S Daniel
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia
| | - John C Su
- Department of Dermatology, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Dermatology, Monash Health, Melbourne, Victoria, Australia.,Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Oliver G C Murrell
- Premier Specialists, Dermatology Trials Australia, Kogarah, New South Wales, Australia
| | - Grant Feng
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Dedee F Murrell
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia.,Premier Specialists, Dermatology Trials Australia, Kogarah, New South Wales, Australia
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20
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Murrell DF, Lucky AW, Salas-Alanis JC, Woodley DT, Palisson F, Natsuga K, Nikolic M, Ramirez-Quizon M, Paller AS, Lara-Corrales I, Barzegar MA, Sprecher E, Has C, Laimer M, Bruckner AL, Bilgic A, Nanda A, Purvis D, Hovnanian A, Murat-Sušić S, Bauer J, Kern JS, Bodemer C, Martin LK, Mellerio J, Kowaleski C, Robertson SJ, Bruckner-Tuderman L, Pope E, Marinkovich MP, Tang JY, Su J, Uitto J, Eichenfield LF, Teng J, Aan Koh MJ, Lee SE, Khuu P, Rishel HI, Sommerlund M, Wiss K, Hsu CK, Chiu TW, Martinez AE. Multidisciplinary care of epidermolysis bullosa during the COVID-19 pandemic-Consensus: Recommendations by an international panel of experts. J Am Acad Dermatol 2020; 83:1222-1224. [PMID: 32682031 PMCID: PMC7363613 DOI: 10.1016/j.jaad.2020.06.1023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/27/2020] [Accepted: 06/29/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Dedee F Murrell
- Department of Dermatology, St George Hospital, University of New South Wales, Sydney, New South Wales, Australia.
| | - Anne W Lucky
- Cincinnati Children's Epidermolysis Bullosa Center, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Julio C Salas-Alanis
- DebRA (Dystrophic Epidermolysis Bullosa Research Association) Mexico, Monterrey, Mexico
| | - David T Woodley
- Department of Dermatology, University of Southern California, Los Angeles, California
| | - Francis Palisson
- Dystrophic Epidermolysis Bullosa Research Association DebRA (Dystrophic Epidermolysis Bullosa Research Association) Chile; Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Ken Natsuga
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Milos Nikolic
- Deptartment of Dermatovenereology, University of Belgrade School of Medicine, Belgrade, Serbia
| | - Mae Ramirez-Quizon
- Department of Dermatology, University of the Philippines, Philippines General Hospital, Manila, Philippines
| | - Amy S Paller
- Departments of Dermatology and Pediatrics, Children's Hospital, Northwestern University, Chicago, Illinois
| | - Irene Lara-Corrales
- Section of Dermatology, Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Eli Sprecher
- Department of Dermatology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Cristina Has
- Department of Dermatology, Medical Center-University of Freiburg, Freiburg, Germany
| | - Martin Laimer
- EB Haus, Department of Dermatology, Paracelsus University, Salzburg, Austria
| | - Anna L Bruckner
- Pediatric Dermatology Department, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado
| | - Asli Bilgic
- Department of Dermatology, Akdeniz University, Antalya, Turkey
| | - Arti Nanda
- Pediatric Dermatology Unit, As'ad Al-Hamad Dermatology Center, Kuwait
| | - Diana Purvis
- Department of Dermatology, Starship Children's Health, Auckland, New Zealand
| | - Alain Hovnanian
- Department of Genetics, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1163, Laboratory of Genetic Skin Diseases, Paris, France; Institut des Maladies Génétiques (IMAGINE), University of Paris, Paris, France
| | | | - Johannes Bauer
- EB Haus, Department of Dermatology, Paracelsus University, Salzburg, Austria
| | - Johannes S Kern
- Dermatology Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia
| | - Christine Bodemer
- Department of Dermatology, Necker Enfants Malades Hospital, University of Paris, Paris, France; Reference Centre for Genodermatoses and Rare Skin Diseases (MAGEC), Paris, France
| | - Linda K Martin
- Department of Dermatology, Sydney Children's Hospital, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Jemima Mellerio
- Adult Epidermolysis Bullosa Service, St John's Institute of Dermatology, St Thomas' Hospital, London, United Kingdom
| | - Cezary Kowaleski
- Department of Dermatology and Immunodermatology, University of Warsaw, Warsaw, Poland
| | - Susan J Robertson
- Dermatology Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of Dermatology, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | | | - Elena Pope
- Section of Dermatology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - M Peter Marinkovich
- Department of Dermatology, Stanford University Medical Center, Palo Alto, California
| | - Jean Y Tang
- Department of Dermatology, Stanford University Medical Center, Palo Alto, California
| | - John Su
- The University of Melbourne, Parkville, Victoria, Australia; Monash University, Eastern Health, Melbourne, Victoria, Australia
| | - Jouni Uitto
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Philadelphia, Pennsylvania
| | - Lawrence F Eichenfield
- Departments of Dermatology and Pediatrics, University of California, San Diego, California; Department of Pediatric Dermatology, Rady Children's Hospital, San Diego, California
| | - Joyce Teng
- Department of Dermatology, Stanford University Medical Center, Palo Alto, California
| | | | - Sang Eun Lee
- Department of Dermatology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Phuong Khuu
- Department of Dermatology, Stanford University Medical Center, Palo Alto, California
| | - Heather I Rishel
- Rishel Pediatric Dermatology, PC, Rishel Enterprises, LLC, San Francisco, California
| | - Mette Sommerlund
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Karen Wiss
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Chao-Kai Hsu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tor Wo Chiu
- Chinese University of Hong Kong, Hong Kong, China
| | - Anna E Martinez
- Paediatric Dermatology Department, Great Ormond Street National Health Service Foundation Trust, London, United Kingdom
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21
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de Lima MAG, Clemons M, Van Katwyk S, Stober C, Robertson SJ, Vandermeer L, Fergusson D, Thavorn K. Cost analysis of using Magee scores as a surrogate of Oncotype DX for adjuvant treatment decisions in women with early breast cancer. J Eval Clin Pract 2020; 26:889-892. [PMID: 31287198 DOI: 10.1111/jep.13223] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/12/2019] [Accepted: 06/16/2019] [Indexed: 12/28/2022]
Abstract
Breast cancer is the most common cancer in women worldwide. Most current guidelines recommend using multigene profiling assays to aid the decision on the addition of chemotherapy to adjuvant hormone therapy for women who present with early-stage, hormone receptor-positive, HER2-negative disease. One of these assays is the Oncotype DX, which predicts the disease recurrence risk and adjuvant chemotherapy benefits. Given its high cost, there is an economic incentive to evaluate its surrogates, such as the Magee equations. We assessed health system costs associated with the use of the Magee scores. A probabilistic decision tree was used to calculate the difference in mean health system costs based on data obtained from a randomized trial and the published literature. Costs were calculated from a perspective of Canada's publicly funded health care system. A series of sensitivity analysis was conducted to assess the robustness of the study findings. The Magee equations were associated with a total cost savings of C$100 per patient (95% CI, -C$3068 to C$5022) compared with standard of care. The difference in costs was highly sensitive to the extent that the Magee scores could reduce the frequency of adjuvant chemotherapy and Oncotype DX requests.
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Affiliation(s)
- Mariana A G de Lima
- Institute of Cancer of the State of São Paulo, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Mark Clemons
- Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Division of Medical Oncology, Department of Medicine and University of Ottawa, Ottawa, ON, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Sasha Van Katwyk
- Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Carol Stober
- Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Susan J Robertson
- Eastern Ontario Regional Laboratory Association, Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Lisa Vandermeer
- Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Dean Fergusson
- Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Kednapa Thavorn
- Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.,Institute of Clinical and Evaluative Sciences (ICES uOttawa), University of Ottawa, Ottawa, ON, Canada
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22
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Verma KP, Robertson SJ, Winship IM. Phenotypic discordance between siblings with junctional epidermolysis bullosa-pyloric atresia. Clin Exp Dermatol 2020; 45:793-795. [PMID: 32359087 DOI: 10.1111/ced.14223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2020] [Indexed: 11/29/2022]
Affiliation(s)
- K P Verma
- Department of Genomic Medicine and Parkville Familial Cancer Centre, Royal Melbourne Hospital, Melbourne, Australia
| | - S J Robertson
- Department of Dermatology, Royal Melbourne Hospital, Melbourne, Australia
| | - I M Winship
- Department of Genomic Medicine and Parkville Familial Cancer Centre, Royal Melbourne Hospital, Melbourne, Australia.,Department of Medicine, University of Melbourne, Melbourne, Australia
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23
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Nasrallah R, Zimpelmann J, Robertson SJ, Ghossein J, Thibodeau JF, Kennedy CRJ, Gutsol A, Xiao F, Burger D, Burns KD, Hébert RL. Prostaglandin E2 receptor EP1 (PGE2/EP1) deletion promotes glomerular podocyte and endothelial cell injury in hypertensive TTRhRen mice. J Transl Med 2020; 100:414-425. [PMID: 31527829 DOI: 10.1038/s41374-019-0317-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/05/2019] [Accepted: 08/20/2019] [Indexed: 12/18/2022] Open
Abstract
Prostaglandin E2 receptor EP1 (PGE2/EP1) promotes diabetic renal injury, and EP1 receptor deletion improves hyperfiltration, albuminuria, and fibrosis. The role of EP1 receptors in hypertensive kidney disease (HKD) remains controversial. We examined the contribution of EP1 receptors to HKD. EP1 null (EP1-/-) mice were bred with hypertensive TTRhRen mice (Htn) to evaluate kidney function and injury at 24 weeks. EP1 deletion had no effect on elevation of systolic blood pressure in Htn mice (HtnEP1-/-) but resulted in pronounced albuminuria and reduced FITC-inulin clearance, compared with Htn or wild-type (WT) mice. Ultrastructural injury to podocytes and glomerular endothelium was prominent in HtnEP1-/- mice; including widened subendothelial space, subendothelial lucent zones and focal lifting of endothelium from basement membrane, with focal subendothelial cell debris. Cortex COX2 mRNA was increased by EP1 deletion. Glomerular EP3 mRNA was reduced by EP1 deletion, and EP4 by Htn and EP1 deletion. In WT mice, PGE2 increased chloride reabsorption via EP1 in isolated perfused thick ascending limb (TAL), but PGE2 or EP1 deletion did not affect vasopressin-mediated chloride reabsorption. In WT and Htn mouse inner medullary collecting duct (IMCD), PGE2 inhibited vasopressin-water transport, but not in EP1-/- or HtnEP1-/- mice. Overall, EP1 mediated TAL and IMCD transport in response to PGE2 is unaltered in Htn, and EP1 is protective in HKD.
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Affiliation(s)
- Rania Nasrallah
- Department of Cellular and Molecular Medicine, Faculty of Medicine, Kidney Research Centre, University of Ottawa, 451 Smyth Road, Room 2514, Ottawa, ON, Canada
| | - Joseph Zimpelmann
- Department of Cellular and Molecular Medicine, Faculty of Medicine, Kidney Research Centre, University of Ottawa, 451 Smyth Road, Room 2514, Ottawa, ON, Canada
| | | | - Jamie Ghossein
- Department of Cellular and Molecular Medicine, Faculty of Medicine, Kidney Research Centre, University of Ottawa, 451 Smyth Road, Room 2514, Ottawa, ON, Canada
| | | | - C R J Kennedy
- Department of Cellular and Molecular Medicine, Faculty of Medicine, Kidney Research Centre, University of Ottawa, 451 Smyth Road, Room 2514, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Kidney Research Centre, University of Ottawa, Ottawa, ON, Canada
| | - Alex Gutsol
- Ottawa Hospital Research Institute, Kidney Research Centre, University of Ottawa, Ottawa, ON, Canada
| | - Fengxia Xiao
- Ottawa Hospital Research Institute, Kidney Research Centre, University of Ottawa, Ottawa, ON, Canada
| | - Dylan Burger
- Ottawa Hospital Research Institute, Kidney Research Centre, University of Ottawa, Ottawa, ON, Canada
| | - Kevin D Burns
- Department of Cellular and Molecular Medicine, Faculty of Medicine, Kidney Research Centre, University of Ottawa, 451 Smyth Road, Room 2514, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Kidney Research Centre, University of Ottawa, Ottawa, ON, Canada
| | - Richard L Hébert
- Department of Cellular and Molecular Medicine, Faculty of Medicine, Kidney Research Centre, University of Ottawa, 451 Smyth Road, Room 2514, Ottawa, ON, Canada.
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24
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Robertson SJ, Pond GR, Hilton J, Petkiewicz SL, Ayroud Y, Kos Z, Gravel DH, Stober C, Vandermeer L, Arnaout A, Clemons M. Selecting Patients for Oncotype DX Testing Using Standard Clinicopathologic Information. Clin Breast Cancer 2020; 20:61-67. [DOI: 10.1016/j.clbc.2019.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 01/18/2023]
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Affiliation(s)
- Anthony D Honigman
- Department of Dermatology, Royal Children's Hospital, Melbourne, Australia
| | - Minhee Kim
- Department of Dermatology, Royal Children's Hospital, Melbourne, Australia
| | - C W Chow
- Department of Anatomical Pathology, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Susan J Robertson
- Department of Dermatology, Royal Children's Hospital, Melbourne, Australia.,Department of Dermatology, The Royal Melbourne Hospital, Melbourne, Australia.,Department of Dermatology, Monash Health, Melbourne, Australia.,Murdoch Childrens Research Institute, Melbourne, Australia
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26
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Arnaout A, Robertson SJ, Pond GR, Lee H, Jeong A, Ianni L, Kroeger L, Hilton J, Coupland S, Gottlieb C, Hurley B, McCarthy A, Clemons M. A randomized, double-blind, window of opportunity trial evaluating the effects of chloroquine in breast cancer patients. Breast Cancer Res Treat 2019; 178:327-335. [PMID: 31392517 DOI: 10.1007/s10549-019-05381-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 07/24/2019] [Accepted: 07/27/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE Chloroquine has demonstrated anti-tumor activities through autophagy inhibition and cell cycle disruption. This study aimed to assess the effect of single-agent chloroquine on breast tumor cellular proliferation in a randomized, phase II, double-blind, placebo-controlled, pre-surgical window of opportunity trial. METHODS Patients with newly diagnosed breast cancer were randomized 2:1 to chloroquine 500 mg daily or placebo for 2- to 6-weeks prior to their breast surgery. The primary outcome was the relative change in measures of proliferation (Ki67) in primary breast cancer cells pre- and post-treatment. Adverse events and toxicity profiles were also evaluated. RESULTS From September 2015 to December 2016, 70 patients were randomized [46 (66%) chloroquine and 24 (34%) placebo]. Ten patients who were randomized to chloroquine withdrew from study due to adverse events. Mean duration of drug intake was 15 days (range 14-29 days). There were no significant differences between the chloroquine or placebo arms with respect to either the percentage change (- 0.4 vs. - 1.2, p = 0.088) or absolute change (- 2.0% vs. - 5.2%, p = 0.066) in Ki67 index pre- and post-drug treatment. Although adverse effects were minimal and all classified as grade 1, the effects were significant enough to cause nearly 15% of patients to discontinue therapy. CONCLUSIONS Treatment with single-agent chloroquine 500 mg daily in the preoperative setting was not associated with any significant effects on breast cancer cellular proliferation. It was, however, associated with toxicity that may affect its broader use in oncology.
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Affiliation(s)
- Angel Arnaout
- Division of Surgical Oncology, Department of Surgery, Ottawa Hospital, Ottawa, Canada.,Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | | | - Gregory R Pond
- Department of Oncology, McMaster University, Hamilton, Canada
| | - Hoyun Lee
- Health Sciences North Research Institute, Sudbury, Canada.,Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Ahwon Jeong
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Luisa Ianni
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Ottawa Hospital Breast Health Centre, Ottawa, Canada
| | - Lynne Kroeger
- Ottawa Hospital Breast Health Centre, Ottawa, Canada
| | - John Hilton
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Division of Medical Oncology, Department of Medicine, University of Ottawa and Ottawa Hospital Cancer Center, The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Canada
| | - Stuart Coupland
- Department of Ophthalmology, University of Ottawa, Ottawa, Canada
| | - Chloe Gottlieb
- Department of Ophthalmology, University of Ottawa, Ottawa, Canada
| | - Bernard Hurley
- Department of Ophthalmology, University of Ottawa, Ottawa, Canada
| | - Anne McCarthy
- Division of Infectious Diseases, Department of Medicine, Ottawa Hospital, Ottawa, Canada
| | - Mark Clemons
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, Canada. .,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. .,Division of Medical Oncology, Department of Medicine, University of Ottawa and Ottawa Hospital Cancer Center, The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Canada.
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27
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Goethel A, Turpin W, Rouquier S, Zanello G, Robertson SJ, Streutker CJ, Philpott DJ, Croitoru K. Nod2 influences microbial resilience and susceptibility to colitis following antibiotic exposure. Mucosal Immunol 2019; 12:720-732. [PMID: 30651577 DOI: 10.1038/s41385-018-0128-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 12/05/2018] [Accepted: 12/16/2018] [Indexed: 02/04/2023]
Abstract
Inflammatory bowel disease (IBD) etiology involves genetic susceptibility, environmental triggers, and the gut microbiome. Antibiotic exposure is associated with IBD, both in early life and adulthood. Here, we investigated whether Nod2-deficiency influenced response of the gut microbiota to antibiotics and subsequent colitis susceptibility. Wild-type and Nod2-/- littermate mice were treated with amoxicillin as adults or neonates, and fecal samples were collected for 16S rRNA sequencing. Five weeks after antibiotic exposure, dextran sulfate sodium (DSS) colitis was induced. Antibiotic treatment altered the microbiota of adult WT and Nod2-/- mice, but recovery was delayed in Nod2-/- mice. Neonatal antibiotic treatment significantly changed the microbiota at weaning in WT and Nod2-/- littermates; however, Nod2-/- mice maintained reduced microbial diversity 14 days after cessation of antibiotics. Although treatment of adult mice did not influence susceptibility to colitis, neonatally treated Nod2-/- mice developed a more severe colitis. Moreover, the colitis phenotype was transferable through fecal transplantation into germ-free Nod2-/- recipients, and was associated with changes in intestinal T cells and the cytokine milieu following inflammation. These data demonstrate that neonatal antibiotic exposure has long-lasting influence on the microbiota and mucosal immunity, and may explain how NOD2 contributes to the risk of intestinal inflammation.
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Affiliation(s)
- A Goethel
- Department of Immunology, University of Toronto, Toronto, ON, M5S 1A8, Canada.,Zane Cohen Centre for Digestive Diseases, The Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, M5T 3L9, Canada
| | - W Turpin
- Zane Cohen Centre for Digestive Diseases, The Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, M5T 3L9, Canada.,Department of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - S Rouquier
- Department of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - G Zanello
- Department of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - S J Robertson
- Department of Immunology, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - C J Streutker
- St. Michael's Hospital, Toronto, ON, M5B 1W8, Canada
| | - D J Philpott
- Department of Immunology, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - K Croitoru
- Department of Immunology, University of Toronto, Toronto, ON, M5S 1A8, Canada. .,Zane Cohen Centre for Digestive Diseases, The Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, M5T 3L9, Canada. .,Department of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada. .,Division of Gastroenterology, Mount Sinai Hospital, Toronto, ON, M5G 1X5, Canada.
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28
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Robertson SJ, Lemire P, Maughan H, Goethel A, Turpin W, Bedrani L, Guttman DS, Croitoru K, Girardin SE, Philpott DJ. Comparison of Co-housing and Littermate Methods for Microbiota Standardization in Mouse Models. Cell Rep 2019; 27:1910-1919.e2. [DOI: 10.1016/j.celrep.2019.04.023] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 02/15/2019] [Accepted: 04/02/2019] [Indexed: 02/07/2023] Open
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29
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Robertson SJ, Ibrahim MFK, Stober C, Hilton J, Kos Z, Mazzarello S, Ramsay T, Fergusson D, Vandermeer L, Mallick R, Arnaout A, Dent SF, Segal R, Sehdev S, Gertler S, Hutton B, Clemons M. Does integration of Magee equations into routine clinical practice affect whether oncologists order the Oncotype DX test? A prospective randomized trial. J Eval Clin Pract 2019; 25:196-204. [PMID: 30672056 DOI: 10.1111/jep.13094] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/29/2018] [Accepted: 12/06/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The three Magee Equations provide an estimate of the Oncotype DX recurrence score using commonly available clinicopathologic information (tumour size, grade, oestrogen receptor, progesterone receptor, HER2, and Ki67). We assessed whether integration of Magee Equations into routine clinical practice affected the frequency of Oncotype DX requests. METHODS Patients with newly diagnosed, node negative, hormone receptor positive, and HER2 negative invasive breast cancer were randomized to undergo a Magee calculation or not. At the first clinic assessment, the oncologist was provided with all routinely available clinicopathologic information (including Ki67) either with or without the results of Magee Equations. Primary outcome was frequency of Oncotype DX ordering. Secondary outcomes included frequency of chemotherapy use, time to commencement of radiotherapy, or systemic therapy. Physician comfort with systemic therapy choices and the use of Ki67 and Magee Equations was also assessed. RESULTS Data from 175 randomized patients was available, 84 patients (48%) with and 91 (52%) without calculated Magee Equations. Oncotype DX was ordered in 10 (12.05%) and 13 (14.44%) (RR 0.83, 0.39-1.80; P = 0.64) in the Magee and no Magee groups, respectively. There were no statistically or clinically significant differences between the randomized groups for any of the secondary outcomes. Availability of both Ki67 and Magee Equations was associated with increased physician comfort around systemic treatment decisions. CONCLUSIONS In a practice where Ki67 is routinely available, addition of Magee Equations into routine clinic practice was not associated with a reduction in Oncotype DX use. Availability of both Ki67 and Magee Equations did however increase physician comfort with systemic therapy decisions.
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Affiliation(s)
- Susan J Robertson
- Eastern Ontario Regional Laboratory Association and Department of Pathology and Laboratory Medicine, The University of Ottawa, Ottawa, Canada
| | - Mohammed F K Ibrahim
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada
| | - Carol Stober
- Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - John Hilton
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada.,Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Zuzana Kos
- Eastern Ontario Regional Laboratory Association and Department of Pathology and Laboratory Medicine, The University of Ottawa, Ottawa, Canada
| | - Sasha Mazzarello
- Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Tim Ramsay
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, The University of Ottawa, Ottawa, Canada
| | - Dean Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, The University of Ottawa, Ottawa, Canada
| | - Lisa Vandermeer
- Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Ranjeeta Mallick
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Angel Arnaout
- Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, The University of Ottawa, Ottawa, Canada.,Division of Surgical Oncology, Department of Surgery, The Ottawa Hospital and University of Ottawa, Ottawa, Canada
| | - Susan F Dent
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada
| | - Roanne Segal
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada
| | - Sandeep Sehdev
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada
| | - Stan Gertler
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada
| | - Brian Hutton
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, The University of Ottawa, Ottawa, Canada
| | - Mark Clemons
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and The University of Ottawa, Ottawa, Canada.,Cancer Research Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, The University of Ottawa, Ottawa, Canada
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30
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Saunderson RB, Vekic DA, Mallitt K, Mahon C, Robertson SJ, Wargon O. A retrospective cohort study evaluating the accuracy of clinical diagnosis compared with immunofluorescence and electron microscopy in children with inherited epidermolysis bullosa. Br J Dermatol 2019; 180:1258-1259. [PMID: 30657165 DOI: 10.1111/bjd.17648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- R B Saunderson
- Department of Dermatology, Royal North Shore Hospital, Reserve Road St Leonards, Saint Leonards, NSW, 2065, Australia
| | - D A Vekic
- Department of Dermatology, Liverpool Hospital, Liverpool, NSW, 1871, Australia
| | - K Mallitt
- School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia
| | - C Mahon
- Department of Dermatology, Bristol Royal Infirmary, Bristol, BS2 8HW, U.K.,Department of Dermatology, Great Ormond Street Hospital for Children NHS Trust, London, WC1N 3JH, U.K
| | - S J Robertson
- Department of Dermatology, The Skin and Cancer Foundation, Level 1, 80 Drummond Street, Carlton, Melbourne, Victoria, 3053, Australia
| | - O Wargon
- Department of Dermatology, Sydney Children's Hospital Randwick, Randwick, NSW, Australia
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Webb MA, Mani H, Robertson SJ, Waller HL, Webb DR, Edwardson CL, Bodicoat DH, Yates T, Khunti K, Davies MJ. Moderate increases in daily step count are associated with reduced IL6 and CRP in women with PCOS. Endocr Connect 2018; 7:1442-1447. [PMID: 30475222 PMCID: PMC6301194 DOI: 10.1530/ec-18-0438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 11/21/2018] [Indexed: 12/19/2022]
Abstract
Aims Physical activity has been proposed to be an effective non-pharmacological method of reducing systemic inflammation and therefore may prove particularly efficacious for women with polycystic ovary syndrome (PCOS) who have been shown to have high levels of inflammation and an increased risk of type 2 diabetes (T2DM) and cardiovascular disease (CVD). Therefore, the aim of the present study was to assess whether modest changes in daily step count could significantly reduce levels of inflammatory markers in women with PCOS. Subjects and Methods Sixty-five women with PCOS were assessed at baseline and again at 6 months. All had been provided with an accelerometer and encouraged to increase activity levels. Multivariate linear regression analyses (adjusted for age, ethnicity, baseline step count, change in BMI and change in accelerometer wear-time) were used to assess changes in daily step count against clinical and research biomarkers of inflammation, CVD and T2DM. Results Mean step count/day at baseline was 6337 (±270). An increase in step count (by 1000 steps) was associated with a 13% reduction in IL6 (β: -0.81 ng/L; 95% CI, -1.37, -0.25, P = 0.005) and a 13% reduction in CRP (β: -0.68 mg/L; 95% CI, -1.30, -0.06, P = 0.033). Additionally, there was a modest decrease in BMI (β: 0.20 kg/m2; 95% CI, -0.38, -0.01, P = 0.038). Clinical markers of T2DM and CVD were not affected by increased step count. Conclusions Modest increases in step count/day can reduce levels of inflammatory markers in women with PCOS, which may reduce the future risk of T2DM and CVD.
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Affiliation(s)
- M A Webb
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- The Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
| | - H Mani
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- Department of Diabetes and Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
- Diabetes and Endocrinology Department, Kettering General Hospital NHS Foundation Trust, Kettering, UK
- Correspondence should be addressed to H Mani:
| | - S J Robertson
- The Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
| | - H L Waller
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - D R Webb
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - C L Edwardson
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - D H Bodicoat
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - T Yates
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - K Khunti
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- The Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - M J Davies
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- The Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
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Grusche F, Kalai C, Chan Y, Robertson SJ. A case of spotty scrotum. Pediatr Dermatol 2018; 35:845-846. [PMID: 30397957 DOI: 10.1111/pde.13618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Felix Grusche
- Department of Dermatology, Monash Health, Melbourne, Australia
| | - Cindy Kalai
- Department of Dermatology, Monash Health, Melbourne, Australia
| | - Yuen Chan
- Department of Anatomical Pathology, Monash Health, Melbourne, Australia
| | - Susan J Robertson
- Department of Dermatology, Monash Health, Melbourne, Australia.,Department of Dermatology, The Royal Children's Hospital, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia.,Department of Dermatology, The Royal Melbourne Hospital, Melbourne, Australia
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Capitano M, Schieda N, Robertson SJ, Morash C, Breau RH, Maciejewski C, Flood TA. Images: Ruptured intratesticular arteriovenous malformation. Can Urol Assoc J 2018; 12:E489-E491. [PMID: 29989884 DOI: 10.5489/cuaj.5049] [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: 11/19/2022]
Affiliation(s)
- Mario Capitano
- Department of Pathology & Laboratory Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Nicola Schieda
- Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada
| | - Susan J Robertson
- Department of Pathology & Laboratory Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Chris Morash
- Department of Urology, The Ottawa Hospital, Ottawa, ON, Canada
| | - Rodney H Breau
- Department of Urology, The Ottawa Hospital, Ottawa, ON, Canada
| | | | - Trevor A Flood
- Department of Pathology & Laboratory Medicine, The Ottawa Hospital, Ottawa, ON, Canada
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Lemire P, Robertson SJ, Maughan H, Tattoli I, Streutker CJ, Platnich JM, Muruve DA, Philpott DJ, Girardin SE. The NLR Protein NLRP6 Does Not Impact Gut Microbiota Composition. Cell Rep 2017; 21:3653-3661. [DOI: 10.1016/j.celrep.2017.12.026] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/17/2017] [Accepted: 12/06/2017] [Indexed: 01/17/2023] Open
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Chan KL, Tam TH, Boroumand P, Prescott D, Costford SR, Escalante NK, Fine N, Tu Y, Robertson SJ, Prabaharan D, Liu Z, Bilan PJ, Salter MW, Glogauer M, Girardin SE, Philpott DJ, Klip A. Circulating NOD1 Activators and Hematopoietic NOD1 Contribute to Metabolic Inflammation and Insulin Resistance. Cell Rep 2017; 18:2415-2426. [PMID: 28273456 DOI: 10.1016/j.celrep.2017.02.027] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [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: 08/11/2016] [Revised: 12/09/2016] [Accepted: 02/07/2017] [Indexed: 12/19/2022] Open
Abstract
Insulin resistance is a chronic inflammatory condition accompanying obesity or high fat diets that leads to type 2 diabetes. It is hypothesized that lipids and gut bacterial compounds in particular contribute to metabolic inflammation by activating the immune system; however, the receptors detecting these "instigators" of inflammation remain largely undefined. Here, we show that circulating activators of NOD1, a receptor for bacterial peptidoglycan, increase with high fat feeding in mice, suggesting that NOD1 could be a critical sensor leading to metabolic inflammation. Hematopoietic depletion of NOD1 did not prevent weight gain but protected chimeric mice against diet-induced glucose and insulin intolerance. Mechanistically, while macrophage infiltration of adipose tissue persisted, notably these cells were less pro-inflammatory, had lower CXCL1 production, and consequently, lower neutrophil chemoattraction into the tissue. These findings reveal macrophage NOD1 as a cell-specific target to combat diet-induced inflammation past the step of macrophage infiltration, leading to insulin resistance.
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Affiliation(s)
- Kenny L Chan
- Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada; Department of Physiology, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Theresa H Tam
- Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada
| | - Parastoo Boroumand
- Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada; Department of Biochemistry, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - David Prescott
- Department of Immunology, University of Toronto, Toronto, Ontario M5S 1A8, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Sheila R Costford
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Nichole K Escalante
- Department of Immunology, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Noah Fine
- Matrix Dynamics Group, Faculty of Dentistry, University of Toronto, Toronto, Ontario M5S 3E2, Canada
| | - YuShan Tu
- Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada
| | - Susan J Robertson
- Department of Immunology, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Dilshaayee Prabaharan
- Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada
| | - Zhi Liu
- Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada
| | - Philip J Bilan
- Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada
| | - Michael W Salter
- Department of Physiology, University of Toronto, Toronto, Ontario M5S 1A8, Canada; Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada
| | - Michael Glogauer
- Matrix Dynamics Group, Faculty of Dentistry, University of Toronto, Toronto, Ontario M5S 3E2, Canada
| | - Stephen E Girardin
- Department of Immunology, University of Toronto, Toronto, Ontario M5S 1A8, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Dana J Philpott
- Department of Immunology, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Amira Klip
- Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada; Department of Physiology, University of Toronto, Toronto, Ontario M5S 1A8, Canada; Department of Biochemistry, University of Toronto, Toronto, Ontario M5S 1A8, Canada.
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Flood TA, Schieda N, Sim J, Breau RH, Morash C, Belanger EC, Robertson SJ. Evaluation of tumor morphologies and association with biochemical recurrence after radical prostatectomy in grade group 5 prostate cancer. Virchows Arch 2017; 472:205-212. [PMID: 28975495 DOI: 10.1007/s00428-017-2241-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 07/06/2017] [Revised: 08/17/2017] [Accepted: 09/26/2017] [Indexed: 10/18/2022]
Abstract
We assessed Gleason pattern 5 (GP5) and other prostatic adenocarcinoma (PCa) morphologies to determine their association with biochemical recurrence (BCR). A search for grade group 5 PCa with radical prostatectomy (RP) yielded 49 patients. RPs were reviewed for %GP5 and morphologies (sheets, single cells, cords, small solid cylinders, solid medium to large nests with rosette-like spaces [SMLNRS], comedonecrosis, cribriform glands, glomerulations, intraductal carcinoma of the prostate [IDC-P], and prostatic ductal adenocarcinoma [PDCa]). Prevalence of morphologies was as follows: single cells 100%, cribriform glands 98.7%, cords 85.7%, IDC-P 77.6%, comedonecrosis 53.1%, sheets 49.0%, small solid cylinders 49.0%, PDCa 44.9%, glomerulations 34.7%, and SMLNRS 14.3%. From 28 patients who were treated with RP as monotherapy, 64.3% (18/28) had BCR. Comedonecrosis, sheets, small solid cylinders, IDC-P, and PDCa were significantly associated with BCR. Number of morphologies on RP and %GP5 were higher in patients with BCR (6.8 ± 2.1 versus 3.7 ± 2.9%; P < 0.001 and 26.9 ± 16.8 versus 11.4 ± 14.1%; P = 0.02) with area under ROC curve of 0.89 (confidence intervals [CI] 0.77-1.00). Sensitivity/specificity was 77.8/80.0% for predicting BCR when ≥ 5 morphologies were present and 0.79 (CI 0.60-0.99) with sensitivity/specificity of 66.7/80.0% for predicting BCR when ≥ 15% GP5 was present. Hazard ratio for BCR was higher with increasing number of morphologies (1.23, CI 1.02-1.49; P = 0.034) but not %GP5 (0.99, CI 0.97-1.02, P = 0.622). Our results indicate that GP5 morphologies may represent a biologically heterogeneous group and that an increasing number of PCa morphologies on RP is strongly associated with an increased risk of BCR.
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Affiliation(s)
- Trevor A Flood
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, 501 Smyth Road, 4th Floor CCW, Ottawa, ON, K1H 8L6, Canada.
| | - Nicola Schieda
- Department of Medical Imaging, The Ottawa Hospital, Ottawa, Canada
| | - Jordan Sim
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, 501 Smyth Road, 4th Floor CCW, Ottawa, ON, K1H 8L6, Canada
| | - Rodney H Breau
- Department of Urology, The Ottawa Hospital, Ottawa, Canada
| | - Chris Morash
- Department of Urology, The Ottawa Hospital, Ottawa, Canada
| | - Eric C Belanger
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, 501 Smyth Road, 4th Floor CCW, Ottawa, ON, K1H 8L6, Canada
| | - Susan J Robertson
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, 501 Smyth Road, 4th Floor CCW, Ottawa, ON, K1H 8L6, Canada
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Tan TY, Dillon OJ, Stark Z, Schofield D, Alam K, Shrestha R, Chong B, Phelan D, Brett GR, Creed E, Jarmolowicz A, Yap P, Walsh M, Downie L, Amor DJ, Savarirayan R, McGillivray G, Yeung A, Peters H, Robertson SJ, Robinson AJ, Macciocca I, Sadedin S, Bell K, Oshlack A, Georgeson P, Thorne N, Gaff C, White SM. Diagnostic Impact and Cost-effectiveness of Whole-Exome Sequencing for Ambulant Children With Suspected Monogenic Conditions. JAMA Pediatr 2017; 171:855-862. [PMID: 28759686 PMCID: PMC5710405 DOI: 10.1001/jamapediatrics.2017.1755] [Citation(s) in RCA: 207] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
IMPORTANCE Optimal use of whole-exome sequencing (WES) in the pediatric setting requires an understanding of who should be considered for testing and when it should be performed to maximize clinical utility and cost-effectiveness. OBJECTIVES To investigate the impact of WES in sequencing-naive children suspected of having a monogenic disorder and evaluate its cost-effectiveness if WES had been available at different time points in their diagnostic trajectory. DESIGN, SETTING, AND PARTICIPANTS This prospective study was part of the Melbourne Genomics Health Alliance demonstration project. At the ambulatory outpatient clinics of the Victorian Clinical Genetics Services at the Royal Children's Hospital, Melbourne, Australia, children older than 2 years suspected of having a monogenic disorder were prospectively recruited from May 1 through November 30, 2015, by clinical geneticists after referral from general and subspecialist pediatricians. All children had nondiagnostic microarrays and no prior single-gene or panel sequencing. EXPOSURES All children underwent singleton WES with targeted phenotype-driven analysis. MAIN OUTCOMES AND MEASURES The study examined the clinical utility of a molecular diagnosis and the cost-effectiveness of alternative diagnostic trajectories, depending on timing of WES. RESULTS Of 61 children originally assessed, 44 (21 [48%] male and 23 [52%] female) aged 2 to 18 years (mean age at initial presentation, 28 months; range, 0-121 months) were recruited, and a diagnosis was achieved in 23 (52%) by singleton WES. The diagnoses were unexpected in 8 of 23 (35%), and clinical management was altered in 6 of 23 (26%). The mean duration of the diagnostic odyssey was 6 years, with each child having a mean of 19 tests and 4 clinical genetics and 4 nongenetics specialist consultations, and 26 (59%) underwent a procedure while under general anesthetic for diagnostic purposes. Economic analyses of the diagnostic trajectory identified that WES performed at initial tertiary presentation resulted in an incremental cost savings of A$9020 (US$6838) per additional diagnosis (95% CI, A$4304-A$15 404 [US$3263-US$11 678]) compared with the standard diagnostic pathway. Even if WES were performed at the first genetics appointment, there would be an incremental cost savings of A$5461 (US$4140) (95% CI, A$1433-A$10 557 [US$1086- US$8004]) per additional diagnosis compared with the standard diagnostic pathway. CONCLUSIONS AND RELEVANCE Singleton WES in children with suspected monogenic conditions has high diagnostic yield, and cost-effectiveness is maximized by early application in the diagnostic pathway. Pediatricians should consider early referral of children with undiagnosed syndromes to clinical geneticists.
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Affiliation(s)
- Tiong Yang Tan
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | | | - Zornitza Stark
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia
| | - Deborah Schofield
- Murdoch Childrens Research Institute, Melbourne, Australia,Faculty of Pharmacy, University of Sydney, Sydney, Australia,Garvan Institute of Medical Research, Sydney, Australia
| | - Khurshid Alam
- Murdoch Childrens Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | | | - Belinda Chong
- Victorian Clinical Genetics Services, Melbourne, Australia
| | - Dean Phelan
- Victorian Clinical Genetics Services, Melbourne, Australia
| | - Gemma R. Brett
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia,Melbourne Genomics Health Alliance, Melbourne, Australia
| | - Emma Creed
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia,Melbourne Genomics Health Alliance, Melbourne, Australia
| | - Anna Jarmolowicz
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia,Melbourne Genomics Health Alliance, Melbourne, Australia
| | - Patrick Yap
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia
| | - Maie Walsh
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia
| | - Lilian Downie
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia
| | - David J. Amor
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Ravi Savarirayan
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - George McGillivray
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia
| | - Alison Yeung
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia
| | - Heidi Peters
- Department of Paediatrics, University of Melbourne, Melbourne, Australia,The Royal Children’s Hospital, Melbourne, Australia
| | - Susan J. Robertson
- Murdoch Childrens Research Institute, Melbourne, Australia,The Royal Children’s Hospital, Melbourne, Australia
| | | | - Ivan Macciocca
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia
| | - Simon Sadedin
- Murdoch Childrens Research Institute, Melbourne, Australia
| | - Katrina Bell
- Murdoch Childrens Research Institute, Melbourne, Australia
| | - Alicia Oshlack
- Murdoch Childrens Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | | | | | - Clara Gaff
- Department of Paediatrics, University of Melbourne, Melbourne, Australia,Melbourne Genomics Health Alliance, Melbourne, Australia,Walter and Eliza Hall Institute, Melbourne, Australia
| | - Susan M. White
- Victorian Clinical Genetics Services, Melbourne, Australia,Murdoch Childrens Research Institute, Melbourne, Australia,Department of Paediatrics, University of Melbourne, Melbourne, Australia
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Ma EH, Robertson SJ, Chow CW, Bekhor PS. Infantile Hemangioma with Minimal or Arrested Growth: Further Observations on Clinical and Histopathologic Findings of this Unique but Underrecognized Entity. Pediatr Dermatol 2017; 34:64-71. [PMID: 27873347 DOI: 10.1111/pde.13022] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Infantile hemangioma (IH) with minimal or arrested growth (IH-MAG) is becoming increasingly recognized in the literature. It is important to be aware of their existence, because the correct diagnosis is essential for prognostication and treatment and, in the case of facial segmental lesions, the direction of further investigations if PHACE (posterior fossa abnormalities and other structural brain abnormalities; hemangioma(s) of the cervical facial region; arterial cerebrovascular anomalies; cardiac defects, aortic coarctation, and other aortic abnormalities; eye anomalies) syndrome or Sturge-Weber syndrome is suspected. Although the clinical and histologic characteristics of IH-MAG resemble capillary malformations, positive GLUT-1 status is a delineating feature. METHODS We reviewed nine cases of infants who presented after 2000 with birthmarks showing unique clinical features suggestive of a special variant of IHs. All patients had serial photographs taken demonstrating resolution of the birthmark over time. Five of these cases had skin biopsy performed, all of which confirmed GLUT-1 positivity. RESULTS This photographic series of IH-MAG demonstrates their unique clinical, histologic, and immunochemistry features. They were nearly fully formed at birth, and their common clinical features included telangiectasia, venules, and matte erythema with light and dark areas. Spontaneous resolution over time without cosmetic disfigurement was the observed natural history in the majority of cases. CONCLUSION IH-MAG is a unique clinical subset of hemangioma for which close observation is the preferred treatment. When in doubt, a biopsy for histology and GLUT-1 status may be needed to confirm the diagnosis before embarking on unnecessary laser treatment or medical interventions.
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Affiliation(s)
- Ellen Hui Ma
- Skin and Cancer Foundation Inc., Melbourne, Victoria, Australia
| | - Susan J Robertson
- Department of Dermatology, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Dermatology, Monash Health, Melbourne, Victoria, Australia.,Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Chung W Chow
- Department of Anatomical Pathology, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Philip S Bekhor
- Director of Laser Unit, Royal Children's Hospital, Melbourne, Victoria, Australia
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Affiliation(s)
- H Rajgopal Bala
- Skin and Cancer Foundation Inc, University of Melbourne, Melbourne, Australia
| | - C C Wong
- Skin and Cancer Foundation Inc, University of Melbourne, Melbourne, Australia
| | - S J Robertson
- Department of Dermatology, The Royal Children's Hospital, Melbourne, Australia.,Department of Dermatology, Royal Melbourne Hospital, Victoria, Australia.,Department of Dermatology, Monash Health, Melbourne, Australia.,Murdoch Childrens Research Institute, Melbourne, Australia
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Selvanantham T, Lin Q, Guo CX, Surendra A, Fieve S, Escalante NK, Guttman DS, Streutker CJ, Robertson SJ, Philpott DJ, Mallevaey T. NKT Cell–Deficient Mice Harbor an Altered Microbiota That Fuels Intestinal Inflammation during Chemically Induced Colitis. J I 2016; 197:4464-4472. [DOI: 10.4049/jimmunol.1601410] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 10/03/2016] [Indexed: 02/07/2023]
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Flood TA, Schieda N, Keefe DT, Morash C, Bateman J, Mai KT, Belanger EC, Robertson SJ, Breau RH. Perineural invasion on biopsy is associated with upstaging at radical prostatectomy in Gleason score 3 + 4 = 7 prostate cancer. Pathol Int 2016; 66:629-632. [PMID: 27709739 DOI: 10.1111/pin.12467] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/08/2016] [Accepted: 09/08/2016] [Indexed: 01/22/2023]
Abstract
This study assesses if perineural invasion (PNI) detected on biopsy with Gleason score (GS) 3 + 4 = 7 prostate cancer (PCa) is associated with upstaging/upgrading of disease after radical prostatectomy (RP). 154 patients with GS 3 + 4 = 7 PCa diagnosed from biopsy who underwent RP were assessed for PNI. The percentage of biopsy sites with PNI (%PNI) was also calculated. Pattern 4 morphologies (ill-defined glands [IDG], fused, cribriform, and glomerulations) were also assessed. Clinical information, GS and stage after RP were retrieved from the medical records. 45 % (69/154) of patients were upstaged (≥pT3) and 29 % (44/154) were upgraded to GS >3 + 4 = 7 after RP. 37 % (57/154) of patients had PNI which was associated with upstaging (RR 1.4; P = 0.04) but not upgrading (RR 0.9; P = 0.7). There was higher %PNI in upstaged patients (12.1 % ± 1.8 vs. 7.1 % ± 1.5, P = 0.03) with a significant correlation between %PNI and ≥pT3 (r = 0.178, P = 0.027). After multivariate analysis, only cribriform formations were significantly associated with upstaging (P = 0.009). The presence of PNI in biopsies with GS 3 + 4 = 7 PCa is associated with upstaging at RP but is a weaker predictor of ≥pT3 disease than cribriform morphology.
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Affiliation(s)
- Trevor A Flood
- The Ottawa Hospital, Department of Pathology and Laboratory Medicine, Ottawa, Canada.
| | - Nicola Schieda
- The Ottawa Hospital, Department of Medical Imaging, Ottawa, Canada
| | - Daniel T Keefe
- The Ottawa Hospital, Department of Urology, Ottawa, Canada
| | - Chris Morash
- The Ottawa Hospital, Department of Urology, Ottawa, Canada
| | - Justin Bateman
- The Ottawa Hospital, Department of Pathology and Laboratory Medicine, Ottawa, Canada
| | - Kien T Mai
- The Ottawa Hospital, Department of Pathology and Laboratory Medicine, Ottawa, Canada
| | - Eric C Belanger
- The Ottawa Hospital, Department of Pathology and Laboratory Medicine, Ottawa, Canada
| | - Susan J Robertson
- The Ottawa Hospital, Department of Pathology and Laboratory Medicine, Ottawa, Canada
| | - Rodney H Breau
- The Ottawa Hospital, Department of Urology, Ottawa, Canada
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Flood TA, Schieda N, Keefe DT, Breau RH, Morash C, Hogan K, Belanger EC, Mai KT, Robertson SJ. Utility of Gleason pattern 4 morphologies detected on transrectal ultrasound (TRUS)-guided biopsies for prediction of upgrading or upstaging in Gleason score 3 + 4 = 7 prostate cancer. Virchows Arch 2016; 469:313-9. [PMID: 27394432 DOI: 10.1007/s00428-016-1981-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 05/16/2016] [Accepted: 06/27/2016] [Indexed: 01/22/2023]
Abstract
Selected patients with Gleason score (GS) 3 + 4 = 7 prostate cancer (PCa) detected on transrectal ultrasound (TRUS)-guided biopsies may be considered for active surveillance (AS); however, a proportion of these will harbor more aggressive disease. The purpose of this study was to determine if morphologies of Gleason pattern 4 PCa may predict upgrading and/or upstaging after radical prostatectomy (RP). A database search for men with GS 3 + 4 = 7 PCa diagnosed on TRUS-guided biopsy that underwent RP between January 2010 and October 2015 identified 152 patients. Two blinded genitourinary pathologists independently reviewed the biopsies and assessed ill-defined glands (IDG), fused glands, small or large cribriform patterns, and glomerulations. Patient age, serum prostate-specific antigen (PSA), percentage (%) of biopsy sites involved by 3 + 4 = 7 PCa, and overall extent of pattern 4 were also recorded. GS and stage (presence or absence of extraprostatic extension [EPE]) were retrieved from RP reports. Data were compared using independent t tests and chi-square. Inter-observer agreement was calculated using Cohen's Kappa statistic. Percent of biopsy sites and extent of pattern 4 were compared to statistically significant morphologies using the Spearman correlation. 28.3 % (43/152) of patients were upgraded to GS >3 + 4 = 7 at RP (GS 4 + 3 = 7 [N = 17], GS 4 + 3 = 7 with tertiary pattern 5 [N = 25], and GS 4 + 5 = 9 [N = 1]) and 44.1 % (67/152) showed EPE after RP. PSA was associated with both upgrading (8.5 ± 5.4 vs. 6.9 ± 3.2 ng/mL, [p = 0.04]) and EPE (8.2 ± 4.6 vs. 6.7 ± 3.2 ng/mL, [p = 0.03]). IDG, fused glands, and glomerulations were not associated with upgrading or EPE (p > 0.05) with moderate to strong inter-observer agreement (K = 0.76-0.88). There was strong inter-observer agreement for small and large cribriform formations (K = 0.93 and 0.94, respectively) and both patterns were strongly associated with upgrading (p < 0.001) and EPE (p = 0.02) on RP. Strong associations were observed between increasing number of morphologies and both upgrading (p = 0.0.25) and EPE (p < 0.001). Overall extent of pattern 4 was associated with upgrading (p = 0.009) and EPE (p = 0.019) while percent of sites involved by GS 3 + 4 = 7 was only associated with EPE (p = 0.023). Cribriform morphology correlated to percentage of sites with 3 + 4 and overall extent of pattern 4 (rho = 0.25, p = 0.002, rho = 0.20, p = 0.015, respectively). Presence of cribriform morphology on TRUS-guided biopsy is strongly associated with upgrading and upstaging at RP and shows near-perfect inter-observer agreement whereas IDG, fused glands, and glomerulations were not useful. Cribriform morphology may be of importance when considering treatment plans for patients with intermediate risk PCa.
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Affiliation(s)
- Trevor A Flood
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, The Ottawa Hospital, The University of Ottawa, 501 Smyth Road, 4th Floor CCW, Ottawa, Ontario, K1H 8L6, Canada.
| | - Nicola Schieda
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, The Ottawa Hospital, The University of Ottawa, 501 Smyth Road, 4th Floor CCW, Ottawa, Ontario, K1H 8L6, Canada.,Department of Medical Imaging, The Ottawa Hospital, Ottawa, Canada
| | - Daniel T Keefe
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, The Ottawa Hospital, The University of Ottawa, 501 Smyth Road, 4th Floor CCW, Ottawa, Ontario, K1H 8L6, Canada.,Department of Urology, The Ottawa Hospital, Ottawa, Canada
| | - Rodney H Breau
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, The Ottawa Hospital, The University of Ottawa, 501 Smyth Road, 4th Floor CCW, Ottawa, Ontario, K1H 8L6, Canada.,Department of Urology, The Ottawa Hospital, Ottawa, Canada
| | - Chris Morash
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, The Ottawa Hospital, The University of Ottawa, 501 Smyth Road, 4th Floor CCW, Ottawa, Ontario, K1H 8L6, Canada.,Department of Urology, The Ottawa Hospital, Ottawa, Canada
| | - Kevin Hogan
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, The Ottawa Hospital, The University of Ottawa, 501 Smyth Road, 4th Floor CCW, Ottawa, Ontario, K1H 8L6, Canada
| | - Eric C Belanger
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, The Ottawa Hospital, The University of Ottawa, 501 Smyth Road, 4th Floor CCW, Ottawa, Ontario, K1H 8L6, Canada
| | - Kien T Mai
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, The Ottawa Hospital, The University of Ottawa, 501 Smyth Road, 4th Floor CCW, Ottawa, Ontario, K1H 8L6, Canada
| | - Susan J Robertson
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, The Ottawa Hospital, The University of Ottawa, 501 Smyth Road, 4th Floor CCW, Ottawa, Ontario, K1H 8L6, Canada
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Zanello G, Goethel A, Rouquier S, Prescott D, Robertson SJ, Maisonneuve C, Streutker C, Philpott DJ, Croitoru K. The Cytosolic Microbial Receptor Nod2 Regulates Small Intestinal Crypt Damage and Epithelial Regeneration following T Cell-Induced Enteropathy. J Immunol 2016; 197:345-55. [PMID: 27206769 DOI: 10.4049/jimmunol.1600185] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 04/21/2016] [Indexed: 12/21/2022]
Abstract
Loss of function in the NOD2 gene is associated with a higher risk of developing Crohn's disease (CD). CD is characterized by activation of T cells and activated T cells are involved in mucosal inflammation and mucosal damage. We found that acute T cell activation with anti-CD3 mAb induced stronger small intestinal mucosal damage in NOD2(-/-) mice compared with wild-type mice. This enhanced mucosal damage was characterized by loss of crypt architecture, increased epithelial cell apoptosis, delayed epithelial regeneration and an accumulation of inflammatory cytokines and Th17 cells in the small intestine. Partial microbiota depletion with antibiotics did not decrease mucosal damage 1 d after anti-CD3 mAb injection, but it significantly reduced crypt damage and inflammatory cytokine secretion in NOD2(-/-) mice 3 d after anti-CD3 mAb injection, indicating that microbial sensing by Nod2 was important to control mucosal damage and epithelial regeneration after anti-CD3 mAb injection. To determine which cells play a key role in microbial sensing and regulation of mucosal damage, we engineered mice carrying a cell-specific deletion of Nod2 in villin and Lyz2-expressing cells. T cell activation did not worsen crypt damage in mice carrying either cell-specific deletion of Nod2 compared with wild-type mice. However, increased numbers of apoptotic epithelial cells and higher expression of TNF-α and IL-22 were observed in mice carrying a deletion of Nod2 in Lyz2-expressing cells. Taken together, our results demonstrate that microbial sensing by Nod2 is an important mechanism to regulate small intestinal mucosal damage following acute T cell activation.
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Affiliation(s)
- Galliano Zanello
- Department of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Ashleigh Goethel
- Department of Immunology, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Sandrine Rouquier
- Department of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - David Prescott
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Susan J Robertson
- Department of Immunology, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Charles Maisonneuve
- Department of Immunology, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Catherine Streutker
- Department of Pathology and Laboratory Medicine, St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada
| | - Dana J Philpott
- Department of Immunology, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Kenneth Croitoru
- Department of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada; Department of Immunology, University of Toronto, Toronto, Ontario M5S 1A8, Canada; Zane Cohen Centre for Digestive Diseases, The Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario M5G 1X5, Canada; and Division of Gastroenterology, Mount Sinai Hospital, Toronto, Ontario M5G 1X5, Canada
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Wasserman JK, Williams PA, Islam S, Robertson SJ. GATA-3 expression is not associated with complete pathological response in triple negative breast cancer patients treated with neoadjuvant chemotherapy. Pathol Res Pract 2016; 212:539-44. [DOI: 10.1016/j.prp.2016.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 02/08/2016] [Accepted: 03/15/2016] [Indexed: 11/26/2022]
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Robertson SJ, Geddes K, Maisonneuve C, Streutker CJ, Philpott DJ. Resilience of the intestinal microbiota following pathogenic bacterial infection is independent of innate immunity mediated by NOD1 or NOD2. Microbes Infect 2016; 18:460-71. [PMID: 27083475 DOI: 10.1016/j.micinf.2016.03.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/24/2016] [Accepted: 03/30/2016] [Indexed: 12/15/2022]
Abstract
The innate immune receptors, NOD1 and NOD2, are key regulators of intestinal homeostasis. NOD2 deficiency is linked to increased risk for Crohn's disease, a type of inflammatory bowel disease characterized by chronic inflammatory pathology and dysbiosis within resident microbial communities. However, the relationship between NOD protein-regulated immune functions and dysbiosis remains unclear. We hypothesized that the relationship between NOD1 or NOD2 deficiency and altered community structure during chronic disease may arise via NOD-dependent impairment of community resilience over time. Using the Salmonella ΔaroA model of chronic colitis with littermate mice to control for environmental influences on the microbiota, we show that NOD proteins exert a relatively minor impact on the chronic inflammatory environment and do not significantly contribute to bacterial abundance or community resilience following infection. Rather, temporal shifts in relative abundance of targeted bacterial groups correlated with inflammatory phenotype driven by presence of the pathogen and the ensuing complex immune response.
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Affiliation(s)
- Susan J Robertson
- Department of Immunology, University of Toronto, Toronto, Ontario, M5S 1A8, Canada
| | - Kaoru Geddes
- Department of Immunology, University of Toronto, Toronto, Ontario, M5S 1A8, Canada
| | - Charles Maisonneuve
- Department of Immunology, University of Toronto, Toronto, Ontario, M5S 1A8, Canada
| | - Catherine J Streutker
- Surgical Pathology, Department of Pathology and Laboratory Medicine, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada
| | - Dana J Philpott
- Department of Immunology, University of Toronto, Toronto, Ontario, M5S 1A8, Canada.
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Swan BC, Robertson SJ, Tuxen A, Ma E, Yip L, Ly L, Bingham L, Davidson A, Bekhor P. Pulsed dye laser treatment of capillary malformations in infants at 2-weekly versus 3-monthly intervals, reducing the need for general anaesthesia. Australas J Dermatol 2016; 58:214-218. [DOI: 10.1111/ajd.12457] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/17/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Bonnie C Swan
- Laser Unit; Department of Dermatology; Royal Children's Hospital; Melbourne Victoria Australia
| | - Susan J Robertson
- Laser Unit; Department of Dermatology; Royal Children's Hospital; Melbourne Victoria Australia
| | - Alana Tuxen
- Laser Unit; Department of Dermatology; Royal Children's Hospital; Melbourne Victoria Australia
| | - Ellen Ma
- Laser Unit; Department of Dermatology; Royal Children's Hospital; Melbourne Victoria Australia
| | - Leona Yip
- Laser Unit; Department of Dermatology; Royal Children's Hospital; Melbourne Victoria Australia
| | - Lena Ly
- Laser Unit; Department of Dermatology; Royal Children's Hospital; Melbourne Victoria Australia
| | - Linda Bingham
- Laser Unit; Department of Dermatology; Royal Children's Hospital; Melbourne Victoria Australia
| | - Andrew Davidson
- Department of Anaesthesia and Pain Management; Royal Children's Hospital; Melbourne Victoria Australia
| | - Philip Bekhor
- Laser Unit; Department of Dermatology; Royal Children's Hospital; Melbourne Victoria Australia
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Williams PA, Parra-Herran CE, Ayroud Y, Islam S, Gravel DH, Robertson SJ, Pratt C. Abstract P1-01-11: Nuclear immunohistochemical IKK-ϵexpression in flat epithelial atypia (FEA) of the breast: A predictor of ipsilateral ADH, in-situ or invasive malignancy? Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-01-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:Flat Epithelial Atypia of the breast (FEA) is associated with in situ and invasive low grade neoplasia. However, the role of excision after FEA on biopsy is controversial as rates of upgrading to atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS) or invasive carcinoma in subsequent excision are relatively low. Problems include difficulties in inter-observer reproducibility and lack of morphologic or immunohistochemistry (IHC) tools that better identify cases at risk for concurrent ADH/Carcinoma. Nuclear image analysis may be useful, but is not widely available. IKK-ϵ, part of the NF-kB activating pathway, is absent in normal breast epithelium and non atypical (usual) ductal hyperplasia, but is over-expressed in >30% of breast cancers. In addition, in our experience ADH/DCIS shows IKK-ϵ staining, mostly cytoplasmic. Of note, in prostate cancer, nuclear accumulation of IKK-ϵ has been described in hormone sensitive prostate disease while cytoplasmic accumulation is associated with metastatic progression. No previous studies of IKK-ϵ levels in FEA are reported. Here we report IKK-ϵ status in FEA and correlation with ipsilateral, synchronous ADH, DCIS or invasive carcinoma.
Method: Resection specimens from 61 patients with diagnosis of FEA were retrieved. Presence of ADH/carcinoma and laterality (ipsi or contralateral) was recorded. Synchronous neoplasia was defined as ADH, DCIS or invasive carcinoma diagnosed within 6 months of the diagnosis of FEA. Presence of FEA was confirmed by three observers using strict morphologic criteria. IHC for IKK-ϵ was performed using ABCAM, rabbit anti-IKK-ϵ (ab7891) and pH 6 citrate buffer heat-induced epitope retrieval for 20 minutes. IHC slides were scanned and FEA regions captured for blind scoring of nuclear and cytoplasmic staining. Cut off for positive nuclear staining was 10% and cytoplasmic staining was graded as negative, weak, moderate or strong positive.
Results:40 patients had ipsilateral synchronous ADH/carcinoma, and 21 did not. Within these groups, 6 patients had contralateral ADH/carcinoma (2 with and 4 without ipsilateral neoplasia). While cytoplasmic staining showed no difference between the groups, nuclear positivity was more frequent in cases with ipsilateral synchronous ADH/carcinoma, χ2(1, N = 61) = 5.1, p = .025 (Table 1). In contrast, there was no correlation between IKK-ϵ staining and ADH/carcinoma in the opposite breast (p=.25).
Table 1Nuclear IKK-eSynchronous Ipsilateral ADH/DCIS/Carcinoma Negative (%)Positive (%)TotalNegative10 (48)11 (52)21Positive10 (25)30 (75)40
Conclusion:Nuclear IKK-ϵ staining may prove useful in predicting synchronous ipsilateral ADH or malignancy in cases of FEA in biopsy material. Given its more frequent association with ipsilateral synchronous ADH/carcinoma, IKK-ϵ nuclear expression in FEA may represent a step in continuous local oncogenesis rather than a general marker of risk. Given the pleiotropic role of IKK-ϵ in growth and survival, the significance of the shift from nuclear staining in FEA to cytoplasmic staining in ADH/DCIS may reflect different signaling pathways and requires further investigation. Further validation of our findings in larger cohorts is necessary.
Citation Format: Williams PA, Parra-Herran CE, Ayroud Y, Islam S, Gravel DH, Robertson SJ, Pratt C. Nuclear immunohistochemical IKK-ϵexpression in flat epithelial atypia (FEA) of the breast: A predictor of ipsilateral ADH, in-situ or invasive malignancy?. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-01-11.
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Affiliation(s)
- PA Williams
- University of Ottawa, Ottawa, ON, Canada; EORLA, Ottawa, ON, Canada
| | - CE Parra-Herran
- University of Ottawa, Ottawa, ON, Canada; EORLA, Ottawa, ON, Canada
| | - Y Ayroud
- University of Ottawa, Ottawa, ON, Canada; EORLA, Ottawa, ON, Canada
| | - S Islam
- University of Ottawa, Ottawa, ON, Canada; EORLA, Ottawa, ON, Canada
| | - DH Gravel
- University of Ottawa, Ottawa, ON, Canada; EORLA, Ottawa, ON, Canada
| | - SJ Robertson
- University of Ottawa, Ottawa, ON, Canada; EORLA, Ottawa, ON, Canada
| | - C Pratt
- University of Ottawa, Ottawa, ON, Canada; EORLA, Ottawa, ON, Canada
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Howe GA, Zhao H, Daneshmand M, Clemons M, Robertson SJ, Arnaout A, Addison CL. Abstract P4-09-08: miR-135a is associated with a metastatic phenotype in invasive lobular carcinoma. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-09-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Invasive lobular carcinoma (ILC) is the second most common type of breast cancer. Classic type ILC is generally regarded as indolent in nature with its favourable biologic characteristics such as low grade, ER positivity and luminal A subtype. Despite this, patients with ILC can develop significant distant recurrence or metastases. Thus the ability to identify those patients at highest risk of recurrence or metastasis, and identification of novel therapies for ILC are urgently required. To this end, we recently profiled the miRNA expression in primary surgical ILC specimens from patients who went on to have metastatic disease compared to those who remained tumor free long term. As miRNA are stable in formalin fixed paraffin embedded tissues1, we speculated they could be robust biomarkers. RNA was isolated from laser capture microdissected ILC tumor epithelium, and subjected to miRNome analysis using a PCR-based amplification method. Many differentially expressed miRNAs were identified, and we initially focused further validation on those which had been previously linked to metastasis. One of these, miR-135a, was elevated in tumors from ILC patients who developed metastases compared to those that did not. We utilized two representative ILC cell lines which differ in their invasive ability, MDA-MB-134VI (non-invasive) and MDA-MB-330 (invasive), to test whether miR-135a regulated ILC invasion. We found that levels of miR-135a correlated with the invasive potential of ILC cell lines and was elevated in the invasive MDA-MB-330 cells compared to less invasive MDA-MB-134VI cells. We also found that decreasing miR-135a expression using specific hairpin inhibitors in MDA-MB-330 cells resulted in decreased cell invasion. As miR-135a has been shown to regulate invasion via targeting metastasis suppressor 1 (MTSS1) mRNA for degradation2, we examined whether MTSS1 levels were inversely associated with miR-135a levels in ILC cells. As predicted, in MDA-MB-330 cells where miR-135a levels were significantly higher, levels of MTSS1 were the lowest while MTSS1 levels were higher in parallel with decreased levels of miR-135a in the non-invasive MDA-MB-134VI cells. Overexpressing miR-135a using miRNA mimics in normal mammary epithelial cells (HMEC) where miR-135a is normally low, reduced levels of MTSS1 supporting suggestions it is a direct target of miR-135a. We also confirmed reduced mRNA levels of MTSS1 in surgical specimens from ILC patients who developed metastases compared to those that did not. Taken together, our results suggest that high levels of miR-135a, and low levels of MTSS1 may be useful prognostic information to assess risk of metastasis in ILC.
References
1. Bovell L, Shanmugam C, Katkoori VR, et al: miRNAs are stable in colorectal cancer archival tissue blocks. Front Biosci (Elite Ed) 4:1937-40, 2012
2. Zhou W, Li X, Liu F, et al: MiR-135a promotes growth and invasion of colorectal cancer via metastasis suppressor 1 in vitro. Acta Biochim Biophys Sin (Shanghai) 44:838-46, 2012.
Citation Format: Howe GA, Zhao H, Daneshmand M, Clemons M, Robertson SJ, Arnaout A, Addison CL. miR-135a is associated with a metastatic phenotype in invasive lobular carcinoma. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-09-08.
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Affiliation(s)
- GA Howe
- Ottawa Hospital Research Institute, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada
| | - H Zhao
- Ottawa Hospital Research Institute, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada
| | - M Daneshmand
- Ottawa Hospital Research Institute, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada
| | - M Clemons
- Ottawa Hospital Research Institute, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada
| | - SJ Robertson
- Ottawa Hospital Research Institute, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada
| | - A Arnaout
- Ottawa Hospital Research Institute, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada
| | - CL Addison
- Ottawa Hospital Research Institute, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada
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Gulavita P, Hakim SW, Schieda N, Breau RH, Morash C, Keefe DT, Robertson SJ, Mai KT, Belanger EC, Flood TA. Prostatic ductal adenocarcinoma: An aggressive variant that is underdiagnosed and undersampled on transrectal ultrasound (TRUS)-guided needle biopsy. Can Urol Assoc J 2015; 9:302-6. [PMID: 26664660 DOI: 10.5489/cuaj.2976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We sought to determine if prostatic ductal adenocarcinoma is undersampled and/or underdiagnosed at transrectal ultrasound (TRUS)-guided biopsy. METHODS With institutional review board approval, we searched our pathology database between 2008 and 2014 for patients with a diagnosis of ≥10% ductal adenocarcinoma on radical prostatectomy and available TRUS-guided needle biopsy specimens. Three blinded genitourinary pathologists independently examined the biopsy slides. The presence or absence of ductal adenocarcinoma was determined. Diagnostic accuracy was calculated using consensus diagnosis as the reference standard. Inter-observer agreement was assessed using Cohen's kappa coefficient. RESULTS Based on consensus review, 66.7% (12/18) biopsy specimens demonstrated ductal adenocarcinoma and 33.3% (6/18) demonstrated conventional acinar prostatic adenocarcinoma. The sensitivity/specificity for each reader (R) was: 83/100% (R1), 100/83% (R2) and 58/83% (R3) and the inter-observer agreement was only fair (K=0.32). Only two of the original needle-biopsy reports correctly identified ductal adenocarcinoma (sensitivity = 17%). The main limitations of the study are the relatively small sample size and the potential for selection bias since we could only examine patients who underwent radical prostatectomy. CONCLUSIONS Prostatic ductal adenocarcinoma may be undersampled at TRUS-guided biopsy and in this study was under-reported in routine clinical practice. This highlights the importance of increased awareness of ductal adeoncarcinoma and the need for clear diagnostic criteria. These findings have significant clinical impact especially when determining candidacy for active surveillance protocols.
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Affiliation(s)
- Previn Gulavita
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, ON
| | - Shaheed W Hakim
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, ON
| | - Nicola Schieda
- Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON
| | | | - Chris Morash
- Department of Urology, The Ottawa Hospital, Ottawa, ON
| | | | - Susan J Robertson
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, ON
| | - Kien T Mai
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, ON
| | - Eric C Belanger
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, ON
| | - Trevor A Flood
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, ON
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50
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Mellerio JE, Robertson SJ, Bernardis C, Diem A, Fine JD, George R, Goldberg D, Halmos GB, Harries M, Jonkman MF, Lucky A, Martinez AE, Maubec E, Morris S, Murrell DF, Palisson F, Pillay EI, Robson A, Salas-Alanis JC, McGrath JA. Management of cutaneous squamous cell carcinoma in patients with epidermolysis bullosa: best clinical practice guidelines. Br J Dermatol 2015; 174:56-67. [PMID: 26302137 DOI: 10.1111/bjd.14104] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 12/24/2022]
Abstract
This article summarizes recommendations reached following a systematic literature review and expert consensus on the diagnosis and management of cutaneous squamous cell carcinomas in people with epidermolysis bullosa. The guidelines are intended to help inform decision making by clinicians dealing with this complex complication of a devastating disease.
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Affiliation(s)
- J E Mellerio
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, U.K.,Department of Dermatology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, U.K
| | - S J Robertson
- Department of Dermatology, The Royal Melbourne Hospital, The Royal Children's Hospital and Monash Medical Centre, Melbourne, Australia
| | - C Bernardis
- Department of Plastic Surgery, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, U.K
| | - A Diem
- Department of Dermatology, Paracelsus Medical University, Salzburg, Austria
| | - J D Fine
- Division of Dermatology, Vanderbilt University School of Medicine, Nashville, TN, U.S.A
| | - R George
- Department of Palliative Care, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, U.K
| | - D Goldberg
- Division of Dermatology, University of Massachusetts, Worcester, MA, U.S.A
| | - G B Halmos
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Groningen, Groningen, the Netherlands
| | - M Harries
- Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, U.K
| | - M F Jonkman
- Department of Dermatology, University Medical Centre Groningen, Groningen, the Netherlands
| | - A Lucky
- Department of Dermatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, U.S.A
| | - A E Martinez
- Department of Dermatology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, U.K
| | - E Maubec
- Department of Dermatology, APHP, Avicenne Hospital, Bobigny, France
| | - S Morris
- Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, U.K
| | - D F Murrell
- Department of Dermatology, St George Hospital, University of New South Wales, Sydney, Australia
| | - F Palisson
- Facultad de Medicina, Clínica Alemana, Santiago, Chile
| | - E I Pillay
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, U.K
| | - A Robson
- Department of Dermatopathology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, U.K
| | - J C Salas-Alanis
- Basic Sciences Department, Universidad de Monterrey, Monterrey, Mexico
| | - J A McGrath
- St John's Institute of Dermatology, King's College London (Guy's Campus), London, U.K
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